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Is Insomnia A Sign Of Depression

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Consider Cognitive Behavioral Therapy


Treating insomnia using cognitive behavioral therapy is highly effective. It is tailored to encouraging not only realistic and positive thought processes when it comes to sleep but also healthier behaviors.

Through CBT, patients are encouraged to practice healthier sleep habits like heading to bed always at the same time as well as getting rid of all distractions inside the bedroom.

CBT also assists folks to counter negative sleep affirmations such as I can never fall asleep, with positive ones such as It is not abnormal to take a little while to sleep.

Unlike the use of drugs, CBT takes a slightly longer time to start working . While that might be the case, the benefits of therapy are long-lasting. With this therapy, what you are learning is a skill set. After you have mastered it, it remains within your system for a long time.

Do you know that CBT tends to be more effective compared to sleeping pills especially in middle-aged and young patients? Now you know!

Depending on your case, some of the cognitive-behavioral therapist techniques that your physician can recommend include:

Do You Feel Sleep Deprived

Take our 2-minute Sleep Deprivation and Depression quizzes to see if you simply aren’t getting enough sleep or if you may benefit from further diagnosis and treatment.

Sleep deprivation weakens the prefrontal cortexs ability to control the amygdala , making it difficult to process and cope with emotions. When the brain is deprived of adequate sleep, it also struggles to concentrate and regulate growth and appetite.

Sleep deprivation can have a profound effect on both the emotional and cognitive functioning of the brain. This results in bad moods, negative thinking, decreased empathy, and poor impulse control.

The good news is that sleep deprivation can be treated, and getting on a regular sleep cycle can alleviate the above symptoms.

What It Is How It Affects You And How To Help You Get Back Your Restful Nights

    According to the American Academy of Sleep Medicines ICSD-3 manual, insomnia is defined as persistent difficulty with sleep initiation, duration, consolidation or quality. Insomnia has many potential contributing factors and symptoms, but its diagnosis hinges on two essential components: sleep difficulties that occur despite adequate opportunities for normal sleep, and daytime impairment that directly results from poor sleep quality or duration.

    Chronic insomnia is characterized by symptoms that occur at least three times per week for at least three months. Insomnia that lasts or less than three months is known as short-term insomnia. In rare cases, patients may exhibit insomnia symptoms without meeting the criteria for short-term insomnia and may warrant some form of treatment. This is known as other insomnia.

    While insomnia can manifest in different ways, most diagnoses fall into one of two categories:

    Some people may have mixed insomnia that involves both sleep-onset and sleep maintenance difficulties, and people with chronic insomnia may find that these symptoms shift over time.

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    Insomnia As A Transdiagnostic Symptom/ Syndrome For Psychopathology

    A further boost for the field came from DSM-5 with the establishment of the category of insomnia disorder, thus ascribing independent value to this symptom complex instead of considering it mainly a symptom of any kind of mental disorder. Still, in DSM-5, separation of condition by categories is current practise but clinical research inspired by RDoC is supporting a dimensional approach using constructs and domains to understand pathophysiology. RDoC has suggested a major domain named arousal and regulatory systems with the constructs arousal, circadian rhythms and sleep-wakefulness with a detailed listing of areas of interest for research from the level of molecules to circuits, behavior and paradigms. Two recently published meta-analysis on PSG derived sleep variables in insomnia and all different types of mental disorders support this concept and stress a transdiagnostic approach of sleep continuity disturbances/ insomnia towards mental illness. Instead of adhering to an approach, which sought to identify disease-relevant mechanisms through identifying biological markers for specific mental disorders, we postulate that sleep and circadian rhythm disturbances occur independently of and predict/coincide with affective disorders, clinical psychopathological syndromes do not necessarily reflect homogenous pathophysiological origin, neuropsychiatric syndromes like depression and sleep/circadian disturbances are linked through common mechanistic origins .

    Tips For Coping With Depression

    Signs of Insomnia

    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 youre not alone. Spend time with others, talk about what youre 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

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    How Symptoms Of Depression Impact Sleep

    Untreated depression can lead to overwhelming sadness, which can affect your ability to sleep. During the night, your mind may ruminate about things that are contributing to negative emotions including sadness, despair and hopelessness.

    While you are lying in bed tossing and turning, the bad feelings you are having can seem much more impossible to deal with. And the more you focus on your uncomfortable emotions, the harder it is to sleep.

    Are Depression And Insomnia Two Sides Of The Same Coin

    Posted April 7, 2011

    Common and Connected

    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 is chicken and which egg? Or are they both?

