Patricia: My doctor has diagnosed me with depression and a sleep disorder. What I can't stop wandering is what came first? Am I depressed because I am not sleeping well or am I not sleeping well because I am depressed? Can anti-depressants help me sleep better?
The Sleep Experts Answers: "This is a good question and a difficult one to answer. Its very common to have a dual diagnosis of sleep disorder and depression. It's also very common to have a dual diagnosis of addiction and sleep disorder (but that's for another blog).
To answer your first question - what came first? Not sleeping well is pretty depressing. It can start with a few nights of broken sleep. You aren't sleeping well so you try going to bed a bit later, thinking that this might help you fall asleep faster, and stay asleep longer. You end up watching far too much late night TV or downloading one too many Youtube clips. Suddenly you find yourself routinely getting far less than the desired amount of sleep. Your brain takes strain. It's not getting a chance to reload and your dopamine levels start to diminish. You gradually have less energy, less desire to do anything and find yourself depressed.
Depression makes good sleep even more difficult to find as it changes your eating patterns too. You will probably start eating foods that improve your energy and mood in the short-term - things like coffee, chocolate, cake and take-aways. This will only lead to more difficulty making dopamine as you aren't getting enough fresh foods packed with nutrients.
And that's not to mention the change in your activity patterns. The less you exercise, get outside and socialise, the less you will feel like exercising, getting out and socialising.
And your second question - can anti-depressants help me sleep better? Yes. The research is clear - if you have a sleep disorder it is necessary to treat both the mood and sleep components. Well done on visiting your doctor and getting some help. Often the first step is the most difficult. Most anti-depressants stimulate seretonin and/or norepinephrine which help in the production of dopamine. This means you will sleep better if you were struggling to fall asleep due to anxiety or irritability. It will also mean that you find it easier to do things during the day (like cook, exercise and work) which also improve both the quality of your sleep and how you feel about your life. The type of sleep disorder you have will determine if you need any other drugs such as antihistamines for allergic rhinitis or sleeping tablets for insomnia. Usually this is a short-term course to break the cycle and get you back on track".