There are several different forms of depression. Some, called diurnal variations, include worsening symptoms at certain times of the day.
Depression signs may include feelings of helplessness, frustration, and hopelessness, and this can get worse in the morning. The common word for this diurnal variability is depression in the morning.
Diurnal means symptoms continue to arise or become more severe each day at a time
Symptoms of morning depression
A person with depression in the morning should experience the diagnostic symptoms of major depressive disorder. Such signs occur in the morning or, more often, intensify.
When the day goes on, the symptoms can dissipate, or feel less intense.
Doctors treat depression by the criteria specified in Mental Disorders Diagnostic and Statistical Manual, Fifth Edition ( DSM-5).
To be diagnosed with depression, a person must experience for 2 weeks or longer five or more of the symptoms mentioned below.
A distinguishing feature of the disorder is a depressive mood, or a lack of interest or enjoyment in once enjoyed activities.
Other symptoms include:
- a depressed mood lasting for most of the day, almost every day, though it may be worse at certain times of day
- diminished or no enjoyment in nearly all activities
- significant weight loss without effort or a decrease in appetite
- difficulty sleeping or sleeping too much
- restlessness throughout most days of the week
- fatigue or a feeling of no energy throughout most of the week
- feelings of worthlessness or excessive guilt
- difficulty concentrating, thinking, or making decisions throughout most of the week
- recurrent thoughts of death, suicide, or self-harm
In addition, a person with morning depression may notice the following symptoms:
- difficulty waking up in the morning
- physical difficulty getting out of bed
- frequent over-sleeping
- difficulty thinking clearly, especially in the morning
- difficulty completing regular morning tasks, such as getting dressed and brushing the teeth
Such symptoms can decrease or disappear in a person with morning depression as the day progresses.
Causes
Doctors do not find a particular cause of morning depression, but several contributing factors do exist.
Since morning depression happens every day at about the same time , doctors frequently link it to imbalances in the circadian rhythm of an individual.
The body ‘s circadian rhythm is a process that signals the sleep-wake cycle, among other things. Hormonal changes can affect circadian rhythm during the day. Melatonin is one of those hormones which makes a person sleepy.
Although individuals who are not clinically diagnosed with depression frequently experience day-round mood changes, those with morning depression tend to have more pronounced highs and lows that occur daily or nearly every day.
Some research indicates that imbalances in the inner body clock of an individual, and the amount of sleep and light exposure may lead to changes in mood, particularly in those with depression.
In addition to changes in the natural rhythms of the body, many other factors can contribute to morning depression and a major depressive disorder. These factors include:
- a family history of depression
- past or ongoing drug or alcohol addiction
- medical conditions that can affect a person’s mood, such as sleep disturbances, chronic pain, anxiety, and attention deficit hyperactivity disorder (ADHD)
- recent changes in life circumstances, such as divorce or loss of a loved one
- trauma
Diagnosis
Doctors start diagnosing depression and any diurnal variations, such as depression in the morning, by asking someone about their symptoms.
They could ask questions about mood , sleep, weight and appetite changes. The doctor should try to assess how long these symptoms have lasted, and whether they are getting better or worse.
They will also attempt to rule out other possible causes, such as a medical condition which may cause similar symptoms. one example is hypothyroidism.
Many drugs can also lead to mood changes and depressive symptoms, and a doctor should also inquire about any drugs a person is taking.
Treatment
Someone who has suicidal thoughts or self-harming thoughts should seek emergency medical attention. A physician may help to provide urgent and continuing care.
There are also therapies for depression. Including:
- Psychotherapy: This can help a person to recognize negative thought patterns and learn positive behaviors. Group or family therapy can help to strengthen relationships.
- Medications: Among those that can help are anti-depressants, mood stabilizers, and antipsychotics. It may take time and some trial-and-error to find the right drug and dosage.
- Exercise: Getting regular exercise, especially outdoors, can help to reduce mild to moderate depression symptoms. Exercising outside can be especially beneficial for people with morning depression, as it may reduce insomnia and ensure plenty of exposure to natural light.
- Brain stimulation therapies: While rarely a first-line treatment, brain stimulation therapies, such as electroconvulsive therapy and repetitive transcranial magnetic stimulation, may reduce symptoms of severe depression.
Alternative therapies do benefit certain people including acupuncture, meditation, and yoga. Although these can help people feel better over time, and retain good mental health, they should not replace medical treatment for major depressive disorder.
Coping
A person may want to adopt habits while still pursuing medical treatments that can help them cope with symptoms. Positive changes may include:
- Improving sleep hygiene. A person can help to promote better-quality sleep by darkening the bedroom, keeping the temperature cool, and eliminating distractions from screens, such as those on cell phones, computers, and televisions.
- Preparing for the next morning at night. Setting out clothes and items for work or school, and putting together lunches in advance can make mornings easier if a person has little motivation or energy when they wake up.
- Getting enough rest. Going to sleep and waking up at the same times, and trying to get 8 hours of sleep per night can improve symptoms.
- Allowing for extra time in the morning. Waking up earlier or adjusting a work schedule to start later, if possible, can relieve pressure and stress in the morning.
- Using light cues. Light can communicate to the body that it is morning and time to wake up. Opening the curtains right away or timing an overhead light to turn on at the same time every day can help the body to wake up.
A physician or therapist may make specific decisions based on the symptoms and needs of the patient.
Outlook
Morning depression is one common type of diurnal depression, according to some studies.
When a person has depression in the morning, there are medical services and resources available to help.
