Even When Mental Health Problems Precede Disrupted Sleep The Lack Of Sleep Might Exacerbate A Person’s Difficulties
His colleague, the clinical psychologist Daniel Freeman, has called for sleep problems to be given a higher priority within mental health care. Because they are common across different diagnoses, they don’t tend to be viewed as central to a particular condition. He feels they are sometimes neglected, when they could be tackled.
Even when mental health problems precede disrupted sleep, the lack of sleep might exacerbate a person’s difficulties. After all, just one night of sleep deprivation has a well-established negative impact on mood and thinking.
The complex relationship between sleep and mental health is further reinforced by the finding that if you treat depression, the problems with sleep don’t all disappear. It’s easy to see how psychological treatments which help people reduce ruminating over negative thoughts could also result in them falling asleep more easily. But in 2020 Shirley Reynolds, a clinical psychologist at Reading University, and her team trialled three different psychological treatments for depression. They worked equally well in reducing depression, but only sorted out the sleep problems for half of the participants. For the other half, the insomnia persisted, suggesting it was independent of their depression and needed to be addressed separately.
A deficit of sleep has well-established negative effects, including a tendency to withdraw from friends and family
What Happens When You Sleep Too Much
It may seem counterintuitive, but it’s just as bad if you sleep too much. Sometimes mental illness sends you signals to sleep all day, even if it’s not satisfying. “It’s not the enjoyable, refreshing kind of sleep,” Mighty community member Kaitlin R. . “I wake up sleepier, which makes me want to sleep again. It’s a vicious cycle of exhaustion that feels impossible to break.”
Hypersomnia — excessive sleepiness — doesn’t help your brain any more than insomnia. Like insomnia, too much sleep is “associated with persistence of depression/anxiety.” In other words, it’ll take longer to recover. Oversleeping also increases your risk for physical issues like stroke, migraine or heart disease. Not to mention, when you sleep longer than your internal body clock needs, you’re likely to wake up feeling lethargic and unmotivated. More sleep doesn’t equal better energy, quite the opposite.
Generally, when you sleep, you’ll go through five stages that get progressively deeper — light sleep stages one and two, deep sleep stages three and four and REM, which is where the memory processing happens in the brain. Each of these cycles lasts approximately 60 to 90 minutes. For the average person, it takes about 7.5 hours to go through this process. When you sleep hours longer than your natural cycle, you increase the chances of waking up in the middle of a later sleep stage. This disrupts your body and brain’s rhythms and will make you feel more tired.
Aging And Your Telomeres
Oversleeping is not only an issue among young people with depression. Among older adults, symptoms of insomnia may be more common. But many older adults also experience hypersomnia in connection with depression. Women, in particular, may be more likely to oversleep and feel excessively tired during the day if they are depressed.
It’s also important to remember that among people with depression, sleep difficulties often take shifting, variable forms. People with depression may experience symptoms of both insomnia and hypersomnia. A 2014 study investigated how often insomnia and hypersomnia occur together in adults with depression in the U.S. Scientists found that more than 27 percent have what’s known as “co-occurring” insomnia and hypersomnia. They also found some other striking, shared characteristics. People with depression who demonstrated both insomnia and hypersomnia had:
- More severe depression.
- Higher rates of impulse control disorder.
- Greater likelihood of drug use disorder.
These people were also more likely to be receiving mental health treatment and more likely to be taking .
Another study released just this year found that among people who’d received a diagnosis of major depression, slightly less than one-third had both insomnia and hypersomnia. These people were at two to three times greater risk for bipolar disorder, according to the study.
When oversleeping is a symptom of a sleep disorder
Other causes of oversleeping:
Being overweight or obese.
How To Feel Better After Oversleeping
You wake up much later than planned, completely out of sorts. You stare at the clock in disbelief and dismay. What next?
If you already feel miserable, it might seem tempting to write the day off and stay in bed.
Yet, even though getting up might feel like an impossible feat, these strategies can help ease that groggy, late-morning funk.
