- Chronic stress can increase your risk for some mental illnesses, including anxiety and depression.
- Findings from a recent study found that adaptive emotion regulation strategies and sleep both play key roles in reducing the risk of anxiety and depression among people experiencing chronic stress.
- This study used an event where people experienced a lot of chronic stress: the COVID-19 pandemic. However, managing chronic stress is vital, regardless of the source.
The COVID-19 pandemic has produced a unique situation where many people have experienced a period of chronic stress. Researchers are trying to understand how such periods of chronic stress affect mental illness and what factors may help improve mental health.
A study published in the journal Bark examined how adaptive emotion regulation strategies or positive coping strategies and sleep quality correlate with rates of anxiety and depression.
The authors found both components to be helpful in reducing rates of anxiety and depression. However, contrary to their hypothesis, they found that the effectiveness of emotion regulation strategies was not largely dependent on sleep quality.
This study was a secondary analysis of sleep and mental health data collected during the COVID-19 pandemic from spring to fall 2020.
The research’s first priority was to see whether adaptive emotion regulation strategies were associated with better mental health.
Adaptive cognitive emotion regulation strategies are thought processes that help improve long-term mental health. An example would be trying to find positive meaning in an event or situation, known as a positive reappraisal.
Second, the researchers wanted to understand whether the effectiveness of adaptive emotion regulation strategies depended on the quality of sleep. They looked at these factors in the context of a natural and chronic stressor, the COVID-19 pandemic.
Study co-author Emma Sullivan explained the key research goals to Medical News Today:
First, we were interested in whether more frequent use of positive coping strategies would be associated with reduced symptoms of depression and anxiety during the COVID-19 pandemic. Second, we were interested in whether the benefits of using positive coping strategies to reduce symptoms of depression and anxiety depended on the ability to get good quality sleep. This is because sleep quality has been associated with both the use of positive coping strategies and symptoms of depression and anxiety.
The study included 1,600 adult participants. Participants filled in information via online forms and provided vital information on demographics. They also completed questionnaires collecting data on emotion regulation strategies, sleep quality, depression and generalized anxiety.
Based on the data analysis, the researchers found that greater use of adaptive cognitive emotion regulation strategies was associated with lower scores for anxiety and depression.
They also found that reports of higher sleep quality were associated with lower scores for anxiety and depression.
Regarding the relationship between adaptive cognitive emotion regulation strategies and sleep quality, they found that people who reported higher quality sleep had higher use of adaptive cognitive emotion regulation strategies.
Their final model that took into account sleep quality found that using adaptive cognitive emotion regulation strategies did not significantly predict anxiety outcomes.
In other words, the effectiveness of using positive coping strategies in reducing depression and anxiety did not appear to depend on how well a person slept. However, positive regulation strategies have shown benefits for mental health, regardless of sleep quality.
Sullivan explained the subtleties of these results to MNT extension:
Indeed, we found that more frequent use of positive coping strategies was associated with a reduction in symptoms of depression and anxiety. Additionally, better quality sleep has also been associated with reduced symptoms of depression and anxiety. However, using positive coping strategies to reduce symptoms of depression and anxiety was not as dependent on getting good quality sleep as we had predicted.
Dr. Lindsay Oberleitner, a licensed clinical psychologist, director of education at SimplePractice, who was not involved in this research, commented on the study findings at MNT extension.
Interestingly, sleep quality and cognitive emotion regulation strategies didn’t work together in their relationship to depression and anxiety as expected, he told us.
However, he noted, this may not be as surprising as it might seem at first glance.
If we take a step back from the present study, this may not surprise us too much. We know that there are complex factors that influence symptoms of depression and anxiety among individuals. Sleep is only one aspect of physical health that affects mental health, and adaptive cognitive strategies are only one part of emotion regulation approaches.
Dr. Lindsay Oberleitner
It is still essential to note the limitations of this study. The researchers relied on participants’ self-report, which is not always accurate.
They note that people often report a lower than objectively measured quality of sleep. They could measure adaptive cognitive emotion regulation strategy and sleep quality only once, meaning they could not measure changes that may have occurred during the study.
The authors also had more data on depression than on anxiety. The study lacked power to measure minor interaction effects that may have been present.
Because of the measurements they used, they were unable to test whether a specific cognitive emotion regulation strategy or a combination was more effective, and how these strategies interacted with sleep quality.
The study included mostly white women in the US with higher education levels. The researchers were unable to account for specific covariates and the data was collected online. All of these factors limit how far study findings can be generalized and point to the need for greater diversity in future research.
Finally, the study authors acknowledge that the COVID-19 pandemic has provided a unique source of stress, so it is difficult to compare this study to other sources of sustained stress and subsequent mental health outcomes.
Sullivan noted that future research could look into other sources of stressors.
Obviously, the COVID-19 pandemic has been a unique stressful situation, so it would be good to replicate these findings when faced with other long-term stressful events, he explained to MNT extension.
Also, because we’ve looked at a number of positive coping strategies together, it may be important going forward to see how specific strategies, such as positive reappraisal (rethinking the situation in a positive light) and perspective (i.e. thinking about the bigger picture) are associated with both sleep quality and depression and anxiety symptoms. she added.
Regardless of the factors that contribute to it, taking steps to
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Betsy Serrano, a board-certified psychiatric mental health nurse at Cora Health Solutions in Phoenix, Arizona who was also not involved in the recent study, offered some tips for managing stress effectively:
Moderate stress and anxiety reduction is achieved through a few simple activities. Physical activities help relax your mind by releasing good endorphins which make you feel better. Eating healthy, not drinking too much caffeine, meditating and doing yoga, even some of the apps on the phone, like Calm, have great benefits when feeling stressed. But if you’re feeling excessively stressed that it’s just interfering with your day-to-day life, then you should consider some counseling and, if necessary, perhaps some medication.
Betsy Serrano, mental health nurse
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