Insomnia, the most prevalent sleep complaint, is a common symptom of depression, as well as constituting a 'primary' diagnosis. Controversy remains about whether insomnia should be regarded as 'secondary' when co-occurring with depression, given that insomnia often occurs prior to other symptoms. This study investigated the extent to which insomnia is considered secondary to unipolar forms of depression using a qualitative case study approach to allow for individual differences and to address the phenomenology associated with these conditions. Seven participants (six with self-reported insomnia, four of whom had also been diagnosed with depression, and one suffering from depression only) were interviewed in a semi-structured format and asked to describe their experiences in terms of symptom onset and impact, and their thoughts about the nature of the relationship between insomnia and depression. The participants with both conditions mostly considered insomnia and depression to be independent, despite commonly experiencing insomnia alongside core depressive symptoms. They all had insomnia prior to depression, and they considered insomnia to be 'primary' rather than 'secondary'. Five out of six participants with insomnia reported having an overactive mind when attempting to sleep. Those with only insomnia potentially differed from other participants due to the content of their thoughts and the presence of factors in their life that may be protective in terms of developing depression. Despite experiencing negative and overactive thoughts, the participant with depression, but not insomnia, attributed having an active working life to avoiding insomnia. Further research investigating the complex interplay between life circumstances (risk and protective factors), the content of overactive cognitions, and endogenous versus reactive forms of depression, would be beneficial to better understand the nature of the relationship between insomnia and depression.
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Copyright 2010 the author - The University is continuing to endeavour to trace the copyright owner(s) and in the meantime this item has been reproduced here in good faith. We would be pleased to hear from the copyright owner(s). Thesis (MPsych(Clin))--University of Tasmania, 2011. Includes bibliographical references