April 30th, 2008
10:21 AM ET

Insomnia and depression

By Yvonne Lee
CNN Medical Producer

The first time I began to associate sleeplessness with depression was after my aunt died. I was 8 years old and living in Los Angeles. My grandmother came to stay with us while the funeral preparations were made. I remember walking into my room and seeing her staring at the wall, eyes red and swollen. My sister and I slept on the floor next to her bed to keep her company. Several times during those few weeks, I woke up in the middle of the night and I'd see my grandmother wide awake, staring at nothing but the wall again. She barely spoke and stayed in bed, even during the day.

At least 80 percent of depressed people experience some form of insomnia, according to David N. Neubauer, M.D, associate director of the Johns Hopkins Sleep Disorders Center – whether it's difficulty falling asleep or staying asleep. The link between the two has been well established. Recently, a study published in the journal SLEEP suggests that insomnia is more than just a symptom of depression; it actually increases your risk of getting it. People with insomnia that lasted more than two weeks were one and a half to two times more likely to develop depression.

I experienced insomnia right after the September 11, 2001 attacks on the Pentagon and the World Trade Center. I was based at CNN's Washington bureau and for months, I couldn't sleep.

I would drive to work absolutely exhausted and numb. Because I lived in Arlington, Virginia, I had to drive past the Pentagon on my way to work. It was an ugly reminder of what how many lives were lost that day.

I worked at the Pentagon on weekends to produce live shots with our reporter. Whenever I walked in, it smelled as if something had been burnt, like you had just put out a campfire.

I didn't realize I was depressed until I saw my doctor and he told me to see a counselor. He prescribed anti-depressants – which did help me get some sleep – until I could get past what happened. Eventually, I felt better and went off the drug and was able to fall and stay asleep.

Have you ever experienced insomnia and later developed depression?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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soundoff (44 Responses)
  1. Marjorie

    For months, I would wake up at about the same time every night (3am), be awake for 2-3 hours, then fall asleep again until my alarm went off. I was getting just enough sleep to manage, but I was anxious and depressed, and I started obsessing about fairly minor problems. A friend suggested therapy – she thought the insomnia was a symptom of depression. But my Dr. gave me Ambien, at the lowest dose, and after a couple of weeks of sleeping through the night, I felt like my old cheerful self again. I still take the Ambien pretty often, which I know some people disapprove of, but I feel terrific.

    April 30, 2008 at 11:23 | Report abuse | Reply
  2. Ann

    My experience with postpartum depression would seem to bear out what recent research has suggested. I believe the lack of sleep I experienced with my newborn son both contributed to me getting PPD in the first place and then prevented me from being able to cope with my feelings. The worst part was that I had trouble sleeping even when my son would sleep, which made absolutely no sense to me (clearly I was exhausted!) until my doctor explained that sleeplessness can be a symptom of depression.

    April 30, 2008 at 13:57 | Report abuse | Reply
  3. Millie Haymon

    I have been on 20 mg. Paxil CR daily for 2 years and .5 mg Xanax & Tranzadone. I take the Paxil CR in the a.m. and the other 2 at bedtime. I was put on these 2 years ago when I was going through a family crisis, but I feel that I can now stop taking some of them. How can I ween myself off of these meds? I am a 53 yr. old woman in otherwise good health. Should get off the Paxil first or all 3 at the same time?

    Millie Haymon

    April 30, 2008 at 16:28 | Report abuse | Reply
  4. Jeanette Smith

    Consult with your doc, and wean off one med at a time. You can do it.

    April 30, 2008 at 19:56 | Report abuse | Reply
  5. Melissa

    I am currently going through this same thing after losing my grandmother. I am currently taking Lexapro 20 mg, Trazadone, and Serquol 350 mg daily. After taking all this medication, I still can not sleep. Could someone please suggest something else. I would love to feel something other than sleeplessness and depression.

    May 1, 2008 at 02:32 | Report abuse | Reply
  6. Dredge K

    I can't sleep until around 5 am, which is why i am commenting at 4:14am. I don't know how much of this had to do with depression, but it's worse when I go through spells of depression. Then I curse the birds chirping in the morning. What's worse for me, meds or a bottle of wine?

