Insomnia and depression

 If you find that you are restless the night before a big event and if you’re having difficulty falling asleep – not to worry. Your mind (and body) are preparing you for something important. However if your inability to sleep soundly occurs night after night for an extended period of time, you might begin to notice a performance decline at work or school. Worse yet, you might face serious health issues such as heart disease, high blood pressure and mood disorders including anxiety and depression.


According to the National Sleep Foundation, most people require between seven and nine hours of quality sleep in order to enjoy optimum physical and mental health. The average American gets about 6.9 hours of sleep per night. Sleep deprivation may lead to a diminished life outlook, diminished energy level, low motivation and unstable emotions. Other effects include feelings of sadness, emptiness and irritability; all symptoms of clinical depression.

The dictionary definition for the inability to fall asleep and / or enjoy quality interrupted sleep is insomnia. Certain medical conditions or the uncomfortable symptoms produced by these conditions  may cause insomnia. A few examples are nasal allergies and asthma, gastrointestinal disorders, endocrine disorders including hyperthyroidism and chronic pain caused by arthritis or back pain. Sleep apnea, repeated awakening during the night due to an obstructed airway, also causes insomnia.  Certain medications may also cause insomnia including those taken for high blood pressure, allergies or even birth control.

Insomnia and depression may work in a circular fashion. Consider this example. A person is extremely worried and anxious about a major life event, say a pending divorce. Child custody, finances and living conditions are all uncertain. The person is overwhelmed with fear and rapid firing irrational thoughts may overtake their mind. The result is insomnia. Without much needed sleep this individual may experience a diminished capacity for tissue growth and repair as well as energy restoration and hormone secretion for muscle development. The hormone cortisol may not increase during the night thereby suppressing morning alertness. Hormones that regulate appetite and fullness are affected so the person may feel the need to eat more which can lead to weight gain. Fatigue and a sense of poor health opens the door to depression which in turn exacerbates the insomnia and the cycle continues. The same cycle applies to exercise as the person is too fatigued to exercise and lack of exercise may contribute further to depression.

How is this vicious cycle broken? Help begins with trained professionals which include a primary care physician, mental health care professional or sleep clinic. One line of defense against insomnia is cognitive behavioral therapy where people learn the benefits of proper sleep, the consequences of improper sleep and behavioral changes to enable quality restorative sleep. Relaxation techniques including mindfulness and meditation are sometimes recommended to help the patient shut down the rapid firing irrational thoughts that create anxiety. Yoga and exercise are both excellent techniques for managing stress and promoting proper sleep. Medication may also be an option. If you believe you are not leading the productive happy life you wish you were leading, and if you believe lack of sleep is the cause, a trained medical or mental health care provider can help.

Carolyn Ehrlich LCSW, CGP specializes in Relationship Counseling Tribeca. I increase your self- awareness and help you gain more insight into your inner-life. We'll work together so you can get more out of every day and meet any challenge life throws at you.

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