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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Not Bob on December 31, 2002, at 3:11:41
Cool link that explains the whole depression/dream
cycle pretty well. I was sleeping about 15
hours a day for the last several years
and had the craziest most vivid
dreams ever. I kinda miss the dreams,
but the Nardil has definitely brought me back
to the land of the living. Good sites like this
can hopefully keep me from relapsing.
http://www.clinical-depression.co.uk/Understanding_Depression/dreaming.htm
Posted by Miller on December 31, 2002, at 8:03:25
In reply to Dreams and Depression, posted by Not Bob on December 31, 2002, at 3:11:41
This was an awesome link, thank you.
-Miller
Posted by IsoM on December 31, 2002, at 22:43:58
In reply to Dreams and Depression, posted by Not Bob on December 31, 2002, at 3:11:41
That link definitely was interesting. I must say I agree what it says about dreaming & depression. Now that I'm feeling good, my dreams aren't as easily remembered or nearly so exciting. But I'd rather that & my good mood than having my sleep time the highlight of my life.
I checked out that site the link came from. I started out skeptical (like I usually am), thinking it was going to be anti-med & have some flightly, unfounded ideas. It was anything but. I really think some good solid advice is given there. Do you use that site for help too, NotBob, & if you do, have you found it benefitted you?
I'm going to include a link from that site to another one that gives patients an idea of how to rate their therapist. I'm not sure how good it is (never having therapy) but I'm sure if it's bad, others will point it out. Anyway, thanks for that original link on dreams!
Posted by Not Bob on January 1, 2003, at 3:39:54
In reply to Re: Dreams and Depression » Not Bob, posted by IsoM on December 31, 2002, at 22:43:58
I think that the dream site is one of the best
I've seen. They don't seem to be trying
to sell any concept or idea really. They really
seem to be trying to totally understand what
depression is about. I think that this
understanding will help me not relapse.
It's kinda complicated, but the concept that
how one's perception of reality can completely
affect your health even into your unconcious
state. Well I think there's probably alot to that.
I also don't remember my dreams now that
I've been taking maoi's for a few months.
Here's another interesting link on learning
and sleep. I think that the key to beating
depression lies in learning how to reinterpret
the perception process. I need to focus on
relearning my thought process while the
drugs are working. That's probably why
therepy plus drugs works better than either
on it's own. The drugs act like starter fluid.
But you'll burn the engine out if you try to
run it on starter fluid all the time. I think
the learned cognitive skills is the unleaded.
Anyway, here's the link. Kinda hard to read.
http://www.wetheliving.com/pipermail/psychology/2002-August/000149.html
Posted by Eddie Sylvano on January 2, 2003, at 15:25:44
In reply to Dreams and Depression, posted by Not Bob on December 31, 2002, at 3:11:41
> http://www.clinical-depression.co.uk/Understanding_Depression/dreaming.htm
---------------------I probably spent an hour or two reading through this site and evaluating what the authors had to say about depression. For those who haven't read it, here's a brief book report...
Depression is caused by maladaptive thought patterns, and not by any type of chemical imbalance. The maladaptive patterns mainly constitute "black and white" thinking. By narrowing the range of possibilities one considers, and focusing on extreme negatives, a sense of hopelessness and loss of control are engendered. This style of thinking has its origins in stressful events, and the explanations we create to rationalize their causes. Dreams come into play as a mechanism to complete incomplete emotional transactions that we encounter or create during they day. The black and white thinker can only ruminate on the bad, building up a resevoir of unsatisfied emotional events. The brain tries to complete these through dreams. The dreams are usually as unpleasant as the thoughts they're derived from. The dreams disrupt our deep, rejuvinative sleep cycle and leave us feeling exhausted and further stressed. This cycle leads to more bad thoughts, more bad dreams, more exhaustion, etc. All of this affects neurotransmitter levels negatively, resulting in the physical manifestations of depression, which also feed into the cycle. To fix all of this, we need to adopt the correct style of thinking. If we do this, the depression will go away.
