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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 52. This is the beginning of the thread.
Posted by linkadge on September 1, 2006, at 6:51:10
When I wake up, I feel a horrable dark cloud over me. Its the worst feeling ever, eps to start the day.
Anyhow, I was reading that sleep deprivation seems to work best for people who are most depressed in the morning, and who get better as the day goes on.
Which medication treatments are better for this type of depression, anyone?
Linkadge
Posted by SLS on September 1, 2006, at 7:27:08
In reply to Most depressed in morning, posted by linkadge on September 1, 2006, at 6:51:10
> When I wake up, I feel a horrable dark cloud over me. Its the worst feeling ever, eps to start the day.
>
> Anyhow, I was reading that sleep deprivation seems to work best for people who are most depressed in the morning, and who get better as the day goes on.
>
> Which medication treatments are better for this type of depression, anyone?
Generally, TCA.
- Scott
Posted by Crazy Horse on September 1, 2006, at 10:11:16
In reply to Most depressed in morning, posted by linkadge on September 1, 2006, at 6:51:10
> When I wake up, I feel a horrable dark cloud over me. Its the worst feeling ever, eps to start the day.
>
> Anyhow, I was reading that sleep deprivation seems to work best for people who are most depressed in the morning, and who get better as the day goes on.
>
> Which medication treatments are better for this type of depression, anyone?
>
> LinkadgeWhen i am experiencing a depressive episode, mornings are HELL for me too. I think sleep deprevation works for early morning depression. And i have read stimulants (upon wakening) are the best meds for early morning depression.
-Monte
Posted by Phillipa on September 1, 2006, at 11:07:43
In reply to Re: Most depressed in morning, posted by Crazy Horse on September 1, 2006, at 10:11:16
Same here but my pdoc said all depression is worst in the morning and gets better as the day goes on. I didn't know specific meds were better. How come the docs don't know? Silly question. Love Phillipa
Posted by linkadge on September 1, 2006, at 11:21:50
In reply to Re: Most depressed in morning, posted by Phillipa on September 1, 2006, at 11:07:43
I don't always think that is the case. My friend who was depressed and responded to celexa said that he was fine in the morning, but anxiety and depression got worse as day progressed.
Linkadge
Posted by Crazy Horse on September 1, 2006, at 11:51:05
In reply to Re: Most depressed in morning, posted by linkadge on September 1, 2006, at 11:21:50
> I don't always think that is the case. My friend who was depressed and responded to celexa said that he was fine in the morning, but anxiety and depression got worse as day progressed.
>
>
> Linkadgeyea, i don't think stimulants should be the first line meds tried. Only if it's so severe you can't get out of bed. For milder cases perhaps Provigal may help some people. For me high dose Lyrica 300 mgs b.i.d. does the trick.
-Monte
Posted by willyee on September 1, 2006, at 12:33:23
In reply to Most depressed in morning, posted by linkadge on September 1, 2006, at 6:51:10
> When I wake up, I feel a horrable dark cloud over me. Its the worst feeling ever, eps to start the day.
>
> Anyhow, I was reading that sleep deprivation seems to work best for people who are most depressed in the morning, and who get better as the day goes on.
>
> Which medication treatments are better for this type of depression, anyone?
>
> LinkadgeMy cocktail actualy works its best in the EARLY AM,i too reliead once on sleep deprivation,but it was too much of a second wind maniac type lift.
Now i look forward to my morning cocktail cause the early AM is when i get most of my stuff done,then i feel myself sink around 11-12 and lift again around 7 pm.
What also helped is a routine,the worst i found was to attempt to stay asleep,instead create a rountine,put the tv on,u dont have to watch it,but get accustomed to hearing a same show every morning,as if it becomes ur morning sidekick u can rely on.Something u once actualy watched.I also am leaving out a critical part,im speaking of the 6am time range,if i wake around 10 or 11 it stinks,the 6-7 time range is best for me.
At first its hard,but if u arrange ur routine and get some stuff done,feel productive it helps.
I of course cant speak for everyone i know when i first began sleeping and waking up at 6am oppposed to my all night binges and waking at 11 12 it was hard,i found myself lost with nothing to do,but time seems to move quite fast at this period.
Looking back,i definatly prefer getting to sleep around 11 and waking at 6 over the old pattern of riding out the night to feel that morning stimulation only to crash and wake later in the day and repeat.The night is quite lonly.
Posted by Meri-Tuuli on September 1, 2006, at 13:29:30
In reply to Re: Most depressed in morning, posted by linkadge on September 1, 2006, at 11:21:50
I'm also a 'morning person' -- I'm way better in the mornings with depression and anxiety, the evenings are by far the worst for me.
Do you think these variations are anything are significant? Or do they mean anything?
I read somewhere that there was a parellel in relation to these daily variations with atypical and melancholic depressions, but I forget which way was which.
