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Insomnia can worsen anxiety, depression and other mental health problems

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Insomnia can worsen anxiety, depression and other mental health problems

It started with mild anxiety. Emily, who asked to be identified by her first name because she was talking about her mental health, had just moved to New York after graduating to start a marketing job at a large law firm. She knew it was normal to feel a little nervous. But she wasn’t prepared for what came next: chronic insomnia.

With only three or four hours of sleep, her anxiety soon increased: at 25, she was “very nervous all the time. A disaster”. When a lawyer at her firm yelled at her one day, she suffered the first of many panic attacks. At a doctor’s suggestion, she tried a sleeping pill, hoping that it would “reset” her sleep cycle and improve her mood. But it does not work.

Americans suffer from chronic sleep deprivation, with one-third of adults in the country reporting sleeping less than 7 hours a night. Teenagers have it even worse: About 70 percent of high school students don’t get enough sleep on school nights. And that has a profound effect on mental health.

An analysis of 19 studies found that while sleep deprivation worsened a person’s ability to think clearly or perform certain tasks, it had a greater negative effect on mood. And when the National Sleep Foundation conducted a survey in 2022, half of those who reported sleeping less than 7 hours each weekday also reported having depressive symptoms.

And it’s important to talk to a doctor, to rule out any physical problems that need to be treated, such as a thyroid disorder or restless legs syndrome. But this is only part of the solution (Illustrative image Infobae)

Some research even indicates that addressing insomnia may help prevent postpartum depression and anxiety. It is clear that sleep is important. But despite the evidence, there is still a shortage of psychiatrists or other doctors trained in sleep medicine, leaving many to train on their own.

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What happens to our mental health if we don’t get enough sleep and what can we do about it? How do sleep problems affect your mood? When people have trouble sleeping, it changes the way they experience stress and negative emotions, said Aric Prather, a sleep researcher at the University of California, San Francisco, who treats patients with insomnia.

“And, for some, this can have a feedback effect: feeling bad, ruminating, getting stressed can impact our nights,” he said. Carly Demler, a 40-year-old stay-at-home mom in North Carolina, says she went to bed one night and couldn’t fall asleep. From that point on, she would get up at least once a week until 3:00 or 4:00 a.m. She continued like this for more than a year. She became irritable, less patient and much more anxious. Hormonal blood tests and a sleep study at a university laboratory offered no answers. Even after taking Ambien, she was still awake most of the night.

“It was like my anxiety was a fire that somehow jumped over the fence and ended up spreading throughout my nights,” she said. “I felt like I had no control.” In the end, cognitive behavioral therapy for insomnia (CBT) provided Demler the most relief. Studies have shown that CBT is more effective than sleep medications in the long term: up to 80 percent of people who try it notice improvements in their sleep.

Americans suffer from chronic sleep deprivation, with one-third of adults in the country reporting sleeping less than 7 hours a night. Teenagers have it even worse (Pxhere)

Demler learned not to “lie down in bed and despair.” Instead, she gets up and reads so as not to associate her bedroom with anxiety, and then she returns to bed when she is tired. “The feeling of gratitude I have every morning when I wake up and feel well-rested, I don’t think it will ever go away,” she said.

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“It’s been an unexpected silver lining.” Adults need between 7 and 9 hours of sleep per night, according to the Centers for Disease Control and Prevention. Teenagers and young children need even more. It’s not just about quantity. Sleep quality is also important. If it takes you longer than 30 minutes to fall asleep, for example, or if you regularly wake up in the middle of the night, it’s harder to feel rested, regardless of the number of hours you spend in bed.

But some people “tend to think they function well even if they feel sleepy during the day or have a harder time concentrating,” said Lynn Bufka, a clinical psychologist and spokesperson for the American Psychological Association. Ask yourself how you feel during the day: are you more impatient or do you get angry more quickly? Do you have more negative thoughts or feel more anxious or depressed? Do you find it more difficult to cope with stress? Do you find it difficult to do your job effectively? If so, it’s time to take action.

In the end, cognitive-behavioral therapy for insomnia (CBT) was what relieved Demler the most (Illustrative image Infobae)

We’ve all heard how important it is to practice good sleep hygiene, using daily habits that promote healthy sleep. And it’s important to talk to a doctor, to rule out any physical problems that need to be treated, such as a thyroid disorder or restless legs syndrome. But this is only part of the solution. Conditions such as anxiety, post-traumatic stress disorder and bipolar disorder can make it difficult to sleep, which can also exacerbate the symptoms of the mental health problem which, in turn, makes it difficult to sleep well.

“It becomes a very difficult cycle to break,” Bufka said. Some medications, including psychiatric medications such as antidepressants, can also cause insomnia. If the trigger is a medication, talk to your doctor about changing it, taking it earlier or lowering the dose, said Ramaswamy Viswanathan, a professor of psychiatry and behavioral sciences at the State University of New York Downstate Health Sciences University and new president of the American Psychiatric Association.

The cycle can also affect those without mental disorders because worries worsen sleep and lack of sleep worsens mood. Emily, who worked at a large law firm, worried so much about her sleeping problems that she didn’t even want to get into bed. “You actually start to believe you’re never going to sleep,” she said.

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“The adrenaline rises so much that it is impossible for you to achieve it.” Eventually she found Say Goodnight to Insomnia by Gregg D. Jacobs. The book, which uses CBT techniques, helped Emily reframe the way she thinks about sleep. She began writing down her negative thoughts in a journal and changing them to positive ones.

Some people “tend to think that they work well even if they feel sleepy during the day or have a harder time concentrating” (Illustrative Image Infobae)

For example: “What if I can never fall asleep again?” became “Your body is made to sleep. If you don’t get enough rest one night, you’ll eventually end up doing it.” These exercises helped her stop catastrophic thoughts.

When he started sleeping again, he felt “much happier.” She is now 43 years old, and although almost two decades have passed since her move to New York, she continues to resort to the techniques she learned and always carries the book on her trips. She stated that if she doesn’t sleep well away from home, she catches up on sleep “for a few days if necessary.” And she said that now she is “a lot more relaxed about it.”

*Christina Caron is a Times reporter covering mental health ©The New York Times

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