Monday, March 03, 2008
I have some days when my depression gets worse, and all I do is want to sleep because I feel so exhausted. My mother tells me I should sleep. What do you think?
There’s a difference between temporary sleepiness brought on by sleep deprivation and the excessive need to sleep that characterizes some forms of depression. No amount of extra sleep actually relieves depression-related fatigue.
Some people feel better if they actually restrict sleep to an amount that would have been normal prior to theirdepression — for example, by setting and adhering to strict times for going to bed and waking up. However, it’s often difficult for depressed people to implement such a schedule. Getting up and moving about, with exposure to morning sunlight and light aerobic exercise — such as a brisk walk out of doors — can help if the depression is not too severe.
Many psychiatrists think that some antidepressants (such as bupropion/Wellbutrin, fluoxetine/Prozac, and the monoamine oxidase inhibitors) are thought to be more helpful for people with excessive sleepiness than others, although this is not a proven fact. Likewise, the alerting medication modafinil (Provigil) — which is approved for treatment of excessive sleepiness associated with narcolepsy and sleep apnea — can be helpful for excessive daytime fatigue that persists despite antidepressant therapy. However, this use for modafinil has not received approval from the Food and Drug Administration and, if not covered by insurance, it is a relatively expensive medication.