We all struggle to get out of bed and start the day sometimes, but if this is your daily reality then you may be experiencing morning depression. For people with morning depression, symptoms will be most intense at the start of the day and gradually improve towards the afternoon and evening.
If this sounds like you, keep reading to learn more about what morning depression is, its symptoms, common treatments for morning depression, and things you can do to start feeling better.
What is morning depression?
Morning depression is a symptom of clinical depression. People experiencing morning depression will find that their depression symptoms are more severe in the morning and tend to gradually improve throughout the day. These symptoms might include extreme sadness, anger, fatigue, and frustration.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), morning depression is not a standalone diagnosis but one of the symptoms of major depressive disorder and bipolar disorder. It’s sometimes also known as diurnal mood variation. This is different from seasonal affective disorder (SAD), which is related to seasonal changes.
Symptoms of morning depression
People with morning depression will experience similar symptoms to depression. The major difference is that these depressive symptoms are worse in the morning and people will often feel better as the day goes on.
Symptoms of morning depression can include:
- Having no motivation or energy to start the day
- Oversleeping
- Struggling to get out of bed
- Frustration or crankiness
- Exhaustion or lethargy
- Feeling hopeless about the day ahead
- Heavy brain fog
- Struggling to do simple tasks, like brushing your teeth or making coffee
- Lack of concentration
- Feeling of emptiness
- Appetite changes (i.e. increased or decreased appetite).
Possible causes of morning depression
Researchers have yet to identify exact reasons why morning depression happens, however, they do have a few clues. These include hormonal factors related to the circadian rhythm, potential inflammation, or other health issues that affect sleep.
Below we look at a few possible causes of morning depression.
Circadian rhythms
The circadian rhythm, also known as the body clock, is a natural process that governs our body’s sleep-wake cycle as well as things like heart rate, body temperature, energy, alertness, and mood.
This 24-hour internal clock is linked with hormonal changes throughout the day, helping us naturally feel more alert in the mornings and sleepier at night. When the sun rises, our bodies release cortisol, a hormone that provides energy to keep us active and alert throughout the day. When the sun sets, we release melatonin, helping us feel tired and prepare for sleep.
When our circadian rhythms are in balance, our bodies release the appropriate hormones at the right times of day, keeping our body healthy and our moods stable. When out of balance, our body can produce hormones at the wrong time of day. This can disrupt our physical and emotional well-being and potentially contribute to things like morning depression.
Because morning depression tends to occur at the same time every day, researchers believe that it’s linked to a person’s circadian rhythm. More recent findings also suggest that people experiencing morning depression have differences in their hypothalamus, which helps regulate circadian rhythms.
Inflammation
Some research has found that people living with depression, including morning depression, may have higher levels of an inflammatory marker called interleukin-6 (IL-6). This inflammation-causing chemical increases and decreases at different times of day for different people, however it most commonly peaks in the early morning and can reverse the circadian rhythm.
More recent research confirms the link between interleukin-6 and depression, helping us better understand why morning depression might occur and which treatments may be most beneficial.
Sleep issues
Some people may also experience morning depression as a result of not sleeping properly. When someone experiences interrupted or low-quality sleep, they’re more likely to feel depressed. At the same time, having major depression can make it more difficult for someone to fall asleep or stay asleep, contributing to morning depression.
One potential cause of sleep issues, and subsequent morning depression, is obstructive sleep apnea. This is when a person’s throat becomes blocked while they sleep, leading them to stop and start breathing throughout the night. Sleep apnea can affect a person’s quality of sleep and lead to extreme tiredness and low mood in the morning. If sleep apnea is the cause of your morning depression, you might find relief by treating your sleep apnea symptoms.
Other factors
Besides the potential causes mentioned above, there are other factors which might contribute to morning depression. These include:
- Recent life changes, such as a relationship breakup or death of a loved one
- Family history of depression
- Medical conditions or chronic pain
- Alcohol or substance use
- Certain medications
- Trauma
- Anxiety or Attention Deficit Hyperactivity Disorder (ADHD).
How to know if you have morning depression
Because morning depression is considered a symptom of depression and not a separate diagnosis, it doesn’t have its own diagnostic criteria. This means it doesn’t come with its own specific symptoms to look out for.
Speaking to a mental health professional is the best way to determine if you have morning depression. They will examine you closely about your sleep patterns and mood changes, such as:
- What times of day your symptoms are worse
- Whether you have trouble getting out of bed in the morning
- If you have difficulty concentrating more than usual
- If your daily routines have changed lately
- Any recent life events
- What kind of things help improve your mood
- If your moods shift dramatically throughout the day
- Whether you’re experiencing changes in weight or appetite
- How long your symptoms have lasted
- Any medications you may be taking
- Your family and personal history of depression.
Speaking with a doctor or licensed professional can also help you rule out other medical conditions that might be contributing to morning depression, such as thyroid issues.
How to treat morning depression
Usually, the best way to treat morning depression is with a combination of medication, therapy, and lifestyle changes. Like other severe depression symptoms, it may take some time and effort to find what works best for you and your symptoms.
Below, we look at the most common treatments for morning depression.
Medication
Antidepressant medications can help ease common symptoms of depression, including morning depression. If you choose to take medication, know that it can take some time to find the right drug and dosage for you. What works for one person may not work for the other, so be patient and work with a licensed professional to ensure you’re receiving the right medication you need.
