Hypersomnia and Anhedonia
Q: When I feel depressed, I sleep…a lot. What’s wrong with me that I can’t just go outside and enjoy the sunshine?
A: So, two symptoms of depression are at work here: hypersomnia (excessive sleep) and anhedonia (inability to feel pleasure).
Hypersomnia is that state that often accompanies depression, where you sleep…a lot, more than your normal pattern. (Insomnia is the other common symptom, where you sleep too little. 80% of depressed individuals experience sleep problems.) Hypersomnia often involves increase in nighttime, as well as daytime sleep, and is a response (as is insomnia) to stress in general that may be triggering depression, as well as the stress of depression itself. Some of this sleep actually can feel restful, and compensate for the stress, but often it makes one feel more groggy and un-rested. Which is hard enough, but then this very un-rest can be interpreted as laziness or as something being wrong with oneself, contributing to the depression.
The second symptom, anhedonia (from Greek, “without pleasure”), is the inability to experience pleasure, where the sunshine just isn’t enjoyable. Scientists describe this as an effect of depression, in that depression apparently compromises the dopamine reward system in the brain, where the normal chemical reward (dopamine is the “feel good” brain chemical) doesn’t happen so easily, where the brain has to work harder than usually to get a pleasant (chemical) reaction to what is normally pleasant experience. Why you can’t just enjoy the sunshine is at least in part because, being depressed, your brain looks at the sunshine and just kind of shrugs.
Now, since depression has much to do with how we interpret our experience (Aaron Beck, the originator of Cognitive Behavioral Therapy, had the great insight into what we now take for granted: thoughts influence emotions and moods), hypersomnia and anhedonia usually are themselves pretty depressing. In other words, to find yourself lethargic and less productive, and unable to find pleasure where you are used to experiencing it, both can be interpreted as not just impersonal effects of a complex illness-depression-but as signs that there’s something wrong with us, our bodies are breaking down, or that even life itself is broken. Otherwise, why would we be feeling so bad?
But in terms of working with depression, it’s very important to hold in mind that these are common (shared by many) symptoms of a very common (pervasive) illness whose origins are still uncertain. As much as depression may try to make the case for your suffering being because of you, personally, individually, essentially…it’s simply not, at the end of the day, that personal.
And why is this important? Because in over-personalizing the experience, one ends up in blame–“What’s wrong with me that I can’t…”–and thus get caught up in a loop of, “There’s something broken about me and I need to fix it to stop suffering.” Then you look for what’s broken, identify it–“I think too much,” or, “I feel too much”–and set about fixing it. Except that depression is too complex to so easily explain (even now, the causes of depression are poorly understood, as much as the symptoms can be clearly identified), and also depression is not about a broken self. Depression is about too many things, generally–the body’s response to stress, patterns of negative thinking, a genetic predisposition to reactivity, trauma, spiritual malaise, cultural oppression and objectification…at least…–to make it so easily “fixed,” as if it were a plastic toy with a loose wheel.
Depression responds best not to problem solving per se, but to acceptance and skillful change. So, here, acceptingthat hypersomnia and anhedonia are just symptoms of a condition called depression, shared by many, understood clearly by few, opens up the possibility to skillfully take actions which are not based in a kind of blame driven panic. So instead of, “Something’s wrong with me that I have to fix, now!” it goes like, “The sun isn’t as attractive and I’m sleeping a lot. Ok, I guess that’s how it is now. So instead of kicking myself when I’m already down, I wonder what I can do that might help. Hmm. Maybe I’ll call my doctor for help with the sleeping. And perhaps a friend can support me in running through the park together. Ok, let’s try.” Very different approaches and tones, no?