    May 1, 2008 at 04:17 | Report abuse | Reply
  7. Anne

    Alph Stim microcurrent machine (FDA approved) cured my insomnia in about a week. It works by putting alpha waves into your brain, by clipping earclips on your ears for appr. 20 minutes per day. It can be purchased on the internet.

    May 1, 2008 at 11:54 | Report abuse | Reply
  8. sandy

    My mother has really bad depression and im scared for her she wakes up every night around 4am. But thats not the worse part, she starts to hallucinate and talking to herself. Making up these crazy stories and all other sorts of things. What should I do???

    May 1, 2008 at 13:47 | Report abuse | Reply
  9. Helen

    After 9/11, I developed anxiety which was less attributed to the attacks then to a painful breakup which coincided with the events. The combination of both and working near World Trade made sleep very difficult. I was prescribed Ambien at the time, but was not properly instructed how to use it by my doctor. I therefore began to take too much of it, which worried me. So I then got into yoga and volunteer work to really shift the focus of my worries – to interacting in a positive environment as an alternative. This really helped me the most. Since then, I take Lunesta (which I personally prefer to Ambien) in moderation. . I also think acupuncture can really do wonders.

    May 1, 2008 at 16:40 | Report abuse | Reply
  10. Lauren R., USA

    Yes, I have experienced this many times, but it always ends up the same: the doctor says its the other way around, that my depression is causing the insomnia. Even when I point out the timetable–say, the insomnia started in September but the feelings of depression didn't start till December, for example, I get the "crazy poo-poo" treatment, you know, the one where the doctors dismiss every word said by a person who's ever had a positive diagnosis of depression in the past. And worse, the doctors never seem to want to prescribe sleeping aids, for fear, possibly based on fact from other depressed patients, that I might have used them to commit suicide. One more thing: I find your experience striking becasue I have ALWAYS had insomnia, even as a child, and despression, too, and can never seem to get any doctor to take seriously the very possibility that insomnia caused my depression, not the other way around.

    May 1, 2008 at 23:35 | Report abuse | Reply
  11. Cindy

    I am 23 years old and have dealt with isomnia since I was in high school. I consequently began suffering from anxiety. I would be exhusted during the day and be anxious about whether or not I would be able to sleep at night. I was very depressed and anxious for some years. I also dealt with self esteem issues leading to a severe eating disorder. Then I found something that took away my anxiety and helped me to sleep. Opiates. Rather than seeing my Dr. to deal with my sleeplessness and depression, I started taking pain pills when I was having severe attecks. This of course led to a full on addiction and a very painful time in my life. I lost my mother in the midst of my addiction and soon after hit rock bottom. I finally came to my father very sick, and I recieved the help that I needed. I am in treatment for my addiction and have a prescription to ambien. I feel like I am actually living life again. Working and going to nursing school full time. I do wonder whether all of this could have been prevented if my insomnia was treated from the beginning.

    May 2, 2008 at 11:33 | Report abuse | Reply
  12. linda

    I went thru some bad times...worse time of my life....i ended up with post traumatic stress syndrome and sleep deprivation as diagnosis...these events causing this lasted 9 months...following the nine months and re-locating to a different enviroment that caused these things to happen to me I did not ever want to go to sleep again...bad things had happened to me at night time during those nine months...but, even when i got into a safe enviroment and was no longer in any danger....i could not sleep....i did not want to sleep....i was placed on paxil and seroquel....gee...that seroquel was not good for me...i would take it....and still fight going to sleep even though i took high enough doses which made me super sleepy....my fear was greater than the medicine...i would eat and eat all night to keep myself awake and avoid sleeping...i had terrible memories during the day and would re-live events at night thru dreams or nightmares...it was terrible...i gained 50 pounds and would fall asleep with food in my mouth and almost choke! I requested to be taken off that medicine...and absolutely could not sleep...i was put on trazodone and hydroxyzine and this worked much better....it relaxed me more versus just making me sleepy...i got more sleep with that...but, still had nightmares...several each night...but that combination worked much better as far as actually getting more sleep...i was on that medication for several years...recently i decided i wanted to try again to sleep without anything...i did it! I found going off these medications actually did not impair my sleep today...i actually am sleeping better without them...i am finding that my normal time of sleep...around 10 pm is when i start actually getting sleepy on my own...it was the time i had taken the sleeping medications for the past few years and i think my body now knows to sleep around that time...i am still on the paxil...but plan to try doing without it soon...time has healed me more than any medications could...but, during the time i took them i really had no choice...going without sleep is not good for anything...being tired all the time makes people less able to deal with and sort thru the things during the healing process...so, I am much better today...it took me around 4 years to get back to my almost normal psychological well being that i was at prior to those events happening to me....i am thankful for the dr's who cared for me, listened to me, prescribed the medication to help me as i healed....and continue to heal...it sure feels good to feel good again!

