Depression and Sleep Disorders

Last updated: May 20, 2019

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The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

Sadness is a part of human life. It is natural for a person to feel sad from time to time. This feeling might be a result of an unpleasant experience or a problem that an individual is facing. However, there are instances when this feeling of sadness is persistent. Anxiety or feelings of hopelessness usually accompanies sadness. When this happens it might be a symptom of depression. Depression affects at least 20 million Americans. This is a disorder that can have serious implications in the way a person lives. It can even affect the way a person sleeps.

There is a complex connection between depression and sleep. Some sleep problems stem from depression. On the other hand sleep problems may be the root cause of depression for some.

What is depression?

Depression is a serious medical condition. This condition negatively affects how a person feels. It also affects the way that a person thinks and how that person acts. Depression causes a feeling of sadness. A depressed individual also loses interest in activities that they once enjoyed. When left untreated depression can result in a wide variety of emotional or physical problems. Depression can also affect a person’s ability to function both at work and at home. This can cause a decline in the affected person’s productivity at the workplace. It can also cause problems with that person’s personal relationships.

One in six people will experience depression at some point in their lives. Depression can affect any age group. Most of the time depression first surfaces to those in their late teens up to their mid-20s. Women have a higher likelihood of experiencing depression compared to men. Around 30 percent of women will experience a major depressive episode at some point in their lives.

Depression and Sadness: Are they the same?

There are many challenging experiences in a human being’s life. Examples of these experiences include the death of a loved one or the critical illness of a family member. Sadness and grief are normal reactions to these situations. Most of the time a person who recently lost a loved one will describe what he is feeling as depression.

The truth is that sadness and depression are different. The way that a person grieves is different from one person to another. Grief and sadness share some of the same features of depression. Depression and grief both involve intense feelings of sadness. Both of them can also result in a person’s withdrawal from his usual activities. Even though grief and depression look the same they actually have fundamental differences.

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When a person grieves, the intense feelings of sadness are frequent but not continuous. Grief is also often accompanied by positive memories of the deceased. These positive memories may cancel out the sad feelings caused by the loss of a family member. With major depression, on the other hand, an individual’s mood or interests gets decreased for most of two weeks.

Even when a person is grieving that person still maintains his self-esteem. On the other hand, a person suffering from major depression have feelings of worthlessness. It is also common for a depressed person to experience self-loathing.

In some instances the loss of a family member or a loved one can result in depression. When grief and depression occur at the same time, grief is often more severe. It also lasts longer compared to grief without depression. Although these two feelings may overlap they are different from one another. The ability to distinguish between the two can go a long way towards getting the appropriate treatment.

What are the symptoms of depression?

The way that depression manifests varies from person to person. However, there are common signs and symptoms of depression. A depressed person may show one or more of these signs. The more symptoms of depression that a person manifests, the stronger the depression is. Common signs of depression include:

Feelings of hopelessness and helplessness

A feeling of hopelessness and/or helplessness is one of the most frustrating feelings that a depressed person can experience. A depressed person often has a bleak or negative view of the future. This is the feeling that whatever happens or whatever that person does, nothing will get better.

Lack of interest in daily activities

When a person gets depressed he no longer cares about former hobbies or pastimes. A depressed person also doesn’t have any interest in social activities or sex. Most of the time depression results in the loss of a person’s ability to feel happiness or pleasure. This feeling is called Anhedonia. It is one of the main symptoms of a major depressive disorder. This is the loss of interest in things or activities that a person previously finds rewarding or enjoyable.

The hedonic function is the total amount of pleasure that a person can get from a particular activity. Depression seems to reduce a person’s hedonic capacity.

Appetite or weight changes

Depression can change the way that a person eats. One of the most common signs of depression is the change in how much a person eats. This is different from person to person. Some people with depression lose their appetite. Others increase the amount of food that they eat when they get depressed.

The loss of one’s appetite is an early sign of depression. For those who used to experience depression, loss of appetite might be a warning sign of a depression relapse.

