Have you been treated for depression?

[TSSleepy]

I've gone through spells where I've struggled with what I thought were depression and anxiety. I even went on prosac for awhile, which didn't really help.

But in the 20/20 hindsight of a sleep apnea diagnosis, these were also periods of my life when my sleep schedule was totally out of whack and I was gaining weight like crazy. In other words, the spells of depression and anxiety corresponded to periods when I was really suffering bad from the effects of untreated sleep apnea.

In retrospect, I think these periods were less about anxiety/depression and more about physical, mental, and emotional "exhaustion"... which made me "too tired to deal with the world".

I never wanted to go anywhere or do anything, because I was pooped. My emotions were raw, because I was pooped. My ability to cope with stress (or even day-to-day chores) was severely compromised, because I was pooped. My immune system was trashed, so I was always coming down with every cold/flu that came anywhere near me...and it took forever to get over them because they made me sleep even worse.

Anyway, back to the original question. I was feeling like that 12-13 years ago and went on prosac for awhile. It didn't help, but made me care a bit less that I felt so horrible. I think I stayed on it for about six months. I felt like that again in 2008, but this time it didn't even occur to me to try to treat it as depression, because I knew there was "something" else wrong.

Thank goodness it turned out to be simple OSA that was easily treatable by APAP.

[Uncle_Bob]

Depression is a very complicated issue. Its a matter of DEGREE. Everyone has it. (very slightly to full blown). Its also a very personal issue, and one that some, no doubt, would rather keep to themselves.

Yes, I have. Both medicine and clinically. It can also take the form of sleeplessness, anxiety, mood changes, stomach disorders, and others. I've suffered them all. I also was told that it "was not my fault", after years of thinking that it was something in my own psyche, and something I should be able to control. In my case, it is a chemical issue in the brain. I once was taken to the emergency room, thinking that I was having a heart attack, in fact, I knew I was. My knees buckled, my heart was racing at about 135 beats per minute and I was having severe atrial fibrillation. I thought I was going to die before I got to the ER. Tests were done, Xanax was administered. Well, it was a panic attack. No problems with my heart.
I could go on and on, but I would probably bore you with all I've been through.

No its not a bore, its very common for the medical profession to recognize and diagnose some of the most common mental illnesses such as anxiety.
I stumbled into an Urgent Care during a panic attack and left with a Rx for some vertigo drugs. I also went for hearing and balance tests.
Of course at the time i did not know anything about anxiety or panic attacks, i just felt i was going to die. Days later i went to the ER with the same symptoms and was put on a drip and even had brain scans.

Eventually one of the specialist doctors who could not find anything medically wrong with me suggested i had anxiety disorder. Thats when my journey began. Anxiety plus sleep apnea did lead to some feeling of depression but i never got so bad that i needed any kind of treatment for that.

-UB

[izzyb]

I am very jealous of all of you that were "cured" of your depression after starting XPap therapy. I was diagnosed years ago with Dysthymia which made sense because I have been an unhappy person as far back as I can remember as a child...moody, melancholy, etc. I am 51 and have lived like this all my life. Sometimes the depression is worse than at other times. I quit taking antidepressants due to side effects about the time I started XPap therapy and since then I have really bad periods with depression and more often. I had hoped that XPap treatment would help this, but it hasn't. My AHI is really good (based on readout on machine, not the smart card) and I have always been compliant from day one. But I just haven't noticed much of a difference in the way I feel. Maybe slightly, but not enough. I have been using a Bi-Pap for three years now and I am not the new person my doctor promised me to be and that most of you here are. My anxiety and obsessive/compulsive tendencies have increased to where they are a problem. I haven't been able to sleep at night for a long time and take Clonazepam (Klonopin) to sleep but it makes my already problematic memory worse so I have cut back from 1 mg to 1/2 mg at night. I thought XPap therapy would help my memory and concentration also, but it didn't. It doesn't help my depression either that I have done so well with my XPap therapy and it hasn't helped any of my problems except to breath while asleep (not that I actually sleep that much). It really makes me upset that it hasn't helped any of my other problems. Anyway, that is my story.

