The relationship between your sleep and your mental condition is mutually interdependent and complex. Disrupted sleep can lead to emotional stress, depression, and anxiety. And psychological problems related to depression or an anxiety disorder almost always disrupt your sleep.
Affected people often don’t realize that lack of sleep is the cause
If you feel depressed or anxious, you may not realize that lack of sleep is the cause. But even small amounts of sleep deprivation over time can severely affect your mood. Just a night of disturbed sleep can leave a person feeling worried and depressed the next day.
You may find that you are less enthusiastic or more irritable or even have some of the symptoms of clinical depression, such as a feeling of persistent sadness or emptiness. All these changes in your mood can affect not only your mental health but also your relationships and family dynamics.
Why insomnia increases the risk of depression and anxiety
Doctors and researchers today widely agree that there is a close connection between sleep and mood. For example, people with insomnia, one of the most common sleep disorder, have a higher risk of depression and anxiety than people with a regular sleep pattern. The likelihood of developing a clinical depression is said to be ten times higher, and it is 17 times more likely to suffer from clinical anxiety.
It is a vicious cycle: The more often a person has insomnia, and the more often he or she wakes up at night, the higher the chances of developing depression.
It is important to note that it is not necessarily the sleep disorder itself that causes depression. But the lack of sleep associated with a sleep disorder or caused by another medical condition or personal problems plays a vital role. Excessive sleepiness strongly impacts your attitude to life, your energy levels, motivation, and emotions. It then can even become the cause of clinical depression or an anxiety disorder.
Can depression cause sleep disorders?
It is estimated that 75% of people who suffer from depression also have insomnia. In fact, one of the most common signs of depression is insomnia, or the inability to fall asleep or stay asleep. Another sign of clinical depression could be too much sleep or oversleeping.
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If depression is untreated, you may experience overwhelming feelings of sadness, hopelessness, worthlessness, or guilt, all of which can interrupt sleep. Or you ruminate over situations over which you have no control. This pondering leads to a high degree of anxiety and fears about poor sleep that further aggravates insomnia.
Poor sleep then often leads to feeling fatigued during the day. When you are tired, you move less, and this leads to a deterioration in your fitness level. Finally, you find yourself in a vicious circle of inactivity and sleep disorders, which causes both physical and mood-related symptoms.
What’s the link between depression and oversleeping?
Same as insufficient sleep due to insomnia, oversleeping could be a sign that someone is depressed.
It’s important to note that although you spend a lot of time in bed, it often means that your sleep quality is poor. That’s why too much sleep is associated with many of the same health risks as too little sleep, including heart disease, metabolic problems such as diabetes and obesity, and cognitive problems, including memory loss.
Risk of misdiagnosis
Since the symptoms of depression sometimes overlap with the symptoms of sleep disorders, there is a risk of misdiagnosis in many cases. For example, a depressed mood can be a sign of insomnia, OSA, or narcolepsy. Restless Legs Syndrome (RLS), a neurological disorder that causes discomfort in the legs and sleep disorders, is also associated with depression.
That is why you must find out the real cause of your suffering so that you engage in the right therapy.
How do you know if you are suffering from depression?
Depression is classified as a mood disorder (major depressive disorder). A person suffering from depression feels discouraged, sad, hopeless, unmotivated, or not interested in daily activities to the extent that it interferes with their everyday activities.
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Common causes of depression are conflict, stress, (hereditary) illness, abuse, death or loss of loved ones, certain medications, genetics, or sleep disorder.
Who risks suffering from depression and insomnia?
Depression affects all types of people around the world, but certain people, including women and older people, are more likely than others to develop depression.
Among older adults, higher rates of depression and sleep problems can be partly explained by higher rates of physical illness.
In women, maternity and hormonal changes throughout the life cycle (menstruation, menopause) may contribute to higher rates of depression. This may also be a reason why women and older adults have insomnia more often than men and younger adults.
Children with depression
Many children and young people with depression suffer from sleep problems such as insomnia or hypersomnia (excessive sleepiness during the day) or both. Also, children with depression who have both insomnia and hypersomnia are more likely to have severe and prolonged depression.
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They are also more likely to suffer from too much or too little weight, restricted mobility, and anhedonia (inability to feel pleasure). In general, young people who feel unhappy report that they cannot sleep well at night.
Seasonal affective disorder and depression
Seasonal affective disorder (SAD), also known as “winter depression”, is a type of depression. SAD is thought to be influenced by the changing patterns of light and darkness that occur as winter approaches. The circadian rhythms are regulated by the body’s internal clock and by solar radiation.
As the days become shorter in the autumn, the circadian rhythms can become desynchronized and cause depression. For most people with SAD, the depressive symptoms dissolve in the spring as the days become longer as the daylight increases.
What is an anxiety disorder?
The term’ anxiety disorder’ refers to specific psychiatric disorders that involve extreme fear or worry and a state of restlessness and agitation. It often goes with panic attacks, of which the common symptoms are palpitations, sweating, trembling, shortness of breath, sense of choking, chest pain, nausea, dizziness, restlessness, irritability, muscle tension, and sleep problems.
Several issues can lead to an anxiety disorder like
- health issues like heart problem, anemia and asthma attack
- abuse of alcohols and drugs
- certain medication that can trigger an anxiety attack
Right now, around one in five people in America have some type of anxiety disorder. There is a variety of them – in addition to generalized anxiety disorder, there is OCD (Obsessive Compulsive Disorder), PTSD (Posttraumatic Stress Disorder), panic, and social anxiety disorders.
Can anxiety cause a sleep disorder?
You wake up in the middle of the night, and your mind is racing, filled with “what if” thinking. You get up to go to the bathroom. You’re up only for a few minutes, but you may have had over twenty different thoughts.
