![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by mtom on May 9, 2019, at 19:30:53
I often need to take late afternoon naps due to fatigue. I have depression, anxiety and Lupus (autoimmune condition) and sometimes don't sleep well at night, although have afternoon fatigue whether or not I've had a decent sleep. Take Cipralex, very low dose (fatigue was worse with higher doses). Also sometimes Benzodiazepines for anxiety, but fatigue has no correlation to whether or not, and/or how much I've taken of these.
Upon waking from these naps, I always have a significant depression dip which lasts a couple of hours. But I can't get through the day without them.
Anyone else experience this? What could be the cause?
Posted by Christ_empowered on May 9, 2019, at 20:24:46
In reply to Why depression much worse after naps, anyone else?, posted by mtom on May 9, 2019, at 19:30:53
do you have a history of trauma? a former psych doc told me that benzodiazepines can sometimes make PTSD-ish things worse...oddly enough, I think she said it was low dose, high-potency ones that were the worst offenders, especially if dissociative stuff is on board.
other than that...??? sleep has such a profound effect on all of us, but i think how it plays out depends on the person. if i hit my 'sweet spot,' everything's great...
too much i feel lethargic, too little i get chipper and anxious, at the same time. blah.
sorry about the fatigue. has anyone offered modafanil, perhaps some kind of long acting Ritalin or Focalin?
Posted by rjlockhart37 on May 9, 2019, at 22:15:26
In reply to Why depression much worse after naps, anyone else?, posted by mtom on May 9, 2019, at 19:30:53
oh yes, went to sleep for a nap i would wake up in a depression where you feel lifeless, like you go to sleep and still feel down, and no energy. I would drink energy drinks or coffee after nap. But prozac has stopped that from happening when it was increased to 80mg
i have a long history of depression i never tell much anyone about but this site. I'm on way to being a better person. But when i layed down, and woke up it's like....you want to go back to sleep, but you don't want too...and you stay in this depressed state. Depression makes you want to sleep then you wake up and you don't feel any better
i think drinking coffee maybe after a nap could help, but i know what it feels like
Posted by Lamdage22 on May 9, 2019, at 22:19:35
In reply to Re: Why depression much worse after naps, anyone else?, posted by rjlockhart37 on May 9, 2019, at 22:15:26
I always feel more upbeat if I didn't sleep for so long. I guess for some of us, depression means sleeping too much. Antidepressant response correlates with less sleep needed.
Posted by Lamdage22 on May 9, 2019, at 22:31:12
In reply to Re: Why depression much worse after naps, anyone else?, posted by Lamdage22 on May 9, 2019, at 22:19:35
At least in my case. Waking up earlyish ready to take on the day is usually a really good sign for me.
Posted by beckett2 on May 10, 2019, at 15:32:34
In reply to Why depression much worse after naps, anyone else?, posted by mtom on May 9, 2019, at 19:30:53
> I often need to take late afternoon naps due to fatigue. I have depression, anxiety and Lupus (autoimmune condition) and sometimes don't sleep well at night, although have afternoon fatigue whether or not I've had a decent sleep. Take Cipralex, very low dose (fatigue was worse with higher doses). Also sometimes Benzodiazepines for anxiety, but fatigue has no correlation to whether or not, and/or how much I've taken of these.
>
> Upon waking from these naps, I always have a significant depression dip which lasts a couple of hours. But I can't get through the day without them.
>
> Anyone else experience this? What could be the cause?I'm curious how you describe your naps. When I nap in the afternoon, I am hard to rouse and can sleep for a few hours. Are your naps like that? I can experience sleep paralysis as well. When I wake, I'm very down for some time. Then, a few hours later, I'm much better. I rarely nap now because it's unpleasant.
What is your daytime sleep like? Do you dream?
