Some of my friends can consistently live on four to five hours of sleep and function flawlessly. They’re a rare breed––most normal human beings need at least six to seven hours. However, there’s also a special group of us with mood disorders with varying sleep cycles––sometimes we can live off six hours, and sometimes we need 12-15 hours.
At first, I thought it was all in my head––how in the world could I sometimes sleep 12 hours and still feel exhausted? Later, it dawned on me: my energy levels directly correlated with my mood. The more anxious or depressed I felt the previous day/week, the more sleep I needed. With this in mind, a study of 517 people, published in the SLEEP journal, reveals that 60 percent of people with simultaneous mood and anxiety disorders display at least one insomnia symptom.
Further research confirms my hypothesis. Harvard Universty reports that sleep and mood remain closely connected. In addition, chronic insomnia can lead to mood disorders, and vice versa. Even partial sleep deprivation, such as a one week of less sleep, can increase irritability, and exhaustion, but a consistent, healthy sleep schedule can dramatically increase mood.
Insomnia –> mood disorders, or the other way around?
It’s unclear whether mood disorders cause insomnia or insomnia causes mood disorders, but both are possible scenarios, according to the American Psychological Association. Actually, those with mood disorders often do not sleep well and those with insomnia can develop a mood disorder from lack of sleep. If you didn’t previously have insomnia, the former is the most likely explanation, but if you have a history of insomnia, targeting insomnia may diminish the mood disorder.
Mood disorders affect one-third to one-half of patients with chronic sleep disorders, according to the U.S. National Library of Medicine National Institutes of Health. Although many people with mood disorders have insomnia, others have hypersomnia and sleep too much. I actually experience periods of both.
Mood disorders generally cause insomnia because a person’s thoughts––whether anxious or depressive––prevent them from sleeping. That’s why disrupted sleep, insomnia, and oversleeping indicate depression symptoms, according to Tuck. This can often result in a vicious cycle because a person cannot sleep, so they become even more depressed and their insomnia becomes uncontrollable. In addition, those with insomnia are 10 times more likely to have depression and 83 percent of people with insomnia display depression symptoms. It’s pretty much inevitable––depression equals insomnia.
Dialogues Clin Neurosci presents a great graph of a healthy individual’s sleep architecture (top) vs. someone with depression (bottom).
Sleep is important. Let me say this again. Sleep is necessary! American culture has decided we can accomplish more with less sleep. At first, this seems rational––but think again. Let’s look at why you need sleep and that may change your opinion.
The importance of sleep
According to a HeadSpace factsheet, adults aged 18-25 need seven to nine hours of sleep each night. So, you don’t need as much sleep as a child, but you still need a good amount of sleep. Positive mental health requires sleep, but environmental factors, such as school workload, can disrupt sleep. Every hour of missed sleep results in the following: a 14 percent increase in the risk of unpleasant emotions that affect daily function; a 38 percent increase in the development of hopelessness, a 42 percent increase of suicidal thoughts, and a 58 percent greater risk of suicidal behavior.
The APA states that sleep helps with muscle reparation and memory consolidation. On this note, a lack of sleep results in poor memory, judgment, mood, and even significant health problems. Furthermore, the National Sleep Foundation reports that 67 percent of respondents with poor sleep also reported poor health conditions. Ergo, poor sleep = poor health. Developing a health problem? Lack of sleep or disrupted sleep may have caused it, but check with your doctor to verify.
Sleep and mood
This past Thursday, I came to work overly anxious and tired. My body hurt and it felt like someone attached 50-pound weights to both my arms. Ouch. I just felt sluggish and my coworker became so concerned, she pulled me aside and asked if everything was okay. I made the mistake of swimming after my shift, then went to bed early and slept 10 hours.
When I worked the next morning, I was a complete mess. I felt emotionally unstable, irritable, and wanted to cry because I had absolutely no energy. I had no motivation and I did everything at half-speed. My manager became concerned when I told her I didn’t eat breakfast and then she sent me home early. I got extra sleep last night (at the time I wrote this post) and my mood improved significantly. Woah! Sleep made all the difference.
An APA survey about stress indicates that 45 percent of adults who receive fewer than eight hours of sleep feel irritable and 25 percent lose motivation for important responsibilities.
Kristen L Knutson, a National Sleep Foundation Fellow, explains how sleep cycles can positively and negatively affect a person’s body.
“Getting enough sleep improves your health, strengthens your immune system, improves your mood and boosts productivity; chronic poor sleep is linked to poor health, mood disorders and low productivity,” said Knutson. “Improving sleep in various demographics could make a positive impact on public health.”
Notice how she mentioned mood disorders. Yes, it seems mood and sleep have a cause-effect relationship.
When sleep isn’t enough
Even on the nights I get enough sleep, sometimes I still feel incredibly fatigued and unmotivated. Why? It’s because emotions can drain your energy, especially if you’re an empath or introvert who internalizes emotions. I’m an empath, so my emotions and energy levels often correlate.
Anxiety specifically causes adrenal and mental fatigue from the constant barrage of thoughts, while depression fatigue results from apathy and severe emotional lows. Therefore, even if you rest well, having anxiety attacks or episodes of depression can cause immense energy crashes and leave you drained throughout the day. There was one day where I had a panic attack and then fell asleep for 15 hours. Talk with your doctor if this becomes a pattern.