When it comes to treating morning depression with medication, research suggests that selective serotonin reuptake inhibitors (SSRIs), a commonly prescribed antidepressant, are not particularly helpful. This includes medications like fluoxetine (Prozac) and escitalopram (Lexapro). Instead, a different class of antidepressants called serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor), may be more helpful.
Talk therapy
For some people, talk therapy can be a helpful way to manage morning depression, especially when combined with medication. Examples of talk therapy are cognitive behavioral therapy (CBT), interpersonal therapy, and humanistic therapy. These therapies can help you identify and address any underlying issues in your life that might be contributing to your depression and making symptoms worse. This might be grieving the death of a loved one, relationship issues, financial hardship, or negative thought patterns.
Light therapy
Light therapy, also known as phototherapy, is often used to treat seasonal affective disorder (SAD). Some research shows that it can also be helpful in treating nonseasonal types of depression, such as morning depression.
This type of therapy involves sitting or working near a light therapy box that mimics natural sunlight, helping improve mood. More studies are needed to confirm how helpful light therapy is in managing morning depression, but it may be effective for some people.
Alternative therapies
People who are interested may also like to try alternative therapies alongside medication and other treatments. This could include:
- Meditation
- Yoga
- Relaxation exercises
- Acupuncture
- Massage
- Music, drama, or art therapy
- Herbs and supplements
- Tai chi.
There is yet to be enough research to confirm the effectiveness of these alternative therapies as standalone treatments for depression. That said, they may help people feel better when coupled with traditional treatments like medication and talk therapy.
It’s always a good idea to speak to a mental health professional before starting an alternative therapy, especially taking herbs and supplements, to ensure that it’s suitable for you.
What you can do
In addition to the above treatments, you may also be able to treat morning depression with some lifestyle changes. Changing certain habits can help stabilize your circadian rhythm, improve your sleep patterns, and reduce your symptoms of morning depression.
Introduce sleep hygiene
Since poor-quality sleep is considered a potential cause of morning depression, improving your sleep can be one way to manage its symptoms. Sleep hygiene is often used to treat insomnia, however introducing a few of its key practices might help ease morning depression.
These include:
- Going to sleep and waking up around the same time everyday
- Avoiding caffeine, alcohol, nicotine, and other sleep-disruptors before bedtime
- Putting electronic devices away one hour before bed, or if using, turn on ‘night mode’
- Introduce a relaxing bedtime activity, such as a warm bath, reading, stretching, journaling, or meditation
- Ensure your bed, mattress, pillows, and sleepwear are comfortable
- Keep your bedroom cool and dark for bedtime.
You may not be able to implement all of these practices, but even a few nighttime routines can help improve your sleep and ease morning depression symptoms. The key is to focus on relaxing before bedtime and avoiding anything that might stimulate your mind and body.
Start the morning with positivity
If you’re experiencing morning depression, it can be helpful to avoid anything that might worsen symptoms. This includes scrolling through the news or social media, where you might be faced with something that brings on negative emotions.
Instead, you might like to take a few minutes to start your day with a gratitude practice. Research suggests that gratitude-based interventions can help improve symptoms of depression, which can include morning depression. It’s easy, too: while still lying in your bed you can think of 5-10 things you’re grateful for in your life. You might like to write these down or just think about them in your head.
Focus on one thing at a time
Morning depression can make it feel impossible to start your day. Instead of thinking about all the things you have to do, try to focus on just one step at a time. This could be brushing your teeth, making a cup of coffee, or feeding your pet.
Once you’ve finished that first task, congratulate yourself for moving forward in the day, then look to the next step. That could be making breakfast, getting dressed, or opening the curtains. Breaking your morning tasks up in this way can make it feel easier to get out of bed and reduce feelings of dread or overwhelm.
Make time for a fun morning activity
Sometimes, morning depression worsens when we have to get up and rush immediately to school or work. Not having enough time to ease into your day can increase stress and anxiety and make it even harder to get out of bed. If possible, try to wake up a little earlier to give yourself more time to get ready in the mornings. Even ten minutes can make a difference between rushing and taking your time.
To really give yourself a boost in the morning, try to make time for a fun morning activity. Choose something you enjoy doing. It could be anything like:
- Listening to music
- Doing a quick yoga routine
- Having a dance
- Reading a few pages of a book
- Playing with your pet.
Whatever it is, make it something that you’ll look forward to and that can motivate you to get moving.
Seek support for depression
Ultimately, the best way to manage depression and its symptoms is with support from a professional therapist. They can help you better understand your experiences and guide you with a customized treatment plan. This might include medication, talk therapy, or other depression treatments such as TMS therapy.
You might find that working alongside a professional relieves you of the pressure to try to ‘do all the work’ yourself. You’ll feel supported and guided by someone who understands depression and can help you manage it in a way that works for you.
Get expert help
Struggling to get out of bed is common, but if it’s starting to interfere with your daily life then you may want to find help from a professional. The good news is that, like other symptoms of depression, morning depression is highly treatable. Working with a licensed therapist can help you find the right combination of approaches for you and your particular symptoms.
At BestMind Behavioral Health, we’ll connect you with a licensed professional who can create a customized mental health treatment for your morning depression. This can include medication management and cutting-edge treatments like TMS therapy. With both telemedicine and in-person appointments in Colorado and Oregon, you can get started whenever you’re ready. Contact us now to be connected with a provider and start treating your morning depression.
