INSOMNIA || Why is it linked to depression?

Image courtesy TMS NeuroHealth Centers

This could be a chicken/egg question, truly... which came first, insomnia or depression?

One can definitely lead to the other. Let's think about this for minute.

Depression can be its own illness, categorized in severity based on a wide range of physical and emotional symptoms and linked to physical illness, hormonal imbalance, stress and aging. When people experience the psychic symptoms of depression (feeling emotionally drained, agitated, anxious, worried, or suicidal, for instance), it makes sense that it could become either difficult for them to sleep or difficult for them to get out of bed feeling rested.

When it comes to insomnia, not being able to sleep due to physiological triggers (other underlying sleep disorders, transient illness, chronic illness, pain, stress, hormonal imbalance, aging) can lead to disorders of mood, thanks to shifting brain and body chemistry and processes that come from not getting adequate sleep. Sleep helps your body to heal itself at the cellular level as well as maintain the proper body and brain chemistry necessary for normal, balanced function. It makes sense that, lacking sleep, a person is more likely to become ill, either physically or mentally, or even suffer from both.

According to a study published in SLEEP in 2005, people with insomnia are 10 times more likely to develop depression than those who sleep well. This is a serious problem, as insomnia is the most common sleep disorder in the United States. Problems with insomnia range from having trouble falling asleep, staying asleep, fragmented sleep and day-after fatigue or excessive daytime sleepiness.

Major depressive disorder, according to the National Institute on Mental Health, is no small problem, either. As one of the most common mental health disorders in the United States, nearly 7 percent of our entire population suffers from it.

It seems there are endless ways in which insomnia and depression can pair up. Drug addiction or withdrawal, for instance, or even the side effects of some maintenance drugs people must take for chronic illness. Major life stressors, such as divorce or the death of a child or a lost job, will cause one or the other--or both--if not addressed. Poor diet or lack of exercise may lead to insomnia or depression. Another common and very specific relationship between sleep and mood--Seasonal Affective Disorder--has also been researched at length (see what SHC published on this topic in 2014).

Treatments for insomnia often mirror treatments for depression, which may simplify the process for many. They usually involve either a pharmacological therapy, cognitive behavioral therapy, or ideally, a combination of both. A medical doctor will review history, symptoms and ask for a thorough physical exam to help establish any biological causes for either sleep insufficiency or depression, to help determine a therapeutic course that serves to treat both.

The main takeaway is this: never think that ongoing symptoms of either insomnia or depression are best ignored. The presence of ongoing bouts with either--and especially both at once--is a major cause for concern and should not be overlooked.

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There is no badge of courage attached to going without sleep; the longer you go without it, the worse your brain and body will suffer. The human body can go for up to 11 days without sleep, and then it will die. Sleep is not optional.

Likewise, there is no shame in admitting to feelings of despair or chronic low mood; in fact, these could by symptoms of a physical condition you could easily treat. Often, the challenges of our lives also require outside help; even the strongest individuals will struggle to power through dark times.

If you are struggling with either condition, you are best advised to seek help regarding either via the healthcare professional you are most comfortable approaching, whether it's your primary care physician, a behavioral therapist you are already seeing, a naturopath, or a specialist who oversees any other chronic health conditions you might have.

(And please avoid going to online forums or private groups as these communities; even when they strive to provide support, they can often be the source of some of the worst, most dangerous misinformation out there. Members and moderators of these groups are generally not medical professionals.)

Ultimately, hope lies in the reality that both insomnia and depression, together and separately, are eminently treatable.