Your alarm goes off—again. You know you should get out of bed, but instead, you hit the snooze button. The thought of facing the day can wait for another nine minutes. Or hours.
Nearly everyone experiences the occasional morning when the siren song of the comforter sings more sweetly than any obligations. Plus, let’s face it—few of us awaken to stretch languidly like Snow White, while flocks of birds make our beds for us—those slacker chickadees!
However, if you find it challenging to face the day every day, you might have more than a case of insomnia. Morning depression could play a role, especially if you’re prone to the disorder.
What makes morning depression unique?
Morning depression shares many traits with major depressive disorder (MDD). Like people with MDD, if you have morning depression, you’ll experience a disruption in your circadian rhythms, the natural sleep-wake cycle of the body. These rhythms influence everything from when your body releases additional amounts of particular hormones to when you feel the urge to eat or sleep.
You have some cognitive control over your circadian rhythms. Did you ever tell yourself that you had to wake up early, perhaps on the morning of an important presentation or exam, only to find yourself opening your eyes before your alarm sounded?
Research explains that a conscious directive to wake up at a particular hour, before hitting the hay, results in your hormonal levels changing approximately one hour before that time. Study participants who received instructions to wake up at 6 a.m. showed an increase in adrenocorticotropin, a stress hormone, roughly an hour before the alarm went off.
Another hormone influencing sleep is melatonin. Your body typically releases melatonin when the sun goes down, to prepare you to rest. If you have morning depression, though, this hormonal sleep and alarm clock system goes haywire.
Your body may amp up cortisol production as the day goes on, keeping you awake at night. When it finally tapers off, melatonin takes over. If your body releases an excess of this hormone in the early morning hours, you might find getting out of bed for work problematic.
The waters grow even murkier when you consider the chicken-or-egg nature of the relationship between sleep and depression. One in five patients with depression also suffers from sleep apnea—a lack of deep or adequate rest can exacerbate your feelings of despair.
This symbiosis can escalate quickly into a vicious spiral—you feel stressed and depressed, so you can’t sleep, which leads to additional stress and depression. With each tick of the clock, you can practically feel your blood pressure increase as you lie with eyes wide open in the dark.
7 symptoms of morning depression
How do you know if you have morning depression? Consider the following to determine whether your depression gets worse when you wake up.
- You struggle to wake up or get out of bed every morning: Nearly everyone experiences the occasional late evening or night spent tossing and turning. However, if you feel like you have 10-pound dumbbells attached to your eyelids every morning, or you repeatedly drift back off despite setting your alarm, you might have a problem.
- You can’t turn your brain off at night: If hormonal disturbances play a role in your a.m. depression, your body might increase cortisol production at night and ramp up melatonin output in the morning. As a result, you might feel ready to go when everyone else is starting to yawn.
- You experience hypersomnia: More than hormonal disturbances can influence your a.m. blues. If this occurs, you might sleep longer than usual—a condition called hypersomnia. People do vary slightly in the amount of overall sleep they need, but if you regularly snooze for 10 hours or longer and still struggle to rise, depression is a likely culprit.
- Your eating habits change: Some people with depression eat to numb the pain. Additionally, a lack of adequate sleep alters the level of ghrelin and leptin in your blood. These hormones influence food cravings and can make you crave junk food when you don’t get enough rest. Alternatively, you might not feel like eating much at all. Depression can steal the joy from activities you formerly found pleasurable, including eating.
- Difficulty accomplishing basic tasks/lack of focus: Even if you get enough sleep, you might feel like you’re in a fog if you have morning depression. You might struggle to make coffee or shave your legs in the shower, for example. As long as you slept for a sufficient number of hours, your concentration should improve as the day continues, but if you’re sleep-deprived, you may feel mentally “off” all the time. This condition can prove to be dangerous—for instance, research indicates that driving while drowsy is as dangerous as driving while intoxicated.
- Intense agitation and anger or feelings of frustration: You might equate depression with people weeping or moping around like Eeyore from Winnie-the-Pooh, but anger can actually mask depressive symptoms. If other people genuinely need to treat you with kid gloves until after your third cuppa, you might want to seek help.
