Insomnia causing depressive symptoms

October 24, 2018 1:53 AM

I have a chronic illness that impacts my sleep. Exhaustion is bringing back depressive symptoms which I haven't suffered from in 18 months. When I am well-rested I don't feel these symptoms, how can I deal with them when I am tired?

I suffer from anxiety and take a moderate dose of an anti-depressant, and see a psychiatrist every three weeks. Since it is hard to rationalise with yourself when tired or depressed, it is really difficult to remember that these feelings will pass. The one-two punch of insomnia means I am often experiencing these symptoms at 3am. What things can I do to remind myself that these feelings aren't final, and how to get through feeling the symptoms?

posted by anonymous to Health & Fitness (7 answers total)

Well, possibly you could change your antidepressant, or augment it with trazodone. I take it for a combination of anxiety, insomnia, and depression. It helps.

The other thing I find helps me with both depression and insomnia is cannabis.

Your doctor may have other suggestions for tackling the insomnia side of the equation, which is the angle I'd personally pursue first.

Other than that, all the things that normally help with depression will also help with insomnia-induced depression. Positive self-talk, forgiveness, social contact, exercise, good work, mental stimuation, sunlight, and just general self care are all good for your mental state.

I'd get real aggressive about attacking the inomnia though. It's very hard to feel good when you're sleep deprived.
posted by Anticipation Of A New Lover's Arrival, The at 4:06 AM on October 24, 2018 [2 favorites]

Exhaustion does feel like depression to me as well, at least sometimes. It's probably a really good idea to talk to your doctor about some sleep aid.
Have you tried meditation? It's not for everyone, but for me, listening to a guided meditation about impermance, especially of negative feelings, before bed really helps. Not necessarily always with sleep, but with my feelings for sure.
posted by LoonyLovegood at 4:58 AM on October 24, 2018 [1 favorite]

Treat the insomnia. There are a few medications for phase 2 insomnia (waking up in the night). Tell your doctor what's going on and ask to try something. Sleeping is really important, and controlling insomnia will help with your other health conditions - people often blow this off as not a big deal, but as someone with chronic insomnia who took years to get treated, I'm here to tell you that those people are wrong. Treat this as seriously as the rest of it, because it is. Good luck.
posted by bile and syntax at 5:28 AM on October 24, 2018 [2 favorites]

I tend to think of anything past about 2.30am as "the witching hour" in which my mind races, my thoughts go insane...I hope you get the picture. It's helped me in the past simply to tell myself that this is the witching hour and anything i'm thinking right now should be disregarded. Sometimes I've written it down to look at in the cold light of day.
posted by london explorer girl at 8:08 AM on October 24, 2018 [1 favorite]

Presumably you are working on getting treatment that will help with the insomnia itself, but I imagine that might be challenging or complicated since it's liked to a chronic illness.

But in the meantime, could you just soothe/distract yourself when you wake up in the middle of the night? Read (or re-read) a favorite book, or watch a tv show that is just mindless enough, or listen to a podcast. You don't want it to be so engrossing that you end up staying up for hours with it, but sometimes when I'm having insomnia, it's helpful for me to accept that I'm not asleep, get up, and do something else for half an hour until I feel sleepy again, and then go back to bed. Beats lying there wide awake with my mind racing, anyway.
posted by aka burlap at 9:46 AM on October 24, 2018 [1 favorite]

I've done much the same as london explorer girl – I think of all the times in the past that I've stayed up resolving issues of worldwide importance only to realize around 9am that none of it had much value. Any parts that did have value, were things I was quite aware of during daylight hours, so there was no point rehashing it at home in bed with no one to witness the TED talk taking place silently in my brain. If that dry sort of humor works for you, it might help too; I like taking those thoughts down a peg since it's relaxing.

Have you got a bedtime ritual? I turn off my computer half an hour before bedtime, and scheduled my iPhone with Night Shift (Settings -> Display & Brightness -> Night Shift) so it goes to warm light. That way you can still be on your phone - even if not ideal - while relaxing in bed. It makes a noticeable difference; sometimes I switch off Night Shift when posting late-night cat pics to Instagram to be sure they aren't really orange and forget to switch it back on, and it's a lot harder to sleep well. Having a set bedtime and ritual definitely makes things easier and cuts down on anxiety because you have a clear way you're taking care of yourself; one less thing for 3am TED talks to focus on.
posted by fraula at 9:53 AM on October 24, 2018

When I'm having a flare up and this happens to me, I mentally tell myself to kind of shelve those ideas and a assess their credibility once I'm better. Like, "you know you're always crazy at this time, let's pick it up on Wednesday and see if there's anything to it."

It doesn't stop them, but it does reduce their potency and makes the "noise" they generate less distracting.

I also listen to reasonably heavy duty science or history audio books to help get to sleep. It's very effective as I can pay attention to something and not get dragged down by negative thinking, but they are also very easy to fall asleep to!

Best of luck.
posted by smoke at 1:36 PM on October 24, 2018 [1 favorite]