Everyone's felt her mood plummet after a few (or more!) bad nights of sleep. And we've all had difficulties sleeping when we're sad or upset. But chronic insomnia and depression combined can turn into a vicious cycle where one exacerbates the other until you wonder if you'll ever feel good again.
Thankfully new research shows that breaking the cycle may be simpler than you think. In the first of four studies on depression and sleep commissioned by the National Institute of Mental Health, researchers found that using talk therapy to resolve insomnia also helped a whopping 87 percent of patients see their depression subside in an eight-week treatment period. [Tweet this news!]
This is important because not only is depression the most common mental illness in America, but insomnia is one of the most commonly reported symptoms, says Kelly Glazer Brown, Ph.D., a clinical psychologist and director of the behavioral sleep program at Northwestern University Feinberg School of Medicine.
"Sleep is quite involved in mood regulation; there are a lot of changes to the brain in areas related to sleep, both structure and functional,” she says. For example, hyperactivity of limbic and paralimbic systems during sleep may be related to increased emotional dysregulation and a negative cognitive bias, more commonly known as seeing the glass half empty.
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It can be hard to know which came first, the dark nights or the dark thoughts, but Brown says that from her research and several other long-term studies, contrary to popular belief, it appears that the insomnia often precedes depression. So focusing on treating the insomnia first makes sense.
Brown adds that patients who have residual symptoms of insomnia after their depression improves have a greater risk of depression relapse. And the new research found that consistently getting a good night's sleep doubled participants' chances for a full recovery from their depression.
In the study, participants attended cognitive behavioral therapy and learned to establish a regular wake time and stick to it; get out of bed during waking periods; avoid eating, reading, watching TV, or similar activities in bed; and eliminate daytime napping.
Colleen Carney, Ph.D., the study's lead author, told the New York Times that the point of the therapy is to “curb this idea that sleeping requires effort, that it’s something you have to fix...That’s when people get in trouble, when they begin to think they have to do something to get to sleep.” The real genius of cognitive behavioral therapy, she says, is that it's cheap, relatively brief, and usually effective—but it’s not currently part of standard depression treatment.
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This may in part be due to time. “Insomnia treatment usually takes fewer sessions,” Brown says, “and then a patient may undergo general psychotherapy for depression treatment specifically.”
The researchers estimate that adding cognitive behavioral therapy to standard depression treatments like conventional talk therapy and antidepressants could boost cure rates from the current 40 percent to a "sharply higher" number.
While Carney admits that more and larger studies need to be done, these results confirm what has already been found in smaller studies performed at Stanford and Duke. In the meantime, since it's non-invasive and looks so promising, it's definitely worth discussing with your doctor if you're one of the 18 million Americans suffering from depression. [Tweet this advice!]