Okay. So that's what I got out of it. I may have missed something here or there, but I think it's mostly there (read it yourself for more info).
The striking claim they make is a reversal of causation: poor thinking causes depression, and not the other way around. This immediately implies that the depressed person is entirely responsible for their own depression. It is, in an unavoidable way from this argument, volitional. Not a disease.
Something that the authors fail to address is how one comes to employ such bad thought processes to begin with. They make ample note of the fact that stressful events alone aren't the causes of depression, but rather the internal explanations one uses to frame the events. Doesn't this simply push off the origin? Why *do* some people create negative stories to define their lives, while others think correctly? What causes *that*?
I'm in agreement with their position that correcting negative thought patterns is a good idea. It's what psychotherapy is based on, and not a novel idea, really. I do take issue with their contention that depression is solely the result of such thoughts, and their lack of an explanation for what causes the negative thoughts to begin with. According to this theory, there is no such thing as an endogenous depression without preceeding negative rumination. What is one to do if they are actively thinking "correctly" but still suffer from depression? According to them, this isn't possible. They must be doing something wrong. I find this assumption galling.
Anyway, I just had to say something after reading this. It amazes me that there is still such a divide of biology vs behavior between those who study depression. Might there not be some middle ground? I'm also skeptical of any theory that attempts to define the mind's operation in purely abstract, philosophical ways. The mind is a result of the brain, a strictly material object, and is constrained in its operation by the functioning of the brain. If something is wrong with the brain, one cannot simply rise above it. The brain comes first. That isn't to say that the brain is unaffected by our thoughts, but that our thoughts are contrained by our brain. Ultimately, it all comes back to that. People need to give the biology of the mind its due.
Posted by Not Bob on January 2, 2003, at 22:11:39
In reply to Weak-mindedness?, posted by Eddie Sylvano on January 2, 2003, at 15:25:44
Hey Eddie...
I actually think that they are saying that depression is the opposite of weak-mindedness. It is stubborn-mindedness to the (n)'th degree where (n) stands for negative and self defeating behavior. Sometimes where the thoughts are so strong that they can overwelm the usual biological instinct to continue living. This is more akin to heroic death than anything. This is where the child you save is your own thoughts and you sacrifice your biological life for those thoughts. This is sick stuff. I've never heard of an ameaba killing himself. Now I really didn't mean to get you upset about this site. I really thought it could help some people. I had been through sleep studies because I was not waking up and I was staying in REM for as much as 16 hours a night and I thought the link had some interesting possibilities. The site paints a more complete picture of depression than I've seen anywhere else so far. If you find more that you like, please send me the links. I am not saying that the site is perfect or anything, but they seem to be genuinely trying to help. They seem to be presently more interested in how to disrupt the cycle of depression than in the root cause. I can give you many quotes from the site where they say that depression might be chemically based. See http://www.clinical-depression.co.uk/Depression_Information/causes.htm. The site is really hard to navigate and is confusing, but there is some good stuff there that might help. I wish you could just see the good. I personally don't care to figure out which came first- the chicken or the egg- because it has turned into a demonic monkey on my back and I just want it off. I myself consider depression to be a personal addiction of mine - and I desperately want to break the habbit. Your brain is not completely trustworthy - your thoughts are not completely yours. I just quit smoking and I know that this is true, at least for myself. People have thousands of thoughts constantly. What counts is which thoughts you hold on to. That is the basis for meditation and I think that that is where this site is coming from. This is my last addiction. If I can find a permanant cure for it, I could care less about the cause.
Still Struggling,
-mike
Posted by jay on January 3, 2003, at 0:19:28
In reply to Dreams and Depression, posted by Not Bob on December 31, 2002, at 3:11:41
I found myself stuck in very lucid, often horrifying unending dreamstate in deep depression and anxiety. It's like I close my eyes, and then it starts and won't let up until I get up. I know that depression is linked with HYPER REM (dream) sleep, and I think this is my case.Just my .02 cents
Jay
Posted by BeardedLady on January 3, 2003, at 7:01:41
In reply to Re: Dreams and Depression » Not Bob, posted by jay on January 3, 2003, at 0:19:28
My doc says we all dream the same.