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When you get back into bed, the thoughts have filled your head so much that you cannot go back to sleep. While you lie there worrying about things that you often cannot even control, you watch the minutes that become hours simply pass by.
If that sounds like you, then you have insomnia, which is probably caused by anxiety.
The strong link between insomnia and anxiety
Research has found a very strong link between insomnia and anxiety – when a person suffers from one, they will likely suffer from both.
People who deal with anxiety disorders generally experience acute stress. It could be the trauma that they are coping with or obsessive thoughts. They may excessively worry about their current situation or what is ahead about their career, relationships, and other responsibilities in life.
Regardless of the source, the constant state of anxiety and stress puts the nervous system on high alert. So at night, as you are lying in bed filled with anxiety, your brain becomes very active, which pushes sleep even further away.
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Why is that? While your body produces the sleep hormone melatonin to send you off to sleep, the stress hormone cortisol overrides it. And the more stress you experience, the more difficult it becomes for your brain to produce the necessary melatonin to put you to sleep at night.
From transient insomnia to chronic insomnia
If your sleeplessness lasts only for a short period and the situation normalizes after a few days, there is no reason to worry. In that case, you are experiencing transient insomnia, which is usually associated with situational stress. For example, you have an upcoming tough presentation at work, an exam, or a move.
Other reasons for situational stress, which can lead to short term insomnia, are generally related to a loss of a loved one, an illness, or maybe environmental factors.
However, in some cases, these events kick off persistent worrying, which can lead to more severe sleep disturbances, such as chronic insomnia. Your insomnia can then increase your anxiety, which can lead to many other conditions later on.
Can snoring and sleep apnea cause anxiety or depression?
Obstructive sleep apnea (OSA) is a condition in which you stop breathing during sleep and wake up frequently and briefly during the night.
OSA is now one of the main types of sleep disorders which can have multiple effects on your health and your daily life. It can cause insomnia at night and fatigue and headaches during the day.
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The highest risk of OSA, however, is that the temporary suspension of breathing limits the oxygen supply to the brain, which can lead to cardiovascular-related conditions like high blood pressure, stroke, and heart attacks. Additionally, what is less well known is that oxygen deficiency in the brain can also trigger anxiety, panic attacks, and depression.
Remember that snoring does not always mean that you have OSA. However, snoring is one of the main symptoms of OSA. So if you snore, it’s worth talking to your doctor to see if the cause is OSA.
What is the right treatment?
In many cases, if one is treated, the other is likely to improve. So managing your sleep problem may also reduce symptoms of depression and anxiety, and vice versa.
Depending on how serious the mood disorder is, psychotherapy (talk therapy or counseling), in combination with medication (antidepressants), is a common treatment approach for depression and anxiety disorders. Antidepressants reduce the symptoms of sadness or hopelessness, while psychotherapy helps to improve coping skills and change negative attitudes and beliefs caused by depression, which also helps you to sleep better.
Why it’s better to focus more on non-drug treatment approaches
There is an issue with antidepressants. One of the side effects of many of them is that they even can worsen insomnia, which in turn can contribute to worsening the depression. Also, avoid sleeping pills if possible; in most cases, they don’t help in the long run and sometimes can even cause depression.
So in case you are suffering from depression and also experience sleeplessness, it’s essential to talk to your doctors to find the right treatment. If possible, don’t rely only on medication but focus more on non-drug treatment approaches like CBT (Cognitive Behavioral Therapy) or ACT (Acceptance and Commitment Therapy).
CBT and ACT are now widely used treatment courses to tackle insomnia, depression, and anxiety. The idea behind these therapy methods is to reframe your negative thoughts that interfere with sleep and to learn healthy habits for sleep instead.
Remember, you’re your best healer!
If you have read some of my posts about self-healing insomnia, you might know that I am a big advocate of using the natural self-healing capacities of our body. If applied correctly and in combination with good sleep hygiene, self-healing will help to get on the right track to overcome insomnia and a related depression or anxiety disorder.
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Here are some simple ways how to get started:
- Start a simple meditation practice that will help to calm your racing mind and to increase relaxation.
- Clear your mind by journaling before going to bed. Important is not to overcomplicate this; the goal is to get the racing thoughts and worries out of your head. Just jot down whatever comes up in your mind or make a short list of activities to be completed the next day.
- Exercise regularly – but make sure that it’s a few hours before bedtime. Also, some simple activities, including walking, stretching, yoga, and pilates, can help ease sleep.
- Avoid screen-time (such as a laptop or television) before going to bed, as the light emitted by computer monitors or LCD screens suppresses the release of the natural hormone melatonin, which signals the brain to go to sleep.
- Eliminate caffeine and reduce alcohol in the evening. Keep in mind that also some medications, such as headache medicines, contain caffeine, which can lead to poor sleep.
- Use the bed only for sleeping and sex. Don’t use your bed as an ‘office’ where you go through emails or documents. In this way, your bed will become a keyword for sleeping, not for lying awake.
- Take a warm shower just before going to bed to intensify the deep sleep while your body cools down.
- Keep your bedroom at a cool temperature.
- Get blackout blinds for your bedroom to prevent outside light from disturbing you.
- A white noise device can also help if you cannot sleep because of household noise.
- Wear a soft sleep mask and earplugs if light and noise disturb your sleep.
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Living with depression, anxiety, and insomnia can be extremely difficult. All these conditions not only affect the way you feel and think but are often associated with other chronic health problems, such as heart disease.
Remember, high-quality sleep is not a luxury but a necessity. In many cases, improving the amount and quality of your sleep can help with depression and anxiety and vice versa. The first and most important step for recovery is to take the emerging symptoms of a depression, an anxiety disorder, or a sleep disorder seriously. Remember, there is a lot you can do yourself but also don’t hesitate to ask for help!