Medicine is an art. It’s meant to be a science, but in fact it isn’t. It is slightly more of a science than many other healing arts, but still most of the decisions made by doctors have very little to do with science based on solid, relevant evidence.
Psychiatric medicine is one of the worst offenders.
As much as psychiatry has tried to build itself a scientific basis it is still woefully flawed at many levels.
So as I began to dig to the bottom of the mess and realized how little basis psychiatry has for it’s scientific claims, I began to need other tools to help me decide how best to help people.
One of those tools is called Occam’s Razor (or Ockham’s Razor.)
Occam’s Razor says that if you have two equally valid explanations for what is going on, choose the simpler one.
It’s not a scientific principle, but it is a good rule of thumb.
In my line of work what this means is that I fix the causes that are definitely present, before I go after any others.
At one stage a woman came to me with a diagnosis of long-standing depression.
She had been on multiple anti-depressants, had sought the usual range of medical and non-medical help, and although she was still seeing a psychiatrist her local doctor had gotten desperate with her lack of improvement and had sent her along to see me.
She came to her assessment visit, and among many other questions I asked her when this all began.
She told me she had been fine all her life until the birth of the first of her three children about 18 years ago. Just 2 months after her son was born she had been diagnosed with post-partum depression, better known as the ‘baby blues’, and had been on and off medication ever since. She had had the same depression again with each of her two other children, and in fact with the last of the three she had had a short stay in hospital.
However even as they had grown up she still hadn’t got rid of the depression.
Fortunately this woman came to be a few years after I had had my first child and so I asked her a very specific question.
I asked her how well she slept after the birth of her first child.
She instantly said that she hadn’t slept at all. From the first night she had been kept awake by the baby crying, and to this day she was a very light and disrupted sleeper. Before having children she had always slept very soundly.
So here was the situation…
This woman was diagnosed with depression.
She had been told by psychiatrists and doctors that the cause was biological, set off by the hormonal changes she had had following the birth of her children.
What I was hearing however was that she had a history of chronic sleep deprivation, starting from two months before she was diagnosed. The effects of chronic sleep deprivation are much like depression ie lacking energy, moodiness, loss of interest in usual activities, unmotivated, poor concentration.
So I had two possible diagnoses: biological depression or chronic insomnia.
The diagnosis of hormonal or biological depression has no proof. It is just a list of complaints with a theory attached to it. There’s no blood test, or brain scan, or psychological checklist that can prove it.
However there was no question that this woman had chronic insomnia. It was just a question of whether this was the cause of her depressive complaints.
Applying Occam’s Razor made my next choice easy.
I recommended that to the woman that we treat her insomnia because until we improved her sleep any other treatment was just based on guesswork.
She was already taking sleeping pills, but they weren’t working for her, and she was worried about staying on them and getting addicted. So I taught her how to use the sleeping pills in a better way to get herself a full night’s rest, AND avoid any risk of being stuck on them. She was delighted.
In the end we never did need to address the “Depression” she had been diagnosed with. Treating the sleep alone was all she wanted to get her life back on track.
She certainly wasn’t the only person I have seen in this situation. In my counselling practice sleep issues are the second most common cause of depression that I treat.
If you have trouble sleeping, and have considered using pills or are currently on them, then you might find many other benefits to getting a better night’s rest.
If you’ve been diagnosed with Anxiety or Depression you may have been told that sleeping problems are one of the symptoms. That may be true, but insomnia can also CAUSE or at least worsen these problems, so consider the simple step of treating sleep issues directly.
However, don’t take sleeping pills the way they are usually recommended. Anyone who sells pills is working against their own best interests to tell you how to get off them quickly. So you won’t find the information I teach on the instructions in any pill packet.
Sleeping pills can be a real benefit, but you have to know how to use them effectively and safely, and you can discover how to do that here:
-Dr Martin W. Russell