Posted by mtom on May 10, 2019, at 16:00:18
In reply to Re: Why depression much worse after naps, anyone else? » mtom, posted by beckett2 on May 10, 2019, at 15:32:34
I'd like to avoid napping because it is unpleasant to wake up feeling more depressed, but I get too fatigued. May be the Lupus (fatigue common), the medications (I get side effects & fatigue's been worse since I've been on AD's), the depression and anxiety that I'm dealing with themselves, or a combination.
Usually I don't just fall asleep easily, I often start listening to a podcast when I lie down then doze off, sometimes on and off, sometimes I wake at the end of the podcast, sometimes I sleep beyond it. So naps are from 45 minutes to perhaps 1 1/2 hours. I wake from naps feeling groggy. I don't get sleep paralysis that I remember. I may sometimes dream when napping through day, although I more often dream, sometimes vividly, at night - but that started only after I started taking AD's, and is less intense on my lowered dose.
Yes, I'm often very down for varying amounts of time after waking from a nap, then it gets better sometime later, maybe 1 to 2 hours.When I wake in the morning, anxiety is more of an issue.
>
> I'm curious how you describe your naps. When I nap in the afternoon, I am hard to rouse and can sleep for a few hours. Are your naps like that? I can experience sleep paralysis as well. When I wake, I'm very down for some time. Then, a few hours later, I'm much better. I rarely nap now because it's unpleasant.
>
> What is your daytime sleep like? Do you dream?
>
Posted by Radish on May 10, 2019, at 20:11:13
In reply to Why depression much worse after naps, anyone else?, posted by mtom on May 9, 2019, at 19:30:53
I feel worse after a nap, partly because once I start napping I cannot wake up for many hours. So Ill often wake up from my nap around dinner time and remain so tired from it still that I cant really do anything and so go back to sleep for good, and then Ive slept like 15 hours total. In general the more depressed I am, the worse hypersomnia I have, so naps usually correlate with my feeling worse generally.
Posted by rjlockhart37 on May 11, 2019, at 0:37:40
In reply to Re: Why depression much worse after naps, anyone else?, posted by Radish on May 10, 2019, at 20:11:13
that used to happen, drink coffee or maybe an red bull energy drink, that's what i did when i was hypersomnia....sleeping too much intself makes me more depressed, only if i had a hard day or being worn down
Posted by beckett2 on May 12, 2019, at 0:12:11
In reply to Re: Why depression much worse after naps, anyone else? » beckett2, posted by mtom on May 10, 2019, at 16:00:18
I don't know what it could be, but I don't think you're alone. You might look up napping practices and experiment, like having a caffeinated drink before napping, napping no more than 20-30 minutes. Daytime fatigue is a problem I've had most of my adult life to varying degrees. Right now I take a little adderall and that helps.
My anxiety and depression used to be bad in the mornings. I don't know what it's changed, but I imagine that's because my depression has improved. I don't know why that is, either.
Have you discussed the daytime fatigue with your physician?
All these symptoms can be difficult to tease apart when there is more than one illness. Autoimmune disease is poorly understood. At least that's my experience. Like with Hashimoto's, I've been told my thyroid replacement should treat most symptoms, but that certainly isn't the case.
May I ask, what is the treatment for Lupus?
> I'd like to avoid napping because it is unpleasant to wake up feeling more depressed, but I get too fatigued. May be the Lupus (fatigue common), the medications (I get side effects & fatigue's been worse since I've been on AD's), the depression and anxiety that I'm dealing with themselves, or a combination.
>
> Usually I don't just fall asleep easily, I often start listening to a podcast when I lie down then doze off, sometimes on and off, sometimes I wake at the end of the podcast, sometimes I sleep beyond it. So naps are from 45 minutes to perhaps 1 1/2 hours. I wake from naps feeling groggy. I don't get sleep paralysis that I remember. I may sometimes dream when napping through day, although I more often dream, sometimes vividly, at night - but that started only after I started taking AD's, and is less intense on my lowered dose.
> Yes, I'm often very down for varying amounts of time after waking from a nap, then it gets better sometime later, maybe 1 to 2 hours.