- Loss of interest in daily activities and persistent emptiness: Nearly everyone experiences moments when they feel down, or when they ask, “What’s the purpose of all this, anyway?” If you have morning depression, though, nothing about the day ahead excites you. You might lose interest in things you once loved, like getting in a morning workout or helping your children get ready for school. You battle a persistent emptiness that feels like walking through life wrapped in a damp grey blanket.
If you experience any of the above symptoms regularly, it’s time to give your physician a call. They can help you select the treatment option that’s best for you.
Factors that influence morning depression
As with many traits, various environmental and genetic factors influence who develops morning depression. Genetic researchers have discovered 15 regions of the human genome that influence whether you’re a night owl or a morning person, including seven markers that determine your circadian rhythms.
This finding doesn’t mean that you’re destined to become a night owl if you have particular chromosomal variations, but it does mean you’ll need to do additional work to adjust to waking up with the early bird.
One environmental factor impacting morning depression is your work schedule. Several studies found a link between depression and those who work non-traditional shifts—typically between the hours of 10 p.m. to 3 a.m.
You should note, however, that researchers don’t credit the unusual hours alone with causing mental health issues. Other factors—such as the social isolation you might experience due to working while the majority of your friends and family members sleep—also play a role.
Your work environment will also impact morning depression, as well as the overall course of MDD. Poor working conditions, combined with high job stress, often result in higher levels of mood disorders.
As with many areas of depression, the work-illness balance typically creates a vicious cycle. When you feel depressed, your performance on the job suffers. You might postpone even urgent tasks while you lack the energy and focus to perform at your best. As a result, you receive negative performance reviews. These decrease your self-esteem and feed your low moods. You may find sleep even more elusive, as you stay up stressing over a possible job loss.
If this cycle has caught you in its trap, the best thing you can do is seek outside help. If you have a good relationship with your immediate supervisor, let them know about the problems you’ve experienced with depression. If your workplace offers an employee assistance team, take advantage of that resource.
Your doctor’s appointment: 3 suggestions
If you’ve decided to seek help for your morning depression, good for you! Finding effective therapy can take time, so the earlier you reach out, the better. To make the most of your appointment, follow these tips.
- Write a list of questions and concerns down in advance: It’s tough to remember all of your symptoms or list all your medications in the 10 minutes you have with your doctor. This principle goes double when you’re unable to concentrate. Start a list of questions and concerns a week before your appointment, and add to it as more items enter your mind.
- Outline what you’ve tried: Chances are, you tried alleviating your morning depression on your own before you called the physician. Write down what you’ve attempted, to no avail.
- Take an advocate with you: This suggestion goes threefold if you’re female—sadly, doctors still dismiss women’s health concerns more often than they do those of men. Sometimes, having a neutral third party to verify your symptoms leads to faster diagnosis and treatment.
8 treatment options for morning depression
The treatments for morning depression mirror those for MDD, with a few exceptions. Your doctor will perform a physical and psychological evaluation. They may refer you to a sleep study to rule out conditions like sleep apnea as contributors to your morning fatigue and despair. Once they determine that depression is the cause, you’ll have multiple treatment options.
Selective serotonin reuptake inhibitors
These medications make up the front line of anti-depressant treatment because they come with few side effects, in most cases. However, due to the hormonal influences at work in many cases of morning depression, they may not work as effectively for this type. Your doctor may prescribe one nevertheless, but be sure to stress that your symptoms are significantly worse in the a.m.
Serotonin-norepinephrine reuptake inhibitors
As the name suggests, these medications work on two different neurotransmitters. Epinephrine is another name for adrenaline, one of the substances responsible for the fight-or-flight response. Because adrenaline works with cortisol to increase blood flow in preparation for stress, such medications can make getting out of bed easier.
These antidepressants can prove highly useful—but they can also come with serious side effects. These medications can increase suicidal ideation in young adults under the age of 25. Some can cause weight gain, while others cause adverse reactions like dizziness upon standing. Your physician probably won’t prescribe these, unless other medications don’t work.
