How Depression Made Me a Morning Person
And how learning to sleep made me superhuman
Despite how click-bait-y this title sounds, it is not an exaggeration.
In the last six months, my average wake time has been 6:30am—including weekends, holidays, and frequent time zone crossings. To be fair, 6:30am is not that early in the realm of early-birds, called larks, who espouse the miracles of a 5am wake up time. But for me, this has been such a momentous change that I’ve become quite literally a different person.
I am now someone that wakes up naturally before their 6:30am alarm with enthusiasm to tackle the day, and with a wide menu of pre-breakfast activities including meditation, yoga, strenuous bike rides, reading, writing, making old-fashioned oatmeal, etc.
I may sound like a holier-than-thou health nut, but I assure you I am nearly as confused as you might be about how I got here.
You see, since my pre-teen years, I had been a die-hard night owl. I loved to read late into the night. In the era before tablets and Kindles, I would pull a desk lamp under the covers with me, so there would be no light peeking from under my bedroom door to tattle to my parents that I wasn’t asleep. I tend to get a creative burst of energy around 11pm (and I still do now, even as a converted morning person). Over the years, I’ve done the bulk of my writing, and sundry projects and hobbies, in the hours spanning midnight. Curiously, there have been mornings where upon reading what I wrote the night before, I’d come upon a word I don’t know. Then upon sheepishly consulting a dictionary to look up a word that I wrote myself, I’d discover my late-night word choice was spot on. I’ve since concluded that my brain is wired to be a night owl. Staying up and waking up late is my best self. Being a night owl is who I am.
I work in tech startups, which seem to be designed for night owls. It’s perfectly acceptable to roll into work after 10am or even 11am. Despite going to sleep at 1am or 2am, I could still get my seven to eight hours of sleep without a sweat. Sure, I knew about the benefits of waking up early. I had the pleasure of working at Coach.me for nearly four years, during which I’ve read countless accounts of how amazing and life-changing waking up early is.
But not for me. During my tenure at Coach.me, I tried out various self-improvement best practices—it’s almost part of the job. I became a runner and started meditating regularly. But I never even considered making a habit of waking up early. I would have scoffed at the idea that I would one day be writing a long Medium article espousing the virtues of waking up early.
Well, the only constant is change, for better and worse. At Coach.me, I worked to help people improve themselves. After I left Coach.me, I got a new job working to improve the lives of others in a different way—by improving government services. Working with the government meant traveling to where our client is—I started traveling to our company headquarters in D.C. from San Francisco every month. There are probably additional factors, but the frequent time zone changes, coupled with a rapid increase in job responsibilities in a rapidly growing startup, led to a proportionate increase in stress and difficulty sleeping for me. Then I slipped into a depression.
Recognizing My Depression
This is not the first time I’ve been depressed. I’ve built up a strong meditation practice, so you’d think I’d be aware of what my mind is up to and be able to recognize the signs. Even so, depression crept up on me unnoticed.
Our brains are very good at covering up problems, through rationalization. I rationalized away my pessimistic feelings as being realistic about the world. I convinced myself that I was a realist and that optimists are delusional, which is not totally untrue—it’s been shown in studies that optimists are over-confident and over-estimate in various ways.
Also, the world as I knew it was deteriorating and it was very difficult to work on improving government services, especially when the president and Congress were actively working to dismantle what we’ve built. I had started my job with gusto to take on the mission of improving public benefit, but my motivation nose-dived. I started having thoughts about how nice it would be to quit and absolve myself of my responsibilities. I struggled to make it through each work day, looked forward to the weekend on Tuesday, and dreaded going back to work on Sunday night.
This is so unlike me. Throughout all of my adult life, I have been dedicated to the work I do, and I considered it a huge privilege that I get to do work I enjoy, to do work that has a huge impact, and to work with so many people that I admire and respect.
I also didn’t have energy for doing anything outside of work. I gradually pulled back from making plans with friends, and I lost all interest in having fun. I was so good at rationalizing: I convinced myself that things that used to bring me joy were inherently meaningless—travel, dining out, taking photos, writing. I was paying for having read my share of existentialist novels.
The worst was when I stopped exercising, because I was just too tired—despite having trained for and competed in two sprint triathlons earlier that year. I started having thoughts that it didn’t really matter if I was around or not. With that—and a gentle nudge from my husband—it finally dawned on me that my brain might be malfunctioning.
That realization kicked me into action: I called my doctor and therapist to set up appointments, and evaluated myself on the Burns Depression Checklist—a set of 15 questions to rate how you feel. I scored 26, which maps to Moderate Depression. Despite its name, “moderate” depression is no joke — it’s only one level better than the worst category, “Severe Depression”.
