Research Shows, Sleep is Vital for Mental and Physical Well-Being

The science of sleep continues to delve into the quantity and quality of sleep needed for maintaining physical and mental health. Sleep deprivation is no longer considered a badge of honor, and poor sleep habits have been linked to an array of physical and mental health concerns.

Sleep deprivation is no longer considered a badge of honor.

Physical Impact of Poor Sleep Behaviors

 A new five-year study funded in part by the National Heart, Lung, and Blood Institute (NHLBI) published by the American Journal of Cardiology on March 2, 2020, reveals that people who do not adhere to a regular sleep schedule with fixed bedtime and wake up schedules are more than twice as likely to develop cardiovascular disease (CVD).

The study group was comprised of older people ranging in age from 45-84. A sleep evaluation was administered to the individual in the group, who were then followed for about a five-year period from 2010-2016.

The technology employed for the study included digital sleep trackers called actigraphs that monitor wake and sleep cycles for seven-day periods. Participants were also given a sleep assessment test called a polysomnography. Among the 111 study participants who developed CVD during the study period, the data indicated that those with the most irregular sleep patterns had double the risk for the disease.

Specific markers that increased for the study group included higher levels of blood sugar and inflammation, which in turn place people at a higher risk for diabetes, CVD, and obesity. Michael Twery, PhD., director of the National Center on Sleep Disorders Research noted that the new study is the largest of its kind, and establishes a definitive link between sleep problems and CVD.

Insomnia and its Impact on Mental Health

But a poor sleep schedule doesn’t just take a physical toll on the body. More evidence is arising from sleep studies to indicate that the toll on mental health well-being is equally as troubling. In December 2019, the scientists Michael Bonnet and Donna Arand published a paper, Risk factors, comorbidities and consequence of insomnia among adults   (Wolters Kluwer) that addresses the mental health consequences of insomnia. In fact, the authors noted that nearly 50% of patients reporting symptoms of insomnia also are affected by other psychiatric disorders. Insomnia imparts a number of adverse symptoms, including:

• Fatigue

• Sleepiness

• Confusion

• Tension

• Anxiety

• Depression

Having a proclivity for experiencing insomnia increase with a number of risk factors. Women (especially those who are peri- and postmenopausal,) older individuals, people who have had previous episodes of insomnia, and those with a family history for the disorder are at higher risk. People with insomnia also can suffer from trait sleep reactivity, in which people suffer from an exaggerated sleep reaction when they experience stressful events. Among older adults, early wake times are a marker for insomnia, while adolescents and younger adults are more likely to experience difficulty falling asleep. For the spectrum of people who suffer from substance abuse disorders, insomnia is a very commonly reported condition across a wide variety of substances and through different stages of illness. For people with alcohol dependency, their insomnia often predates their problem with substance abuse, and insomnia in turn is an important risk factor for relapse among those who are in remission. Not too surprisingly, a large number – 80% - of patients with depression also report insomnia. Similarly, the majority of patients with anxiety also report that they have symptoms of insomnia. PTSD is also highly correlated with sleep problems: the authors note one study indicating that 70-90% of PTSD sufferers have difficulty falling or staying asleep.

In Conclusion: Research is Showing that Sleep is Integral to Overall Health

Having established a link between poor sleep hygiene and CVD, future research will also attempt to establish a link between biomarkers that explain the link and are indicators for enhanced risk.

Researchers note that disrupting the circadian rhythm of sleeping and waking cycles affects metabolic functions and causes a spike in cholesterol among other problems. But further research is required to gain more insight and to establish conclusive finings in this area.

One thing is certain: good sleep hygiene is beneficial. Most adults fall in the range of needing 7-8 hours of sleep per night. Just like maintaining a healthy diet and exercising, sleep is integral to health.

Centerway Behavioral Health has comprehensive services to help with Sleep Disorders.

Contact us today if you’re struggling with sleep patterns and your mental health.

