Anxiety/Depression Archives - Page 2 of 2

In my private practice as a Psychologist, whenever a client tells me about feeling symptoms of depression or anxiety; one of the first things I ask is: How is their sleep? I do that because getting enough rest is super important to our overall mental wellness and is especially important when it comes to people suffering with anxiety and/or depression.

Sleep is a basic physiological need. Like breathing, drinking water, and eating, we need proper rest at night in order to survive and thrive. Proper and adequate rest is intricately related to our emotions/moods and can affect our mental health in many significant ways.

For instance, how do you feel after missing a night of sleep? Obviously, tired and fatigued, but you’re also likely to feel emotional in some way; perhaps irritable, angry or frustrated, maybe sadness, or maybe even have increased anxiety and worry.

During our days, we are surrounded by stimulation and new information. A good night’s rest is believed to give our brain some rest or down time in which it can process and store the myriad of information we’ve gathered during our days. Regularly getting enough zzzz’s improves our concentration, motivation, memory, ability to learn new things and even our creativity. Not getting enough rest can leave us feeling cognitively and emotionally frazzled.

People who have insomnia on a regular basis are much more likely to develop a mental illness like depression, than those who don’t. Lack of sleep can also hinder and stall the recovery from a mental illness.

In an important 2013 study that followed 440 repatriated prisoners of war for over 37 years (from the Vietnam War to today) quality sleep after their repatriation/rescue was the strongest predictor of future mental health resilience. In these POW’s, those who were able to get quality sleep after their release were significantly more likely to be resilient and have positive overall mental health.

Particularly interesting were the repatriates who seemed to have “bounced back” from the captivity experience in reporting fewer sleep complaints at repatriation were nearly 2 ½ times more likely to be resilient than the groups reporting sleep difficulties at repatriation.

There is an intricate relationship between mental health and proper rest. Chronic insomnia type issues affect 50% to 80% of psychiatric patients, compared to 10% to 18% of adults in the general population. Insomnia type problems are particularly common in patients with anxiety, depression, bipolar disorder, substance abuse, and attention deficit hyperactivity disorder (ADHD). Poor sleep and depression are very closely related and treating either the sleep or the depression, will often improve the other. Research suggests that 60-90% of patients with depression also have some type of insomnia. Patients with persistent and untreated insomnia are at between 2 and 10 times the risk for new or recurring episodes of major depression!

The Harvard Mental Health Newsletter states that:

“Once viewed only as symptoms, sleep problems may actually contribute to psychiatric disorders” (2009).

On a positive note, though, this also means that treating a person’s sleep problems may actually help to prevent, reduce and maybe even alleviate the symptoms of the mental health problem they are experiencing! By learning strategies for sleeping better, people can often begin to feel better sooner and reduce the impact of their mental illness!

How much sleep do we really need?

Most adults have a typical rest at night lasting from about 6 to 9 hours. The amount that one actually needs is very individual with some people needing less, and others more. The amount that an adult needs is really whatever is enough to awaken feeling fresh and to be able to perform as best they can during their day. Needs are also affected by lifestyle and our health. For instance, many seniors report needing less sleep while people with auto-immune disorders or other health problems often require more than the average. When it comes to sleep needs? One size does not fit all. The National Sleep Foundation Scientific Advisory Council recommends:

Newborns (0-3 months ): 14-17 hours each day
Infants (4-11 months): 12-15 hours
Toddlers (1-2 years): range widened by one hour to 11-14 hours (previously it was 12-14)
Preschoolers (3-5): 10-13 hours
School age children (6-13): 9-11 hours
Teenagers (14-17): 8-10 hours
Younger adults (18-25): 7-9 hours
Adults (26-64): 7-9 hours
Older adults (65+): 7-8 hours

What if you have insomnia?

What is insomnia? Here is a description from the Canadian Sleep Society (2012):

Problems such as difficulty falling or staying asleep, and waking up too early, all describe insomnia. Along with difficulty sleeping, some people don’t feel refreshed on waking and feel that their rest was not restorative. This is also a form of insomnia. Other consequences may be fatigue, emotional distress, impaired mental ability, poor concentration and memory, and emotionality. For some people insomnia may be situational (such as sleeping in a different place) or it may be intermittent (such as at exam time). The reason for the difficulty sleeping may be apparent and insomnia transient. When insomnia lasts for weeks/months/years, it is important to treat. Usually insomnia that persists does not resolve on its own and can lead to a reduced quality of life.

Here is a link to a comprehensive booklet with more information on dealing with insomnia:

https://css-scs.ca/files/resources/brochures/Insomnia_Adult_Child.pdf

If you have chronic or recurring insomnia that really affects your life and your psychological/emotional functioning? You may want to consult your family doctor, a Psychologist or even a “Sleep Clinic”.

