INSOMNIA & DEPRESSION
Find out why these conditions are often linked
Have you ever witnessed the downward spiral of an overtired child from seemingly happy and alert to suddenly cranky? You may be aware of how a couple of nights of poor sleep affects your mood. Perhaps you become snappy and feel like just dragging yourself around. Temporary bad moods can improve after a good night’s sleep, but what are the links between insomnia and the commonest mood disorder, depression? Past studies have variously explored insomnia as part of depression, insomnia as a cause of depression and depression as a cause of insomnia. So, which comes first the chicken or the egg? It’s complicated. The answer is either one. Sometimes they come together. However, they are defined as separate disorders. Although insomnia can be part of depression, depression is characterised by persistent low mood, feelings of hopelessness and loss of enjoyment affecting all parts of a person’s life. Chronic insomnia does seem to increase vulnerability to future depression and occur perhaps as a marker before depression. However, the jury is still out as to if and how insomnia may cause depression. More studies are needed. Conversely, depressed people have trouble falling asleep, staying asleep or they may wake up in the early hours of the morning. These sleep problems can be the first reason why depressed people present to their pharmacist or doctor, even if they don’t realise they are depressed. Unfortunately, insomnia that is a part of depression, often does not respond to insomnia treatment alone, such as over the counter treatments or other sleep medication. If a person has both insomnia and depression, the fact that they are separate disorders means that treating only the insomnia will not necessarily fix the depression. It also means that even when depression is treated, insomnia can persist.
So, what can you do today if you’re suffering insomnia or suspect it’s leading to a low mood? To ensure that sleep quality is always a priority, implement the simple techniques outlined in the article, Do You Struggle with Insomnia? in the January/February issue of Great Health GuideTM. A QUICK UPDATE OF THESE TECHNIQUES: 1. Limit the use of smartphones, tablets and computers for an hour before bed. 2. Have some wind down time, to become sleepy before attempting to sleep. 3. Regulate body temperature in readiness for sleep. 4. Keep a consistent bedtime and bedtime routine. 5. Stop checking the clock, this only adds to the frustration. 6. Limit caffeine and alcohol for several hours before bedtime. 7. Don’t sacrifice your sleep time for work. If you are suffering persistent insomnia or low mood, make an appointment to see your local doctor. Understand that if insomnia is part of depression, it will rarely respond to isolated insomnia treatment. Also, if you are treated for depression with an anti-depressant and yet still have insomnia, talk to your doctor as you may require additional advice to address each separately.
Dr Tammra Warby is a General Practitioner with a PhD, who works at Foxwell Medical. She is on the FRACGP Future Leaders program 2018 and manages chronic disease such as asthma and diabetes, with further qualification in skin cancer surgery. She can be followed on Twitter.