Morning depression: What you need to know

It’s gotta’ stop. Not only are you waking up two hours before you want to, you can barely get out of bed when the time is right. And the depression is scary dark. Yeah, that’s enough.

The first version of this piece was written five and a half years ago. I’ve been hearing a lot of morning depression stories lately, so I decided to rework it and bring it to you again.

We’re going to be reviewing a whole lot of information. So maybe a couple of sittings or printing the piece will be helpful.

Let’s go…

What is morning depression?

For some, having a rough time getting after it in the morning is no big deal. Eh, throw some caffeine and a shower at it and life’s good.

But there are those for whom most every morning is a depressive hell. And let’s throw some crippling anxiety on the heap.

Sure, they most often feel better as the day goes on; however, thoughts of another brutal go in the morning are hard to shake.

That’s morning depression. And that’s what we’re going to work toward understanding.

Diurnal mood variation

Gaining insight into morning depression begins with learning about something known as diurnal mood variation (DMV).

You guessed it, keyword: diurnal…

Behavior characterized by activity during the day, with a period of sleeping, or other inactivity, at night.

In putting this section together, I turned to a fascinating article written by Dr. Anna Wirz-Justice, “Diurnal variation of depressive symptoms.”

Now, Wirz-Justice refers to “variation of depressive symptoms” and we’re discussing “diurnal mood variation.” We’re in the same ballpark.

Melancholia

Okay, the good doctor kicks things off by stating diurnal variation (DV) with early morning worsening is considered a core feature of melancholia.

What’s that? Well, these days it’s used as a major depressive disorder (MDD) diagnostic specifier. It features symptoms such as loss of appetite, excessive guilt, early morning awakening and, yes, early morning mood worsening.

And, by the way, early morning worsening isn’t the only pattern, as an afternoon slump or evening worsening can occur.

Circadian rhythm

Keep in mind, experiencing morning depression doesn’t 100% equate to having MDD with melancholic features. In fact, people considered to be “nonclinical” often have diurnal mood swings.

See, studies have shown that mood follows a circadian rhythm with the lowest values at around 4 a.m., the time when our core body temperature is at its minimum. And any interruption in circadian rhythm can result in a mood drop – for anyone.

I’ve always found comfort in explanations.

More from the doc

Need to share a few more interesting things from Wirz-Justice’s work…

• A study showed that for those in the midst of a major depressive episode, the lowest circadian mood occurred around the time of awakening. That shifted to several hours later, post-episode.
• Those diagnosed with MDD with melancholic features believe their mood variations are “uninfluenceable.” Nonclinicals believe their mood variations are almost exclusively related to their own activities and/or external circumstances.
• Evidence exists that shows there are definitely circadian underpinnings to mood, and timing and duration of sleep can be a modifier.
• Stable timing between internal rhythms such as temperature and sleep with respect to the external day/night cycle is crucial for overall well-being.

Dr. Wirz-Justice wraps things up by reiterating that mood changes throughout any given day are normal. If that’s the case, diurnal variation can’t be inherently pathological.

Still, research tells us any misalignment of internal clock, sleep, and external light/dark cycle can generate mood changes, especially in vulnerable individuals – like us.

Blood sugar levels and sleep

If you’re a frequent reader, you know I like to explore as many angles as possible. So let’s talk about the potential role of low blood sugar – hypoglycemia – in morning depression.

We’ll hit some biochemistry to get us started…

Insulin and glucagon

Our blood sugar levels are chemically regulated by the hormones insulin and glucagon. Glucagon increases blood sugar, insulin decreases it.

And wouldn’t you know it, the amount of sleep we get impacts the release of both. Hence, regulating our sleep patterns helps keep blood sugar levels within the norm during waking hours.

Now, blood sugar levels rise and fall during waking and sleeping hours. After at least eight hours of not eating, in a perfect world our blood sugar level is typically between 70-100 mg/dL. The level pops-up after eating; however, drops to less than 180 mg/dL two hours after.

With glucagon at work, our blood sugar levels start to rise in the evening and peak about three to four hours after falling asleep. And then along comes insulin to bring it down as an eight-hour sleep cycle ends. Could this drop generate morning depression? Hmm.

Sleep deprivation and other effects on blood sugar

Fact: “short-sleepers” have a much higher risk of developing impaired fasting blood sugar levels than “regular-sleepers.” Factors such as age, gender, and family history of diabetes can aid in determining the level of risk.

Some people deal with increased irritability or sad mood when they’re experiencing a rapid change in blood sugar level. That can be a decrease, but still in normal range (80-130 mg/dL), and it can be when levels are low (below 70 mg/dL).

Then there are those who may experience irritability or sadness when blood sugar levels are high (250 mg/dL+).

In either case, changes in mood tend to be temporary and will be reduced or cease when blood sugar levels return to target range.

Huge factor to explore, don’t you think?

The transitioning to reality crash

As we wrap up this info fest, I want to mention a phenomenon I’ve always believed to be at play with my morning depression – and anxiety.

I’ve even named it: the “transitioning to reality crash.” And it especially applies to those who, at baseline, lean toward the lowish-mood and/or anxious.

Even in particularly depressed or anxious times, most of us can manage to pull off at least a couple hours of sleep – leaving our woes behind. Yeah, but then it’s time to wake-up, and it doesn’t take long for our misery to resurface.

It’s my opinion the onslaught – transition to reality – can be hard to handle. And let’s keep in mind we haven’t had much time to crank up our trusted defenses. So we’re, um, raw.

Good news is, if we can get active, we can expect a significant improvement in fairly short order. The bad news is, getting through it is such a drag.

Let’s get to work

Well, that’s a wrap. I realize we didn’t get into remedies, but there’s only so much space. Besides, now you have all sorts of info to get you started on your research and custom solutions.

Morning depression: scary dark, for sure. However, with knowledge, tenacity, and creativity, a peaceful coexistence is ours for the taking.

Come on, let’s get to work.

Suggesting you read Dr. Wirz-Justice’s article. Well worth the time.

And then there are those Chipur mood and anxiety disorder info and inspiration articles. Go ahead and check ’em out.