There are many types of depression. Some involve symptoms that get worse at certain times of the day.
Symptoms of depression can include feelings of helplessness, sadness, and hopelessness.
When a person experiences diurnal variation, it means their symptoms will occur or be more severe around the same time each day. This can be the morning, afternoon, or evening.
Many people experience fluctuations in mood throughout the day, and, according to the American Psychological Association (APA), it is not unusual to have a low mood on waking up.
A person with depression may have similar fluctuations, but the low mood will be more intense and persistent. People with morning depression may feel particularly low when they wake up. The symptoms may lessen as the day goes on.
Doctors diagnose depression based on the following criteria.
For a diagnosis of depression, a person must experience five or more of the symptoms below for 2 weeks or more.
Other symptoms include:
- a low mood lasting for most of the day, almost every day, though it may be worse at certain times of day
- diminished or no enjoyment in nearly all activities
- significant changes in weight or appetite
- difficulty sleeping or sleeping too much
- a persistent feeling of restlessness
- fatigue or low energy throughout most of the week
- feelings of worthlessness or excessive guilt
- difficulty concentrating, thinking, or making decisions throughout most of the week
- recurrent thoughts of death, suicide, or self-harm
A person with morning depression may also notice they find it hard to:
- wake up in the morning
- get out of bed
- avoid over-sleeping
- think clearly, especially in the morning
- complete regular morning tasks, such as getting dressed
In a person with morning depression, these symptoms will reduce or disappear as the day progresses.
Anyone having thoughts of suicide or self-harm should seek emergency medical attention. A doctor can help to provide immediate and continuing care.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.
Doctors have not identified a specific cause of morning depression, but there are various reasons why depression occurs, and hormonal factors may affect the timing of symptoms.
The body clock
Many people experience mood changes throughout the day. However, according to an older article, people with morning depression may experience more variable highs and lows than most people.
Since morning depression occurs at around the same time every day, experts have suggested that imbalances in a person’s circadian rhythm may be a factor.
The circadian rhythm, or body clock, is a process that signals the sleep-wake cycle, among other things. Hormonal changes that occur throughout the day have links to this process. The British Journal of Pharmacology (BJP) explain that when darkness falls, for example, the body produces more melatonin, a hormone that makes a person sleepy.
According to a 2015 article, the hormone cortisol plays a role in the stress response. The body clock plays a role in regulating this response.
Some research suggests that imbalances in a person’s internal body clock and the amount of sleep and light exposure they have could lead to mood changes, especially in those with depression.
According to the Centers for Disease Control and Prevention (CDC), other factors may contribute to morning depression and major depressive disorder, such as:
If a person goes to a doctor with symptoms of depression, the doctor may ask about:
- changes in mood, sleep, weight, and appetite
- how long the symptoms have lasted
- whether they are improving or getting worse
- any medications the person is taking that could affect their mood
- lifestyle habits
- family and personal history of depression
- recent life events
They will also try to rule out other possible causes, such as a medical condition that can cause similar symptoms. Hypothyroidism, or an underactive thyroid, is one example.
Many treatments for depression exist. Here are some examples.
This can help a person to recognize negative thought patterns and learn positive behaviors. Cognitive behavioral therapy as individuals, in a group or family therapy can help.
Getting regular exercise, especially outdoors, can help to reduce mild to moderate depression symptoms.
Current guidelines recommend getting 150 minutes of moderate intensity exercise each week, divided up into, for example, five sessions of 30 minutes.
The BMJ Open suggest some alternative therapies, including:
- herbs and supplements
- light therapy
- massage therapy
- music or drama therapy
- tai chi
Some of these may support medical treatment and help people feel better, but they should not replace a doctor’s recommendations. In most cases, however, there is not enough evidence to prove that they are effective.
People should speak to a doctor before starting a new therapy to ensure it is suitable for them.
Medical treatments can be effective way in treating morning depression, but lifestyle habits can also help.
The following tips may help manage some practical challenges and stabilize circadian rhythms.
Improve sleep habits
According to an older article in Dialogues in Clinical Research, there are strong links between sleep and depression. Improving sleep patterns may help manage depression.
To improve sleep quality, it may help to:
- darken the bedroom
- keep the temperature cool
- ensure the bed is comfortable
- shut out noise
However, some factors that may be hard to change include:
- shift work
- taking care of another person during the night
- physical symptoms, such as snoring or a cough
These strategies may help maintain more regular circadian rhythms and lower the risk of depression on waking in the morning. If it seems impossible to rearrange these factors, talk to a doctor who may offer further suggestions.
Get enough rest
Going to sleep and waking up at the same times, and trying to get at least 7 hours of sleep per night can improve symptoms.
Leaving mobile phones and other distractions outside the sleeping area, if possible, can also help.
Using light cues
Light can communicate to the body that it is morning and time to wake up.
Opening the curtains right away or timing an overhead light to turn on at the same time every day can help the body to wake up.
Prepare for the next morning at night
Setting out clothes and items for work or school, and putting together lunches in advance can make mornings easier for people who have little motivation or energy when they wake up.
Allowing for extra time in the morning
Waking up earlier or adjusting a work schedule to start later, if possible, can relieve pressure and stress in the morning.
Many people do not feel at their best first thing in the morning, but some people with depression can experience intense symptoms at this time.
If a person has morning depression, medical treatments and support are available to help.