Living with depression is not easy. It can be difficult to be present while experiencing depression. While some people experience depressive feelings around the clock, others are overcome with sadness at different points in the day. 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. If you are suffering with depression, consider getting treatment today by going through a therapy matching service like Advekit.
Why is depression often worse in the evening? For most people, the reason is the lack of distractions. Often throughout our day, we are consumed by all the things and people that need our attention, and come nighttime, we are left to confront our own thoughts. Other reasons depression, or feeling sad, is often worse in the evening include:
exhaustion that makes negative emotions harder to deal with
loneliness, which can be intensified as compared to during the day when we are often surrounded by other people such as workmates and family
feelings of disappointment in productivity or accomplishment from the day
Let’s explore the causes, and ways to combat low feelings and clinical depression that feels worse at night.
Sleep and mental health are closely connected. This is why depression that feels worse at night can impact sleep, which in turn affects mental health. Sleep deprivation affects your psychological state and mental health. And, those with mental health problems are more likely to have insomnia or other sleep disorders, which only exacerbate the mental health issues. It’s a vicious cycle involving depressive symptoms and sleep disturbance.
Americans are notoriously sleep deprived, but those with psychiatric conditions are even more likely to be yawning or groggy during the day, and perhaps irritable and unable to cope by the end of the evening because of poor sleep. Chronic sleep problems affect 50 to 80 percent of patients in a typical psychiatric practice, compared with 10 to 18 percent of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety disorder, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).
Traditionally, clinicians treating patients with psychiatric disorders like depression have viewed insomnia and other sleep disorders as symptoms. But, studies in both adults and children suggest that sleep problems may raise risk for, and even directly contribute to, the development of some psychiatric disorders. This research has clinical application, because treating a sleep disorder may also help alleviate symptoms of a co-occurring mental health problem.
But, neuroimaging and neurochemistry studies suggest that a good night's sleep helps foster both mental and emotional resilience, while chronic sleep deprivation sets the stage for negative thinking and emotional vulnerability.
During "quiet" sleep, a person progresses through four stages of increasingly deep sleep. Body temperature drops, muscles relax, and heart rate and breathing slow. The deepest stage of quiet sleep produces physiological changes that help boost immune system functioning.
The other sleep category, REM (rapid eye movement) sleep, is the period when people dream. Body temperature, blood pressure, heart rate, and breathing increase to levels measured when people are awake. Studies report that REM sleep enhances learning and memory, and contributes to emotional health — in complex ways.
Although scientists are still trying to figure out all the mechanisms, they've discovered that sleep disruption — which affects levels of neurotransmitters and stress hormones, among other things — wreaks havoc in the brain, impairing thinking and emotional regulation. In this way, insomnia may amplify the effects of psychiatric disorders, and vice versa.
Serotonin is a naturally occurring substance that functions as a neurotransmitter to carry signals between nerve cells throughout your body. Most commonly, people are aware of serotonin's role in the central nervous system. In the brain, serotonin helps with mood regulation and memory.
Serotonin's effects in the brain regulate your mood. It is often called the body's natural "feel-good" chemical. Serotonin's influence on mood makes it one of several brain chemicals that are integral to your overall sense of well-being. The neurotransmitter's effect on mood is also why it's often a target of medications that are used to treat depression, anxiety disorder, and other mood disorders. For example, serotonin plays a prominent role in treatments with the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs).
The exact nature of serotonin's role in sleep has been debated by researchers, but it's believed to influence when, how much, and how well you sleep. Serotonin does not regulate these tasks alone; other neurotransmitters like dopamine also play a key role. A hormone called melatonin is also critical to the proper functioning of your sleep cycle. Your body needs serotonin to make melatonin, so not having enough of the neurotransmitter (or having too much of it) can affect the pattern and quality of your sleep.
Your brain has specific sections that control when you fall asleep, regulate your sleep patterns, and wake you up. The parts of your brain that are responsible for regulating sleep also have serotonin receptors. The serotonin-melatonin relationship might also contribute to sleep disruptions like insomnia that are common in people with depression.
Depression and other mood disorders that are linked to serotonin are multifactorial, meaning there is more than one reason they occur. Having low serotonin levels is not, on its own, enough to cause depression. Low levels can, however, contribute to depressed moods, disrupted sleep, poor digestion, and other issues. To learn more, read our article answering the question, “How does depression affect the brain?”
There's no single cause of low serotonin levels, but it typically occurs for one of two reasons: not having enough serotonin or inefficient use of the serotonin you have. In the first scenario, you have low levels of serotonin because your body is not producing enough to maintain normal levels. Your body might not be able to produce enough serotonin because of other factors, such as nutritional and vitamin deficiencies.
Many people feel they're only depressed at night and fine during the day. This can be confusing for anyone. The thing about depression, though, is that it isn't something that happens to you just at night. Though feelings of depression might be worse at night, it’s probably affecting you in some way during daytime hours if you have clinical depression. Exactly what does depression feel like? Here are some of the symptoms that could indicate that your feelings of depression may actually be clinical depression:
feelings of sadness
feeling worthless or guilty
changes in weight or appetite
changes in sleep patterns
loss of pleasure in things once enjoyed
feeling restless or agitated
If you are suffering with these symptoms, we have written in detail about why it is important to identify and treat clinical depression as soon as possible.
Mental illness or symptoms of depression can seem magnified at night. During the day, you may be busy with work and other necessary activities. But at night, you probably have fewer things distracting you from negative thoughts and emotions. So, depression or negative feelings can make you feel worse in the evening.
If you’re finding yourself feeling down in the evening and into the night, you might need to alter your lifestyle or find different ways of coping with negative feelings.
When you’re feeling poorly, it’s worth it to try 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. Pivot to a positive activity to enjoy for the evening and begin to relax after acknowledging the negative feelings and consciously setting them aside as they don’t serve you in that moment.
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. This isn’t a recommendation to avoid dealing with your feelings or real issues. It’s more of a way to move yourself away from unproductive negative feelings, or to get yourself unstuck from a loop of bad feelings or ideas. This may include gentle exercise, reading, playing an instrument, getting creative, watching a movie 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 ones at bay.
Consuming large amounts of alcohol or caffeine at night, or even during the day, can actually amplify feelings of depression, as well as keep you awake. Instead of reaching for a late afternoon coffee or cocktail at happy hour, try drinking some water or a herbal tea. This way you will be hydrating your body, and more likely to achieve an uninterrupted sleep.
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 ensure that you both fall and stay asleep. It is much harder to manage the symptoms of depression if you are sleep deprived.
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. Activate night mode on your electronics at least one hour prior to sleeping as 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. It’s also a good practice to try and 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 recognize when it is time to sleep.
Regular mindfulness meditation practice has an array of benefits for sufferers of depression. It’s a practice that can be used as a tool in moments of crisis, or extreme anxiety. There are many mindfulness meditation exercises and apps available out there for beginners.
When diet and lifestyle changes aren’t proving to alleviate the overwhelming negative feelings at night, it might be time to seek professional help. If you have already been diagnosed with clinical depression or another mental illness, your disease may be exacerbated at night and a therapist will be able to help pinpoint the issue. If you have not been diagnosed, a therapist will be able to identify whether or not your symptoms are more serious and decide what the best course of treatment could be.
If you’re feeling unusually depressed at night, Advekit can help match you with a therapist for depression today.