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Are You Depressed -- or Just Sleepy?

Sleep loss and depression are so closely linked, treating one condition will often improve the other.
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WebMD Feature

You’ve been feeling listless and low, can’t concentrate, and don’t enjoy doing anything that used to give you pleasure. You can barely keep your eyes open during the day, yet the minute your head hits the pillow at night, you are wide awake. 

This is an all too common scenario because lack of sleep and depression tend to travel together. The good news is that treating one condition may have spillover benefits for the other.

Insomnia and Depression

Depression can stem from any sleep disorder that causes chronic fatigue and mood problems. But insomnia, the inability to fall asleep or stay asleep, is the sleep disorder most often linked to depression.

“If you were to follow people with insomnia and no history of depression, they would be four times more likely to develop depression than individuals with no history of insomnia,” says R. Robert Auger, MD, a sleep specialist at the Mayo Center for Sleep Medicine in Rochester, Minn. This increased risk persists even decades later.

Which Comes First, Sleep Loss or Depression?

“In people who have bad insomnia and bad depression, it is often very difficult to tell which came first,” says Mark Mahowald, MD, director of the Minnesota Regional Sleep Disorders Center in Hennepin County. “Sleep deprivation can impair mood, and impaired mood can result in impaired quality and quantity of sleep.”

According to Auger, the relationship between sleep and depression is not entirely understood. “But there is a well-established connection between lack of sleep and mental and physical health,” Auger says. “Sleep is as important an aspect of health as exercise and nutrition. Sleep is non-negotiable.”

How Treating Insomnia Can Improve Depression

The first step to better sleep is to diagnose and treat the sleep disorder and/or the underlying depression. “If you treat the insomnia in someone with depression, you will improve their chances of achieving remission from the depression,” Auger says.

Your primary care doctor may be able to educate you about sleep habits that will help your insomnia. In some cases, your doctor may treat insomnia with prescription sleeping aids. Some individuals will respond to them. Others may not if they have another underlying sleep disorder such as sleep apnea that is also robbing them of quality sleep.

Your primary care doctor may also refer you to a sleep specialist.

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