There are many reasons why you may not be able to sleep. The number one reason is poor sleep habits. Eating or drinking foods with a lot of caffeine that can keep you up such chocolate, teas, and sodas. Some foods may say they have no caffeine but may have other ingredients that act like caffeine hidden in their label. Exercising before bed or working late without time the necessary time to wind down. Watching TV or reading for long periods of time in bed can wire your brain to associate your bed with staying up and paying attention rather than winding down and shutting off. You could have a medical condition that affects your sleep such as hormone or blood sugar problems, thyroid disease, nutritional deficiencies, or chronic pain. Stress, anxiety, depression and other psychiatric disorders often impact sleep, which of course then makes those conditions worse. Alcohol , marijuana and other drugs can help put you to sleep but may not give you the best quality of sleep. So you may be fooled into thinking your sleeping better when using drugs and/or alcohol but in reality your brain isn’t getting the deep sleep it needs. Also, unfortunately, we live in a culture that doesn’t always allow for flexible sleep schedules. Your body may not be able to conform to the typical 10 at night and awake at 6 am routine. You may be someone that does better sleeping in 2-3 hour spurts, or maybe you do better going to bed early in the morning and sleeping during the day. But your home, work, school responsibilities may not allow for that. If you can adjust your school or work to accommodate a sleep schedule that better fits you that could make a big difference There are also sleep disorders that often require a sleep study to diagnoses and treat. This includes sleep apnea or restless legs, for example.The first thing to do if you have sleep issues is do a deep dive into your sleep hygiene including activity, diet, stress level. There are apps that can measure your sleep time and quality but they aren’t always that accurate and can be misleading. Before asking your doctor for sleeping pills make whatever life style changes you can such as diet changes, stress reduction, exercise (not before bed). Maybe some natural supplements can help such as melatonin- make sure you ae not taking too little but not too much. Most experts suggest 3-10mg. Some people need higher dose melatonin and some less. Camile tea, magnesium. Valerian, CBD (not marijuana with THC) root, kava, l -theonine are other over the counter supplements that may work. Some people do better on one than other or need a combination of a few. Check with your doctor before taking any supplement to make sure they are safe with any medicine you take or health condition you may have. Just because it’s over the counter doesn’t mean it’s safe. If you do need sleeping pills, try not to use them every night. Next blog, I will discuss sleeping medications-pros and cons.
Dr. Banov discusses his concerns and cautions regarding the flurry of over promises around psychedelics as potential treatments for a variety of mental health conditions including treatment resistant depression and anxiety.
Ketamine is an effective treatment for depression that works quickly in those who have not responded to standard antidepressant therapies. But what can you do if you feel the old symptoms are coming back while still getting treatment?
Dr. Banov discusses the controversial issue of off-label use of treatments for mental health conditions such as ketamine. While the FDA has not approved ketamine for mood and anxiety, we have decades of clinical experience to show it works and is safe.
Ketamine has been shown to be a rapid and effective treatment for an acute depressive episode but what about its' effectiveness in preventing a depression relapse? Can and should ketamine be used as a maintenance depression therapy? Is ketamine a cure?
Psychiatry has evolved in the last decade to offering more interventional therapies for treatment resistant psychiatric conditions. We now have transcranial magnetic stimulation (TMS), ketamine, and Spravato. Which is best? Answer: Depends.
Dr. Banov discusses alternatives to treating depression without typical antidepressant medications. Antidepressants do not work at all or only a little in many people with depression and there are new options available.