‘Urgent studies needed’ into mental health impact of coronavirus

Rapid and rigorous research into the impact of Covid-19 on mental health is needed to limit the impact of the pandemic, researchers have said.

Experts say newly conducted polls and emerging studies into Covid-19 together with lessons from past outbreaks suggest that the pandemic could have profound and potentially long-term impacts on mental health.

The team say it is now crucial to begin a thorough and coordinated programme of research to delve into the impact of the coronavirus itself, as well as policies like lockdown..

Prof Ed Bullmore, head of the department of psychiatry at the University of Cambridge and a co-author of the new report, said research conducted so far has been small-scale and fragmented.

“Our key message is that Covid is likely to have major impacts on mental health now and into the future and we need to start thinking about that immediately,” he said.

Writing in the journal Lancet Psychiatry, Bullmore and a team of colleagues in mental health sciences brought together by the charity MQ and the UK Academy of Medical Sciences, say that among key priorities is the need for real-time monitoring of mental health issues, both across the general population and at-risk groups, as well as healthcare professionals.

“The pandemic is clearly having a major social and psychological impact on the whole population, increasing unemployment, separating families and various other changes in the way that we live that we know are generally major psychological risk factors for anxiety, depression and self-harm,” said Bullmore.

The team say there is also a need to look at the impact of policies to manage the pandemic on unemployment and poverty, which play a role in mental health problems.

They add that among other priorities, it is important to explore ways people have found to cope with the pandemic, and urgently find ways to support mental wellbeing, particularly in vulnerable groups as well as healthcare workers..

They also flag a need to understand the impact of repeatedly looking at news and other media around Covid-19

And the researchers say more investigations are needed into the possible impact of the coronavirus on the brain, noting recent research from China which found that of 214 patients in hospitals in Wuhan with Covid-19, 78 reported neurological symptoms.

“We think it is also possible that there will be an impact on mental health more specifically in Covid patients in ways that are linked to the brain and the body’s response to viral infection,” said Bullmore.

The team stress that the research programme could not only provide insights into how to tackle outbreaks and ramifications of Covid-19 in the future, but could help in the short-term – for example in finding the best way to communicate public health measures and change behaviours without triggering distress, and repurposing digital therapies that can be rapidly scaled up and delivered to those in need.

Prof Rory O’Connor, from the University of Glasgow, a co-author of the study, said that while it is too early to say for certain what the mental health impact of Covid-19 will be, there are lessons to learn from the past.

“If we look at the Sars outbreak in 2003, we know there is evidence there that there were increased rates of anxiety, increased rates of depression and post-traumatic stress and, in some groups, there were also increased rates of suicide,” he said.

The team also reveal results from two online surveys, covering more than 3,000 people in total, conducted in the UK in the week the lockdown began. One focused largely on people who had experience of mental health problems while the other involved the UK general public.

The team say the surveys flagged widespread concerns among participants about the impact of the coronavirus on mental health, from access to support services to concerns around social isolation and increases in anxiety and other problems.

While Bullmore added that it was understandable that the physical health impacts of Covid-19 had received significant funding, it was also important to prepare for the mental health aspects.

“When we are thinking about this as a health crisis we need to keep thinking about mental and physical health together and not apart,” he said.

Prof Wendy Burn, president of the Royal College of Psychiatrists, welcomed the team’s call for action, adding that mental health research is significantly underfunded, lagging behind funding for illnesses such as cancer.

“The long-term mental health impacts of this unprecedented pandemic – on people with existing mental illness and other vulnerable groups, on the health and social care workforce, and on the healthy population – are not yet fully known but they may be equally unprecedented,” she said.

• In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at



Neuro-Linguistic Programming Therapy

Zaharia C, Reiner M, Schutz P. Evidence-based neuro linguistic psychotherapy: a meta analysis. Psychiatria Danubina. 2015;27(4):355-363.

Neurolinguistic Psychotherapy and Counseling Association (UK)

Wake L and Leighton M. Pilot study using neurolinguistic programming in post-combat PTSD. Mental Health Review Journal. 2014;19(4):251-264.

Hollander J and Malinowski O. The effectiveness of NLP: Interrupted time series analysis of single subject/data for one session of NLP coaching. Journal of Experiential Psychotherapy. December 2016;19(76):41-58.

