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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by KaraS on January 16, 2005, at 16:37:31
A friend of mine has been experiencing early morning depression. She said that she's fine as the day goes on as long as she gets out of the house and keeps busy. To me she sounds dysthymic but she won't accept that. Here's part of her e-mail to me:
"I know it's not an emotional depression because I'm really not depressed about anything immediate -- I'm pretty sure it's from (and I've read about this) my seritone (sp?) levels going down while I'm asleep, just as my blood pressure goes down too, and that they need to rise gradually once I'm up and about -- so obviously it's a chemical thing -- I'm wondering if there was something I could do (not take medication) that would keep the seritone levels from dropping while I'm sleeping."
I tried to clarify some things for her and told her about 5-htp and tryptophan. I also suggested St. John's Wort. I'd be interested in other people's responses to her message and what they would advise her.
Kara
Posted by jujube on January 16, 2005, at 19:35:25
In reply to What do you think of this?, posted by KaraS on January 16, 2005, at 16:37:31
Kara,
A few things come to my mind. First, I think that hypothyroidism can make it difficult to get out of bed and cause early morning depression. It could also be a blood sugar problem. Perhaps she could try taking some chromium and eating a light snack with some protein and a smsll amount of carbs before bed to see if there is even a small improvement. A sleep disorder resulting in non-restorative sleep could also be the culprit. Finally, SAD (seasonal afffective disorder) can make the mornings harder to bear. I, personally, have always found January and February to be particularly trying months, even when I am not experiencing depression.
Hope you friend starts to feel better soon.
Tamara
> A friend of mine has been experiencing early morning depression. She said that she's fine as the day goes on as long as she gets out of the house and keeps busy. To me she sounds dysthymic but she won't accept that. Here's part of her e-mail to me:
>
> "I know it's not an emotional depression because I'm really not depressed about anything immediate -- I'm pretty sure it's from (and I've read about this) my seritone (sp?) levels going down while I'm asleep, just as my blood pressure goes down too, and that they need to rise gradually once I'm up and about -- so obviously it's a chemical thing -- I'm wondering if there was something I could do (not take medication) that would keep the seritone levels from dropping while I'm sleeping."
>
> I tried to clarify some things for her and told her about 5-htp and tryptophan. I also suggested St. John's Wort. I'd be interested in other people's responses to her message and what they would advise her.
>
> Kara
>
>
>
>
>
>
Posted by KaraS on January 16, 2005, at 22:56:49
In reply to Re: What do you think of this? » KaraS, posted by jujube on January 16, 2005, at 19:35:25
> Kara,
>
> A few things come to my mind. First, I think that hypothyroidism can make it difficult to get out of bed and cause early morning depression. It could also be a blood sugar problem. Perhaps she could try taking some chromium and eating a light snack with some protein and a smsll amount of carbs before bed to see if there is even a small improvement. A sleep disorder resulting in non-restorative sleep could also be the culprit. Finally, SAD (seasonal afffective disorder) can make the mornings harder to bear. I, personally, have always found January and February to be particularly trying months, even when I am not experiencing depression.
>
> Hope you friend starts to feel better soon.
>
> Tamara
>
> > A friend of mine has been experiencing early morning depression. She said that she's fine as the day goes on as long as she gets out of the house and keeps busy. To me she sounds dysthymic but she won't accept that. Here's part of her e-mail to me:
> >
> > "I know it's not an emotional depression because I'm really not depressed about anything immediate -- I'm pretty sure it's from (and I've read about this) my seritone (sp?) levels going down while I'm asleep, just as my blood pressure goes down too, and that they need to rise gradually once I'm up and about -- so obviously it's a chemical thing -- I'm wondering if there was something I could do (not take medication) that would keep the seritone levels from dropping while I'm sleeping."
> >
> > I tried to clarify some things for her and told her about 5-htp and tryptophan. I also suggested St. John's Wort. I'd be interested in other people's responses to her message and what they would advise her.
> >
> > Kara
> >Hi,
Those are some really good suggestions. I think she's been tested for hypothyroidism though I'll check to be sure. She has tried taking some milk before bedtime but she hasn't tried the carbohydrate or the chromium with it. I hadn't even thought of the sleep disorder or SAD. I'll mention those to her as well. If this is a recent phenomenon then SAD is a very good possibility.Thanks for your input.
Kara
Posted by Cairo on January 18, 2005, at 16:03:16
In reply to What do you think of this?, posted by KaraS on January 16, 2005, at 16:37:31
My doctor told me to walk for an hour in the early evening, eat some protein/carb (like apple with peanut butter), and then take a warm, not hot, bath for 20-30 minutes to boost serotonin. It helped my sleep some, but not enough to do without sleep meds. Since serotonin is affected by other neurotransmitters, assuming it's only serotonin may be simplistic. I agree with the above poster in checking thyroid function, but even thyroid levels may be "normal" but you may still have a hypofunctioning HPA axis.