Some of this might ring true also. If you think you might be depressed or are having suicidal thoughts, please please please seek professional help.
What’s so nefarious about mental health issues is that the faculty you use to monitor problems—your brain—is the same faculty that’s broken.
My doctor gave me a list of things to do, such as to start exercising again, and seeing friends, all of which I already knew, but I just didn’t have the energy.
A common misconception about depression is that depression is a state of being very sad. Depression is not a worse form of sadness, depression is an annihilating form of apathy.
If I was sad, I would still care. When I’m depressed, however, I stop caring. It is a huge struggle to do work, or have hobbies, or go to events, or meet people, because I don’t care about any of that anymore, because I stopped caring about myself.
The Link Between Depression and Sleep
When I finally mentioned to my doctor that I haven’t been sleeping well for a while, I was surprised to hear that sleep problems can lead to depression. Furthermore, I learned that depression can also cause sleep disturbance.
One of the questions from a typical depression checklist is about sleep problems: “Do you suffer from insomnia and find it hard to get a good night’s sleep? Or are you excessively tired and sleeping too much?” Depression and insomnia’s combined effects can self-reinforce into a spiral—making each worse.
The doctor’s visit finally clarified for me that I had insomnia, which is a sleep disorder characterized by difficulty falling asleep or to stay asleep for as long as desired for a few days or more.
By then, I had already been struggling with sleep for many weeks, within the realm of long-term insomnia. Once I determined my goal is fixing my sleep as quickly as possible, I went into action, beginning with carrying home an armful of library books on how to overcome insomnia.
Despite going to bed much earlier than I used to, I would be lying in bed for longer and longer, flooded with thoughts about what I needed to do at work and feeling anxious about other stressors in my life, until I’d finally fall asleep from sheer exhaustion. I was constantly tired and had no energy for anything, which exacerbated my depression.
I was getting pretty desperate, and knew I needed help, but I didn’t want to try sleeping pills. I know about the undesirable side effects, and the last time I had been prescribed a sedative (which I didn’t realize it was a sedative — I thought it was cold medicine), the drug made me feel like a zombie the next day.
Between jobs, I had done some freelance consulting — working with a company that wanted to better understand the effects of medical marijuana on different conditions. One of those conditions is insomnia and marijuana does not have the side effects of traditional sleep drugs. Taking advantage of the many perks of living in California, I went to visit a “doctor” — who turned out to be a man dressed in a lab coat in LA that I talked to through an iPad — to get a card that would allow me to buy medicinal marijuana.
Because marijuana is a federally banned substance in the U.S., research and credible information about the medicinal properties of marijuana are woefully lacking. So I had to experiment to figure out what would help me sleep without getting high — not as pleasant a process as it might sound! Because I don’t smoke, and tinctures seemed too advanced for me, I relied on edibles. Edibles take hours to take effect—they are very difficult to time and dose properly. What I ate that day affected both the timing and strength of the effect. Nevertheless, despite these hurdles, I did manage to start falling asleep reliably.
But I still had insomnia.
Insomnia is not only difficulty falling asleep, but also difficulty staying asleep, and I had both. Despite being able to now fall asleep within a reasonable time, I’d still wake up in the early morning hours, around 4 to 5am, and again be flooded with anxious thoughts, struggling to fall back asleep. On better nights, I’d be able to get a few more hours of asleep, waking up groggy and tired when my alarm sounded and wanting to stay in bed. On the worst nights, I couldn’t sleep again at all.
My alarm started being both a blessing and a curse: a blessing that I could finally stop torturing myself for unsuccessfully trying to sleep, and a curse that I had to now face a challenging job with only a few hours of sleep.
Marijuana suppresses the REM (rapid eye movement) sleep cycle, and though researchers are still trying to learn many things about how sleep works, we do know that getting REM sleep is essential for memory and creativity, and probably other important functions. Marijuana could be useful as a short-term solution, but, like many other sleep aids, it does not produce restorative sleep. Over the long-term, I knew I had to learn how to sleep naturally.
This is when I discovered Cognitive Behavioral Therapy for Insomnia (CBT-I). Or I should say “re-discovered,” because I recalled that a friend of mine, who is an entrepreneur in the behavior change space, had told me about her experience researching CBT-I and how effective it was, when I saw her less than a year ago. This just goes to show that information only turns into knowledge after you can apply it.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
Before I explain how I applied CBT-I, let me first start with CBT — Cognitive Behavioral Therapy.
