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Is Insomnia a Symptom of Depression?

Written by Beth Holloway, RN, M.Ed

Is there a link between your mood or feelings and how you sleep? The answer is “yes.” That is unlikely to come as a surprise to you. 

The next question you may ask is “what can I do about it?”


Relationship Between Depression and Insomnia

What Is Depression?

What Are The Symptoms Of Depression?

How Common Is Depression?

What Is The Treatment For Depression?

Which Prescriptions Are Used To Treat Depression?

Is Treatment Follow-Up Needed?

Should I Contact My Doctor?

Relationship Between Depression and Insomnia

There is a clear relationship between depressive symptoms and insomnia, as well as a diagnosis of clinical depression and insomnia. Trouble sleeping is a risk factor for and often worsens depression and anxiety. Furthermore, depression and anxiety often make it difficult to sleep.

If you’re able to sleep better, it may help with depression and other mental disorders. Likewise, treatment for mental disorders, including depression, may lessen or even resolve your sleep problems.

What Is Depression?

Clinical depression, also known as major depression or major depressive disorder (MDD), is much more than feeling sad or down for a short time. It is a serious condition that interferes with all aspects of a person’s life

There are also other types of depression with some of the same symptoms but also with differences. For example, postpartum depression is associated with childbirth, and persistent depressive disorder (dysthymia) is long-term but less severe than clinical depression.

What Are The Symptoms Of Depression?

Goodpath asks about the symptoms of MDD in its sleep assessment. The answers help identify people who may have depression. It also allows Goodpath to evaluate and monitor its severity among its members. The symptoms are: 

  1. Little interest or pleasure in doing things.

  2. Feeling down, depressed, or hopeless.

  3. Trouble falling asleep or staying asleep, or sleeping too much.

  4. Feeling tired or having little energy.

  5. Poor appetite or overeating.

  6. Feeling bad about yourself, that you’re a failure, or you’ve let yourself or your family down.

  7. Trouble concentrating on things like watching television or reading.

  8. Moving or speaking so slowly that others notice, or restlessness and moving around a lot.

These symptoms occur at least several days over a two-week period.

How Common Is Depression?

MDD is very common. In 2017, over 17 million adults in the U.S. had at least one episode of MDD, which is over 7% of all adults in the U.S. MDD is more common in women than men. By age group, it is most common in adults 18 to 25 years old.

What Is The Treatment For Depression?

Major Depressive Disorder (MDD) treatment may include:

  • Talk therapy or psychotherapy (e.g., cognitive behavioral therapy or CBT).

  • Lifestyle changes (e.g., increasing physical activity).

  • Complementary therapies (e.g., relaxation/meditation, supplements).

  • One or more prescription medicines.

It is not uncommon to use more than one type of treatment. For example, a person may establish a regular exercise routine, start seeing a therapist, and begin taking antidepressant medicine.

Related Article: The therapist's role in mental health treatment

Which Prescriptions Are Used To Treat Depression?

Before prescribing medicine to treat depression, your healthcare provider will talk with you about the effects of different medicines, side effects, costs, and your preferences

Antidepressant for sleep?

Choosing an antidepressant is often a trial-and-error process. There isn’t a "best antidepressant"; one may work well and have few side effects for someone else, but may not be effective and cause side effects for you. Likewise, there isn’t a "best antidepressant" for sleep and depression. At times, a low dose of certain antidepressant medicines (e.g. doxepin and trazodone) may be prescribed for the treatment of insomnia

The prescription medicines most often used to treat depression are selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs).

  • Some common SSRIs are fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro).

  • Some common SNRIs are venlafaxine (Effexor XR), desvenlafaxine (Pristiq), and duloxetine (Cymbalta).

  • Another antidepressant that is often used is bupropion (Wellbutrin).

Each person responds differently to antidepressants

The journey for each person is unique:

  • It often takes weeks to feel the full effects.

  • Your doctor may start you at a low dose and slowly increase it.

  • It may be necessary to try different antidepressants to find the one that works best with the fewest side effects.

  • Antidepressants may be prescribed in combination with each other or other medicines and supplements to help treat depression.

Is Treatment Follow-Up Needed?

It is essential for a person with depression to follow up with their healthcare provider. Treatment for depression is divided into three phases, each with important reasons for seeing the healthcare provider:

  • The acute phase lasts at least 6 to 12 weeks. The goal is to achieve remission, reducing or stopping symptoms.

  • The continuation phase is about 4 to 9 months. The goal is to prevent symptoms from recurring.

  • The maintenance phase is a year or more. The goal is to protect against depression relapse. 

Your healthcare provider may suggest a plan to slowly taper antidepressant medicine, with careful monitoring for worsening symptoms.

Related Article: Depression After Cancer

Should I Contact My Doctor?

If you have symptoms of clinical depression, you should contact your doctor to schedule an appointment. In some cases, your primary care doctor can provide treatment. They may also refer you to a psychiatrist, psychologist, or mental health counselor. At the same time, you can take part in the Goodpath sleep program

Participating in Goodpath’s sleep program can help you fall asleep, stay asleep, and improve your overall sleep quality. Improving your sleep can also help with depression.  

Our program addresses sleep disturbances (for example, short-term trouble sleeping) and sleep disorders (for example chronic insomnia) without the use of sleeping pills. It includes cognitive behavioral therapy specific to insomnia (CBT-I), mind-body techniques, supplements, and nutritional support.

The first step is our 5-minute assessment, which allows us to look at your specific symptoms and needs. Start your free assessment today.