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Old 09-22-2004, 10:19 AM
ZIM ZIM is offline
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Default DEPRESSION/SLEEP?

8) Dr.Joe,I've suffered from depression for a very long time. At the age of 18, my only child had passed on.prior to her death last year, I've had a very serious sleep problem. I cannot sleep and welcome sleep at any time.other then day time.If I do sleep it is very minimal.and I am not tired during the day either.when I do feel tired I seem to get my second wind and can't sleep. I am on lexapro(30mg AM),kolonapin.05mg x3 a day, and for thee months on resteril 30mg PM.Still my sleep is not right.Alot of times I know I'm not either from lack of sleep.Two times had psychosis due to sleep depervation. with all this mediceine I don't understand why I cannot get to sleep.I also have mixed sleep apnea, the central apnea is more severe. I cannot lay dowm and take is this forced air and oxygen,if I am feeling that I won't be sleeping.So I shut my ventilator off.then eventually I do dose off. but I don't sleep but for 1-4 hours maybe 3-4 x's a week.Is there any help for a person that has depression that can't sleep? thanks for your support. I'm a 43 year old female. zim....zzz
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Old 09-24-2004, 01:29 PM
Dr. Joe Dr. Joe is offline
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Iím afraid I canít offer any insight regarding your sleep difficulties. Obviously, this situation requires close supervision and communication with your physician/psychiatrist. The depression, however, is one variable that can be addressed.

Sometimes, with sleep difficulties, thereís a tendency to become agitated, if not compulsive, about needing to get to sleep. This can lead to an intensification of anxiety that will work against you when it comes to relaxing and sleeping. Iíd like you to look at my Self-Coaching philosophy articles at this website, recognizing that depression, anxiety, etc., need to be fed by insecurity if theyíre going to go on disrupting your life. Your job is to find out where youíre feeding your depression/anxiety (i.e., worry, fear, agitation about not getting to sleep, etc.). Use the following metaphor to help you understand this valuable concept:

Imagine that every morning you go out on your deck and manage to spend a leisurely half hour relaxing and enjoying the paper. One morning you go out and notice a few pigeons milling about, pecking and minding their own business. Enjoying their company, you remember to bring out a handful of breadcrumbs the next morning to throw to the birds. Within a few days, you're inundated with hundreds of pigeons, leaving your once pristine deck world a shambles of feathers, droppings, and mayhem. You come to me and ask, "Dr. Joe, what am I to do?" I ask one question: "Are you still feeding the pigeons?" "Well, yes," you answer innocently. Incredulously, I respond, "Then STOP feeding the pigeons!" If you worry, fear, fret, or otherwise deplete yourself, you're feeding the pigeons of insecurity. And if you insist on feeding your insecurity, than the distasteful truth is that youíll wind up fueling your sleep difficulties.

So often Iím amazed at how creative anxiety/depression can be when it comes to symptoms (notice that I often include anxiety with depression, so often you see components of each in these types of struggles). First, anxiety and depression are opportunistic and will always exploit your weaknesses (fears, doubts, etc.) and, second, anxiety and depression can be viewed as a form of hypnosisóself-hypnosis. Think of it as suggestion or, auto-suggestion, where you implant an idea or notion in your mind (Iím not going to be able to get to sleep) and then, like a hypnotized subject, you allow this belief to rule you. Hereís an excerpt from The Power of Self-Coaching that I think youíll find illuminating:

If you're prone to overthinking and generating worry and anxiety in your life, then it's imperative for you to recognize the enormous power of the mind. When I was studying hypnosis in graduate school, I remember seeing a training film where a subject was induced into a deep state of hypnosis. While the subject was in this state, the hypnotist told him that he was going to burn his hand with a cigarette. The hypnotist touched the subject's hand with an ice cube. The subject winced, as if actually touched by a cigarette, but what was remarkable was that the spot where the ice cube touched formed a welt! What we tell ourselves and what we believe make all the difference. If you implant a bit of suggestion (self-hypnosis) in your mind and you believe it, you will live that suggestion.

Whenever you allow insecurity to ìsuggestî that you might not be able to get to sleep and then you begin to spin with these fears and doubts, well, then we can conclude that youíve been hypnotized once again. You definitely could benefit from some Self-Talk which can help you begin separating fact from fiction. Itís not that hard once you begin to see through insecurityís faÁade.

I do wish you well with this struggle.

Yours,
Dr. Joe
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