Why Is My Depression Worse in the Morning?

November 8, 2022   •  Posted in: 

Do you ever wake up feeling depressed? You might have a hard time going through your morning routine. You could feel totally unmotivated about the day ahead and feel hopeless about being able to get through it. Perhaps you even go back to bed when you feel this way, which could cause serious problems in your work life and relationships.

This is a common experience for many people who live with depression. “Morning depression,” a type of diurnal mood variation, is when people wake up feeling very depressed but feel slightly better over time.

Although it’s not a diagnosis on its own, it’s a very common feature of major depressive disorder. Here’s the science behind why you could feel more depressed in the morning as well as what you can do about it.

 

What is morning depression?

“Morning depression” is a colloquial term that people may use when their depression symptoms are worse in the morning. It is not an official mental health condition that you can be diagnosed with. If you feel depressed in the morning, you would likely be diagnosed with a mood disorder like major depression or persistent depressive disorder.

In research, morning depression may be referred to as “diurnal mood variation.”[1] This is when your mood changes depending on the time of day.

For most people with diurnal mood variation, their mood is worse in the morning but improves as the day goes on. Others’ mood may worsen throughout the day. They may go through an “afternoon slump” or have worse depression at night. Diurnal mood variation is a common feature of major depressive disorder, especially with the melancholic type[2].

People without depression can also go through mood changes throughout the day. But for depressed people, their lows are lower. Depression may also cause mood changes to feel spontaneous rather than a result of an event or activity.

Signs of morning depression

If you have “morning depression,” then you may:

  • Have a hard time getting up in the morning
  • Experience hypersomnia, or sleeping too much
  • Be flooded with hopeless or suicidal thoughts when you wake up
  • Have a hard time going to sleep because you don’t want to face another morning
  • Feel exhausted as soon as you start your day
  • Have a hard time going through your morning routine (like showering or brushing your teeth)
  • Wake up with severe brain fog

On top of these signs, people with morning depression also have the symptoms of major depression. According to the Diagnostic and Statistical Manual (DSM-V-TR), these include:

  • Sad or empty mood almost all the time
  • Feelings of worthlessness, guilt, or helplessness
  • Feelings of hopelessness
  • Loss of energy
  • Changes in eating habits
  • Difficulty sleeping
  • Difficulty with concentration
  • Thoughts of death or suicide

How common is morning depression?

Since “morning depression” isn’t a clinical diagnosis, we don’t know exactly how common it is for depression symptoms to be worse in the morning. But diurnal mood variation is often considered a very common feature of major depressive disorder.

Based on our decades of clinical experience treating people with depression, it’s not uncommon for symptoms to feel worse in the morning. A 2006 study[3] also states that these changes in mood throughout the day are often seen in people with depression.

Depression itself is one of the world’s most common mental health conditions. Over 280 million people worldwide live with depression, according to the World Health Organization.

Although morning depression isn’t a clinical diagnosis, it’s still important to let your mental health provider know that your symptoms are worse in the morning. This information can help them rule out other conditions and make the correct diagnosis. It may also help in creating a treatment plan for you.

 

Causes of morning depression

There isn’t a clear explanation about why some people’s depression symptoms are worse in the morning, but there are some promising theories.

Circadian rhythm

Many researchers say that mood can be linked to circadian rhythm.[4] The circadian rhythm is the “biological clock” that all living things have. It is controlled by light (as the Earth moves its way around the sun), and dictates things like the sleep-wake cycle, core body temperature, cortisol levels, and more.

When people have disrupted circadian rhythms, they may be more likely to have depression. Many studies have been conducted on the effects of overnight shift-work on mental health. The circadian rhythm dictates that we wake during the day and sleep at night; people who sleep during the day so they can work at night naturally have disrupted circadian rhythms.

Additional research has found that night-shift workers are up to 40% more likely to have depression than people who work during the day (and sleep at night).[5] In one study, people with diurnal mood variation (or “morning depression”) were more likely to have differences in their circadian rhythm.[6] This was true regardless of other factors like quality of sleep.

Certain genes, like the RORA gene, have also been found to be connected to circadian rhythm and may also contribute to diurnal mood variation for people with depression.

Circadian rhythm influences mood in both depressed and non-depressed people. But one research report states that for people with depression, their lowest circadian mood tends to happen upon waking.[7] This is in contrast to the lowest circadian mood for non-depressed people, which tends to happen in the middle of the night.

All of these factors could contribute to why you may feel more depressed in the morning.

