By Nicole Roder, LCSW-C, DBT-LBC,  DBT Therapist

How much sleep did you get last night? If you are like one-third of American adults, the answer is probably “not enough.” According to the U.S. Centers for Disease Control and Prevention, the problem is even worse for adolescents. Between 70.1 percent and 84.3 percent of American high school students get less than the recommended amount of sleep. And among children, between 25.2 percent and 52.5 percent don’t get enough sleep.

 

We all know this is a problem. Sleep deprivation makes us feel cranky, fatigued, and downright miserable. But missing out on sleep is much more than a painful inconvenience. It can have a significant impact on your mental and emotional health. 

So why is sleep important? And how does it affect your mental health?

How Sleep Affects Mental Health

There are many mental health benefits to a good night’s sleep. While you snooze, your body engages in a number of essential functions to keep your brain working properly. 

For example, did you know that your brain accumulates waste throughout the day? According to a paper from scientists at the National Institute of Health, every night while you sleep, your brain clears out toxic cellular garbage known as beta amyloid. This effectively “clears the cobwebs” from your brain, allowing you to function normally the next day.

In addition, several studies, including this one from the Journal Physiology, have shown that during some stages of sleep, the brain is able to turn off certain neurotransmitters like norepinephrine and serotonin, which are essential to emotional health. Turning off these neurotransmitters allows their receptors to “rest” so that they can be more sensitive during the day and support a healthy mood. 

During sleep, your body engages in other biological processes as well. Your brain stores new information, your nerve cells communicate and reorganize, your body repairs cells and restores energy, and you release hormones that are essential for growth and health.

In kids and adolescents, sleep is also a key factor in healthy growth and brain development.

All of this in combination means that a good night’s sleep significantly improves your brain and body functioning, which improves your mood, learning, and problem solving skills. It also helps you pay attention, make wise mind decisions, and enhance creativity.

 

The Psychological Effects of Sleep Deprivation

So if getting enough sleep has such a positive impact on your mental wellness, does that mean the opposite is true as well? Can sleep deprivation negatively impact your mental and emotional health? Yes it can. 

There are short term and long term sleep deprivation effects. In the short term, too little sleep makes you more vulnerable to intense emotions. You’ve probably noticed that the little things that usually feel slightly annoying can cause you to feel intense anger, sadness, or anxiety when you’re over-tired. Poor sleep hygiene reduces your concentration, increases irritability, and makes your body tired. All of that combines to make you more vulnerable to stress and emotional crises.

This is because sleep deprivation causes changes in your brain’s molecular biology. It physically alters certain parts of your brain, including the hippocampus, amygdala, and prefrontal cortex. These areas are responsible for learning, memory, and emotion. 

The prefrontal cortex, in particular, controls a lot of your executive functions. So if you are sleep deprived, you may have difficulty making decisions, coping with change, getting started on or completing a task, regulating your emotions, and controlling your behavior.

In the long term, sleep deprivation can cause much more serious mental health problems, like depression, suicide, and excessive risk-taking.

Kids and teens who don’t get enough sleep might feel angry, act impulsively, have frequent mood swings or feel depressed. They’re also likely to have problems with attention, making friends, and achieving in school.

 

Sleep and Depression

Nearly every mental health disorder is linked to problems with sleep. This is especially true for mood disorders, like depression. People with insomnia–difficulty falling or staying asleep–are ten times more likely to develop depression than people who regularly get enough sleep. Like we mentioned above, poor sleep can cause difficulty regulating emotions, which can leave you more vulnerable to depression in the long term.

It’s also true that depression can cause insomnia. Sleep problems can also be a side effect of some of the medications used to treat depression.

The relationship between sleep and depression is kind of a chicken and egg scenario. Which comes first?

Many studies have found that people with depression are more likely to have problems with sleep quantity and quality. Nearly 90 percent of patients with depressive disorders say they have difficulty sleeping. About two-thirds of people having a major depressive episode have insomnia. Approximately 40 percent of depressed patients say they have trouble falling asleep, staying asleep, or waking up too early. 

And about 15 percent of people with depression have hypersomnia, which means they have trouble staying awake during the day even if they got enough sleep the night before. 

 

How Can You Improve Your Sleep (And Your Mental Health!)?

First of all, it’s important to practice good sleep hygiene. “When my clients tell me they are having difficulty sleeping, I tell them sleep is a building block for mental wellness, and prioritizing sleep will have numerous benefits,” says Rebecca Blake, LCSW-C, DBT-LBC, Co-Director of Gladstone’s DBT Program. “I think it’s important to evaluate their sleep hygiene and identify different things to try. Implementing sleep hygiene tips can make a real difference in our sleep quality and quantity.”

According to Dialectical Behavior Therapy (DBT), these are the steps to good sleep hygiene:

• Develop and follow a consistent sleep schedule, even on weekends. And no naps longer than 10 minutes!
• Don’t use your bed in the daytime to watch TV, work, or play with your phone.
• Avoid caffeine, nicotine, alcohol, heavy meals, and exercise late in the day.
• At bedtime, keep the room dark and quiet and the temperature cool and comfortable.
• Give yourself 30-60 minutes at most to fall asleep. If it doesn’t work, evaluate whether you are calm, anxious, or ruminating.
• DO NOT CATASTROPHIZE. Remind yourself that staying awake is not a catastrophe. There are skills you can use that will help.

So, let’s say it’s been an hour and you’ve evaluated your mental state. Now what?

If you are calm but wide awake, DBT wise mind says to get out of bed and go to another room. You can read a book, have a light snack like an apple, or engage in another calming activity. Once you feel sleepy, go back to bed and try again.

If you are anxious or ruminating, you can try one of the following:

• Use the cold water TIP skill, then get right back in bed and do the paced breathing TIP skill. 
• Do the 9-0 meditation practice: Take a deep breath. When you exhale, count “9.” Take another breath. When you exhale count “8.” Continue breathing deeply and count down to “0,” then start over again at “9.” Repeat until you fall asleep.
• Be mindful of how the rumination feels in your body.
• Reassure yourself that the ruminations are just “middle-of-the-night” thinking, and you’ll feel different in the morning.
• Read an emotionally engrossing novel for a few minutes. Then close your eyes and try to continue the novel in your head.
• If the rumination doesn’t stop, here are the rules–If it’s solvable, solve it now. If it’s not solvable, practice the DBT skill, cope ahead. 
• If nothing else works, close your eyes and listen to public radio on low volume.

 

If Sleep Problems are Having a Negative Impact on Your Mental Health, See a Professional

At Gladstone Psychiatry and Wellness, we offer medication management, psychotherapy, and DBT Therapy, and we are in network with most major insurance plans. Call us today to schedule an appointment: 443-708-5856.