Back to basics: Sleep, sunshine, and things that make you happy

[kestrell]

Earlier this week I had a morning where I woke up and immediately realized that I felt *great*, as in Tony the Tiger ggggrrr-ATE!
I had the energy and focus to do all sorts of things I hadn't had the energy to do in weeks (to tell the truth, I was actually a little hyper, which can be a natural state for me).

So, I began trying to reason out what was the factor/factors which had resulted in this infusion of energy and focus.

Well,
1. sleping through the night was the big one.

I've been waking up at 4 a.m. most mornings. The Night before the Big Sleep I had finally taken one of Alexx's Gabapentin, because I had begun to feel seriously achy, including daily headaches or migraines. The week before I had begun to feel so rundown that I was concerned that my blood pressure might be dangerously low (the last time I felt that rundown was last summer, when a drug medication caused my blood pressure to drop drastically). However, using a talking blood pressure monitor informed me that my blood pressure was perfect, and only one point off from the numbers stated in the booklet as being ideal.

What had begun to worry me most wasn't feeling exhausted: it was that I was feeling less and less able to deal with the day. Except for a bout of menopause-related depression, I don't suffer from depression but that in itself indicated, to me, something with a physical cause (I know, you can't separate physical from mental causes of depression, but I was hoping I could figure out if it was a chicken or an egg problem).

It turns out that there is a strong link between sleep and depression, even for people who aren't normally depressed.
The Sleep Foundation
Depression and Sleep
https://www.sleepfoundation.org/articles/depression-and-sleep
(I'm hoping to find more resources on this subject, if anyone can provide some pointers.)
2. Things that make me happy
Another thing that had boosted my happy quota was that, for the past few days and evenings, I had been rereading a book that made me really happy. I mean, I love this book (for the curious, it is _Meddling Kids_ by Edgar Cantero, and you can find it as an ebook from Bookshare, but I encourage folks to listen to the audiobook, available on NLS, because the reader is *so amazing!*).

I don't know about you, but sometimes I forget to do things that make me happy. I have this Ravenclaw drive to learn new things, a Slytherin drive to not just accomplish but excel at things, and a Gryffindore need to help people and produce resources that benefit people.

During one period of my life, when ai was killing myself trying to make other people happy, I went without eating dessert for a run of years. Let me state this explicitly: EVERYBODY DESERVES DESSERT!

So, that book made me happy. Reading and writing fan fiction makes me happy. Listening to my favorite music, as opposed to just listening to whatever is one the radio station, makes me happy.

Have you done something that makes you *really* happy this week? Not just mildly enjoyable, but really happy, where it leaves you feeling energized for hours afterward? And don't wait until a special occasion to treat yourself well: eVERY DAY IS SPECIAL ENOUGH TO WEAR THE GOOD BRA! (Women, you know what I'm talking about, right?)

3. Sunshine
Connected to the feeling exhausted and feeling I have to be productive, I've been forgetting to go out and just absorb some sunshine this summer.

VITAMIN D IS THE BEST FREE THERAPY YOU CAN GET! So, go outside, soak up the sun, do some deep breathing, relax your shoulders and spine. Listen to the goddamn happy birds for as long as you can stand it.

I know that these three basics aren't enough for everyone but, as we all have so much more stresses we are dealing with, we need to remember to take care of ourselves, because that is the best preventive medicine we can take.

Comments

I'm so glad to hear you're finding some happy!

[jesse_the_k]

It's a non-trivial task these days.

I threw my hands in the air and said Amen! re: sleep. Poor sleep also makes my fibro flare.

The association between pain and sleep in fibromyalgia is a meta-analysis of 16 studies which supports this connection.

I can't disentangle the body-mind connection when it comes to pain and depression. There's nothing more depressing than trying to live through pain. Pain means I wake up through the night. Shitty sleep means I have less resources to use to manage depressive thoughts. And so forth.

My current med routine ensures that I sleep almost all night (except before therapy appointments, when I get anxious because we're trawling through trauma). It also means I'm kinda dopey during the day -- I have to write things down that I use to be able to just remember. I'm humming in harmony with the always wear the good bra song -- I've come to the realization that the level of meds which keep me happy is the level I need, even if it dulls some of my sharpness. I'm finally disentangling my worth as a human being from my IQ score.

