Autonomic Nervous System Disorders and Depression: Key Insights

Q: Autonomic Nervous System Disorders and Depression: Key Insights

Hello： 1. Weight loss, decreased appetite, and lack of interest may be symptoms of depression. 2. The assessment of autonomic nervous system dysregulation is often based on subjective feelings reported by the patient through questionnaires. 3. Simi

Autonomic nervous system dysfunction, trust in medication, depression?

Background: At the end of October 2023, due to a breakup, I experienced interrupted sleep, waking up every one to two hours and having difficulty falling asleep.
The doctor determined that this was due to a significant event, so I began taking sleeping pills.
In December and January, I experienced dizziness (lasting all day), severe ear pain, and high eye pressure pain.
A psychiatrist diagnosed me with autonomic nervous system disorder.
Treatment process: Although I followed the doctor's advice to reduce the sleeping medication (feeling that my mood was okay, I reduced it by 1/4 every two weeks), I later experienced autonomic nervous system disorder, and the reduction process was interrupted from February 9 to February 14.
During the Lunar New Year holiday, feeling happy, I stopped the medication on my own (only the sleeping pills were not stopped).
During this period, I really did not feel any discomfort.
However, a few days ago, I started experiencing persistent all-day dizziness, slowed reaction time, and thinking.
I then resumed taking medication for the autonomic nervous system.
At the same time, I noticed an unnatural weight loss of two kilograms.
I do not lack appetite, but I have no desire to eat and also experience bloating.
Last week, I also had emotional issues: I had no interest in anything, felt worthless at work, wanted to find someone to talk to, and was afraid of being alone, so I kept scheduling activities, but I did not have suicidal thoughts.
I have taken a screening test and do not consider myself to have depression.
Medications: 1 tablet of Yiqining, 0.5 tablet of Fanduo Shanshan, 0.5 tablet of Lianduomian.

Questions:
1.
Given my abnormal weight loss and other symptoms, is it possible that I have depression? The doctor did not diagnose me with depression.
2.
The doctor mentioned that my sleep had improved significantly (I no longer fear insomnia or feel anxious about waking up in the middle of the night), so I stopped the medication on my own.
This is common among many patients who stop medication after feeling better.
How can we assess the improvement of the autonomic nervous system?
3.
Many articles online state that autonomic nervous system disorders are similar to depression; even if symptoms improve, should medication be continued for 4-6 months?
4.
Why are medications for treating the autonomic nervous system also used for depression and anxiety?
5-1.
Is it true that autonomic nervous system disorders and insomnia are due to abnormalities in melatonin and serotonin production, which is why related medications are needed?
5-2.
If I improve, does that mean melatonin and serotonin will be secreted normally again, and I can stop taking the medication?
6.
I have read in Traditional Chinese Medicine and online articles that long-term use of melatonin and serotonin (even under a doctor's guidance) may cause the body to stop producing them naturally.
What are the inaccuracies in the views of Traditional Chinese Medicine and online articles regarding this?
7-1.
How can we fully trust doctors and medications?
7-2.
Are autonomic nervous system disorders and depression symptoms that must rely on medication for improvement?
8.
I am a bit scared about my recent abnormal weight loss.
How can I adjust my mood? What should I closely monitor regarding weight loss? (I had a full health check last year, so other possibilities have been ruled out.)

Miss Zhang, 30~39 year old female. Ask Date: 2024/03/08

Dr. Li Zhengfeng reply Psychiatry

Hello:
1.
Weight loss, decreased appetite, and lack of interest may be symptoms of depression.

2.
The assessment of autonomic nervous system dysregulation is often based on subjective feelings reported by the patient through questionnaires.

3.
Similar to depression, it is recommended to continue medication for 4-6 months even after symptoms improve to prevent immediate relapse.

4.
Autonomic nervous system dysregulation often coexists with anxiety and depressive symptoms, so treatment typically involves antidepressants and anxiolytics.