The Fine-Line Between Being Detail-Oriented and Obsessive

Certain behaviors can mimic obsessive-compulsive disorder (OCD) If someone is highly focused on attention to detail, or is preoccupied with organization or maintaining an uncluttered environment, it does not necessarily mean they truly have OCD.

In childhood, there can be some cases of confusion between children who exhibit behaviors characteristic of autism like repetitive behaviors. Children who have OCD generally do not lack the social skills like their peers with spectrum disorders.

If you do suspect you or a loved one is suffering from OCD, one sign is that their compulsions have an affect on their daily life, either inhibiting necessary activities or being overly focused on other activities to the point that it is unproductive.

How do I know if I might have OCD?

OCD is characterized by intrusive thoughts, images or urges that usually cause anxiety or distress. Two related types of behavior that that often independently indicate that someone has OCD are that a person feels impelled to perform certain repetitive acts in relation to an obsession or that they must religiously follow self-imposed rules to achieve completion of a goal or an activity.

Avoiding activities that can trigger obsessions or compulsions, excessive time spent acting on compulsions, avoiding going to the doctor because of contamination concerns and avoiding interactions with family and friends due to fear of harm have historically been indications of obsessive compulsive behavior.

OCD usually begins in childhood, and persists into adulthood. Studies have indicated that there is a genetic component to the disease, particularly as it relates to childhood onset. The mean age of onset for OCD in the US in 19.5 years, with 25% of the cases beginning at 14 years old.

OCD Treatment Options: Cognitive Behavioral Therapy, Medication & More

Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitor medications (SSRIs) both achieve positive outcomes for treating OCD as supported by randomized trials. SSRIs denote antidepressant medications, including Fluoxetine and Clomipramine, which inhibits the reuptake of serotonin and norepinephrine in the nervous system.

CBT is a set of behavioral techniques that is used to modify patterns of maladaptive behaviors. CBT has been shown to be effective for OCD at all levels of symptom severity.

It is important to understand whether you are simply a compulsive person or someone who may have OCD. There are different and effective treatment options available if you suspect this may be the case for your or a loved one.

Centerway Behavioral Health can Help You Determine if You Have OCD

Contact us to schedule a consultation.

Major Depressive Disorder and Initial Treatment Options

With the holidays approaching, depression and anxiety come to the fore for many people. Stresses relating to social gatherings, travel, entertaining, and financial stress can trigger depression or make existing depression worse. For some people with depression, it follows a seasonal pattern. In most of the cases, the episodes begin in the fall or the winter and remit in the spring.

Major Depressive Disorder is a Serious Condition that Deserves Medical Attention

One severe form of depression, major depressive disorder (MDD), not only has the potential to cause disability, but it also has a high rate of recurrence. Seeking treatment for MDD can be tricky, due to the fact that most people visit a primary care physician as opposed to a psychiatrist. In 2017, the National Institute of Mental Health estimated that over 7% of adults in the US had at least one major depressive episode.

Major depression episodes that occur in a seasonal pattern are often characterized by overeating (especially carbohydrates), sleeping more than usual, weight-gain, but still maintaining energy throughout the day.

Symptoms to Watch Out for If You Feel You May be Experiencing MDD

We don’t encourage self-diagnosis but it’s very important to be self-aware and seek help when you suspect your mental health is unwell. There are a number of behavioral characteristics that are present that may be indicative of having MDD. Symptoms to watch out for include a depressed mood most or all of the time, feelings of helplessness and hopelessness, the onset of phobias, rumination, excessive concern over physical health.

Choosing a Treatment Option That’s Right for You

Choosing a treatment option can be overwhelming. There’s a lot to consider: severity of the depression being experienced, lifestyle, demographics and physical health. Gelhorn, et. al. surveyed peer reviewed literature to determine how patient preferences affect treatment outcomes for depression disorders. For practitioners, it is important to take into account patient preference for treatment along with a clinical evaluation.

