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:
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.
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