Attack the insomnia. “You need to treat the insomnia at the same time as you treat the depression,” says Sonia Ancoli-Israel, Ph.D., a professor of psychiatry at the University of California at San Diego. “You don’t just treat the depression and then assume that the insomnia will go away on its own.”
What’s more, she adds, “There have been studies on depression that show that if you treat both the depression and the insomnia at the same time, concurrently, you’ll get a better, faster response not only to the insomnia, but to the depression as well.”
So put the basic insomnia-fighting strategies to work: Go to bed at the same time every night. Get up at the same time every morning. Walk in the noonday sun without sunglasses. Each of these strategies uses the presence or absence of light to set off a chemical reaction in your brain that ultimately affects the neurotransmitters involved in depression. It’s no coincidence that light therapy alone is used to treat a specific form of depression called “winter depression”
If you’re still not sleeping after a few days, ask your health-care provider to give you a hand, says Dr. Ancoli-Israel. “And don’t let her dismiss the idea that sleep is important,” she adds. “If necessary, make a separate appointment to discuss your insomnia with her.”
Report thoughts of suicide immediately. The idea of suicide is common in severe depression. If the thought even passes through your mind, call your doctor or 911 immediately. Severely depressed people do commit suicide.
See a sleep specialist. If you have severe depression and you can’t sleep, you may want to ask your doctor for a referral to a sleep center, suggests Dr. Benca. A sleep center’s specialized testing and trained scientists may be able to give you some help.
Practice your faith. A study at Duke University found that severely depressed people who put their faith at the center of their lives recovered 70 percent faster than those who did not.
Sweat. Another Duke University study found that 30 minutes of exercise, in which you work up a sweat, is just as effective as antidepressants in reducing major depression. What’s more, another study found that exercise is key to preventing relapses — a serious problem in those who have had more than one episode of depression.
Hang out with friends. In a British study, hanging out with a friend on a regular basis lifted the spirits of those with mild depression.
Structure your day. People who have depression frequently lead unstructured lives, says Ruth Benca, M.D., P.h.D. Unfortunately, it contributes to both depression and insomnia. So put yourself on a schedule and stick to it. Eating, sleeping, working, exercising, socializing — figure out what times work for you and then carve them in stone.
If it swims, eat it. Those who consume diets rich in omega-3 fatty acids, a type of fat found in cold-water fish such as salmon, are less likely to experience depression than others, reports a Dutch study. And a study in England found that pregnant women who ate 10 ounces of fish a day had half the rate of depression as women who didn’t. In fact, some researchers think that the amount of depression in America is directly related to a lack of fish in our diet.
Enlist your partner. A study of 84 depressed pregnant women found that those who were given two 20-minute massages a week from their partners reduced their incidence of depression by 70 percent. The researchers suspect massage boosts serotonin levels and reduces levels of stress hormones.