Depression & Sleep Apnea

[amandalee]

I've read that depression can be a symptom of SA. I'm going to start CPAP treatment soon, and I'm wondering if any of you have noticed an improvement in depressive symptoms since getting treatment?

I've been diagnosed with depression in some form or another since age 18 (8 years). I didn't want to take medication, so I just managed it on my own until I was about 22. Since then I have tried Prozac, Effexor, Wellbutrin, and Lexapro. Those medications sort of helped with mood symptoms, but my biggest complaint was always that "I'm sooooo tired and don't feel like doing anything."
Finally, I was referred to a psychiatrist, who diagnosed me with "atypical depression" and put me on a combination of Cymbalta and Adderall. Like the other medications, these help with the mood symptoms, but not the fatigue.

While this isn't an experience I'd wish on anyone, I'm wondering if any of you have suffered similar circumstances? I'd especially like to hear from anyone who was able to lower their dose of antidepressants after starting xPAP, or stop taking them entirely.

While I do think psychiatric drugs can be really helpful to some people in certain circumstances, I also think that they are often prescribed as a "quick-fix" when doctors have no idea what's really wrong with you. I wish I had gotten this diagnosis of sleep apnea 8 years ago, instead of trying drug after drug. All the medications just delayed getting a real diagnosis. If I hadn't gone in for the study when I had, I don't know what I would've done, because I just couldn't live with being so tired all the time...

[SleepGuy]

amandalee, you're certainly not alone. There are a number of threads on the forum very similar to yours. I wasn't on meds but I felt like I was on the verge of a complete breakdown before a good doctor suspected apnea and sent me home with an oxymeter.

You're definitely on the right path! Treatment of OSA will very likely resolve your other symptoms. Just stick with it!

[jskinner]

I've read that depression can be a symptom of SA. I'm going to start CPAP treatment soon, and I'm wondering if any of you have noticed an improvement in depressive symptoms since getting treatment?

I think you will find many on this board who's depression has improved with OSA treatment.

Since then I have tried Prozac, Effexor, Wellbutrin, and Lexapro. Those medications sort of helped with mood symptoms, but my biggest complaint was always that "I'm sooooo tired and don't feel like doing anything."

Keep in mind that being on these meds may actually impact your ability to feel fully better while on CPAP. For example many antidepressants impact sleep architecture. I advice would be one you get used to CPAP try SLOWLY titrating off your medication. (And I do mean slowly so that you don't create an even worse depression from withdrawal)

Finally, I was referred to a psychiatrist, who diagnosed me with "atypical depression" and put me on a combination of Cymbalta and Adderall. Like the other medications, these help with the mood symptoms, but not the fatigue.

Good god, these doctors just keep pilling on the meds don't they... there should be a law...

While this isn't an experience I'd wish on anyone, I'm wondering if any of you have suffered similar circumstances? I'd especially like to hear from anyone who was able to lower their dose of antidepressants after starting xPAP, or stop taking them entirely.

Yep. Your story sounds very familiar.

I also think that they are often prescribed as a "quick-fix" when doctors have no idea what's really wrong with you. I wish I had gotten this diagnosis of sleep apnea 8 years ago, instead of trying drug after drug. All the medications just delayed getting a real diagnosis. If I hadn't gone in for the study when I had, I don't know what I would've done, because I just couldn't live with being so tired all the time...

I really feel your pain. My story is similar. Doctors use these drugs as a quick fix because they can _sometimes_ improve your mood. Often they just mask the real problem.

As I like to say Depression is a _symptom_ not a disease. You need to find and treat the cause not the symptom. But then that wouldn't please the drug companies would it...

[amandalee]

Thanks for the replies. Nice to know I'm not alone. Switching between all those drugs has been a total nightmare and I'm sorry for anyone else who's experienced something similar. I always felt that my problems with depression were a symptom of a bigger problem, but good luck getting a doctor to beleive that when they've already decided on a diagnosis.

Anyway, it's nice to finally be headed in the right direction.

[jskinner]

Switching between all those drugs has been a total nightmare and I'm sorry for anyone else who's experienced something similar.

Its a bit like torture isn't it. Worst part is that when they create new side effects with the meds they start claiming new illness and then prescribe more meds to treat the side effects... and so on...

The problem with psychiatry is that its not based on science... plain and simple. If a doctor tells you have a chemical imbalance ask them to prove it with a test...

good luck getting a doctor to believe that when they've already decided on a diagnosis.

Arrogant aren't they... they seldom admit they could be wrong.

[drummergirl410]

My mom has depression also, and was diagnosed with "mild" sleep apnea a few years back. Since my issues have come about, my sleep doc. has been not-so-subtly dropping hints to my mom to be retested. I'm not sure if she's going to do it but I wonder if her quality of life would improve if she went on CPAP. Doc. must really have an inclination about it or he wouldn't give her such a hard time about getting tested again when I go.

[Julie]

Hi. just for the record, though it would be nice to believe, depression can well be the 'disease' and not just a symptom, and while probably many, many OSA patients have been wrongly diagnosed with depression, some may also have been legitimately depressed, and many with depression don't have OSA. Being 'down', overtired, sad, even losing interest in usual pursuits can be 'depression', but it also can be a terrible, deadening, totally disabling thing, if only for a few months of 'crisis' time, and isn't always helped by meds, Cpap or even ECT. It may stem from lack of serotonin in the brain, or hormonal imbalances, genetic predisposition (probably incorporating the other two), etc. A short term 'grief reaction' may feel like a depression to some, but is really not the same thing unless it progresses to a more serious and ongoing problem.

