Insomnia and Anxiety/Depression

Most all of us have had the occasional sleeplessness night for one reason or another. Maybe you have a work project on your mind or it could be that you are worried about a family issue and can’t seem to fall asleep or stay asleep. Whatever the reason, having more than a few nights of less than quality sleep can make anyone feel fatigued and more than a little depressed. That stands to reason: after all, who wouldn’t be depressed when they are totally exhausted? But, the combination of insomnia, depression, and anxiety may mean more than just a lack of sleep. In fact, studies have shown that at least 80% of people who suffer from anxiety and depression also have chronic insomnia. This is so prevalent that researchers are now saying that chronic insomnia may actually be a predictor of the onset of depression and/or anxiety. Insomnia Symptoms Chronic insomnia is defined as having trouble falling asleep or having problems staying asleep most nights during the month. Insomnia symptoms may include some or all of the following:

• Difficulty falling asleep
• Waking too early or waking up throughout the night
• Being sleepy or tired during the day
• Feeling irritable, anxious, or depressed
• Loss of interested in social activities
• Loss of libido
• Difficulty in completing tasks or staying focused
• An increase in accidents or errors
• Physical symptoms of insomnia may include headaches, stomach or GI distress, or not feeling well, in general

Is There a Link Between Insomnia and Depression/Anxiety? If you can’t get to sleep or can’t stay asleep, it’s easy to see why you’d become depressed from fatigue or become so tired that you might become anxious about things that might not normally bother you. Current sleep research has found, however, that “insomnia and depression are two distinct but overlapping disorders,” says Michael Perlis, Ph.D., associate professor of psychiatry at the University of Pennsylvania and director of their behavioral sleep medicine program. “Until recently, insomnia was typically seen as a symptom of depression,” says Perlis. “Treat the underlying depression, the thinking went, and sleep problems would go away.” But, recent findings show that insomnia often shows up or gets worse just before a bout of depression. “Insomnia may serve as a trigger for depression,” Perlis says. “But it also appears to perpetuate depression.” Treating Insomnia and Depression or Anxiety In our practice, we find that Cognitive Behavior Therapy, used in conjunction with Mindfulness Meditation, often helps the most to relieve the anxiety experienced by having insomnia. CBT teaches people healthier behaviors and helps them gain more positive and realistic thought processes regarding their sleep. This therapy encourages better sleep habits and helps reduce the fears and replace the negative thoughts that can keep them from falling asleep or staying asleep. Research has shown that Cognitive Behavioral Therapy has longer-lasting, more sustainable effects on insomnia and depression. This is because it teaches you a skill set that you can use for the rest of your life. CBT gives you the power to cope with your situation in a healthy way and feel better about yourself and your world. Mindfulness Meditation is also used to help the patient learn self-awareness. It teaches that our inaccurate view of the world is what triggers our negative emotions. Through practicing Mindfulness Meditation, the person trains their mind to overcome their worries and painful emotions, so they can be free of their suffering. Other Ways to Treat Insomnia There are also other schools of thought about ways to treat both insomnia and depression or anxiety. One idea is to specifically treat the insomnia by itself: research indicates that the treatment of sleep problems can help relieve and prevent a recurrence of depression and anxiety. In fact, several studies have found that depressed people who also had insomnia and were treated with both an antidepressant and a sleep medication did much better than those who were treated just with antidepressants. They slept better and their depression scores improved significantly over people who were just taking antidepressants alone. Another method for treating insomnia is to actually wake a depressed insomniac early. This boosted mood in 30-60% of cases, but the cure is short-lived: the sufferer often becomes depressed again after they sleep once more. Chronotherapy has also been used – in this type of therapy, those who have trouble falling asleep reset their internal circadian rhythm by adjusting the time they go to sleep over a period of days. Light therapy can also help: it exposes the insomniac to bright lights to help change their sleep cycles. We Can Help Are you or a loved one fighting chronic insomnia? It may be time to talk to a professional to see if there is an underlying condition that is contributing to your sleep problems. Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are ready to take your call and make getting help easier. Contact Dr. Rosen at 561-496-1094 or email Dr. Rosen and The Center today.