An Answer for Our Toughest Battle of the Day

JAN. 11, 2017

By Danei Edelen and Alex Hanna


My psychiatrist once said to me, "The most important issue for anyone with a mental health condition is sleep." At the time, I agreed with him, but I didn't fully understand his comment. Like many with a mental health condition, I have struggled with sleep—getting out of bed every morning is always a challenge—but I didn’t understand why.

Getting up each day is just something people do. Even if reluctantly, most people can muster the strength to slip out from under the sheets, put their feet on the floor and stand up. For some of us, getting out of bed is not so simple. For some of us, it’s our toughest battle of the day. Now there might be plenty of people out there who think we just aren't trying hard enough, or that we don't feel the same sense of responsibility for daily chores. But that just isn’t the case.

The Science Behind the Battle

A study published in the April 2016 Biological Psychiatry journal may have an explanation. “For more than 50 years, there’s been evidence that there’s something wrong with circadian rhythms in people with bipolar disorder…” reports Harry Pantazopoulos, lead author of the study. A circadian rhythm is the 24-hour cycle your body undergoes. In general, it tells you to feel tired and when to feel awake. It can be impacted by several external factors: how long you've been awake, the amount of light outside, whether you’ve just landed in a new time zone or even by something like temperature.

“Results of the study link abnormalities in circadian rhythms to changes to…a neuron responsible for a healthy circadian rhythm. [This]… correlates very strongly with the established severity of depression and anxiety symptoms in people with mood disorders.” The study also notes that this abnormality frequently occurs in the morning.

So, what does this mean? It means that people with certain mood disorders don't—likely can't—follow what would be deemed a "normal" sleep pattern. And the science isn’t restricted to people with mood disorders. Other mental health conditions, such as depression, are found to have a similar correlation, as is discussed in an article published by Live Science.

But What Can I Do?

  • Consult your mental health care provider or primary care doctor. I personally benefit from prescription medication (as directed by my mental health physician). While it took me years to find the right medications, I can say that the difference is night and day (get it!?). Others may benefit from the supplement melatonin, which can be bought over-the-counter at any drugstore.
  • Exercise. It has been incredibly helpful for me to regularly exercise, even when it’s just walking around the block. Exercising daily has been key for my body to develop a routine. Especially in the mornings—when every ounce of my being fights back—my habit of waking up and exercising has saved me from otherwise dark days in bed.
  • No electronics before bedtime. We have a rule in our house: No electronics after 9pm. The artificial light produced by computers, smart phones, tablets, TVs, and the like trick your body into thinking it’s a different time of day. By removing that artificial light, your body can naturally produce melatonin as the sun goes down, which helps you become sleepy.
  • Set your alarm clock. Going to bed and getting up at the same time every day—even on weekends—helps me maintain a healthy sleep routine. After starting this routine, it has been easier for me to get to sleep at night, sleep soundly through the night and wake up in the morning. 

There are several other healthy habits that can provide relief for those of us with abnormal circadian rhythms. There are absolutely factors outside of our control, but we are not powerless in making changes that can impact our circadian rhythms.

My daily struggle to get out of bed is still what I consider to be my toughest battle. It doesn't make sleeping any easier, but it does bring a level of comfort to know that there are scientific answers for why so many of us experience the same struggle. And it makes me feel even better that there are little things I can do every day to make the battle easier—even if it’s just slightly so.


Danei Edelen is married and lives with her husband and son in Cincinnati, Ohio. Danei owns Instant Marketing LLC. Danei has a bachelor's degree and over 20 years in marketing. She is also a NAMI presenter for the Southwestern Ohio chapter speaking to groups of all ages to help end the stigma. She blogs for the Challenge the Storm, and the Mighty. Danei enjoys, reading, writing, exercise and learning about nutrition. 


AUG, 12, 2017 02:50:56 AM
Lithium, a drug used for bipolar disorder, works by replacing potassium in the body. Why not get a prescription for potassium instead? It would be safer, healthier and more effective. This is a good question without a good answer, you should ask your psychiatrist this question. Also, all psychiatric patients should ask all their providers if their illness is associated with nutritional disorders because research indicates that there is nutrition therapy available for most mental illnesses, including depression, psychosis, bipolar disorder, schizophrenia, epilepsy. Ask each one of your providers each time that you see them. Good nutrition is enormously helpful in persons with mental illness.

