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Insomnia due to depression - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Depression
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   Hi, I need your help. I have trouble sleeping. I've had this problem for a while now now and i honestly don't know what to do. Can you help me?
Doctor :   Hi
User :   Hi, your a real doctor right?
Doctor :  

Doctor :  
now explain to me in detail about your sleeping difficulty problem
User :   Thank you for helping me.
User :   Well...
User :   I don't feel ok. I've had trouble sleeping since 08 and lately i've been trying to stay postive and be strong but i feel it's beyond my control now. i went to a sleep clinic and they did a sleep study on me. They told me i have paradoxical insomnia. apparently my body rests but my concious is still awake like a self-defense mechanism or something. I take zoloft but it doesn't help the sleep.
Doctor :   zoloft was advised by the sleep clinic?
User :   no tylenol pm. my psychiatrists gives me zoloft for depression
Doctor :   ok

User :   i'm in pain physically. It's a strain on my brain when i write and talk or do anything. Functioning is very hard, my cognition is horrible. I go places and not know where i am. who i am talking to on the phone. I feel fatigue, massives headaches, and recently my heart has had weird feeling and i'm breathing differently, like 2 breaths instead just up and down
Doctor :  
User :   everytime i try to go to sleep i can't, what should i do?
User :   can i heal from this or die?\
Doctor :  
this can be healed
User :   another symptom is numbing face as well
Doctor :  
and defenitely insomnia is a disorder which will cause distress but not death
User :   oh ok
Doctor :   you are on the medication for the depression from when?
User :   I was on zoloft in high school for a few yrs, then i got off of it because i was strong, mentally and emotionally. i felt very positive and i let nothing get to me, then i crashed again in 2008 when my verbally abusive aunts rage had me not sleeping because her voice seemed violent like she would attack me or something so maybe that part of the paradoxical insomnia i don't know
Doctor :   ok

Doctor :   may i know your age and gender?
User :   22 female
Doctor :   may i know your height and weight?
User :   5'6 about 160 in weight i think
Doctor :  
can you explain me about your sleeping habit?
Doctor :  
like what time you go to bed?
User :   I try to stay up in the day to sleep at night like around9 or 10, but right now i feel like sleeping :) guess thats good. maybe i should focus on other things besides my problem.
User :   but i still can't sleep when it's time for bed i don't know why
Doctor :   you are suffering from a disorder called depression and one of the effect of the depression is insomnia

Doctor :  
the depression itself causes difficulty in sleep
Doctor :  
as such you are on treatment with zoloft
Doctor :  
but it takes time and as such the natural history of the depression is it will have exacereberation and remission
Doctor :   when ever there is excereberation it is that period you will have this sleeping difficulty
User :   oh ok. does severe sleeplessness cause stress on brain and heart, organs etc.
User :   ?
Doctor :  
the present sleeping difficulty is not a separate entity it is the result of the depression
User :   ok
Doctor :   sleeplessness may cause high blood pressure, poor immunity, over weight
Doctor :   the major effect is the reduced cognitive performance and slow reaction time
User :   THAT is what i hate most
User :   i'm not my normal self and can't do things to my full potiental with the impairment. i struggle ot function everyday. even right now
User :   it's like i'm not almost but still alive
Doctor :   not to wory
Doctor :   everything has a solution
Doctor :  
here the treatment is multimodality and medications have only limited role
Doctor :  
first and foremost is consult your psychiatrist and find out is the zoloft is sufficient or any other medication is necessary or any other form of therapy is required
Doctor :   this is for the exceberation of the depression
User :   ok
Doctor :  
once the depression is treated probably the sleeping difficulty will disappear by itself
User :   how long left do we have to talk?
Doctor :   i think other 30 minutes
User :   ok thank you
User :   because my head hurts so bad right now. when i struggle to think and type it hurts. but yes, i think you are right about the depression exceberting
User :   or whatever
Doctor :   ok
User :   lately i have felt good yesturday because i went and spent timw with my younger sister but bad majority of the time it's ver bad. i keep resisting strong suicide ideations all the time
User :   it horrible
User :   hopefully i will be ok
Doctor :   change of the environment is one option which has a good effect on the mood and has sleep enchanting property

Doctor :   your spending time with your sister yesterday made you feel better is one example
User :   Yeah. I live in New York, not such a good environment but i love the city, i couldn't stay in PA because my aunt yelled to much with rage and that had me sleepless
User :   so now i live with my dad and step mom. i plan to move out with a roomate in a few months
Doctor :   this may prove to be beneficial for your depression and sleeping difficulty

Doctor :   apart from tylenol pm what other measures did the sleep clinic people advised?
User :   um, sleeping same time every night i think and tylenol thats it
User :   i forgot
Doctor :   ok
Doctor :  
apart from the sleeping same time every night you can try this also
Doctor :   maintain a time gap of 20 to30 minutes from the dinner to the bed time
User :   so eat dinner then sleep a half hour later?
Doctor :   yeah
Doctor :  
also consumption of a glass of milk 10 minutes before bed time
Doctor :   about the sleeping environment
Doctor :   it should be calm, dull light on no light and sound free
User :   ok ,i'm lactose. should i drink chocolate milk
User :   ?
Doctor :   yes that can be an alternate option
Doctor :   avoid tv and reading books while on bed
User :   ok.i like to read a lot but i will not read. i think i am afraid to sleep also. like i will be attacked or something in sleep or wake up still impaired
Doctor :  
also a short prayer before bed time will help you lot in relieving you of all the worries
Doctor :   so that the mind is prepared for sleep free from the worries
User :   my parents tell me that too, to trust in god and fear nothing
Doctor :   yes they are right

User :   i feel there is so much on my mind though, i don't want to sabotage and go to sleep and stress in m sleep so i will do what you say
Doctor :  
i dont see any much problem in you what is needed is a mild adjustment in your sleeping habit
Doctor :  
i think with in a week or so you will be able to achieve the good sleep what you are looking for
User :   why is the cognitive part and headache so bad though, my speech is affected. is it because speech isn't rested so it doesn't work?
Doctor :  
it is the fatigue of the brain because of no rest in the form of sleep
Doctor :  
once you achieve proper sleep and rest the brain all this symptoms will disappear by itself
User :   Do you have a number or doctors you can refer me too. ? i know it's almost time for the chat to stop. so thank you for everything
Doctor :   i suggest you not to change the doctors frequently. and in the matter of the depression it is strongly advised to stick to the basic psychiatrist whom you consulted in the beginning
User :  
User :   oh ok
User :   well do you have a phone #
Doctor :   this is because he will be knowing the present status as he is following you from long time and your symptoms can be controlled very quickly by him only

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