How Depression Causes Sleep Problems

This article explores the link between depression and problems with sleep which could potentially lead to insomnia.

We’ll start by taking a look at the symptoms of depression, moving on to the effect depression has on sleep, and then finally how to overcome depression.

Symptoms of Depression

So how do you know if you have depression? The main symptoms of depression are as follows:

  • Increased anxiety
  • Less inclined to socialize
  • A loss of interest in things that you once enjoyed
  • Reduced self image – feeling hopelessness and worthlessness
  • A long period of sadness
  • Problems sleeping

Many people suffer from one or more of these symptoms over the course of their lifetime, but unlike a bad
day or a bad week, people with depression suffer from these symptoms over a prolonged period of time.

Tests such as the Zung Self-Rating Depression Scale can be used to judge whether you have depression and to what extent it could be affecting your sleep. After answering twenty questions that relate to the symptoms of depression and how often have appeared during the past few days, you’ll get a score to indicate either no depression, mild depression, moderate depression or severe depression.

Some forms of depression come in cycles. People with bi-polar are sometimes prone to suffering from bouts of depression that can last for at least a few weeks.

Seasonal Affective Disorder, also known by the acronym SAD, is where there is a strong correlation between episodes of depression and the season. As winter comes, people with SAD begin to feel depressed, and as the spring comes, their depression lifts.

Depression may be caused by a single event, such as a death in the family, or by long term patterns of negative thinking that have built up over time.

Which came first – Depression or Insomnia?

Depression and SleepThere is a strong correlation between sleep problems and depression. People who are depressed tend to get less sleep, for the reasons we will cover in detail in the next section. However, people who have problems sleeping, have an increased likelihood of developing depression.

This is what makes the issue of depression and sleep complex to decipher. For some people, depression caused their sleep problems, so the solution to sleeping better is to resolve the depression. But for others, sleep problems caused their depression, so their solution would be to resolve the sleep problem and as they sleep better, the depression will naturally lift.

It’s for this reason it’s very helpful to know what came first, the sleep problem or the depression. That way you know which area needs your attention and which will resolve naturally.

The Effects of Depression on Sleep

Depression can affect your sleep in many different ways, such as:

  • Falling asleep
  • Staying asleep
  • Sleeping too much or oversleeping
  • A lack of refreshment provided by sleep

Not everyone will suffer the same effects, you may just suffer from one or two.

In this section we’ll take a look at how depression affects your sleep.

Problems falling asleep

To fall asleep, first your body must relax. This requires you to let down your guard and let go of the day’s events. However, if your mind is producing anxious thoughts in bed from unresolved issues, you will find it much harder to fall asleep.

Your mind doesn’t know the difference between a real event and a vividly imagined one. This means your body’s biology will react to your thoughts as if they were actually happening. If you think fearful thoughts, your body will respond with what’s known as the fight or flight response. Adrenaline will pump around your body, making your heart beat faster and your muscles tense. Your body is effectively preparing you to either fight the threat or physically run away from it. But of course, neither result will help resolve your thoughts. Unless you can stop having the thoughts, your body will continue to react to them.

And since preparing for a burst of energy is the complete opposite to falling asleep, your body will continue to stay awake.

If this was to continue night after night, your sleep timing could be affected if you’re unable to stick to a sleep pattern. You could also develop what’s called learned insomnia, where you body associates your bed not with falling asleep, but with staying awake thinking those thoughts, making it harder to fall asleep each night.

Problems staying asleep

Some people who have a high sleep drive, might not have any problems getting to sleep. If you go to bed sleepy enough, you can bypass all those anxious thoughts that you might have otherwise had. But that’s not to stay they necessarily disappear.

Everyone wakes up at least a few times every night. These nocturnal arousals are a completely natural part of your sleep cycle, and most of the time they are so brief you don’t even remember having them.

If you have a lot of suppressed anxious thoughts, the brief arousal gives them an opportunity to occupy your mind and make their voice heard. Since your sleep drive is not as high as when you first went to bed, you may not be able to fall back sleep.

And so you find yourself in the same situation as mentioned in the ‘problems falling asleep’ heading above. The stressful thoughts will keep you awake until you either stop having them or are sleepy enough to suppress them and fall asleep, where they will be waiting for you on the other side.

Reduced quality of sleep

People who are depressed spend more of time sleeping in a stage called REM, standing for rapid eye movement. REM is a light, very active stage of sleep. It’s known as paradoxical sleep, because although you are asleep, your brain is very active.

The problem with REM sleep is that it’s not very refreshing. The increased amount of REM in the sleep cycle comes at the cost of having less of the deeper stages of sleep, and it’s those deep stages of sleep that provide refreshment.

REM sleep is the stage you experience dreams. One of the symptoms of depression is vivid dreams for this very reason. If the dreams are distressing, it could make going to sleep a frightening experience, which could in turn develop into a further sleep problem.

Early Morning Awakenings

Waking up early in the morning and being unable to fall back to sleep, but at the same time, not feeling refreshed from sleep, is a well known symptom of depression.

It’s caused by an advancement of your sleep cycle. Non depressed people experience a number of cycles of NREM sleep (stages 1, 2 and 3, with stage 1 being light sleep and stage 3 being deep sleep) before moving to primarily light and REM sleep until they eventually wake up. However people with depression encounter REM sleep much earlier in the night, essentially skipping a large portion of the sleep cycle.

So depressed people experience the same depth of sleep as someone without depression would a few hours before they wake up much earlier in the night, and so they also wake up earlier.

