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Thursday, May 23, 2013
Sleep and Depression
I have a history of what I believe to be undiagnosed depression. However, lately I've been feeling well and the negative, irrational thoughts that used to plague me during the day are no longer as prevalent. I am happy and active during the day. However, at night what appears to be depression resurfaces. I will wake up with very negative thoughts and a tight feeling in my chest. It takes me about a half hour after waking to shake these thoughts. It frustrates me because I work hard during the day to stay positive, and these feelings at night make me not want to sleep. Is there an explanation for this? Could it be related to low thyroid, which I am on the borderline of?
You may have recovered from your depression partially, but not fully. You must already be doing lots of things well to manage your symptoms in the daytime. I suggest you consult your doctor or therapist to add the final pieces to your treatment plan that will manage your nighttime symptoms, such as more effective sleep management. Careful and regular symptom monitoring with the PHQ 9 (Patient Health Questionnaire) or the Beck Depression Inventory can help make the difference between partial and full recovery.
Lawson Wulsin, MD
Professor of Psychiatry and Family Medicine, Training Director of the Family Medicine Psychiatry Residency Program
College of Medicine
University of Cincinnati