I agree with Dr. Seifert, Be sure to get a check up. I had a son who had issues like yours. He had an over active thyroid. We kept trying to get him to eat more, but he didn't gain weight. A check up showed the over active thyroid. Thyroid is a gland that regulates your metabolism that sounds like it is over active. Be sure to tell your Doctor all you wrote here, and also if you have had a bump on the head.

There are so many reasons why you may be having difficulty sleeping, but the fact that you are is of concern, since most teens are sleep deprived and cannot get enough sleep. You indicate possible Bi-polar disorder and then mention ADD and ADHD. If you are on medication for ADD or ADHD, these meds can cause sleeplessness depending on the time of day they are taken . . . check with your prescribing doc. Depression in teens can cause sleeplessness so if this is a current symptom of your possible bi-polar disorder, this could also be a contributing factor. Are you having difficulty shutting down your mind . . .if so stress may be playing a role. My point here is it may not be a single cause. Has something changed recently in your life . . . new med? family situation? school or dating challenges? I might recommend a sleep study and a complete physical as a first step towards a definitive diagnosis.

There are good suggestions in the replies below. You cannot fix something unless you know what is causing it. It may be physical or you may have a Bipolar disorder as you say in your note. A physical checkup and a psychological check-up are great ideas. good sleep habits such as no caffeine after 2 or 3 in the afternoon, relaxation MP3's or relaxation self-help books. For your sleeping area use a dark, quiet room, and regular sleep times. Good luck.

Yes get it checked out by your doctor. Nerve damage may be happening.

First of all, get yourself to the doctor. There are some physical conditions that may first appear with these symptoms. All are very treatable and the faster they are controlled, the better. If everything checks out physically, the doc may prescribe a short, monitored course of sleep medications. Ok, I know most of us prefer NOT to take medications, but if you continue to be sleep deprived, that in and of itself may contribute to your depression (I suggest you research this issue to learn more about it). You may also discuss medication alternatives with the doctor such as chamomile tea, or one of the various NATURAL sleep aids available over-the-counter (make sure that it is a homeopathic or natural product as some of the other products on the market may contain chemicals that will raise your blood pressure and we don't want that).

Next, go to psychologist. We all have issues that stress us out during the day and keep us from getting a good night's rest. These issues need to be addressed in order to reduce your stress levels effectively. It may be something as simple as changing your point of view on certain subjects or life experiences, or it could be something as complicated as changing your lifestyle radically. Only a mental health professional will be able to help you determine the best answer in your case.Before you go see a mental health professional go online and take the DASS (Depression Anxiety Stress Scales) questionnaire. This is a well-researched instrument that will help you and your psychologist determine specifically which of these conditions (depression anxiety or stress) are most serious in your case, and provides a good starting point for treatment.

The next thing I recommend to all of my patients is to practice some sort of meditation regimen including biofeedback, neurofeedback, or just plain old sitting in a quiet space and "letting go" of your thoughts and quiet your mind. There are probably a number of organizations in your area that can teach you different techniques, philosophies etc. The good news is that this is a skill that would help you throughout your lifetime! if you're able to combine this daily practice with a low impact exercise program you may find that your sleep will improve dramatically as well as your ability to deal with stress more effectively.

One more thing I will suggest to you is to NOT self-diagnose. After all, it sounds like you have enough stress in your life as it is why add to it by worrying about something that is best determined by somebody else (self-diagnosis is not a smart thing to do even if you are a doctor). And even if you are diagnosed with one of these conditions remember it's only a label, and labels place limitations on people. They can be treated very effectively with a combination of medication, psychotherapy, and behavior therapy.

Finally, I would like to suggest a couple of books: "The Relaxation and Stress Reduction Workbook" is an excellent and inexpensive resource for learning relaxation techniques. Includes a section at the beginning of the book that includes various questionnaires the you can self administer so you can learn how stressed out you are, what your coping style is, and what chapters of the book are most likely to help you. That way you won't have to read the whole thing! :-)

If you would like to learn more about the effects of chronic stress, pick up a book called "Why Zebras Don't Get Ulcers" by Dr. Robert Sapolsky. I love this book, I've used it in class to teach students about the physiological effects of chronic stress and I recommend it to many of my patients.

