Insomnia and depression have a “what came first, the chicken or the egg” sort of relationship. Most people who habitually struggle with sleep will acknowledge that this takes a toll on their mood. Indeed, insomnia can frequently predate an episode of depression.
On the other hand, one of the common symptoms of clinical depression is disturbed slumber – either tossing and turning throughout the night or sleeping excessively.
The trick is to stop this vicious cycle, and recent research suggests that a short course of talk therapy focused on treating insomnia can indeed do the trick.
Researchers at Ryerson University in Toronto investigated the effect of cognitive behavior therapy for insomnia (CBT-I) as an add-on to standard depression treatment.
Techniques taught in CBT-I included the following:
1. Adopt a regular sleep-wake schedule. In other words, even if you don’t feel tired, go to bed at the same time every night. Along similar lines, get up at the same time each morning, whether or not you’ve slept well.
2. Get out of bed if you find yourself awake for more than a few minutes during the night.
3. Don’t take naps during the day.
4. Refrain from activities such as watching TV, reading, or eating in bed.
The study, led by Dr. Colleen Carney, led to the eradication of depressive symptoms within eight weeks for 87 percent of the subjects. These results held true whether or not the subjects were also on antidepressant medication or a placebo pill. This is impressive, especially considering that the subjects participated in a mere four sessions of CBT-I, held biweekly. As Dr. Carney stated, “The way this story is unfolding, I think we need to start augmenting standard depression treatment with therapy focused on insomnia”.
Dr. Carney admitted that hers was a small study, with only 66 patients. However, other research teams at Stanford, Duke, and the University of Pittsburgh are also studying the link between insomnia and depression and plan to release their findings in 2014. So, more light will soon be shed on the subject.
Such news may be welcome for the many people struggling with depression who don’t respond to either antidepressants or talk therapy without an insomnia component. The rate of full recovery from depression for individuals who utilize both antidepressant medication and standard psychotherapy is about 40%, so there’s definitely room for improvement.