Today is World Mental Health Day and I’m joining the 3rd Annual World Mental Health Day Blog Party. I thought I’d address the issue of sleep in mental health, particularly in anxiety and depression.
If you’ve ever been depressed or anxious you probably know firsthand that these conditions often are linked to sleep problems. Research studies have shown that having an anxiety disorder quadruples the odds of having insomnia, while depression increases the odds of having insomnia by a factor of 5. For example, Johnson and colleagues found that 43% of individuals with OCD had insomnia, compared to 11% of individuals in the general population.
So do anxiety and depression cause insomnia or does insomnia cause these mental health conditions? There’s evidence that the causal arrows run in both directions. More than one study has shown different patterns of insomnia onset in depression vs. insomnia, with anxiety more likely to precede insomnia and depression more likely to start after insomnia.
It’s not uncommon for insomnia to stick around even after the anxiety or depression is better, which not only is miserable but raises the risk of relapse. Therefore it’s important to address any lingering sleep problems. Following healthy sleep habits can go a long way toward promoting good sleep (a list is here). There are lots of good sleep resources on the web (including a few here), and professional help may be needed in some cases. Fortunately there are cognitive-behavioral treatments that don’t require the use of medications (that don’t tend to be that effective in the long-term anyway).
It’s tough to be hit with the one-two punch of anxiety or depression plus insomnia. The good news is that effective anxiety and depression treatment often improves sleep, and treating insomnia can reduce the risk for future anxiety and depression. And of course good sleep helps with pretty much everything,
Jansson-Frojmark, M., & Lindblom, K. (2008). A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population. Journal of Psychosomatic Research, 64, 443-449.
Johnson, E. O., Roth, T., & Breslau, N. (2006). The association of insomnia with anxiety disorders and depression: Exploration of the direction of risk. Journal of Psychiatric Research, 40, 700-708.
Neckelmann, D., Mykletun, A., & Dahl, A. A. (2007). Chronic insomnia as a risk factor for developing anxiety and depression. Sleep, 30, 873-880.
Ohayon, M. M., & Roth, T. (2003). Place of chronic insomnia in the course of depressive and anxiety disorders. Journal of Psychiatric Research, 37, 9-15.