Complaints about poor sleep are typical of depression. People complain that they fall asleep late, often wake up at night, get up too early. It is not surprising that at the same time they suffer from a terrible mood in the morning. Surprisingly, in many patients with depression, the mood improves somewhat in the evening, although during the day they do not fall asleep and the lack of sleep is not compensated.
Even more surprising is another phenomenon that I noticed after detailed questioning of my patients. They said that in the early hours of the morning they were often in a strange half-asleep state.
They don’t want to wake up completely, there is no feeling that they had a good night’s sleep (and this is not surprising, because the dream was bad), according to them, some broken thoughts flash through their heads, interspersed with vague visual visions. They are like dreams, but somewhat fragmentary, and the person has the impression that he is in an indefinite state between wakefulness and sleep.
Very often in this state, a person suffering from depression is forced to feel helpless and confused in front of threatening events and frightening images that pop up in the imagination.
If patients manage to interrupt this drowsy state, the development of morning depression can be prevented.
A similar state of semi-drowsiness occurs in a healthy person, when he has not had enough sleep and is very tired, but circumstances do not allow him to relax and fall asleep, and during wakefulness his eyes involuntarily close and short-term visions appear in drowsiness that have nothing to do with what he is. just tried to do it.
But the difference between healthy and sick people is that healthy people often feel some decrease in fatigue after such conditions, short-term relief, and in sick people they often turn into a morning exacerbation of depression.
Moreover, it turns out that if patients manage to interrupt this half-asleep state and, instead of staying in bed, get up and start doing something, even the simplest housework, the development of morning depression can be prevented.
This amazing phenomenon has a scientific justification. In the morning, all people have an increase in the amount of so-called “REM” sleep, the state in which we see and experience dreams.
Dreams perform a very important function. If they are qualitatively complete, they ensure the restoration of search activity after its decrease, which occurred during the wakefulness period for various reasons – from stress caused by failures to relaxation associated with the successful achievement of important goals.
Search activity not only helps to overcome life’s difficulties, but also increases the body’s resistance to stress and allows you to maintain physical and mental health.
This morning state is a mixture of drowsiness with fragments of such inferior REM sleep.
Therefore, a healthy person is usually ready to actively overcome difficulties in the morning after sleep, in contrast to his condition in the evening hours. But this only happens when REM sleep is functionally complete.
And in patients with depression, it is qualitatively flawed and not only does not contribute to the restoration of search activity, but even aggravates the state of refusal to search and enhances the feeling of helplessness. And this morning state is a mixture of drowsiness with fragments of such an inferior REM sleep.
In recent years, in some psychiatric clinics, the method of systematic early morning awakening has been used in the treatment of depression, which makes it possible to save patients from these states of drowsiness mixed with fragments of REM sleep. This leads to a good therapeutic effect.