Stay Alert For Signs Of Depression
These include feeling hopeless, helpless or sad; trouble concentrating and remembering things; loss of energy; daytime sleepiness; loss of interest in activities that once gave you pleasure; or thoughts of suicide or death. Tell your doctor if you have any of these.
This is especially important if you’re discussing insomnia with your doctor. “Insomnia may be a separate condition or it may be a symptom of depression,” Finan explains. “Your doctor needs to know as much as possible to treat the right problem.”
What Are The Symptoms Of Depression
The symptoms of depression can include physical changes as well as changes in moods and thoughts that interfere with normal daily activities. Symptoms may include:
- Persistent sad, low, or irritable mood
- Feelings of hopelessness, worthlessness, or guilt
- Loss of interest or pleasure in activities
- Decreased energy and fatigue
- Insomnia, waking up too early, or oversleeping
- Low appetite or overeating
- Thoughts of death or suicide
Depression is more common in women and there may be differences in the symptoms of depression based on sex and age. Men often experience symptoms such as irritability and anger, whereas women more frequently experience sadness and guilt. Adolescents with depression may be irritable and have trouble in school, and younger children may pretend to be sick or worry that a parent may die.
Holistic Activities Complement Depression Treatment
Psychiatry has begun to embrace holistic therapies as complementary to traditional treatment modalities for depression, as these activities can help reduce stress and induce feelings of calm. Some of the holistic treatment elements include:
- Yoga. Yoga involves slow, purposeful physical poses with a focus on breathing. Yoga is known to promote relaxation and reduce stress while also strengthening and stretching muscles, and reducing blood pressure and heart rate.
- Acupuncture. Acupuncture uses tiny needles to open up energy paths in the body thought to assist in the improvement of mind-body connectedness and wellness.
- Meditation. Mindfulness meditation is also helpful in training the brain to focus purposefully on the present moment, taking in the various sensory stimuli and focusing on rhythmic breathing.
- Exercise. The positive effects of getting regular exercise are caused by the release of brain chemicals, such as endorphins, serotonin, and dopamine.
- Aromatherapy. Certain essential oils have been found to relieve symptoms of depressed mood. These include jasmine, citrus oils, bergamot, and chamomile oils.
- Nutritional counseling. A diet rich in lean proteins, nuts and seeds, fresh vegetables and fruits, oily fish such as salmon, beans, and whole grains can significantly contribute to mental stability.
How To Tell If You Are Depressed Or Just Tired
With both depression and fatigue, symptoms include low energy, low motivation, and anhedonia, or a loss of interest in pleasurable activities, Dimitriu says.
One distinguishing factor can be the desire to engage in activities — people who have fatigue wish to do things, but lack energy, whereas people with depression have lower interest in activities, he says.
“Another important consideration is the duration of the low mood and if it improves with sleep,” Dimitriu says. A single good night’s sleep can improve a tired person’s mood, he notes.
But depression-related fatigue permeates every facet of a person’s life, says Ricke. The effect is felt:
- Physically: Everyday tasks — eating, showering, getting dressed, and so on — may become difficult. “The body can feel heavy, slow, and stiff due to depression,” Ricke says.
- Cognitively: Due to depression, you may experience “difficulty sustaining focus, concentrating, and processing information,” Ricke says. Of course, lack of sleep can have a similar cognitive impact, making it challenging to concentrate.
- Emotionally: Here is where the effects may be most profound. “Fatigue makes it more difficult to weed through the already confusing thoughts and feelings that are part of depression,” Ricke says. Forming emotional connections with friends, family, and the people around you may be more challenging when you’re fatigued, she says. And that, in turn, “can perpetuate feelings of aloneness and hopelessness,” Ricke says.
Tips For Coping With Depression
In addition to talking to a provider about treatments for depression, there are several steps you can take on your own:
- Exercise: Low-intensity exercise, even walking 10 minutes a day, can lead to improvements in mood and physical health. For some people with mild to moderate depression, exercise can work as effectively as an antidepressant.
- Support: Experiencing depression can feel isolating and hopeless, so remember that you’re not alone. Spend time with others, talk about what you’re experiencing, and try not to isolate yourself.