Gray RM. Current Research in NLP (Vol 2): Proceedings of 2010 Conference. p.33-42.

Witkowski, T. (2010). Thirty-Five Years of Research on Neuro-Linguistic Programming. NLP Research Data Base. State of the Art or Pseudoscientific Decoration? Polish Psychological Bulletin,41(2). 

Sturt, J., Ali, S., Robertson, W., Metcalfe, D., Grove, A., Bourne, C., & Bridle, C. (2012). Neurolinguistic programming: A systematic review of the effects on health outcomes. British Journal of General Practice,62(604).



Neuro Linguistic Programming

What is Neuro-Linguistic Programming?

Neuro-Linguistic Programming (NLP) is the systemic study of human communication and how humans create their reality. NLP is often known as the study of replicating excellence, as it asks the question, how successful individuals consistently achieve the results they do. These successful people have naturally created internal productive strategies which they can repeat and map over to different areas of their life. NLP is an approach, a methodology, and a skill set to recognize and change the structure of your habits and experience promoting ongoing personal growth. 

Why is the course called  Neuro-Linguistic Programming?


Neuro is short for neurology. The structure of your mind and how you think, everything you experience stems from the neurological processes of your sight, hearing, smell, taste, and touch. You experience the world through your five senses; you make “sense” of the information and then act on it. By understanding neurology, you can achieve excellence in action.


Linguistic refers to language. How you use your language and how it affects you. We use language to order our thoughts and behaviors to communicate with others. Excellent communication is the basis of creating excellent results. This is true internally as well as externally.


Programming here is meaning the sequence of your internal processes, actions and outward behaviors that you use to achieve your goals. You can choose to organize your ideas and actions to produce the results you want.

Take your Neuro-Linguistic skills even further! This is an interactive 12-day course of NLP training that builds on the NLP Practitioner Training. It is divided into 2 parts and encompasses 6 core components. Deepen and expand your NLP skills as a Coach and immerse yourself in an environment that supports your evolution and capacity for lifelong change.

Learn More About NLP Master Practitioner Training

Would you like to contact one of our Enrollment Advisors directly?  Call us Toll Free: 1 877-435-1455



What is NLP?

“The conscious mind is the goal setter, and the unconscious mind is the goal getter.”

Your unconscious mind is not out to get you–rather, it’s out TO GET FOR YOU whatever you want in life. However, if you don’t know how to communicate what you want properly, it will keep bringing steaming bowls of liver stew out of the kitchen. In fact, go ahead right now and think of, if there was one thing you could change, one habit you could break, what would it be?



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Transcendental Meditation: Benefits, Technique, and More

Transcendental Meditation (TM) is a technique for avoiding distracting thoughts and promoting a state of relaxed awareness. The late Maharishi Mahesh Yogi derived TM from the ancient Vedic tradition of India. He brought the technique to the U.S. in the 1960s.

While meditating, the person practicing TM sits in a comfortable position with eyes closed and silently repeats a mantra. A mantra is a word or sound from the Vedic tradition that is used to focus your concentration.

According to supporters of TM, when meditating, the ordinary thinking process is “transcended.” It’s replaced by a state of pure consciousness. In this state, the meditator achieves perfect stillness, rest, stability, order, and a complete absence of mental boundaries.

Some studies have found that regular meditation can reduce chronic pain, anxiety, high blood pressure, cholesterol, and the use of health care services.

Meditation, both TM and other forms, is generally safe and may improve a person’s quality of life. But experts agree that meditation shouldn’t be used as a single treatment for any particular health condition, or instead of conventional medical care.

Unlike some forms of meditation, TM technique requires a seven-step course of instruction from a certified teacher.

A TM teacher presents general information about the technique and its effects during a 60-minute introductory lecture. That’s followed by a second 45-minute lecture in which more specific information is given. People interested in learning the technique then attend a 10- to 15-minute interview and 1 to 2 hours of personal instruction. Following a brief ceremony, they’re each given a mantra, which they’re supposed to keep confidential.

Next come 3 days of checking for correctness with 1 or 2 more hours of instruction. In these sessions, the teacher does the following:

  • Explains the practice in greater detail
  • Gives corrections if needed
  • Provides information about the benefits of regular practice

Over the next several months, the teacher regularly meets with practitioners to ensure correct technique.