"As for dreaming, the question is not whether one dreams or how much, we all do about the same. The question is
more about remembering one's dreams. We're not all equal when it comes to remembering. Generally, when people wake it's at the end of a dream episode. So it may just be that people with interuption insomnia remember more of their dreams because of that."Indeed, on the nights I don't wake up, I remember a dream, maybe, or a hint of one. On the nights I wake up frequently, I remember them all, in detail. I don't think excessive dreaming is causing the excessive wakening but that the excessive wakening is only making it look as if I've dreamed more.
My therapist admitted that he doesn't know if depressed people remember their dreams more than those who aren't depressed. (But logic says that insomniacs do.)
I have to say I've been dreaming wildly and vividly and frequently since I was a child. I used to study them--keep a journal about them next to my bed. I'd awaken at the end of every dream and write down what happened, and then I'd easily fall back to sleep. I wasn't depressed or suffering from insomnia.
I also believe that my dreams are responsible for my sleeping and my awakening. Some work very hard to keep me asleep. Others (like the searching for a place to pee dreams) let me know that I have to wake up or I'll wet my bed!
I hope this adds a different perspective to the discussion.
I truly do not believe depressed people dream more unless they are actually sleeping more. I think some people have a better ability to recall them, and those who are depressed are so inward focused, they'd seem the likely candidates for remembering dreams.
beardy : )>
Posted by Eddie Sylvano on January 3, 2003, at 9:25:53
In reply to Re: Weak-mindedness?, posted by Not Bob on January 2, 2003, at 22:11:39
> I actually think that they are saying that depression is the opposite of weak-mindedness. It is stubborn-mindedness to the (n)'th degree where (n) stands for negative and self defeating behavior.
-----------------------Yes, they're careful to emphasize the fact that although they support the idea of depression being caused by an individuals thinking styles, "That does NOT mean that people who become depressed are to be blamed, it simply gives us an insight into why depression occurs." The issue of blame (origin) is never addressed.
>This is where the child you save is your own thoughts and you sacrifice your biological life for those thoughts.
---------------That's a good way to put it, and more descriptive than the author's. My main tangle with the article (and it's mainly an academic one) was the avoidance of *why* person A or B should adopt such a severe thinking style, while the majority of others do not.
>Now I really didn't mean to get you upset about this site. I really thought it could help some people.
---------------It didn't upset me horribly. I just have a habit of arguing oppposing viewpoints when I see weak arguments for causation. Too many are allowed to pass without scrutiny. Half the people in my office probably hate me for doubting the efficacy of their HerbaLife products.
>I wish you could just see the good. I personally don't care to figure out which came first- the chicken or the egg- because it has turned into a demonic monkey on my back and I just want it off.
----------------Yeah, and I didn't mean to come across too harshly. After you get beyond the framework of their causation and dream theory, their advice to actively reform negative thought processes makes total sense and I agree with it. I'm sure they're not trying to mislead anyone, but to help people relate to their illness in a way they can address. In this regard, the site is engaging and approachable. 80% of it works for me. It's just the almost total dimunition of the constant role of the brain that worries me. The site only acknowledges depressive brain chemistry as a result of essentially bad habits, and assumes implicitly that we all work from the same ground state. To quote, "Depression can not be said to be a disease, because it is not primarily a biological disorder - that is, the root cause of the symptoms are not usually physical." Depression is, to decode the backplane, the result of previously normal people thinking themselves into it. That's not even an idea that I would disagree with, necessarily. It's more the lack of an explanation of why someone would do that. Is it a choice, or is one predisposed? If one is predisposed, what causes that? The theory lacks a true origin, beyond suggesting that it may be a result of the media, self centeredness, dispersed communities, and consumerism. If the site didn't try to be so authoritative on depressive causes and instead stuck to the issue of resolution through (what is essentially) therapy, it would be a better page. At any rate, if it helps someone get better, it's been a good resource.
