Sunday, July 29, 2012

Treatment for Diurnal Mood Variation - Why do I feel better at night?



I have come up with a few different ways to help me overcome Diurnal Mood Variation (DMV) that I am anxious to share with you. First for those who do not know what DMV is let me give you a brief explanation.

Diurnal mood variation is symptom of depression which can make the person feel more depressed in the morning and daytime hours and as the day progresses into afternoon, evening hours they feel better. It is more commonly related to those who suffer from a more severe form of depression. There is not too much information about what causes DMV, but from what I have read it entails an individual’s biological circadian rhythms (biological clock).

What is Circadian Rhythm? Circadian rhythm is still being researched, but what is known is that it is guided by hormonal release and natural patterns of variations in wakefulness, body temperature and blood pressure that the body develops through in the course of a 24-hour day. Humans and animals have an internal clock that is coordinated with light to dark cycles in the organism’s surroundings. The internal clock is what helps us get up at the same time every day and sometimes without an alarm clock. Our internal clock is situated in the brain’s hypothalamus and pineal gland, these glands release melatonin responding to information received from photoreceptors in the retina. At night time melatonin secretion rises and during the day it restrains it. It is also known that alterations in human’s daily schedules interfere with Circadian rhythms and that it aids in animals sleeping patterns.

Diurnal mood variation is not treated as a secluded symptom since often times it is part of many other symptoms associated with clinical depression. Many individuals who have DMV often have a major depressive disorder and are being treated through a professional, licensed mental health provider such a psychiatrist or psychologist. Individuals who would like to learn how they can go about treating it should discuss it with their doctor to learn about the appropriate treatments available to them. What I am doing to help me with my Diurnal Mood Variation.

I am doing a few different things to help me overcome DMV that so far have been working out well and I would like to share them with you.

First, I have been waking up at least an hour earlier than usual every morning, in the beginning that was a bit difficult for me but as my biological clock got use to it overtime it has become easier. I have a usual morning routine, a set schedule that I go by after I wake up. It includes having my two, sometimes three cups of coffee, shower, get dressed, internet time and make any needed phone calls.

Second, which is in my opinion the most important one, I get busy and productive throughout the day; I do things such as run my errands, shopping, and appointments. I do a lot of walking and I also try to pick a different spot everyday to have my lunch at. If I get done early doing everything I needed done, instead of going home I will take my laptop to the local library or Wi-Fi spot. The important thing for me is to keep busy during the daytime hours and out and about away from my home where I tend to be less productive and more idle which is like sending out an invitation for depressive symptoms to invade my time.

Third, by the time I get home I do my afternoon schedule, cook, tidy up my place, eat dinner, internet time, shower and watch my favorite T.V. shows which helps me wind down for bed time. Over the course of implementing this new routine it is becoming normal for me to function during daytime hours without feeling depressed and easing on into the afternoon with a stable mood which carries me into a restful evening and eventually a good night’s sleep.

For now this has been working better for me during the week days. It has been trying to put this to work on my weekends which, I have found now to be more prone to DMV symptoms. I suppose for me this might be mostly due to an open weekend as opposed to a scheduled one. In the coming months I will look into it some more. For now, I will give myself a big star and celebrate what I have accomplished with my Diurnal Mood Variation symptoms.







18 comments:

  1. Stopping by from TTWFI hop! Love for you to stop by and return the follow. I am hosting Mom's MOnday Mingle now. Love for you to link up!

    www.thenaptimereview.com

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  2. Hi Madison. Sad to know about this syndrome. I'm not sure if I get to experience this but sometimes I do. Thanks for the information. WOuld you mind if we exchange links? Feel free to shoot me an email. Thanks. Looking forward.

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  3. Participating in Mom's Monday Mingle for the first time! I'm your newest fan. :)


    Kristina
    http://www.yomichaelmichael.com

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  4. I think that schedules are very helpful for several different syndromes. I worked in the mental health field for several years with people diagnosed with mental retardation & developmental disabilities. One of the main things that always helped with the day to day life was a schedule that kept the clients entertained and busy. Idle time seemed to create confusion as well as some anxiety depending upon the specific diagnosis. This was especially true in a setting outside of the home. So many different triggers & variables that cause that anxiety effect in people.

