Depression: Is it Clinical or Something Else?

My Story

A few months ago I went to the doctor because I couldn’t concentrate on anything and the Friday before I went to the doctor I’d walked around the house all day in a fog, crying for no reason. Now, when you’re a stay at home dad, that isn’t a good thing. I had laundry to do, food to make for my family, bills to pay and the sweetest little boy on Earth to take care of. I knew something was wrong so I went to the doctor where, after I described my symptoms, I filled out a questionnaire and was told that I was bipolar.

Bipolar disorder (manic-depression) comes in two flavors: Bipolar I and Bipolar II. Bipolar I is classic manic-depression with periods of high energy, high activity, euphoria, aggression, increased sex drive and a predilection to abuse of alcohol or drugs followed by a depressive state of low energy, feeling worthless, submission, decreased sex drive, a predilection to abuse alcohol or drugs and sometimes feelings of suicide. If you experience either of these states for a week or more, please see your doctor as you are at risk. You don’t have to feel bad anymore, help is available. Thankfully, I was not in this category of the disorder.

Instead I was classified as bipolar II, which has many of the same symptoms, but in a milder form. So, the doctor put me on an anti-seizure drug which is indicated for bipolar II and sent me home. At first, I couldn’t tell if it was working or not, but by the third week I noticed that I felt like I was walking around in a fog and my wife said that I was much calmer. Well, of course I was calmer, because half the time I couldn’t feel my own face.

That wasn’t going to work, so I went off the pills and tried some meditation techniques that I looked up on the Internet, but that didn’t seem to help much either. Over the space of the next four months or so I just kept hanging on hoping that I would improve. I had my ups and downs, but everything changed when I realized that my CPAP mask was not fitting correctly.

Sleep Apnea and Depression

Depression is caused, primarily, by a chemical imbalance in the brain. The typical drugs used to treat this condition change the chemical balance in the brain by blocking certain chemicals or enhancing certain chemicals. Sleep, especially deep sleep, helps the brain to “clean house” or do basic upkeep that is largely still not understood. However, several studies have closely liked sleep apnea and depression.

Depression and You

Many people get depressed for many different reasons: Body image issues, recent diagnoses with a disease, abuse, brain chemistry issues or fatigue. In most people the symptoms of depression don’t last very long, but if they last over a couple of weeks, I would strongly advise you to seek medical attention.

Sleep apnea, as research shows, impacts the body in many different ways. It can be caused by excessive weight, which can lead to diabetes, which can lead to depression. Sleep deprivation caused by sleep apnea can also lead to mood swings or general malaise which can mimic depression. In short, sleep apnea can either exacerbate depression that exists or it can mimic bipolar disorder by depriving you of the sleep that your body needs.

In my case, I could not tolerate the medication that the doctor gave me for bipolar II and, based on my research I didn’t think that I was really bipolar II in any case, but something was causing my symptoms. While in the midst of trying to figure this out, my wife woke me one night and asked me why I was having trouble breathing and it all became clear at once. Like a lightning bolt out of the blue, I understood what was causing my symptoms.

The CPAP Connection

If you have sleep apnea and wear a CPAP (continuous positive air pressure) mask, one of the critical things is to follow the recommendations of the manufacturer for replacement and maintenance of your particular CPAP mask. Well, with all of the hoohaw of being a stay at home dad, taking care of the baby and learning to be the happy homemaker, I had forgotten to do this and now I was paying the price.

When I woke up the next morning, feeling awful, I checked my mask and noticed that the straps were so loose that it was sliding off of my face when I rolled over onto my side to sleep. In short, although I was wearing my mask and turning on my machine like I was supposed to, it wasn’t doing what it should.

So, I called the medical supply company where I get my CPAP supplies and they were kind enough to rush one to me that got there that day. That night, I made sure the straps were tight and went to sleep hoping that I had found the answer to my prayers.

A Happy Ending

The next morning I woke up feeling refreshed and better than I had in months. Now, of course, some of that was psychological, but some of it had to do with the fact that I had just gotten the best nights sleep I’d had in a long time. Within a couple of weeks I noticed that I felt better in general and no longer felt depressed or manic. Sleep really was the best medicine for me and all I really needed.

Some people ask me why the doctor wouldn’t catch this. Well, one of the problems with sleep apnea is that doctors don’t follow up on it unless the patient complains. The general feeling out there in the medical community is that once obstructive sleep apnea has been treated it is not the basis for diagnosing other conditions. In general, I would agree with the medical community. However, it is up to those of us with this condition to pay attention to our bodies and remember that the symptoms of sleep apnea, while not the end all be all of all of the problems that afflict us, can masquerade as something else.

Needless to say, I’m much better now and my family is happy that I was able to figure it out. I no longer walk around the house crying all day and am able to do all of the things that I need to do to make a happy home for my family. Now, if I could just figure out how to get those darn windows to stay clean!