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Why a lack of sleep makes us depressed ... and what we can do about it

The physical symptom that links the lack of sleep and depression may be inflammation.

Historically, insomnia has been thought of as secondary to other disorders such as depression. The idea was that you became depressed – and that your sleep got messed up as a consequence. This might involve difficulty falling asleep, excessive time awake at night or waking up earlier than hoped.

This may make sense to those who have experienced depression and found that thoughts of distressing events such as of a deceased loved one, or previous failures, keep them awake at night. The possibility that depression leads to insomnia is also consistent with research in which I have been involved – where we found that adults with insomnia were more likely than others to have experienced anxiety and depression earlier in life.

But could things really be the other way around? Could poor sleep be making you depressed? Over the past decade or so it has become increasingly clear that disturbed sleep often comes before an episode of depression, not afterwards, helping to do away with the notion that sleep problems are secondary to other disorders.

This is not too hard to relate to either – just think about how you feel after you have slept poorly. Perhaps you feel tearful or snap at those around you. The literature seems to back up the idea that our ability to regulate our emotions is reduced after a bad night’s sleep. Insomnia has also been shown to predict depression defined according to diagnostic criteria.

So why does poor sleep lead to depression? Lots of different mechanisms have been proposed. To give just a few examples, let’s start by thinking about our behaviour. I, for one, am more likely to cancel an evening out with friends or an exercise class after a poor night’s sleep. This could be part of the problem, as such events are exactly those that may help to keep depressive symptoms at bay.

If we think about what happens to the brain when we miss sleep, there are clues as to why sleep and depression are linked. One study on this topic focused on an area of the brain called the amygdala. This is an almond-shaped structure located deep in the brain that is believed to play an important role in our emotions and anxiety levels.

It was found that participants who had been sleep deprived for approximately 35 hours showed a greater amygdala response when presented with emotionally negative pictures when compared to those who had not been sleep deprived. Interestingly, links with parts of the brain that regulate the amygdala seemed weaker, too – meaning that the participants were perhaps less able to control their emotions. Such findings could help to explain how poor sleep may actually cause difficulties such as depression.

Inherited insomnia

Over the years, my own work has taken a behavioural genetic perspective in an attempt to understand the links between poor sleep and depression. From my twin research and work led by others it seems that poor sleep and insomnia symptoms could be, to some extent, part of the same genetic cluster – meaning that if we inherit genes which make us susceptible to insomnia, we may also be vulnerable to depression.

When trying to explain the link between sleep and depression, I’m also intrigued by recent work on the immune system and depression. Studies have found that those suffering from, or at risk of, depression may show high levels of inflammation in their bodies. Their immune systems appear to be in hyper-drive as if they’re fighting infection or healing from injury. When we disturb or restrict sleep we may also experience inflammation, so perhaps inflammation could also help to explain the link between sleep and depression.

So what can we do about it? It has been proposed for some time now that by improving sleep we can perhaps prevent or treat depression. Recently, data have started to emerge from studies suggesting that this may indeed be the case. For example, researchers at the University of Oxford in collaboration with the psychological therapy provider Self Help Manchester evaluated whether an online treatment for insomnia reduces symptoms of anxiety and depression. They advised people with these difficulties to take steps such as keeping a consistent wake time, getting out of bed when they can’t sleep, and challenging beliefs that a bad night’s sleep is incapacitating.

They found that both anxiety and depression symptoms were reduced after insomnia treatment. Other groups are currently looking at whether by improving our sleep we can reduce other types of psychiatric difficulties, too. But even before this work is complete, the take-home message from research to date is clear: we need to begin to prioritise our sleep.

Alice M. Gregory, Professor of Psychology, Goldsmiths, University of London

This article first appeared on The Conversation.

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Money plays a big role in leading a fulfilled life. But here are some other factors to not discount

A large global survey has some surprising answers to how we think about life.

What’s the one thing that makes you feel most fulfilled? This was one of the simple questions asked to more than two million people in a worldwide survey conducted by Abbott, the global healthcare company. According to the survey, on a scale of 100, with 100 being “living fully”, Indians ranked themselves at 61, behind the global average of 68.4 and much behind China at 79 and Mexico at 75. Not surprisingly, with such a massive scale and scope, the survey results offered some startling insights into how people across countries think about their lives.

One of the biggest paradoxes the survey uncovered was that most people—nearly 44% of the respondents—felt money was the ultimate stumbling block keeping them from a fulfilled life. When asked about the one thing that makes them feel most fulfilled, money was not the number one response for even a single country. So why did people still claim it to be the top barrier?

One way to understand this is to study the top things that do make people fulfilled across the world. This showed a remarkable consensus. Globally most respondents selected “family” as the number one factor of fulfillment except in China, where “health” was considered more crucial to personal fulfillment. Attributes like “spirituality”, “success”, “giving”, “travel”, “community”, “health”, “music” and “adventure” also scored well in different parts of the globe.

Source: Abbot Global Study
Source: Abbot Global Study

It is clear that money can enable us to accomplish many of the things which give us a sense of fulfillment. It enables us to travel more, learn new things and even take better care of our health.

However, it is when we consider the pursuit of money as the primary key to fulfillment and an end in itself that the problems begin. Perhaps this is because we postpone our immediate happiness or ignore the things that give us joy for the sake of some distant financial goal. In India, especially, there is a tendency to prioritise work over family and friends. In the pursuit of wealth, we often avoid social occasions and get-togethers and skip simple acts of companionship like dining with family or wishing friends on important occasions like birthdays or anniversaries. Tellingly, nearly 23% Indian respondents chose “priorities” as the top barrier to fulfillment. This can lead to fatigue or burnout. It can also lead to increased emotional distance from friends and family, and contribute to a general sense of apathy in life. To top that, we may never realise how much money is enough money to do things that will bring us happiness and may continue to chase money at the cost of other joys. While being financially responsible is undeniably a virtue, it should not distract us, at least for long, from other drivers that directly contribute to personal fulfillments.

Ultimately, happiness is a choice. Many people choose to hold on to the “negative stimuli” in their lives. They choose to focus on the problems they face rather than the positive aspects in their life. Once you choose to be happy and focus on taking decisions that will make you happy rather than just make you money or bring you superficial success, it will become a lot easier to feel fulfilled. Think of happiness as a resource—an asset that needs be grown and cultivated just like your bank balance.

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The path to greater fulfilment is a deeply personal one. Thankfully, there are many resources available that can help people around the world define and lead a more fulfilled life. Abbott is committed to helping people live the best life possible. Their website features life hacks for work or personal time like those listed below. These are great tools for those ready to lead a more fulfilled and meaningful life, starting today.

Source: Abbot Global Study
Source: Abbot Global Study

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.

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