People practice TM twice a day for 15 to 20 minutes. That usually means once in the morning before breakfast and once in the afternoon before dinner.

TM does not require any strenuous effort. Nor does it require concentration, or contemplation. Instead, students are told to breathe normally and focus their attention on the mantra.

A few reports suggest that meditation can cause or worsen symptoms in people with certain psychiatric conditions. If you have an existing mental health condition, consult your doctor before starting TM. Also let your meditation instructor know about your condition.

WebMD Medical Reference Reviewed by Tyler Wheeler, MD on January 27, 2020



National Center for Complementary and Alternative Medicine: “Meditation: An Introduction.”

American Cancer Society: “Meditation.”

Agency for Healthcare Research and Quality: “Meditation Practices for Health: State of the Research.”

Maharishi Foundation USA: “The Transcendental Meditation Program: How to Learn,” “The Transcendental Meditation Program: Research.”


Cath Lab Digest: “American Heart Association: Transcendental Meditation a Proven Approach to Lowering Blood Pressure, Doctors May Consider in Clinical Practice.”

© 2020 WebMD, LLC. All rights reserved.



Mental health effects of COVID-19 revealed in new study

New research has demonstrated that the pandemic has led to a significant increase in the number of mental health issues affecting people in the United Kingdom.

A mother in the United Kingdom seen on a conference call while attending to her toddler in order to illustrate mental health effects of COVID-19.Share on Pinterest New research shows that mental health issues significantly increased during the lockdown.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub and follow our live updates page for the most recent information on the COVID-19 outbreak.

Mental health issues significantly increased in the U.K. during lockdown in response to the COVID-19 pandemic, a new study has suggested.

Furthermore, the study identifies some of the mediating factors that affected people’s ability to cope with the pandemic. It also highlights the particular effect that the pandemic had on the people whom the U.K. government identified as vulnerable.

The research, which appears in the journal American Psychologist, could help inform future mental health strategies for dealing with the psychological consequences of the pandemic.

COVID-19 has had a devastating effect on people’s physical health. Across the world, hundreds of thousands of people have died, and many people have experienced persistent symptoms long after leaving the hospital.

However, as well as causing major physical health issues, the pandemic has also been taking a toll on people’s mental health.

Earlier this year, researchers looking at the effects of past quarantines on mental health also sought feedback from the general population and people with preexisting mental health issues on their experiences during the current pandemic. The team concluded that a significant negative effect is an expected consequence of the various lockdowns that governments have implemented around the world.

Further research from China found that 35% of people experienced mental distress during the first month of the COVID-19 outbreak and that these levels continued as the disease spread over the coming months.

A global pandemic is clearly a distressing event. People react to distressing events in different ways, with some reactions having a more detrimental effect than others on a person’s quality of life.

In the present study, the authors wanted to identify the general level of psychological distress that people experienced during the pandemic and the resulting lockdown in the U.K., as well as the factors that meant that some people experienced more distress than others.

The authors also looked specifically at people whom the U.K. government classed as vulnerable to COVID-19. This group included people with underlying health conditions, such as chronic respiratory disease, those aged 70 years or over, individuals with a weakened immune system, and pregnant women.

According to the lead author of the study, Dr. Hannah Rettie from the University of Bath’s Department of Psychology:

“The COVID-19 pandemic has caused global uncertainty, which has had a direct, detrimental effect on so many people across the U.K. and around the world. People have been unsure when they would see relatives again, job security has been rocked, there is an increased threat to many people’s health, and government guidance is continuously changing, leading to much uncertainty and anxiety.”

“What our research focused in on is how some individuals have struggled to tolerate and adapt to these uncertainties — much more so than in normal times,” continues Dr. Rettie.

“These results have important implications as we move to help people psychologically distressed by these challenging times in the weeks, months, and years ahead.”

To conduct their study, the authors recruited 842 people via social media and other online channels. These individuals answered questions during a 10-day period in April, after the U.K. had entered a national lockdown.

80% of the respondents were female, and the average age was 38 years. Of the respondents, 22% reported a preexisting mental health condition — primarily anxiety, depression, or mixed anxiety and depression.

