Depression & Sleeping Patterns

Hi. I've rejoined a gym and bought a dog to force me to exercise and tire myself out - it hasn't worked over the last six months or so. I guess I'll try staying awake all day and all night. Tried everything else!
Thanks.

How can someone sleep over 10 hours??
Before I came Japan, I could go to bed at about 12 or 1 but still could get up at 7 or even at 6 in the next morning. But now, OH! I cannot fall in sleep the whole night, I just lay down on the bed till 4 or 5am. If I am lucky, I can sleep till 9 or 10.

Hey sleeping has gotten worse, so bad in fact that i have not slept since monday night and it is now thursday morning, i dont have a lot of energy and am struggling to get on but i still went to work yesterday and am going to lectures today, dont know how am gonna last till half ten tonight though when i will finally get in.

Also find that i have lost my appetite and really not feeling good, antone have any advice, after not sleeping tuesday night thought i would have no problem sleepinglast night but this wa not the case and in the end decided to give up and get on with things!

What happens if i have the same problem tonight? any advice would be very welcome.

sleep? what is that lol? really need some advice with this now as have only had 3 hours sleep in the last 74 hours! am feeling ok at the moment but know later on i will be feeling really weak! no matter how hard i try cannot relax.

Depressed individuals commonly show disruption of normal sleep patterns but this can be reflected either in difficulty falling asleep (initial insomnia), or waking up a short while after falling asleep (middle insomnia), or excessive sleep (hypersomnia), simply restless sleep (moving around more than usual), or sometimes altered sleep pattern exhibited as changes in the amount of time spent in the different stages of sleep.

Part of the reason for this has to do with neurochemistry - one of the things that happens when someone is depressed is that there are changes in brain chemistry, specifically in the relative levels of serotonin, norepinephrine, and dopamine (whether this is cause or effect isn't entirely clear). One of the links to sleep is that serotonin is normally replenished during deep stage (REM) sleep. Deprivation of deep stage sleep, even if one is sleeping 8-10 hours a night, results in serotonin depletion, which in turn is linked to depression and other problems in emotional regulation. When this occurs, it sometimes causes further disruption of sleep patterns in a kind of vicious cycle. Sometimes, it leads to excessive sleeping as the body tries to correct the balance.

I am certainly not trying to say that the causes of depression are entirely physiological, or that the cure is solely a question of taking medications. However, one of the things I do emphasize to my clients is that the key to recovering from depression is restoring normal sleep patterns, including and most importantly normal deep stage sleep patterns. One way to do this is via various types of medication but it's not the only way - looking at factors like diet (avoiding stimulants like caffeine in coffee, tea, soft drinks, or chocolate; avoiding stimulating mental or physical activities late in the day; etc.), looking at methods that promote relaxation (a warm bath; meditation; relaxation therapy), making sure you don't eat a large meal shortly before bedtime, etc.

minstrel wrote:One of the links to sleep is that serotonin is normally replenished during deep stage (REM) sleep. Deprivation of deep stage sleep, even if one is sleeping 8-10 hours a night, results in serotonin depletion, which in turn is linked to depression and other problems in emotional regulation.

That seems to be in contradiction with "all anti-depressants work by suppressing REM sleep, which as you now know, will lift depression."

Minstre's posting says "during deep stage (REM) sleep". But isn't REM stage sleep different from "deep stage sleep"?

Kathleen

One of the links to sleep is that serotonin is normally replenished during deep stage (REM) sleep.

I think there may be a difference in terminology here. As I understand it Minstrel, serotonergic neurons are almost totally inactive during REM sleep - where most dreaming takes place, more active during SWS, more active during idle waking and most active during vigorous exercise.

Also, depressed people dream up to 3 times as much as non-depressed people, which may contribute to serotonin depletion, and certainly contributes to exhaustion, stress hormone depletion and nervous system activation. It also causes a lack of SWS (slow wave sleep), which is non-REM sleep and seems more implicated in bodily repair and immune system activity.

Joe Griffin's recent research into Dreams theorizes that the over-dreaming associated with depression is caused by the emotionally-arousing introspection typically done by depressed people. This in turn exhausts them, making mornings awful and leading to the general improvement in energy and mood as the day progresses and hormonal balance starts to normalize.

