Depression and Mental Health

Depression and Sleep

Various biological factors can affect mood and behavior. Biological treatment of mental health disorders is not limited to drugs. New research indicates different biological mechanisms may underlie some mental health disorders and need to be investigated before use of drugs. Such factors include hormone levels (especially thyroid), diet (especially alcohol and caffeine, heavy metals)), Structural/postural distubances, Pain/Inflammation, Neurotransmitter metabolism/synthesis  imbalances , amount/quality of regular sleep and exercise.

Executive functioning’ disorder (EFD) is A new area of mental health disorders, defined by neuropsychologists,. It refers to the inability to develop and sustain an organized, future-oriented, and flexible approach to problem situations. The executive functions allow individuals to adaptively use their basic skills (e.g. core language skills, visual–perceptual ability, rote memory capacity) in a complex and changing external environment .For example, persons of high intellect but poor executive functioning may experience occupational and social failure because their verbal discourse is disorganized and disjointed, marked by `losing track’ of what was being said, redundant, at times irrelevant or tangential, rigid, or lacking appropriate emotional overtones.

Successful performance on executive functioning level requires intact prefrontal processing in the brain. PFC( prefrontal Cortex) is the `hardest working’ region of the brain during wakefulness, necessitating the greatest recovery during sleep. Adults whom are Sleep-deprived, have sleep Disturbances (Obstructive Sleep Apnoea) display more PFC-related cognitive dysfunction compare to normal non sleep disturbing population.

For example: Improper Glutamate modulation during sleep and wakefulness has shown to be involved in poor prefrontal cortex activity and mental health disorders. Other risk factors are: Obesity, genetic predisposition, intermittent blood gas abnormalities, abnormal hormonal regulation of upper airway musculature, Insulin resistance, Inflammation, represent the most frequent risk factors.

Another example is Cortisol-melatonin ratio: Previous studies have demonstrated elevated cortisol levels in depressed patients compared with controls, and cortisol levels are lower in the same patient during depression-free intervals . This finding has led to the hypothesis that the pituitary– adrenal axis contributes to the genesis of depression. cortisol–melatonin ratio may help differentiate between a primary sleep disturbance, in which the ratio is low, and psychiatric depression causing disturbed sleep, in which the ratio is high .

Depression is the queen of psychiatric disorders. Discovery of REM deviations (short REM Latency, increased REM density) made REM sleep a biological marker for depression.

Depression remains one of the most debilitating and paradoxically treatable disorders in mental health. As many as 1 in 5 people will have a bout of clinical depression at some point in their life. In addition, every episode increases the likelihood of further episodes. Therefore, aggressive treatment of the first episode can lead to a better long-term outcome.

The Signs and Symptoms of Depression and Poor Mental Health

Part of the challenge of early and accurate identification is knowing the signs and symptoms. Many patients with clinical depression do not present with sadness and hopelessness as chief complaints. In fact, many patients will deny these symptoms and remain convinced that they have a medical problem. Sleep disturbances, fatigue, lethargy and changes in appetite can often push a patient to a general practitioner or medical specialist instead of a mental health professional.

Depression is the queen of psychiatric disorders...

A wide range of studies have been published over the past two decades that involve the intersection of sleep EEG, insomnia, psychiatric illness (especially depressive disorders) and psychopharmacology. Much of value has been discovered, but there have also been false starts and contradictory results.

There is in fact strong evidence that insomnia is associated with medical and psychiatric illness and that the sleepiness associated with insomnia is the cause of many accidents. Thus, the direct (visits to doctors, cost of sleeping medication, complications from use of these medications) and indirect (accidents, quality of life) costs of insomnia are enormous and constitute a major public health problem in the industrialized countries.

Sleep in Psychiatric, Alcohol, and Substance Use Disorders:

Most psychiatric and substance use disorders are associated with sleep disruption. Alcohol dependence and use of other psychoactive substances lead to complaints of insomnia and sleep disruption that can persist for months into recovery. These sleep disturbances may result in continued alcohol and/or drug use to alleviate symptoms, and thereby precipitate relapse. Psychiatric disorders can also be associated with daytime sleepiness, fatigue, abnormal circadian sleep patterns, disturbing dreams and nightmares. Conversely, increasing evidence suggests that primary insomnia (without concurrent psychiatric disorder) is a risk factor for later developing psychiatric disorders, particularly depression, anxiety, and substance use disorders.

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