Do You Suffer from Depression or Delayed Sleep Phase Syndrome?

- exhaustion upon waking and difficulty falling asleep

- disrupted sleep, often due to vivid, graphic dreams

- difficulty concentrating

- decreased energy

- decreased pleasure

- anxiety and irritability

Oddly, these signs, recognized by laypeople and clinicians alike, are the same for depression and Delayed Sleep Phase Syndrome. This close relationship between the two often leads to confusing misdiagnosis and further complications due to ineffective treatment. Complications from DSPS may lead to depression, just as complications from depression may lead to DSPS. In fact, 90% of people diagnosed with clinical depression are also diagnosed with a sleep disorder. So how do you recognize if you have DSPS, depression, or both? If you do have both, then which is which?

DSPS is a disruption in circadian rhythms which regulate the body's biological clock and sleep-wake patterns. The disruption caused by DSPS is described as being "out-of phase" of sleep patterns. The "delay" part comes into play when a person's sleep onset time is late at night, usually around 3 a.m. or so. Naturally following these out-of-phase patterns (going to sleep late at night and getting a full 8-10 hours sleep), an individual with DSPS will keep the symptoms at bay, but attempting to follow a 9-5 work schedule interferes with the daily schedule. Imposing an earlier sleep time on an individual with DSPD, for example going to bed at 10 p.m expecting to sleep to 6 a.m. versus sleeping from 3 a.m. to 1 p.m, will lead to sleep onset insomnia, inability to sleep before the body's specified time, or restless non-REM sleep. Attempting to adhere to a schedule different from the body's rhythms puts stress on the body and not being able to sleep and wake at desired times subsequently leads to anxiety. This stress and anxiety, in turn, may cause fatigue, daytime sleepiness, irregular eating habits, and even full-blown depression.

In the advent of the pill age, it is highly likely that a doctor will write a prescription for an anti-depressant after only an initial evaluation. Clinicians often recognize improved sleep in psychiatric patients as recovery right around the corner. On the other hand, patients may improve mentally and still be suffering from a sleep disorder that might not have even been diagnosed. Needless to say, diagnosing depression and sleep disorders are tricky business and you should not trust your well-being to doctor who acts only as a pill-dispenser. If your physician thinks that your symptoms are severe enough to immediately begin a regimen of anti-depressants, he should also immediately refer you to a counselor. It is a good idea for anyone experiencing sleep problems to receive treatment for those symptoms, but if you are seeing a physician and/or counselor, continue working with them as well as seeking help for a possible sleep disorder.

The exact causes for DSPS are unknown and treatment options do not have high success rates, since they are aimed at re-phasing circadian rhythms. To completely cease the effects of DSPS, one must follow the body's natural sleep-wake phases, however a vaiety of treatment exists that is safe. Bright light therapy, chronotherapy, B12 vitamin supplements, and practicing good sleep hygiene (avoiding caffeine, alcohol, and cigarettes as well as exercising at proper times and using stress-reduction techniques) are safe options that can be tried. Melatonin is a hormone produced by the pineal gland as the body prepares to sleep. Melatonin treatment is controversial because of the lack of precise knowledge of the function of the pineal gland. Sleeping pills are often prescribed but have little effect on DSPS and are never recommended for long-term use.

Educate yourself on your condition(s) and if you suspect you may have a sleep disorder, contact your doctor or schedule an appointment with a specialist or one of the many sleep centers around the U.S. like Sleepmed or Sleepquest.

Note:

This article is not meant for substitute, but rather supplement for medical advice.

Sources:

Signs of Depression. www.clinical-depression.co.uk/Depression_Information/signs.htm

Sleep Disorders. www.sleepdisorderchannel.com