After analyzing the data, the authors found that almost 25% of the respondents experienced significantly worse anxiety and depression during lockdown.

In total, 37.5% of the respondents met clinical metrics for generalized anxiety, depression, or health anxiety during the survey period.

Health anxiety — being fearful of developing a serious disease, despite reassurances from medical professionals — was significant enough to be clinically recognized in almost 15% of the respondents.

The health anxiety of those in vulnerable groups was about twice that of people in the general population. People in vulnerable groups also experienced more depression and generalized anxiety.

The authors found that key predictors for worse mental health were a person’s “intolerance of uncertainty” and how they coped with this intolerance.

Coping strategies that experts consider unhelpful, such as denial, self-blame, and substance use, tended to have a negative effect on a person’s mental health. This was the case whether the person was part of a vulnerable group or not.

As a consequence of their findings, the authors suggest focusing psychological resources on helping individuals learn how to use coping strategies that tend to promote positive mental health.

They also suggest that policymakers ensure that vulnerable groups receive adequate mental health services, as they experience higher levels of distress and are also likely to have been in isolation for the longest.

Anxiety is an understandable response to the current pandemic. However, if anxiety becomes severe, it can have a significant adverse effect on a person’s day-to-day life.

As the research lead Dr. Jo Daniels, also of the Department of Psychology at Bath, notes: “While this research offers important insights into how common distress was during ‘lockdown,’ it is important to stress that anxiety is a normal response to an abnormal situation, such as a pandemic. It can be helpful to mobilize precautionary behaviors, such as hand washing and social distancing.”

“Yet for many,” continues Dr. Daniels, “as reflected in our findings, anxiety is reaching distressing levels and may continue despite easing of restrictions — it is essential we create service provision to meet this need, which is likely to be ongoing, particularly with current expectations of a second wave. Further longitudinal research is needed to establish how this may change over time.”



Meditation | UMD Health Center

Mondays: 9:30 am – 10:15am

This free session is open to students and will begin Monday, September 14th.


Message Card Meditation

Participants will be invited to intuitively select an oracle card (also called “affirmation cards” or “medicine cards”), revealing a theme or message that will serve as your personal point of reflection for the practice. You will be guided through individual meditation anchored in the medicine of your card, and then everyone will be offered the opportunity to share reflections with the group if desired, and we will join in gentle breathwork together to close out the practice.

Please Note: Registering for Monday will give you one access link for all Monday sessions for the duration of the semester.

zoom registration

Tuesdays: 2:00pm – 2:15pm

This free session is open to students, staff, and faculty and will begin Tuesday, September 15th.


Movement and Mindfulness Meditation

In this short, guided practice, participants will have the chance to slow down and focus on the present moment while exploring a form of movement that feels right for them. 

Please Note: Registering for Tuesday will give you one access link for all Tuesday sessions for the duration of the semester.

zoom registration

Wednesdays: 12:30pm – 1:00pm

This free session is open to students, staff, and faculty and will begin Wednesday, September 9th.


Community Meditation

This mid-week guided meditation is an opportunity for students, staff, and faculty to join together as a community, pause, and focus on the present moment. Sessions may include breathing practices, progressive muscle relaxation, guided imagery, and more. 

Please Note: Registering for Wednesday will give you one access link for all Wednesday sessions for the duration of the semester.

zoom registration

Thuesdays: 9:30am-10:15am.

This free session is open to students and will begin Thursday, September 10th.


Circle Meditation

For the first part of practice, participants will practice meditation through gentle breathwork or another mindfulness exercise, and then be guided through a meditative practice to nourish the mind, body, and spirit. The second part of practice will be spent in community, where we will hold supportive space for each other, called “circle”, to share what came to us through our meditation experience – or to simply be together.

Please Note: Registering for Thursday will give you one access link for all Thursday sessions for the duration of the semester.

zoom registration

Fridays: 4:00pm-5:00pm.

This free session is open to staff and faculty and will begin Friday, September 11th.


Wind Down for the Weekend

As we continue to navigate both remote and on-campus work, we must continue to find ways to care for and nourish ourselves. Join together with fellow staff and faculty on Friday afternoons to wind down from the work week and transition to the weekend. Sessions will explore breathing practices and various meditation styles, along with time for guided reflection. 