The change in a depressed individual’s eating habits may be a result of the other symptoms of depression. An example is fatigue. The lack of energy that a depressed person feels may push that person to lack the energy to eat. Although the loss of appetite is common among those who are experiencing depression, the feelings of sadness or worthlessness can make others overeat. This is what we call emotional eating. Emotional eating is an event where one’s need to eat is not because of physical hunger. A depressed person may use emotional eating as a response to emotional hunger. Emotional eating is using food as a soothing mechanism. Eating changes the chemical balance in the brain. It also produces a feeling of fullness that can be comforting to an empty stomach. Some people also use easting as a positive association with happier times.

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Anger or irritability

Irritability is a core symptom of depression, especially in children and adolescents. Anger is an emotion that makes a person want to hurt or attack another person. This is often directed to a person whom a patient sees as a threat. In adults, depression combined with anger is a sign of bipolar disorder or personality disorder. A depressed person feels agitated and restless. The tolerance level of a depressed person is also lower compared to a person without depression. A depressed individual feels as if everything and everyone around him is getting on his nerves.

Loss of energy

When a person is experiencing depression it is natural to feel fatigued. A depressed individual also feels sluggish and physically drained. Most of the time, even the most menial tasks feel exhausting or takes quite a long time to complete.

Which sleep disorders have a link to depression?

Insomnia

Insomnia is one of the most common sleep disorders. This sleep disorder is also something that most depressed patients complain about. A person with insomnia is ten times more at risk of getting depressed compared to people who enjoy quality sleep.

Obstructive Sleep Apnea

This sleep disorder is also linked with depression. Depressed people are five times more likely to develop sleep-disordered breathing.
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Restless Legs Syndrome

Restless Legs Syndrome is a neurological condition that causes discomfort in the legs. It is also considered as a sleep disorder because the said discomfort can result in lack of sleep or poor quality of sleep. Based on a report by the Restless Legs Syndrome Foundation, 40 percent or close to half of people with RLS suffer from depression.

Hypersomnia

Hypersomnia is a disorder that causes excessive sleepiness. When an individual has both of these disorders, they have a higher chance of having depression that is more severe and lasts longer.

How is depression treated?

Treating depression usually involves using a combination of psychotherapy and/or pharmacological treatment. These therapies may be useful in treating both depression and insomnia. Treatments for sleep disorders are often crucial in the effectiveness of depression therapy.

Sleep disorders, however, often complicate the treatment of depression. If a person with depression also suffers from Obstructive Sleep Apnea antidepressants may result in breathing suppression. This will then worsen Obstructive Sleep Apnea. This is why it is important to relay to a therapist any sleep disorder symptoms prior to any therapy for depression. The effective treatment of a sleep disorder may be enough to ease symptoms of depression in some cases.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a way of treating depression. This behavioral approach is popular because it is effective and it doesn’t have any side effects. CBT is a type of talk therapy. For some people it works well or even better than medications as a treatment for depression. This is a treatment that is effective for mild or moderate depression. It can also be effective in treating severe cases of depression. However, its effectiveness against severe cases of depression depends on the skill of the therapist. CBT might work best when used in combination with other treatments, like the use of antidepressants.  

Medications

There are medications that a doctor can prescribe as a treatment for insomnia. A doctor or a sleep specialist will determine which medication will work best for a patient. The type of medication will depend on the patient’s symptoms as well as any other underlying medical conditions. Some of the most common medications for depression include:

Selective Serotonin Reuptake Inhibitors (SSRIs) – these are the most commonly prescribed antidepressants. SSRIs can ease depression through the increase of the levels of serotonin in the brain. Serotonin is a neurotransmitter that carries signals between brain cells. SSRIs work by blocking the reabsorption of serotonin in the brain. This will result in the availability of serotonin. SSRIs are selective since they only affect serotonin and not the other neurotransmitters.

