Depression and Sleep: How to Sleep Better With Depression

Depression can affect sleep in various ways, including insomnia and oversleeping. The relationship between depression and sleep is bidirectional, with poor sleep habits worsening depression and vice versa. Depression can be diagnosed through a session with a medical professional, and treatment often involves a combination of psychotherapy and medication. Tips for better sleep with depression include establishing a bedtime routine and limiting phone use before bed.

Depression can easily creep into your day, whether it’s a meeting where you can’t focus or trying to work up the motivation to go for a run instead of staying on the couch. But it tends to permeate into nights as well, throwing off sleep in a variety of ways.

Ahead, you’ll learn more about depression, how it affects sleep, and what you can do to prevent depression from ruining your sleep quality.

What is depression?

Depression is a type of mood disorder that’s defined as a psychiatric condition by the medical community. It affects 3.8% of the worldwide population.

“Individuals with depression are often unmotivated or unable to take care of many of their basic life activities due to an overwhelming feeling of sadness, distorted thinking, and sometimes even suicidal thoughts,” explains Haley Neidich, licensed clinical social worker. “Depression is not just a bad mood and it’s not something that an individual can push through with willpower. It’s a psychiatric condition that requires serious treatment.”

What causes depression?

Depression can be brought on by a wide array of factors. It’s a “complex mental illness that rarely has only cause,” says Neidich.

Some of the causes that come into play can include family history, chemical imbalance, trauma, grief, a major life change, substance abuse, physical illness, and medications.

What are the symptoms of depression?

According to Neidich, some of the common signs and symptoms of depression include:

  • Feelings of sadness or hopelessness
  • Irritability or anger
  • Loss of interest or pleasure in activities
  • Anxiety/nervousness
  • Exhaustion and lack of motivation
  • Sleep disturbances like insomnia or hypersomnia (oversleeping)
  • Feelings of worthlessness and shame
  • Trouble with decision-making and concentration
  • Frequent thoughts about death, suicidal thinking, or suicide attempts
  • Inability to care for basic life activities or hygiene
  • Reduced or increased appetite
  • Other behavioral changes
  • Social isolation

What’s the connection between depression and sleep?

Depression and sleeping have a bidirectional relationship. “Worsening sleep often increases depression and depression often causes poorer sleep habits,” says Neidich.

She often reminds her clients that there’s a link between sleep deprivation and depression, noting that “without proper sleep, it’s very unlikely to see an improvement in mental health symptoms.”

While there’s a well-known connection between depression and sleeping too much, you may not realize that depression can cause insomnia as well.

“Sleep issues with depression can vary,” Neidich says. “Some individuals tend to oversleep while others struggle with insomnia. Other folks will vacillate between the two.”

Neidich adds that insomnia is one of the most common symptoms of many depressive disorders, and depression is more commonly seen in individuals with poor sleep habits.

“The same brain chemicals that contribute to depression also have a tendency to cause difficulty with sleep,” she says. “Additionally, folks with depression are less likely to be able to stick to a good sleep routine and care for themselves in general.”

What’s more, there’s also a link between sleep apnea and depression. In fact, one 2017 study found that depression and obstructive sleep apnea (OSA) are “major associated comorbidities” and can be attributed to the fact that sleep apnea disrupts sleep, leading to mood problems, anxiety, and poor concentration.

How is depression diagnosed?

Depression can be diagnosed during a session with a psychotherapist or other licensed medical professional who will ask several questions about your symptoms while they listen to and observe you, explains Neidich.

They may ask you to fill out a questionnaire to help them better understand the severity of your symptoms as well as a tool to help guide the conversation.

“If you believe you may be depressed, be sure to tell your doctor about your symptoms so that they can properly assess you,” says Neidich.

How is depression treated?

While depression may feel like a fairly hopeless state of mind, know that there are several treatment options available today. Since each person is different, you may need to combine a few therapies—and it may take time to find what works best for you.

“Depression is most commonly treated with a combination of psychotherapy and medication,” Neidich says. However, keep in mind that many medical professionals who prescribe medication for depression won’t provide a referral to a psychotherapist—so you may need to find one on your own. (Here’s how antidepressants affect your sleep.)

“Therapy is essential because depression is typically caused by a number of factors,” says Neidich, “and in order to heal and prevent future episodes, folks with depression must also learn coping skills and process any potential causes or triggers which can contribute to their symptoms.”

Neidich adds that this combination of therapy is especially important when insomnia or hypersomnia is present. She encourages individuals to explore a possible treatment plan with a doctor and therapist to find the right one.

If you need additional support, you can always call the National Suicide Prevention Lifeline at 800-273-8255.

Tips for sleeping better with depression

While oversleeping can certainly negatively impact your circadian rhythm, a lack of sleep and depression can also create worsened symptoms.

If you’re wondering how to sleep with anxiety and depression, Neidich shares her best tips:

  • Give your phone a graduated bedtime—no news or social media after dinner and no phone at all besides meditation or relaxation apps beginning at least 90 minutes before bed. Set reminder alarms on your phone and be committed to making this change.
  • Give yourself a simple and comforting bedtime routine and stick to it. Soft music, bathing, journaling, meditating, safely lighting a candle, and reading are all lovely things to include in your new routine. Your routine should begin at least 45 minutes before you hope to climb into bed.
  • Get out of bed in the morning and make your bed. One of the behaviors that can contribute to sleep issues and depression is staying in bed all day—or, in this day and age, even working from bed. Getting out of bed and making your bed is a great way to avoid climbing back in before bedtime.

The bottom line: “If you notice a major change in your sleep habits, this is not something that should be ignored,” says Neidich. “If it persists, speaking to your medical doctor or a therapist is a great first step.”

What is cognitive behavioral therapy for insomnia and can it help ease some of your depression-related sleep issues? Read our guide to CBT-I to learn more.

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