Another reason is the same as the one mentioned in the ‘problems staying asleep’ heading. As the night goes on, you’ll become less tired, and so find it harder to suppress anxious thoughts during natural awakenings and light sleep. The thoughts can take center stage in your mind and keep you awake.

There’s a theory that the brain may actually wake you up early on purpose to prevent you from getting too much REM sleep. The reasons for this are not fully understood, but indications are that it could have something to do with preventing you from experiencing too many dreams.

Sleeping too much or oversleeping

This can be caused by three factors; motivation, reduction of sleep quality, and the effects of SAD.

First, if you are depressed, you may be less motivated to wake up in the morning. For some people sleep is a way to escape from the day ahead. Others just don’t see the point in waking up. A loss of interest in activities you once enjoyed is a symptom of depression, and is what could be behind not wanting to wake up in the morning.

Second is because the reduced quality of sleep leaves you still feeling sleepy, so you may accidentally oversleep or might go back to sleep because you believe you have under slept.

The third factor is the effects of seasonal depressive disorder or SAD. Waking up early in the morning in the winter is different than waking up in the summer because the levels of light are different. The amount of light around us is one of the clues our bodies use to figure out the time of day, so your internal body clock knows when you should sleep and when you should wake up. There’s a hormone called melatonin that makes us sleepy, that is excreted during darkness but suppressed by daylight. So by waking up in the dark, your body still thinks its night time and the melatonin is still being secreted, making your feel sleepy. You then may either wake up tired or oversleep by mistake, or by choice if you felt you hadn’t gotten enough sleep.

How to Overcome Depression

This is by no means intended to be an exhaustive list to overcome depression, but I hope it provides at least a starting point. As always, if you have a medical or mental health concern, you should consult a medical professional.

Provide a time and place for your thoughts

The reason why you think anxious thoughts is because your thoughts are trying to tell you something. The more you ignore them, the more they bid for your attention. Suppressing thoughts does not make them go away, it only temporarily suspends them.

So instead of ignoring these thoughts, why not give them a time and a place to have their say.

A popular cognitive behavioral technique is to vividly imagine the thought as a letter. Imagine the letter floating towards you, reach out for it, see if it is addressed for you, and if it is, open the letter and acknowledge the message behind the thought. Then after consideration either dismiss the thought or take note of it, thanking the thought for its message as you let it go.

You may need to go through this process several times for persistent thoughts, but by acknowledging them at a time and place that’s suitable for you, less thoughts will appear while you’re in bed.

Some people like to do this in their mind while others like to write down the process in a journal. No one way is better so choose what feels right for you.

Wind down before bed

One of the best methods to shorten the time between going to bed and falling asleep is to have an hour long buffer period before you fall asleep. During this hour, avoid bright lights and any stressful thinking. Read a book, do the washing up, catch up on some cleaning, anything that provides a mental shift in gears before you go to bed.

By using this technique, you’ll be able to fall asleep fast even after the most stressful of days. Because you’re already relaxed before you get into bed, you’ll be less likely to experience anxious thoughts that have the potential to keep you awake.

A good way of winding down before bed is to have a warm bath. To sleep, the core temperature of your body needs to slightly drop. By coming out of a warm bath and cooling down, you speed up this natural reduction of your body’s core temperature that speeds up the onset of sleep.

Light therapy

Known in the field as Bright Light Therapy or BLT. This is a technique of exposing yourself to light in the morning, letting your body know that it’s daytime, removing the feelings of sleepiness as you gradually feel more alert. By using light, you suppress a hormone called melatonin, a hormone used by your body to promote sleepiness during darkness.

Light therapy is particularly useful for people who suffer from SAD, seasonal affective disorder, with studies showing an 80% reduction of symptoms in sufferers by the use light therapy. You might find it useful to take a look at my light therapy product reviews to see what’s available on the market.

For further methods on how to stop oversleeping and instead naturally wake up fresh and alert in the morning, see the oversleeping article.

Get better sleep

If problems sleeping was the cause of your depression, and not the other way around, by getting better sleep your depression will naturally lift. The process I recommend to get better sleep is to understand why you can’t sleep and why insomnia is the resultant outcome, and then applying changes to your daily routine.

I recommend taking a look at the following series:

  1. What is Sleep
  2. What is Insomnia
  3. How to Sleep Better

Another good resource for finding out why you can’t sleep is the Causes of Insomnia Questionnaire.

An article in particular I recommend reading from the how to sleep better series is How to Reduce Stress and Anxiety which contains a range of ideas to reduce stress and anxiety both before you go to bed and while you’re in bed.

Hypnosis

Hypnosis is not only effective at treating sleep problems, can it can also be used to treat many forms of depression and anxiety.

Hypnosis works with the notion that thoughts create behaviours, which lead to habits, and our habits ultimately form how we live our lives and how we feel about ourselves.

People have negative thoughts, which could lead to anxiety, which could lead to not being able to fall asleep, and which ultimately results in making us feel that we’re not living up to our full potential. It’s a negative cycle.

Hypnosis tackles the root of the problem, the initial thoughts inside your brain, and seeks to change them with something more positive and often more accurate about your own situation.

If you’re interested in using hypnosis to help tackle depression, take a look at the Depression Program from Uncommon Knowledge. It’s a comprehensive course of treatment for depression from one of the leading providers of hypnosis. You get 2 ebooks and 17 audio sessions designed to rapidly lift your mood and create a long term shift in your thinking.