How to cope with insomnia when you have depression

From metro.co.uk

3am has to be the loneliest time in the world. While everyone else sleeps, those of us with depression are often lying awake as negative thoughts run on repeat. As we toss and turn, longing for the blissful oblivion of sleep, worries are magnified and daybreak feels like it’s an eternity away. Depression and insomnia tend to go hand in hand. Mental health conditions can have a negative effect on your sleep, and those who suffer from insomnia have been shown to be around 10 times more likely to have depression. Dr Pablo Vandenabeele, clinical director for Mental Health at Bupa UK, tells Metro.co.uk:
‘Often, people with depression find it hard to fall asleep initially, or wake up a number of times during the night.’ I know from experience how awful depression insomnia can be. I’ve spent many a long night lying awake with my mind leading me into ever darker places. I begin to panic about how I’m going to cope with the exhaustion the following day, which in turn makes it even harder to fall asleep. It’s during these sleepless hours that my thoughts are most likely to turn to self-harm and suicide.

Jodie,* a stay-at-home mum who has suffered from depression since the birth of her three-year-old son, feels the same.
‘During the day, I’m busy enough to keep my thoughts under control, but when I’m lying awake at night, that’s when my depression hits hardest,’ she explains. ‘There’s no one to talk to, and it feels very lonely.’ Given the strong link between depression and insomnia, it’s vital that we take measures to improve the quality and quantity of our sleep.

So what can we do to help ourselves get a more restful night?

Don’t take technology to bed
When I’m in the middle of a sleepless night, the temptation is to reach for my phone and start scrolling through Facebook as a distraction, but having technology near your bed is a surefire way to disturb your sleep. ‘Tablets and smartphones emit blue light, which suppresses the body’s natural sleeping hormone, melatonin, and can throw out your body clock, so try to avoid using devices once you’re in bed,’ says Dr Vandenabeele.

Exercise a little more
Just leaving the house can feel impossible when you’re depressed, let alone going for a run or to the gym, but exercise is known to improve sleep and depressive symptoms. ‘Regular exercise will not only help you fall asleep, but it will also improve the quality of your sleep,’ explains Dr Vandenabeele. ‘It also boosts endorphins, which can help give you a good night’s sleep.’ Jodie says she reaps the benefits of exercise: ‘It takes a lot of effort to make myself go for a run, but I definitely sleep better when I do.’

Cut yourself some daytime slack
Depression on its own can make it difficult to get on with everyday activities like work, socialising and housework, and these tasks can feel even harder if you’re exhausted. Spending all day in bed can then mean you don’t sleep at night, but, equally, there’s no harm in taking time to rest. I never used to be a napper, but going back to bed for an hour in the afternoon is sometimes the only way to get through the day.

Implement a good bedtime routine
‘It’s something that we don’t tend to think about as adults, but the body has an internal clock and hormones that control sleepiness and wakefulness, which work best if there is a regular sleeping routine,’ Dr Vandenabeele explains. ‘Try to implement a routine around an hour before bed; it could involve relaxing in a warm bath or reading a few chapters of a book before getting your head down.’

Practise mindfulness or meditation
‘If you’re to have a good night’s sleep, you need to avoid having things playing on your mind,’ says sleep expert Dr Helen Nightingale, spokesperson for the Alpha-Stim AID (anxiety, insomnia and depression) device. ‘Practicing mindfulness or meditation is very good for calming you down, especially if you’ve had an experience that has deregulated your emotions, like a separation or bereavement.’

Cut down on alcohol
Having a few glasses of wine before bed helps me drop off more easily, but then I inevitably wake in the early hours with a raging thirst and a crushing sense of dread (red wine is a particular culprit for me). Ok, so a bedtime cup of tea may not be as appealing as an alcoholic nightcap, but alcohol affects sleep quality, so it’s best not to overdo it. ‘It can make it more difficult for your body to go into the deep sleep state needed to re-energise you for the next day,’ explains Dr Vandenabeele.

Get your worries out of your head
If my mind is torturing me at night, it sometimes helps if I switch on the light and write down my worries. The same applies if something pops into my head that I need to remember the following day. ‘Worrying is a key factor in insomnia, with anxiety, stress, fear and troubles being major contributors,’ says Dr Nightingale. Pragya Agarwal, who juggles running two businesses, The Art Tiffin and Hedge & Hog Prints, with caring for her young children, agrees. ‘I cope by writing a to do list before I go to sleep so I can put aside my stresses for the next day. I also find doodling really helps calm my thoughts and create a mindful feeling before bed,’ she says.

Keep a sleep diary
Dr Nightingale recommends keeping a sleep diary for a couple of weeks to see if it reveals any factors that trigger your insomnia. ‘This should include the time you went to bed, the time you fell asleep, the time you first woke up, and the number of disturbances throughout the night,’ she says. ‘Also, record the time you woke in the morning, and the time you got out of bed, and rate your sleep quality on a scale of one to 10 – but fill in your diary in the morning, rather than writing it down in the middle of the night.’

Have a medication review
Sometimes, mental health medication can affect your sleep. If you think this is the case, it’s worth seeing your doctor. ‘Some antidepressants have a calming effect, while others may make you feel more alert,’ Dr Vandenabeele says. ‘Depending on which medication you’re on, consider the time of day you take it. If it makes you more alert, take it in the morning rather than before bed.’

Know when to seek expert help
Because insomnia can have such a profound effect on mental health, it’s important not to suffer in silence, says Dr Vandenabeele. ‘Quality sleep enables your brain to reset itself ready for the next day, and without enough sleep, you may experience issues like reduced alertness and concentration, an increase in stress, and a compromised immune system,’ he says. ‘If you’re experiencing insomnia, it’s a good idea to speak to your GP: they will look at the underlying causes and work out what the best options are for you.’

*Name has been changed

https://metro.co.uk/2018/06/20/how-to-cope-with-insomnia-when-you-have-depression-7610088/