Sleep and Depression

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  • in overdose.
  • Some physicians use an SSRI in combination with a low dose of a sedating antidepressant (such as Trazodone) or a short acting hypnotic (such as Ambien, Sonata, or Temazepam). The advantage of this approach as that the combination of medications used to treat the depression can also address the sleep problem, and the physician has the option of discontinuing the sleep drug while continuing to treat the depression.
  • A fourth approach is to use either an SSRI or psychotherapy for depression with behavioral treatment for insomnia. There are studies that also show behavioral treatments for insomnia can be helpful in treating depression and minor sleep complaints.

The approach varies with the type of depression and the nature of the sleep disturbance.

How do you know if you have a condition that requires medical attention?

The general rule is that if you have a sleep disturbance at night and daytime drowsiness, or if you have a mood disturbance that is severe enough to interfere with your daily activities or your ability to function, than you should seek treatment. For depression, the key symptoms are a persistently low mood and a loss of ability to feel pleasure in things. If this lasts several weeks or more, then you should seek help. If you have thoughts of suicide, you should seek counseling immediately. Start with your primary care provider.

-- Dr. Buysse is Associate Professor of Psychiatry at the University of Pittsburgh, Western Psychiatric Institute and Clinic in Pittsburgh, PA. He has been on the faculty for 14 years.

This article originally appeared in the Fall 2001 issue of sleepmatters.

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