This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.

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Treatment option 6: Improving your sleep

A complete sleep might be longer than what you’re used to, but you know when you’ve had it: you feel fully able to get out of bed and start the day’s tasks. Increased energy can increase motivation, which often increases productivity. Productivity, in turn, produces confidence and optimism. In addition, emotional energy–patience, distress tolerance, etc.–can be enhanced through proper rest. In people who are chronically tired, increased sleep might be the most effective mood booster available. It might also increase the effectiveness of other depression treatments.

Cognitive behavioral therapy for insomnia (CBT-I) is the behavioral modification therapy of choice for sleep problems. If you think you might need professional help for this issue, find a mental health counselor trained in this modality. Different people benefit from different CBT-I interventions. Briefly, CBT-I practices include:

• Adjusting your sleep schedule as closely as possible to your natural circadian rhythms;
• Going to bed at around the same time every night, and getting up at (as nearly as possible) the same time every morning–even on the weekends;
• Using various techniques to reduce sleep anxiety;
• Staying busy during the day and refraining from napping;
• If needed, reducing your time in bed and/or getting out of bed during wakeful night hours to reset; and
• Tracking your sleep patterns in a sleep journal.

Substance and caffeine use can significantly impact sleep, reducing the length of your phase three deep sleep and increasing the length of your less restorative REM sleep.

Finally, if you are consistently sleeping poorly even while maintaining good habits, consider setting up a consultation with a sleep specialist. You might be suffering with a sleep disorder like sleep apnea without knowing it.

If desired, add “improving my sleep” to your depression treatment plan. Then set specific sleep-related goals and write them on your ongoing to-do list.

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