The webinar was structured around four main topics: depression, the basics of insomnia, the connection between depression and insomnia, and effective management strategies. Dr Korb began by discussing the symptoms of depression, drawing from the latest classification systems like the DSM-5 and ICD-11, although he mentioned that many practitioners still rely on the older ICD-10. “It’s essential to understand the various symptoms of depression, which can be categorised into psychological, physical, cognitive, and social symptoms,” he explained. The psychological symptoms include feelings of sadness, guilt, and suicidal thoughts, while physical symptoms may manifest as insomnia, energy loss, or changes in appetite.
Dr Korb emphasised that insomnia is often a primary complaint among patients with depression, revealing a significant overlap between the two conditions. “Up to 90 percent of patients with major depression report some form of sleep problem,” he stated. According to Dr Korb, this statistic underscores the need for clinicians to inquire about sleep disturbances when assessing depressive symptoms. He also pointed out that untreated insomnia can exacerbate depression, leading to more severe symptoms and a prolonged recovery process. “If insomnia persists after depression is managed, the chances of relapse into depression increase three to six times,” he cautioned.
When discussing management, Dr Korb stressed a holistic approach: “Pharmacotherapy is just one avenue; lifestyle changes, exercise, and psychological therapies are equally vital.” He advocated for mindfulness and social support mechanisms, and acknowledges the potential of new treatments like archetamine, which is currently still experimental in South Africa. He encouraged a comprehensive understanding of both insomnia and depression, noting, “We need to consider the total picture, not just medication.”
