Insomnia and Depression: Is insomnia making your depression worse and keeping you from getting better?

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Depression and Insomnia

Insomnia, stress, depression, and anxiety are like a group of good friends. Where you find one there is a good chance you will find the other. In fact, 65% of people with depression also have severe sleep problems [1]. When I talk with people about their insomnia and they also have depression, the questions I am most often asked are, “Which one came first?” and “Is my insomnia causing my depression or is my depression causing my insomnia?” The answer I most often give is, “yes.”

Insomnia Worsens Depression and Keeps Depression from Getting Better

As researchers work to understand the relationships between these problems we are coming to understand how closely tied together they really are. For example, one of the most common and stubborn symptoms of depression is insomnia [1]. Alternatively, if you have insomnia long enough your chances of developing depression skyrocket [1]. In addition, once each of these problems gets established, you will almost certainly have to take some focused action to eliminate each problem specifically [1].

“…[individuals] who experience insomnia may have more depression not only because of their insomnia per se, but also because insomnia exacerbates other symptoms of depression.” [1]

So, when I answer “yes” to the questions, “Which one came first?” and “Is my insomnia causing my depression or is my depression causing my insomnia?” I am basically saying that most of the time it doesn’t really matter. It doesn’t matter because if these problems have been going on for more than six months or so they have each almost certainly taken on a life of their own. More importantly, the will each require unique targeted solutions to help you start feeling great and sleeping great again. To explain, let me share some of the research [1].

– If you have insomnia for one year, your risk of developing depression increases dramatically.

– If you have depression and you treat it successfully, there is a 50% chance that your insomnia will continue even after all other signs of depression have lifted.

– If you successfully treat your depression but your insomnia continues, you are 5 times more likely to have another major episode of depression within 2 years.

– 70% of people with depression and normal sleep get better, while only 30% of people with depression and abnormal sleep get better.

 

Treating Insomnia  Improves Sleep and Depression

Compared to depression treatment alone, combining cognitive-behavioral treatment of insomnia with medication treatment for depression doubles your chances of eliminating depression and makes you 5 times more likely to experience elimination of your insomnia [1].

Remission rates for depression and insomnia with single versus combined treatment in depression bar chart (6.15.2013)
Combined treatment for insomnia and depression is more likely to eliminate depression and insomnia than depression treatment alone.

With this information, we now know that the greatest chance for eliminating insomnia and depression and maximizing life satisfaction comes when we take action to fix both problems as soon as possible and at the same time.

 

References.

1. Manber R., Chambers A. Insomnia and depression: A multifaceted interplay. Current Psychiatry Reports 2009;11:437-442.

2. Manber R., et al. Cognitive Behavioral Therapy for Insomnia Enhances Depression Outcome in Patients with Comorbid Major Depressive Disorder and Insomnia. SLEEP 2008;31:489-495.

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