An imbalance in brain chemicals (monoamines) could result in poor sleep and the reverse is also true. Although there are more than two brain chemicals, I will only focus on two for the purpose of this post.
I take a Selective Serotonin Reuptake Inhibitor (SSRI), Fluoxetine, for my anxiety and a Serotonin Norepinephrine Reuptake Inhibitor (SNRI), Buproprion, for my depression and ADHD. Before taking these medications, I always had trouble falling asleep. Now? I fall asleep easier because my serotonin and norepinephrine levels have become more stable.
Medical News Today states that serotonin, “The happy chemical,” helps regulate mood and appetite.According to MayoClinic, SSRIs help ease depression by increasing serotonin levels. Norepenephrine, also known as the “stress hormone,” activates the flight-or-fight system and increases alertness, according to Everyday Health. Like serotonin, it can also affect the mood.
The inadequate sleep epidemic
Californians are notorious for sleep deprivation––after all, we have many major cities with large corporations. San Francisco. Los Angeles. San Diego. Everyone’s busy and doesn’t have enough time in the day. Inadequate sleep has become an epidemic. A map from the CDC shows that 32.5-36.6 percent of adults in California report sleeping less than seven hours a night. That’s just California. The Eastern half of the USA fares even worse.
So, how can someone tell if they experience sleep disruption from a mood disorder? Here’s a list of common signs: Hypersomnia, decreased total sleep time, waking up too early in the morning, decreased REM latency, fatigue, excessive sleepiness, disturbing dreams, and poor sleep quality, among other things.
Lack of sleep in students
Students and workers especially need sleep. The APA reports that a lack of sleep leads to poor work or academic performance. Speaking from experience, my lack of sleep from anxiety and depression when I battled severe gastritis and GERD made me so unmotivated, I turned in a final project with several typos and failed a midterm––I’m normally an A-plus student. However, I’ve let myself sleep 14-hour days this semester when I felt exhausted, and guess what? I felt incredible the next day! I finished a couple big projects and actually felt like myself.
Ever almost fallen asleep in class? I almost did last Tuesday! I actually got seven hours of sleep, but my body needed more because I swam a couple intense sets the previous two days. Shockingly (or not so shockingly) enough, about 50 percent of college students report daytime sleepiness and 70 percent do not receive sufficient sleep, according to Nature and Science of Sleep. Continuing with the same theme, Brown University reports that 73 percent of college students report sleep problems. Depression actually becomes common among college students––14.8 percent of students report a depression diagnosis, which could contribute to this statistic.
The majority of college students sleep between 6 to 6.9 hours, according to the University of Georgia Health Center. The Health center additionally lists symptoms that may indicate a correlation between mood disorders and sleep patterns.
Sleep and depression:
- Insomnia (often sleeping 6 hours or less a night)
- Too much sleep (often sleeping 10 hours or more a night or “escape sleeping”)
- Regularly feeling fatigue, constantly wishing you were sleeping or napping
- Engaging in day to day responsibilities feels highly tiring or burdening
Sleep and anxiety:
- Racing thoughts (very high paced) that prohibit settling into sleep
- Recurrent and persistent thinking about 1-2 topics that prohibit settling into sleep
- Repetitive behaviors that needed to manage anxiety that inhibits falling asleep
- Pattern of stressful and anxiety-provoking thoughts that wake you up during sleep
- Experiencing shortness of breath when attempting to fall or stay sleep (that can’t be explained by a medical condition)
As a result of all the aforementioned information, management of mood disorders is crucial for optimal health.
Here are a couple suggestions from my personal experience:
- Don’t think about your “to-do” list before bed––it’ll keep you up all night.
- Don’t make a list of all the bad things that have happened within a day or week. Try to push them out of your mind and live in the present instead of the past.
- Cut off homework at least one hour before sleeping.
- Refrain from engaging in stimulating activities immediately before bed.
- Play relaxing music about a half hour before bed.
- Play white noise as you sleep.
- Don’t eat heavy meals or drink caffeine late at night.
Sleep hygiene and routines
Although managing mood disorders is the first step to improving sleep quality, sleep hygiene and routines are equally crucial.
These are a few suggestions:
- Sleep in a cold, dark room
- Establish normal sleep and wakeup times
- Use your bedroom only for sleeping
- Exercise regularly, but avoid working out two hours before bed.
- Find a comfy pillow and mattress.
- Unplug at least an hour before sleeping
- Keep the clock away from you
- Take a warm shower
- Dim the lights at least 30 minutes before bed
All in all, sleep and management of mental illnesses is crucial. If you’re trying to sleep and simply cannot fall asleep, try establishing a normal night routine. If that doesn’t work, try taking melatonin (which helps control your sleep and wake cycles) or Benadryl (for short term use only––long term use can lead to an intolerance and will not help). Meet with a counselor if anxiety or depression becomes an obstacle to a good night’s sleep. If you’re sleeping enough, make sure you get personal time and space away from the craziness of life.
*cover photo by Christian Sampson, via Pinterest.