Depression Insomnia: The Link Between Depression And Sleep

Medically reviewed by Laura Angers Maddox, NCC, LPC and Nikki Ciletti, M.Ed, LPC
Updated September 24, 2024by BetterHelp Editorial Team

Insomnia, a condition that generally makes it difficult to fall and stay asleep, can be a common symptom of depression. When depression and insomnia occur together, it can be vital to determine which occurred first in order to choose the right form of treatment. 

Treatment options for both depression and insomnia generally consist of a combination of therapy, medication, and lifestyle changes. If you’re living with depression insomnia, consider reaching out to a licensed therapist in person or online for professional guidance.

This article explores the link between sleep and depression, how depressive symptoms can lead to sleep disturbances, and tips that may help improve sleep quality and depression symptoms. We’ll also highlight resources for individuals who would like to find mental health support for symptoms of depression, chronic insomnia, and other sleep problems. 

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Stop depression from keeping you up at night

Is depression insomnia different from typical insomnia?

What is it that makes depression insomnia different from a standard case of insomnia? Understanding the relationship between depression and insomnia can help when seeking a treatment approach.

The link between insomnia and depression 

Insomnia is a sleep disorder that often accompanies major depression, affecting the sleep-wake cycle. This connection between depression and sleep is well-documented and medically reviewed, with research highlighting how insomnia symptoms can exacerbate depressive symptoms. 

In the short term, lack of sleep can worsen mood and increase the severity of depression. REM sleep, crucial for emotional processing, is also disrupted in those with insomnia and depression. 

How can sleep hygiene and medication treat depressive symptoms

Patients experiencing both depression and insomnia may benefit from improving their sleep hygiene and habits. Treatment may involve medications like selective serotonin reuptake inhibitors (SSRIs) to help manage depressive symptoms. SSRIs are also sometimes prescribed to help manage insomnia by affecting serotonin levels in the brain, so this may be particularly helpful for those who wish to address symptoms of insomnia and depression together. 

For personalized guidance regarding medication, insomnia, and depression, seek medical advice tailored to your specific symptoms and needs.

What is insomnia?

Many people use the term insomnia loosely or casually. If they fail to sleep well for a night or two, they might mention to a coworker the next day that they are experiencing daytime sleepiness due to insomnia. Insomnia that begins to cause larger problems typically lasts for more than just a night or two. 

Acute insomnia usually refers to several nights or weeks of poor sleep. Chronic insomnia, however, can describe a month or more of sleepless nights, which can be related to melatonin and depression.

Insomnia may not only be considered nights of no sleep. It can also involve the nights in which it takes a long time to fall asleep, the mornings when you wake up far too early, and the nights in which you find it difficult to remain asleep. You might experience daytime sleepiness, irritability, an inability to focus, and clumsiness.

Link between typical insomnia, stress, and anxiety

Typical insomnia can be the result of a variety of causes. Stress, anxiety, trauma, shift work, varying working hours, and poor sleeping habits tend to lead to insomnia. Several disorders and diseases can also cause it. Pinpointing the cause of your insomnia can be crucial to knowing how it should be treated.

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

What is depression insomnia?

Depression insomnia can be different from a standard case of insomnia because of its cause. Depression may cause insomnia in many people. Although the two conditions can feed on one another, meaning depression can cause insomnia and insomnia can contribute to the development of depression, identifying insomnia as a symptom of depression usually also means that treatment options are clearer.

Insomnia can be caused by several factors that also tend to play a role in depression. For example, a risk factor for both depression and insomnia may be hormonal shifts, such as those that occur during pregnancy, the menstrual cycle, and menopause. Additionally, an erratic schedule, like one caused by depression or a varying work schedule, can add to the chance you may experience insomnia.

Risk factors of depression insomnia 

Knowing these risk factors, you may wonder how depression insomnia is treated. Should you aim to treat the depression or the insomnia? Treatment usually starts by identifying which condition came first, but it can be important to treat both. Although getting more sleep will likely improve your depression, it may not completely heal the illness. 

Are the treatment options different?

Depression treatment is commonly done through therapy, medication, or natural remedies, such as lifestyle changes. Insomnia can also be treated with therapy, medication, or natural remedies. Although the treatments tend to be similar, there can be slight differences in how the treatments are used. Therapy, for example, tends to be a common treatment option for depression. Therapy for depression typically addresses how you think, feel, and behave in response to your thoughts and feelings.

