Why Do I Get Depressed at Night?

Depression is a mood disorder affecting millions of people in the United States and around the world, which in its most severe forms can have a major impact on the everyday lives of sufferers.

Each individual with this disorder will have a very different experience. In many cases, for example, people report that their symptoms get worse at nighttime.

Others, however, may experience an afternoon slump or a worsening of symptoms in the morning upon waking up.

What Are the Symptoms?

Clinical depression can have a significant impact on the daily life of sufferers, often interfering with an individual's work and social life, in addition to basic behaviors such as sleeping and eating. For a mental health professional to diagnose someone with depression, the patient usually must have experienced symptoms for at least two weeks.

According to the National Institute of Mental Health, the severity of these symptoms differs significantly between individuals—and not everyone will experience all of them—but they can include:

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

What Can Cause Symptoms to Worsen at Night?

Many depression sufferers report that some aspects of their condition, such as feelings of sadness or worthlessness, seem to get worse at nighttime. There could be a number of reasons for this, involving biological, environmental and psychological factors.

One potential factor is the manner in which our mood is affected by regular changes that occur in our body every day.

"The circadian system, or biological clock, drives all our behavior, physiology, biochemistry following a 24-hour pattern," a chronobiologist from the Psychiatric Hospital of the University of Basel, Switzerland, told Newsweek. "Our mood, alertness, performance, well-being—as examples—follow the circadian rhythm of core body temperature, which has its maximum in the late afternoon and minimum in the second half of the night."

According to Anna Wirz-Justice, nighttime tends to be when mood is lowest in everyone, and this phenomenon can serve to exacerbate symptoms in those who are already depressed.

"It is normal to have some mood changes throughout the day, but this high and low is exaggerated and worse in those with depressive symptoms," she said.

Another reason that people may report worse symptoms at night is the fact that many people find themselves on their own at this time, removed from the many distractions of the day that usually keep them busy.

It could be the case that some people who report worse symptoms at night—perhaps when they are preparing to go to sleep, or lying in bed—may be somewhat distracted in the daytime as they work or engage in other activities. Only at nighttime, when they are on their own and alone with their thoughts, do they really become aware of how they are feeling.

Being alone at night also creates the ideal conditions for rumination, which is a common feature of depression. In this context, rumination is when people repeatedly focus on negative thoughts or aspects of their condition.

This can contribute to worsening symptoms at nighttime, by increasing feelings of sadness or anxiety, among other aspects of the disorder. Some people may also find themselves ruminating at night about the next day—for example, if they are dreading going to work.

When depression sufferers are alone at night—away from coworkers, friends or family—this may also contribute to feelings of isolation or loneliness, which in turn can exacerbate some of their symptoms. In addition, people may feel fatigued or exhausted at the end of the day, making it harder to deal with negative emotions.

Nighttime depressive symptoms can also interfere with the ability to sleep, keeping people awake as they lie in bed. This can lead to feelings of anxiousness or frustration, that in turn, make it even harder to sleep, while worsening some depressive symptoms further. The use of phones and other devices before bed can make the situation worse because the blue light they emit contributes to sleep problems.

Getting Therapy

Dr. Ken Duckworth, Chief Medical Officer at the National Alliance on Mental Illness, told Newsweek that the key for depression sufferers who experience daily variations in their symptoms is to understand your own particular pattern and discuss the issue with a therapist or health care provider.

"I don't think we really understand some of these patterns in detail," Duckworth said. "Let's assume you work during the week. Is the pattern different on the weekend? Is the structure of work and engagement in activities, presumably, in a community of people, helping you—through connection, engagement and activity—not feel as sad?"

"The test would be on a week off, how do you do? Is the pattern the same? Because that would imply a more biological route to it as opposed to environmental. Most of us do better when we're connected to people, engaged in activity, moving and sleeping well. But that doesn't mean that everybody has all those things all the time."

According to Wirz-Justice, anyone with two weeks or more of depressive symptoms—whether or not they experience them at day or night—should seek professional help.