[John_M]

While my AHI's are good (< 2 ) and I am sleeping well I am still feeling very tired, sleep a lot and I am wondering if I am heading into depression again.

But I was thrilled when I found a new book, "The Mindful Way through Depression" by Williams, Teasdale, Segal and Kabat-Zinn. It describes the way I spiral down into a depression to a T .

And the "cure" it advocates is awareness practise, no drugs, nothing but awareness. So I am going off into a meditation binge and am having fun trying to be aware.

And I am keeping my fingers crossed medically speaking. Have an appointment with a heart-lung specialist. Now that the Sleep Apnea is out of the way, maybe they can find something else.

John M

[jskinner]

depression can well be the 'disease' and not just a symptom,/quote]

Where is the evidence for that? How do you know for sure that every occurrence of depression isn't just a symptom of an undiagnosed problem? If depression is a disease unto itself how come now one has ever found an underlying cause of said disease?

some may also have been legitimately depressed

Sure you can have OSA and unrelated depression. The depression could be a symptom of another problem...

many with depression don't have OSA.

I didn't to imply that OSA was the only problem that had depression as a symptom. Of course many things can have depression as a symptom. Psychological problems, low B 12, thyroid, etc

It may stem from lack of serotonin in the brain

Really? Depression is sometimes caused by lack of serotonin in the brain? Thats NEVER been shown to be true. Not once. I challenge you to find some research to support that belief. The first person to be able to do that will be given an Nobel prize. People have been trying in vain for decades to make that connection.

The reason that people believe that is that increasing serotonin in the brain will _sometimes_ make you feel better. That doesn't mean its the cause. Just like taking asprin and making a headache go away doesn't mean you where deficient in asprin. Increasing serotonin will affect mood becases it somehow related to how we feel. NO one understands it.

People believe that low serotonin is the cause of depression because of one thing: Prozac. They marketed it in such away to make people believe they had proven this. It was a lie.

A short term 'grief reaction' may feel like a depression to some, but is really not the same thing unless it progresses to a more serious and ongoing problem.

And yet these short term greif reactions are exactly the type of events that doctors regularly tell patients they need meds for...

[roster]

......

It may stem from lack of serotonin in the brain

Really? Depression is sometimes caused by lack of serotonin in the brain? Thats NEVER been shown to be true. Not once. I challenge you to find some research to support that belief. The first person to be able to do that will be given an Nobel prize. People have been trying in vain for decades to make that connection.

.........

jskinner, This is what I was thinking about when I watched this cartoon, http://www.mercola.com/townofallopath/index.htm.

[roster]

[quote="amandalee"]...........

..... I wish I had gotten this diagnosis of sleep apnea 8 years ago, instead of trying drug after drug. All the medications just delayed getting a real diagnosis. If I hadn't gone in for the study when I had, I don't know what I would've done, because I just couldn't live with being so tired all the time...

[chriml]

I just want to say that I to was diagnosed with depression and sleep apnea. I started zoloft 6 months ago and cpap 1 month ago. Not Sleeping has to do alot with depression. I will give you a little hope It took a month but I can make it through most of the day without sitting on the couch most of the day. I started gardening which I have never had the energy to do, I can clean my house without taking a break every 10 minutes & best of all I am exercising and losing weight which had been out of control for many many years. I take it day by day and I know I will have bad days but at least now I feel like there is hope for me. Keep taking the pills and get your cpap machine ( remember use it even though it is a pain) you will adjust and be happy and feel good soon. Lot's of luck! Remember everyone here is always willing to help they are WONDERFUL!!!!!

[Daddysaur]

Well, you have a variety of similar stories listed here on meds and depression. I don't have one of those,but I can tell you the second morning after using the CPAP machine I found myself standing at the sink in the kitchen singing...not humming part of a tune, but singing! It had been a long time since I felt that "UP" in the morning. This is the third week of getting used to the CPAP nights and the posts discussing longer term improvements are very encouraging. I hope you have similar changes with the "Hosehead lifestyle". I'll take the better mood and alert days over the fog I was in with poor sleep.

M

[socknitster]

You are not alone. I'm 35 and was originally diagnosed with depression at about age 22 or 23. At that very dr appt I told him about feeling so tired and sleepy during the day and he just ignored it.

I have been on and off nearly evey depression med (sometimes more than one) for over 10 years. Almost a year ago, I told a psych I would like to do a sleep study and he said all my "need for sleep" was in my head, even though my primary depressive complaint was fatigue and lack of energy.

It took my gp noticing how large my tonsils are at a visit where I was complaining of fatigue despite a recent increase in dose of antidepressants, before the words sleep apnea were ever uttered in my presence in regards to me. I had already developed high blood pressure which seems to be going down on its own now. Thank goodness I hadn't developed diabetes yet!

Jen

[Andrew]

I've suffered bouts of depression on and off for years. It ranges from mild to extreme and like you, I've tried medications but the overall weariness seems to outweigh any benefits.
I've recently been diagnosed with SA and have had a Cpap machine on trial now for almost 3 weeks.
I'm finding it almost impossible to get used to it and since bringing it home I've noticed a marked increase in my depression.
Lack of sleep, the fact I'm sleeping with this thing attached to my face and frustration at my situation saw me at 4am in tears on Sunday morning.
I've not worn the mask (nor used the machine) since.
I feel both despair and depression increasing and cannot see a solution at hand.
I'm off to my sleep specialist again in 2 weeks. I'll will be asking about surgical solutions as an alternative to Cpap.