The statistics don’t lie: according to the World Health Organization, depression is the leading cause of disability worldwide. In the U.S., it affects more than 18 million adults and is the primary reason why there is a death by suicide every 12 minutes.
As any therapist can tell you, depression is intertwined with sleep disorders. Persons living with depression may also suffer from insomnia, hypersomnia, or more, and lack of sleep may exacerbate the symptoms of depression.
But there’s more to it than just that. The COVID pandemic and resulting economic recession have greatly increased the likelihood of depression for many. During the worst of the pandemic, 4 in 10 adults in the U.S. reported symptoms of anxiety or depressive disorder. That, too, led to increased sleep problems, with researchers coining the term “coronasomnia” to describe the fact that many Americans have found their sleep disrupted by worry and fear throughout 2020.
If all this sounds uncomfortably familiar to you, you’re not alone, and you should be congratulated for searching out possible solutions to the double challenges of sleep and depression. Depression can be overwhelming, and your first course of action should always be to consult with a physician on the best course of treatment.
In this article, we will discuss the relationship between sleep and depression and offer some tools for living that can help. We’ll also share resources that provide aid and assistance for you if you are living with depression.
What Is Depression?
According to the American Psychiatric Association, major depressive disorder is “a common and serious medical illness that negatively affects how you feel, the way you think, and how you act.” Symptoms, which include feeling sad, loss of appetite, and trouble sleeping, must last at least two weeks.
Clinical depression is more profound than just random feelings of sorrow. “Clinical depression is not just about the feelings of sadness and grief, but is a sickness that challenges your ability to normally perform daily activities, including eating, bathing, or going to work,” says Dr. Mubashar Rehman of HealthCreeds.com.
Depression can wear many masks, and every individual will experience it in a slightly different way. For some people, it is cyclical and comes and goes with the seasons.
Seasonal Affective Disorder
Seasonal Affective Disorder, or SAD, is a type of depression that is tied to the change of seasons. Symptoms usually begin in the fall and continue through winter, slowly fading away in the spring months. Less commonly, it may be the opposite, getting worse during summer months.
Symptoms of SAD include depression, lack of interest in activities you usually enjoy, and a feeling of low energy. You may have difficulty concentrating, as well as problems getting a good night’s sleep — or issues with staying awake.
Although the causes of SAD aren’t fully understood, it seems to be related to your circadian rhythm and may also indicate a lack of two chemicals in your body: serotonin and melatonin.
Treatments for SAD include talk therapy, antidepressant medications, and the use of light therapy, which requires you to sit a few feet from a special light box that mimics natural outdoor light. If you suspect that you suffer from SAD, talk to your doctor about possible treatment plans.
What Is The Relationship Between Sleep And Depression?
When we are asleep, our body is repairing and refreshing itself, and our brains are working to process the day’s information and rest up for the day ahead. Sleep problems are often linked to both physical and mental ailments — including depression.
You may wonder if poor sleep can cause depression or if depression causes sleep issues. The answer might just be “both.”
“The relationship between sleep and depression is bi-directional,” says Dr. Bruce D. Forman, a psychologist practicing in Weston, F, who treats insomnia and mood disorders. “That is, certain types of depression that are accompanied by agitation result in insomnia. But chronic sleep deprivation is a risk factor for depression, anxiety, and even suicide, as well as a host of medical problems like diabetes, hypertension, obesity, and cognitive decline.”
How Sleep Impacts Depression
In other words, if you are tossing and turning through the night, you run the risk of outcomes other than just feeling tired the next day.
Why does lack of sleep sometimes trigger depression? For starters, sleep impacts depression by altering hormones, such as cortisol and melatonin, that play a role in the regulation of mood. Sleep deprivation can also impact your circadian rhythms, which tell you when it’s time to go to bed and wake up.
Finally, a chronic lack of sleep may alter the fundamental properties of your neuroendocrine stress system, changing the way you react to stress and making it harder for you to be flexible and able to handle the ebb and flow of daily life. That, in turn, makes you more susceptible to disease and illness, including depression.
How Depression Impacts Sleep
Let’s flip the equation now and look at how depression impacts sleep. If you have struggled with depression, you’ve likely experienced at least some insomnia since it’s estimated that roughly 75% of those with depression have trouble sleeping.
You may also have experienced hypersomnia — excessive daytime sleepiness, sleep inertia, and a prolonged need for sleep. Hypersomnia, like insomnia, is consistently seen as a symptom of depression and may be just as debilitating.
Research also indicates that those with depression have about a 20% chance of having obstructive sleep apnea. This respiratory disorder causes a collapse of airway while the individual is asleep, leading to disturbed and difficult patterns of breathing.
All together, it’s clear that most people with depression also deal with a sleep disorder that is associated with it. But when you’re trying to keep your head above water and treat your depression properly, difficulty sleeping is the last thing you need.
How Can Medication Impact Your Sleep?
But even that isn’t the full picture in the depression/sleep conundrum. Another factor that plays a role is the medications that are often prescribed for depression. Some of these may impact your sleep patterns, for better or worse.
Selective serotonin reuptake inhibitors (SSRIs), for example, may cause sleeping issues, according to Dr. Hemangi Mishra of springhomeo.com. Examples of this category of drugs include fluoxetine, paroxetine, and sertraline. Other medications that can hinder sleep include ACE inhibitors, statins, and alpha-blockers.
