- Why anxiety at night can be even worse than during the day
- Why anxiety can feel worse at night
- Nighttime depression: Causes and treatment
- What To Do When Depression Gets Worse In The Evening
- Write Down Your Worries And ‘Put Them Aside’
- Distract Yourself With Positive Activities
- Limit Alcohol and Caffeine Intake
- Practice Gratitude
- Practice Good Sleep Hygiene
- Give ‘Mindfulness Meditation’ A Shot
- Give Problem-Solving A Try When You Feel Up To It
- Why Do I Get Depressed At Night And What Can I Do About It?
- Why Am I Depressed Only at Night?
Why anxiety at night can be even worse than during the day
After a long day, you climb into bed and wait for sleep to come – but your mind has other ideas. Instead of restful slumber, you start to think about work, bills or an awkward conversation you had earlier that day, and your head soon becomes crowded with worries.
“I think my anxiety, when it's worse at night, is when I feel completely alone,” says Crissy, 26. “I overthink which stops me from sleeping as I just can't switch off.
“The worst is when it turns into panic attacks where my chest tightens. I feel I can't breathe and I do get night sweats,” she adds. “The next day I'm drained, I can barely function and I just find it hard to get up which then sets back my entire day.”
Why anxiety can feel worse at night
“Sleep promotes rest and relaxation, and gives us a chance to recuperate and let go of the stresses of the day,” says Dr Natasha Bijlani, a consultant psychiatrist who provides treatment for anxiety at Priory Hospital Roehampton. “However, this isn't the case for the many individuals who struggle with anxiety and panic attacks at night.”
There is no single reason why people experience anxiety or panic attacks at night, she explains, but several factors may be involved.
“We do know that the brain doesn't 'switch off' during sleep, so it's possible for any pent-up worries or anxieties to manifest in our unconscious brains, leading to nocturnal panic attacks,” Bijlani says.
Simply being aware that others are sleeping soundly can lead to a sense of isolation and worsen anxiety, too. Small problems, such as forgetting to post a letter, can suddenly seem much worse than they actually are.
“Those who struggle with daytime anxiety and panic attacks are more ly to experience such symptoms at night because there are fewer distractions to prevent them from worrying excessively and further, their heightened anxiety is ly to affect their quality of sleep,” Bijlani explains.
When people are anxious during the day, they can avoid thinking about the thoughts that cause them distress by doing activities, says Nicky Lidbetter, CEO of Anxiety UK. “At night that is harder, and everything is quiet,” she says.
Some also worry their night-time anxiety may impact others in a negative way.
“People also say to us that they're worried about having a panic attack in the night and waking up other people,” Lidbetter explains.
“We get calls about night-time panic too. People go from being in a relaxed state of sleep to waking up with a jolt, with an adrenaline surge,” Lidbetter says. “That can be hard to cope with because it can be very sudden and render them into a state of panic in a few seconds. It can feel quite destabilising.”
Another factor is the closure of support services at night, which some people rely on during an anxiety or panic attack.
“People who seek reassurance, which is a common characteristic of anxiety, also find at night that most help services are closed,” Lidbetter says.
“With the exception of helplines the Samaritans which run on a 24/7 basis, I think it's fair to say that most primary care mental health services close, which can rack up people's anxieties.”
The relationship between sleep and mental health is cyclical. If you have poor sleep, you're ly to feel tired the next day, which can make things even more difficult and stressful, which can make anxiety worse and result in another night of disturbed sleep. If you are struggling with anxiety and have trouble falling asleep, though, there are steps you can take.
“Limit caffeine, sugar and alcohol before bed,” Bijlani says. “These substances can make you anxious and jittery at night, and can prevent you from getting to sleep and staying asleep.”
You could also try herbal teas, including chamomile or valerian extract, which can aid sleep.
“None of these are cures to night-time anxiety, but they can make it more ly that someone will have a better sleep,” Lidbetter says.
Getting yourself organised for the following day can help put your mind at ease, Bijlani says.
“Many people struggle to get to sleep because they are anxious about the following day. You can try to reduce this anxiety by making sure that you have everything prepared. For example, you could have a to-do list or even get your clothes ready.”
Developing a 'wind-down' routine before bed helps your body recognise when it's time for sleep.
“Try to go to bed and wake up at the same time every day. Even at the weekends, try to get up at a time that isn't too different to when you get up during the week,” Bijlani advises.
It's also important to make sure you give yourself time to get the sleep you need, too.
“Going to bed too late and not leaving enough time for sleep may result in you constantly checking the clock and worrying that you're not going to feel rested the next day,” Bijlani explains. “These negative thought processes can fuel anxiety.”
