Most people who have experienced depression know that it is often accompanied by sleep problems. People with depression may find it difficult to fall asleep and stay asleep during the night. They may also have excessive daytime sleepiness or even sleep too much.
At the same time, sleep problems can worsen depression, leading to a negative cycle between depression and sleep that can be difficult to break. Poor sleep can even trigger depression in some people.
Understanding the complex relationship between sleep and depression can be an important step toward improving sleep quality and better managing depression.
What is depression?
Feelings of sadness, disappointment, or hopelessness can be a healthy response to life's challenges. These feelings usually come in waves, are associated with thoughts or reminders of challenging situations, last only a short time, and do not interfere with school, work, or relationships.
In depression, these feelings follow a different pattern. If they last longer than two weeks, are felt almost every day, and last most of the day, they may be related to a group of mood disorders called depressive disorders. Depressive disorders, also called clinical depression, include feelings of sadness, disappointment, and hopelessness, as well as other emotional, mental, and physical changes that lead to difficulty with daily activities.
Depression is the leading cause of disability worldwide, affecting about 4.4% of the world's population. After anxiety, depression is the second most common mental health problem in the United States. As many people with depression know, it can dramatically affect a person's sleep and overall quality of life.
What causes depression?
While scientists do not know the exact cause of depression, there are a number of factors that can increase the risk of developing the condition. These include a personal or family history of depression, experiencing major stressors or trauma, taking certain medications, and specific illnesses.
Family history is a factor in about half of people with depression. A person's genetics can affect the function of neurotransmitters (substances that help nerve cells communicate) that are associated with depression, such as serotonin, dopamine, and norepinephrine.
Symptoms of depression
Symptoms of depression can include physical changes as well as changes in mood and thoughts that interfere with normal daily activities. Symptoms may include:
Persistent sad, depressed, or irritable mood
Feelings of hopelessness, worthlessness, or guilt
Loss of interest or pleasure in activities
Decreased energy and fatigue
Difficulty concentrating
Insomnia, waking up too early or sleeping too much
Low appetite or overeating
Thoughts of death or suicide
Depression is more common in women, and there may be differences in symptoms of depression based on gender and age. Men often experience symptoms such as irritability and anger, while women are more likely to experience sadness and guilt. Adolescents with depression may be irritable and have trouble at school, and younger children may pretend to be sick or worry that a parent may die.
How is depression diagnosed?
Depression can only be diagnosed by a doctor, so people experiencing symptoms of depression should talk to their doctor, counselor or psychiatrist. They may ask about the severity of the symptoms and how long they have been going on. They may also suggest tests that can help them better understand your situation and monitor changes or improvements over time.
A provider may also refer patients to a sleep disorder specialist to help determine if there is an underlying sleep disorder, such as sleep apnea or restless legs syndrome, that may be causing depression or contributing to symptoms.
Types of depressive disorders
It is common for all to experience significant feelings of sadness or loss of interest in their normal daily activities. Specific forms of depression vary according to the severity of the symptoms and the situation in which they develop.
The most well-known type is major depressive disorder and is characterized by symptoms that affect a person practically every day for a long period of time. It usually involves sleep disturbances.
Persistent depressive disorder, also called dysthymia or chronic depression, may involve fewer symptoms than major depression, but symptoms last at least two years (one year in children and adolescents) and any symptom-free period lasts no longer than two months.
Other types of depression, such as premenstrual dysphoric disorder and seasonal affective disorder, tend to come and go in shorter periods but can also involve significant sleep problems.
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