Posted by Noa on January 3, 2003, at 14:26:58
In reply to About Dreaming--from my therapist » jay, posted by BeardedLady on January 3, 2003, at 7:01:41
I think on average, we all dream same amount, but I have read that there is increased REM associated with certain kinds of depression and also that SSRIs tend to induce vivid dreaming.
Posted by Not Bob on January 3, 2003, at 15:21:30
In reply to About Dreaming--from my therapist » jay, posted by BeardedLady on January 3, 2003, at 7:01:41
Hey Lady...
I'm afraid your doc is misinformed.
Depressed people actually do dream alot more than non depressed. Whether they remember their dreams or not. There are thousands of sleep studies to prove this, including my own. One of the methods for determining if someone is depressed is by their onset of REM and the duration of the REM stages.
Posted by Tabitha on January 3, 2003, at 15:43:52
In reply to Dreams and Depression, posted by Not Bob on December 31, 2002, at 3:11:41
That site is really interesting. It's so nice to read a theory explaining depression. I felt the same enthusiasm and hope as when reading other theories (like it's all sub-clinical hypothyroidism, or food sensitivity, or magnesium deficiency, or ...) But they don't really seem to have any research to back up their claims.
I'd tend to agree that when I'm depressed, I sure spend a lot of time in highly emotional thought loops (worry and recycled anger). Those thought loops cause exhaustion for me in two ways, one they make me physically exhausted, and two they cause insomnia. If I could just shut them off I think I'd feel way better, but so far I can't find a way short of taking a seroquel, but then I get the seroquel hangover, and first thing in the morning the worry hits me even harder.
The idea that depression is basically exhaustion and sleep deprivation makes a lot of sense. I can recover my balance with lots of sleep and avoiding stress.
Some of that site reminded me of the theory in "Learned Optimism". That one says that depression is caused by rumination plus pessimism. Another interesting theory, but it didn't help me change at all.
Posted by beardedLADY on January 3, 2003, at 16:21:19
In reply to Re: About Dreaming--from my therapist, posted by Not Bob on January 3, 2003, at 15:21:30
Okay, Not. I'm going to a sleep clinic in ten days, and I'll let you know what I find out. It's at Johns Hopkins, and this guy is supposed to be one of the top sleep docs in the country.
I have never seen any such study (and what is the one you call your own to which you refer?). I do believe, however, that SSRIs can and do induce vivid dreams and nightmares.
I'll check in after my appointment on the 14th.
beardy
Posted by Dinah on January 3, 2003, at 16:24:41
In reply to Re: Dreams and Depression, posted by Tabitha on January 3, 2003, at 15:43:52
They're definitely linked but which causes which?
Posted by Not Bob on January 3, 2003, at 23:01:13
In reply to Re: About Dreaming--from my therapist » Not Bob, posted by beardedLADY on January 3, 2003, at 16:21:19
Hey Bearded...
These are quotes and links from Google.
I'm not just making it up, really.
EEG (Electroencephalogram)
Q: Sleep EEGs! What would they show?
A: Studies have shown that individuals with either unipolar or bipolar depression have sleep patterns different from those of people who do not have mood disorders. The rapid-eye-movement (REM) phase of sleep associated with dreaming occurs earlier in people with mood disorders. People with mood disorders also have more eye movements during REM sleep, less deep or slow-wave sleep, and more problems staying asleep.
Still, this pattern is most pronounced in people who are severely ill; it's not a reliable measure of less severe depression.
http://www.sistahspace.com/WeepingWillows/getdown.html
MAOIs significantly reduces REM (rapid eye movement),
sleep density, REM time and the REM percentage of
total sleep time in patients with major
depression.a. Indeed, all drugs that suppress REM have an antidepressant effect (Vogel et al.,
1990) suggesting that at least some of the antidepressant action of drugs might be due to the
suppression of REM, although the presence of several antidepressants that do not suppress REM
precludes this as the sole mechanism by which antidepressants work
The possibility that coexisting depression, which is known to affect REM sleep, accounted for this divergence of findings was not supported by studies comparing groups of patients with and without major depression in addition to PTSD.55,63 Patients with PTSD had both higher and lower values for REM latency than patients with major depression.
http://www.inchem.org/documents/pims/pharm/pimg025.htm
http://my.webmd.com/content/article/16/1663_51686?