SSRIs appear to decrease the amount of time we spend in REM sleep, which allows your brain to make neural connections that help with mental and physical well-being. Your body and mind are revitalized during REM sleep, and without it, your overall health will decline.
On the other hand, medications that can help you to sleep better include the antidepressant trazodone, as well as doxepin, zolpidem, and antihistamines, and other over-the-counter sleeping aids, says Dr. Mishra.
Antidepressants that help you sleep better, however, may cause oversedation. Research indicates that they should be used in small doses to allow the medication to impact the depression without also causing daytime sleepiness.
Meditation For Better Balance And Sleep Health
There is no miracle cure for depression — or for sleep challenges, either. But meditation may come close. Meditation is a broad term that refers to a wide range of practices that have served to create a state of peacefulness and calm for centuries.
Meditation uses a variety of techniques to help you regain a sense of self in a chaotic world. One common meditative practice is to focus on your breath while engaging in deep breathing exercises.
Meditation can help you sleep better, and there is research that it may help mitigate depression, too. If you’ve never tried it, it’s important to note that meditation doesn’t have to take a great deal of time, and it is not difficult. Here are a few tips for integrating meditative practices into your life:
- Find a time: it could be on your morning commute or your evening shower. Any time you can carve out a spare five or ten minutes, you can have a mini-meditation session.
- Don’t sweat the small stuff: yes, there are hundreds of meditation guides online that tell you the “best way” to do it, but in reality, there is no right or wrong way to meditate.
- Pay attention to your body: you can do meditation while sitting, lying down, or even standing. But you should be in a comfortable position that allows you to relax.
- Notice your breath: most meditative practices ask you to give attention to your calm breathing as you inhale and exhale.
- Be kind to yourself: meditation isn’t hard, but it does take practice. Don’t feel bad if your mind wanders; just return your attention to your breathing when you notice that you’ve wandered.
To get started, try playing this meditation recording by Carrie Byrd, a Trauma-Informed Mindfulness Facilitator. They will guide you through a short session designed to prepare you for a good night’s sleep.
Our meditation guides:
Sleep Tips That Help With Depression
- Go to bed at the same time every day, even on weekends. Research shows that our brains thrive on routine and respond positively to regular sleeping hours.
- Exercise regularly, but not too close to bedtime. This can be hard when you are depressed but can help prepare you for a better night’s sleep.
- Assess the comfort of your sleep space. Make sure your pillows, mattress, and other sleep surroundings are comfortable and designed to help you drift into slumber.
- Spend time outside. Being in sunlight helps regulate your biological clock, which tells you when to sleep and when to wake up.
- Avoid technology. At least an hour before bedtime, close the laptop and put away your cell phone for the night. Your devices emit blue light, which can keep you from sleeping.
- Have a sleep routine. Maybe you read before bed, take a warm bath, or have a snack. Whatever your routine, allow yourself to unwind and relax before bedtime.
- Ask your doctor about cognitive behavioral therapy. “The gold standard for treating chronic insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I),” says Dr. Forman.
- Avoid alcohol before bedtime. It might seem like a glass of wine would be a great way to relax, but alcohol can actually disrupt your sleep patterns and make for a fitful night’s rest.
- Keep naps short. If you can manage without taking a nap during the day, that’s great. If you feel that you truly need some shut-eye, keep it to 20-30 minutes, max.
- Don’t use your bed for anything other than sleep or sex. Try not to lie in bed when you’re working, talking on the phone, or watching TV.
|National Alliance on Mental Health (NAMI)||The NAMI hotline can answer questions, offer support, and provide the next steps for those with a mental health crisis.|
|American Psychiatric Association (APA)||The APA’s information page on depression is packed with information to help you understand this illness.|
|U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)||SAMHSA’s national helpline offers referrals to treatment facilities and support groups for those suffering from mental illness or substance abuse — and it’s available in English and Spanish.|
|Sleep Foundation||Learn more about Cognitive Behavioral Therapy for Insomnia (the “gold standard” according to our source) at the Sleep Foundation’s info page.|
|National Suicide Prevention Lifeline||Go here or call 1-800-273-8255 if your sleepless nights or depression leave you with suicide ideation.|
|Mindfulness Meditations for Depression: 100 Practices for Solace and Self-Compassion||There are many books available to help with both depression and sleep issues; we like this one, which features easy practices to relax and calm you.|
|Postpartum Support International||If your depression and sleep challenges are related to childbirth, this organization offers online support groups and more.|
|Veterans Crisis Line||If you are currently serving in the military or are a veteran, you are at a higher risk for sleep issues and depression. This crisis line can help.|
|U.S. National Library of Medicine (NLM)||The NLM’s Medline Plus website is a wealth of information on depression, sleep issues, medications and their side effects, and more.|
If you suffer from depression and sleep-related challenges, we hope the tips and resources we’ve included are useful to you and provide a positive step in your journey to wellness. If you haven’t already done so, consider talking to your doctor about ways you might continue to heal. Modern therapy techniques, such as cognitive behavior therapy and both OTC and prescription medications, are available to bring relief from both the symptoms of depression and the pain of sleepless nights. It may take some effort to find the right treatment for yourself, but it’s worth it in the long run to regain your joy in life and to benefit from nights of restorative slumber.