Sleep and Depression
How Are Sleep Disorders and Depression Treated?
The treatment for clinical depression depends on how serious the mood disorder is. For instance, psychotherapy (talk therapy or counseling) combined with medications (antidepressants) is highly effective in treating depression. The antidepressants work to decrease symptoms of sadness or hopelessness while the psychotherapy helps improve coping skills and change negative attitudes and beliefs caused by depression. Talk therapy also works on coping skills to help you fall asleep more easily.
Which Medications Help Sleep Disorders and Depression?
Your doctor may treat sleep disorders and depression with an antidepressant such as an SSRI -- a selective serotonin reuptake inhibitor. Additionally, your doctor may prescribe a sedating antidepressant or a hypnotic medication -- a sleeping pill or other medication that helps people sleep.
Which Types of Antidepressants Can Help With Sleep?
Your doctor may prescribe one of the following antidepressants that can also help you sleep:
- An SSRI such as Zoloft, Prozac, Celexa, Lexapro, and Paxil. These medications can perform double duty for people by helping them sleep and elevating their mood. Some people taking these drugs, though, may still have trouble sleeping. Other antidepressant medicines that affect serotonin through multiple serotonin receptors include Viibryd and Brintellix.
- Tricyclic antidepressants (including Pamelor and Elavil)
- SNRIs (serotonin/norepinephrine reuptake inhibitors such as Effexor, Pristiq, Khedezla, Fetzima, or Cymbalta)
- Sedating antidepressants (such as Remeron). The antidepressant trazodone is not widely used to treat depression but because it can cause drowsiness it is often paired as a sleep aid that can be used with other antidepressants.
Which Hypnotics or Sleeping Pills Are Most Effective?
Your doctor may prescribe one of the following hypnotics or sleeping pills to help resolve insomnia:
- Ambien/Ambien CR
Are There Other Sleep Tips That Can Help Depression?
Here are some lifestyle tips that -- in combination with antidepressants and sedative-hypnotics -- may help improve sleep and resolve insomnia:
- Meditation, listening to soft music, or reading a book before bedtime can help increase relaxation while focusing your thoughts on neutral or pleasant topics.
- Clear your head of concerns by writing a list of activities that needs to be completed the next day. Then tell yourself you will think about it tomorrow.
- Get regular exercise -- but no later than a few hours before bedtime. Daily exercise, including stretching and conditioning exercises, can help to facilitate sleep and relieve the associated anxiety many people have about staying asleep.
- Avoid looking at a bright screen (for example, a laptop or television) prior to bedtime because the light emitted from cathode ray tube computer monitors can suppress release of the natural hormone melatonin, which signals the brain to go to sleep.
- High levels of arousal associated with racing thoughts, worries, or rumination may delay sleep onset. Relaxation therapies such as yoga and deep abdominal breathing may be useful in initiating sleep.
- Don't use caffeine, alcohol, or nicotine in the evening. Check the ingredients in any over-the-counter or prescription medications to see if "sleeplessness" is indicated. Some medications such as headache medicines contain caffeine, which can cause poor sleep.
- Don't lie in bed tossing and turning. Get out of bed and do some light activity (such as reading or listening to soft music) in another room when you can't sleep. Go back to bed when you are feeling drowsy.
- Use the bed only for sleeping and sex. Don't lie in bed to watch TV or read. This way, your bed becomes a cue for sleeping, not for lying awake.
- Take a warm shower right before bedtime to increase deep sleep as your body cools.
- Keep your bedroom at a cool temperature.
- Wear earplugs and a sleep mask if noise and light bother your sleep.
- Get blackout shades for your bedroom to keep outside lights from bothering you.
- A white noise machine may also help if you cannot sleep because of household noises.