    May 2, 2008 at 11:52 | Report abuse | Reply
  13. Shari

    Message to Melissa – My teen daughter was on Lexapro for depression for a year and had problems sleeping and was up all night. She just starting taking 50mg of Zoloft and is sleeping through the night. and feeling much better Check with your doctor. Sometimes you just need to try something else until you find what works for you.

    May 2, 2008 at 15:37 | Report abuse | Reply
  14. ken

    As a second semester medical student, I have found that the only way to survive the intensity of the program is to sleep less, which allows addtitional time to study. Not the most sound approach but it appears to be working. My concern is not getting at least 6+ hours of sleep will lead to episodes of depression/anxiety throughout the remainder of my educational training and beyond The adage that as "one ages one needs less sleep" is the farthest from the truth. I have found that on days when I slept less than 4 hours my ability to comprenend and dissiminate facts was severely challenged. Have tried various sleep aids(OTC, herbal, prescription meds) that knock me out but my brain is like Jello the next day. A glass of warm milk has been the best remedy for falling asleep that I have found without the negative morning side effects.

    May 2, 2008 at 15:56 | Report abuse | Reply
  15. Karen

    This article is so right on. I am an RN who suffered a major depression. I worked in an Operating Room and due to call, swinging shifts, just plain stress of the job and ill famiily members I began at night to have a rolling tape in my head that would not shut off. I thing innsomnia contributes to depression; however, after chemotherapy I have found my depression has contributed to my innsomnia. I am in counseling, take medication and have chemotherapy side effects still five years later. I also wear a CPAP because I was not breathing correctly at night. When I wear it I usually sleep. Recently, I was able to join a fitness center where I am beginning to work out in the gym and have a warm water pool routine. When I do not go...I ache and do not sleep. When I do go I find my mood lifts, I hurt less and I sleep better. I like walking the track because I have balance problems post chemo, have had many falls outside on pavement and I am very overweight. I hit 54 and saw the writing on the wall after a father who had diabetes and heart disease and a mom who was bionic from all the joints she had replaced. Both died at 76. I also find for me that faith is a very important factor and when I can't sleep I read my Bible or a boring article and guess what?.... I fall right off. It is nice to read everyone's comments.

    May 2, 2008 at 19:27 | Report abuse | Reply
  16. Joanne Ciccone

    insomnia hasbeen a part of me for a very long time. My first bouts of insomnia started when I was in the 8th grade (I am almost 60 now). It started out of nowhere. Suddenly I just couldn't sleep. I was awake till 2 or 3 am. 'we had a large volume of 1000 short stories and I distinctly remember going through that book figures why waste time if i just couldn't sleep. I have very fond memories of that anthology, but not of the insomnia or of falling asleep the next day during home economic class.

    I gradually worked out of that insomnia period, but it started to reassert itself as I gave birth to two sons. I supposed, being a mother and always being on alert to their noises influenced my quality of sleep then.

    My sons have been on their own for quite a while now, but this persistent insomnia still visits me most nights. I have taken various sleep medicines, including Trazadone, until just this week. I also am allowed to take Ambien every night although I try not to unless total sleeplessness sets in. I have come off Trazadone after taking it for years as it hasn't seemed to work for so long.

    I have always been a very light sleeper and wonder if just being aware of so many low noises around me (that lots of people wouldn't notice) has contributed to my sleeplessness. My hearing test shows that i am super sensitive to low level pitch noises.

