My Experience Only. YMMV.

Posts tagged ‘sleep’

Self-Care: Beyond Pets, Sleep, and Creativity?

New research from Western Sydney University has revealed that simple self-care strategies, such as spending time with animals and getting enough sleep, are helpful for people managing bipolar disorder symptoms. (https://medicalxpress.com/news/2018-02-pets-people-bipolar-disorder.html)

Sleep, pets, and photography – everything in one bundle

This is not exactly news, but the headline (“Sleep and time with pets help people living with bipolar disorder”) reflected my life so perfectly that I had to read on.

It turns out that the research involved only 80 subjects and was conducted by Edward Wynter, an honors student, who says he hopes “that knowledge of effective strategies can inspire proactive therapeutic engagement and empower people living with bipolar disorder to improve their health and wellbeing.”

And here’s the money quote:

This research reveals support for strategies already well known to professionals and people living with bipolar disorder, including those relating to quality and quantity of sleep, and drug and alcohol abstinence; but this study also highlights the effectiveness of several strategies yet to be explored such as spending time with pets and engaging in creative pursuits. (emphasis added)

Here’s some news, Mr. Wynter: Spending time with pets and engaging in creative pursuits are not “yet to be explored,” except perhaps by researchers. As he himself notes, professionals and people with bipolar disorder already know these concepts. I wonder what sort of grade this research gained him?

I’ve written about pets and creative pursuits myself. Service dogs for the mentally ill, for example (https://wp.me/p4e9Hv-nN):

Emotional Support Animals are dogs or cats (or, less commonly, other animals such as miniature horses or guinea pigs) that live with and provide comfort to a person with a psychiatric disorder, [t]ypically … one that qualifies as a disability under the Americans with Disabilities Act (ADA).

And even everyday pets can help (https://wp.me/p4e9Hv-jS). As I said of my very first cat: “We needed each other. I needed someone to care about, to focus my attention outward on. She needed someone to draw her out of her shell, to care for and about her.”

And regarding creativity (https://wp.me/p4e9Hv-uT):

Coloring books and pages for adults have been the trend for a while now. (Some of them are really for adults.) Jenny Lawson draws and also puts together tiny little Ferris wheels. I know someone who can make little sculptures out of drink stirrers or paper clips. The point is … [j]ust keeping your brain and your hands occupied is a good idea.

As for sleep, we all know that proper rest is a good thing, even if we’re not always able to achieve it. And I’ve written about that too (https://wp.me/p4e9Hv-vk):

Whether you sleep too much or not enough, bipolar disorder may be the cause. There are treatments, some involving meds, and others not. Meditation, for example, helps many people sleep … It’s a thing to discuss with your psychiatrist and/or your psychotherapist.

If I, a non-professional, already know about these aspects of treatment for bipolar that don’t involve therapy or medication (though I’m not knocking either one), why is research covering this old ground? Surely even lowly grad students can think of better, more productive topics than this.

 

To Sleep or Not to Sleep – That Is the Question

According to WebMD (which I find a pretty reliable source), “An inability to sleep is one of the key signs of clinical depression. Another sign of clinical depression is sleeping too much or oversleeping.” http://www.webmd.com/depression/guide/depression-sleep-disorder#1

So, apparently, with either unipolar or bipolar depression, either way you’re screwed when it comes to sleeping.

Most of what I could find online about depression and sleep talked about depression and insomnia. WebMD says:

An inability to sleep, or insomnia, can be one of the signs of depression…. Lack of sleep alone cannot cause depression, but it does play a role. Lack of sleep caused by another medical illness or by personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed. http://www.webmd.com/depression/sleep-depression#1

But, they add, “a small percentage of depressed people, approximately 15%, oversleep or sleep too much.”

I seem to be in the 15% that sleep too much. I usually wake up around 7:00 or 8:00, take my morning meds, and go back to sleep until 9:30 or 10:00. Sometimes I have a little nap in the afternoon. (For me, a “little nap” is about two hours.) I take my nighttime meds at 11:00 and am asleep by 12:00.

That’s a lot of sleeping.

Of course, those are just averages, just when I’m depressed, and just when I have no deadline-dependent work to do. Many days lately, I have been getting out of bed when I first wake up and skipping the afternoon nap. But then I go to bed even earlier, though I usually read for a couple of hours.

On the other hand, I’m subject to mixed states, when depression and anxiety coexist. When that happens, I want desperately to sleep, but can’t turn off my idiot bipolar brain. I’ll lie awake thinking about my writing, or my finances, or any damn thing. I’ll wake up at 5:00 and do the same. Those are often the days when I try to work in a nap.

Back to WebMD. They note:

Doctors may sometimes treat depression and insomnia by prescribing an SSRI along with a sedating antidepressant or with a hypnotic medication. However, hypnotic drugs usually should be taken for a short period of time. http://www.webmd.com/depression/sleep-depression#

Part of my nighttime meds are an anti-anxiety drug and a sleeping aid, plus an SSRI and an atypical. So, am I overmedicated?

