Why Do People with Depression Sleep all of the Time?
Those who are diagnosed with depression may experience physical symptoms of depression before recognizing the emotional one’s. One of the many physical symptoms is changes in sleep patterns.
While depression naps and oversleeping are the commonly talked about symptoms of depression, only about 15% of people struggling with depression deal with oversleeping. In fact, most people with depression tend to struggle more with insomnia and lack of sleep.
Both groups of over and under-sleeping are perceived as “sleeping all day” due to their sleep patterns and constant exhaustion. Having inconsistent sleep patterns can make depression worse as well as completely disrupt daily function.
What does it feel like to be depressed and tired all of the time?
Waking up everyday to feelings of complete exhaustion is not fun or healthy. It’s easy to romanticize “no sleep” in the work hustle culture, but for someone with depression, this can lead to more severe health problems and is not by choice; the mind and body will not allow you to shut down for the night.
A majority of people struggling with sleeping or extreme exhaustion during the day struggle with insomnia (inability to sleep) and a small percentage struggles with oversleeping directly. Both groups struggle with similar symptoms though.
Some of these symptoms include:
Brain fog
Slowed thinking
Poor cognitive function
Poor memory
Difficulty accomplishing simple tasks
Poor focus and productivity
Depression naps that disrupt the day, but feel necessary for physical wellbeing
An increase in depression from inability to function “normally”
Even with these symptoms alone, this can drastically decrease the quality of life for the person struggling because, not only are they struggling with depression, they’re also struggling with not having the physical energy required to accomplish tasks. When/if it gets bad enough, even within a matter of days, if the person is not able to fall asleep, this can lead to mania or psychosis.
Depersonalization begins within the 24 to 48 hour mark of sleep loss. This is an experience where the person feels disconnected from their body as well as feeling lack of control over their body (ie: when moving your arms, it feels like someone else is in control). It’s an unpleasant and frightening out of body experience. This, even for a short period of time, can increase the risk of suicide.
Within the 48 to 72 hour mark of lost sleep, hallucinations begin. Hallucinations include hearing, smelling, tasting, seeing, and feeling things that aren’t really there. After the 72 hour mark, psychosis or mania begins to set in. For every 100 people in a room, 3 of those people will experience psychosis in their lifetimes.
What’s going on in the brain when we can’t seem to get enough sleep?
The two main causes of this are lack of restorative sleep and atypical depression.
YOUR SLEEP ISN’T RESTORATIVE
When sleeping, your body attempts to process your depression through REM sleep.
REM sleep is one of the stages of sleep that requires the most amount of physical energy in order to process through your dreams. As far as we know, we have very little direct control over our stages of sleep or how much REM sleep we will get. For those struggling with depression, we don’t get the option to choose to reserve our energy for during the day; this is just part of what comes with mental health. This is oftentimes why those struggling with depression will wake up feeling tired and exhausted.
This lack of restorative sleep then goes on to impact your “orienting response,” which allows you to adapt, react, and function within the environment and accomplish your basic daily tasks. This happens because the neurons don’t fire as efficiently when awake due to the fact that they were working excessively during sleep (for a depressed person).
STRUGGLES WITH ATYPICAL DEPRESSION
If you’re one of the 15% of people who gets too much sleep, you may be struggling with atypical depression. The two common symptoms that differentiate this from typical depression is that you’re sleeping too much and have a heightened appetite as a symptom vs. not getting enough sleep and experiencing a loss of appetite. You may also experience more temporary highs in your mood based on positive experiences in the environment.
Getting too much sleep with atypical depression can oftentimes be as a way to escape the pain of depression rather than sleeping because you’re physically exhausted, although these cycles can lead to exhaustion as well.
These abnormalities in sleep patterns from the depression can throw off the circadian rhythm, making it even harder to get into a healthy routine. When the circadian rhythm is thrown off, this impacts when you fall asleep, when you wake up, when you feel most alert, and when you feel most tired.
Why is inconsistent sleep a problem?
Getting too much or too little sleep becomes problematic when your life is impacted by it. Daily life or life tasks are typically the first struggle that is experienced when depression impacts energy levels.
Furthermore, both of these sleep abnormalities lead to an increased risk for heart disease, diabetes, strokes, cognitive decline, obesity, and fertility issues. This will also likely increase the symptoms of depression and create more of a distance and separation between them and the rest of the world.
The lack of sleep, specifically, is seen as so problematic in the health field that hospitals anticipate higher rates of heart attacks when we lose an hour of sleep due to time change. Hospitals anticipate less heart attacks when we gain an hour of sleep due to time change. Sleep, and specifically quality of sleep, is extremely important.
How can you improve your energy levels when you’re depressed?
Short naps (~20 minutes) during your day aren’t typically seen as harmful. That said, if it begins to impact your life, then its something you want to correct.
Try this to get better sleep and balance your energy levels:
Avoid drinking caffeine after noon (or altogether)
Work on getting daily exercise and movement
Get off your phone/any screens before bed
Go to bed at the same time every night
Wake up at the same time everyday
Set an alarm clock up across the room so you can’t just hit the snooze button and fall back asleep
Stay consistent with sleep patterns on the weekends
Find healthy ways to manage stress during the day
Take melatonin 30 minutes before bed
Get outside as much as possible for at least 15 minutes of sunlight exposure
Sometimes following through with just a few of these can do the trick to start seeing improvements. If you’re not seeing improvements, go to your primary care doctor to discuss getting additional help with the depression and sleep!
They may recommend therapy, sleep medications, anti-depressants, or a combination of all three.
There have also been reports of wake therapy being a success for about 50% of people with depression. Those who are struggling with their circadian rhythms are the people who tend to benefit from this type of therapy; not only seeing improvements in sleep, but also in their depression.
This type of therapy intentionally keeps you awake and uses light therapy to help reset your circadian rhythm through melatonin release. This is something you would want to do while supervised with a doctor as there is also a chance it can trigger mania or psychosis.
If you’re struggling with getting sleep alongside your depression, start by working on one or two of the things that you think can be improved on and go from there to find what is best for you!