Well, I think I've covered most of the bases. I noticed that your question has elicited some excellent responses and advise from other contributors, and I think that whichever one you choose will set you well on your way to feeling better!

Depression can cause sleep deprivation and issues of waking in the middle of the night. I would want more information about the specific kinds of stress that you have been under. I would ask questions about what are your thoughts and feelings when you wake up in the middle of the night. Your mind could be trying to resolve issues that are left unresolved during the day. Your thoughts and feelings can be an indication of the problem. I would recommend writing down your thoughts and feelings when you are unable to sleep in a notebook. Sometimes just paying attention to those thoughts and feelings can help lead you to the resolution you need.

Have there been any major changes in your life? Have there been any major losses of friends, pets, people, relationships? If so, you may have feelings that need to be addressed.

You mention that you are not on any medication. Are you drinking alcohol? Are you smoking marijuana? Are you taking any over the counter drugs? Any of these and or a combination of these could cause the problems you are experiencing.

In addition, when you can not sleep, try getting up and working on a project, watch television, catch up on writing, etc. If you get up and do something rather than staying in bed when not sleepy it can help reverse what appears to be a chronic problem.

The next recommendation would be to see a psychologist to try and resolve the underlying issues. Take your notebook with your thoughts and feelings with you. Taking prescription medication would be my last advise because the medication will mask and not resolve the problem. Sometimes an over the counter, natural herbs and teas can help with sleepless nights.

If all of the above solutions fail, then seeing a psychiatrist to offer a mild sedative might be an alternative. I would not recommend taking any kind of medicine for over three months as this can create an addiction and more problems than being unable to sleep. If this is the alternative you choose, I would combine it with seeing a psychologist to resolve the underlying issues.

You should probably make an appointment with the psychologist or a psychiatrist or possibly her primary care physician.

I will list below some common insights on better sleep, however finding out the actual cause of your impaired sleep is the first step and that involves going to see your health care provider. They will in turn send you to someone that will specialize in the area you may have if not resolved. There are no real short cuts in life and this is true in medicine also. Make an appointment today.

With the above in mind, here are some ways to help you sleep and things to consider:

Sleep Better

How to sleep better tip 1: Keep a regular sleep schedule

Getting in sync with your body’s natural sleep-wake cycle—your circadian rhythm—is one of the most important strategies for achieving good sleep. If you keep a regular sleep schedule, going to bed and getting up at the same time each day, you will feel much more refreshed and energized than if you sleep the same number of hours at different times. This holds true even if you alter your sleep schedule by only an hour or two. Consistency is vitally important.

◾Set a regular bedtime. Go to bed at the same time every night. Choose a time when you normally feel tired, so that you don’t toss and turn. Try not to break this routine on weekends when it may be tempting to stay up late. If you want to change your bedtime, help your body adjust by making the change in small daily increments, such as 15 minutes earlier or later each day.

◾Wake up at the same time every day. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock to wake up on time, you may need to set an earlier bedtime. As with your bedtime, try to maintain your regular wake-time even on weekends.

◾Nap to make up for lost sleep. If you need to make up for a few lost hours, opt for a daytime nap rather than sleeping late. This strategy allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm, which often backfires in insomnia and throws you off for days.

◾Be smart about napping. While taking a nap can be a great way to recharge, especially for older adults, it can make insomnia worse. If insomnia is a problem for you, consider eliminating napping. If you must nap, do it in the early afternoon, and limit it to thirty minutes.

◾Fight after-dinner drowsiness. If you find yourself getting sleepy way before your bedtime, get off the couch and do something mildly stimulating to avoid falling asleep, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.

How to sleep better tip 2: Naturally regulate your sleep-wake cycle

Melatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Melatonin production is controlled by light exposure. Your brain should secrete more in the evening, when it’s dark, to make you sleepy, and less during the day when it’s light and you want to stay awake and alert. However, many aspects of modern life can disrupt your body’s natural production of melatonin and with it your sleep-wake cycle.

Spending long days in an office away from natural light, for example, can impact your daytime wakefulness and make your brain sleepy. Then bright lights at night—especially from hours spent in front of the TV or computer screen—can suppress your body’s production of melatonin and make it harder to sleep. However, there are ways for you to naturally regulate your sleep-wake cycle, boost your body’s production of melatonin, and keep your brain on a healthy schedule.