[jnk]

. . . (not that I actually sleep that much). . . .

I am sorry to hear of your continued struggle with such things, but your wording made me wonder whether your insomnia is being fully explored by your doctors or if, instead, they may be shrugging that off as part of the depression/anxiety. The chicken and egg thing can get confusing. But solving the OSA problem may not do as much for someone who has sleep issues beyond OSA, as I understand it.

If you don't mind my asking, has the successful treatment of OSA allowed your issues with insomnia to be addressed at all by your medical team? It is often, I believe, the overall improvement in sleep and the amount of sleep that can help with depression/anxiety issues, whether it solves them completely or not.

[rosiefrosie]

A few years ago I was treated for depression with an antidepressant. I took this for about 1 year and it was a very small dose. I decided that it really was not helping and no longer wanted to take the medication. I am a nurse and one of the jobs I use to do was psychotropic monitoring of clients. So I knew that the medication needed to be decreased gradually. It took a few months for me to come off the medication, if I tried to decrease the dose too fast I was left feeling dizzy, nauseated and unable to walk. It is very important to make sure you don't just discontinue the medication on your own. I have to say after my experience with the medications I will think twice before I take them again. But that being said, antidepressants do have their place and work very well for some people trying to manage depression.

What really helped me was getting the proper treatment for my apnea. Also Vit D replacement has helped the blue feelings I would get, especially during the fall and winter months. (SAD, seasonal affective disorder) This is the first winter in a long time that I have not had feelings of depression.

rosie

[jnk]

An interesting study on the subject at hand . . .

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2045710/

. . . the data from our study suggests that successful CPAP therapy is associated with a statistically significant improvement in those symptoms of depression delineated in the [Beck Depression Inventory--Fast Screen for Medical Patients], and that the improvement is sustained long term . . ." J Clin Sleep Med. 2007 October 15; Copyright © 2007 American Academy of Sleep Medicine "For Individuals with Obstructive Sleep Apnea, Institution of CPAP therapy is Associated with an Amelioration of Symptoms of Depression which is Sustained Long Term"--Daniel J. Schwartz, M.D. and Gillian Karatinos, M.D.

[izzyb]

As far as my doctors addressing my insomnia, neither my regular doctor nor my sleep apnea doctor (Pulmonologist) has really tried to solve the underlying problem. I asked my doctor for something to sleep and she has prescribed me everything I think is out there except one (I can't remember the name off hand), including Ambien, Ambien CR, Rozeram, and Lunesta. Although the Ambien helps me sleep, it affected my memory, motor skills, etc. so badly that I stopped taking it. Rozeram didn't really help at all and I think Lunesta made me feel bad the next day and didn't help with sleep that much (I can't remember very well on that one). Anyway, my sleep doc prescribed the Clonazepam. I worried about addiction and tolerance, but he was very nonchalant about it. I then asked him to try Trazedone since it was an antidepressant and is prescribed for insomnia. I thought I would kill two birds with one stone. (I had read up on it as I do with all my meds). I couldn't take it because of it drying out my eyes like all other antidepressants. That is the main side affect I get from antidepressants. It is severe enough that I just can't take them and I have tried just about all of them. Anyway, I went back to the Clonazepam because I have to get some sleep. Even it doesn't help me sleep as well as I would like, but it works better than anything I've tried. I do have the problem with memory, concentration, etc. with it, but not as bad as with Ambien. Of course, I do know that these symptoms could also be at least partly from my depression. Everything is confusing because everything causes everything. As someone said, which came first.

I am very informed on the meds I take or have taken and certainly weaned myself off the antidepressant that I took for eight years. I have read too many horror stories about withdrawal, although I don't seem to have a problem with that.