Please Note: Registering for Friday will give you one access link for all Friday sessions for the duration of the semester.

zoom registration



Acute mental health care | Washington State Health Care Authority

When people are gravely disabled or likely to harm themselves or others, they receive acute psychiatric inpatient treatment in a community hospital or a certified evaluation and treatment facility. This level of care is to quickly evaluate, diagnose and stabilize acute symptoms. 

Do you need immediate assistance? ​Crisis services are available to all Washington residents. Find a crisis line near you.


Lourdes Counseling Center
1175 Carondelet Drive, Richland, WA 99352
Phone: 509-943-9104

  • Adult inpatient evaluation and treatment facility


Daybreak Youth Evaluation and Treatment Facility
11910 NE 154th St, Brush Prairie, WA 98606
Phone: 888-454-5506​


PeaceHealth St John’s Medical Center
1615 Delaware St, Longview, WA 98632
Phone: 360-414-2000

  • Adult inpatient evaluation and treatment facility


Auburn Multicare behavioral health inpatient services

BHC Fairfax
10200 NE 132nd Street, Kirkland, WA 98034
Phone: 425-821-2000

  • Adult inpatient evaluation and treatment facility
  • Child inpatient evaluation and treatment facility

Cascade Behavioral Health Hospital

Harborview Medical Center
325 Ninth Avenue, Seattle, WA 98104-2499
Phone: 206-744-3076

  • Adult inpatient evaluation and treatment facility
  • Emergency crisis intervention services

2600 SW Holden Street, Seattle, WA 98126
Phone: 206-933-7299

  • Adult inpatient evaluation and treatment facility

UW Medical Center-Northwest
​1550 N. 115th Street Seattle, WA 98133
Phone: 206-368-1835

  • Older adult inpatient evaluation and treatment facility

Swedish Medical Center inpatient services

Telecare Corporation Evaluation and Treatment
33480 13th Place South
Federal Way, WA 98003
Phone: 253-285-7101


Kitsap Adult Inpatient Unit
5455 Almira Drive NE, Bremerton, WA 98311
Phone: 360-377-8581

  • Adult inpatient evaluation and treatment facility
  • Child inpatient evaluation and treatment facility

Kitsap Youth Inpatient Unit
​5455 Almira Drive NE, Bremerton, WA 98311

  • Child inpatient evaluation and treatment facility
  • Adolescent evaluation and treatment facility


ABHS Secure Withdrawal Management and Stabilization Facility
505 SE Adams St, Chehalis, WA 98532
Phone: 360-266-5029

  • Adult withdrawal management and stabilization facility

Lewis County Evaluation and Treatment facility
3510 Steelhammer Lane, Centralia WA 98531
Phone: 360-623-8001

  • Adult inpatient evaluation and treatment facility


Greater Lakes Evaluation and Treatment Facility
14016 South A Street, Parkland, WA 98444
Phone: 253-503-3649

  • Adult evaluation and treatment facility

RI International Evaluation and Treatment Facility
8103 Steilacoom Boulevard SW, Lakewood, WA  98493
Phone: 253-942-5644

  • Adult evaluation and treatment facility


Skagit Valley Hospital
1415 E Kincaid, Mount Vernon, WA 98274 
Phone: 360-814-2422 or 360-428-2293

  • Adult inpatient evaluation and treatment facility

Telecare North Sound E&T
7825 North Sound Drive, Sedro Woolley, WA 98284
Phone: 360-854-7400

  • Adult inpatient evaluation and treatment facility


Monroe Fairfax Psychiatric Unit
Evergreen Health Center
14841 179th Avenue SE, Monroe, WA
Phone: 360-365-5300

Snohomish County Evaluation and Treatment Facility
10710 Mukilteo Speedway, Mukilteo, WA 98275
Phone: 425-349-6200

  • Adult inpatient evaluation and treatment facility

Swedish Edmonds Hospital
21601 76th Avenue West, Edmonds, WA 98026 
Phone: 425-640-4090

  • Adult inpatient evaluation and treatment facility


ABHS Secure Withdrawal Management and Stabilization Facility
44 E Cozza Dr, Spokane, WA 99208
Phone: 509-325-6800

  • Adult withdrawal management and stabilization facility

Calispel Evaluation and Treatment Facility
1401  North Calispel, Spokane, WA  99201
Phone: 509-838-4651