- Be realistic: Even with effective treatment, symptoms of depression may improve gradually.
Having depression can increase thoughts of suicide. If you or someone you know is in crisis, the National Suicide Prevention Lifeline provides 24/7, free and confidential support.
National Suicide Prevention Lifeline
Sleeping In Can Derail Your Plans For The Day
You went to bed last night with big plans for the morning: Get up early, do some chores, take a long walk, and go grocery shopping for an afternoon barbecue with friends.
When you wake up 2 hours later than you planned, your mood instantly plummets as you realize you’ll need to hustle to even get half of those things done. You were looking forward to knocking out some cleaning and getting some exercise, but you’ll probably have to skip one of those.
Feeling as if you’ve already wasted your day can frustrate you and leave you grumpy and irritated. You might even decide not to bother with any of your plans, since you can’t do exactly what you wanted to do.
If oversleeping regularly keeps you from meeting friends or doing other things you enjoy, you might begin to feel guilty and disappointed in yourself. You might even stop making plans entirely, which can fuel and, in time, .
Treatment To Help With Sleep Problems
If sleep problems don’t respond to self-help, talk to your doctor. It may be worth keeping a sleep diary for 10 days before your visit so you can explain the problem. Doctors will generally look for any underlying medical or psychological reason for the problem and may suggest further changes to your routine or lifestyle to help improve your sleep.
If these don’t work, your doctor may suggest sleeping pills for insomnia. Sleeping tablets can help in the short term but quickly become less effective and can even make your sleeping problems worse. They can also be very addictive. For all these reasons, sleeping pills are generally prescribed at the lowest dose and for a short period of time.
If your problems persist, your doctor may refer you to a specialist sleep disorder clinic.
Treating Depression And Sleep Disorder
Depression is treated with :
- Medications, such as antidepressants, to treat the symptoms
- Psychotherapy, such as cognitive-behavioral therapy, interpersonal therapy, counseling, especially to learn coping strategies to prevent the onset of future depressive symptoms
- Or, often a combination of both of the above
Sleep disorders like insomnia, are treated with the following methods :
- Medications, such as benzodiazepines, benzodiazepine receptor agonists , ramelteon, melatonin.
- Cognitive-Behavioral Therapy for Insomnia . This treatment modality combines behavioral and cognitive techniques to overcome dysfunctional sleep behaviors and misperceptions, distorted, disruptive thoughts about sleep. Cognitive and behavioral techniques include universal sleep hygiene, stimulus control therapy, sleep restriction therapy, relaxation therapies and biofeedback, cognitive therapy, and occasionally, paradoxical intention.
Coping With Sleep Disturbances During Depression
Dealing with sleep disturbances when you’re feeling depressed can seem like a vicious circle. The more depressed you feel, the harder it is to sleep. And the more exhausted you feel, the harder it is to fight depression.
It can feel like there’s no way to break the cycle. And it’s frustrating to feel tired yet be unable to fall or stay asleep. Here’s what you should know about the relationship between sleep disturbances and depression.
What Are The Types Of Depressive Disorders
Significant feelings of sadness or a loss of interest in their normal daily activities are common in all depressive disorders. Specific forms of depression vary based on the severity of symptoms and the situation in which they develop.
The most well-known type is major depressive disorder, and it is marked by symptoms that affect a person virtually every day for an extended period of time. It commonly involves sleep disruptions.
Persistent depressive disorder, also called dysthymia or chronic depression, may involve fewer symptoms than major depression, but symptoms last for at least two years 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 over shorter periods but can also involve significant sleeping problems.
Oversleeping: How Much Sleep Is Too Much
The amount of you need varies significantly over the course of your lifetime. It depends on your age and activity level as well as your general health and lifestyle habits. For instance, during periods of stress or illness, you may feel an increased need for sleep. But although sleep needs differ over time and from person to person, experts typically recommend that adults should sleep between seven and nine hours each night.
Is 10 Hours Of Sleep Too Much
How long you should snooze is dependent upon your age and individual health circumstances. 10 hours a night can be a healthy duration for children and teens, but for adults, experts with Johns Hopkins Medicine suggest a minimum of 7 hours a night and that regularly sleeping more than 9 hours is considered too much sleep.
