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