Managing similarities between OSA and depression?

jskinner wrote:...I'm very curious why there was such a strong reaction to my idea that depression is a symptom rather than a disease? I don't see how that idea changes anything about how terrible depression is. I have encountered this reaction a lot when I suggest it and ever quite understood the reaction. Do people think that calling it a symptom is some how dismissing its seriousness? I certainly don't believe that.

I think for many people, if you call depression a symptom, there is some stigma that it is "caused" by something that they are responsible for. It's kind of like the "argument" that sleep apnea is only overweight people, therefore it is the person's own fault for being overweight, and that if they only lost weight, they would not have sleep apnea any longer. Many (although not all) of us on this board realize that this "theory" is just not true.

I think people who have battled long-term depression kind of feel the same way when someone says that the depression is not a medical condition--that then it must be "self-induced", or at least that it can be treated by just "getting over it".

I realize that is NOT what you had said, and I see now that you do understand the depth of depression. But I think that might be what some people think when they hear that it is a symptom. And, in case you haven't noticed many people who are currently struggling with depression have very little self esteem, and therefore take anything said against what they are currently doing as an insult, sometimes pushing them further into their depression.

Personally, I think it is a combination of a medical disorder made worse by other things (such as SDB, improper diet, failing relationships, etc, etc, etc.). I am personally very hopeful that if we can ever get my SDB under control, that my depression will improve. But I do believe there is a medical basis for depression. That's just MY personal opinion, and everyone is welcome to their own.

Beautifully said,jbn3boys.

I have realized for a long time that my OSA symptoms resemble severe depression almost to a T. I still have to take an SSRI. But lets put it this way, if I dont use my CPAP gear, my depression comes back with a vengeance with a capital V. If I use my CPAP gear my depression is manageable.

One of the symptoms that really is troubling is off CPAP, or if CPAP is not working right, I get severe irritability. To the point people dont like being around me and vice versa. Most people do dont understand this (except for my sleep medicine doctor).

Mikey

After having been through severe depression, heavily ameliorated by CPAP, one thing in particular gets on my nerves. When I read or hear people "intellectualizing" major depression, that ticks me off. For example when people try to get all intellectual and bring out these famous psychologists and talk about their books and their "wonder therapies" and stuff, I am like you have no clue what you are even talking about.

To me, severe depression is primarily a biological thing that can be helped or hurt by your physical environment. First you have to get on the right medical treatment plan, which might mean CPAP in many cases, perhaps an antidepressant or both CPAP plus an antidepressant. Or it might mean CPAP, plus testosterone gel for men plus still an antidepressant. Or it might mean CPAP plus getting treated for anemia or iron deficiency or some other medical illness that causes fatigue like thyroid problems or B12 supplements or getting treated for type II diabetes....all cause severe fatigue and "depression."

Once you have the medical part treated, the next thing is to get yourself into a physical environment that is basically positive. And not negative. That might simply mean avoiding negative people in our life, it might mean getting to the YMCA a lot to get a lot of exercise, it might mean a different job or a relationship change. It might mean a geographical location change. It might mean financial changes. Whatever it is, less stress helps but being a realist you cannot avoid stress totally in our world.

But you CAN decrease stress levels by carefully planning your life out.

Combine the two, a good biological approach to "depression" with a positive environment and stress control and you can probably get a handle on your depression. If not, there is always ECT <grin>

But it really rubs me the wrong way after what Ive been thru when I hear people breaking out Freud and talking about their dreams and negative childhood experiences or other psychologists and saying things like "have you read their work yet?" I roll my eyes.

Mikey

I thought I was clinically depressed - lack of motivation, fatigued all the time, difficulty concentrating, anxious, trouble sleeping, complete anhedonia (lack of enjoyment from things you once found enjoyable, especially anything requiring effort e.g. socializing). Was surprised to discover it was really just long-standing, untreated OSA. Even though my OSA therapy is nowhere near perfect, any supposed depressive symptoms have long since disappeared since learning to sleep with CPAP and have not returned. I am very thankful for this.

