Insomnia has long been recognized as
a symptom of depression and anxiety disorders, but we’re learning
that the relationship is a lot more complex. While negative thoughts,
stress, worry, or irrational fears can keep you up at night and make
it hard to fall asleep, good sleep is also essential for your mental
health. This means that it isn’t a one-way street and insomnia or
poor quality sleep can also contribute to or exacerbate anxiety and
depressive disorders. In many ways the link between insomnia,
anxiety, and depression is like the classic case of the ‘chicken or
the egg’, where it’s hard to really pinpoint either as being the
primary cause or the outcome. Understanding their relationship,
however, can help in the development of effective prevention and
treatment strategies.
How Insomnia Increases the Risk of Anxiety & Depression
Just one night of poor sleep can
take a toll on your mood, leaving you feeling fatigued and down the
following day. The effects are even worse when you don’t get
adequate sleep on a regular basis, so it should come as no surprise
that insomnia significantly increases the risk of depression. Studies
suggest that individuals who suffer from insomnia may
be up to ten times more likely to eventually suffer from depression,
as compared to people who sleep well. Even in cases where insomnia
doesn’t itself give rise to anxiety or depressive disorders, it can
have a cascading effect, delaying recovery from mental illness. For
example, research
shows that patients are less responsive to treatments
for anxiety and depression when they continue to
suffer from insomnia.
Although we don’t fully understand
how insomnia makes us more vulnerable to depression, we’re gaining
new insights from research. It appears that insomnia and sleep
deprivation can adversely affect our ability to process and deal with
negative emotions. A study that appeared in the journal Biological
Psychology shows that individuals suffering from sleep
deprivation have a stronger emotional response to negative images, as
opposed to those with positive or neutral emotional content. In those
with healthy sleep patterns, no such difference in response was
observed. Other
research also supports these findings, with brain
scans revealing higher activity in emotion processing areas of the
brain with negative stimuli. What this means is that when you are
sleep deprived, you will find it harder to control your emotions,
especially when dealing with unpleasant tasks and situations.
Poor quality sleep also has an
impact on mood and energy levels, making it hard to stay motivated,
focused, and to perform at optimal levels during the day. This
reduction in quality of life can make you feel even worse about
yourself, increasing the risk of depression and anxiety or worsening
the conditions if they are already present.
How Anxiety & Depression Increase the Risk of Insomnia
Insomnia is regarded as one of the
key problems that can develop as a result of mental illness,
affecting up to 80%
of people with depression and around 70%
of those with generalized anxiety disorder. While this
doesn’t necessarily mean that all cases of prevalence indicate
insomnia to be an outcome, patients who suffer from anxiety disorders
and depression commonly report difficulty falling and staying asleep.
Patients typically suffer from higher than normal levels of
psychological distress, making it harder to relax and this reduces
one’s ability to fall asleep. It is not uncommon for anxiety to
give rise to insomnia, as anxiety disorders involve a heightened
state of arousal. Depression on the other hand may not always cause
insomnia, but even if an individual gets enough sleep, this is often
of a poor quality.
Studies have found that individuals
suffering from generalized anxiety disorders tend to have increased
sleep latency, which refers to the time it takes for one to fall into
the state of sleep. They also have more wakefulness after the onset
of sleep, with the combined effect of a reduction in the total amount
of sleep time. Early morning awakenings are also a lot more common
and may be observed as a symptom in individuals who suffer from
either anxiety or depressive disorders.
When it comes to the link between
insomnia and anxiety or depression, the relationship is best
described as bidirectional, as it’s usually hard to establish which
problem appeared first. What’s clear is that having one problem can
worsen or trigger the onset of the other and vice versa, making it
important to address both problems simultaneously.