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 play videoTime: 05:09 minutes |
Participants
, Daniel J. Buysse M.D., James C. O'Brien MD, FCCP ,, Arthur J. Spielman PhD, Allen Blaivas MD
Summary
We all know that when we're low or anxious it's hard to sleep. But did you know that sleep problems may also induce depression? Listen to experts talk about the link between sleep and depression and what you can do about it.
Webcast Transcript
ANNOUNCER: Is the glass half empty or half full? For people suffering from depression, unfortunately that glass is usually half empty.
ARTHUR SPIELMAN, PhD: People have a distinct kind of sadness. They can't enjoy the things that they, they're used to doing. They look depressed. People who are depressed belittle themselves, put themselves down, see things as very dark.
JAMES O'BRIEN, MD: They have less energy in terms of doing activities; their libido is down; their memory is poor. They're eating more than they usually do; they're eating less than they usually do. They're not participating in life, and they know something isn't right.
ANNOUNCER: For some the feelings are short lived; for others it is a life long battle. There are a lot of factors that can contribute. How well we're doing with our jobs, family, health, family history and, as it turns out, how well we sleep at night.
ARTHUR SPIELMAN, PhD: I think almost everybody's had the experience of a bad night leading to an irritable, mildly-depressed day.
It's now been shown that insomnia is a risk factor for depression, which means they looked at patients who had insomnia, and then looked at what proportion of them had depression a year later. And the ones who got help with their insomnia and didn't have the insomnia later weren't depressed, whereas the ones who continued to have insomnia had a greater degree of major depression.
People start to feel very lousy about their life, and in fact start obsessing about their insomnia and start to feel like they're not in control, they're not well-regulated, and this can start a spiral of negative thinking and negative functioning and negative performance, which is enough, I think, to then trigger a real depression.
We know that in adults, one of the biological markers of a serious depression is a short time from when you first fall asleep to when you first enter REM sleep
JAMES O'BRIEN, MD: During REM-stage sleep is where we learn situations and incorporate situations and deal with emotions that, unless we deal with it properly, will affect us in terms of our daytime functioning on a mental, emotional level.
ANNOUNCER: While insomnia may increase the risk of depression, depression may be keeping us from getting the sleep we need.
JAMES O'BRIEN, MD: People who are depressed will have difficulty sleeping because, oftentimes, they're not happy or comfortable on a psychologic, emotional basis when they go to sleep at night.
ANNOUNCER: While psychotherapy is helpful for depression, often an antidepressant or combination of antidepressants may be prescribed. However, while they may lift a person's mood, some may actually worsen sleep difficulties.
JAMES O'BRIEN, MD: Antidepressants can come in a variety of forms. You have sedating antidepressants and more stimulating types of antidepressants. And clearly a stimulating antidepressant can have an effect in one's ability to initiate sleep and maintain sleep.
ANNOUNCER: For people with depression who need treatment for insomnia, experts suggest a variety of tactics. The first thing is to look at bed time behaviors
ARTHUR SPIELMAN, PhD: One of the methods is to not stay in bed awake thrashing around, writhing around agitated and feeling hopeless that you'll ever get to sleep. That builds an association between that experience and that turmoil, and being in bed trying to sleep.
You don't want to associate the bed and your sleep environment and the time for going to sleep with activity.
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