These include drugs such as Wellbutrin and Trintellix that don’t fit neatly into any other anti-depressant category. Your doctor may suggest one of these medications if others fail.
Monoamine oxidase inhibitors
These medications also serve as a final line of defense against depression. If your doctor prescribes these drugs, you’ll have to follow a strict diet. Certain wines and cheeses, along with other foods, can trigger a deadly reaction.
Cognitive-behavioral therapy (CBT) teaches patients that while they can’t control every aspect of their world, they do have power over their reactions to events. It helps you recognize automatic negative thoughts (“I can never get enough sleep!”) with evidence that either supports or discounts each statement. Once patients gain awareness of the way specific thought patterns influence them, they become able to reframe them in a more positive, healthy manner.
Acceptance and commitment therapy
The acceptance part of this talk therapy technique refers to helping patients accept distressing realities—such as the fact that they may never enjoy mornings much. Plus, this type of therapy helps patients clarify what they value most in life. This treatment also helps chronic pain patients, and it may benefit you if conditions like fibromyalgia or rheumatoid arthritis contribute to your morning exhaustion.
If you live in the northern hemisphere, you might find that your morning depression worsens in the wintertime. Even people who don’t have any depressive disorder find it more difficult to leave the sheets when it’s still dark outside. Light therapy uses select lamps that mimic the effect of sunlight. You can find versions that work as alarm clocks by gently illuminating your room gradually, the way dawn lights up the morning sky.
6 wholistic treatments for depression relief
Maybe you lack the extra time for talk therapy in your schedule, or you prefer to use natural methods over medication. What if you don’t have health insurance coverage to pay for medicine or treatment? Whether economic or personal concerns keep you from the doctor, natural therapies can help alleviate morning depression.
Make your bedroom your sanctuary
Today, many people take their laptops and cellphones to bed with them. They work and watch TV under the comforter. Then they wonder why their eyelids don’t close when their heads hit the pillow. As Ivan Pavlov could tell them, they’ve conditioned themselves to do anything but sleep in the bedroom.
To fix this problem, reserve your bedroom for sleeping and sex. Set up a charging station in your living room or kitchen and place your devices there 30 minutes before bedtime. Establish a ritual of performing gentle stretches in bed or reading a book before you turn off the light.
If you suspect your morning depression stems at least in part from tossing and turning earlier in the night, try amping up your workouts. It’s almost impossible not to sleep when you’re exhausted from running a few miles or hitting the weights.
If you’re sedentary, try to gradually build up to 30 minutes of moderate exercise most days per week. If you already hit the gym, try adding in some more vigorous intervals or taking a high-intensity interval training (HIIT) class.
Modify your diet
Eating a big meal before bed can make it difficult to fall asleep. This trouble can make waking up in the morning more problematic. Strive to eat at least two to three hours before turning in for the night.
You can practice mindfulness meditation to gain many of the same benefits you can get from CBT. Practice sitting quietly with your thoughts as a neutral observer—as feelings and ideas arise, let them do so without judging them. Then, write down the negative patterns you observed.
Ask yourself, “How can I reframe these more positively?” For example, “I messed up at work, and now my boss hates me,” can become, “I made a mistake, but I learned from it. Now I know what to avoid the next time.”
Scents like lemon and sweet orange help put some pep in your step and wake you up. Aromas like lavender can help you sleep more soundly, so try a few spritzes on your pillowcase. See if it helps you feel more awake when the alarm sounds.
Change your work schedule
It sounds like a no-brainer, but if your morning depression persists, despite everything you do to solve the problem, stop fighting your biology. If you feel less depressed at different times of the day, see if you can arrange your work schedule to match your peak productive times. Seek out flexible work arrangements that allow you to produce at midnight, if that’s your Zen hour.
Chances are, you can take your pick of shifts if you work in a 24-hour industry like health care. Few nurses and respiratory technicians relish the red-eye shift, but society needs them—just as it needs late-night convenience store clerks and shelf stockers.
Yes, you can overcome morning depression!
Depression hurts. The disorder can even kill. If your blues grow worse in the morning, don’t pull the covers over your head in despair. Take some tips from this list and get relief— and some Zzzs—soon.