Depression and Sleep Problems: How to Improve Without Medication

The agony of insomnia affects about 10 to 35 percent of us. Once sleep loss starts, it becomes a psychological and physical battle.

It can feel like the myth of Sisyphus, who night after night pushed a large weighted stone up a hill only to see it roll down again. But there are ways to reduce the weight and size of this “stone.”

Research and clinical experience show that insomnia is associated with reduced quality of life as well as depression. In turn, depression can lead to sleep problems. Insomnia can also lead to feelings of anxiety, frustration, hopelessness, exhaustion, and an inability to concentrate.

The more we look for sleep, the less we find it. Let go of the pursuit and focus on doing what you can to improve the situation.

Calm Your Mind

You can take actions to improve the quality of your nighttime rest. In the moments of your sleeplessness and distress, you can work to calm your mind and body through the use of conscious relaxation, cognitive therapy, and dialectical behavior therapy techniques. I recommend that you first consult your therapist, psychiatrist, or doctor to ensure that you have no psychological issues, medical complications, or medication interactions that could be causing your difficulties with sleep.

When it comes to sleep hygiene, studies show that a bedtime routine that includes a period of time to unwind can be effective. A common practice is to turn off all electronics after 9:00 pm and then get dressed and washed up for the night. Once ready for bed, do a relaxation exercise and spend 30 minutes reading a book before finally closing your eyes. If you are still struggling to sleep, try to reduce the amount of time you toss and turn by getting out of bed and going to a quiet, comfortable spot in another room or area of the bedroom to read or do more relaxation exercises.

Focus on the Body

If you have consistent trouble calming your mind, it can be more effective to focus on the body first. You can use relaxation techniques, breathing exercises, and somatic therapy techniques. One example of these techniques is to focus on your breath and body rather than on negative thought patterns and frustration. To do so, you breathe slowly in through your nose and out through your mouth. This simple exercise will automatically slow down your breathing and help your body relax. Then, after a few breaths, breathe through your nose for both the inhalation and exhalation, and begin to follow your abdomen’s rise and fall. This is called “riding the wave” of your breathing. Even if you do not fall asleep, your body is at rest.

To work with the mind, cognitive therapy and DBT techniques can be effective in challenging negative thinking and inserting reaffirming statements. A challenging statement could be, “Even though I am struggling to fall asleep, I can work to calm my mind and body the best I can.” Or, “I am struggling with sleep, and it will not last forever. I can be patient.” You want to validate your feelings, state the facts, and reassure yourself that you are doing the best that you can. Keep a log of your sleep activity, helpful ways you cope with negative thinking, and your relaxation exercises — all helpful for you as well as your health care professionals.

Lara Schuster Effland, LCSW, is the Vice President of the Mood and Anxiety Program and Residential Services at Insight Behavioral Health Centers of Chicago. Ms. Effland clinically specializes and trains others in dialectical behavior therapy, mindfulness-based therapies, exposure and response prevention, and trauma treatment.