Warning Signs Of Sleeping Too Much
If you’re wondering if you’re sleeping too much, look out for some of these warning signs:
- You’re always tired, even if you get a good amount of sleep or spend lots of time in bed. This can take the form of daytime drowsiness and lethargy.
- You feel moody and irritable.
- Pain you’ve been experiencing is getting worse. For example, back pain can worsen from spending too much time laying down and being inactive.
- You’re dealing with , migraines and/or brain fog.
- You have slower reaction times, poorer problem-solving skills and generally worse mental performance.
- is worsening. Excessive sleep can raise levels of .
- You might be gaining weight and feeling sluggish due to inactivity.
Healthwhat To Say To Someone Who Is Depressed
Young people in their 20s and 30s who are experiencing increased sleepiness during the day and who are taking these so-called “depression naps” may actually be sleep-deprived rather than clinically depressed, Zak explained. They may be working long days or spending too much time on their screens at night, leading to poorer sleep quality and more stress, she said.
Can Sleeping Too Much Affect Me
The truth is that too much sleep can be bad for you. Multiple studies have been done on sleep habits and some adverse effects due to sleeping too much have been noted. Some of the effects include:
- Diabetes mellitus
- Heart disease especially coronary artery disease
Multiple studies have proved that people who regularly sleep more than nine hours a night have significantly higher death rates than those who sleep seven to eight hours a night.
The Link Can Go Both Ways
Sleep problems can develop long before depression, though experts have yet to determine exactly how sleep difficulties might contribute to depression risk.
When you live with depression, oversleeping on a regular basis could potentially worsen your symptoms.
A 2014 study even suggested that people who sleep for more than 8 hours may experience more depression symptoms than people who sleep 8 hours or fewer each night.
Think of it as a cycle. Depression often affects your mood, energy, and outlook for the future. You might feel drained and lethargic, less interested in your usual activities, and hopeless that your symptoms will ever improve.
Sleep, then, offers more than one solution. You might sleep because:
- you feel fatigued
- you have little interest in anything else
- sleep helps you temporarily escape other symptoms
Even simply lying in bed and occasionally dozing off might seem like the best way to spend your time when you don’t feel up to anything else. But then you might start feeling about spending so much time in bed, leading to an even more dismal mood.
It’s normal to feel a little down or “blah” after sleeping in, but that doesn’t necessarily mean you have depression.
Clinical depression causes persistent changes in mood that show up in most areas of life.
You might notice:
- changes in your normal energy levels
- feelings of sadness or hopelessness that don’t go away
- less interest in the activities you usually enjoy
Oversleeping Disrupts Your Usual Sleep
Not getting the right amount of sleep can throw off your circadian rhythm, or your natural sleep-wake cycle. This internal biological clock helps regulate daytime energy and alertness and nighttime sleepiness by sending signals to your body when it’s time to go to sleep or wake up.
Sleeping too little or too much can confuse the cells that send these signals, leaving your body uncertain how to respond. Should you wake up and feel energized? Or is more sleep the answer?
Consequently, you might wake up exhausted and lethargic, or feel ready for bed just a few hours after getting up. Over time, an inconsistent sleep-wake schedule can make it difficult to get the sleep you need — even when you aim for just the right amount.
Why Do People Sleep Too Much
For people who suffer from hypersomnia, oversleeping is actually a medical disorder. The condition causes people to suffer from extreme sleepiness throughout the day, which is not usually relieved by napping. It also causes them to sleep for unusually long periods of time at night. Many people with hypersomnia experience symptoms of anxiety, low energy, and memory problems as a result of their almost constant need for sleep.
Obstructive sleep apnea, a disorder that causes people to stop breathing momentarily during sleep, can also lead to an increased need for sleep. That’s because it disrupts the normal sleep cycle.
Of course, not everyone who oversleeps has a sleep disorder. Other possible causes of oversleeping include the use of certain substances, such as alcohol and some prescription . Other medical conditions, including , can cause people to oversleep. And then there are people who simply want to sleep a lot.