Stephen Buckley, head of information at the mental health charity Mind, says taking steps to relax before bed can also make a difference.
“Some people find that calming themselves through listening to relaxing music or having a bath can help. Breathing exercises, muscle relaxation and visualising scenes associated with happy memories can also help,” he says.
Avoiding your laptop or phone an hour or so before bed is key, however, as certain devices give off blue light which research suggests can interrupt our sleep.
Insomnia is frustrating, but lying in bed and trying to get to sleep is only going to make you feel worse. If you can't get back to sleep within 20 minutes, get up.
“Some people get a sleep phobia where they get fixated on not being able to get to sleep, which can become a big anxiety worry,” Lidbetter says. “If you can't go to sleep, get up and do something else. Reading can be therapeutic or you could practise mindfulness.
“Anxiety UK has a strong partnership with the Headspace people, which is a great app and something you can just practise which is relatively easy to do. It just sets the scene for a restful night's sleep because it calms down your sympathetic nervous system and puts you into relaxation mode.”
If you struggle with anxiety which is impacting your sleep or other aspects of your life, it's important to get help.
“If you find that feelings of anxiety are starting to significantly affect your day-to-day life, including feeling unable to sleep, you can talk with your GP about treatment options, such as talking therapies or medication,” Buckley says.
Talking therapies may include cognitive behavioural therapy, which can help change the way we think and behave, particularly when it comes to negative thinking.
“Talking about your problems with your doctor can be challenging, so Mind has produced a guide – 'Find the Words' – to help you prepare for the short time you get with your GP.”
Nighttime depression: Causes and treatment
Several things can cause nighttime depression, such as being unable to sleep due to insomnia. Depending on the cause, possible treatments could involve psychotherapy or antidepressant medication.
Depression is a common mental health condition that can lead to low mood and feelings of hopelessness. In some people, these symptoms can worsen at night.
Keep reading to learn more about the causes of nighttime depression, some potential risk factors, and some possible treatment options.
Share on PinterestInsomnia and fatigue can be symptoms of depression.
The symptoms of depression include:
- feelings of hopelessness and worthlessness
- a persistently low mood
- loss of interest in hobbies or activities that used to be pleasurable
- difficulty concentrating or remembering
- suicidal thoughts
- feelings of isolation
- feelings of emptiness
At night, some of these symptoms can become worse, making it harder to sleep. In turn, this could worsen insomnia and fatigue the next day, which can further worsen the depression a person in experiencing.
There are also some symptoms of depression that may be harder to spot. Read about them here.
The causes of depression are ly to be a combination of factors relating to genetics and the environment, such as experiencing trauma or chronic stress. It is less clear why these symptoms may worsen at night.
People who experience insomnia as a symptom of depression may feel frustrated about their inability to sleep. The frustration ly peaks at night, when a person is unable to sleep despite feelings of fatigue and exhaustion during the day.
Being unable to sleep could worsen depression symptoms such as irritability or low mood.
It is also possible that the lack of stimulation at night makes it more difficult for someone to distract themselves from their symptoms. This could give rise to rumination.
Rumination is a common feature of several mental health conditions. It occurs when a person repeatedly goes over a negative thought or problem without finding any solution. This can increase feelings of worthlessness or hopelessness.
Learn more about ruminating thoughts here.
There are several possible risk factors for depression, including:
- a family history of mental health problems
- past trauma
- chronic stress
- long-term physical health conditions, such as heart disease
- other mental health problems, particularly anxiety disorders
- low self-esteem or pessimism
- heavy alcohol or drug use
Factors that increase the risk of nighttime depression could include experiencing symptoms such as insomnia or rumination.
People with depression are more ly to have other behavioral problems and mental health conditions.
For example, a study of 1,783 people in the Journal of Clinical Psychiatry found that 75% of those with depression also had an anxiety disorder during their lifetime. People with anxiety disorders tend to experience overwhelming feelings of fear and worry.
People with depression are also more ly to have problems with substance abuse. A review of 115 studies found that people with illicit drug use disorder were significantly more ly to experience depression.
Research is increasingly showing that people with depression are also at greater risk of physical health complications.
For example, according to one study that used data from over 3 million people, those with depression have a 72% higher risk of heart disease than those without depression. They were also more ly to die at a younger age.
The best way to deal with nighttime depression is to seek treatment for the depression itself.
There are several ways to treat depression. Finding the best way to deal with the symptoms may involve trial and error and take some time. For some people, a combination of different methods might be the most beneficial.
