Sleep Apnea: Depression’s subtle sidekick.

A client presents with irritability, drowsiness, lack of energy,  and hypersomnia. You’d suspect depression, possibly Bipolar Disorder, and you’d likely be correct. It might also be something more.

Just over a year ago, Texas governor Rick Perry was hailed as the Republican party’s best choice to win the White House in 2012.   Poor debate performances sank his candidacy, most notably when he couldn’t remember a third government department he planned to eliminate.  In his new book “Oops“,  Texas Tribune correspondent Jay Root claims Perry’s lapses were due to a sleep disorder:

“…by early October, days after the Florida fiasco, (Perry) had urgently consulted sleep specialists. After conducting overnight tests on Perry, they produced a rather startling diagnosis: He had sleep apnea, and it had gone undetected for years, probably decades.”

Rick Perry’s doctors: “Oops.”

Sleep apnea causes sleepers to stop breathing. These pauses can last several minutes and occur  thirty times or more per hour. Unknowingly, sufferers’ wake dozens of times per night. This sleep disruption can slip past diagnosticians because it shares so many symptoms with depression. When a client presents with  fatigue, forgetfulness and lack of motivation, a family doctor might refer them to counseling instead of a sleep study.  The assessing therapist might ask the person if they ever wake up gasping for air. More likely, they’ll focus on all of the mental health questions we have to squeeze into an assessment session.

Along with serious physical risks, sleep apnea can cause depression and memory troubles, via sleep deprivation.With depressed clients who report fatigue, but no trouble sleeping, it’s smart to ask about the following:

  • Morning headaches
  • Memory or learning problems and not being able to concentrate
  • Waking up frequently to urinate
  • Dry mouth or sore throat when you wake up
  • Snoring
  • Reports from bedmates that you stop breathing in the night.

Two years ago, I started to encourage clients to report such symptoms to their family doctors. An impressive percentage have returned with a positive diagnosis for sleep apnea. So far, each who pursued treatment have reported improved mood and energy. Each was genuinely depressed; disrupted sleep made each’s depression significantly worse. With sleep apnea, sleep deprivation can hamper therapy even when a client believes they sleep all too well.

 

@ 2012 Jonathan Miller All Rights Reserved

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