Posted by SLS on September 1, 2006, at 13:36:29
In reply to Re: Most depressed in morning » linkadge, posted by Meri-Tuuli on September 1, 2006, at 13:29:30
> I'm also a 'morning person' -- I'm way better in the mornings with depression and anxiety, the evenings are by far the worst for me.
>
> Do you think these variations are anything are significant? Or do they mean anything?
>
> I read somewhere that there was a parellel in relation to these daily variations with atypical and melancholic depressions, but I forget which way was which.
According to some researchers:Mornings = Worst = Melancholic = TCA
Mornings = Best = Atypical = MAOI
- Scott
Posted by rjlockhart on September 1, 2006, at 14:33:54
In reply to Re: Most depressed in morning, posted by Crazy Horse on September 1, 2006, at 10:11:16
I have had bad sleep deprivation and the next days i was so alert i was almost psychotic. Mean, irrtible, but i was not depressed i was just very alert, which is very very ironic since this is sleep deprivation, my eyes would look red, but i had sort of almost a euphoria, stimulation.
Now, alot of times i wake up at 5:30 in the mornings, i am in a GOOD mood, i even want to just get up, but if i wake up like at 11:30am in the morning on my days off i feel HOrrible, for atleast an hour. I just feel like staying asleep now i slap my slelf, get out of the bed or your going to feel like crap.
Extra sleeping i heard actaully causes decreased dopamine, which decreases the pleasure of life, i mean you feel like sh*t.
Anyways thats my put. Im not saying, yea go stay up 2 nights, no, but try to stay up, and get like 5 hours of sleep. Try it. But not extreme.
Matt
Posted by linkadge on September 1, 2006, at 16:39:10
In reply to Re: Most depressed in morning, posted by rjlockhart on September 1, 2006, at 14:33:54
Its a horrable feeling, worse than death itself, very hard to describe.
It does slowly go away as the day goes on.
I could try a different TCA. The ones I tried, clomipramine, and doxapin helped, but seemed like part of my brain was always awake at night.
Linkadge
Posted by Phillipa on September 1, 2006, at 20:59:00
In reply to Re: Most depressed in morning » linkadge, posted by willyee on September 1, 2006, at 12:33:23
Willyee boy we're opposites I hate the early morning and always have. If I sleep til 10am I feel much better. I worked too many years 3-ll And loved being able to sleep longer in the am. I have always feared not being able to sleep as my Mother who was sick used to sit in the bathtub (skin condition) all night and sleep all day. I enjoy staying up late. Love Phillipa
Posted by Phillipa on September 1, 2006, at 21:03:52
In reply to Re: Most depressed in morning, posted by linkadge on September 1, 2006, at 16:39:10
Link sounds like we're the same. Scott so EMSAm is out for me? I guess I better see what link comes up with. Wanna be med buddies? Love Phillipa ps no wt gain though. Oh pamelar left me plastered to the bed till 2pm at l0mg.
Posted by UgottaHaveHOPE on September 2, 2006, at 3:04:31
In reply to Re: Most depressed in morning » linkadge, posted by Phillipa on September 1, 2006, at 21:03:52
I would think the majority of people challenged by depression feel it more in the morning than any other time of the day.
Why? Well, for starters, if you haven't had a good night's sleep, then you automatically feel lousy and then you feel depressed because you might feel that way the rest of the day.
At the start of the day, so many things are unknown about the rest of the day, such as how you are going to fill all that time before you can escape back to the bed again (speaking from mine own personal experiences). It's a daunting thought.
At the start of the day, it's hard to get going, get moving.
My heart goes out to you.
Posted by cecilia on September 2, 2006, at 5:41:15
In reply to Majority feel more depressed in the morning, posted by UgottaHaveHOPE on September 2, 2006, at 3:04:31
I agree, I think most depressed people feel worse in the morning. I've always hated mornings. It takes me at least 2 hours to be semi-functional no matter what time I get up. And I definitely fit the criteria for "atypical" depression, which I've read is actually by far the most typical type of depression. Cecilia
Posted by SLS on September 2, 2006, at 6:01:58
In reply to Majority feel more depressed in the morning, posted by UgottaHaveHOPE on September 2, 2006, at 3:04:31
> I would think the majority of people challenged by depression feel it more in the morning than any other time of the day.
>
> Why? Well, for starters, if you haven't had a good night's sleep, then you automatically feel lousy and then you feel depressed because you might feel that way the rest of the day.
>
> At the start of the day, so many things are unknown about the rest of the day, such as how you are going to fill all that time before you can escape back to the bed again (speaking from mine own personal experiences). It's a daunting thought.
>
> At the start of the day, it's hard to get going, get moving.
The worsening that occurs with endogenous, melancholic, or "typical" depression is crushing and paralyzing, and is not simply a lack of energy and motivation or a difficulty in starting the day. It really is different from an atypical presentation.