It’s possible. But I trust my psychiatrist, and I’ve been on this regimen for a number of years now. My bipolar symptoms are now fairly well controlled, I’m able to work, and with the help of my husband, I manage to get through most days with level moods, only mild depression, and only occasional hypomania. I’ve been on other drugs and other combinations of drugs that did not work as well, or gave me horrible and vivid nightmares or other side effects.

I don’t want to hear opinions on the drugs I take from people who are not M.D.s and have never met me, or as Jenny Lawson said recently, “something that every person who deals with mental illness dreads…well-meaning advice from others.” Believe me, whatever it is, I’ve tried it. That’s not why I’m writing this.

What I do have to say: Whether you sleep too much or not enough, bipolar disorder may be the cause. There are treatments, some involving meds, and others not. Meditation, for example, helps many people sleep. (My mother used to sing herself to sleep with hymns when she had insomnia.) It’s a thing to discuss with your psychiatrist and/or your psychotherapist. He or she may be able to help. You don’t have to go through sleep disruptions without treatment. Even with all the problems that sleep causes me, I’ve got a system that works well enough for me.

And … now my insurance company thinks it knows better than my psychiatrist and only allows me a sleeping aid every other day. Apparently my choices are pay for it myself or take Benadryl. Again, I’m not asking for advice. Just restful, restorative sleep.

Self-Care and Sleep: Fact or Fiction?

Every article you see about self-care for bipolar disorder will tell you, Get enough rest or Get enough sleep.

Sleep is that golden chain that ties health and our bodies together.  – Thomas Dekker

But what did Thomas Dekker know? For many of us, proper, beneficial sleeping is easier said than done.

Neon light owlEven with my prescribed Ambien and Ativan, I’ve done the wide-awake-at-3:00-don’t-get-to-sleep-till-5:30 thing. And the unsettled-from-nightmares-afraid-to-go-to-sleep thing. (Also the just-one-more-chapter thing, but that’s my own fault.)

Then the next day I have to take a mega-nap (http://wp.me/p4e9wS-iO), which leads to guess what? More insomnia.

But this coin has another side as well. There are days when all I do is sleep. A full night plus (at least 10 hours), then a mega-nap, then right back to bed after dinner.

I don’t think I was awake for much of my childhood. I did a lot of napping. This might have been a defensive measure against encroaching depression. – Michael Ian Black

I know that part of my problem is my husband’s work schedule – third shift – and wanting to be awake at least at some of the same times that he is.

Another part of the problem is my medication. If I wake at 8:30 (yeah, I work at home) and take my meds, I’m down for the count again until at least 10:30. Or 11:00. Or even noon. I hope my clients think that I run errands in the morning or work on my projects with chat, IM, and phone turned off so as not to be disturbed.

And then there is my meal schedule, which is just as erratic as my sleep schedule. Most days I try to eat at least one good, full, hearty meal (another self-care recommendation, though they usually advise more than one meal). But after I eat – especially a hefty meal – I get postprandial torpor, the technical term for why you fall asleep on Thanksgiving after eating all that turkey. (And you thought it was the tryptophan.) And there comes another nap.

The repose of sleep refreshes only the body. It rarely sets the soul at rest. The repose of the night does not belong to us. It is not the possession of our being. Sleep opens within us an inn for phantoms. In the morning we must sweep out the shadows.  – Gaston Bachelard

But recently, it’s been the not-able-to-sleep thing. There’s a Tarot card that symbolizes the feeling – the 9 of Swords. In the Rider-Waite deck, the image is of a person sitting up in bed, hiding her face, with nine parallel swords floating in the background. I always refer to it as The Dark Night of the Soul. (The 6 of Cups usually means something like Childhood Memories, but for me it means “See Your Therapist.”)

(Note: I had a rather irregular introduction to the Tarot deck, and for me it acts sort of like a Thematic Apperception Test. I apologize to those of you I have just offended in one way or another.)

Sleep is when all the unsorted stuff comes flying out as from a dustbin upset in a high wind. – William Golding

Anyway, a recent event caused me a fair amount of trauma that I had to suppress at the time, and it came out immediately as bloody horrible nightmares the next time I slept. I haven’t had any more of those since, but I suspect they’re still lurking at the back of my brain.

That we are not much sicker and much madder than we are is due exclusively to that most blessed and blessing of all natural graces, sleep. – Aldous Huxley

I guess what I mean by all this is that sleep as self-care is wonderful, if it cooperates. But there are so many things that can go wrong and screw it all up – grief, guilt, depression, sorrow, anxiety, fear, loneliness, restlessness, obsessive thoughts, worries. It doesn’t feel like something that I have much control over.

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