    I hope that you can get your weekend schedule updated so that it helps you feel better.

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  5. Shelly, I can see how that can happen with what you described working in the mental health field. Thanks for sharing it! I am happy to say that since I wrote this post my my schedules have been more structured and working for me.

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  6. I found this site (among others) when I did a Google search for "depressed in the morning feel better at night." I was surprised that this situation is not common to me. I have read that it is associated with Major Depressive Disorder, of which I have been diagnosed.

    Your suggestions are very good ones. Keeping busy helps. Getting out of bed early may be the single most important action, at least for me. These days, I just roll over and try to sleep away the day, getting up well past noon. I have no urge to shower or do anything. When I have a little coffee, it seems to perk up my mood but the depression still lingers.

    Keeping a schedule is a great idea. I'm usually a very ordered person when I'm feeling well. Structure is important.

    Tony, NYC

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    1. Hi Tony, I know exactly what you mean about sleeping well past twelve and the lingering depression. I have been fortunate not to have experince it in quite a while, but of course it takes commitment and perseverance. Keeping a schedule as well as following the tips I mentioned also help. That's not to say that I don't have my day's, night's or moment's with difficulty sleeping or depressive episodes because I do, but they are much less and easier to overcome.

      I hope you are dealing with your challenges in a healthy way.

      Thank you for visiting!

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  7. Very interested in your blog abut diurnal mood variation. I suffer similar symptoms which also disappear if I am busy and involved with others. In 2002 I suffered a brain injury which has caused all sorts of issues for me, including a mood disorder. But, like you, routine is good and so is being involved with others. I think this is key. Being on my own is dreadful but because I suffer from fatigue when cognitively overwhelmed (a whole host of reasons) as well as noise intolerance, I can only be with people for so long and then have to go home. Because of everything, I am not able to work, have limited social interaction and a lot of the time lack the motivation to go out. Its not easy that's for sure. I take a lot of vitamins and look at nutritional supplements rather than prescription medicines only because I think my brain injury has disrupted my head so much that conventional medication will not help me. Great to read of other's experiences though. Knowing others are out there is helpful. Best wishes

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    1. Thank you for sharing your experience with us. Your comment is surely appreciated.:)

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  8. I have dealt with severe depression for about 25 years. One of the benchmarks of my illness is DMV. Terrible mornings, mediocre afternoons, fantastic nights; after only a few hours' sleep, I'm down again. I do walk every day -- at least 3 miles. The activity, combined with being outside, is somewhat soothing. I also find that drinking lots of Vitamin C - infused water helps my mood. And yes, medication. SSRI's are horrible on my stomach lining; tricyclics work great BUT make me huge; Wellbutrin makes me an agitated, hypertensive jerk; SNRI's spike my blood pressure into stroke territory. So really, I don't see medication as the cornerstone of my treatment. I would LOVE to sleep 10 hours a night -- but I find DMV isn't as bad if I sleep just 5 or 6 hours a night. It's a bit of a tortured existence. Your blog reminds me that there are others in this world who share my experiences. Thank for your blog.

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    1. Hi Scott, thank you so much for visiting my blog and reading this post. It is comforting to know that others have a similar experience as I do. I identify with the 5 or 6 hours sleep. I'm curious about the infused vitamin C water, how exactly do you combine both or do you purchase it that way?

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  9. I have also dealt with severe depression on and off for about 30 years. In this most recent bout I am experiencing very notable DMV-- I never knew before that it was a "thing"until this week, when I googled "depression most intense in morning." So I am learning a lot, and hope that this knowledge will help me.

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    1. Hi Ray, thanks for sharing your thoughts, I appreciate your comment. I hope it helps too.

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  10. Thank you for posting! Nice to know I'm not alone in this!