- Scott
Posted by polarbear206 on September 2, 2006, at 9:24:24
In reply to Most depressed in morning, posted by linkadge on September 1, 2006, at 6:51:10
Early morning depression that lifts as the day goes on is one of the markers for diagnosis of bipolar spectrum disorder. In my case, a mood stabilizer in addition to AD helped tremendously. Dx of soft bipolar and on effexor and lamictal.
Posted by valene on September 2, 2006, at 9:46:50
In reply to Most depressed in morning, posted by linkadge on September 1, 2006, at 6:51:10
Linkadge, I always am worse in the mornings. It is quite common. I have a feeling of gloom and doom and start ruminating on everything bad in my life before I get out of bed. Why?
One reason for this is that our cortisol, and related neurochemistry, are activated when we wake up. It's part of the system that actually wakes us up in fact. I don't know the solution to it. I was blaming the benzo withdrawal at first but I think it is very common for many, many people with anxiety/depression. It's the cortisol I believe.
Val
> When I wake up, I feel a horrable dark cloud over me. Its the worst feeling ever, eps to start the day.
>
> Anyhow, I was reading that sleep deprivation seems to work best for people who are most depressed in the morning, and who get better as the day goes on.
>
> Which medication treatments are better for this type of depression, anyone?
>
> Linkadge
Posted by SLS on September 2, 2006, at 10:34:04
In reply to Re: Most depressed in morning, posted by polarbear206 on September 2, 2006, at 9:24:24
> Early morning depression that lifts as the day goes on is one of the markers for diagnosis of bipolar spectrum disorder.
That's interesting. I've never heard that.
My diurnal pattern is kind of weird. My best time is in the morning. My worst time is in the middle of the afternoon - around 2:00 PM. I then recover somewhat in the evening. Presumably, I have bipolar disorder. I suffer chronic depression with drug-induced manic episodes.
With endogenous/melancholic depression, there is usually early morning awakenings and insomnia along with the morning worsenings.
- Scott
Posted by TENMAN on September 2, 2006, at 11:28:23
In reply to Most depressed in morning, posted by linkadge on September 1, 2006, at 6:51:10
I am at my best first thing in the morning. My mood will then progressively darken throughout the day until the evening when my depressions sometimes take over me. Sometimes in the morning I can feel almost normal before regressing again. Strange.
Posted by Maximus on September 2, 2006, at 12:05:16
In reply to Re: Most depressed in morning, posted by linkadge on September 1, 2006, at 16:39:10
Excercice!! Excercice!! And alternative treatments such as cucumber oil and salted water. Excercice!! Excercice!! BUT do not take any chemical drugs!! You could mutate into a xenomorph!!
Posted by linkadge on September 2, 2006, at 14:59:58
In reply to Re: Majority feel more depressed in the morning, posted by cecilia on September 2, 2006, at 5:41:15
Atypical, thats oversleeping and overeating? Thats not me at all.
Linkadge
Posted by Bob on September 2, 2006, at 15:10:12
In reply to Most depressed in morning, posted by linkadge on September 1, 2006, at 6:51:10
My depression is much, much worse in the morning. I have never been an early riser, and am quite envious of all those around me who pop up at 6am or so and get out of bed like they had just been laying down for a few minutes. All the meds I have taken over the years to stem the anxious, ruminative, and emotionally unstable parts of my illness have ALWAYS eventually led to much deeper sleep in the mornings. A number of meds have resulted in me sleeping well into the afternoon, such as Effexor, and Paxil. It's almost as if the biological changes that must occur to get someone awake no longer work when I take significant amounts of serotonin. It gets so bad that that issue itself becomes very depressing.
The only treatment I've ever had that changed this sleep/wake cycle was ECT. I began popping awake, to the point where I was no longer sleeping very soundly. Unfortunately, other negative effects of ECT became profoundly dangerous, and in the end was not a good treatment for me.
Posted by linkadge on September 2, 2006, at 15:11:16
In reply to Re: Majority feel more depressed in the morning, posted by SLS on September 2, 2006, at 6:01:58
For several weeks, I have been completely free from work, school, or any major responsability. When I wake up, I am not filled with anxiety at all, but rather I feel like I am dying, or perhaps already dead. Its a strange sadness that is hard to explain, feelings of life and how beautiful and precious it is, but that I just can't have it. Feelings like life is passing me by. Everything seems meaningless.
Perhaps its common, I don't know, but the emotions are impossalbe to process. Very strong, but impossable to process.
Sorry for rambling.
Linkadge
Posted by linkadge on September 2, 2006, at 15:12:24
In reply to Re: Most depressed in morning, posted by polarbear206 on September 2, 2006, at 9:24:24
>Early morning depression that lifts as the day >goes on is one of the markers for diagnosis of >bipolar spectrum disorder. In my case, a mood >stabilizer in addition to AD helped >tremendously. Dx of soft bipolar and on effexor >and lamictal.
I'd never heard that, do you have any literature about that theory? Not to sound like a nerd, I'd just like to hear more.
Linkadge
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