Increase light exposure during the day

◾Remove your sunglasses in the morning and let light onto your face.

◾Spend more time outside during daylight. Try to take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.

◾Let as much light into your home/workspace as possible. Keep curtains and blinds open during the day, and try to move your desk closer to the window.

◾If necessary, use a light therapy box. A light therapy box can simulate sunshine and can be especially useful during short winter days when there’s limited daylight.

Boost melatonin production at night

◾Turn off your television and computer. Many people use the television to fall asleep or relax at the end of the day, and this is a mistake. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it. Try listening to music or audio books instead, or practicing relaxation exercises. If your favorite TV show is on late at night, record it for viewing earlier in the day.

◾Don’t read from a backlit device at night (such as an iPad). If you use a portable electronic device to read, use an eReader that is not backlit, i.e. one that requires an additional light source such as a bedside lamp.

◾Change your bright light bulbs. Avoid bright lights before bed, use low-wattage bulbs instead.

◾When it’s time to sleep, make sure the room is dark. The darker it is, the better you’ll sleep. Cover electrical displays, use heavy curtains or shades to block light from windows, or try a sleep mask to cover your eyes.

◾Use a flashlight to go to the bathroom at night. If you wake up during the night to use the bathroom—as long as it’s safe to do so—keep the light to a minimum so it will be easier to go back to sleep.

How to sleep better tip 3: Create a relaxing bedtime routine

If you make a consistent effort to relax and unwind before bed, you will sleep easier and more deeply. A peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses.

Make your bedroom more sleep friendly

Make Sure Your Bed Is Comfortable ◾Keep noise down. If you can’t avoid or eliminate noise from barking dogs, loud neighbors, city traffic, or other people in your household, try masking it with a fan, recordings of soothing sounds, or white noise. You can buy a special sound machine or generate your own white noise by setting your radio between stations. Earplugs may also help.

◾Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.

◾Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. If you often wake up with a sore back or an aching neck, you may need to invest in a new mattress or a try a different pillow. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more or less support.

Reserve your bed for sleeping and sex

How to sleep better tip 4: Eat right and get regular exercise

Your daytime eating and exercise habits play a role in how well you sleep. It’s particularly important to watch what you put in your body in the hours leading up to your bedtime.

◾Stay away from big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Fatty foods take a lot of work for your stomach to digest and may keep you up. Also be cautious when it comes to spicy or acidic foods in the evening, as they can cause stomach trouble and heartburn.

◾Avoid alcohol before bed. Many people think that a nightcap before bed will help them sleep, but it's counterintuitive. While it may make you fall asleep faster, alcohol reduces your sleep quality, waking you up later in the night. To avoid this effect, stay away from alcohol in the hours before bed.

◾Cut down on caffeine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! Consider eliminating caffeine after lunch or cutting back your overall intake.

◾Avoid drinking too many liquids in the evening. Drinking lots of water, juice, tea, or other fluids may result in frequent bathroom trips throughout the night. Caffeinated drinks, which act as diuretics, only make things worse.

◾Quit smoking. Smoking causes sleep troubles in numerous ways. Nicotine is a stimulant, which disrupts sleep, plus smokers experience nicotine withdrawal as the night progresses, making it hard to sleep.

If you’re hungry at bedtime

For some people, a light snack before bed can help promote sleep. When you pair tryptophan-containing foods with carbohydrates, it may help calm the brain and allow you to sleep better. For others, eating before bed can lead to indigestion and make sleeping more difficult. Experiment with your food habits to determine your optimum evening meals and snacks.

If you need a bedtime snack, try:

◾Half a turkey sandwich

◾A small bowl of whole-grain, low-sugar cereal

◾Granola with low-fat milk or yogurt

◾A banana

You’ll also sleep more deeply if you exercise regularly. You don’t have to be a star athlete to reap the benefits—as little as 20 to 30 minutes of daily activity helps. And you don’t need to do all 30 minutes in one session. You can break it up into five minutes here, 10 minutes there, and still get the benefits. Try a brisk walk, a bicycle ride, or even gardening or housework.

