An Overview of Diurnal Mood Variation

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While it’s technically not a separate form of depression, diurnal mood variation is sometimes referred to as “morning depression.” Diurnal mood variation doesn't appear as a unique entry in the Diagnostic and Statistical Manual (DSM-5), though it's considered a hallmark symptom of severe clinical depression (specifically the melancholic subtype). 

People who experience diurnal mood variation typically feel the symptoms of melancholic depression most intensely in the morning and notice a gradual improvement as the day goes on. 

For those who have mild depression and other mood disorders, it's not uncommon to experience the opposite: a person may have more energy and a better mood earlier in the day, with symptoms of depression being worse at night.

Studies have also shown that people who don’t have depression may also experience similar fluctuations in mood, however, they usually report these fluctuations are in response to certain situations or influences.

People who are depressed may feel there is no clear reason for the mood changes they experience at certain times of the day, and unlike people who do not have depression, typically feel they are unable to alter them. 

While there are some similarities, diurnal mood variation differs from mood changes that occur with the change of seasons. It's also not the same as seasonal affective disorder (SAD), which is typically influenced by the time of year rather than the time of day. 

Symptoms

People who have depression with diurnal mood variation have a low mood and feel that their depression symptoms are at their worst in the morning, but they seem to get better throughout the day. 

In addition to characteristic clinical depression symptoms like profound sadness and low mood, people with diurnal mood variation may also:

  • Sleep longer than normal (hypersomnia)
  • Have trouble waking up or getting out of bed
  • Feel extremely tired and lethargic upon waking, creating difficulty completing daily tasks or a morning routine (showering, dressing, making breakfast)
  • Have problems focusing and poor concentration
  • Be irritable or easily frustrated
  • Have little to no enthusiasm or interest in the day ahead (even if pleasurable activities are planned)

Causes

As with the causes of depression, the driving force behind diurnal mood variation isn't completely understood. One theory researchers are exploring that seems likely is that the variations occur in response to circadian rhythms.

Your circadian rhythm is the natural pattern of variations in wakefulness, body temperature, blood pressure, and hormone levels that your body goes through during a 24-hour day.

Even people who don't have a mood disorder can experience sleep trouble based on changes in their circadian rhythm, so it makes sense that these irregularities could contribute to symptoms of depression. 

Researchers know that people who have depression are especially vulnerable to irregularities in their internal clock and sleep patterns. A person’s mood can be affected even when they knowingly alter their sleep patterns, such as by staying up later or rising earlier to accommodate work or social activities. 

Mood swings may be instigated by changes to external light and dark cues, such as the timing of sunrise and sunset. These factors can also influence other depressive disorders, such as SAD.

On a positive note, research also suggests that making changes to try to stabilize the relationships between such activities as sleep, wakefulness, eating, exercise, meal times, and the timing of medication can help decrease the impact of diurnal mood variation.

Diagnosis

Diurnal mood variation doesn’t have its own specific diagnostic criteria. People who experience it are usually diagnosed with major depression or a similar condition. For example, some people with bipolar disorder experience similar symptoms and may be initially misdiagnosed with unipolar depression.

A thorough assessment by a trained professional is vital to making the distinction, as these conditions require different treatments. 

While your doctor or psychiatrist is evaluating you for depression or another mental health disorder, they will often ask questions about your sleep habits, as well as how your mood changes throughout the day.

For example, they may ask if you are sleeping more or less than usual, how well you are sleeping, and if you feel better in the morning than in the afternoon or evening.

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Treatment

If you experience diurnal mood variation, start by talking to your doctor or mental health professional about your options for treating the specific type of depression you have, including different forms of therapy, medications, or a combination of interventions. 

It’s unclear if depression causes circadian rhythm disturbances or if disruption of one’s circadian rhythm contributes to depression. In either case, you may also find it helpful to try making some lifestyle changes to see if your symptoms improve.

  • Stick to a sleep schedule. Go to bed at the same time each evening and wake up at the same time each morning. 
  • Don't take naps. If you can’t do without, try to keep naps short. Avoid taking one late in the day, as it may affect your sleep at night.
  • Curate a sleep space. Make your bedroom conducive to rest and relaxation. Keep it quiet, cool and dark. Don't do any activities in your bed other than sleep or have sex. Your brain associates your bed with what you do there. If you watch TV, do work on your laptop, or play games on your phone in bed, it becomes associated with these activities. 
  • Dim the lights. The light from your computer, TV, and phone screen can trick your brain into thinking it's morning, making it more difficult to fall and stay asleep. Turn off screens at least one hour before you head to bed.
  • Avoid stimulants. Don’t drink alcohol or caffeine-containing coffee, tea, or hot chocolate too close to bedtime. Tobacco can also contribute to poor sleep quality—another reason to try to quit smoking.  
  • Get physical. Regular exercise helps regulate mood and can improve your sleep, but timing is key. A good workout can be stimulating, so some people prefer exercising in the morning. If you’re not an early riser or your schedule only leaves time for the gym later in the day, just try to wrap up your workout at least four hours before it’s time to tuck in.
  • Optimize your mental energy. If you have any flexibility to your schedule, try to avoid making appointments, taking meetings, or working on big projects earlier in the day. Studies have even suggested going to therapy later in the day (when you may feel more mentally up for a session) can be beneficial. 

Light Therapy

Phototherapy may also help people with morning depression. Also known as light therapy or lightbox therapy, phototherapy involves shining full-spectrum bright light that mimics natural outdoor light directly into your eyes. During photography, you will either sit in a lightbox or be fitted with visor designed to expose your eyes to artificial light that mimics natural daylight.

Light therapy is used to treat an array of medical and mental health conditions, including bipolar disorder, schizoaffective disorder, premenstrual syndrome, and sleep disorders like insomnia.

Medications & Supplements 

There are several different classes of antidepressant medications that can be prescribed for depression. Research has suggested that some medications may be more effective at addressing morning depression than others.

Melatonin is a hormone that helps regulate your body's circadian rhythm. Some people find taking a melatonin supplement improves their sleep patterns and may help them cope with symptoms of morning depression.

Research has suggested that a specific atypical antidepressant called agomelatine, a synthetic form of melatonin, could be an effective treatment for depression with diurnal mood variation.

However, as of 2019 agomelatine is not available in the United States. The drug is available in the United Kingdom where it is sold under the brand name Valdoxian.

A Word From Verywell

If you have depression, you may notice your symptoms seem worse at certain times of the day. When symptoms are worse in the morning and gradually improve as the day progresses, it’s referred to as diurnal mood variation. While it’s not a diagnosis in and of itself, it can be a symptom of major depression (specifically melancholic depression) though it can also be confused for bipolar disorder. It’s important that you talk to your doctor or a mental health professional if you have any symptoms that are impacting your daily life. While the relationship between mood disorders and diurnal mood variation isn’t fully understood, it’s likely related to your circadian rhythm. Certain medications, therapies, and lifestyle changes may be able to help you cope with the fluctuations in your mood throughout the day.

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