    Of interest is that three years ago my husband and i flew across country from Virginia to Los Angeles to help drive our son and his college stuff cross country from LA to Virginia. In that 17 day trip I slept so much. I would go to bed around 8 PM and nap during the day in the cozy back seat of our car. I had no sleep troubles on this trip.

    I wonder if the total lack of any responsibilities during this cross country trip allowed my body and mind to relax to the point where sleep was desired and easy to obtain.

    To sum it up: Maybe our constant daily responsibilities, whether real or perceived, on a long term basis puts our mind in a constant groove (like an old LP record) of perpetual sleeplessness. To be able to get back to "sleeping like a baby", we need to find a way to make a new mind grove in our brain.

    May 3, 2008 at 07:13 | Report abuse | Reply
  17. Stephanie

    I used to be someone who could sleep easily, even though I had a history of depression and generalized anxiety disorder. Then I took a very stressful, sometimes dangerous job, that left me unable to fall asleep. I tried a variety of natural things, such as meditation, exercise, avoiding caffeine, and proper sleep hygiene. Nothing worked. So I tried Ambien, and would wake up after 2 hours. I would lay down exhausted, but my brain just would not shut off. I also tried Seroquel, but it left me feeling groggy and made me exceptionally hungry. I quit the job, but months later, the insomnia persists. Presently, I'm taking 100 mg of Trazodone and 0.75 mg of lorazepam every night. Most nights I can fall asleep, but some nights not. It is my goal to taper off the meds and eventually sleep on my own, but I can see that it's going to be a slow process. People who have never experienced weeks on 2 hours/night of sleep have no idea how awful and debilitating insomnia can be. I hate the recommendations for a warm bath and herbal tea. They have no idea how lousy this advice is for someone with insomnia.

    May 3, 2008 at 11:48 | Report abuse | Reply
  18. Joanne, Edmonton Alberta

    I've suffered from depression and insomnia for years, and have been on a whole lot of anti-depressants. However, they just seemed to mask the symptoms. I finally found a really good psychiatrist who specializes in talk therapy. It's taking a long time, but things are starting to come around, and best of all I've been off all medication for well over a year now! Yes, sometimes meds are appropriate, but sometimes the hard (and long) work of slogging through your issues with a professional can get rid of, not mask, the problem.

    May 5, 2008 at 17:49 | Report abuse | Reply
  19. Kristine

    I found out about 15 years ago that I have a sleep disorder, and it's a layered disorder. I went to all sorts of people, tried all sorts of drugs, and ultimately learned that drugs are no cure. I think a lot of people miss this. Most of the time our reasons for not being able to sleep are psychological in nature–whether it be anxiety, depression.....a person needs to learn to adequately cope and deal with things. I am a shining example that this is true, and the more stories I hear from frustrated people who are looking for the magic drug (that goes for depression as well) the more frustrated I feel for them. It's worth a little emotional pain to get a good night's sleep. TRUST me. And if the issues are anxiety/depression, a medical doctor will not have the expertise to prescribe correctly. Don't do that to your body. Go to someone who understands psychology as WELL as medical.

    May 6, 2008 at 16:32 | Report abuse | Reply
  20. Melissa Myers

    I first experienced insomnia as an 18 year old. I had gone away to college and after about three months just quit being able to sleep. I suffered severe insomnia (sleeping 1 night in 4) for about three weeks. My parents decided I needed to come home, and that really helped me. I switched to a local community college, was much happier, and my normal sleeping patterns resumed. I then experienced the same problem four years later when I graduated college. I suffered for three months before I was put on Serzone, which literally got me back sleeping and feeling good within one week. Now I am a 34 year old, and have been experiencing insomnia and anxiety again for the past two years, mostly due to many changes in my life.....marriage....moving across country twice.....two new jobs, etc. With all of these experiences I have learned that change is extremely difficult for me. When I am anxious about upcoming change, or unhappy, I quit sleeping. It's tough. I've always wished I was one of those people who thrive on change, but I don't, and I probably never will. I have seen a therapist and taken ambien. They both help me a great deal.

