Insomnia and Depression

The relationship between insomnia and depression is a vicious cycle. Which causes which? Insomnia has been, for a long time, viewed as a symptom of an underlying health condition such as depression. Recent studies, however, show that insomnia can also result from depression.  Lack of sleep can lead to depression, and depression can lead to sleeping problems. Tackling this issue goes beyond the cause and effect perspective. Depression and insomnia are two distinct health conditions that need to be addressed in order to treat one and the other.


What is depression?

In its simplest definition, depression can be described as feeling “blue” over a period of time. It is experiencing unhappiness or misery along with negative behavior, thoughts, and physical problems. Depression is not always manifested through feelings of sadness but even through anger and irritability.

It is normal to feel sad at times, but if an intense feeling of sadness coupled with feelings of unworthiness and helplessness lingers every day for at least two weeks and it keeps an individual from functioning well, it may already be a sign of clinical depression.

While depression is quite common, it is a very real illness, a serious condition that impacts the brain. It can affect anyone regardless of age or gender.

What triggers depression?

The exact cause for depression is still unknown; however, there have been numerous factors or combinations of factors cited as possible causes of depression. It can be triggered by any of the following (or a combination thereof):

  • Major life transitions: death, loss of a job, rifts in relationships, divorce, or social isolation. These life events can trigger depression. Once the triggering factors are resolved, depression may also be resolved.
  • Medical conditions such as cancer, hyperthyroidism, hypoglycemia, or chronic physical pain.
  • Substance abuse, use of steroids, alcoholism
  • Genetics
  • Changes in hormone levels
  • Insomnia or recurring sleep disturbance
  • Stress


What is Insomnia?

Insomnia is a common sleep disorder. It is characterized more on the quality of sleep rather than on the number of hours of sleep. It is an individual’s inability to fall asleep, stay asleep, or both. People suffering from insomnia also have the problem of waking up too early. Even with long hours of sleep, a person suffering from insomnia can still wake up and not feel refreshed, rejuvenated, or rested and consequently feel drowsy or fatigued throughout the day.

What Causes Insomnia?

Insomnia can either be acute which lasts for a few days or weeks and goes away on its own, or chronic which is ongoing and can even last for a month or longer. Furthermore, insomnia can also either be primary or secondary.

Acute insomnia is caused by temporary situations such as family pressures, work-related stress, or a traumatic event. When the temporary triggering factor is resolved, the insomnia will also most likely go away.

Chronic insomnia is usually secondary insomnia which means that it is a symptom of underlying emotional, neurological, medical, or sleep disorder.

Emotional disorders that can cause secondary insomnia include posttraumatic stress disorder, anxiety, and depression. A couple of examples of neurological disorders that cause secondary insomnia are Alzheimer’s diseases and Parkinson’s disease. Medicines to treat asthma and some allergies can also cause secondary insomnia as well as the use of certain substances (like caffeine), stimulants, alcohol, and nicotine products.

Primary insomnia, on the other hand, is not a symptom but is a distinct disorder on its own and lasts for about a month. The causes of primary insomnia are not yet fully understood

There are many other disorders that can lead to insomnia. These can include any of the following:

  • Overactive thyroid
  • Menopause or hot flashes
  • Respiratory conditions that results in difficulty in breathing (such as asthma and heart failure)
  • Chronic pain (like arthritis and headache)
  • Stroke


The question then remains: Which causes which? Depression and insomnia are two distinct conditions that overlap each other and it is not often easy to tell at which point these two overlap.

As can be seen above, insomnia is a triggering factor for depression, and depression can be an underlying symptom of insomnia.

Although insomnia can be a precursor to the onset of a severe case of depression, it can perpetuate depression as well. Insomnia is to depression what high cholesterol level is to heart attack: having a high cholesterol level may lead to a heart attack but not everyone who has high cholesterol levels will eventually have a heart attack.

In a nutshell, not all who suffer insomnia will suffer depression, but all who suffer depression also suffer from insomnia.

Again, insomnia and depression is a vicious cycle. Chronic loss of sleep can lead to loss of pleasure in life which can lead to depression. The constant feeling of sadness or misery can make it hard for an individual to get adequate quality sleep.


If insomnia is treated, will depression also be treated? Studies show that treating these two conditions simultaneously have a higher rate of success rather than treating each one separately. Insomnia can be treated either by giving medications or cognitive behavior therapy.

There have been studies conducted involving patients suffering from both depression and insomnia. Consider the following results:

  1. Treating the sleep disorders eased depression symptoms and even helped prevent relapses. In one study, more than 50% of patients who were given psychotherapy to treat their sleep problems had eased symptoms of depression even though their depression was not addressed.
  2. In another study, when the patients were given both sleep medication and antidepressants together, the patients’ depression scores improved significantly. Patients were able to sleep better and therefore were enjoying the pleasures of life more.
  3. Patients who were given only antidepressants did not fare any better.

Therapy vs. Medication for Insomnia Treatment

At this point, the question has changed. Both approaches have their pros and cons.

Medications to treat insomnia give instant results; however, once the patient are taken off the medication, their sleep problems often recur.

Therapy, on the other hand, takes a much longer time for its benefits to take effect, but these benefits can be more permanent than temporary. Therapy is providing the individual a lifelong skill-set, a habit-forming regimen that can be practiced and mastered throughout life.

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