    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, where the sleep architecture goes fantastically out of line: 1. Deep sleep, where we produce growth hormone, a stage critical for memory and , may altogether disappear with depression. 2. Awakenings and arousals increase dramatically. Sleep becomes highly fragmented. 3. REM sleep is often broken up, and its very appearance changes. Rapid eye movements may appear both erratic and dense. The changes are so characteristic that Professor Jerry Vogel and others from the 1970’s on tried to treat depression by waking folks every time they started REM sleep. Preliminary results were strongly favorable, but faded.

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    Insomnia And Depression Are Two Disorders Says Study

    The common belief that insomnia is a secondary symptom of depression when they co-occur is not supported by scientific evidence, and doctors should direct targeted diagnostic and treatment attention to both disorders, according to a narrative review published by the Medical Journal of Australia.

    Up to 90% of patients with mood disorders also report difficulties initiating and/or maintaining sleep, and about 20%-50% of patients with insomnia disorder report symptoms of depression, wrote the authors of the review, led by Dr Alexander Sweetman, Adelaide Institute for Sleep Health Research Associate and Flinders University College of Medicine and Public Health colleagues.

    The co-occurrence of depression and insomnia is associated with reduced quality of life, greater overall morbidity, and increased health care use, compared with either depression or insomnia alone, they say.

    Therefore, it is critical to consider diagnostic and management approaches for patients with co-occurring depression and insomnia to improve patient outcomes and reduce health care costs.

    Depression is commonly conceptualised as the primary disorder, and the insomnia as a secondary symptom. This is evidenced by clinicians prioritising the management of depression over insomnia, and an expectation that insomnia symptoms will abate when depression is successfully managed.

    A Vicious Cycle: Insomnia Anxiety And Depression

    What is Insomnia?Causes, Signs and symptoms, Diagnosis and treatment

    Heed this condition it could lead to early detection of mental disorders and other illnesses.

    Chronic insomnia can increase a persons chances for developing anxiety disorders and depression, according to a study conducted by Dag Neckelmann, MD, PhD, of the Department of Psychiatry at Haukeland University Hospital in Bergen, Norway.

    The study, published in the July 1, 2007, issue of the journal SLEEP, was based on data collected from 25,130 adults from two general health surveys conducted over a 10-year period. Neckelmann found significant associations between the long-term course of chronic insomnia and the development of anxiety disorders and depression.

    Compared to the group of participants without chronic insomnia in both surveys, the group with chronic insomnia had increased associations with anxiety disorders and depression. Those subjects who reported that they had insomnia during the initial survey had a higher risk of developing an anxiety disorder during the second phase of the study conducted 10 years later.

    The findings were upheld even when factors such as the patients age, gender, and educational level were taken into consideration.

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    The Link Between Insomnia And Depression

    Nothing is more frustrating than tossing and turning all night when you should be sleeping. Lying there, anticipating the alarm going off at 6:00 am as the hours tick by, can cause deep distress. You cringe when considering the coming day, knowing that you will be functioning on fumes.

    Insomnia is one of the most commonly heard complaints at the doctors office, with about 30% of Americans struggling with sleep disturbance, according to the Sleep Foundation. What is not as well understood is the strong connection between insomnia and depression. The co-occurrence of insomnia and depression is so common that doctors are warned not to be swift in diagnosing depression unless insomnia is a presenting symptom.

    A groundbreaking epidemiological study, conducted in 1989 with nearly 8,000 participants, was important in quantifying the increase in depression symptoms from one year to the next. It was found that 14% of the participants who reported having insomnia in the first year went on to develop depression by the second year follow up survey. Subsequent studies have further reinforced this association between insomnia and depression. So, with the link between the two so clear, how do you go about treating individuals with co-occurring insomnia and depression?

    Depression Symptoms To Watch For

    While severe sadness is the most well-known symptom of depression, knowing how to recognize other signs can help head off a future depressive episode.

    If you’re one of the 20 million people in America with depression, you know that it’s not a condition to be taken lightly. It’s important to manage symptoms of depression with therapy and medication as prescribed by your doctor, both to feel better now and to reduce the risk of a depressive episode in the future.

    One of the best ways to minimize the physical and emotional damage of an episode of depression is to recognize depression early and take action which can mean getting back on track with treatment or talking to your doctor about whether your treatment plan needs to be reviewed and revised. But not all symptoms of depression are easy to identify, and the early signs can be different for everyone. Here are some common symptoms you should look for.

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    Each Person Responds Differently To Antidepressants

    The journey for each person is unique:

    • It often takes weeks to feel the full effects.

    • Your doctor may start you at a low dose and slowly increase it.

    • It may be necessary to try different antidepressants to find the one that works best with the fewest side effects.

    • Antidepressants may be prescribed in combination with each other or other medicines and supplements to help treat depression.

    Why Is Sleep So Important


    Normal sleep is a restorative state. However, when sleep is disrupted or inadequate, it can lead to increased tension, vigilance, and irritability.