CBT is founded on the premise that your thoughts are the root cause of depression and anxiety, and if you can replace negative irrational thoughts with positive realistic thoughts, your mental health will improve. CBT incorporates many strategies to change one’s thinking. The behavioral aspect of CBT is the premise that one can effectively change one’s thoughts by changing one’s behavior. If you have been reading Better Humans for a while, or if you are a Coach.me user, you’re very familiar with this concept—cognitive change can be brought about through behavioral change, and vice versa.
I am a huge proponent of CBT, because during my first significant struggle with depression a few years earlier, my depression magically disappeared once I let go of a fundamental belief I had previously held. My depression checklist score went from 30+ to low single digits literally over night, and consistently stayed below 10, “Not Depressed”, after that.
This sounds like magic (and it still feels magical to me), but this result only came after months of hard work—seeking out multiple therapists, reading many books on my own, and diligently doing the exercises prescribed by CBT. If you have had the experience of being depressed, you’ll know how hard it is to do anything with that mental wet blanket weighing you down. Knowing how effective CBT had been in the past for me, I embraced CBT-I with similar enthusiasm.
Before discovering CBT-I, the strategy I used was the same as most people: I wasn’t getting enough sleep, so I naturally tried to sleep more. I went to bed earlier, and stayed in bed longer, trying to catch those extra zzz’s.
What’s surprising about CBT-I is that it’s the opposite of what I had been doing. CBT-I can be summed up as:
Sleep less to sleep more.
This counter-intuitive advice is based on the concept of “sleep drive”. Sleep drive is our bodies’ natural desire to go to sleep. Sleep drive is what causes us to feel sleepy. Our bodies know how to sleep. Babies and other animals do not experience insomnia. So what’s up with human adults?
What makes humans different is our cognitive ability—our big brains.
Sometimes we think too much, and we forget how to sleep.
To understand how it’s possible to sleep less in order to sleep more, we have to first differentiate between time spent sleeping and time in bed. The ratio of the time you spend sleeping and the time you spend in bed is known as your sleep efficiency.
Before CBT-I, I thought I was trying to sleep more, but I was actually just spending more time in bed. I was sleeping around 5 to 6 hours, but I would go to bed at 11pm, and wake up after 8am, spending more than nine hours in bed. But my sleep efficiency was only 5/9 or 55%. CBT-I focuses on increasing sleep efficiency. The target is over 90%! In other words, I was failing, and I needed to get to an A+.
If you want to change your behavior, you need to track and monitor the behavior you’re changing. It’s no different with sleep.
CBT-I therapists recommend starting with tracking your sleep in detail using a sleep journal for a couple of weeks without sleep aids (drugs), in order to establish a baseline before starting CBT-I.
However, I couldn’t stomach the idea of two more weeks of insomnia, so I just jumped into CBT-I head-first.
Instead of chronicling my sleep activities by hand as recommended, I found an Apple Watch app to track my sleep, and I started wearing my watch in bed. An app is not as accurate as diligently recording by hand, and I didn’t trust the app’s assessment of when I was in light, vs deep, vs REM cycles, nor the app’s ratings for how well I slept each night. But for the convenience and getting a close-enough idea of how I was sleeping, using an app was good enough for me.
Core CBT-I strategies
CBT-I encompasses many things, including improving your sleep hygiene, and changing negative thoughts about sleep, but at its core are two behavioral strategies: stimulus control and restricting sleep. These two strategies can be used individually or combined. Since I have over-achiever tendencies, I went all in on everything.
But there’s a downside to that: when you work on both strategies at the same time, you sleep even less.
I was very very tired for the better part of a month. It is extremely unpleasant, but I stuck with the regimen and got results faster.
The basics of Stimulus Control Therapy (SCT) are about learning to associate your bed with only sleep:
- Go to bed only when you feel sleepy. Note that being tired isn’t the same as feeling sleepy. Only when you feel your eyes drooping, head getting heavy, and you’re starting to nod off, should you get into bed.
- If you don’t fall asleep quickly, get out of bed. If after 15–20 minutes, you’re not asleep, go to another room until you feel sleepy again, then come back to bed.
- Don’t do any other activity in bed that’s not sleeping. No reading, no working, no texting, no watching TV, nothing. (With the exception of sex, but apparently that’s just because researchers discovered their clients were not creative or motivated enough to find another place for it.)
The basics of Sleep Restriction Therapy (SRT) are to only spend as much time in bed as your body is physically able to sleep:
- First, you’ll need to figure out how much time you’re actually sleeping, using your sleep log, not just time spent in bed. When I did this, I was sleeping about 5 hours a night. What’s surprising and motivating about doing this exercise is you’re almost always sleeping more than you think you are. I felt like I was only sleeping for 4 hours.