Different types of psychotherapy are available for depression. For example, cognitive behavioral therapy can help people with depression identify and change their negative thought patterns.
There are also many antidepressant medications available. Selective serotonin reuptake inhibitors are common drugs for treating the symptoms of depression.
Also, the Food and Drug Administration (FDA) recently approved the use of esketamine for treating depression. This is a new class of drug that can help people with cases of depression that do not respond to other treatments.
Other strategies for dealing with the symptoms of depression include making lifestyle changes. For example, one review of 25 trials found that exercise interventions were effective for people with depression. Other trials have found that eating a healthful diet can also reduce symptoms.
For people experiencing nighttime depression, getting a good night’s sleep will also help — though this can be difficult. Some tips for getting a good night’s sleep include:
- doing something relaxing before bed, such as reading a book
- not napping during the day
- going to bed and waking up around the same time every day
- exercise regularly
- making sure that the bed is comfortable
- restricting bright lights within an hour of bedtime
- not consuming caffeine in the evening
- avoiding alcohol, cigarettes, and heavy meals near bedtime
Read more about how to sleep better here.
Depression is a common mental health condition with a number of symptoms that can worsen at night.
Increased feelings of depression at night could be the result of people having fewer distractions.
Depression can lead to insomnia, which can increase frustration at night, further worsening the underlying depression.
Treating nighttime depression usually involves treating the root cause of the depression itself.
Although it may be difficult, the best way to treat nighttime depression is often to get a good night’s sleep. There are a number of things a person can try in order to achieve this, including restricting bright lights in the bedroom and avoiding caffeine before bed.
What To Do When Depression Gets Worse In The Evening
Living with depression is not easy when you feel you have a dark cloud hanging over your head; achieving the things you need to do at home, work and with family and friends can be a real effort indeed. For many sufferers of depression, symptoms such as low mood or sadness, loss of pleasure in usual activities, feelings of worthlessness and fatigue often worsen in the evening.
Why is depression often worse in the evening, you may wonder? For most people, the reason is lack of distractions. Often throughout our day, we are distracted by all the things and people that need our attention, and come night time, we are left to confront our own thoughts. Other reasons depression is often worse in the evening include:
– exhaustion (our negative emotions are harder to deal with when we are tired)
– loneliness, compared to during the day when we are often surrounded by other people such as workmates and family
– feeling dissatisfied that we weren’t able to get through everything we had planned for the day
Do not despair however – there are a number of gentle activities you can introduce to help ease your symptoms of depression at night, which can also help to prepare you for a decent night of sleep.
Write Down Your Worries And ‘Put Them Aside’
If you find yourself sitting at the dining table or on the couch and your depression is intensifying, get a journal out and write down your thoughts and feelings. When you are finished, close the journal and put it aside, and try to think of ‘saying goodnight’ to your worries by doing so. Now you can decide on a positive activity to enjoy for the evening and begin to relax.
Distract Yourself With Positive Activities
One of the most important things you can do to lessen any worsening feelings of depression at night is to stay busy and distract yourself by engaging in activities that make you happy. Think about what you really enjoy, or perhaps an activity you’d to do more of.
This may include doing some gentle exercise, reading, playing an instrument, getting creative, watching something that brings you joy or spending time with people that make you feel happy.
By doing so, you will encourage positive thoughts and be better able to keep the negative thoughts at bay.
Limit Alcohol and Caffeine Intake
Consuming large amounts of alcohol or caffeine at night can actually amplify feelings of depression, as well as keep you awake and wreak havoc with your sleep overnight. Instead of reaching for a coffee or glass of alcohol, try drinking some water or a peppermint tea. This way you will be hydrating your body, and more ly to achieve an uninterrupted sleep.
Gratitude is a very powerful tool for increasing happiness and reducing symptoms of depression. Each night (you may wish to make this part of your pre-sleep routine), take a moment to think of three to five things you are grateful or thankful for that particular day. You may wish to jot them down in a ‘gratitude journal’. Things you may be grateful for on a particular day:
– the love and support of your partner/family/friends as you manage depression
– the smile from a stranger as you walked home from work
– the beautiful fresh food you ate for dinner
– access to clean running water so you could enjoy your warm bath before bed
– your warm and cosy bed.
When we look around, particularly in Australia, there is an abundance of things to be grateful for. Thinking about the things that made you feel happy or relieved during your day is a good starting point. Nothing is too simple to be grateful for!
Practice Good Sleep Hygiene
‘Sleep hygiene’ refers to habits or a routine you follow before you go to bed to ensure a restful night of sleep.
