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Insomnia doesn't cause depression


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See my exchange with this psychiatrist in the "Psychology Today" forum:

 

http://www.psychologytoday.com/blog/fighting-fear/201307/diagnosing-depression/comments#comment-544765

 

Don't you love how he says insomnia doesn't cause depression even though it feels that way to the patient?   So instead of sending the patient to be screened for possible sleep breathing disorders, he would rather put the person on up to 3 medications.

 

I am speechless at this guy's reasoning.

 

CS

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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Stupidity abounds.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Great response Alto.

 

By the way, is it stupidity or arrogence? The reason I am asking is these guys are so sure their theories are right about depression causing insomnia and that there couldn't be an alternative explanation.

 

CS

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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Great response Alto.

 

Ditto.

 

By the way, is it stupidity or arrogance?

 

It is hard to differentiate the two in my experience.  Flip a coin.

 

The reason I am asking is these guys are so sure their theories are right about depression causing insomnia and that there couldn't be an alternative explanation.

 

CS

 

I agree.  There are many, many maladies which have depression as a symptom and I would think insomnia would be one of them.  Not getting enough sleep and gradually getting more and more tired and ineffectual would be enough to depress just about anyone.  That just seems like common sense to me.  Of course, we seldom find any of that at the doctor's office.

Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/

 

Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 

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Great response Alto.

 

Ditto.

 

By the way, is it stupidity or arrogance?

 

It is hard to differentiate the two in my experience.  Flip a coin.

 

The reason I am asking is these guys are so sure their theories are right about depression causing insomnia and that there couldn't be an alternative explanation.

 

CS

 

I agree.  There are many, many maladies which have depression as a symptom and I would think insomnia would be one of them.  Not getting enough sleep and gradually getting more and more tired and ineffectual would be enough to depress just about anyone.  That just seems like common sense to me.  Of course, we seldom find any of that at the doctor's office.

 

Hi Jemima,

 

Regarding whether a doctor is arrogent or stupid, I agree it is hard to differentiate because being arrogent is pure stupidity.:)

 

Let's face it, doctors in general, particularly psychiatrists, commonly throw psych meds at a problem, instead of taking the time to investigate underlying causes. Depression and insomnia are easy targets.

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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My response to this doctor:

 

Going without sleep does not produce depression--although sometimes patients experience the problem in this way. Actually the sleeplessness is caused by the depression. Multiple studies in which patients are kept up arbitrarily support this fact. When this syndrome appears, anti-depressants are very effective in ameliorating the sleeplessness--which would not be true in cases of sleep apnea. I agree that sleep apnea is under-diagnosed and should be suspected and tested for much more than it is.
 
Dear Doctor,
 
That statement above is so ridiculous, it leaves me speechless. Almost.  I have experienced, countless of times, insomnia induced depression.  Yes, I suffer from depression, but I don't feel depressed every day. However, on days when I get only 4 hours of sleep, I am a mess.  I feel down, am less able to cope, and cry easily.  Interestingly enough, this also happens when I take Ambien or Klonopin for sleep and/or anxiety. Even though these meds let me sleep for 8 hours, the fact that they depress the Central Nervous System, only adds to the lethargic, vegetative depression that you describe.
 
Which brings me to your description of Depression number 3 and the manisfestation of Insomnia. I find your description highly inaccurate.  As someone who has experienced both Depression #1 and #2 and #3, I can tell you that 90% of the time, Insomnia happens when going to bed. It is hard to fall asleep. But then I can sleep and sleep and sleep. Oversleeping and having a hard time getting up in the morning, still feeling fatigued after hours of sleep is a classic sign of depression.  Your description needs to encompass this type of insomnia, to be comprehensive.
 
The Insomnia that you describe, the early morning waking, is something that I've experienced only as a side effect of antidepressants or withdrawal from antidepressants.  Never as a symptom of depression itself. Perhaps some people do experience this, but you cannot discount the type of insomnia that I am describing, which a lot of people experience as well.
 
Next, I would like to say that I really liked your description of  Depression #1 & #2.  I realized that it was #1 coupled with multiple #2's that actually led to depression #3.  The sensible thing to do, is address the source(s) that led to the depression in the first place. 
 
Perhaps short term antidepressant use for the severely depressed might be a solution. But I wouldn't recommend it as a first course of treatment. Some of us develop severe side effects and protracted withdrawal from even short term antidepressant therapy. Also, as I now know, throwing antidepressants at depression, long term, only serves to make Depression chronic, by severely down-regulating receptors that may take years to return to normal.  Long term antidepressant use has also shown me that antidepressants severely reduce a person's coping mechanism.  I have years of journals that clearly show how I was able to cope with multiple stressors, losses, and depression pre-antidepressants, and post-antidepressants.
 
Antidepressants and other Psychotropic medication has done so much harm to so many people, that one can say that it is a silent epidemic.

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin,Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Extremely sensitive to stress which triggers Myoclonus.)

Intro page: http://survivingantidepressants.org/index.php?/topic/4149-lilu-depression-worsened-by-meds/

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Excellent response, Lilu.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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Excellent response, Lilu.

 

Thanks Barbara!

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin,Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Extremely sensitive to stress which triggers Myoclonus.)

Intro page: http://survivingantidepressants.org/index.php?/topic/4149-lilu-depression-worsened-by-meds/

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Excellent response, Lilu.

Totally agree

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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This article is a definite improvement and in my opinion more accuratelu covers the issues of how insomnia can cause depression. It seems to be in line with what Dr. Krakow has said about depression and insomnia having a complicated bi-directional relationship.   Not a surprise since the author, Dr. Michael Breus, PhD, also is in Sleep Medicine.

 

Thanks for the link, Barb.

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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