    Physical or emotional trauma and metabolic or other medical problems can trigger sleep disturbances. Poor sleep can lead to fatigue. With fatigue, you exercise less and that leads to a decline in your fitness level. Eventually, you find yourself in a vicious cycle of inactivity and disturbed sleep, which causes both physical and mood-related symptoms.

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    Mechanism Between Insomnia And Depression

    The circadian process regulates the sleep-wake cycle. When it is working optimally, this process operates in-tandem with the normal days cycle. As our bodies prepare to sleep and daylight turns into nighttime, we tend to get tired. As night turns into day, we become awake.

    The internal mechanisms that inform the circadian cycle entail a sophisticated transposition of the neurophysiological and neurochemical that the hypothalamus presides over.

    On the other hand, depression is both a mood disorder and a medical condition.

    Although there are countless antecedents to depression such as environmental and genetic factors, the neurophysiological causes relate to a lack of some chemicals in the brain which regulates norepinephrine, dopamine, and serotonin.

    Nonetheless, there is more to these neurotransmitters than mood regulation. They also play a huge role in sleep efficiency.

    Disruptions in the brain chemicals result in sleep disturbances especially REM sleep. They can also result in more restlessness in normal times when we need to be in bed. This creates a vicious cycle where the more aggravated ones depression turns out to, the more he or she suffers from insomnia. The reverse is also true the more your insomnia becomes, the more depression you suffer from.

    Create Time To Decompress Before Bed

    This may be especially important if rumination is causing insomnia. O’Neill says this can be any calming bedtime ritual that primes the body to expect sleep, such as dimming the lights and reading a book, or taking a bath.

    Make sure to avoid the blue light of electronics, or stressful activities like watching TV or reading the news, as this can have a stimulating effect.

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    People With Severe Insomnia Face A Higher Risk Of Developing Many Diseases

    When one has difficulty sleeping, the waking world seems opaque. On top of feeling tired and fatigued, those who experience sleep disturbances can be irritable and have difficulty concentrating.

    With more severe cases of insomnia, one also faces a higher risk of developing heart disease, chronic pain, hypertension, and respiratory disorders. It can also cause some to gain weight.

    Sleep disruptions can also have a major impact on one’s emotional well-being. A growing body of research has found that sleep disturbances and depression have an extremely high rate of concurrence, and many researchers are convinced that the two are biconditionalmeaning that one can give rise to the other, and vice-versa.

    A paper that was published in Dialogues in Clinical Neuroscience concluded, The link between the two is so fundamental that some researchers have suggested that a diagnosis of depression in the absence of sleep complaints should be made with caution.

    The paper’s lead author, David Nuttthe Edmond J. Safra Chair in Neuropsychopharmacology at Imperial College Londonfound that 83 percent of depressed patients experienced some form of insomnia, which was more than double the amount of those without depression.

    The Mechanisms Behind the Two Diseases

    Fatigue Or Lack Of Energy

    What are the Different Types of Insomnia and Their Symptoms?

    We all feel less energetic from time to time, so fatigue on its own isn’t necessarily a symptom of depression or a sign of a depressive episode, says Gabriela Cora, MD, managing partner of the Florida Neuroscience Center and a diplomate of the American Board of Psychiatry and Neurology. “However, if fatigue lingers and is accompanied by low mood and decreased motivation or interest, this lack of energy may be tied to early signs of depression,” she says.

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    What’s The Link Between Sleep Disorders And Depression

    An inability to sleep is one of the key signs of clinical depression. Another sign of clinical depression is sleeping too much or oversleeping.

    Having a sleep disorder does not in itself cause depression, but lack of sleep does play a role. Lack of sleep caused by another medical condition, a sleep disorder, or personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed.

    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 youre 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.

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    Insomnia Causes And Symptoms

    Insomnia is believed to originate due to a state of hyperarousal that can impact sleep-onset and sleep maintenance. Hyperarousal can be mental, physical, or a combination of both. Environmental, physiological, and psychological factors can all play a role in insomnia. These include the following:

    Insomnia has also been linked to unhealthy lifestyle and sleep habits. Many people adopt these habits when they are younger, making them hard to break as adults. These habits can include going to bed at a different time each night or napping too long during the day. Exposure to screen devices like computers, televisions, and cell phones can also cause sleep problems, as can working evening or night shifts. Other factors can cause difficulty falling or staying asleep, such as inadequate exercise during the day or excessive noise and/or light in the sleepers bedroom.

    The most common symptoms among chronic insomnia patients include difficulty falling and/or staying asleep, waking up earlier than planned, and not feeling tired or ready for bed at scheduled times. Daytime impairment is a necessary component of insomnia, and this can also manifest in different ways. Common impairments include fatigue and malaise, memory and concentration difficulties, mood disturbances and irritability, and behavioral problems such as hyperactivity and aggression.

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