    My first thought upon waking is - I wish I were dead. Lovely. Only, I am not suicidal. So, I know this is not me talking. I mean, it is me, but something is causing that thought other than my life. I don't have MDD - I have anxiety-related depression, and when I get the anxiety under control (CBT has helped A LOT) - then the depression lifts. Except ... I can't seem to shake that morning - I hate myself, I hate my life, I feel like shit. Oddly,this mood lifts significantly after I go to the er ... ladies room. (Is that true for you, too?) Then give it another 2-3 hours, and I'm mostly normal. By nightfall, I'm completely "normal."

    I get early morning wakefulness when I can't get the anxiety under control as much as I'd like - for example now - as I stupidly (opps, CBT would say I should not berate myself) took a RIF (reduction in force, lay off) from my job, and now 2 months later I am having a bit of a problem getting a new job (hence the anonymous posting - can't have prospective employers discovering I have early morning Wish I Were Dead). So, I am awakening at 5 am now instead of my usual 7 am. So, I am going to try the structured morning to fight my way through it.

    Here is something odd - my early morning Hate Myself was much worse before. Then, about 2 months ago, I found out my cholesterol is a bit high, and I started taking Crestor - as prescribed. Lo and behold - the early morning My Life is Horrible lessened. I mean, it is still unpleasant, but not like before. Before it would hit me like a tidal wave. OK, maybe like a REALLY big wave at an ocean beach. The kind people surf on. Now, it is more like a bucket of water. A really big bucket.

    See, with anxiety-prone folks - it is all about the digestive system. Nervous stomach, nervous intestine ...racing thoughts, catastrophic expectations. So, I am wondering - for folks who are more majorly depressive, does it work like that for you, too? - or is your GI not so much in the picture? In case you are wondering - Pepto Bizmo, Tums, etc. unfortunately don't work, although it would be so fantastically wonderful if they did - benzodiazepines do make the GI shut up and stop bothering me - but unfortunately, long term use resulted in - you guessed it - depression. Oddly, they were never addictive for me. I could take them or leave them.

    I hope you respond as it is the not knowing what the heck is up that really causes a lot of anxiety. I will check back periodically.

    Thanks again.

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    1. Dear Anonymous, thank you so much for sharing your experience. I must say, I relate to a lot of what you described and I am also grateful for you sharing because, you see, I almost forgot that I too suffered at one point from that early morning dreadful feeling, and sometimes it is good for us to keep it green and occasionally remember the pain in order to appreciate just how well one has become.Okay, the morning dreads......when I was in the mist of my depression and anxiety that was one of the worst times of the day for me. The hollowness in the tummy, the turmoil of anxiety was just enough to bring me to my knees and hope the ground would swallow me. How and exactly when did this blackness go away, I'm not 100% sure, but I know therapy and filling a good part of the early day with positive activity certainly contributed to it. Also, it did not go away over night for me, I believe that as my days got fuller and therapy was being infiltrated, all of the sudden the dreadful mornings became less and less and now I no longer feel them. As for you, I am so glad to read that the tidal wave is no longer and that it's more of a bucket of water.....soon enough with your hard work at self care and self awareness, it will be a drop of water in a glass. You know, with different folks and different levels of depression, sometimes we just will never know what the heck is really up.....I guess that why for some it truly is more chemical than circumstancial, and yes fustrating too.But, as tough and debilitating as it was, I was up for the challenge...or better said, I was ready for the war, because my life is worth it and I deserve to fight for it to the fullest, so I did and I do. I love that you shared and that you are taking part in healing and recovery, that is truly awesome keep up the good work and please share your thoughts again.

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    2. Thanks for response! I was looking through my bookmarks and saw this and decided to check back, and there it was. Reflecting and identifying that early morning is specifically worse for me, then validating that it is something that does happen to other people, too, has helped me a lot. So, your post helped me, and it looks like it helped other people, too. May sound cliche,but, knowledge is power. Best wishes to you, too!

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  11. I am also suffering major depressive episodes from late morning as soon as the sun rises until late afternoon. The sun seems to play a significant role in my depression. I feel lonely and very depressed at those times. however, thankfully that terrible dark feeling evaporates at night. I am happy again. I would do anything to escape that dreaded feeling. Words cannot describe it. Wishing I had been aborted, it gets so bad. I am going to try some of the techniques you have shared. Maybe spending several hours at my gym during those peak times. Thank you for sharing.

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