I also have problems often with finding the correct word to use. I will think of one similar but not quite the one I know is in there somewhere. From what I have read here, that seems to be a common side affect from sleep apnea. I have never read about that associated with depression. I really don't know what is causing what and no one seems interested in finding out the root. I suspect that my depression is causing the insomnia and the adjustments that have to be made during the night with the mask doesn't help matters. Not that I have a major problem with my mask, but it has to be reseated during the night sometimes which seems to be the norm.

If the depression is causing the insomnia then I don't see any resolution in sight. I cannot take antidepressants due to my dry eyes, so that leaves me with my poor memory, lack of concentration, hopelessness, worthlessness, insomnia, irritability, etc. and most of these things are worsened by the Clonazepam. It is a catch 22. (Is that the right phrase?) Sometimes I feel brain dead. I am not sure of what I think I used to know.

[jnk]

As far as my doctors addressing my insomnia, neither my regular doctor nor my sleep apnea doctor (Pulmonologist) has really tried to solve the underlying problem. . . .

Just an idea:

http://www.mayoclinic.com/health/insomn ... nt/SL00013

[izzyb]

jnk, good article. I have read articles about sleep hygiene and practice all of it except the exercise which seems to be the cure all for everything. I know that I need to be in some kind of therapy for my depression, anxiety and OCD. I guess I can add insomnia to that list. That is the first time I have read about using any kind of therapy for it. Of course, that is not going to happen. I can't ask my boss for regular time off to visit a therapist. It is just not possible in my world.

[carbonman]

My anxiety and obsessive/compulsive tendencies have increased to where they are a problem.

Another idea:
Sound Sleep, Sound Mind-Barry Krakow
Sleep dynamic therapy-
Close your day
SOLO technique to clear your mind
TFI(thoughts, feelings, image) balancing

It's not an easy read.
It is a read parts over and over,
practice, read again,
practice, parctice, practice.

Requires honest introspection on your part...
which can be painful and scary.....
but it does work.
I know.
I make it work everynight.

[jnk]

. . . except the exercise which seems to be the cure all for everything. . . .

If you have the time to live, you have the time to move. But I get your point. Thing is, moving around helps to burn off the anxiety juice and makes you the kind of tired that helps you sleep.

CBT therapists often aren't the "let's see you 45 minutes every Tuesday for the rest of your life" kind of therapists. Some, I hear, can do wonders with just a few appointments, if you are good about doing your homework.

Carbonman's ideas sure sound good to me, either way.

Point is to do something, and NOT to accept the insomnia until you've exhausted (if you'll pardon the expression) every possibility. If depression is "anger without enthusiasm," sometimes it helps to get a little more enthusiastic about fighting it. Trying new things to sleep better is a fine way to direct some enthusiasm. You've got it in you. After all, you made PAP therapy work! It is just time for the next step.

jeff

[carbonman]

Point is to do something, jeff

Actions kill fear.

[izzyb]

Thanks everyone for your help and suggestions.

carbonman, that sounds like a lot of work.

izzyb

[carbonman]

carbonman, that sounds like a lot of work. izzyb

I have made the journey to and through the
gates of my personal hell.

The work never ends.

Just depends on where you want to be.

[BlackSpinner]

I also have problems often with finding the correct word to use. I will think of one similar but not quite the one I know is in there somewhere. From what I have read here, that seems to be a common side affect from sleep apnea. I have never read about that associated with depression. I really don't know what is causing what and no one seems interested in finding out the root. I suspect that my depression is causing the insomnia and the adjustments that have to be made during the night with the mask doesn't help matters. Not that I have a major problem with my mask, but it has to be reseated during the night sometimes which seems to be the norm.

I see your are female, this word thing is also a classic menopause symptom (or even pms). I had it also and it went away when my hormones finally balanced after my hysterectomy, except when I get a migraine or take cold medication.

Heavy exercise causes changes in the brain chemicals - just so you know- which is why I was able to survive through what I now know was a depression after my divorce - I ran and lifted weights and I danced.