Why Am I Depressed Only at Night?

The Link Between Depression and Nighttime Rumination

person on a computer late night
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In the United States, an estimated 16.2 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. 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.

Symptoms of Depression

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
  • Irritability
  • Feeling sad and/or anxious
  • Feeling hopeless
  • Crying
  • Restlessness
  • Feeling isolated or lonely
  • Feeling worthless, guilty, or helpless
  • Difficulty concentrating
  • Suicidal thoughts or attempts, or thinking about death

Causes of Nighttime Depression

There are several factors that may lead to worsening feelings of depression at night.

Rumination

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 most of us. End-of-the-day fatigue 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.

Light at Night

There have been numerous studies on the link between exposure to light at night and depression. One study showed a correlation between low-level bedroom light exposure during sleep and developing depression symptoms in elderly adults, though light exposure was more than likely 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.

Circadian Rhythm Disruption

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.

Your Chronotype

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 percent lower risk of developing depression than the intermediate women, while the night owls had a 6 percent higher risk. The results clearly showed that the more strongly a woman identified as being a night owl, the higher her likelihood of developing depression.

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.

Coping

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 prayers. Basically what you're trying to do is to 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 that nothing can be done about the situation. Instead, take a moment when you're thinking clearly and identify at least one step you can take to overcome your problems. This can even be something as simple as calling a friend to try and brainstorm a solution. This helps 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 novel 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.

Therapy for Rumination

If self-help strategies like 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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