- Then, determine when you should go to bed based on the amount of time you’re sleeping, and when you want to get up. I set a wake up time of 6:30am, and I was sleeping for 5 hours, which meant I could only go to bed past 1am (allowing for some time to fall asleep). Regardless of how tired or sleepy you are, only go to bed after your calculated bed time. The goal is to aim for 90%+ sleep efficiency, i.e. you’re spending nearly all of your time in bed actually sleeping.
- Once you have achieved 90%+ sleep efficiency consistently over a period of one week, you may increase the time you spend in bed by 30 minutes. So, once I was able to sleep for a full 5 hours, I could go to bed earlier, 12:30am. Then the week after, if I can sleep for at least 5.5 hours most nights, I can start going to bed at midnight, and so on. However, if at any time your sleep efficiency is falling well below 90% for the week, then you may need to decrease the time you spend in bed again.
The two strategies also share some common habits: no sleeping anywhere else that’s not your bed, no napping, and restricting caffeine.
I’m not a napper and I already don’t drink coffee, so these weren’t problems for me.
However, with both SCT and SRT, the single most important thing is getting up at the same time every day—including weekends.
As someone who deeply enjoys sleeping in, especially on weekends, I thought I’d have trouble with this. But my sleep was so bad, I had lost the ability to sleep in anyway!
Waking up at the same time every day was difficult—especially at first, when it meant getting even less sleep. But I am convinced that it is what ultimately improved the quality of my sleep.
CBT-I worked very well for me.
I did a combination of stimulus control and sleep restriction for three weeks, and then just stimulus control after that, and have kept near 90% sleep efficiency ever since, even with continued frequent travel across timezones.
If you’re interested in sleeping better, and you only do one thing, make it getting up at the same time every day.
The most remarkable and important thing that I learned through practicing CBT-I is actually not how to sleep more. Because I did not sleep much more.
The amount of time I spent sleeping crept up to 6.5 hours a night and stayed there, and I continued to have nights where I’d get 5 or 6 hours of sleep—noticeably lower than the recommended 7 to 8 hours of shut-eye.
And trust me, I did nearly everything else that was recommended, and then some:
- I did restorative yoga poses, used aromatherapy candles, and took hot showers and baths to relax before bed.
- I bought nicer cotton sheets, a down comforter, and linen bedding to make the bed more welcoming and comfortable. (We already had a great foam mattress that prevents my husband and I from interfering with each other’s sleep).
- I sewed my own black-out curtains because our bedroom window was so wide (and had a near-panic attack from feeling overwhelmed and anxious at taking on such a large project.)
- I bought a doctor-approved light therapy lamp, to see if I needed extra help regulating my melatonin (the hormone that triggers sleepiness). I didn’t find light therapy to have an effect. I then learned that if you have insomnia, don’t try light therapy yourself, because you could actually make insomnia worse through improper use.
- I started a worry journal, so I could compartmentalize all the anxious thoughts that were waking me up. For 10 minutes each morning, I would write down all the things I was worrying about, and to keep writing until the time was up. I recommend trying out a worry journal if you’re experiencing a lot of anxiety.
- I bought prescription glasses that are tinted yellow to specifically block out the blue light emitted by electronic screens, which trigger wakefulness in the brain. I put these on around 9pm each night.
- The very best thing I did for my sleep besides CBT-I was exercising regularly again. I used the power of accountability by signing up for a triathlon with a friend, and used that as motivation to start training. Exercise is an effective treatment on its own for insomnia, and also shown to be as effective as anti-depressants for alleviating symptoms of depression. Win-win!
Despite mostly sticking with all these things over the last six months since I started CBT-I, I still sleep less than 7 hours every night… and it’s been fantastic!
This is because outside of the behavioral changes that I made practicing CBT-I, I also experienced a dramatic cognitive change. I held a belief that I needed to have close to 8 hours of sleep to have a good day, to be productive at work, to have energy to exercise and pursue hobbies—and this is simply not true.
Once I let that belief go, I started to enjoy myself a lot more.
As soon as my anxiety about not sleeping melted away (in the very first week of practicing CBT-I ), my depression also lifted. My depression checklist score instantly lowered by 10 points to Mild Depression, and a month later, dropped to below 10, Not Depressed. For the last three months, I’ve scored only a 1.
I later learned that sleep restriction is an effective way to treat depression—one on par with anti-depressants. I can only surmise at the reasons why this isn’t better known, but a discussion about profit incentives in the healthcare industry belongs in a different Medium article.
