Depression is a mood disorder that is characterized by sadness, or having the blues. Everyone feels sad or down from time to time. Sometimes, however, the sad feelings become intense, last for long periods, keep a person from leading a normal life, and can interfere with sleep, appetite, and energy.
The depression symptoms may include:
- Feeling extremely sad or empty
- Feeling hopeless, worthless, or guilty
- Feeling very fatigued and slow or anxious and irritable
- Loss of enjoyment in things, which were once pleasurable
- Lack of energy
- Difficulty concentrating, thinking, or making decisions
- Changes in appetite that lead to changes in weight
- An increase or decrease in the need for sleep
Thoughts of death or suicide, or attempting suicide (if you are thinking of acting on ideas about suicide, it is important to get help or call your local 24-hour suicide hotline right away).
Depression is classified as major if the person has at least five of these symptoms for two weeks or more. However, there are several types of depressive disorders. Someone with fewer than five of these symptoms who is having difficulty functioning should still seek treatment for his or her symptoms. Tell your doctor how you are feeling. He or she may refer you to a mental health care specialist.
How Are Sleep and Depression Linked?
An inability to sleep, or insomnia, can be one of the signs of depression (a small percentage of depressed people, approximately 15%, oversleep or sleep too much). Lack of sleep alone cannot cause depression, but it does play a role. Lack of sleep caused by another medical illness or by personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed.
What Causes Depression?
Several factors have been linked to it, including:
- Negative environment and accumulations of pain and loss from the past
- Physical and mental health disorders
- Environment, such as living in a place that is often cloudy and gray
- Stress and inablilities to handle life's ups and downs
- Alcohol or drug abuse
- Side effects of prescription medication
- Lack of support from family and friends
- Poor diet and nutrient deficits
Insomnia and Depression
Depression can stem from any sleep disorder that causes chronic fatigue and mood problems. But insomnia, the inability to fall asleep or stay asleep, is the sleep disorder most often linked to depression.
You’ve been feeling listless and low, can’t concentrate, and don’t enjoy doing anything that used to give you pleasure. You can barely keep your eyes open during the day, yet the minute your head hits the pillow at night, you are wide awake.
This is an all too common scenario because lack of sleep and depression tend to travel together. The good news is that treating one condition may have spillover benefits for the other.
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Which Comes First, Sleep Loss or Depression?
“In people who have bad insomnia and bad depression, it is often very difficult to tell which came first,” says Mark Mahowald, MD, director of the Minnesota Regional Sleep Disorders Center in Hennepin County. “Sleep deprivation can impair mood, and impaired mood can result in impaired quality and quantity of sleep.”
The relationship between sleep and depression is not entirely understood. “But there is a well-established connection between lack of sleep and mental and physical health. “Sleep is as important an aspect of health as exercise and nutrition. Sleep is non-negotiable.”
How Treating Insomnia Can Improve Depression
The first step to better sleep is to diagnose and treat the sleep disorder and/or the underlying depression. “If you treat the insomnia in someone with depression, you will improve their chances of achieving remission from the depression
Seeing a Sleep Specialist
A sleep specialist will conduct a thorough evaluation and sleep study, in which you are monitored while sleeping, and then develop a treatment plan.
Your better sleep treatment plan may include good sleep hygiene techniques – ways to prepare your body for sleep. Avoiding caffeine after lunch, not consuming alcohol within six hours of bedtime, and not smoking or using any type of nicotine product before bedtime are some sleep hygiene techniques. Experts may also teach you relaxation techniques and cognitive therapy, in which you learn to replace sleep worries with positive thoughts.
Treating Depression to Improve Insomnia
Insomnia can precede a bout of depression or increase risk of a relapse in someone with a history of depression, but treating the insomnia can improve the outcomes of depression.