Ask the Psychiatrist: The Intimate Relationship Between Emotion, Mood, Sleep and Mental Health

“All of us know that when we don’t get the sleep we need, it affects our mood the next day. We’re moody, irritable and unable to focus or think clearly,” says Rachel Rohaidy, M.D., a board-certified psychiatrist with Baptist Health Primary Care. The simple solution is to get more sleep but that’s easier said than done, she acknowledges.

Even partial sleep deprivation can have a deleterious effect on mood, according to Dr. Rohaidy. Studies at the University of Pennsylvania and other institutions have shown that subjects who had just 4.5 hours of sleep per night for one week were feeling more stressed, angry, sad and mentally exhausted.

“Harvard Medical School has conducted several studies that demonstrate a clear link between sleep deprivation and mental health disorders such as anxiety and depression,” Dr. Rohaidy says. “The impact on your mental health can be significant and serious.”

Dr. Rohaidy explains that the brain needs to decompress and heal at night to enable the formation of long term memory. Without proper sleep, anything you learned during the day will be gone, she notes.

The link between how well you sleep and your mood is strong, Dr. Rohaidy says, as anxiety and stress can increase agitation and keep your body aroused, awake and alert. “If you’re sleep-deprived, you might also find that you can’t turn your brain off, your heart beats faster and your breathing is quick and shallow,” she says.  

Sleep affects your mood, mood affects your sleep

A study done last year by the National Institute of Mental Health showed 19 percent of adults are affected by anxiety disorder. “I don’t like to prescribe medications to treat anxiety and depression but will do so if behavior modifications – including sleep hygiene – don’t work,” Dr. Rohaidy says. “I prefer to send patients to Primary Care first to rule out a medical condition like thyroid disease that might be causing the symptoms.”

As medical director of the Recovery Village at Baptist Health, Dr. Rohaidy sees a wide variety of clients, a number of whom are being treated for pandemic-related stress issues.

“Many of the patients I see, when I ask them why they’re here, they say ‘I’m irritable and depressed, but nothing else is happening,’ yet during our conversations, I’m likely to learn that they’ve been sleeping poorly or not sleeping at all,” says Dr. Rohaidy. “There’s a circular effect – poor sleep affects your mood and your mood affects your sleep, and then it becomes self-reinforcing.”

Difficulty sleeping is one of the first signs of anxiety or depression, Dr. Rohaidy notes. “Roughly 15 to 20 percent of patients diagnosed with insomnia also have depression. It’s not the only issue, but it’s on the list,” she says. “Sleep is not the cure for mental illness, but it does help.”

Put a better night’s sleep on your ‘To Do’ list

“Thinking you don’t need to sleep is wrong,” Dr. Rohaidy says. “Your body needs to rest to help control stress, emotions and anxiety. Good sleep helps.” Unfortunately, she says, sleep and self-care often get pushed aside, thanks to our busy, stressful lives. “Getting enough sleep may seem intuitive but somehow it always gets bumped down on our ‘Must Do Today’ lists.’’ 

Human beings have two nervous systems, Dr. Rohaidy notes – rest and digest, and fight or flight. Fight or flight, she says, is your body’s way of “slamming the accelerator down and revving stress levels up” to give you the adrenaline jolt you need for an extra surge of energy in stressful situations.

“When that adrenaline jolt stays high, however, your body is in a constant state of arousal and doesn’t rest,” Dr. Rohaidy says. “And that can make you more prone to cardiovascular disease, heart attack, diabetes, cancer and poor outcomes in therapy.”

Dr. Rohaidy offers these tips for getting a better night’s sleep:   

• Plan – Pencil in a few things on your calendar to remind yourself to sleep and take care of yourself. It’s that important. Develop a time management strategy which includes adequate time for exercise, meditation and sleep.

• Exercise – Exercise is medicine. Twelve different studies have shown how exercise may be a treatment for anxiety and depression, and can help diminish some of their symptoms. Exercise can be anti-inflammatory, too. Identify what exercise gets your heart rate up a little and best fits your lifestyle.

• Meditate –Meditation looks like a lot of different things to different people. Try mindfulness meditation, yoga or get an app.

• Pray –Prayer helps you take stock of your emotions. In a recent study, meditation/prayer was found to be very helpful for anxiety and depression.

• Relax – Being in a comfortable position that is safe for you will help bring down those stress hormones.

• Supplement – Herbal supplements can be helpful, such as magnesium 500mg, which relaxes the muscles. Talk with your doctor before starting supplements to make sure they’re really good for you.

• Adopt – Many people adopted pets during the pandemic and studies have shown pets to be calming and help decrease your body’s stress response and inflammation. People who cared for pets had improved mental and psychological health, and older people who experienced pet therapy had less stress as well.  

• Sip – Have a cup of SleepyTime or some sort of relaxing green tea before bed.

• Unplug – Your bedroom is your sanctuary, and your bed is for two things – sleep and sex. Put your phone on sleep mode and don’t watch TV.

Dr. Rohaidy says if you try to practice even just one or two things on the list, you’ll find you’ll be sleeping better soon. It’s not a quick fix, she says, and it takes time to learn how to bring down your stress and get a better night’s sleep.

“As a society, we are sleep-deprived and we don’t value sleep as well as we should,” Dr. Rohaidy says. “But practicing good sleep hygiene and getting adequate rest really can help alleviate stress, anxiety and depression.”