While narcolepsy is not a mental health condition, modern neuroscience shows that nearly every illness can be traced to the human mind. It is now clear that just about every illness, mental and physical, is related to emotional problems such as stress, anxiety, and trauma. While narcolepsy symptoms are often mistaken for depression, narcolepsy disorder often goes hand in hand with depression, especially in adolescents and young adults. Research studies on correlation between narcolepsy and depression are inconsistent regarding the rate of co-occurrence for depression and narcolepsy. Researchers claim that the rates of depression symptoms in narcolepsy patients are anywhere between 17% (Roth et al., 1975) and 50% (Daniels et al., 2001). The studies also differ in the conclusion on whether the depression is a cause or a consequence. When depression is suspected, mental health practitioners need to use social-emotional psychological assessments to identify whether observed symptoms have physical or mental health roots or both.
Word “Narcolepsy” gets its meaning from the Greek words “seized by numbness”. Two of the leading symptoms actually serve to reflect this phrase; they are the excessive sleepiness that is marked by “sleeping attacks” during the day that could be a physical version of a panic attack. Another leading symptom that validates the Greek phrase is the severe muscle weakness known as cataplexy which is actually brought about by very strong emotional stimuli. Cataplexy only occurs in approximately 2/3 of patients that are diagnosed with Narcolepsy and only gets triggered by a sudden emotion, such as anger or laughter, or a heavy meal, and during stressful periods in general. The attacks can last up to thirty seconds, making it sound more like a physical version of a panic attack, and are usually missed by the most skillful of observers. There are some attacks that can last quite a few minutes and are marked by the sufferer’s head dropping forward, knees buckling, and their jaw going slack. The sleepy individual’s speech may also become more stutter-like or even extremely loud.
A couple other symptoms of narcolepsy that are mental health related are atonia and hypnagogic hallucinations with the former being merely a brief moment of paralysis that can last up to twenty minutes. This can be extremely terrifying, especially first thing in the morning, since it can resemble a stroke. The hallucinations, on the other hand, are intrusive dreams that hit the individual upon waking up and can be either audio or visual and can even include touchable sensations. The visual hallucinations can seem like a dream that features strong emotional content, sort of like a film running through someone’s heard-in 3D. Other hallucinations can be more random or include melodies, feelings of light rubbing, touching, and even levitation.
Microsleep, or automatic behavior, during periods of daytime sleep attacks during a narcoleptic episode can include:
- Driving or walking, though competent, and still manage to end up in an unintended location.
- Randomly jumping from one topic to the next or stop talking altogether.
- Performing bizarre reactions such as getting the refrigerator mixed up with the washing machine; i.e., putting socks and underwear in the fridge and food in the washing machine.
- Severe forgetfulness and/or slow and clumsy movements, as well as behavior that could easily resemble and epileptic seizure.
Some other deficiencies that set off a sleep attack are:
- A low level of histamine which is a hormone that promotes wakefulness. You know how you take an anti-histamine when you have a cold or allergy attack and it makes you tired?
- A low level of epinephrine which is another word for adrenaline which leads to a more difficult time staying alert or aroused which can cause a decrease in the enjoyment of everyday activities.
- An increase in acetylcholine that increases REM sleep which is why people with narcolepsy fall into this type of rapid eye movement sleep within fifteen minutes.
- Marked changes in the chemical messenger of the brain known as dopamine which actually regulates sleep; too little dopamine decreases energy while too much energy turns you into an insomniac. The actual medical terminology these days for this “increased energy” is “manic” which is commonly used in the diagnosis of Bipolar Disorder or manic depression.
- Lower levels of leptin, another hormone that is associated with obesity which explains why most people with narcolepsy, and a lower metabolism in general, gain weight even if they do not eat much.
Now do you see the connection between mental health and narcolepsy? Many of these symptoms, such as the hallucinations and randomness, could easily be passed off as depression, bipolar, or schizophrenia. Likewise, these mental health symptoms could easily be caused by the marked sleepiness that is found in narcolepsy. Hence, in other words most people being treated for mental health are merely sleep deprived. Intense emotional problems is the underlying issue of many illnesses whether it is mental or physical. To add to this, melatonin secretes in the brain the longer an individual is in the dark which promotes sleep. Melatonin converts to serotonin which increases energy and is marked by positive emotions. Therefore, lack of sleep could lead to a lower level of energy, which would make a person more tired and less social. Because we are social beings this antisocial behavior can also lead to depression as we feel more isolated.
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