More often than not, when I tell people either that I work for the Depression and Bipolar Support Alliance (DBSA) or that I personally have a diagnosis of depression, people will ask, “What medications do you take?”

While I understand and don’t mind the question, I try to use it as an educational opportunity. To many people, treatment for psychiatric conditions equates to taking pills, and while such pharmacologic interventions are important to treatment and wellness for many people, they’re hardly the whole picture.

Answering completely

Successful treatment approaches for people who have depression or bipolar disorder usually involve a balance among medication, talk therapy, peer support (through actual support groups or otherwise) and lifestyle choices like diet, exercise and—perhaps most importantly—sleep.

"Both too little and too much sleep have been shown to exacerbate many of the physical conditions, like hypertension or diabetes, among others, that frequently co-occur with mood disorders."

You see, among a majority of the roughly 21-30 million American adults who have depression or bipolar disorder—known collectively as mood disorders—the relationship with sleep is fraught. Sleep disturbance is a symptom associated with mood disorders: some individuals experience sleeplessness or inadequate sleep; some people have hypersomnia and sleep too much; and still others experience both extremes from time to time.

Sleep’s value

Yet there is also evidence that sleep disturbance is in and of itself a potential cause or trigger of mood-related symptoms, with decreased sleep perhaps precipitating the mania or hypomania of bipolar disorder and both too little and too much sleep connected to the onset of depression.

What’s more, it’s not just how much or how little you sleep that can cause issues—fluctuations in when you go to sleep and wake up present challenges and can both signal and contribute to the onset of mood symptoms. And if that weren’t enough, both too little and too much sleep have been shown to exacerbate many of the physical conditions, like hypertension or diabetes, among others, that frequently co-occur with mood disorders.

The linkage between sleep and mood disorders is fascinating, and research about why and how they’re connected is important. Yet in the here-and-now, for people like me who experience depression and bipolar disorder, there isn’t time to wait for better understanding of sleep and mood disorders’ intersection. Yet there’s plenty of evidence—and the urgency of life-and-death stakes—to make sleep hygiene a top priority within our treatment plans.

So whether you personally have a diagnosis of a mood disorder or care about someone who does, “How’s your sleep?” is one of the top questions to consider. And if your sleep is poor, addressing that fact seriously and urgently in collaboration with your doctor is crucial to achieving and maintaining wellness.