Do sleep disorders cause mood disorders or vice versa?
A. That s not an easy question to answer. It is a relationship that goes both ways. There is very clear evidence that when a person is experiencing a mood disorder, particularly a major depressive episode, he or she is highly likely to suffer from sleep disturbance — most often, insomnia. In fact, insomnia is so expected that it s part of the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). When surveying people who are depressed, we find that 80% experience sleeplessness, and it s not only the classic early-morning awakening associated with depression, but rather all the possibilities, including difficulty falling asleep and middle-of-the-night awakenings. There is also the issue of severity: The more depressed someone is, the more likely it is that he or she will have insomnia. The converse is true, too. If a person suffers from insomnia, over time it creates a risk for developing a mood disorder such as major depression. The
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