Cairo
> A friend of mine has been experiencing early morning depression. She said that she's fine as the day goes on as long as she gets out of the house and keeps busy. To me she sounds dysthymic but she won't accept that. Here's part of her e-mail to me:
>
> "I know it's not an emotional depression because I'm really not depressed about anything immediate -- I'm pretty sure it's from (and I've read about this) my seritone (sp?) levels going down while I'm asleep, just as my blood pressure goes down too, and that they need to rise gradually once I'm up and about -- so obviously it's a chemical thing -- I'm wondering if there was something I could do (not take medication) that would keep the seritone levels from dropping while I'm sleeping."
>
> I tried to clarify some things for her and told her about 5-htp and tryptophan. I also suggested St. John's Wort. I'd be interested in other people's responses to her message and what they would advise her.
>
> Kara
>
>
>
>
>
>
Posted by KaraS on January 18, 2005, at 17:18:56
In reply to Re: What do you think of this?, posted by Cairo on January 18, 2005, at 16:03:16
> My doctor told me to walk for an hour in the early evening, eat some protein/carb (like apple with peanut butter), and then take a warm, not hot, bath for 20-30 minutes to boost serotonin. It helped my sleep some, but not enough to do without sleep meds. Since serotonin is affected by other neurotransmitters, assuming it's only serotonin may be simplistic. I agree with the above poster in checking thyroid function, but even thyroid levels may be "normal" but you may still have a hypofunctioning HPA axis.
>
> Cairo
>
>
>
> > A friend of mine has been experiencing early morning depression. She said that she's fine as the day goes on as long as she gets out of the house and keeps busy. To me she sounds dysthymic but she won't accept that. Here's part of her e-mail to me:
> >
> > "I know it's not an emotional depression because I'm really not depressed about anything immediate -- I'm pretty sure it's from (and I've read about this) my seritone (sp?) levels going down while I'm asleep, just as my blood pressure goes down too, and that they need to rise gradually once I'm up and about -- so obviously it's a chemical thing -- I'm wondering if there was something I could do (not take medication) that would keep the seritone levels from dropping while I'm sleeping."
> >
> > I tried to clarify some things for her and told her about 5-htp and tryptophan. I also suggested St. John's Wort. I'd be interested in other people's responses to her message and what they would advise her.
> >
> > Kara
Thanks. I've forwarded that information on to my friend as well.I know what you mean about normal thyroid levels but still having an underactive HPA axis. I bet that would describe me.
k
Posted by Cairo on January 19, 2005, at 9:06:54
In reply to Re: What do you think of this?, posted by KaraS on January 18, 2005, at 17:18:56
Cymbalta at only 5mg seems to jump start my thyroid - more energy, less orthostatis dizziness, weight going down, less acne and hair loss. But I've got to be careful about the SSRI component as I get serotonin syndrome symptoms very easily and SSRIs worsen my muscle tightness and knots.
Cairo
> Thanks. I've forwarded that information on to my friend as well.
>
> I know what you mean about normal thyroid levels but still having an underactive HPA axis. I bet that would describe me.
>
> k
>
>
Posted by Mistermindmasta on January 19, 2005, at 11:51:30
In reply to Re: What do you think of this? » KaraS, posted by jujube on January 16, 2005, at 19:35:25
> A few things come to my mind. First, I think that hypothyroidism can make it difficult to get out of bed and cause early morning depression. It could also be a blood sugar problem.
This is true, in my opinion. Keeping blood sugar level as you're going to bed could be important for her. I feel very drained when I wake up and haven't eaten in a very long time.
>A sleep disorder resulting in non-restorative sleep could also be the culprit.
I agree with this, as well. The depression she experiences could just be fatigue from improper sleep. And then once she gets moving, she gets over the fatigue...
> Finally, SAD (seasonal afffective disorder) can make the mornings harder to bear.
I believe extra vitamin D (through cod liver oil) can help this.
Serotonin levels going down during sleep is really normal. In fact, serotonin and norepinephrine circuits COMPLETELY shut off in some areas of the brain during sleep. The only time you could say it wasn't normal is if you were taking an SSRI, which tends to keep these serotonin circuits active during sleep, disrupting certain stages of sleep. The problem might be lower than optimal serotonin levels when she wakes up, not when she sleeps, in which case a 100 - 200 mg 5-HTP or 1000mg tryptophan pill before bed with a light carbohydrate snack could theoretically fix her. The effects should last into the morning hours.
Posted by KaraS on January 19, 2005, at 22:09:29
In reply to Re: What do you think of this? » KaraS, posted by Cairo on January 19, 2005, at 9:06:54
Maybe it's the norepinephrine that does that for you. I kind of felt that energy when I briefly tried nortriptyline and desipramine. I'm hoping to get some energy back from adding DLPA to my regimen (once I get my anxiety under control).