Inflammation

Brain inflammation in the morning could also play a role in morning depression. Studies have found that people with depression have higher levels of peripheral or central cytokine interleukin-6 (IL-6), a sign of inflammation in the brain. A 2016 meta-analysis concluded that levels of IL-6 often peak in the morning.[8] This could be one reason why morning depression is so common.

Cortisol

Cortisol is a hormone that your brain releases when it’s under stress. People with depression often have higher cortisol levels than people without depression.

Your body secretes cortisol at different times in the day; a large part of this is dictated by the circadian rhythm and your sleep patterns. Some people with depression might have higher cortisol levels in the morning, which could contribute to morning depression. This could be related to disruptions in circadian rhythm.

Having to face reality

Although there isn’t scientific research that’s studied this claim, many of our clients with morning depression tell us they feel more depressed in the morning because they feel hopeless about having to face the reality of the day ahead. For people with depression, sleep may feel like a small reprieve from their painful symptoms.

Waking up in the morning could feel like a sudden return to “hell.” As the day goes on, however, you might be distracted by work or naturally experience a lift in your mood.

 

How to manage morning depression

If you’re waking up feeling depressed every day, then you likely have depression or another mood disorder, even if you start to feel slightly better as the day goes on. Depression is a serious health condition, and requires treatment to get better.

The most common types of treatment for depression include:

  • Psychotherapy
  • Medication

On top of these two treatments, however, there are many holistic lifestyle changes you can make that may be effective in helping you wake up feeling less depressed.

Psychotherapy

Certain types of therapy, like cognitive-behavioral therapy and mindfulness-based therapies, have lots of evidence supporting their effectiveness for people with depression. These therapies can help you identify and challenge unhelpful thinking patterns that may be worsening your depression, as well as teach you new skills to deal with depression.

You may be able to include the skills you learn in therapy in your morning routine. Starting every morning off with healthy practices, like mindfulness meditation or yoga, could help you start your day in a better mood.

Alter your circadian rhythm

People with depression often have differences in their circadian rhythms. It’s possible to reset your circadian rhythm to feel more rested and start your day off right. Some tips to reset your circadian rhythm include:

      • Keep a regular sleep schedule — go to sleep, and wake up, at the same time every day
      • Eat scheduled meals at regular times, distributed evenly throughout the day
      • Get regular physical exercise, but not too close to bedtime; exercising in the middle of the day has been shown to fix circadian rhythm for some people

However, these strategies may not be enough to manage morning depression if you don’t also receive treatment for the depression itself.

Medication

Antidepressant medications can be effective in treating depression and other mood disorders, but they’re not your only option. Most experts recommend combining medication with therapy. Sleep aids might sound like a good option to help you fall asleep at night, but they actually move your circadian rhythm even more off-base.

Physical exercise

Research has consistently found that physical exercise has numerous benefits for your mental health, including lowering symptoms of depression. As we mentioned before, physical exercise (especially in the middle of the day) can also help you reset your biological clock.

Light therapy

Light therapy, also known as phototherapy or bright light therapy, is an intervention that uses artificial light to mimic natural light. Light therapy can help correct circadian rhythms and improve mood. It’s usually used in the treatment of seasonal affective disorder (a type of depression in which symptoms vary by the season), and it could be helpful for morning depression as well.

 

Get Treatment for Morning Depression

You don’t need to wake up feeling depressed every day. This is a feature of a mood disorder, and it can be treated.

At The Center • A Place of HOPE, our clinical team has decades of experience working with people with depression and helping them heal. We use a unique Whole-Person approach to depression treatment that considers every part of who you are — your personality, your history, your experiences, your interests, and more — to build a treatment plan that’s made just for you.

Get in touch with us today to learn more about our admissions process and start healing from depression.


[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181887/
[2] https://pubmed.ncbi.nlm.nih.gov/8817739/
[3] https://pubmed.ncbi.nlm.nih.gov/16938080/
[4] https://www.tandfonline.com/doi/full/10.31887/DCNS.2008.10.3/awjustice
[5] https://www.ncbi.nlm.nih.gov/pubmed/28581264?dopt=Abstract
[6] https://pubmed.ncbi.nlm.nih.gov/16938080/
[7] https://www.tandfonline.com/doi/full/10.31887/DCNS.2008.10.3/awjustice
[8] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0165799

Dr. Gregory Jantz

Pioneering Whole Person Care over thirty years ago, Dr. Gregory Jantz is an innovator in the treatment of mental health. He is a best-selling author of over 45 books, and a go-to media authority on behavioral health afflictions, appearing on CBS, ABC, NBC, Fox, and CNN. Dr. Jantz leads a team of world-class, licensed, and...

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