>
> When I wake in the morning, anxiety is more of an issue.
>
> >
> > I'm curious how you describe your naps. When I nap in the afternoon, I am hard to rouse and can sleep for a few hours. Are your naps like that? I can experience sleep paralysis as well. When I wake, I'm very down for some time. Then, a few hours later, I'm much better. I rarely nap now because it's unpleasant.
> >
> > What is your daytime sleep like? Do you dream?
> >
>
>
Posted by pedr on May 12, 2019, at 5:34:44
In reply to Why depression much worse after naps, anyone else?, posted by mtom on May 9, 2019, at 19:30:53
Yes! I get this heavily. Also my mood is often worse after just waking up. Similarly my mood is often better if I don't sleep at all. Sleep and depression are heavily related for me.
As to why it happens? Not any of my doctors I've ever had know, that's for sure. No idea.
Pete
Posted by Radish on May 12, 2019, at 6:32:02
In reply to Re: Why depression much worse after naps, anyone else? » mtom, posted by pedr on May 12, 2019, at 5:34:44
Also my depression, and so anxiety, is worse if I sleep over 7 to 8 hours. I havent experimented with less sleep.
Posted by mtom on May 12, 2019, at 7:58:47
In reply to Re: Why depression much worse after naps, anyone else?, posted by Radish on May 12, 2019, at 6:32:02
There must be a physiological reason when so many seem to experience this, e.g. neurotransmitters.
I seem to recall, maybe wrongly, that years ago Dr. Bob would sometimes comment.
I know Docs can't give medical advise over the Internet. However this isn't Medical advice, just an academic general explanation of why depression and/or anxiety is often worse upon waking.....
Posted by mtom on May 12, 2019, at 8:07:39
In reply to Re: Why depression much worse after naps, anyone else? » mtom, posted by beckett2 on May 12, 2019, at 0:12:11
You asked what I take for my Lupus. I take Hydroxychloroquine (Plaquenil) which is an antimalarial that reduces symptoms for many people and is the standard first line treatment for Lupus, and often used in Rheumatoid Arthritis too. If flares become severe, e.g. Lupus arthritis starts impairing day to to day functioning, or other organs are showing signs of damage, they add corticosteroids, short or long term as needed. I've never taken these. Sometimes take NSAIDS, but some Doctor seem to like to limit these due to side effects and possible interactions. Or will prescribe a Proton Pump Inhibitor to also take (adding 1 more med to the mix, especially when also taking meds for depression/anxiety - not something I want to do).
I think all these meds (and some common supplements) have interaction potential from what I've read - often based on the fact that many use the same liver enzymes (P450's) for metabolism (so compete), or in some cases inhibit them. I believe drug interactions are common.
> I don't know what it could be, but I don't think you're alone. You might look up napping practices and experiment, like having a caffeinated drink before napping, napping no more than 20-30 minutes. Daytime fatigue is a problem I've had most of my adult life to varying degrees. Right now I take a little adderall and that helps.
>
> My anxiety and depression used to be bad in the mornings. I don't know what it's changed, but I imagine that's because my depression has improved. I don't know why that is, either.
>
> Have you discussed the daytime fatigue with your physician?
>
> All these symptoms can be difficult to tease apart when there is more than one illness. Autoimmune disease is poorly understood. At least that's my experience. Like with Hashimoto's, I've been told my thyroid replacement should treat most symptoms, but that certainly isn't the case.
>
> May I ask, what is the treatment for Lupus?
Posted by mtom on May 12, 2019, at 8:26:14
In reply to Re: Why depression much worse after naps, anyone else? » beckett2, posted by mtom on May 12, 2019, at 8:07:39
Hi A few people have suggested caffeine. But I've always been caffeine sensitive all my life (even before mood issues), more than 1 cup cofee (or even 1 cup if strong) would give me jitteriness, and if drunk late in the day would cause insomnia. Tea not quite so much.
Since my anxiety has become worse, I've avoided caffeine - drink decaf coffee and tea. Avoiding caffeine and other stimulants is typically recommended in anxiety disorders.
