Stress, Sleep Disorders, Depression and Their Cure.

Throughout 12,000 years of human history, pandemics have killed an estimated 300 million to 500 million people, with the bubonic plague decimating an estimated 60% of the European population during the Middle Ages. Despite modern advances in medicine, coronavirus disease 2019 (COVID-19) has caused more than 1 million reported deaths in less than a year. Aside from the death toll, the pandemic has triggered significant emotional, physical, and economic problems around the world. But even in the midst of this crisis, nations have an opportunity to share and learn from each other’s experiences.

Patients recovering from COVID-19 may face a second battle -- coping with the disease's mental health ramifications.

This is particularly true for the sickest of the sick who required time in the ICU and intubation. These patients may experience "post-intensive care syndrome" (PICS) that could manifest as a combination of physical, cognitive, and mental health impairments following an ICU stay for a critical illness.

Adult patients may experience difficulties resuming the activities of daily life or struggle to return to work. Physically, patients may suffer from muscle weakness and chronic pain. Cognitively, these individuals may have trouble with concentration and memory, and cognitive issues may be particularly pronounced in people with a history of dementia. People suffering from PICS may experience anxiety, sleep difficulties, depression, or stress.

● How is depression diagnosed ?

Depression can only be diagnosed by a medical professional, so people experiencing symptoms of depression should talk with their doctor, counselor, or psychiatrist, physician. They may ask about the severity of the symptoms and how long they’ve persisted. They may also suggest tests that can help them to better understand your situation and monitor changes or improvements over time.

A provider may also refer patients to a specialist in sleep disorders to help determine if there is an underlying sleep disorder, such as sleep apnea or restless leg syndrome, that may be causing depression or contributing to symptoms.

● How is depression treated ?

While depression can have dramatic effects on a person’s sleep and overall quality of life, it can be treated. After working with a doctor or mental health provider to understand the type and severity of depression, treatment may include:

◆Counseling:

Depression can be treated effectively with several types of counseling, including cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). CBT for insomnia (CBT-I) is a type of CBT that focuses on managing chronic insomnia.

Medications: Antidepressants are an effective treatment for depression. These prescription medications usually take time before they begin to improve symptoms and patients may need to try several antidepressants before finding the right fit. A doctor or psychiatrist can discuss the appropriateness of these medications and recommend a specific type.

◆Brain stimulation therapies:

When medications and other approaches are not effective, some people with depression consider electroconvulsive therapy (ECT) or other, more recent types of brain stimulation like repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). These treatments can be effective but are only provided under the guidance of a trained professional.

Treatment often isn’t limited to just one of these approaches; in fact, combining medication and psychotherapy has shown higher rates of improvement than one approach alone.

● Tips for better sleep.

Sleep problems can increase the risk of initially developing depression, and persistent sleep issues can also increase the risk of relapse in people who have successfully been treated for depression. As a result, taking some of the following steps can both help you sleep better, boost your mood, and help decrease some of the problematic symptoms of depression.

◆Talk to a therapist:

There are several different kinds of therapy to help you cope with depression and change your thinking about sleep. Therapeutic models such as CBT, interpersonal psychotherapy, and psychodynamic therapy can help you process some of the underlying feelings and challenges that contribute to depression. Mental health professionals can also suggest concrete behavioral changes to mitigate some of the symptoms of depression and give you coping mechanisms to manage restless, sleepless nights.

◆Keep a regular sleep/wake time:

Suffering from depression can make it difficult to stick to a routine. Keeping a consistent bedtime and wake time sets aside the requisite 7-9 hours of sleep, and gives your body the opportunity for a full night of sleep. Additionally, establishing a nightly routine provides a cue for your body to begin winding down and prime itself for sleep.

Nap carefully: Restless or inconsistent sleep at night can make it tempting to nap during the day. Research has found the ideal nap length is between 10 and 20 minutes, what is usually called a “power nap.” These power naps can help regulate our emotions, reduce sleepiness, and lead to an overall uptick in performance. It’s important to keep your napping relatively brief, however. Naps that last longer than 20 minutes could interfere with your ability to fall asleep, while naps shorter than 10 minutes just aren’t long enough to gain the benefits from napping.

◆Avoid alcohol:

It can be tempting to have a drink or two to promote relaxation and sleepiness, but alcohol has a deleterious effect on our sleep. While studies have shown that binge-drinking before bed leads to difficulty falling asleep and staying asleep, even moderate drinking is enough to disrupt your sleep cycle and shorten REM sleep.

◆Get outside:

One of the simplest ways to aid your sleep if you suffer from depression is to spend time outside. Exposure to sunlight aligns our body’s internal clock — our circadian rhythms — and gives us cues when to be alert and when to sleep. For instance, when we get regular sunlight, it is a signal to our body to be alert and active. As the sun sets, our bodies then produce melatonin to induce sleepiness and promote sleep. Time outside can be a simple and effective way to trigger the natural chemicals in our brain that promote high-quality sleep.

◆Exercise regularly:

A great way to spend time outside is exercising. Not only do you gain the benefits of exposure to sunlight, but it improves sleep quality. In fact, research indicates those who engage in light, moderate, or vigorous exercise reported very good or fairly good sleep quality. Additionally, regular exercise has shown to significantly decrease symptoms of depression, making it an excellent choice to promote sleep health and mental health. If you decide to begin an exercise regimen, consider doing your workout during the first half of the day; exercising in the evening could interfere with your ability to fall asleep.

● Tips For Coping With Depression.

In addition to talking to a provider about treatments for depression, there are several steps you can take on your own:

◆Exercise:

Low-intensity exercise, even walking 10 minutes a day, can lead to improvements in mood and physical health. For some people with mild to moderate depression, exercise can work as effectively.

◆Support:

Experiencing depression can feel isolating and hopeless, so remember that you’re not alone. Spend time with others, talk about what you’re experiencing, and try not to isolate yourself.

◆Be realistic:

Even with effective treatment, symptoms of depression may improve gradually.

Dr. Gaurav Upadhyay

Contact- +91 7017569384, +91 9997059035