Summary
Things you should know:
- People with depression often do not sleep well.
- Those who suffer from insomnia or sleeping problems have a higher risk of depression.
- Not all people with depression have sleeping problems and not all those with sleeping problems have depression, but it is more common.
- If sleep can be improved, this may help with depression.
- Being exposed to bright light (outdoor or artificial) can help with both sleep problems and depression.
I think I’m depressed; how do I know?
If you keep feeling hopeless, helpless and sad, then you could have clinical depression. You may have low motivation and low energy. It might seem like there is no joy in life anymore. Changes in how you sleep and eat are also a sign of depression. Some depressed people feel shame, guilt or low self-esteem. ‘Clinical depression’ is a serious condition. It is more than feeling sad or ‘blue’ sometimes. If you are unsure whether or not your feelings could be clinical depression, discuss your concerns with your doctor.
When I have slept well, I don’t feel depressed. What does this mean?
It could be that your mood is linked to how well you sleep and how much sleep you have. Depression and not getting enough sleep are two different things. But it is easy to confuse the two. It’s often hard to know which one came first. If the depression seems to go away with good sleep, it may mean that in fact you don’t have depression. You should seek help with making your sleep better.
I haven’t slept well for years but don’t think I’m depressed.
Although sleep problems can lead to depression, this is not always the case. A lot of people with Insomnia do not have depression. There may be another reason that you are unable to sleep well. See our page on Common Sleep Disorders. Not everyone with depression has a problem with their sleep.
Should I cut out all caffeine and alcohol?
Both of these can be bad for sleep. We recommend having as little of these as you can. Then they will not impact on how well you sleep. Small amounts of these are not a problem but try not to have them for at least 4 hours before going to bed. For some people caffeine in the afternoon can still affect their sleep. Remember that there is caffeine in cola drinks and chocolate, as well as in tea and coffee. Watch out for how much caffeine is in your food and drinks.
What can be done about insomnia and depression occurring together?
The best treatment for Insomnia is Cognitive Behavioural Therapy, known as CBT. A sleep psychologist will help you to look at how your behaviours, thoughts, and feelings affect how you sleep. It does not involve any drugs. CBT usually requires several sessions over a period of weeks or months. It will help you learn lifelong strategies for better sleep. It can also be used to help with depression. Psychologists who specialise in either sleep problems or depression may work with both problems. It is not unusual for such treatment to happen alongside a course of antidepressants. Ask your GP about seeing a psychologist, either linked to asleep centre or specialising in sleep and depression.
My depression is worse in winter. Can light help?
Bright light therapy works with sleep problems with a link to the Body Clock It also helps with depression that is caused by a lack of bright light. This type of depression is seasonal, and much more of a problem when daylight hours are short. Outdoor, natural light is best to help with seasonal depression. But such light may not be easy to get in winter months in some parts of the world. Artificial bright light can be used in this case. For how much artificial light you need and when you need it, it is best to speak to a sleep specialist. For many people, increasing the amount of outdoor light they get, especially in the morning, is a good start to help with seasonal depression and sleep problems.
I’ve heard antidepressants make sleep worse. Is this true?
There is a type of antidepressant medication called SSRIs. SSRIs work to make mood better in many people. But they may also cause or worsen insomnia in a few patients. This is not the case for all people. It is best to discuss the pros and cons of each type of drug with your doctor. Sometimes changing the time of day of taking the tablet to the morning can help your sleep. It is common for patients to use a mix of medication and other treatments.
Are naps bad? How long should a nap be?
It is normally best to avoid daytime naps as this can make it harder to fall asleep at night. This is especially so after 2-3pm. If you do need a nap, then keep it short; no more than 15-20 minutes. It is best to set an alarm to avoid long naps. Your naps should total less than 30 minutes for the whole day.
I am having problems with my sleep. What should I do?
There are things you can do yourself to help. See Sleep Hygiene: Good Sleep Habits. Talk to your doctor. There are sleep specialists who can help.
How can I find out more?
https://www.sleepfoundation.org/articles/depression-and-sleep
The following link focuses on seasonal depression: https://www.rcpsych.ac.uk/mental-health/problems-disorders/seasonal-affective-disorder-(sad)