5.
It is currently believed that autonomic nervous system dysregulation may be caused by an imbalance of neurotransmitters, so medications are usually related to this.
After improvement, it is advised to continue medication for 4-6 months and only discontinue once stable; if a relapse occurs, medication should be resumed.

6.
The body will naturally secrete neurotransmitters and will not stop producing them due to external supplementation.

7.
The doctor-patient relationship is very important; it is recommended to choose a physician you trust for consultation.
Non-pharmacological treatments such as psychotherapy and activity therapy are also available for autonomic nervous system dysregulation and depression, often used in combination.

8.
Weight loss does not necessarily indicate a serious problem; it is advisable to continue monitoring and discuss with your physician if there is a possibility of a physiological condition.

Wishing you a speedy recovery.

Reply Date: 2024/03/08

More Info

Understanding the relationship between autonomic nervous system (ANS) disorders and depression is crucial, especially given the complexities of how these conditions can interact and manifest in individuals. Your situation, marked by significant emotional stress and subsequent physical symptoms, highlights the intricate interplay between psychological and physiological health.

1. Weight Loss and Depression: The unintentional weight loss you are experiencing can indeed be a symptom of depression, even if you do not identify as having depression. Depression can manifest in various ways, including changes in appetite and weight. The lack of interest in food and the sensation of bloating can be linked to anxiety and stress, which often accompany depressive states. It's essential to monitor these changes closely, as significant weight loss can lead to further health complications.

2. Evaluating Improvement in ANS Disorders: Improvement in autonomic nervous system disorders can be subjective and may not always be easy to quantify. Common indicators include reduced frequency and severity of symptoms such as dizziness, palpitations, and anxiety. Regular follow-ups with your healthcare provider can help assess your progress and determine whether adjustments to your treatment plan are necessary.

3. Medication Duration: The recommendation to continue medication for 4-6 months after symptom improvement is standard practice in both depression and ANS disorders. This approach helps prevent relapse and allows the body to stabilize. Discontinuing medication prematurely can lead to a resurgence of symptoms, which is why it's crucial to follow your doctor's advice regarding medication tapering.

4. Overlap of Medications: The use of antidepressants and anti-anxiety medications in treating ANS disorders is common because these conditions often share overlapping symptoms. Medications that affect neurotransmitters like serotonin can help stabilize mood and alleviate anxiety, which in turn can improve physical symptoms associated with ANS dysfunction.

5. Neurotransmitter Function: Your understanding of melatonin and serotonin's roles is correct. These neurotransmitters are crucial for regulating sleep and mood. When there is an imbalance, medications may be necessary to restore normal function. Improvement in symptoms may suggest that your body is beginning to regulate these neurotransmitters more effectively, but it does not always mean you can stop medication without professional guidance.

6. Concerns About Long-term Medication Use: The fear that long-term use of supplements or medications could lead to the body becoming reliant on them is a common concern. However, this is not universally true. While some individuals may experience changes in their body's natural production of certain hormones or neurotransmitters, many can successfully taper off medications under medical supervision without significant issues.

7. Trusting Healthcare Providers: Building trust with your healthcare provider is essential. Open communication about your concerns, treatment options, and any side effects you experience can foster a better therapeutic relationship. It’s also beneficial to seek second opinions or consult with specialists if you feel uncertain about your treatment plan.

8. Managing Weight Loss and Emotional Well-being: To address your weight loss and emotional state, consider implementing a balanced diet that includes nutrient-rich foods to support your overall health. Engaging in regular physical activity, even light exercise, can also help improve your mood and appetite. Additionally, mindfulness practices such as meditation or yoga may assist in managing anxiety and stress. If feelings of fear or anxiety persist, discussing these with a mental health professional can provide further support.

In conclusion, the relationship between autonomic nervous system disorders and depression is multifaceted, and managing these conditions often requires a comprehensive approach that includes medication, lifestyle changes, and psychological support. Regular communication with your healthcare provider is key to navigating your treatment effectively.

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