How Much Sleep Is Too Much
Generally, experts recommend adults get between seven to nine hours of sleep per night, but this can vary based on individual needs. There will also be times when you’ll need more sleep than usual, such as when you’re suffering from jet lag, experiencing an abnormal amount of stress, or recovering from an illness.
You’ll know you’re getting enough sleep when you wake up feeling refreshed and restored. However, if you’re regularly sleeping more than nine or 10 hours per night, and you still feel tired during the day, that’s a sign you’re oversleeping. Around 8% to 9% of people oversleep, with women being more likely to do so than men.
What Is Sleeping Too Little Or Too Much
How much sleep is too little or too much?
Throughout our adulthood, most of us need somewhere around 6-9 hours of sleep a night. Very few of us can function and feel at our best on 5 hours of nightly sleep or less. But if you’re regularly sleeping more than 9 hours and still feeling tired and fatigued, that’s an indication that you’re oversleeping.
However, there is no single right amount of sleep applicable to everyone. Sleep needs vary from person to person. The factors determining that are:
- Both circadian rhythms and internal sleep drive, the two primary biological sleep systems, are influenced by genes.
- In the 20s you may need 7 or more hours of sleep, but in the 50s or 60s you may need only around 6 hours of sleep.
- Activity level.The body needs sleep to recover from exertion. The more active you are, the more sleep you may need.
- Both short-term illnesses, like colds and flu, as well as long-term or chronic conditions—everything from arthritis to cancer—increase the need for additional rest and sleep.
- Life circumstances.Stress and periods of change can temporarily increase the need for sleep. They can also make it difficult to sleep. Chronic stress can create a chronic sleep debt. Also, even big positive life changes can increase the demand for more sleep.
Depression Acts On Neurotransmitters To Make You Tired
Depression is likely associated with changes in brain neurotransmitters, such as dopamine, norepinephrine, and serotonin. “These neurotransmitters play important roles in regulating energy levels, sleep, appetite, motivation, and pleasure,” Ricke says.
According to Harvard Health Publishing, depression is a complex disease with many possible and interlinked causes, including genetics, medical conditions, stressful life events, and brain chemistry. And it can be challenging to tell the difference between everyday tiredness and depression-related fatigue.
“Fatigue and depression can look quite similar,” says Alex Dimitriu, MD, psychiatrist and sleep medicine expert, and founder of Menlo Park Psychiatry & Sleep Medicine.
About Upmc Western Behavioral Health
UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. UPMC Western Psychiatric is the hub of UPMC Western Behavioral Health, a network of nearly 60 community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors throughout western Pennsylvania.
How Sleep And Depression Are Related
2 Minute Read
January 15, 2018
Sleep and depression are so intertwined that it’s hard to know if one causes the other or if they’re just associated.
Both insomnia and sleeping too much are symptoms that can help diagnose depression. Excessive fatigue during the day, called hypersomnia, is also a signal.
Sleep isn’t just something you do to feel alert during the day. It also allows your body to perform necessary biological repairs, affecting your immune systems, heart health, and other cell functions. Researchers and clinicians still aren’t sure what the exact relationship is between sleep and depression, but they do know there’s a link.
Let’s start with a few statistics:
- At some point in their lives, depression will affect 25 percent of women and 10 percent of men.
- A study published in the journal Dialogues in Clinical Neuroscience found that about 75 percent of patients with depression also have insomnia.
- Those with insomnia have a 10 times greater risk of developing depression than those who sleep well, says the National Sleep Foundation .
Changes In Appetite And Weight
We all tend to overeat or feel loss of appetite from time to time. However, if it’s coupled with other symptoms, such as feeling depressed or losing interest and pleasure in usual or favorite activities for two weeks or more, it could be a sign of a depressive episode, according to Simon Rego, PsyD, director of psychology training at Montefiore Medical Center in the Bronx, N.Y. A weight gain of at least 5 percent of a person’s total body weight in a short period of time that causes significant distress may be considered part of depression, Dr. Rego says.