Rambling on and on about insomnia

This really rambles….





I once had a bout of insomnia that lasted several months.  I slept two hours a night.  After a time I became agitated.  On a walk with Tiger (my dog) I saw a man standing by the side of a tire shop, smoking a cigarette, and I wanted to kill him, just because he was there, and at that moment it took everything in my power not to do him harm.


It all started when I saw psychiatrist named Dr. Michael Detke, who eventually stopped treating patients and went into research.  He couldn’t understand why I wasn’t sleeping, so he sent me to the sleep clinic at McLean Hospital. 


There I met with a psychologist (not an MD) who told me I had bad “sleep hygiene,” meaning poor habits regarding sleep, and that’s why I wasn’t sleeping.  (Looking back, there was nothing wrong with my sleep habits.)  The psychologist told me I should turn my clock so that it doesn’t face me, and stop listening to the radio as I fell asleep, and those were the only changes she could think of that would help.  I had to keep sleep charts, which was my first and only reason for using Microsoft Excel, noting what time I went to bed, what time I woke up, and so on.


This continued for several months with no improvement.  At my last appointment, the psychologist told me I was doing “extraordinarily well.”  As he said these words, I struggled to keep my eyes open and my head erect.  I was on the verge of collapse.


Meanwhile, Dr. Detke continued to raise my Effexor, a stimulating antidepressant, and lower my Seroquel, a very sedating antipsychotic.  At the hospital, it was more of the same: insistence that I needed more antidepressant.


The doctors at the hospital were just as incompetent as Dr. Detke; in fact, my first inpatient doctor was fired from the staff while I was there.  I was transferred to another incompetent, Dr. Abraham, who raised my Effexor more, then threw his hands up in the air and said, “Your insomnia will take a year to solve.  Goodbye.” 


Goodbye and good riddance. 


On that note, I was released from the hospital.  I had no desire to see Dr. Detke ever again, and I found myself with a wonderful doctor named Dr. David Brendel.  He asked me a few questions, to which I sleepily replied, then he looked at my medication list and said, “Whoa!  Your medications are all wrong.”  He took me off Effexor entirely and gave me more antipsychotics, including Thorazine.  After two weeks of treatment with this new doctor, I slept.


It is said that Pope John Paul II slept only an hour every night.  People suffering from mania sleep very little.  I need about eight hours.  Most people with mental illnesses notice their symptoms worsen when they are sleep-deprived; I am the opposite.  I have deliberately deprived myself of sleep at times, to “protect” myself from Evil Beings, and it works.  I wish I could keep it up, but eventually my body forbids me to stay up any longer.  A periodic all-nighter does me a world of good.  A research study suggested sleep-deprivation can help people with depressive symptoms, but the study was dismissed as unsubstantiated, and I’ve never heard of sleep deprivation as a “cure” for psychosis–quite the opposite.  For instance, last night my puppy woke me for his usual midnight romp.  (Pain in the butt that he is, I do love the little squirt.)  I felt restless and stayed up the rest of the night.  Today I feel cleansed of illness. 


People of certain religions believe that denying oneself food is cleansing to the body and soul.   Many religions encourage a modest lifestyle and restraint regarding pleasurable activities.  A person who eats excessively is a glutton.  One who sleeps too much is lazy.  A drinker is a drunk and a woman who overindulges in sex is a slut.  But to hold back, to restrain oneself is considered stoical and brave.  I am reminded of the giving up of pleasures for Lent, a practice traditionally upheld by Catholics and many non-Catholics nowadays.  To quit smoking is admirable.  Giving up sweets will improve one’s oral health.  But to quit entirely something the body or mind requires for functioning is impossible or at least unwise. 


People with severe mental illnesses require medication to stay mentally healthy.  A certain few will refuse medication and still live fairly reasonable lives, but the vast majority of us require medications.  Stopping medication is the number one reason that mentally ill people are re-hospitalized.  I have occasionally gone without medication, though at these times I usually am mistaken as to whether I’ve taken the pills, and the result was hospitalization each time.  Even lowering medication, without my doctor’s approval, has led to disaster.  Unlike restraint for the purpose of cleansing, going without medication is not only looked down upon, but also considered damn stupid.  Almost all violent acts committed by people with mental illnesses are done while the patient is not taking the required medication; patients who “cooperate with treatment” are no more violent–if anything, less violent–than the general population.  Perhaps we can consider it an act of discipline to take one’s pills every day!


When I can’t sleep, I suffer; when I choose not to sleep, I thrive.  Perhaps choice is the factor here.  To take control of one’s life is to choose wellness over excessiveness, moderation over extremes.  To be in control of one’s actions, though one can’t always control the results of one’s actions, is a reasonable way to live.


But what of adventure?  Don’t I need to give up that control every now and then, to set out without a map or compass just to see where I end up?  Certainly, a person with an excess of control has little enjoyment in life.  I have known a handful of people who wrestle with that problem.


To control what one can, and to let fate control the rest, is the key.  To rest my head on my pillow is my choice; whether I sleep well is less controllable.  I choose to take my medication (though I hate taking it), and take good care of myself, but that won’t prevent breakthrough symptoms to appear now and then.  Adventure has its place, as does regularity.  I’ve deprived myself of sleep–or, perhaps it is my puppy who has denied me sleep–let me sleep well tonight.  If I wake up tomorrow morning alive and breathing, I’m having a good day.


Sweet dreams.