Mental Health – What is it?

Sleep and mental health are rarely talked about on the same plane, but their relationship is much more intimate and complex than we give them credit for.  For example, studies have shown that in the U.S. chronic sleep disorders affect 50% to 80% of adults who have been diagnosed with a mental illness and are receiving treatment from a psychiatric practice. This compares to the 10% to 18% of adults without mental illness that struggle with a sleep disorder. The most common mental health issues associated with sleep problems and sleep disorders are anxiety, depression, and bipolar disorder.

Sleep and Depression

Difficulty falling asleep and getting a quality sleep every night increases the risk of developing depression. Studies show that approximately 75 percent of people suffering from depression also endure symptoms of insomnia and sleep deprivation. Although insomnia is not considered to be a symptom of depression, people with insomnia are five times more likely to develop the mental health disorder. Adding to the issue of sleep loss, some antidepressants affect sleep and specifically make it difficult to fall and stay asleep at night. Studies have also shown that patients who are depressed and experience chronic insomnia are less likely to respond to antidepressant medication treatment compared to patients who sleep well. Depressed people with continual sleep issues are more likely to relapse after their mood improves, more likely to consider suicide, and more likely to die of suicide than patients with good sleep hygiene.

Physicians are not sure exactly how or why, but it is clear that disrupted sleep wreaks havoc in the brain; affecting stress hormones, memory, impairing thinking, and altering emotional regulation. In short, poor sleep and chronic insomnia actually intensify the effects of mental health disorders and, in turn, mental health disorders can introduce and amplify sleeping disorders like insomnia. This creates a serious and very detrimental cycle of losing sleep and falling into deep depression.

Sleep and Anxiety

Insomnia for people with anxiety is very common and extremely problematic. Having difficulty staying or falling asleep effect more than 50 percent of adult patients with generalized anxiety disorder. Although it is not as common as with depression, insomnia is also a risk factor for developing an anxiety disorder. Lack of quality sleep affects the brain in very negative ways, and sleep experts agree that issues with sleep can lead to anxiety. Mental health physicians know that anxiety often leads to insomnia because anxiety makes people very stressed, nervous, and alert, making it difficult to both fall asleep and stay asleep during the night. While experiencing major anxiety, it is almost impossible to fall asleep, and when someone has an anxiety attack, they will not be able to calm down maybe for hours, let alone find a way to get some rest anytime soon.

Sleep and Bipolar Disorder

The relationship between bipolar disorder and sleep is a complex one. It is very different from sleep and depression or anxiety mainly because bipolar disorder consists of such lows and high’s in people’s mood. The difference between how patients act before, during, and after a manic episode may be extremely different. In the same way, sleep for people with bipolar disorder plays a completely different role during each stage.

During a manic episode, the majority of patients with bipolar disorder report needing less sleep. Some may even feel they don’t need to sleep at all while others experience insomnia to a great degree and can’t get any sleep. These manic episodes can last days. Once this episode ends, patients may completely flip around and begin to experience hypersomnolence to the point they won’t get out of bed. This behavior can last days as well. Patients go from lots, and lots of energy without any need for sleep to a depressive state where all they want to do is sleep, and they refuse to do anything else, to the point some won’t even get out of bed.

Studies have suggested that insomnia or other problems with sleep can progressively get worse before a manic episode and some physicians believe insomnia or other sleeping problems are a trigger for a manic episode of bipolar disorder.

Possible solutions

When dealing with sleep issues and mental health issues getting to sleep can be a great challenge. We have gathered tips on possible lifestyle and behavioral changes that have been proven to help people get the sleep they need, even those battling sleep depriving mental health disorders like the previous ones mentioned. Keep in mind that it is important also to discuss lifestyle and behavior changes with your doctor before you add the changes and during the process. They may provide additional tips, information, and/or instruction to help you get the appropriate amount of sleep.

• Establish a routine—go to bed only when you feel tired enough to sleep. Then get up at your usual time. This may mean you will spend less time actually in bed, but more of the time in bed asleep.
• Relax before you go to bed—create a relaxing bedtime ritual free from electronics. Bedtime rituals are something you consistently do before going to bed for the night. This can include taking a warm, relaxing bath, reading a good book, or listening to soft, relaxing music.
• Breathing exercises – in a comfortable position, try this: breathe into your belly (not your chest) then out through your nose, making your out-breath longer than your in-breath; repeat until you feel relaxed.
• Muscle relaxation – consciously tense and relax your muscles, one after the other, starting with your toes and working up your body until you reach the top of your head; Progressive Muscle Relaxation is a technique some people find useful.
• Visualization – picture a scene or landscape that has pleasant memories for you.
• Meditation – you can learn meditation techniques at a class or from self-help guides; many people also find mindfulness helpful.
• Make sure where you sleep is comfortable—sleep on a comfortable mattress and make sure your bedroom is comfortable for sleep. Keep the temperature cool, but not cold, keep the room dark, and consider running a fan or white noise machine to help induce sleep.
• Keep a sleep diary—you may find it difficult to work out what’s affecting your sleep. A sleep diary involves recording information about your sleep habits to help you understand your sleep problem and what’s affecting it. If you want to, you can show it to professionals you’re working with, so you can work together to understand the problem you’re having.
• Try to resolve stresses and worries—try to identify anything in your life that’s causing you stress or worry that might be affecting your sleep. You may find it helpful to talk to a friend about the thoughts and feelings that affect your sleep or write them down.
• Give yourself some tech-free time—use of bright screens on laptops and phones in the evening has been shown to affect sleep negatively. Try to give yourself some tech-free time an hour or so before bed, to help yourself prepare for sleep.
• Consider food and drink—caffeine, alcohol, and sugary foods may give short-term help but they can all disturb your sleep patterns.
• Exercise—staying active is great for your overall health and also promotes a good night’s sleep with no interruptions. However, be sure to avoid exercising within 3-4 hours of your bedtime. Otherwise, the stimulation from exercise can keep you from falling asleep.
• Consider your medication—some medication, particularly depression medication, can actually disturb sleep and induce insomnia. If you suspect your medication may be affecting your sleep, talk to your doctor and consider alternative medications and meditative options.
• Ask about treatment options—you don’t have to do it all by yourself. You might want to talk to your doctor or mental health professional about what you’re experiencing and the treatment options available. Medication such as sleeping pills and SSRI antidepressants can be helpful in dealing with short periods of severe insomnia, as they can help you break a cycle of not sleeping and help you return to a more regular sleep pattern.

Why get treatment?

Getting treatment for both your mental health disorder and your sleeping problems are crucial to achieving healthy sleep. Understanding the interplay between mental health disorders and sleep problems can aid in proper diagnoses and improved treatments for both conditions. As we covered, these issues both play off of each other, making your sleep worse and straining your mental health. Treating your sleeping problems or sleep disorder may help alleviate a mental health issue and end the vicious cycle of no sleep and worsening mental health, which causes more sleeping issues.

If you are experiencing poor sleep and noticing worsening issues with your mental health, or even worsening issues with an already diagnosed mental health disorder, it’s time to get help! Lack of sleep is very dangerous to your mental health, and you should learn what you are up against so you can properly treat your sleeping issues as soon as possible. Schedule an appointment with your personal physician to discuss your results and their recommended treatment. Get the sleep you need and get back to resting easy at night.