  • Adult evaluation and treatment facility

Foothills Evaluation and Treatment Facility
505 East North Foothills Drive, Spokane, WA  99207
Phone: 509-838-4651

  • Adult evaluation and treatment facility

Providence Sacred Heart Medical Center
101 West 8th Ave. Spokane, WA 99204
Phone: 509-474-3131

  • Adult and adolescent evaluation and treatment facility


Alliance E&T
230 East Birch Street, Colville, WA  99114

  • Adult evaluation and treatment facility

Mason and Thurston County

Thurston-Mason Evaluation and Treatment Center
3436 Mary Elder Road, NE Olympia, WA 98506
Phone: 360-528-2590

  • Adult inpatient evaluation and treatment facility


Peace Health Medical Center
2900 Squalicum Parkway, Bellingham, WA 98225
Phone: 360-788-6993

  • Adult evaluation and treatment facility


Yakima Valley Memorial Hospital
2811 Tieton Drive,Yakima, WA 98902
Phone: 509-575-8002

  • Adult inpatient evaluation and treatment facility



Sleep and mental health – Harvard Health

sleep and mental health

Sleep and mental health are closely connected. Sleep deprivation affects your psychological state and mental health. And those with mental health problems are more likely to have insomnia or other sleep disorders.

Americans are notoriously sleep deprived, but those with psychiatric conditions are even more likely to be yawning or groggy during the day. Chronic sleep problems affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).

Traditionally, clinicians treating patients with psychiatric disorders have viewed insomnia and other sleep disorders as symptoms. But studies in both adults and children suggest that sleep problems may raise risk for, and even directly contribute to, the development of some psychiatric disorders. This research has clinical application, because treating a sleep disorder may also help alleviate symptoms of a co-occurring mental health problem.

The brain basis of a mutual relationship between sleep and mental health is not yet completely understood. But neuroimaging and neurochemistry studies suggest that a good night’s sleep helps foster both mental and emotional resilience, while chronic sleep deprivation sets the stage for negative thinking and emotional vulnerability.

Key points

  • Sleep problems are more likely to affect patients with psychiatric disorders than people in the general population.
  • Sleep problems may increase risk for developing particular mental illnesses, as well as result from such disorders.
  • Treating the sleep disorder may help alleviate symptoms of the mental health problem.

How sleep affects mental health

Every 90 minutes, a normal sleeper cycles between two major categories of sleep — although the length of time spent in one or the other changes as sleep progresses.

During “quiet” sleep, a person progresses through four stages of increasingly deep sleep. Body temperature drops, muscles relax, and heart rate and breathing slow. The deepest stage of quiet sleep produces physiological changes that help boost immune system functioning.

The other sleep category, REM (rapid eye movement) sleep, is the period when people dream. Body temperature, blood pressure, heart rate, and breathing increase to levels measured when people are awake. Studies report that REM sleep enhances learning and memory, and contributes to emotional health — in complex ways.

Although scientists are still trying to tease apart all the mechanisms, they’ve discovered that sleep disruption — which affects levels of neurotransmitters and stress hormones, among other things — wreaks havoc in the brain, impairing thinking and emotional regulation. In this way, insomnia may amplify the effects of psychiatric disorders, and vice versa.

Psychological effects of sleep deprivation

More than 70 types of sleep disorders exist. The most common problems are insomnia (difficulty falling or staying asleep), obstructive sleep apnea (disordered breathing that causes multiple awakenings), various movement syndromes (unpleasant sensations that prompt night fidgeting), and narcolepsy (extreme sleepiness or falling asleep suddenly during the day).

Type of sleep disorder, prevalence, and impact vary by psychiatric diagnosis. But the overlap between sleep disorders and various psychiatric problems is so great that researchers have long suspected both types of problems may have common biological roots.

Depression. Studies using different methods and populations estimate that 65% to 90% of adult patients with major depression, and about 90% of children with this disorder, experience some kind of sleep problem. Most patients with depression have insomnia, but about one in five suffer from obstructive sleep apnea.