Insomnia therapy, usually known as cognitive behavioral therapy for insomnia, normally addresses the root issue as to why you are not sleeping well. A therapist may have patients keep a sleep journal so that the main concern can be identified, and better sleep habits can be taught. If both depression and insomnia are present, a therapist will likely work with the individual on both challenges.

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Mental health therapy for depression and insomnia

Medication can also be a common form of treatment for both insomnia and depression. However, many professionals recommend trying therapy before any prescriptions are given. Always speak to your doctor or psychiatrist before starting or stopping any form of medication.

Alternative medication

Natural methods can be helpful for depression insomnia, as both depression and insomnia can be healed using some of the same approaches. For instance, exposure to natural sunlight often helps to adjust your body’s internal clock and can improve mood. Exercise at the right time of day can help you feel tired at the appropriate time and release chemicals that improve how you feel. 

Healing from depression insomnia

Depression insomnia is not something that has to last forever. With the appropriate treatment and effort on your part, you may find that your sleep improves, and your depression gets better over time. However, this difficulty is something that may relapse. After learning how to sleep better, you must maintain your usual sleep schedule and habits. The habits you will likely be taught by a therapist can help you stay on track.

Bedtime routine

Remember to maintain a normal bedtime routine. This generally includes going to bed at the same time each night, even on the weekends. It can also mean getting into a consistent routine before you sleep so that your body and mind know what is coming. For example, if you find it easiest to fall asleep after half an hour of light reading, brushing your teeth, and washing your face, stick to that routine. If a bath helps you relax an hour before bed, keep doing it. Consistency can be key.

Lighting and late-night activities

Bright lights and energizing activities can keep you awake later than planned. By dimming your lights at least an hour before you plan to sleep, you may find that it becomes easier to fall asleep. This can also be true for the bright light on your phone or tablet. The blue light emanating from modern screens can trick your mind into thinking it is not time for sleep. Avoiding these kinds of lights an hour before bedtime can help your mind and body realize it is bedtime. It can also be a good idea to avoid any exercise within a few hours before you sleep, as it can amp up the mind and prepare it for more activity.

Beverages before bed

Water, juice, and milk tend to be common before-bed beverages, but they can interrupt your sleep when you must get up in the middle of the night to relieve your bladder. It is usually best to avoid drinking something too close to bedtime. Alcohol is another beverage that should generally be avoided if you are struggling to fall asleep. Although it can make you feel sleepy, alcohol does not usually allow for restful sleep. An individual who has been drinking alcohol will likely wake up throughout the night or earlier than necessary.

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Stop depression from keeping you up at night

Morning or early afternoon exercise

Try to time your workouts correctly. Many individuals thrive on a morning workout. However, if the morning is not a good time for you, try to keep your exercise far from bedtime. Giving yourself three to four hours between exercise and sleep can help your mind calm down after the endorphin release from your workout.

Reach out to a therapist 

You might consider therapy to work through your depression and insomnia. A therapist may help you pinpoint the causes of these challenges and suggest effective ways to address them.

Online therapy can be a flexible and convenient option for those living with depression insomnia. The daytime drowsiness that often accompanies insomnia can make it difficult to drive safely, so attending therapy sessions from the comfort of your home may be an advantage. You may also schedule sessions close to bedtime so that your therapist can walk you through various relaxation exercises that may help with insomnia.

According to a 2019 study, online therapy can be an effective treatment for depression. The researchers stated that “depression symptom severity was significantly reduced after the use of the multimodal digital psychotherapy intervention.” As insomnia can be a symptom of depression, online therapy may effectively address both mental health concerns.

Takeaway

While depression often involves symptoms like a persistent low mood and lack of interest in previously enjoyed activities, insomnia normally refers to an inability to fall and stay asleep. Insomnia can be a symptom of depression, and this can be referred to as depression insomnia. Treatment options usually involve therapy, lifestyle changes, and medication. Maintaining a consistent bedtime routine, avoiding screens and bright lights for an hour before bed, and fitting in a morning workout can be helpful for both depression and insomnia. You may also find it beneficial to work with a licensed therapist for additional insight.

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