The Science Behind Morning Depression (And What to Do About It)

So what causes this? Why do so many people with depression experience their worst symptoms right when they wake up? Well, it helps to understand the body’s internal clock, which is called the circadian rhythm. 

By the way, here’s my win for the day: I finally learned how to spell rhythm!

The Role of Circadian Rhythm (4) (5) and Misalignment with Depression

Like I said, your circadian rhythm is your body’s internal clock. Not only does it help us fall asleep and wake up, but it also regulates our heart rate, body temperature, energy, alertness, and mood. Without us thinking about it, our body releases certain hormones throughout the day to help us regulate our biological processes and activity levels. 

At night the brain begins to release melatonin, your body temperature decreases, this helps us get ready to sleep. In the morning it releases a dump truck load of cortisol, the stress hormone. This helps us get moving and take action for our day.

So what does this have to do with symptoms of depression in the morning? There’s at least 3 things going on here. 

1. The Cortisol Awakening Response

Cortisol levels typically are at their absolute highest right after waking up, and it’s common for people to feel a spike in their anxiety first thing in the morning. So why would this make some people feel depressed?

Here’s my theory on this. Cortisol spikes, paired with depressed inaction, lead to a trapped, frozen stress response in the body. Imagine it like this, you wake up with a ton of racing thoughts, and a ton of buzzing energy, paired with this chronic feeling of “Why try, this is all hopeless, there is nothing I can do that will make my life better”. 

On top of this, cortisol makes it hard to think clearly, which makes catastrophizing much more likely. Your nervous system moves right past activation into shut-down mode, which is called a “hypoarousal response”. Your nervous system flips the switch from “let’s try hard” to “this is pointless, let’s conserve energy” and it shuts down. 

This is a subconscious survival response, your body is trying to protect you from more pain and it triggers that leaden feeling, making it hard to move, or you feel numb. That’s the morning depression we’re talking about. Because moving is pointless, it would just lead to more pain. (I talk about this state more in other videos).

2. A Misaligned Sleep Cycle can Exacerbate Depression

OK, here’s the second thing that can cause morning depression. Studies (6) have shown that people with depression and bipolar disorder have measurable differences in the RORA gene, which is connected to the circadian rhythm. This means that their body clock isn’t aligned with when they are supposed to wake up. A higher percentage of people who are “Night owls” develop depression and many depressed people have a disorder called Delayed Sleep Phase, which makes you want to wake up a little later and later each day. It’s like each night your bed flew to a time zone that’s an hour earlier- and it feels impossible to catch up on sleep. And guess what? More than 60% of people with Delayed Sleep Phase also have depression. 

Recent research is showing that the hypothalamus could also be a culprit of morning depression. The hypothalamus is a little gland deep in your brain. Its job is to regulate hormone timing, aka your circadian rhythm. A recent study (7) found that people who experience morning depression may have an inflamed hypothalamus. (8) In fact, the larger the gland, the more severe the depression. (9) 

Don’t hate me for this… I’m totally a morning person, a lark. If I have a spike in negative feelings, it’s usually at bedtime. When it comes to  , the low mood period of the day tends to overlap with when body temperature is the lowest, which is typically during sleep. We are built to sleep when mood and energy are at their lowest. But a lot of us have literal alarm clocks that fight our circadian clocks. Your schedule might force you awake during the lowest time of the circadian rhythm. You have to get up and going while your body is saying, “Wait a minute! I’m not ready for this! I hate every thing!” 

Long story short, for many people with depression – the time that they are supposed to be waking up is when their body clock is right in the middle of a low energy, low mood stage of their circadian rhythm. And that makes them physically feel leaden, groggy, and down. It’s not just

“laziness” or lack of motivation, it’s a biological misalignment of their internal clock with the world’s schedule.

3. The Role of Inflammation and Depression (10) (11) 

OK, on to the third biological reason. Research has found that people with depression may have higher levels of an inflammatory marker called interleukin-6. This inflammation-causing chemical rises and falls at different times for different people, but it most commonly peaks in the early morning, which may contribute to depressive symptoms.

Research is still new in this area, but chronic inflammation may play a role here.

Luckily, you can do something about inflammation. Exercise, staying hydrated, a healthy diet, anti-inflammatory drugs, and stress reduction techniques might also help reduce depression by lowering IL-6 levels or improving brain health. 

OK, so those are the first three biological reasons why your depression symptoms might spike in the morning. They’re all related to your circadian rhythm- the Cortisol Awakening Response, a Misalignment of your body clock and your alarm clock, and Inflammation. Now hang tight because we are going to talk about how to do a circadian rhythm reset in just a minute. But first we have to talk about sleep disorders and sleep deprivation. 

4. Sleep Disorders and Sleep Deprivation

There’s a reason I have a long playlist of videos about sleep. Depression is closely related to sleep disorders, which impact mood and energy levels. Sleep phase disorders like I mentioned above, and sleep apnea, seasonal affective disorder, parasomnias, insomnia, struggling to fall asleep, struggling to stay asleep–all of those can aggravate depression, and depression makes them worse. It’s a vicious cycle. And one study found that for people with both depression and insomnia, when the insomnia was treated 87% saw their depression go away. 

And even if you don’t have a sleep disorder, simply not getting enough sleep can absolutely be a contributing factor to depression in general, leaving you feeling exhausted and unmotivated in the morning. This sounds too simple, but have you tried getting more sleep? 

And that takes us to our next point-

5. Underlying Physical Exhaustion can Cause Depression

Okay, so being depressed makes you exhausted–but being exhausted can make you depressed. When we’re treating depression we have to explore whether your low energy is from a physical illness that is untreated. Maybe it’s low thyroid or anemia or low vitamin D or a hundred other disorders that make people feel exhausted or low energy. It’s usually a good idea to work with a doctor to rule these things out.