MAR, 13, 2017 11:46:04 PM
I was diagnosed with bipolar 2.however when I take my anti depressants with a mood stabilizer I get extremely hostile, then my psychiatrist got me off mood stabilizers and put me on psychiatric meds.holy sh## even I still considered bipolar even though I can not take them?

MAR, 11, 2017 05:49:43 PM
I have schizoaffective disorder, anxiety disorder, add and ptsd. The schizoaffective disorder comes with bipolar disorder, but in my case that means like five days of manic per month (which I hate because I can't sleep during them), while the rest of the month I'm unable to get out of bed until...say...2 or 3pm at the earliest. And I'm completely exhausted by about 8 to 10 at night and go to bed then. I get nothing done around my house. I feel totally pathetic. I'm on 60 mg of time-release adderall/day and it makes me slightly more focused when I DO do something, but if I'm tired it doesn't help at all.
I think exercise might work. My knees are REALLY bad but I can swim, and there's a YMCA close to my house. I'll do anything; today I got up at 2:30 and now it's almost 5 and I'm fully ready to call it a day. Thanks for the article.

FEB, 07, 2017 08:07:24 PM
Jolene Noland
One more thing: As always, be sure to tell your healthcare provider of any over the counter anythings you are taking. Sometimes, desperate for sleep, people will try various herbs, OTC pills promising sleep. They may or may not work, but they may interfere with your prescribed psych and other prescribed meds. Just because something can be bought off of a shelf, even vitamins, does not necessarily mean harmless - each person is different; each person's medication menu is unique. Not criticizing or endorsing any med or OTC, etc. Just think before you put something in your mouth. Thank you.

FEB, 07, 2017 06:38:02 PM
Having a pet such as a dog or cat that you love very much that depends on you to feed it (and take care of it in general), if you have no one or nothing else to force you out of bed, can be a great motivator. Having tried prescription sleeping pills, OTC melatonin (which some pharmacists say gets you in the mood to sleep but does not keep you sleeping,) benedryl (once for allergies only, now appearing in some OTC sleep medications) and having no success, that is what gets me out of bed, even if I have to drag myself out of bed to do so. Also, some meds that don't work that night may cause you to suddenly close your eyes the next afternoon-you HAVE to sleep right then. Lack of sleep and some meds can impair judgement, balance, coordination...Be careful!

JAN, 27, 2017 02:27:28 AM
Trudy Bostick
I'm glad to know that my sleep disorder maybe connected to me having bipolar disorder. However, sometimes I feel like I fight sleep like a errant child. I don't have the discipline to maintain a routine sleep pattern and I have tried, along with my mental health professional to no avail. I can only seem to carry it off for a couple of weeks at best.

JAN, 27, 2017 12:08:01 AM
This article is way too basic. Having said that, after spending the majority of three years in bed, I started taking melitonin. It does help. Also, I enjoy being lulled to sleep by the television. I use a sleep mask so that I can listen to it while falling to sleep and it keeps the bright light out of my eyes. Now I can't sleep without one.

JAN, 26, 2017 06:59:04 PM
It's the absolute worst part of the day, waking up, a flood of disinformation and negative thoughts. Ugh. But, with meds, I get through it. It's good to talk about this.

JAN, 23, 2017 07:59:32 AM
Mornings are are ok, but i don't want to sleep. i have too much energy yet nothing to do.

JAN, 21, 2017 09:57:32 AM
Thank you theses are plosives changes that I will share with our family member

JAN, 20, 2017 12:18:44 PM
Crystal Freeman
I struggle with "severe anxiety (panic disorder with agoraphobia) with psychotic symptoms" along with an unspecified mood disorder, as well as ADHD, and very evident Borderline Personality Disorder, AND insomnia every night. I am glad to see that others go through these tough times.

JAN, 14, 2017 06:11:41 AM
Dan Davis
Studies have also shown that a driver lacking sleep drives as poor as an intoxicated driver, so it's no surprise sleep also affects mental health.

JAN, 12, 2017 09:40:03 PM
I have a daughter that is. ADHD and strong welled and is demanding makes bad grades no drive beautiful but has no friends. I am worried about her future. She does not even think about her future.

JAN, 12, 2017 02:26:34 PM
Kristine Eiffert
Thank you for speaking to this subject. I struggle with mornings and often get so called friendly jabs or teasing from family and friends. To all my family and friends who are early birds especially my husband I know they don't understand. I try to relate it to early evening when they start feeling run down and tired. I don't feel like there's even an effort to understand it by people without mental illnesses.

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