Depression is a common mental health disorder that many Americans struggle with on a daily basis. Depression can have many symptoms that interrupt the day. One part of the day that depression can severely interfere with is sleep. Sleep and depression have a bidirectional relationship where they both affect the other period for example the more severe one suppression is, the more severe their sleep related issues are. And vice versa. The more sleep problems one has, the worse their depression seems to be.
Some people have depression all day every day. However others only have depressions in certain parts of the year, or even certain parts of the day. For those who only have depression at certain parts of the day, either at night or in the morning, this is called diurnal mood variation. If you find yourself only getting depressed late at night whenever you're getting ready to go to bed, but feel great in the morning, you may be one of these people. Continue reading to learn more and see what you can do to help yourself get a good night's rest.
Symptoms of depression
In order to be diagnosed with depression, you have to meet the criteria in the DSM-5, which is a manual that is used by psychiatrist to diagnose psychiatric illnesses. You have to experience these symptoms for more than two weeks as well, and it cannot be in the setting of another medical illness or situation (e.g. grief). Common symptoms include:
- sleep issues
- changes in eating patterns
- weight loss or gain
- little interest in activities once enjoyed
- low energy
- difficulty focusing we're concentrating
- somatic symptoms such as headaches and stomach aches or other pains
- feelings of sadness or hopelessness
- crying without cause
- suicidal thoughts, or attempts
Causes for feeling depressed at night
There are many reasons why one may feel depressed at night. Some issues may be easily adjusted, while others require intense intervention. One reason that you may be unable to sleep at night, and that you may feel more depression at night, is that you have more time to ruminate. Rumination as the process of constantly thinking about something and being unable to let it go. This can interfere with sleep because your mind seems to be going a million miles an hour without a clear answer, which leads you to be too hyped up and anxious to fall asleep. Rumination is normally on thoughts that are more negative, and considering depression is related to negative thoughts, this is why you may experience depression late at night if you struggle with rumination. The night time is so quiet, free from other distractions, which is why it may be the part of the day in which you ruminate the most.
Another cause for increased depression night is light exposure. Research still has not figured out the direct link between light exposure and depression, however studies have found a correlation between light exposure and levels of depression in older individuals. It is suggested that this depression worsens and young people. One theory is that exposure to light interferes with your sleep cycles, and as stated before issues with sleep can worsen depression symptoms.
Circadian rhythm disruption is another potential cause for increased depression at night. Your circadian rhythm is your biological sleep-wake clock. Whenever it is disrupted due to interrupted sleeping patterns, changes in time zones, or just poor sleeping habits, it can throw off the entire synchronization within your body. These hormonal changes may lead to feelings of depression especially at night.
Interestingly enough another potential link between depression at night is your chronotype, or what time of the day you normally function. If you'd like to wake up early in the morning and tend to go to sleep early in the day, then you are a morning bird. If you like to go to sleep late at night, and wake up later in the day, then you are a night owl. Studies have shown a link between the type of chronotype that you have and your risk for developing nighttime depression. Women who were morning birds were less likely to develop depression than women who reported being night owls. It's important to note that the study does not show that being a night owl causes depression, but simply shows that there is a link between that particular chronotype and the risk for developing depression.
Coping with nighttime depression
If you are someone who struggles with sad thoughts late at night, there are some things that you can do to mitigate the amount of sadness that you feel right before going to bed. One of these things is to create positive thoughts. If you can participate in a hobby that you enjoy right before going to bed, this can help create positive thoughts and energy so that way you can fall sleep. It's important to try and fill your mind with positive things so that way there is no space for any negative thoughts or rumination to creep in and ruin your ability to go to sleep.
Take time to problem solve some of the negative things that you are ruminating about. Those who ruminate often think about the things that happened during the day, and how they could have better solved them or some of the potential consequences of something they may have done. It's important to take time when you are thinking clearly to really think about how to overcome some of the issues that you're facing. This time is not going to happen in the middle of the night, so it's important to just set those worries aside until the following day. However when you are energized and in a good mood, it's important to take time to problem solve some of the issues that plague you at night.
Improve your self-esteem as well. Sometimes with depression you may think that you are just worthless and unable to do anything right. Most of the time that is simply not true, and it is just intrusive thoughts that have convinced you that you are not an important individual. Therefore it's going to take conscious undoing of those thoughts to improve your self-esteem and make you feel deserving of good things. Use affirmations to speak good things about yourself into the universe. If you save them enough times, eventually your brain will start to believe them and your actions will follow suit.
Practice good sleep habits. Again getting good sleep and improving your depression symptoms go hand in hand. So if you can get better sleep, then you will be able to hopefully address some of the feelings of sadness that you have. Improving your sleep consists of going to bed and waking up at the same time every day, making sure that you're sleeping environment is cool, dark, quiet, and clean.
Make sure to minimize your exposure to screens and blue light before bed so that way you have a seamless so creation of melatonin from your brain. And All in all you want to make sure you create a bedtime routine that helps relax your body, but also helps train your body for bed. Sleep training is not just for babies, it is for everybody. If you are able to do the same activities before bed in the same order, eventually your brain and body will log those activities as cues and will start to prepare for bed as soon as you engage in those activities.
Treatment for depression does not just stop at sleep hygiene. Although improving your sleep and self-esteem can definitely play a large part, depression is largely a chemical imbalance. Therefore it may require other methods of intervention for a true recovery. One of those interventions may include therapy period a popular type of therapy is called cognitive behavioral therapy. This is a type of therapy that takes your thoughts and tries to make them more positive, and also helps you learn to engage in behaviors that are the opposite of the negative thoughts you may be having. There is also a specific type of CBT for insomnia, which can help you undo some of the negative thoughts you have about going to sleep, and also provide you with tools and resources to engage in behaviors that positively help you go to sleep.
You may also benefit from medications, such as SSRI's, or selective serotonin reuptake inhibitors. These are first line medications for depression symptoms and are prescribed by physicians and psychiatrists. They increase the amount of serotonin available in your brain which can mitigate some of the depressive symptoms that you are experiencing. They do take about six weeks to work, so if you do start this drug it's important that you continue the regiment for at least two months and report anything adverse effects to your physician. If you do not see a change, then it's important to inform your physician of this so they can put you on a drug that is better suited for you.
Another thing you can try our lifestyle changes. Exercising and eating a better diet can help your body feel better, so that way your mind can feel better period whenever you are sluggish and eating foods that are not nutritionally beneficial for your body, you may feel sick and not really like yourself. Getting active releases endorphins which can make you feel really good about yourself, and your hormones can be greatly influenced by the types of foods that you're eating so it's important that you keep a balanced diet that can properly regulate your hormones and also make you feel energized.
If you are having trouble sleeping, and feel extra sad at night, then we may be able to help. Please click the orange button below to take a free online sleep test and get in contact with one of our sleep health professionals.