Cold medications containing pseudoephedrine and similar have also always made me jittery and caused insomnia, even before feeling generally anxious. Have read this is not uncommon also.
Some of us are just more sensitive to things that increase "stimulating" neurotransmitters. This has been one of my problems with finding an antidepressant that works without increasing my anxiety.
Posted by Ruuudy on May 13, 2019, at 1:32:13
In reply to Re: Why depression much worse after naps, anyone else? » beckett2, posted by mtom on May 12, 2019, at 8:07:39
This is such an interesting topic - sleep hygiene & depression!
I have noticed for quite some time that if I wake up in the morning for a few minutes and then fall back asleep (which I might repeat a couple of times on particular mornings), I can sometimes have nightmares or wierd dreams during that extra sleep, and then feel really lousy & depressed upon waking back up.
One of the best things I can do to improve my mental health would be to change my terrible sleep patterns (as I type this @ 2:30am!)!
Take care!
Rudy
Posted by rjlockhart37 on May 14, 2019, at 20:32:31
In reply to Depression after waking then falling back asleep, posted by Ruuudy on May 13, 2019, at 1:32:13
i don't have any medical explantions for it, what i do know is i used to have it, after a nap i would have to drink energy drinks to get out of this, and even today, i take ginseng when i can't get out of a slump, being slow and cognitive decline.
All i can recommend is increase in antidepressant, you said you have anxiety, that may need ... buprioin is known to cause anxiety and skitzy feeling. It happed with me, others it works great and gives them energy. Effexor and other stimulating ADs .... that's all the advice i can give. Kinda genergic, there's so many scientific studies about fatigue and low energy. It's hard to single it out.
just keep posting on babble and write your progress or expereinces during the day
r
Posted by rjlockhart37 on May 14, 2019, at 20:34:47
In reply to Re: Depression after waking then falling back asleep, posted by rjlockhart37 on May 14, 2019, at 20:32:31
"bupropion" sorry misspelled, just listen to other posters, im kinda lacking medical research on explain condition
Posted by beckett2 on May 20, 2019, at 19:59:24
In reply to Re: Why depression much worse after naps, anyone else? » beckett2, posted by mtom on May 12, 2019, at 8:07:39
A friend took interferon for Hep C and the resulting depression was very difficult to tolerate. I was wondering if immunosuppression was used for Lupus. I hope your depression medication is able to deal with this side effect well enough.
Can you tolerate green tea? Some people who cannot handle caffeine well do alright with it.
When we were talking about sleep, I forgot the term 'sleep drunk'. That's how I felt often after napping.
> You asked what I take for my Lupus. I take Hydroxychloroquine (Plaquenil) which is an antimalarial that reduces symptoms for many people and is the standard first line treatment for Lupus, and often used in Rheumatoid Arthritis too. If flares become severe, e.g. Lupus arthritis starts impairing day to to day functioning, or other organs are showing signs of damage, they add corticosteroids, short or long term as needed. I've never taken these. Sometimes take NSAIDS, but some Doctor seem to like to limit these due to side effects and possible interactions. Or will prescribe a Proton Pump Inhibitor to also take (adding 1 more med to the mix, especially when also taking meds for depression/anxiety - not something I want to do).
>
> I think all these meds (and some common supplements) have interaction potential from what I've read - often based on the fact that many use the same liver enzymes (P450's) for metabolism (so compete), or in some cases inhibit them. I believe drug interactions are common.
>
> > I don't know what it could be, but I don't think you're alone. You might look up napping practices and experiment, like having a caffeinated drink before napping, napping no more than 20-30 minutes. Daytime fatigue is a problem I've had most of my adult life to varying degrees. Right now I take a little adderall and that helps.
> >
> > My anxiety and depression used to be bad in the mornings. I don't know what it's changed, but I imagine that's because my depression has improved. I don't know why that is, either.