If you feel heightened symptoms of depression in the evening, it is a good idea to put into place a pre-sleep routine, to save you lying in bed ruminating i.e. going over and over the same depressive thoughts in your mind.
(Getting a solid sleep can also help you with the new day that follows – it is much harder to manage the symptoms of depression if you are running on interrupted sleep or affected by insomnia).
You may wish to include some or all of the following things in your pre-sleep routine:
– Allow yourself adequate down-time before bed: ideally one to two hours at a minimum i.e. no physically or mentally demanding tasks are to be completed during this time.
This helps your body to slow down and prepare for sleep.
(Whatever you choose to do during this time, ensure you engage in things that create positivity – this way you can distract your mind from any negative thoughts).
– Activate ‘night mode’ on your electronics: at least one hour prior to sleeping, turn any electronics such as a smartphone or tablet to ‘night mode’ (blue light is designed to keep us alert). It can also help to dim any ceiling lights or lamps in the room(s) you find yourself in before heading to bed.
– Undertake a relaxing activity before bed: choose an activity you can do at home before bed that you find relaxing – this may include drinking a warm cup of herbal (non-caffeinated) tea, reading a relaxing book (such as a happy novel), taking a warm bath/shower or doing some drawing or colouring. Ensure the activity you choose focuses on relaxing you and your mind (as opposed to stimulating your mind).
– Go to bed at the same time each night (and wake up at the same time each day): by practicing a routine regarding what time we go to bed, our body can begin to recognise when it is time to sleep, (thus saving you laying there getting lost in your thoughts instead).
A handy hint: Be sure to keep your bedroom a calm, relaxed sanctuary (e.g. free of clutter, work and anything else that makes your mind wander before you go to sleep).
Give ‘Mindfulness Meditation’ A Shot
Put simply, ‘mindfulness meditation’ is the practice of focusing the mind (meditation) on the present moment (mindfulness). Practicing meditation is a great way to help you unwind both your body and mind when you are feeling depressed.
Regular mindfulness meditation practice has an array of benefits for sufferers of depression. For more information on these benefits, check out our article ‘Beginners Guide To Mindfulness Meditation For Depression And Anxiety’ here.
There are many mindfulness meditation exercises and apps available out there for beginners.
We have detailed the steps of two great starting exercises: ‘Mindfulness Meditation Breathing Exercise’ and ‘Mindfulness Meditation Body Scan Exercise’ in our article ‘Beginners Guide To Mindfulness Meditation For Depression And Anxiety’, which you can access here. Give one (or both!) exercises a try and see how you feel.
Give Problem-Solving A Try When You Feel Up To It
When we feel depressed we often think about why we are not coping, or feel defeated about a situation, etc. When you are able to think clearly, it is worth giving problem-solving a shot.
Try thinking about one or more things you can do to begin overcoming your hurdles. You may wish to brainstorm on paper, or call a loved one for their ideas.
This tactic can help you to stop ruminating over the same problem and instead help you to move forward from it.
The above techniques are very helpful for easing symptoms of depression that may get worse at night. However, they are not a substitute for professional help and should be used in partnership with ongoing therapy in order to fully overcome depression. Contact Brain Wellness Spa today for help to manage and overcome your depression.
Why Do I Get Depressed At Night And What Can I Do About It?
By Julia Thomas
Updated February 27, 2020
Why Am I Depressed Only at Night?
Peter Dazeley / Getty Images
As one of the most common mood disorders, major depression can develop in anyone, at any age, at any time. However, for some people, symptoms of depression may be worse at night, leading to difficulty in getting to sleep, anxiety, and feelings of isolation and hopelessness. Some people may have depression in the morning, which is called diurnal mood variation.
Major depression causes severe symptoms that interfere with your mood and activities of daily living. If you've experienced a number of these symptoms for the majority of the day, almost every day, for the past two weeks or more, and they aren't getting better, you should see your doctor.
Symptoms of depression include:
- Sleep issues, such as sleeping more than normal or difficulty getting to sleep or staying asleep
- Eating more or less than you normally do
- Weight loss or gain
- Losing interest and/or pleasure in activities you once enjoyed
- Lack of energy
- Difficulty engaging in normal tasks of daily living such as brushing your teeth or bathing
- Headaches, stomachaches, or other pain that doesn't respond to treatment and has no obvious cause
- Feeling sad and/or anxious
- Feeling hopeless
- Feeling isolated or lonely
- Feeling worthless, guilty, or helpless
- Difficulty concentrating
- Suicidal thoughts or attempts, or thinking about death
There are several factors that may lead to worsening feelings of depression at night.
