The relationship between sleep and depressive illness is complex: depression may cause sleep problems and sleep problems may cause or contribute to depressive disorders. A closer look at symptoms along with professional assessment by a psychiatrist or sleep specialist will help shed light on what may seem a chicken-and-egg proposition.
Depression is characterized by persistent feelings of sadness, anxiety, hopelessness and disinterest in things that were once enjoyed. Depression is not something that a person can ignore or simply will away. Rather, it is a serious disorder that affects the way a person eats, sleeps, feels and thinks.
"One of the core features of a clinical depression is a disturbance in sleep," says Ranji Varghese, MD, a board-certified sleep physician, psychiatrist and medical director at North Memorial Sleep Health Center."Patients that are depressed tend to wake up more often during sleep and have a harder time getting back to sleep, though a small minority of patients with depression may actually sleep more than they normally do." With treatment of depression, sleep disturbances generally improve.
On the other hand, inadequate sleep can be a contributing factor in depression. "Sleep is very important for physical and mental rest," says Dr. Varghese. "We are beginning to learn that the energy that the brain uses during the day is replenished in very specific stages of sleep. Sleep is important for memory consolidation, mental concentration and reaction times." People with loss of sleep may complain of irritability or other personality changes, including a tendency to worry over lost sleep. New data suggests that there may be an association with insomnia and new onset depression in some people, particularly in the elderly.
If your symptoms include depressed mood for most days, diminished interest or pleasure in activities, unexplained changes in weight, being agitated or slowed down, loss of energy, feeling of worthlessness, difficulties with concentration and recurrent thoughts of death, you should see a psychiatrist. "Rarely do patients with primary sleep disturbances have recurrent thoughts of death or a diminished interest in activities they once enjoyed," says Dr. Varghese.
Sleep loss or a decreased quality of sleep due to a primary sleep disorder such as sleep apnea can result in daytime sleepiness, having a lack of energy and diminished ability to concentrate. Sometimes this can be misinterpreted as depression. A sleep specialist can be very helpful in identifying the quality of sleep or diagnosing disorders like sleep apnea or restless legs, which can disturb sleep and cause disturbances in mood.
If you’re concerned about the quality of your sleep, you should consult your physician. For more information about the North Memorial Sleep Center, click here.