I'm nodding along on the sunshine & vitamin D. I use a lightbox year round (90 minutes in the winter; 45 now) and I also take a ton of vitamin D supplements. The latter are the single most effective pill I take for depression. (My endocrinologist was perturbed by my blood levels, but we eventually settled that too much vitamin D can screw with calcium levels, so she'll keep an eye on those and I'll continue to have a will to live.)

/opens brain, empties it out.

[siderea]

It turns out that there is a strong link between sleep and depression, even for people who aren't normally depressed.

That, if anything, manages to understate the case. There isn't one link. There's multiple links. The relationship between sleep and depression is amazingly complex and weird, and as of yet mostly not understood.

For my psychopharmacology class in Spring 2008, I got to spend half the semester on a reading project of my choice, so I picked Sleep, Depression, and Antidepressants. IIRC, one the papers I found explained that if you subjected people with Major Depressive Disorder to a polysomnography study, you would see their sleep architecture is – to use the technical term – somewhat fucked in some specific and predictable ways, such a protracted onset latency (meaning they fall asleep more slowly than normal matched controls) and malformed, disrupted sleep cycles (meaning they keep bouncing out of sleep before getting down to restorative Stage 4 sleep). If you asked them, "How are you sleeping", they would tell you, "Terrible. I can't fall asleep, and I toss and turn all night, then wake up tired." But then, if you gave them certain standard SSRI antidepressants, some of them would go into remission in their depression. They would tell you their mood lifted and their other depressive symptoms eased or went away. If you asked them how their sleep was, they'd tell you they were sleeping much better now.

But if you actually subjected these successfully treated depression patients to polysomnography again, their sleep architecture was even worse: their onset latency was even longer and their sleep cycles even more malformed.

Everything about sleep, depression, and antidepressant medication just gets weirder from here.

Did you know that whether or not an antidepressant medication is sedating is pretty much random? In two senses. First, one might think, hey, if an antidepressant is an SSRI, well, all the SSRIs are pretty similar, so they probably all are likely to be sedating? Like, we expect all benzodiazepines to be sedating; it would be awfully weird if a quarter of them were uppers, instead. But, no, SSRIs – and other antidepressants – are all over the map with their effects on sleep and alertness. But then, it would be nice if any given SSRI had a reliably alerting or soporific effect on users, but, no to that too. Standard initial prescription for, e.g., Celexa (citalopram) is "take it before bed, unless you find it keeps you up, in which case take it when you wake up". Something like a third of users find it is a stimulant and two thirds a sedative, or maybe it was the other way around. Anyways, you find out if Celexa is a stimulant or a sedative for you when you take it, and not before.

Wake therapy – and I've never heard of it actually being used in practice, for what will become obvious reasons – is simply keeping someone with severe depression awake long enough, because it's been discovered that after about 24 hours awake, the depression fully remits.

Until the person goes to sleep again.

Thereby making this one of the most useless therapies ever. But oh so tantalizing! Every, oh, ten years or so, somebody else takes a crack at trying to come up with a form of wake therapy that is clinically useful. I'm due to check in on the topic again, I suppose; it's been about ten years. And it suggests the hypothesis that there's something about sleep that has become toxic for people with severe chronic depression, such that sleeping makes their depression worse. It also suggests the hypothesis – which I think has been disproven? – that the way (some?) antidepressants
work is by messing up one's sleep more, so that one is just getting less toxic sleep, and one is receiving wake therapy in pill form. But nobody'd come up with anything useful from either of those hypotheses, either, when last I checked the state of play, ten years ago.

I am aware that there's an entire school of thought that sleep regulation has a lot to do with the management of bipolar disorder, aka manic depression, but I don't know the details.

Everything about sleep and depression (and antidepressants) is unbelievably complex and weird and makes no sense.

[kestrell]

Wow!!! Can you suggest resources so I can begin larning more?

[siderea]

I know of nothing useful for the general audience (though wake therapy is googleable by that name); I was getting this all right out of the research databases I had access to in gradschool. I still have that stuff somewhere, and have long had on my to-do list writing it up for a post.