Personally I think this insight is an astounding advance in the understanding and treatment of depression (and other mental illness - not to mention psychology generally), and lowering rumination certainly works for our depressed clients, and those of our colleagues. If anyone would like to read more on this, see this New Scientist article:
Depression and dreaming

When it comes to the topic of neurochemistry, I am certainly not goinjg to say that any of you are wrong. A while back, I spent a couple of years working with and doing research with a psychiatrist who had originally trained as an endocrinologist and subsequently a neuroendocrinologist (he was born and trained in the UK incidentally, and worked for a few years at the Maudlsey; FWIW, I wasn't trained in the UK but I was born in London and can lay claim to being a true Cockney). What I learned during that period was that almost anything I might say when it comes to neurochemistry or endocrinology is bound to be at best an oversimplification - each of the neurotransmitters is not only inextricably linked to the others, but also to the entire endocrine system. Thus, it is difficult to cause or observe changes in one element without seeing a corresponding change all along the line, like a domino effect. Throw in the neurotransmitter precursors like tryptophan and melamine and you get an even more complex picture.

As to the relationship betwen sleep and serotonin, or REM sleep and serotonin, there are, as with almost all research in this area, contradictory findings, which I suspect may be related to degree of sleep deprivation and/or the degree and stage of depression or other conditions which affect these systems. There have been some findings which suggest that seroptonin may be related primarily to sleep onset and slow wave sleep while norepinephrine is more closely related to REM sleep and arousal.

One of the observations that is taken as support for the serotonin depletion hypothesis during REM sleep is that following prolonged sleep (or REM sleep) deprivation patients often show a reduction in depth of depression, albeit temporary. However, it has also been observed that prolonged sleep deprivation causes a rise in prolactin - interestingly, one also observes a sharp rise in prolactin following ECT or insulin-induced shock therapy, which has led some to speculate that the improvment in depression may be due to the prolactin changes.

As to whether SSRIs suppress dreaming or REM sleep, again the evidence as I read it is equivocal and again may be dependent upon the degree or stage of depression and other factors which may be linked to sleep and dreaming. Certainly, among my clients, almost all of them report "increased dreaming" and increased vividness of their dreams with SSRIs, especially after being on these medications for a while but some right from the beginning. Similarfly, if you examine the list of potential side-effects for most of the SSRIs, what strikes me is that there tend to be as many people reporting insomnia as reporting hypersomnia as a side-effect.

As you may have gathered, I find this whole area of research to be fascinating but also incredibly complex - and maybe those two characteristics are related! ;o)

This is confusing to me.
First you say, "Deprivation of deep stage sleep, even if one is sleeping 8-10 hours a night, results in serotonin depletion, which in turn is linked to depression and other problems in emotional regulation."
And then, "following prolonged sleep (or REM sleep) deprivation patients often show a reduction in depth of depression, albeit temporary."
Does sleep deprivation cause an increase or a decrease in depression?

When it comes to the topic of neurochemistry, I am certainly not goinjg to say that any of you are wrong.

Judging by the level of my own knowledge, it wouldn't be a big risk David !

But I would like to take a look this to find out what is right, regardless of who is right. The way we come at depression, this point is very interesting.

From a bit of brief research I found:

"In his article, Hobson (bear, 1996) wrote that the most surprising observation that he and his coworkers made was that both the noradrenergic locus coeruleus and the serotonergic raphe neurons "turn off" in REM sleep (table 1). This finding was a surprise because every one had predicted the opposite."
http://www.epub.org.br/cm/n02/mente/neuroestrut_i.htm

"Additionally, like norepinephrine, serotonergic neurons become virtually zero during REM sleep."
http://www.macalester.edu/~psych/whatha ... uro04.html

"The cessation of firing of serotonergic dorsal raphe neurons is a key controlling event of rapid eye movement (REM) sleep."
http://ajpregu.physiology.org/cgi/conte ... 273/1/R451

Additional psychological insight: Difficulty reading research papers correlates directly with volume of wine imbibed.

RogerE wrote:Additional psychological insight: Difficulty reading research papers correlates directly with volume of wine imbibed.