> >
> > Have you discussed the daytime fatigue with your physician?
> >
> > All these symptoms can be difficult to tease apart when there is more than one illness. Autoimmune disease is poorly understood. At least that's my experience. Like with Hashimoto's, I've been told my thyroid replacement should treat most symptoms, but that certainly isn't the case.
> >
> > May I ask, what is the treatment for Lupus?
>
Posted by mtom on May 21, 2019, at 15:12:06
In reply to Re: Why depression much worse after naps, anyone else? » mtom, posted by beckett2 on May 20, 2019, at 19:59:24
Interferon is an Immune System Stimulant, ramps up your immune system to fight Hep C and sometimes for Cancer. I've heard it's hard to tolerate. Also, many people get depressed on it - it is one of the pieces of evidence that led to the "Inflammatory Theory" of depression - a ramped up immune system increases inflammation which is part of the immune response, and this inflammation may be getting to the brain. See other posts discussing inflammation, anti-inflammatories and depression.
Immunosuppression is used for more severe flare-ups of Lupus, especially if severe symptoms and/or organ damage is occurring. Often corticosteroids are used in this case, sometimes stronger drugs if the flare up is potentially life threatening e.g. anti-rejection drugs.
As mentioned I take Plaquenil for Lupus, an anti-malarial. They don't know exactly why and how it works, it's felt to somehow "modulate" the immune system in Lupus and Rheumatoid Arthritis, without actually suppressing it.
I drank Green Tea for years. Sort of went off it last year and now drink decaf coffee. Never felt the Green Tea helped with anything (I drank 2 to 3 cups most days).
> A friend took interferon for Hep C and the resulting depression was very difficult to tolerate. I was wondering if immunosuppression was used for Lupus. I hope your depression medication is able to deal with this side effect well enough.
>
> Can you tolerate green tea? Some people who cannot handle caffeine well do alright with it.
>
> When we were talking about sleep, I forgot the term 'sleep drunk'. That's how I felt often after napping.
>
> >
>
Posted by beckett2 on May 21, 2019, at 19:30:13
In reply to Immunosuppression Re:Why depression after naps.... » beckett2, posted by mtom on May 21, 2019, at 15:12:06
Oh, thank you for the explanation. I was given Valaciclovir for HHV-6 to treat chronic fatigue, and unfortunately I became suicidal. I don't know if it works as an immune stimulant or has other mechanisms. It was terrible.
Plaquenil was used for lupus since WWII? I didn't realize lupus has been recognized since then or before.
> Interferon is an Immune System Stimulant, ramps up your immune system to fight Hep C and sometimes for Cancer. I've heard it's hard to tolerate. Also, many people get depressed on it - it is one of the pieces of evidence that led to the "Inflammatory Theory" of depression - a ramped up immune system increases inflammation which is part of the immune response, and this inflammation may be getting to the brain. See other posts discussing inflammation, anti-inflammatories and depression.
>
> Immunosuppression is used for more severe flare-ups of Lupus, especially if severe symptoms and/or organ damage is occurring. Often corticosteroids are used in this case, sometimes stronger drugs if the flare up is potentially life threatening e.g. anti-rejection drugs.
>
> As mentioned I take Plaquenil for Lupus, an anti-malarial. They don't know exactly why and how it works, it's felt to somehow "modulate" the immune system in Lupus and Rheumatoid Arthritis, without actually suppressing it.
>
> I drank Green Tea for years. Sort of went off it last year and now drink decaf coffee. Never felt the Green Tea helped with anything (I drank 2 to 3 cups most days).
>
> > A friend took interferon for Hep C and the resulting depression was very difficult to tolerate. I was wondering if immunosuppression was used for Lupus. I hope your depression medication is able to deal with this side effect well enough.
> >
> > Can you tolerate green tea? Some people who cannot handle caffeine well do alright with it.
> >
> > When we were talking about sleep, I forgot the term 'sleep drunk'. That's how I felt often after napping.
> >
> > >
> >
>
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.