Bob3000 wrote:I thought I was clinically depressed - lack of motivation, fatigued all the time, difficulty concentrating, anxious, trouble sleeping, complete anhedonia (lack of enjoyment from things you once found enjoyable, especially anything requiring effort e.g. socializing). Was surprised to discover it was really just long-standing, untreated OSA. Even though my OSA therapy is nowhere near perfect, any supposed depressive symptoms have long since disappeared since learning to sleep with CPAP and have not returned. I am very thankful for this.

I relate to this strongly.

Mikey

One of the symptoms that really is troubling is off CPAP, or if CPAP is not working right, I get severe irritability.

I am hoping you get your cpap working right very soon.

ResmedUser wrote:
I relate to this strongly.

Mikey

Ditto.

I see depression as the brain simply struggling to function normally. Many things can cause dysfunction be it physical (B12, Apnea, Thyroid, etc) or psychological. The key is finding the cause and treating it.

I thought I might chime in here. I am currently being treated for OSA and generalized anxiety disorder. I have only been using CPAP for 10 days but i have been taking
an anxiety medication for 4 years or so. As of a few weeks ago, it was almost unbearable to be at work. I would have panic attacks for no particular reason and it
was debilitating. My blood pressure was really high too. Since I have been on CPAP, i have been noticing an evolution in my fatigue, anxiety, and blood pressure levels.
I wake with an overwhelming sense of calm and some things that normally trigger anxious symptoms are no longer causing such extreme reactions. I have a bit more spring in my step.
My BP has come down slightly since my CPAP allowed me a few good nights rest.

I also noticed that I don't hit snooze 12 times on my alarm clock each morning. I would have to say that CPAP thus far isn't fixing my anxiety but it is taming its grip on me.
I am hopeful that anxiety is strictly a side effect of my OSA. The jury is still out on whether that is the case.

Oh, wow, SnoozyQ, I relate so much to your post. The one thing I would tell you is to hang in there and keep working on your problems, because while it may not seem like it, you are making headway.

I have dealt with depression all of my life. I started antidepressants when I was thirty because the new SSRIs had just come out, and I responded immediately. Then I had problems with that first med, but I saw such a powerful change, I knew that medication was the only thing helpful to me. I also knew that I needed counseling to problem solve after I felt better.

Meds aren't perfect. Depression is still being studied, and while certain brain chemicals are involved, it's still an unknown as to why certain meds work for some people and others don't. I would say that meds can be one tool in your toolbox in dealing with your depression.

But you have complex depression. As others have noted, are all of your physical needs being met? Has your thyroid been checked, Vit. D levels checked, etc? I have severe thyroid disease, and with meds I was able to treat it and physically feel better, which was one less thing to complicate my life.

At some point, you do need to consider therapy, but I understand your anxiety. What about a support group? One for anxiety perhaps. One that requires minimal sharing until you feel comfortable?

Also, cognitive behavior therapy focuses on recognizing patterns in your responses and behaviors and helps you to form new patterns of responding to situations. Maybe at some point finding a CBT therapist would help.

It can get better, but it will require challenging your boundaries, even a little bit at a time. I wish you luck.

Metta

acc0mpl1ce wrote:I am currently being treated for OSA and generalized anxiety disorder... Since I have been on CPAP, i have been noticing an evolution in my fatigue, anxiety, and blood pressure levels.I wake with an overwhelming sense of calm and some things that normally trigger anxious symptoms are no longer causing such extreme reactions.

You may want to pick up a copy of Dr Steven Parks book called Sleep Interrupted. In the book he has an entire chapter dedicated to how sleep disordered breathing can lead to anxiety and panic attacks. Every breathing event during the night activates your sympathetic nervous system and leaves it in a hyper aroused state which can lead to anxiety. Suffocating is stressful!

Rjaye wrote: I saw such a powerful change, I knew that medication was the only thing helpful to me.

I used to feel exactly the same way.

I think this is the problems with antidepressants, if they make you feel better you will assume that they are fixing the problem. In my opinion however they are just manipulating some of the underlying chemicals involved in our mood. Unless someone actually has low neurotransmitters, for which there is no test, then its more likely they are creating an imbalance than fixing one. Boosting these neurotransmitters can mask the real problem by forcing your mind to feel better. I'm not saying in some cases that they are not useful but I feel that in an awefull lot of cases finding the real cause and treating that would produce longer lasting result with less side effects.

thanks, that helped me a lot!
regards,
chantal