Depression and Insomnia

From Psychology Today:

Is Depression Making Me Sleepless, Or Is Insomnia Making Me Depressed? 

Depression and insomnia are common and possess common symptoms. Some estimate that 30% of Americans will eventually experience clinical depression, and perhaps 40% of adults complain that many or most nights they don’t get enough sleep, wake too often, or feel unrested on awakening.

So which came first the chicken or the egg?

Depression Causes Insomnia

One of the earliest symptoms for many depressives is insomnia. They can’t fall asleep. They can’t stay asleep. There are times you can almost diagnose depression by looking at individual sleep studies.

  1. Deep sleep, where we produce growth hormone, a stage critical for memory and decision making may altogether disappear with depression.
  2. Awaking and arousals increase dramatically. Sleep becomes highly fragmented.
  3. REM sleep is often broken up, and its very appearance changes. Rapid eye movement may appear both erratic and dense.

Depression and Sleeping Pills

As people become depressed they often identify sleeplessness as their main problem. Insomnia is common and holds little stigma; depression is a “disease” that can cost you jobs, insurance, relationships and self-esteem. People in depressive episodes often seek sleeping pills, sometimes with desperation. Generally they feel better – for a while. Unfortunately the quality of sleep tends to decline as long as the depression is not fully treated. Frequently sleep medications stop working altogether. Behavioral and other regimes may also then fail.

Many times depressed people tend to take enormous doses of sleeping pills and then they hardly sleep at all. Sleep can be the last thing to normalize in a depressive episode. So it’s strange to many, including sleep clinicians, that depression can also cause insomnia’s opposite – prolonged sleepiness. It’s even more of a surprise that forcing people to stay awake at night can improve depression.

Insomnia and depression are directly related – both influence each other. If you are an insomniac, the lack of rest required for your body’s natural regeneration provokes a greater tendency to depression. Depression itself massively reorders sleep, often in the form of horribly disrupted sleep and seemingly “untreatable” insomnia.

Insomnia and depression are deeply interlinked, as are the brain areas involved in both.