The US Food and Drug Administration has approved the following SSRIs as a treatment for depression:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil, Pexeva)
  • Sertraline (Zoloft)
  • Vilazodone (Viibryd)

Tricyclic antidepressants – These are also called cyclic antidepressants and are among the earliest antidepressants. Although they are effective in treating depression, they’ve been replaced by other antidepressants that have fewer side effects. It is still a good option for some people though. They can relieve depression when other forms of treatment fail.

Cyclic antidepressants work by impacting neurotransmitters used to communicate between brain cells.

US FDA approved Tricyclic antidepressants include:

  • Amitriptyline
  • Amoxapine
  • Desipramine (Norpramin)
  • Doxepin
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Protriptyline (Vivactil)
  • Trimipramine (Surmontil)

Bright Light Therapy

Bright Light Therapy is a treatment option for individuals who suffer from Seasonal Affective Disorder (SAD). SAD is a type of depression and is also known as winter depression. SAD is believed to be a result of the changing patterns of light and darkness because of the approach of winter. The body’s exposure to sunlight can affect the Circadian Rhythms or Sleep-Wake Cycles. Because of the shorter days during autumn, there is a desynchronization of the Circadian Rhythm. This triggers depression. Most of those who suffer from SAD experience relief in springtime due to the increase in the hours of daylight.

Light therapy may use natural light or a light box. Health professionals consider this as a safe therapy. A patient should consult a doctor or a sleep specialist before undergoing any form of light therapy.

The treatment of clinical depression takes time. Medications designed to treat depression often takes weeks to become fully effective. There are also individuals who may need to try several drugs until they find one that works best for them. The intake of medications should also be continuous and a patient should not stop taking it if he or she felt relief. A patient should only stop taking a medication upon the instructions of a doctor.

Coping with depression

Depression is a disorder that can be stressful. It can also be exhausting. Most of the time a patient feels depression together with feelings of helplessness and hopelessness. When coupled with sleep disorders, depression can have a huge impact on a person’s well-being. On top of medical or mental health treatments there are ways to cope with depression and sleep disorders on a daily basis.

Keep a regular sleep/wake schedule

Adhering to a regular sleeping and waking time can help a person with insomnia. This is a way of training the body to feel sleepy or alert when a particular time comes.

Absorbing bright light in the morning

Soaking up as much morning sunlight as possible will help the body shake off the cobwebs of sleep. Light gets absorbed through the eyes and signals the brain that it is time to become alert. Darkness works the opposite way. Being in the dark releases melatonin which makes the body sleepy.

Exercise Daily

A daily exercise regimen will keep the body healthy. It will also act as a form of pastime that an individual with depression can use to keep the mind occupied. Setting an exercise goal is also important. This way the patient will have a target that he or she can strive for. This gives the person a purpose and might help ease depression. However, it is important to schedule an exercise session for at least 4 hours before bedtime. Exercising is a stimulating activity and might prevent an individual from falling asleep during bedtime.

Avoid afternoon naps

Avoid taking afternoon naps especially if a person has insomnia. Naps have a refreshing effect on the body. This refreshing effect might carry on until bedtime and make falling asleep difficult.

Limit caffeine, nicotine, and alcohol

Caffeine and nicotine are stimulants. When absorbed in the body they can make an individual more alert. If it is unavoidable consume caffeine or take nicotine only up to at least 4 hours before bedtime. This is a way of ensuring that the stimulating effects of caffeine or nicotine have worn off come bedtime.

Alcohol, on the other hand, can help a person sleep. However, alcohol only results in light sleep and not deep sleep. The deep stages of sleep are the ones that are restful and rejuvenating. Consuming alcohol also increases the frequency of urination. This can interrupt sleep in the middle of the night when a person needs to visit the bathroom to relieve himself/herself.

Confide in loved ones

This is probably the most important item on this list. Nobody should face depression alone. Confiding in loved ones will add an extra layer of support for a depressed individual. It is also important for a depressed individual to have a person to talk to whenever the need arises. A family member or a friend can help a person realize that they have a purpose in life and that they are not hopeless or helpless.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

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