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What is morning depression?
Morning depression is a symptom experienced by some people with major depressive disorder. With morning depression, you may have more severe depression symptoms in the morning than in the afternoon or evening. These symptoms can include extreme sadness, frustration, anger, and fatigue.
Morning depression is also known as diurnal variation of depressive symptoms or diurnal mood variation. It’s different from seasonal affective disorder, which is related to changes in seasons. Experts used to consider morning depression as a clinical diagnosis on its own, but now they consider it one of the many possible symptoms of depression.
A 2013 study found that people with depression often have disrupted circadian rhythms. This disruption is one of the main causes of morning depression.
Your body runs on a 24-hour internal clock that causes you to feel sleepier at night and more awake and alert during the day. This natural sleep-wake cycle is known as the circadian rhythm.
The circadian rhythm, or natural body clock, regulates everything from heart rate to body temperature. It also affects energy, thinking, alertness, and mood. These daily rhythms help you keep a stable mood and stay in good health.
The rhythms of certain hormones, such as cortisol and melatonin, help your body prepare for certain events. For example, your body makes cortisol when the sun rises. This hormone gives you energy so you can be active and alert during the day. When the sun sets, your body releases melatonin. That hormone that makes you sleepy.
When these rhythms are disrupted, your body starts to make hormones at the wrong time of day. This can have a negative effect on your physical health and emotional well-being. For instance, when your body makes melatonin during the day, you may feel very tired and irritable.
People with morning depression often have severe symptoms in the morning, such as feelings of sadness and gloom. However, they feel better as the day goes on. Symptoms may include:
- trouble waking up and getting out of bed in the morning
- a profound lack of energy when you start your day
- difficulty facing simple tasks, such as showering or making coffee
- delayed physical or cognitive functioning (“thinking through a fog”)
- inattentiveness or a lack of concentration
- intense agitation or frustration
- lack of interest in once-pleasurable activities
- feelings of emptiness
- changes in appetite (usually eating more or less than usual)
- hypersomnia (sleeping longer than normal)
Because morning depression is not a separate diagnosis from depression, it doesn’t have its own diagnostic criteria. That means there are no established symptoms that your doctor will look for to determine if you have it. However, to determine if you have morning depression, your doctor or therapist will ask you about your sleep patterns and mood changes throughout the day. They may ask you questions such as:
- Are your symptoms generally worse in the morning or in the evening?
- Do you have trouble getting out of bed or getting started in the morning?
- Do your moods change dramatically during the day?
- Do you have trouble concentrating more than usual?
- Do you find pleasure in the activities that you usually enjoy?
- Have your daily routines changed recently?
- What, if anything, improves your mood?
Here are some of the treatments that can help ease morning depression.
Unlike other symptoms of depression, morning depression doesn’t respond well to selective serotonin reuptake inhibitors (SSRIs). SSRIs are commonly prescribed antidepressants that can help ease symptoms of major depression.
However, serotonin–norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) may be helpful for people with morning depression.
Talk therapies — such as interpersonal therapy, cognitive behavioral therapy, and psychotherapy — can also treat morning depression. Medication and talk therapy are especially effective when combined.
These therapies can help you address any issues that may contribute to your depression and make your symptoms worse. Issues might include conflicts in a romantic relationship, problems in the workplace, or negative thought patterns.
Light therapy, also known as bright light therapy or phototherapy, can also help treat people with morning depression. With this type of therapy, you sit or work near a light therapy box. The box emits bright light that mimics natural outdoor light.
The exposure to light is believed to affect brain chemicals linked to mood. Although generally recognized as a treatment for seasonal affective disorder, some people with depression may find this approach helpful.
Electroconvulsive therapy (ECT)
ECT is performed under general anesthesia, which means you’re asleep during the brief procedure. The electric impulses are given in a controlled setting to achieve the best outcome with the fewest possible risks. Every medical procedure carries risks. ECT may cause heart rhythm problems. Following ECT, individuals may experience a brief period of confusion, temporary headache and nausea.
In addition to these treatments, making small shifts in your sleep patterns may help. These changes could help align your sleep/wake cycle with your body clock and reduce your symptoms of morning depression. Try:
- going to bed and waking up at the same time every day
- eating meals at regular times
- refraining from taking long naps
- creating an environment that promotes sleep, such as a dark, silent, cool room
- avoiding substances that can prevent a good night’s sleep, such as caffeine, alcohol, and tobacco
- exercising often, but avoiding strenuous exercise for at least 4 hours before bedtime
Taking these steps can help stabilize your circadian rhythm so that your body makes the correct hormones at the right time. And that should help improve your mood and other symptoms.
Like other symptoms of depression, morning depression is treatable. If you think you have morning depression, talk to your doctor. They can talk with you about your symptoms and suggest a treatment plan to help you.