Many patients find healing using first-line treatment options including antidepressants, psychotherapy, and cognitive therapies like cognitive behavioral therapy (CBT). Certain studies have analyzed the efficacy of antidepressants along with non-drug treatment options. Second-generation antidepressant medications have also been shown to produce positive treatment response. We typically find that counseling combined with an anti-depressant medication works best. 

Symptoms to Watch Out for If You Feel You May be Experiencing MDD

We don’t encourage self-diagnosis but it’s very important to be self-aware and seek help when you suspect your mental health is unwell. There are a number of behavioral characteristics that are present that may be indicative of having MDD. Symptoms to watch out for include a depressed mood most or all of the time, feelings of helplessness and hopelessness, the onset of phobias, rumination, excessive concern over physical health.

Choosing a Treatment Option That’s Right for You

Choosing a treatment option can be overwhelming. There’s a lot to consider: severity of the depression being experienced, lifestyle, demographics and physical health. Gelhorn, et. al. surveyed peer reviewed literature to determine how patient preferences affect treatment outcomes for depression disorders. For practitioners, it is important to take into account patient preference for treatment along with a clinical evaluation.

Many patients find healing using first-line treatment options including antidepressants, psychotherapy, and cognitive therapies like cognitive behavioral therapy (CBT). Certain studies have analyzed the efficacy of antidepressants along with non-drug treatment options. Second-generation antidepressant medications have also been shown to produce positive treatment response. We typically find that counseling combined with an anti-depressant medication works best. 

Seasonal Affective Disorder is More Serious than Just Seasonal Sadness

After many years of conjecture, mental health experts are gaining a deeper understanding of Seasonal Affective Disorder (SAD,) a condition that affects many adults. SAD is characterized by episodes of major depression, mania, or hypomania that regularly occur in particular seasons.

SAD is Triggered by a Transition in the Season and Not Necessarily a Particular Season

The two recognized patterns of SAD are fall/winter onset and spring/summer onset. Most people who experience SAD have depression symptoms in the winter that generally lift in the spring or summer. SAD is not classified as a separate mood disorder, but as a subset of major depressive disorder.  

People who suffer from fall/winter onset SAD can experience multiple symptoms, including increased appetite, reduced energy, weight gain, increased sleep, and carbohydrate craving. The symptoms mirror those for people suffering from major depressive disorder.

Spring/summer onset SAD, also known as summer depression, is also characterized by typical depression symptoms such as decreased appetite, weight loss and insomnia.

Assessment of and Treatment of SAD

In order to assess the severity of SAD, a Patient Health Questionnaire (PHQ) is administered. Patients with severe major depression often score 20 or more points on the questionnaire and often have suicidal thoughts. Patients who score less than 20 points often have mild-to moderate cases of SAD a do not have generally have suicidal thoughts.

Medical practitioners have developed a roster of modalities to alleviate SAD symptoms, including:

·         Antidepressants

·         Light therapy

·         Sleep hygiene

·         Daily outdoor walks

·         Aerobic exercise

·         Enhanced indoor lighting

First-Line Treatment of SAD

The recommended first line treatment for patients with severe SAD is antidepressants combined with light therapy, although antidepressants alone may be sufficient. For patients with less severe cases, light therapy alone is considered to be a reasonable first line treatment alternative.

Sleep regulation is particularly important for treating AD, since insomnia and hypersomnia are common symptoms of the disorder. SAD therapy includes focusing on the sleep-wake cycle and minimizing blue light exposure from electronic devices within two hours of going to bed.

Second-Line and Third-Line Treatments for More Extreme Cases of SAD

For patients who are unresponsive to first line therapies, additional steps may be required. Second line therapies involve modifying a patient’s medication and incorporating the form and amount of light therapy used. Third line therapies can incorporate psychotherapy into the equation.

It is important to realize the symptoms of SAD if you or a loved one experience recurring, seasonal depression. Seeking out a qualified mental health professional is an essential first step towards regaining your mental well-being.

 Are You Struggling with Seasonal Affective Disorder? Help is Close-at-Hand! Contact Us Today to Book an Appointment.