Feeling sad every now and then is a fundamental part of the human life, especially during difficult or tiring times. In contrast, persistent feelings of sadness, anxiety, disinterest and hopelessness in things that were once enjoyed are symptoms of depression, an illness that affects at least 20 millions of Americans. Depression is not something that a person can ignore or simply walk away through. Rather, it is a serious disorder that affects the way a person eats, sleeps feels and thinks. The cause of depression is not known, but it can be effectively controlled with treatment.
The relationship between sleep and depressive illness is complex. Depression may cause sleep problems and sleep problems may cause or contribute to depressive disorders. For some people, symptoms of depression occur before the onset of sleep problem. For others sleep problems appear first. Sleep problems and depression may also share risk factors and biological features and the two conditions may respond to some of the same treatment strategies. Sleep problems are also associated with more depressive illness.
Insomnia is very common among depressed patients. Evidence suggests that people with insomnia have a ten-fold risk of developing depression compared with those who sleep well. Depressed individuals may suffer from a range of insomnia symptoms, including difficulty in falling asleep, difficulty in staying asleep, and daytime sleepiness. However research suggests that the risk of developing depression is highest among people with both sleep onset and sleep maintenance insomnia.
Depression is the major cause of insomnia and yet it is also the symptom of insomnia. The mood sleep connection often plays out in a frustrating cycle for sufferers of either condition; anxiety and rumination keep them up at night and the lack of restorative sleep triggers a worse state of mind the next day.
Sleep disturbances are a hallmark of depression, but insomnia can actually unleash the mood disorder. Treating sleep disturbances might help prevent depressive episodes. Sleep disturbances and unipolar depression are such intransigent bedfellows that trouble sleep and are considered as a hallmark of the mood disorder. At least 80% of depressed people experience insomnia-difficulty in falling asleep or most often, staying asleep indeed; early morning awakening is a virtual giveaway of depression. Another 15% of the depressed sleep excessively. But it may be that insomnia is more than just a symptom of depression. It may in fact unleash the mood disorder. Sleep disorder appears to precede episodes of depression by about five weeks and intensifies over the course of a new depressive episode or relapse.
In a complex mix of chemistry and behavior, disordered sleep may actually bring on depression, setting in motion an array of forces in the nervous system that result, ultimately in a frank depressive episode.
Depressed people lapse quickly into REM sleep, as if they were in a hurry to get the highly emotionally charged activity. “For some reason there is a lot of pressure to get into it and it is unusual both in duration and intensity, more dense, intense and long-lasting.
The insomnia that occurs in major depression typically leaves patients with six or more hours of sleep per night. That however is enough to interfere with one of the primary functions of sleep-consolidation like learning and memory.
The loss of slow-wave sleep and the rush to REM sleep have a significant effect on information and memory processing. They enhance it and the ability to recall information appears to get in the way of perceiving what is actually going on around the time of falling sleep. As a result, patients with insomnia overestimate the time it takes them to fall sleep and underestimate the amount of time they actually spend in sleeping. It is entirely possible that the disturbed sleep causes depression in the body’s own attempt to correct itself. Researchers have evidence that in a certain cases, sufferer’s insomnia has an antidepressant effect. Sleep deprivation has been used as a depression treatment. Awakening patients early improves mood in 30% to 60% of cases. The problem is that the effect is short-lived. Once patients sleep again, they wake up depressed next day. A variation of sleep deprivation called phase advancing is now used as treatment in some circumstances. There are many causes which emphasize on the fact that depression causes insomnia. Some are given below;
- Insomnia is related to decreased quality of life, social and interpersonal functioning and workplace performance and any of these could result in levels of distress or life events that may trigger, maintain or worsen.
- Lying awake in the dark presents a tabula rasa for depressive rumination that may trigger a depressive episode.
- Loss of control on sleep may trigger thoughts of helplessness and hopelessness, which might “activate” the template for helpless and hopeless schema common to depression.
- Insomnia promotes a level of circadian misalignment that may also contribute to decrements in diurnal mood and performance.
- Sleep loss or sustained wakefulness may cause alterations in neurobehavioral functions that may result in depression.
Future direction in the area of research might involve a variety of variations on the designs. Certainly better longitudinal studies of insomnia and depression are needed where careful definition of insomnia and depression are obtained.. Depression leads to insomnia.
Once a bout of insomnia occurs most people experience a great deal of frustration and anxiety about falling asleep and staying asleep. They take behavioral steps to compensate for the sleep loss, napping during the day of early evening. They go to bed early the next night. They stay in bed later the next morning or they drink to relax themselves into sleep. The depression is actually secondary to the insomnia and it is disrupting the brain and serving as a stressor itself, sleeps loss renders even more neurobiological vulnerable people to depression and precipitates onset of episodes. When the depression will be gone, the chances of suffering from insomnia will decrease automatically.