Morning depression

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Morning Depression: Insights from Recent Research

Morningness-Eveningness and Depressive Symptoms

Morningness-Eveningness and Depression in University Students

Research has shown a significant relationship between morningness-eveningness preferences and depressive symptoms among university students. A study involving 974 Polish students found that those with a morning preference (morning affect, MA) exhibited fewer depressive symptoms across various components, including depressed/somatic affect and positive affect, compared to those with an evening preference . This suggests that individuals who are more active and alert in the morning tend to experience fewer depressive symptoms.

Chronotype and Depression Severity in Inpatients

Further supporting these findings, another study on hospitalized patients with depressive disorders revealed that those with an evening preference had higher depression scores at both admission and discharge compared to those with a morning preference. Cognitive symptoms were particularly more pronounced in evening types, highlighting the importance of considering chronotype in the diagnosis and treatment of depression .

Biological and Psychological Mechanisms

Cortisol Levels and Depression

Elevated morning cortisol levels have been identified as a biomarker for major depression, particularly in boys with high depressive symptoms. This hormonal marker, combined with high depressive symptoms, indicates a higher risk for clinical depression, suggesting that morning cortisol levels could be used to identify at-risk adolescents .

HPA Axis Dysregulation

The hypothalamic-pituitary-adrenal (HPA) axis plays a crucial role in the stress response and is often dysregulated in depression. Studies have shown that individuals with melancholic depression, characterized by severe morning depression, exhibit hyperactivity of the HPA axis, leading to elevated cortisol levels and other stress-related symptoms 69. This dysregulation is less pronounced in atypical depression, where symptoms are often worse in the evening.

Impact of Sleep on Morning Affect

Sleep Duration and Quality

Sleep disruptions significantly impact morning affect, especially in individuals with higher depression severity. Research indicates that sleeping longer and later than usual is associated with better morning mood. Conversely, shorter sleep duration and poor sleep quality exacerbate morning depressive symptoms in those with severe depression . This suggests that improving sleep hygiene could be a potential intervention for reducing morning depression.

Therapeutic Interventions

Bright Light Therapy

Bright light therapy has been shown to be effective in treating winter depression, with morning light proving more beneficial than evening light. Patients exposed to bright light in the morning experienced a significant reduction in depressive symptoms compared to those who received evening light therapy . This highlights the potential of morning light exposure as a non-pharmacological treatment for morning depression.

Exercise Timing

Exercise, regardless of whether it is performed in the morning or evening, has been found to improve mood and reduce depression. A study on former elite male athletes demonstrated that both morning and evening exercise significantly reduced depressive symptoms, suggesting that physical activity at any time of day can be beneficial for mental health .

Conclusion

Morning depression is a multifaceted issue influenced by chronotype, biological mechanisms, sleep patterns, and lifestyle factors. Understanding the interplay between these elements can help in developing targeted interventions to alleviate depressive symptoms. Morning light therapy, proper sleep hygiene, and regular exercise are promising strategies for managing morning depression. Further research is needed to explore these interventions and their long-term efficacy in diverse populations.

Sources and full results

Most relevant research papers on this topic

Morningness-eveningness and depressive symptoms: Test on the components level with CES-D in Polish students.

Morningness-eveningness is linked to less depressive symptoms in university students, with morningness-eveningness being more associated with positive affect and better interpersonal relations.

Observational StudyHighly Cited

2016·

70citations

·K. Jankowski

A Note on Morning Depressions

The purpose of this communication is to consider some aspects of depressed mood in the morning. Such a consideration can account for a very wide range of depressed affect. This will include getting up on “the wrong side of the bed and feeling down in the dumps,” or “having the blues” for a few hours in the morning as well as the depression of the psychotic patient who so often has intolerable mornings. In the field of dreams and affects, this note will cover only two points of relationship: a theoretical consideration of depressed affect after waking and, af€ect as a consequence of thoughts and affects while sleeping. Freud (8) in his “Mourning and Melancholia” discussed the clinical similarities as well as some important differences between grief and melancholia. In grief, following the actual loss of a loved object, a feeling of impoverishment and emptiness pervades, while in melancholia there is an emotional loss of the love object. “The melancholic displays an extraordinary fall of self-esteem, a loss of the ego: the ego itself seems poor and empty, and is inclined to self-reproaches.” These states also have been considered by Abraham (1, Z), Rado (14), Federn (6), Edoardo IYeiss (16), Edith Jacobson (lo), and others. There are two major trends of thought in considering the mechanism of depression. These have been elaborated upon recently by Edward Bibring (3). He approaches

1954·

2citations

·S. Guttman

Clinical Practice Guidelines for the management of Depression

Depression presents with a combination of symptoms, including depressed mood, loss of interest or pleasure, decreased energy, fatigue, reduced concentration, and self-esteem, thoughts of guilt and unworthiness, and disturbed sleep and diminished appetite.

Rigorous JournalHighly Cited

2017·

165citations

·S. Gautam et al.

Patterns of self-reported depressive symptoms in relation to morningness-eveningness in inpatients with a depressive disorder

Evening preference (chronotype) is associated with higher depressive symptoms and cognitive symptoms in hospitalized patients with depressive disorders.

Observational StudyRigorous Journal

2016·

31citations

·Matthias J. Müller et al.

Elevated morning cortisol is a stratified population-level biomarker for major depression in boys only with high depressive symptoms

High morning cortisol levels are a common biomarker for major depression in boys, with impaired memory recall in both sexes.

Observational StudyHighly Cited

2014·

115citations

·M. Owens et al.

Organization of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states

Melancholic depression is associated with hyperactive stress response, while atypical depression is associated with down-regulated stress response and CRH deficiency.

Highly Cited

2002·

1302citations

·P. Gold et al.

Bright light treatment of winter depression: morning versus evening light

Morning bright light significantly reduces winter depression symptoms more effectively than evening light.

RCTHighly Cited

1990·

117citations

·David H. Avery et al.

Waking up on the wrong side of the bed: Depression severity moderates daily associations between sleep duration and morning affect

Sleeping longer or later than usual improves morning mood, but sleep duration and quality impact morning affect differently for individuals with higher depression severity.

Observational Study

2023·

2citations

·D. Wescott et al.

HPA axis and aging in depression: Systematic review and meta-analysis

Older individuals with depression show high dysregulation of HPA axis activity, potentially due to physical illnesses, CNS alterations, and immune-endocrinological alterations.

Meta-AnalysisHighly Cited

2014·

307citations

·M. Murri et al.

Effect of Time-of-Day-Exercise in Group Settings on Level of Mood and Depression of Former Elite Male Athletes

Exercise at different times of the morning or evening can improve psychological state and reduce depression in former elite male athletes.

RCTRigorous Journal

2019·

29citations

·K. Irandoust et al.

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