Advice and What to Expect
As you can imagine, based on what I described above, doing CBT-I leads to some weird behavior. With stimulus control, when I woke up early with racing thoughts, I had to physically haul my tired self out of bed, and go do a boring, non-stimulating activity in the living room until I was sleepy again. However, with my changed belief that I don’t need to struggle with going to sleep, that my body will sleep when it’s ready, I embraced the quirkiness of getting up in the middle of the night to do things.
I listened to a bunch of podcasts and audiobooks this way. I could fold laundry and do other small chores. I spent a lot more time petting our cats. To make myself a bit more comfortable, I set aside a cozy sweater and slippers by the bed, to make it more palatable to get out of a warm bed.
With sleep restriction, I needed to keep myself awake until my set bedtime, even if I felt sleepy. I caught up on a lot of TV, and read a lot of management books during this time. This became highly enjoyable and productive! Talk about the ultimate life hack: not only was I becoming more productive, I could still watch all the Netflix I wanted!
If you sleep with a partner, like I do, practicing CBT-I has an added challenge. My husband basically stopped seeing me in bed. I’d always go to bed after he’s fast asleep, and when he wakes up, I’d already have been up for hours. Even now, this is mostly the case. I recommend having a conversation about the realities your new sleep schedule will impose, and how that will affect your relationship. Hopefully, your partner will see how much happier and more energetic you will become, and that it’s worth sacrificing not going to bed at the same time. You can try replacing going to bed together with another bonding activity.
The most dramatic change since starting CBT-I has been in my mood. In my previous depressive episodes, my depression was not accompanied by anxiety, like it was this time with insomnia. I learned that what exacerbates difficult sleeping and creates the vicious cycle that turns one bad night’s sleep into chronic insomnia is not physically sleeping less, it is the anxiety in the mind about not getting enough sleep.
I still have nights when I wake up too early and am unable to go back to sleep. But now, instead of being anxious about not being able to sleep, I embrace the opportunity to get up and do something with my new-found time.
However, since I started CBT-I, I really feel like I’ve unlocked a secret towards becoming superhuman. The results have astounded me. I have found a renewed sense of purpose in my work—becoming much more productive, while sustainably working longer hours than before.
My productivity has both expanded and been on an upward spiral. I’m speaking at two industry-leading conferences this year, after not even being able to think about giving a talk again. Even my run-of-the-mill public speaking anxiety isn’t rearing its head. I’ve become hyper-social, to the point of tipping over from introvert to being an extrovert, where I’m gaining energy from interacting with lots of people. I have a new appreciation for spending time with friends and talking to strangers.
I’ve become a bona-fide triathlete, training nearly 10 hours each week, and placed 8th in my age group for the sprint distance triathlon at Wildflower, a course that’s recognized as hilly and difficult. I’m gearing up for my first Olympic distance triathlon in a week! Before I was intimidated by the thought of swimming 1500m, biking 40km, followed by a 10k run, now I feel pumped.
My body’s the strongest it has ever been in my life, and I feel great nearly all the time— sometimes with a stupid grin on my face for no reason—when before I had perfected my RBF.
Finally, I’ve started writing publicly again in earnest after a two-year writer’s block, as this 5000-word article attests. I am riding a burst of creative energy I don’t even know what to do with, that—in a strange turn of events—is waking me up early. The only difference now is that though I continue to not get enough sleep on a regular basis, those nights don’t really affect me. Sure, I’m a bit more tired the following day, but I still do all the things I planned to do, and most importantly, it doesn’t affect my ability to sleep well the following night. Goodbye, insomnia!
From avowed night owl to chipper lark, from introverted bookworm to extroverted athlete, from depression to superhuman, I hope you enjoyed taking this long and winding journey with me—and everything I’ve learned about how to sleep. This has been truly life-changing for me, and I hope this provides a spark for you too!
End the Insomnia Struggle: A Step-by-step Guide to Help You Get to Sleep and Stay Asleep — I read a few books on CBT-I, and I liked this book the most, because the author takes a comprehensive yet customizable approach that lays out all the options for you and tells you what to expect for each option, as well as what to do if you fall behind in applying the advice. This book is about as close as you can get to working with a sleep therapist without actually doing so. It includes worksheets and templates to get you started with things like sleep logging, and the last section also contains tailored information for certain conditions, e.g. insomnia caused by menopause. It includes advice on where to find resources for more severe sleep disorders.
Feeling Good: The New Mood Therapy—This is a classic book on CBT for treating depression and anxiety, and stands the test of time. I have referred to it again and again over the last couple of years since I first read it, and it contains highly relevant advice even when you’re not struggling with depression or anxiety.