It's so strange how differently we all respond. I am wondering now if I shouldn't try Cymbalta again. It made me so groggy yet also nervous at the same time. It was very uncomfortable and I think I was only at 10 mg. Maybe I could try it low dose for a while and see what happens. Did you have that nervous yet groggy feeling when you first started on it? Do you take anything else (medications or supplements) with the Cymbalta? If not, you must REALLY be sensitive to serotonin.
Kara
> Cymbalta at only 5mg seems to jump start my thyroid - more energy, less orthostatis dizziness, weight going down, less acne and hair loss. But I've got to be careful about the SSRI component as I get serotonin syndrome symptoms very easily and SSRIs worsen my muscle tightness and knots.
>
> Cairo
>
>
> > Thanks. I've forwarded that information on to my friend as well.
> >
> > I know what you mean about normal thyroid levels but still having an underactive HPA axis. I bet that would describe me.
> >
> > k
>
>
> >
> >
>
>
Posted by KaraS on January 19, 2005, at 22:14:25
In reply to Re: What do you think of this?, posted by Mistermindmasta on January 19, 2005, at 11:51:30
> > A few things come to my mind. First, I think that hypothyroidism can make it difficult to get out of bed and cause early morning depression. It could also be a blood sugar problem.
>
> This is true, in my opinion. Keeping blood sugar level as you're going to bed could be important for her. I feel very drained when I wake up and haven't eaten in a very long time.
>
> >A sleep disorder resulting in non-restorative sleep could also be the culprit.
>
> I agree with this, as well. The depression she experiences could just be fatigue from improper sleep. And then once she gets moving, she gets over the fatigue...
>
> > Finally, SAD (seasonal afffective disorder) can make the mornings harder to bear.
>
> I believe extra vitamin D (through cod liver oil) can help this.
>
> Serotonin levels going down during sleep is really normal. In fact, serotonin and norepinephrine circuits COMPLETELY shut off in some areas of the brain during sleep. The only time you could say it wasn't normal is if you were taking an SSRI, which tends to keep these serotonin circuits active during sleep, disrupting certain stages of sleep. The problem might be lower than optimal serotonin levels when she wakes up, not when she sleeps, in which case a 100 - 200 mg 5-HTP or 1000mg tryptophan pill before bed with a light carbohydrate snack could theoretically fix her. The effects should last into the morning hours.
>Thanks for the information. I didn't realize that about the serotonin levels during sleep though it gives a more scientific explanation to what I was intuitively thinking about her situation. I will forward your information to her also.
Take care,
K
Posted by Cairo on January 26, 2005, at 21:06:28
In reply to Re: What do you think of this? » Cairo, posted by KaraS on January 19, 2005, at 22:09:29
I started at 30mg and felt MANIC. An example of this was that I was sitting in my car, waiting for my daughter, and one acorn fell from a tree and hit the roof. I literally jumped out of my seat and felt like I was going to have a heart attack. I didn't feel groggy, but was too wired. My husband couldn't even look at me and I'd be yelling. You should have seen my startle reflex. I tapered down the dose and am quite comfortable on 5mg. I've perfected the technique of pouring pellets in my hand, then into a Dixie cup with a crease. I then pour it into my mouth and immediately swallow water. SSRIs make me fall asleep at the worst times. I fell asleep standing up at the checkout counter of the supermarket while leaning on the little raised counter to write my check! Not good.
I'm waiting to ask my psychiatrist if a tiny bit of Wellbutrin may help residual "blahness". I wonder if a little dopamine enhancement may help my knotty muscles. A recent study showed that Mirapex helps some with Fibromyalgia. Wouldn't surprise me since there's a history of Parkinson's in my family. I try to talk to the doctors about this but they look at you like you're crazy.
I look for Babblers who list similar symptoms and medication responses. They would be more instructive than general responses to meds.
My supplements include 2Gm EPA/DHA, 400-600mg magnesium (I alternate between malate and a mixture of Krebs Cycle chelates mixed with other minerals such as zinc and chromium, boron, etc), Ester-C 500mg, B-50, methylcobalmin 3000-5000mcg. The methylcobalamin definitely helps energy levels a bit. I also try to eat foods with a higher tyrosine content such as turkey. I take periodic breaks from magnesium as tolerance seems to develop similar to what I experienced with Neurontin (relaxes muscles, but oh the brain fog).
Despite all this, my muscles are still horrible. Oh well...
Good luck to you.
Cairo
Did you have that nervous yet groggy feeling when you first started on it? Do you take anything else (medications or supplements) with the Cymbalta? If not, you must REALLY be sensitive to serotonin.
>
>
> Kara
This is the end of the thread.
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