The Sleep-Depression Connection
Akil said the consistency of circadian rhythms has an evolutionary basis. Early humans would forage during daylight, so our brains evolved to signal our body to be alert during the day and slumber at night.
Ellen Frank, co-director of the University of Pittsburgh's Bipolar Institute, says that virtually all symptoms of depression run on a twenty-four-hour clock. Even suicidal thoughts and acts tend to occur at certain times. An Italian study found suicidal adolescents most often take their lives in the mid-afternoon while middle-aged people often choose times between 8 and 11 a.m.--partly because of their internal clocks.
Frank explains that most depression cases involve role changes or interpersonal struggles: transitioning from a college student to a cubicle worker, having a major dispute with a child, experiencing the death of a spouse. In the latter case, Frank says, partners have matching routines in sleep and mealtimes. "One adapts to that rhythm, and, when that partner's no longer there, that partner is at loose ends."
Understanding the importance of circadian rhythms, Akil says, opens new paths to treating mood disorders. Caregivers can focus on identifying disruptions in daily rhythms then look for solutions.
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