Insomnia and other sleep problems also increase the risk of developing depression. A longitudinal study of about 1,000 adults ages 21 to 30 enrolled in a Michigan health maintenance organization found that, compared with normal sleepers, those who reported a history of insomnia during an interview in 1989 were four times as likely to develop major depression by the time of a second interview three years later. And two longitudinal studies in young people — one involving 300 pairs of young twins, and another including 1,014 teenagers — found that sleep problems developed before major depression did.

Insomnia and other sleep problems affect outcomes for patients with depression. Studies report that depressed patients who continue to experience insomnia are less likely to respond to treatment than those without sleep problems. Even patients whose mood improves with antidepressant therapy are more at risk for a relapse of depression later on. Depressed patients who experience insomnia or other sleep disturbances are more likely to think about suicide and die by suicide than depressed patients who are able to sleep normally.

Bipolar disorder. Studies in different populations report that 69% to 99% of patients experience insomnia or report less need for sleep during a manic episode of bipolar disorder. In bipolar depression, however, studies report that 23% to 78% of patients sleep excessively (hypersomnia), while others may experience insomnia or restless sleep.

Longitudinal studies suggest that insomnia and other sleep problems worsen before an episode of mania or bipolar depression, and lack of sleep can trigger mania. Sleep problems also adversely affect mood and contribute to relapse.

Anxiety disorders. Sleep problems affect more than 50% of adult patients with generalized anxiety disorder, are common in those with post-traumatic stress disorder (PTSD), and may occur in panic disorder, obsessive-compulsive disorder, and phobias. They are also common in children and adolescents. One sleep laboratory study found that youngsters with an anxiety disorder took longer to fall asleep, and slept less deeply, when compared with a control group of healthy children.

Insomnia may also be a risk factor for developing an anxiety disorder, but not as much as it is for major depression. In the longitudinal study of teenagers mentioned earlier, for example, sleep problems preceded anxiety disorders 27% of the time, while they preceded depression 69% of the time.

But insomnia can worsen the symptoms of anxiety disorders or prevent recovery. Sleep disruptions in PTSD, for example, may contribute to a retention of negative emotional memories and prevent patients from benefiting from fear-extinguishing therapies.

ADHD. Various sleep problems affect 25% to 50% of children with ADHD. Typical problems include difficulty falling asleep, shorter sleep duration, and restless slumber. The symptoms of ADHD and sleeping difficulties overlap so much it may be difficult to tease them apart. Sleep-disordered breathing affects up to 25% of children with ADHD, and restless legs syndrome or periodic limb movement disorder, which also disrupt sleep, combined affect up to 36%. And children with these sleeping disorders may become hyperactive, inattentive, and emotionally unstable — even when they do not meet the diagnostic criteria for ADHD.

Sleep and mental health lifestyle changes

In some respects, the treatment recommended for the most common sleep problem, insomnia, is the same for all patients, regardless of whether they also suffer from psychiatric disorders. The fundamentals are a combination of lifestyle changes, behavioral strategies, psychotherapy, and drugs if necessary.

Lifestyle changes. Most people know that caffeine contributes to sleeplessness, but so can alcohol and nicotine. Alcohol initially depresses the nervous system, which helps some people fall asleep, but the effects wear off in a few hours and people wake up. Nicotine is a stimulant, which speeds heart rate and thinking. Giving up these substances is best, but avoiding them before bedtime is another option.

Physical activity. Regular aerobic activity helps people fall asleep faster, spend more time in deep sleep, and awaken less often during the night.

Sleep hygiene. Many experts believe that people learn insomnia, and can learn how to sleep better. Good “sleep hygiene” is the term often used to include tips like maintaining a regular sleep-and-wake schedule, using the bedroom only for sleeping or sex, and keeping the bedroom dark and free of distractions like the computer or television. Some experts also recommend sleep retraining: staying awake longer in order to ensure sleep is more restful.

Relaxation techniques. Meditation, guided imagery, deep breathing exercises, and progressive muscle relaxation (alternately tensing and releasing muscles) can counter anxiety and racing thoughts.

Cognitive behavioral therapy. Because people with insomnia tend to become preoccupied with not falling asleep, cognitive behavioral techniques help them to change negative expectations and try to build more confidence that they can have a good night’s sleep. These techniques can also help to change the “blame game” of attributing every personal problem during the day on lack of sleep.

Image: © monkeybusinessimages | GettyImages

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