[ezgeez]

Hi Dozydame,

Yes the situation with “Sleep Restriction Therapy” is very interesting. It was not helpful for me, and in fact my GP–who has generally been very considerate–told me she found a study in the British Medical Journal which did not support it at all. This has put me in a debacle since, after a wait of many months, I am two weeks away from receiving treatment in the NHS CBT-I (cognitive behaviour therapy for insomnia) group, a main component of which, as I have been told, is indeed Sleep Restriction Therapy. I thus have to choose between my gut instinct, which tells me to stop heaping attention and pressure on the sleep, and a gruelling treatment which experts in the NHS insomnia clinic say is the “standard” for chronic insomnia.

I quickly looked up “Sleep Deprivation Therapy” online–when you were administered it I am sure it was analogous to Sleep Restriction Therapy but it looks like these days the term refers to a treatment for depression. I find this hard to fathom since going without sleep makes me quite depressed!

I had never heard about “Sleep Tracks” before, it sounds very interesting. I have never found relaxation music helpful–I am a musician myself and am easily put off by cheesy synth compositions!

[jayinsf]

Helen, I also recently was put on Citalopram (Celexa); it's been two months now at 10mg and so far I've noticed no difference. I'm going to talk to my doctor about doubling the dosage and see what happens. I also have grappled for years over the link between depression and insomnia; there have definitely been times when I wake up continuing to feel as or more tired than the day before and I definitely feel more depressed as result. I have still not figured out if my problem is actua insomnia or some other underlying thing that is causing me to feel fatigued all the time, regardless of the amount of sleep I have had; or whether such fatigue maybe results from depression? It is all jumbled together. I've dtried cognitive behavioral therapy but as I said my fatigue seems to stay whether or not I've been managing to sleep well. So we'll see if the Citalopram helps. But I've also read that most of the effect of anti-depressants is due to the placebo effect (60 Minutes had a story on this a few weeks ago)… So who knows?

[Nicole]

very interesting topic! I have suffered from mild depression since childhood. Once I gave birth to my daughter 6 years ago, I suffered from post-partum depression and since then my depression went from mild to major. My insomnia started when I had my daughter and I struggle with it still, but find that if I am on my anti-depressant and trazadone I do well. I just pray that the trazadone does not poop out in the future! As to which causes which: when I have depression my sleep goes as does my appetite. When I have insomnia my depression gets worse because of the lack of sleep and my worrying over the insomnia. So it becomes a vicious cycle. When insomnia comes back, I start to panic because I remember how awful the previous episodes were and of course the panic doesn't help matters. I guess I have to address the panic I get over the insomnia. Such a horrible thing both insomnia and depression are. Good luck everyone.

[Robskie]

I think there a two types of depression/insomnia associations. Firstly there are those who suffer from depression (or stress) which then causes the insomnia, and then there are others who experience insomnia which then causes the depression.

I'm in the latter group. When I'm able to sleep well I'm a very happy well adjusted bunny. However, when I have a bad night's sleep I immediately feel really down, and if the bad sleep continues my mood will become worse and worse, but when I get the good sleep again I bounce right back.

That's why I get very annoyed at the doctors who immediately assume that because you have insomnia it must be because you are depressed, and only want to addresse the depression. Yes you're depressed, but it's because you can't sleep. You just have to work out what comes first – the insomnia or the depression.

[Tommy ToXen]

Well I've always pondered the question, is my depression caused by my insomnia, or my insomnia caused by the depression?

I'm on Citalopram at the moment, and symptoms of depression are waiving, but my insomnia has come back with a vengeance. Which is OK actually at the moment, as I stay up all night developing.

So I'm starting to come to the conclusion that insomnia was not caused by depression.

Whether it's the other way around, I don't think I'll find that answer out. If I do need to really sleep, my doctor prescribed me with diazapam.

[roozie]

The two are linked without a doubt and i think it's always going to be a circular pattern. It's a fact that prolonged insomnia depletes serotonin levels and depleted serotonin levels contribute to insomnia. I too have found GPs v ready to prescribe anti-d's as a first line treatment when i tell them my insomnia is bad, which, for years, i have gone along with becasuse my insomnia does ease up on SSRI's like citalopram ( after several weeks of even worse side effect insomnia hell of course!) I guess if anti-d's break the chemical cycle by boosting serotonin etc then they are a valuable tool although by no means a complete solution as we all know. I think gp's/the NHS could make other non-drug treatments, that address how to manage and live with insomnia, more accessible. I, like many others i'm sure, have had to spend a fortune on seeking help privately, with managing the impact insomnia has on my day to day life. To date the mose effective treatment that i think is slowly helping, has been a therapy called ACT (acceptance and committment therapy) which i think a few of you have referred to in other posts. For me, it works where other approaches like CBT fall down, because it doesn't encouarage you to devote time and energy to the problem, by indulging and challenging the insomnia – one good analogy it uses is of tug of war ie. the more you pull against insomnia the stronger it pulls/fights back,. Instead it encourages you to”gently” acknowledge and “welcome in” all the negative insomnia thoughts and emotions that are experienced every day in order to lessen their improtance and make them less scary. It also helps you to sit with insomnia at night without freaking out, using mindfulness techniques, which i do think can help.

Sorry, lots of blurb but if anyone is interested i can let you know more details. I attended a one day workshop about ACT run by a really nice guy (called Guy!) and have had a couple of one to one follow up's with him since then. He does skype calls so you don't have to trek to London each time for appt's. not cheap tho')

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