The relationship of depression and insomnia

Which comes first: depression or insomnia? The relationship of depression and insomnia is two-way and for this reason it’s hard to identify which was there first. Chronic sleep problems affect 50% to 80% of the patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general population. Doctors have traditionally viewed insomnia and other sleep disorders as symptoms of depression and other mental health problems. However, the recent studies indicate that insomnia more often precedes depression than the other way round. New information shows that treating insomnia will help treat your depression. The relationship between insomnia and depression is far from simple. Most experts today agree that that insomnia and depression are two distinct but often overlapping disorders.

Insomnia in the early hours often stems from depression. Depression is also linked to increasing dreaming which focuses the early hours and can cause awakenings. The assumption is that our subconscious is working through dreams to get rid of depression. Sometimes depression is so strong that it requires longer than average sleep time.  When sleep increases, the amount of dreaming increases and deep sleep gets disturbed. As a consequence, depression deepens and requires medication.

It seems that creativity and latent depression walk hand in hand. Sensitive sleepers are more often creative than good sleepers. Creative people’s brains live very intensively which can then lead to challenges with sleep and depression.


In psychology, stress is a feeling of strain and pressure. Symptoms may include a sense of being overwhelmed, feelings of anxiety, overall irritability, insecurity, nervousness, social withdrawal, loss of appetite, depression, panic attacks, exhaustion, high or low blood pressure, skin eruptions or rashes, insomnia, lack of sexual desire (sexual dysfunction), migraine, gastrointestinal difficulties (constipation or diarrhea), and for women, menstrual symptoms. It may also cause more serious conditions such as heart problems.

Small amounts of stress may be desired, beneficial, and even healthy. Positive stress helps improve athletic performance. It also plays factor in motivation, adaptation, and reaction to the environment.

Excessive amounts of stress may lead to many problems in the body that could be harmful. Stress could be something external and related to the environment but also may not be directly created by external events, but instead by the internal perceptions that cause an individual to have anxiety/negative emotions surrounding a situation, such as pressure, discomfort, etc., which they then deem stressful, for example in PTSD (Post traumatic stress disorder).

External factors that by themselves are not threatening or stressful are deemed such for someone experiencing PTSD. Triggers can be stressful, such as when a person reports stress when hearing a song on radio or seeing a type of object that may remind the person of prior threatening events. Humans experience stress, or perceive things as threatening, when they do not believe that their resources for coping with obstacles (stimuli, people, situations, etc.) are enough for what the circumstances demand. When we think the demands being placed on us exceed our ability to cope, we then perceive stress.


Depression is a state of low mood and aversion to activity that can have a negative effect on a person’s thoughts, behavior, feelings, world view, and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, hurt, or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions, and may contemplate or attempt suicide. Insomnia, excessive sleeping, fatigue, loss of energy, or aches, pains, or digestive problems that are resistant to treatment may also be present.

Depressed mood is not necessarily a psychiatric disorder. It is a normal reaction to certain life events, a symptom of some medical conditions, and a side effect of some medical treatments. Depressed mood is also a primary or associated feature of certain psychiatric syndromes such as clinical depression.


Anxiety (also called angst or worry) is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. It is the displeasing feeling of fear and concern. The root meaning of the word anxiety is ‘to vex or trouble’; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness, and dread. It is also associated with feelings of restlessness, fatigue, concentration problems, and muscle tension. However, anxiety should not be confused with fear, which is more of a dreaded feeling about something which appears intimidating and can overwhelm an individual. Anxiety is considered to be a normal reaction to someone suffering with stress. It may help an individual to deal with a demanding situation by prompting them to cope with it. However, when anxiety becomes overwhelming, it may fall under the classification of an anxiety disorder. Anxiety can be confused with fear. However, fear is concrete, (a real danger) whereas anxiety is the paranoia of something out there that seems menacing but may not be menacing, and, indeed, may not even be out there.

Panic attacks

Panic attacks are periods of intense fear or apprehension that are of sudden onset and of variable duration from minutes to hours. Panic attacks usually begin abruptly, may reach a peak within 10 minutes, but may continue for much longer if the sufferer had the attack triggered by a situation from which they are not able to escape. In panic attacks that continue unabated, and are triggered by a situation from which the sufferer desires to escape, some sufferers may make frantic efforts to escape, which may be violent if others attempt to contain the sufferer. Some panic attacks can subside on their own over the next several hours. Often, those afflicted will experience significant anticipatory anxiety and limited symptom attacks in between attacks, in situations where attacks have previously occurred. The effects of a panic attack vary. Some, notably first-time sufferers, may call for emergency services. Many who experience a panic attack, mostly for the first time, fear they are having a heart attack or a nervous breakdown. Experiencing a panic attack has been said to be one of the most intensely frightening, upsetting and uncomfortable experiences of a person’s life and may take days to initially recover from. Repeated panic attacks are considered a symptom of panic disorder. Screening tools like Panic Disorder Severity Scale can be used to detect possible cases of disorder, and suggest the need for a formal diagnostic assessment.


Burnout is a psychological term for the experience of long-term exhaustion and diminished interest. Research indicates general practitioners have the highest proportion of burnout cases; according to a recent Dutch study in Psychological Reports, no less than 40% of these experienced high levels of burnout.

The Maslach Burnout Inventory (the most well-studied measurement of burnout in the literature) uses a three-dimensional description of exhaustion, cynicism, and inefficacy. Some researchers and practitioners have argued for an “exhaustion only” model that sees exhaustion as the hallmark of burnout. Maslach and her colleague, Michael Leiter, defined the antithesis of burnout as engagement. Engagement is characterized by energy, involvement and efficacy, the opposites of exhaustion, cynicism and inefficacy.

Many theories of burnout include negative outcomes related to burnout, including job function (performance, output, etc.), health related outcomes (increases in stress hormones, coronary heart disease, circulatory issues) and mental health problems (depression, etc.). It has been found that patients with chronic burnout have specific cognitive impairments, which should be emphasized in the evaluation of symptoms and treatment regimes. Significant reductions in non-verbal memory and auditory and visual attention were found for the patient group.


Schizophrenia is a mental disorder characterized by a breakdown of thought processes and by poor emotional responsiveness. Common symptoms include auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social or occupational dysfunction. The onset of symptoms typically occurs in young adulthood, with a global lifetime prevalence of about 0.3–0.7%. Diagnosis is based on observed behavior and the patient’s reported experiences.

Do contact your doctor if you suspect any of the psychological sleep disorders. You can find more help/information also under useful links.


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