Shift work, and night shift work in particular, is linked to poorer sleep and higher rates of depression, anxiety and burnout. Roughly a quarter of the adult workforce works shifts, according to a StatPearls review published by the National Library of Medicine, yet most mental health care still runs on a daytime schedule. This article explains how shift work affects mental health, what to watch for, and how to get support at hours that fit your life.
How does shift work affect sleep?
Working nights means sleeping against your body clock. A NIOSH analysis of U.S. workers found that 61.8% of night shift workers slept too little, compared with 35.9% of day workers, and that insomnia was more than twice as common among night shift workers (18.5% against 8.4%). NIOSH also notes that drowsiness, fatigue and circadian rhythm disruption are associated with immune dysfunction, diabetes, cardiovascular disease and other chronic health problems.
Shift work and mental health
Poor sleep and mental health feed each other. The StatPearls review reports that shift workers experience higher rates of burnout, depression, anxiety, excessive sleepiness, insomnia and suicidal ideation, and that depression is more strongly associated with rotating shifts than with fixed shifts. The same review cites a study of 2,570 U.S. shift workers in which 14% of night workers and 8% of rotating shift workers had symptoms meeting the criteria for shift work disorder.
Shift work can also strain relationships and support networks. When you sleep while family and friends are awake, it becomes harder to stay connected, and isolation can make stress, low mood and intense emotions harder to manage.
Signs it may be time to talk to someone
- Low mood, irritability or anxiety that lasts for weeks rather than days.
- Feeling emotionally overwhelmed, or reacting more intensely than you want to.
- Relying on alcohol, caffeine or other substances to switch on or switch off.
- Pulling away from family, friends or activities you used to enjoy.
- Thoughts of self-harm or that life is not worth living.
If you are having thoughts of suicide, call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day. In an emergency, call 911.
Why therapy is hard to fit around shift work
A typical therapy appointment falls in the middle of the day. For a nurse finishing a 7pm to 7am shift, a first responder on rotating nights or a warehouse worker on third shift, that time slot means cutting into sleep or taking time off work. Many people put off getting help for exactly this reason, not because they do not need it.
How can therapy help night shift workers?
Evidence-based therapy gives you practical tools for the pressures shift work creates. Dialectical Behavior Therapy (DBT) teaches skills for managing intense emotions, tolerating distress and reducing vulnerability to low mood, including building steadier sleep and self-care routines. Cognitive Behavioral Therapy (CBT) helps you notice and change unhelpful patterns of thinking and behavior. Trauma-informed therapy supports people whose work exposes them to stressful or traumatic events.
After-hours therapy for shift workers in Texas and Florida
North Texas DBT Associates offers after-hours therapy by telehealth for night shift workers, night owls and early birds in Texas and Florida. Late night and early morning sessions are available with Courtney Hicks, a DBT-Linehan Board of Certification, Certified Clinician™, and cost the same as daytime appointments. Learn more about after-hours therapy or email courtneyh@ntxdbt.com to ask about availability.
Sources: NIOSH Science Bulletin, Shift Work and Sleep (CDC); Reinganum MI, Rausch-Phung EA, Thomas J. Shift Work Hazards. StatPearls, National Library of Medicine, updated 2024.