Depression and Sleep

There are strong links between depression and sleep and understanding these links can help us to move towards recovering from depression.

We all dream for about two hours a night, even though we often don’t remember having done so when we wake up the next morning. There is evidence to show that the function of dreaming, which occurs predominantly during what is called rapid eye movement or REM sleep, is the metaphorical acting out (not the resolving) of unexpressed, emotionally arousing preoccupations, so that the arousal can be discharged and the brain freed up to deal with the concerns of the following day. The process of discharging, and thus completing, patterns of arousal in this way preserves the integrity of our core personality.

In depression, however, this process goes dramatically wrong. Instead of having about 25 per cent (REM) sleep and 75 per cent slow wave sleep (which boosts energy levels in the brain), these proportions become inverted, with the depressed person having far too much REM sleep and too little slow wave sleep.

The prolonged negative self examination and introspection which tends to characterise depressed people creates higher than average arousal levels and greater need for discharge during dreams. The first period of REM sleep occurs much earlier in depressed people, because the pressure for discharge is so great. The first REM sleep period is also more prolonged and shows an especially high rate of discharge. However, so much discharge activity not only reduces the arousal levels in the brain but also depresses and exhausts it, leaving the dreamer likely to lack motivation the following morning. Indeed, very many depressed people say they wake up from sleep feeling exhausted.

In experiments in the sleep laboratory, if depressed people are woken every time they go into REM sleep, their depression lifts. Antidepressants also reduce REM sleep, and this is thought to be why they can help to lift depression.

Counselling and Depression

As a counsellor working with people with depression, I use a combination of behavioural, cognitive and interpersonal approaches with relaxation and visualisation techniques, to motivate people to widen their life view, raise their self esteem and solve problems. I work alongside patients giving practical guidance for breaking problems down into manageable chunks (focusing outwards on resolution rather than inwards on non-productive worrying).  I sometimes use humour to gently nudge them out of their black and white thinking, reframe their negative comments in a novel, positive way; inform, set tasks, encourage them to engage again in fun activities or involve themselves in helping others, rouse their curiosity, and so on. I also use their imagination in guided imagery to help them vividly see themselves making the changes they need to make in order to overcome their difficulties. This works on the time honoured principle that the human brain tries to bring about what it focuses on.

Need some more advice and support?

If you are feeling low or depressed and would like to talk it over in complete confidentiality, call Alison Winfield, Mindfully Well Counselling Cork on 087 9934541.

Other related articles on depression: Beat Depression Fast! What is Depression?