Work, Work Hours & Mental Illness

I have frequently discussed the importance of examining other real-life factors, such as economics and housing, as we discuss reducing mental illness and suicides. Well, here’s a great article on why: A new study directly ties shift work and varying hours to depression. From the article:

In particular, the study found, shift workers were 33% more likely to have depression than people who didn’t work nights or irregular schedules.

Shift workers also had a higher chance of developing anxiety, but in this case the difference was too small to rule out the possibility that it was due to chance.

Women appeared particularly vulnerable to the negative mental health effects of shift work, researchers report in the American Journal of Public Health.

Compared to women who worked consistent weekday schedules, women who worked nights or split shifts were 78% more likely to experience adverse mental health outcomes.

The article was based on a report which examined seven studies, totally 28,438 participants. It specifically blamed this increase in depression and anxiety to a disruption of sleep; the connection between a lack of sleep and mental illness has been well documented.

This, obviously, is not the only study which ties work challenges to mental illness – or economic trouble in general. When unemployment increases, so does depression and suicide. Increases in foreclosures and evictions are directly tied to increases in suicides, and states which increased their minimum wages saw slower growth in suicides than states which held their minimum wages even.

This goes back to one of the points I have hit on this blog and in my advocacy over and over again: Mental illness is not always about mental health. It’s myopic to make such an assumption. As we talk about reducing mental illness, we have to talk about increasing the social safety net, about making sure people can get good jobs for fair wages, about giving people a chance to recover from economic hardship. And yes, this unquestionably informs my politics.

The working poor are not more likely to have mental illness or die by suicide than the economically secure, but suicide increases in both groups when there is a change in economic status. We can’t necessarily stop someone’s economic situation from turning south, but we need to at least make sure that everyone has the resources in place to give them a chance to recover.

 

This is how depression & sleep trouble are related

For me, there have always been two markers that are my “canary in a coal mine” when it comes to depression – the two factors that tell me I’m depressed even when I may not realize it right away. First is eating. Some people eat more, some stop. I’m the later. I drop weight when I am depressed.

The second, and the one I wanted to write about today, is insomnia. Simply put, when I get depressed, I have a huge problem sleeping. When I get to sleep, I usually stay asleep, but the challenge for me is that I can’t sleep when I’m depressed. I’ve never been exactly sure why. Maybe it’s because I cannot shut my mind off, or maybe it’s because there’s some unresolved conflict that is prohibiting me from sleep.

Unfortunately, I’m not the only one who gets these issues. Even more unfortunately is this: When you are depressed, you can’t sleep. And not sleeping may mean more depression.

Alright, first, the evidence. Sleep and depression are strongly connected, and it’s not just me saying that. This comes straight from the DSM-V (Diagnostic & Statistical Manual):

Insomnia (inability to get to sleep or difficulty staying asleep) or hypersomnia (sleeping too much) nearly every day

So, one of the formal criteria for diagnosing a depressive episode or illness is the above. Unfortunately, it’s a two-way street, as not getting enough sleep – or getting a poor quality of sleep – can lead to depression. From The Sleep Foundation:

The link between sleep and mood has been seen over and over by researchers and doctors. For example, people with insomnia have greater levels of depression and anxiety than those who sleep normally. They are 10 times as likely to have clinical depression and 17 times as likely to have clinical anxiety. The more a person experiences insomnia and the more frequently they wake at night as a result, the higher the chances of developing depression.

There’s so much irony in the discussion about depression and sleep it’s ridiculous. What always frustrated me the most, however, was this: When you can’t sleep, and you are having prolonged trouble sleeping, all you can think about is how YOU CAN’T SLEEP, and this will worry you/frustrate you/depress you. This, in turn, will worry/frustrate/depress you even more, and then – you guessed it – you can’t sleep! It creates a vicious lack of sleep cycle.

Do I have any magic cure? No. Heck no. While there is plenty of advice on how to sleep when you can’t, I’ve found that everyone’s experiences are deeply personal. Related to that, I can tell a story about how I broke through my sleep issues when I was depressed. There was a period where I wouldn’t be able to sleep for 3-5 days a week. Not until 3am or so, only to become a sleepy zombie the next day and not be able to sleep at all the following night, and thus, the cycle continues.

One night, I’m in Harrisburg for session. I can’t sleep, it’s 2am and I am miserable. And I remembered something my therapist said a week or so before about how he had patients who had broken through their anxiety and phobias when they accepted the worst. And as I laid there, I said to myself, “You know what? Screw it. I’m done. I’m not gonna sleep, I’m gonna have the worst day of my life tomorrow, and then when I drive back to Allentown, I’m gonna crash the car. It’s over and I accept!!”

I slept that night.

It was an interesting moment for me, so if I have any piece of advice, it is this: When you accept the worst, you can get where you need to be.

Any thoughts, tricks or tips are appreciated! Leave them below!