...and with hours of sleep deprivation! ;o)

My interest is re-tweaked, Roger. It's been a few years since I actively looked at that literature and as I said what I was reading were often contradictory findings... I'll have a look at your referenced sources and do some additional research myself.

This is what I love about forums -- the opportunity to rethink something I thought I'd thunk already! ;o)

First, let me say that I have spent quite a bit of time researching the question of the role of serotonin in sleep, which of course branched me off into looking at the neurochemistry of depression, anxiety, PTSD, and OCD as I went along - now I am sleepy but not depressed or anxious (so far)

I must thank Fathom for pointing me in the direction of this forum and Roger and the other members for getting me thinking and reading about this fascinating area again...

Now read this carefully because it's not something I find myself saying very often

It appears that you guys are right - as I said, I haven't looked at more recent research in this area for a few years and the conclusions I drew back then are aptly summarized in one of the articles Roger referenced:

Despite our understanding of serotonin in REM sleep, we are unclear in whether serotonin induces/maintains sleep or whether sleep maintains/restores the serotonin system. (http://www.macalester.edu/~psych/whathap/UBNRP/sleep_deprivation/neuro04.html)

However, my take on it now is that, although the interplay between various neurochemicals and precursors is awfully complex, the picture is clearer (to me at least) than it was a few years ago.

It appears that serotonin is indeed depleted during REM sleep. Now, I think this makes sense of some common clinical observations when we think about what is happening in depression. For example, it seems to me to help explain why insomnia and/or disturbed sleep is so common in untreated major depression - perhaps this can be thought of (oversimplified of course) as the system's natural defense against falling serotonin levels. Conversely, following extended use of SSRI's and relief of the symptoms of depression, I have often observed decreased energy and increased somnolence in patients (anectdotal evidence only by the way but from more than one client), which I am starting to look at as a signal that the medications are no longer necessary, having done what they need to do, and in fact are now counterproductive.

On the other hand, it raises (like all research) another question: In some patients with untreated depression, rather than insomnia we observe excessive sleeping. How can we understand this in terms of the above? is it a contradiction? or is it explained by other factors?

I also want you guys to know I've been reading all this material instead of finishing a report that was due last Monday - thanks!

I also want you guys to know I've been reading all this material instead of finishing a report that was due last Monday - thanks!

LOL! Glad to be of service.

perhaps this can be thought of (oversimplified of course) as the system's natural defense against falling serotonin levels.

Indeed, this is something we have also thought, or it could be seen as a defence against the overloading of the system by excessive dreaming caused by introspection.

In some patients with untreated depression, rather than insomnia we observe excessive sleeping.

I wonder whether this is due to their need for slow wave sleep that is squeezed out by excessive REM (Which is always prioritized), or just down to a natural response to exhaustion? I suspect there is a more elegant reason than that, but those are just my thoughts.

Thanks for reporting back on that Minstrel, it is good to hear your thoughts on this.

Roger

Hiya - new to the forum, but very interesting stuff.

i have a question though - i dream in technicolour every night - my boyfriend says i also talk and move around a lot in my sleep - both of which i'm aware of because some nights its so bad i wake myself!

also, currently replasing depressive (noticing the signs, and trying to deal with them early - hence my interest in this site) and have found the discussions about the link between dreaming and depression very enlightening, as the dreams are getting more frequent lately - though no less disturbing. I have, simply thorugh ignorance and experience, already come to the conclusion that a) i'm shattered all the time because i don't get any restful sleep; b) my mood and emotions suffer when i'm exhausted; c) i work better and am more stable emotionally late at night, hence i do most of my best work (studying for a philospophy degree) in the early hours, but am totally unmotivated for my 9-5:30 working day.

So, while i'm able to identify the causes - stress of working, single parenting, studying and all the other things that run my life - and identify the 'cure' - getting a good night's restful sleep - i am at a loss as how to get the two reconciled!

I do the normal things usually suggested - warm baths, lavender aromotherapy stuff, chamomile tea (yurkk!!) or warm milky drink before bed, stopping work an hour or so before bed, excersise during the day (well, some days) i even tried meditating ... but to no avail. I either sleep badly, or so lightly that the merest smidgeon of a dream, or outside interuption can wake me.

HELP!!!

Ally