Some people prefer to schedule exercise in the morning or early afternoon as exercising too late in the day can stimulate the body, raising its temperature. Even if you prefer not to exercise vigorously at night, don’t feel glued to the couch, though. Relaxing exercises such as yoga or gentle stretching can help promote sleep.

How to sleep better tip 5: Get anxiety and stress in check

Do you find yourself unable to sleep or waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. When you wake up or can’t get to sleep, take note of what seems to be the recurring theme. That will help you figure out what you need to do to get your stress and anger under control during the day.

If you can’t stop yourself from worrying, especially about things outside your control, you need to learn how to manage your thoughts. For example, you can learn to evaluate your worries to see if they’re truly realistic and replace irrational fears with more productive thoughts. Even counting sheep is more productive than worrying at bedtime.

If the stress of managing work, family, or school is keeping you awake, you may need help with stress management. By learning how to manage your time effectively, handle stress in a productive way, and maintain a calm, positive outlook, you’ll be able to sleep better at night.

Relaxation techniques for better sleep

Relaxation is beneficial for everyone, but especially for those struggling with sleep. Practicing relaxation techniques before bed is a great way to wind down, calm the mind, and prepare for sleep. Some simple relaxation techniques include:

◾Deep breathing. Close your eyes, and try taking deep, slow breaths, making each breath even deeper than the last.

◾Progressive muscle relaxation. Starting with your toes, tense all the muscles as tightly as you can, then completely relax. Work your way up from your feet to the top of your head.

◾Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel.

If you associate your bed with events like work or errands, it will be harder to wind down at night. Use your bed only for sleep and sex. That way, when you go to bed, your body gets a powerful cue: it’s time to either nod off or be romantic.

Relaxing bedtime rituals to try

◾Read a book or magazine by a soft light

◾Take a warm bath

◾Listen to soft music

◾Do some easy stretches

◾Wind down with a favorite hobby

◾Listen to books on tape

◾Make simple preparations for the next day

◾Stay out of your head. The key to getting back to sleep is continuing to cue your body for sleep, so remain in bed in a relaxed position. Hard as it may be, try not to stress over the fact that you’re awake or your inability to fall asleep again, because that very stress and anxiety encourages your body to stay awake. A good way to stay out of your head is to focus on the feelings and sensations in your body.

◾Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, deep breathing, or meditation, which can be done without even getting out of bed. Remind yourself that although they’re not a replacement for sleep, rest and relaxation still help rejuvenate your body.

◾Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, try getting out of bed and doing a quiet, non-stimulating activity, such as reading a book. Keep the lights dim so as not to cue your body clock that it’s time to wake up. Also avoid screens of any kind—computers, TV, cell phones, iPads—as the type of light they emit is stimulating to the brain. A light snack or herbal tea might help relax you, but be careful not to eat so much that your body begins to expect a meal at that time of the day.

◾Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when you are fresh and it will be easier to resolve. Similarly, if a brainstorm or great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive and creative after a good night’s rest.

Sleep well...

Dr. Scott Rowlett

Difficulty with sleep is a common problems and can have many causes. Since you have listed possible bipolar disorder and ADD/ADHD I would recommend starting with a psychiatric evaluation coupled with possible counseling. Having good sleep hygiene can help ( not watching television in your bedroom, not reading or using any electronics in your bedroom, going to sleep the same time every night). There are behavioral programs that can help with the sleep hygiene component, sometimes associated with a sleep lab. Try to avoid ambien and xanax as much as possible for sleep aid medications, I have seen too many patients become addicted. A formal sleep study may also help (evaluating for sleep apnea and restless leg syndrome).

I agree with others that you should try and get some help from a professional, whether it be first talking to a school counselor or approaching your parents about getting a medical or psychiatric evaluation. I am wondering if you self-diagnosed the Bipolar, ADD and ADHD or if a professional has give you those diagnoses. Since you are not on any medication, I am thinking that the Bipolar might be your guess or some other non-professional's guess? If that is so, its all the more important for you to get a formal diagnosis. Bipolar in adolescents can be pretty torturous and there are medications that help dramatically. Chronic sleep deprivation and depression are a bad combination which, as people have said, can intensify each other over time. Please let someone know you are struggling!!