Make it a priority

Getting better sleep is about developing an awareness of how very important it is to maintaining positive mental health. Like anything else we want to improve in our lives, we need to make it a priority, just like the effort to eat well, taking time for exercise or other important self-care. (BTW Here is an article I wrote on self-care strategies: roberthammel.com/7-steps-to-emotional-self-care).

And finally here is a list of helpful tips to help you get started on a getting a good night’s rest. Sweet dreams.

Robert is a licensed Psychologist in Calgary, Alberta, Canada, where he lives with two outrageously energetic herding dogs and an exceptionally lazy cat. He has been in private practice since 2010 and sees a range of clients for a variety of issues. Robert has worked extensively with individuals, couples and families — including couples counseling, anxiety/depression, addictions, and relationship issues. Previous to becoming a Psychologist, Robert worked as a Social Worker for almost a decade working with adolescents and their families.

References:

Canadian Sleep Society. 2012. Insomnia (https://css-scs.ca/files/resources/brochures/Insomnia_Adult_Child.pdf)

Harvard Mental Health Newsletter Sleep and Mental Health. (2009) http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2009/July/Sleep-and-mental-health

National Sleep Foundation (2016) HOW MUCH SLEEP DO WE REALLY NEED? https://sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need

Segovia F, More JL, Lineville S, Hayle, RE and Haine, RE. Sleep and resilience: a longitudinal 37-year follow-up study of Vietnam repatriated prisoners of war. Mil Med 2013 Feb: 178(2): 196 -201. https://www.researchgate.net/publication/236049880_Sleep_and_Resilience_A_Longitudinal_37-Year_Follow-up_Study_of_Vietnam_Repatriated_Prisoners_of_War

Web MD. Are You Depressed — or Just Sleepy? (2010) http://www.webmd.com/sleep-disorders/features/depression-lack-of-sleep#1

What exactly is a critical inner voice? Whether in therapy, a psychology class, in the media, or somewhere in the mountains of self help books or on the internet — I’m sure most of you have heard the term self-talk or the term inner voice, or even the intimidating sounding “critical inner voice” or “negative self talk”.

But what exactly is self-talk or the inner voice? Well, it appears to be a form of natural and automatic “inner dialogue” that pops in and out our conscious thinking. It takes the form of thoughts, expressions, suggestions, ideas and concepts that transmit themselves into our “consciousness” and into our awareness. It is often this “little voice” that guides our day-to-day behaviors and tells us we should “call our mom, catch up on our paperwork or try harder at some task”. No the little voice does not mean you are crazy. Pretty much everyone has a little self-talking voice to some degree.

From the neurobiology perspective the automatic thoughts and inner voice that come with it can possibly be explained by well worn neural pathways that have been created by the combination of our genetics, our years of life experience and maybe especially in all the cumulative experiences of our childhood.

When the Inner Critical Voice is a Problem…

Everyone has anxieties & worries and sometimes even an inner voice that leans towards giving us critical messages. Sometimes these more critical messages can help motivate us and drive us to make better choices and actions in our lives. For some people though, it becomes a much bigger problem. It can readily be described as the jerk or even the a**hole voice in our head, criticizing us, limiting us in what we think we are capable of, or even chastising us with negative “we can’t possibly do THAT” and we will certainly fail if we try” kind of thoughts. Most of us would not abide our work colleagues, friends or family speaking to us in this very negative way, so why do we stand by while we do this to ourselves? Why do we even listen to these insidious little voices?

We listen because they are part of the deep-rooted patterns of thinking that come from all of our past experience and our own uniquely developed patterns of seeing and interpreting the world. Often things like physical and emotional abuse, overly controlling, critical or demanding parents, teachers or coaches, critical friends, and of course past emotional traumas can all contribute to these negative self -talk patterns. We listen to the voice and its castigating, critical language because it’s become deeply worn into our thinking patterns and even into the biological structure and chemistry of our brains. Many people do not stop it because they simply do not realize it is happening and if they do, they do not know how! For many people we take the voice for granted and do not even realise what’s happening, let alone knowing how to stop it.

When people with degrees of anxiety and depression have a negative, critical self-talk message appear in their consciousness, they unfortunately believe it; when that happens they emotionally tear themselves down — and that causes even more negative thoughts to appear!!! These new critical thoughts end up supporting the earlier critical thoughts creating a vicious cycle! It can become a snowballing mess of negative critical thoughts and self-defeating perceptions of ourselves that can push us towards even deeper anxieties and depressions. It can effectively destroy our self-confidence, and self worth, keeping us from trying new things and leading us down the garden path to self destructive, and sometimes even addictive behaviours and habits. The bad coping habits we develop can then create even more negative self-talk messages effectively strengthening the vicious cycle.

How to Shush the Critical Inner Voice…

Awareness

The first step in taking back our thoughts from the monster of critical inner thinking is……read more

Sleep, mental health & some tips for better zzzz’s