There is a great deal of literature that reviews which aspects of sleep are most associated with depression, when measured by conventional EEG techniques. These include reduced REM latency, i.e. the time between sleep onset to the first appearance of REM (Reynolds & Kupfer, 1987), less short wave sleep, particularly in the first NREM/REM sleep cycle (Kupfer & Reynolds, 1992) and lower production of delta waves in NREM sleep (Kupfer, et al., 1990).
http://www.solent.ac.uk/socsci/agm/homepage.htm
http://www.parkinson.org/sleepdisturbances2.htm
http://rjews.net/v_rotenberg/sleep_in_depression.html
Polysomnographic recordings of depressed patients often reveal reduced slow-wave sleep, an early onset of the first episode of REM sleep, and increased phasic REM sleep.9 A deficit in serotonergic neurotransmission, a relative increase in pontine cholinergic activity, and, perhaps, an excess of nor-adrenergic and corticotropin-releasing–hormone activity have been implicated in the pathogenesis of severe depression.9,10
Posted by beardedLADY on January 4, 2003, at 6:15:19
In reply to Re: About Dreaming--from my therapist, posted by Not Bob on January 3, 2003, at 23:01:13
Now I'm really confused. I just did a google search for sleep stages, and I found this, which said depressed patients have a shortened REM, which contradicts what you've said. It also said that meds like Prozac help to lengthen REM, thereby improving sleep.
http://www.sleepdisorderchannel.net/stages/
Factors that Affect Sleep Stage and the Sleep Cycle
The sleep cycle is variable, influenced by several agents. Sleep cycles subsequent to the first one in a night’s sleep typically feature less slow-wave sleep, as Stages 3 and 4 shorten. Slow-wave, deep sleep is longest early in a night’s sleep. Generally, sleep disorders affect the quality, duration, and onset of sleep. Sleep deprivation, frequently changing sleep schedule, stress, and environment all affect the progression of the sleep cycle. Rapid eye movement latency (the time it takes a person to achieve REM sleep) may be affected by a sleep disorder like narcolepsy. Psychological conditions like depression shorten the duration of rapid eye movement. Also, treatment for psychiatric conditions often positively affects sleep, typically inducing some desired change in sleep habit. For example, antidepressants like Prozac® usually quicken sleep onset and lengthen REM stages. People who take antidepressants often benefit from the effects they have on the quality and duration of the sleep cycle.
Posted by Noa on January 4, 2003, at 7:47:35
In reply to thanks for the links. here's one... » Not Bob, posted by beardedLADY on January 4, 2003, at 6:15:19
maybe differnt kinds of depression? I don't think we know yet if there are many different underlying diseases causing depression.
Also--just to add to the mix here, those of us with sleep apnea (or other sleep disorders perhaps), which can also cause depression, may have not only less of the deep sleep (stage 4, I think) but also not enough REM sleep. I was only receiving 25% of normal REM sleep, according to my sleep study. But my system was always trying to make up for it by sleeping every chance I could. Only problem was that I wasn't getting the continuous sleep needed to go through normal sleep stages.
Posted by Not Bob on January 4, 2003, at 19:55:44
In reply to thanks for the links. here's one... » Not Bob, posted by beardedLADY on January 4, 2003, at 6:15:19
Hey Bearded...