    May 6, 2008 at 17:54 | Report abuse | Reply
  21. Katy

    I've always been a light sleeper, and I usually sleep with a fan on to smooth out the noise bumps: a creak in the floorboard, a tire screech, a neighbor's phone ringing. Most often I used earplugs. I was diagnosed with severe depression a number of years ago. But it was only recently I was prescribed Trazadone (100mg). It made me sleep "hard" and I was uncomfortable with it at first. But the doctor insisted I try it a little longer, and soon I was not waking up every couple of hours, or starting at every little noise, but I was sleeping a full night's sleep every night. And the more uninterrupted, quality sleep I got, the better I felt. Imagine that. Now I get it: sleep, is truly a " balm of hurt minds" as the Bard so rightly put it. And as for the possible addiction: I'll gladly trade that nightly horror for this addiction, because I've found that I'm really mostly addicted to a good night's sleep. If you have asthma and you can't breathe, would you stop using your inhaler because you might become addicted?

    May 7, 2008 at 03:49 | Report abuse | Reply
  22. Katy

    Incidentally, I also use a homeopathic OTC product called Calms that helps turn down the volume inside my head, for anyone who needs a non-doctor's-office-visit solution. Anywhere vitamins are sold.

    May 7, 2008 at 03:54 | Report abuse | Reply
  23. janet

    I find when I cannot sleep that praying and concentrating on the words rather then just repeating them by memory can be very helpful. You might also want to try a CD with sound effects to aid in sleep or a childrens lullaby CD with soothing music. I also have a room air cleaner and the drooning sound of that is helpful... I have not had a problem sleeping in many years except ocassionaly. But I do remember as a younger women not being able to sleep due to bills I could not pay, and bill collectors calling constantly. Bankruptsy cured that. God Bless

    May 14, 2008 at 11:10 | Report abuse | Reply
  24. gabriel_g

    I have suffered from severe-chronic insomnia all my life, have a history of severe depression-anxiety, a 'chicken an egg' case i believe..every night i wake at around 2 am, take something to make me drowsy, sleep until 4, then wake again and nothing will get me to sleep..weird thing is recently have relaxed and overcome depressive feelings about this problem ..I believe in such cases the brain is switched on to HIGH AROUSAL, possibly due to excess cortisol (stress hormone which is dissolved by sleep itself) and even curing the anxiety and depression, which i have done recently doesn't stop the insomnia...to be honest it wears me down and think if it continues i will not be able to cope, Heath Ledger, Marilyn Monroe etc etc..all died as a result of bad insomnia and desperately trying to overcome it with a combination of med's..hope i don't go the same way.

    August 27, 2008 at 02:32 | Report abuse | Reply
  25. gabriel_g

    another thing, the cost of insomnia is still not truly appreciated, constant lack of sleep wears down the immune system and makes it more likely you'll get chronic disorders such as Chronic Fatigue Syndrome, post viral illnesses etc etc.. a famous doctor in the 1920's who had some success with insomnia said that 'insomnia is like a vampire that drains you of your vitality when awake and peace when trying to sleep, it is more responsible for suicide or reckless/dangerous behaviour leading to death than it's related disorders [eg depression]'

    August 27, 2008 at 02:38 | Report abuse | Reply
  26. Maya Bailey

    Anxiety and depression is one hell of a nasty disease. even if you have everything but if you have clinical depression, you are still nothing.,."

    May 1, 2010 at 09:53 | Report abuse | Reply
  27. Carpet Tiles ·

    anxiety depression is really an evil disease, it can really worsen your great life "

    November 7, 2010 at 11:50 | Report abuse | Reply
  28. Michelle Vega

    This is something I also struggle with. Here's a blog article that sums it up for me written from the point of view of someone who struggles with this and what actually goes through their minds during episodes of insomnia. I think it would be useful for the medical community to compare what people are thinking when they cant sleep and how it relates (or doesn't relate) to depression. Maybe some people are "working" or "excited" and have no depression. Or maybe they are. Maybe only people with disparaging thoughts are depressed. Or maybe not. It could be interesting to discover what types of thoughts are associated with mental illness. http://mormon-with-depression.blogspot.com/?m=1

    November 6, 2013 at 05:39 | Report abuse | Reply
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