Verywell / JR Bee
People, particularly people with depression, often go through a process called rumination in which they repeatedly mull over past events and issues that concern them, trying to make sense of them or imagine them having a different outcome.
Since depression causes the tendency to focus on negative events (for example, mentally reliving a fight with a friend), rumination can fuel your feelings of depression and anxiety, and it's usually a major cause of nighttime depression symptoms.
Not too surprisingly, you tend to be more prone to rumination when you're alone and free from distractions, which tends to be at night for many of us. Fatigue at the end of the day can also make us more prone to feeling down. Though rumination is normal, it can be extremely unhealthy, particularly if it's causing or worsening your depression or anxiety.
There have been numerous studies on the link between exposure to light at night and depression.
One study published in the American Journal of Epidemiology showed a correlation between low-level bedroom light exposure during sleep and developing depression symptoms in elderly adults, though light exposure was more than ly not the only cause. The risk could be even higher for younger people since their eyes are more sensitive.
It's still unclear how exactly light and depression are related, but it's possible that being exposed to even a tiny amount of light during the night interferes with your sleep cycles, which in turn interferes with your mood.
Multiple studies have shown that when your circadian rhythm, or internal sleep clock, is disrupted, your risk of developing depression or worsening symptoms is higher. Circadian rhythm disruption can occur as the result of a whole host of factors from jet lag to working the night shift to increased light exposure at night.
No matter your natural circadian rhythm, disrupting it can have negative effects.
In general, it's best to be awake and active during the day and work to make sure you get the best quality of sleep you can at night.
Do you consider yourself an early bird, a night owl, or somewhere in between? How long and when you sleep at night is called a chronotype. One study on the link between chronotype and depression looked at 32,470 females who were, on average, 55 years old and did not experience depression. They each categorized their chronotype: early, intermediate, or late.
Of these women, 2,581 ended up with diagnosed depression across a follow-up period of four years. The women who identified as early birds had a 12% lower risk of developing depression than the intermediate women, while the night owls had a 6% higher risk.
The results clearly showed that the more strongly a woman identified as being a night owl, the higher her lihood of developing depression.
In the United States, an estimated 17.3 million adults age 18 years and older were affected by at least one episode of major depression in the last available year's statistics, as were around 3.1 million adolescents age 12 to 17 years.
While this study doesn't show that being a night owl causes depression, the fact that there are multiple studies that indicate a link between chronotypes and depression means that more research on this connection is warranted, especially regarding the genetic and environmental connection.
In order to break the cycle of nightly negative thoughts and curb nighttime depression symptoms, try the following:
- Engage in activities that create positive thoughts. Some examples are participating in a hobby that you enjoy, such as writing, playing an instrument, drawing, or painting, and meditation or prayer. What you're trying to do with these activities is fill your mind with positive things so that there's no room for the negative thoughts to creep in and occupy space.
- Problem-solve the negative events. People who ruminate tend to not only replay events but also engage in thoughts such as, “Why does this always happen to me?” and “What's wrong with me that I can't cope?” These types of thoughts lead to feelings of helplessness. Instead, take a moment when you're thinking clearly and identify at least one step you can take to overcome your problems. It can even be something as simple as calling a friend to try and brainstorm a solution. This mental interruption and proactive action help you regain power over the situation and feel less helpless.
- Build up your self-esteem. What are you good at? What do you enjoy? Think of some ways to build up your sense of self-worth, such as taking a martial arts class, starting a new hobby, picking up that musical instrument you used to play, or taking a night or online class in a subject that fascinates you. Feeling good about yourself and what you're accomplishing helps keep rumination at bay.
- Don't go to bed until you're really tired. This gives you less time to start thinking about all the problems and negative events in your life. If you aren't sleepy, try reading a book or magazine until you are.
- Keep your room dark. It doesn't hurt to make your bedroom as dark as possible to help prevent any disruption to your sleep during the night. Try room darkening shades or blinds and don't leave the TV on at night.
- Minimize your exposure to screens before bed. Turn off screens and electronics a minimum of two hours before bed to help maximize your sleep time. Exposure to the blue light emitted from screens right before bed can interrupt your sleep and lead to a poorer quality of sleep as well.
If self-help strategies these fail to help you with your rumination, a type of psychotherapy called cognitive-behavioral therapy (CBT) is also an option to help you deal with this problem. Rumination-focused CBT is a type of therapy that's specifically geared toward helping patients with rumination, though studies are still being done on its effectiveness.
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