Well, below is some studies and who did them. The link you gave didn't say where they got the info. I wonder if they confused latency with duration? I tried to email them but their physician response section is down and there is no way to contact them until they open it back up. I couldn't find any other links that support what they say. That's the problem with the net - so much misinformation. I am glad that you are helping me search this out. I also wonder how the REM latency and percentages differ between people with insomnia depression and people with hypersomnia depression. Also, I find it interesting that Alcohol has also been shown to decrease REM. I wonder if this could be why depressives are more prone to alcoholism? Self-medication maybe?http://www.michaelgrandner.com/mg/relay/papers/sleepeegdepression.doc
"Another major study, undertaken by the World health Organization (WHO), took measures from laboratories all over the world (i.e., Athens, Brussels, Mexico, Munich, Naples, Sapporo, Tokyo and Zegreb) in order to validate the connection between polysomnography measures and depression (Mendlewicz & Kerkhofs, 1991). This study found that depressed patients showed lowered stage 2 percent, lowered stage 3 percent, lowered stage 2 time, lowered stage 3 time, and decreased REM onset latency. Additionally, they found that depressed patients exhibited increased stage 1 percent, more REM onset latency awake time, higher REM density and increased REM percent (Mendlewicz & Kerkhofs, 1991).""For example, almost all antidepressant medications suppress REM activity (Vogel, Buffenstein, Minter, & Hennessey, 1990). Monamine oxidase inhibitors (MAOIs) have the strongest effect, sometimes virtually eliminating REM altogether during treatment (Boyd & Weissman, 1981; Wyatt, Fram, Buchbinder & Snyder, 1971; Wyatt, Fram, Kupfer, & Snyder, 1971). Newer antidepressants, such as SSRI and tricyclic medications, reduce REM activity by 50 percent or more (Hartmann, 1968; Kupfer, Spiker, & Rossi, 1982). Even ECT has been shown to prolong REM onset latency (Grunhaus, Tiongco, & Pande, 1988)."
Posted by justyourlaugh on January 4, 2003, at 23:53:56
In reply to Re: thanks for the links. here's one..., posted by Not Bob on January 4, 2003, at 19:55:44
very interesting,
lack of sleep(or rem?)can be onset-or trigger- of many difficulties of mental health..
yet the meds that are suppose to help us..
may be also surpressing the true need of sleep(rem)?
jyl
Posted by Not Bob on January 5, 2003, at 20:44:47
In reply to Re: thanks for the links. here's one... » Not Bob, posted by justyourlaugh on January 4, 2003, at 23:53:56
Well...
It seems that in depression, the REM cycle goes haywire. The meds might be helping because they supress REM. REM is the stage that seems to resolve cognitive processes, but it is not very restful. It can actually wear you out more than being awake ie. nightmares etc. This might be why meds don't always continue to work. They may merely be decreasing the REM side affect of depression while the reason the REM cycle started working in overtime has not actually been resolved. Check out the original Dreams and Depression link if you haven't. It's kinda interesting.
Posted by coral on January 9, 2003, at 12:12:37
In reply to Dreams and Depression, posted by Not Bob on December 31, 2002, at 3:11:41
Maybe I'm the odd duck on this one but LACK of dreaming is a major signpost that depression is attempting to make a come-back in my life. While depressed, I didn't dream very much at all --- and I had plenty of time to dream ---- hours a day in that hazy zone... plus hours a day actually asleep.
Pre-depression, ever since childhood, I've had vivid, in-color dreams almost nightly. Once depression hit, dreaming stopped. After months of therapy and meds, I started dreaming again which was extremely beneficial (dream content) in terms of my recovery.Now, if I stop dreaming, I have to find out what's causing me to shut my emotions down.... it's a warning for me.
Posted by FredPotter on January 22, 2003, at 21:02:06
In reply to Re: Weak-mindedness?, posted by Eddie Sylvano on January 3, 2003, at 9:25:53
The thing which caught my attention was depression being 10 times as prevalent since the war. Globalisation causes it. It sort of rang a bell with me. I live in NZ my Mother and my siblings in UK. But then the site didn't mention it again. I thought we were about to get something really revolutionary like "go and join a tribe in Papua-New Guinea".
A lot is said in CBT about spiralling effects. If A causes B and this feeds back to promote A further then the cycle goes out of control. This would mean a panic attack would end in death very rapidly rather than stop at some point, which is what really happens. Similarly Depression. All these "break the vicious cycle (sic for circle)" theories talk like this. There must be a threshold that stops an exponential increase in A and B
This is the end of the thread.
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