Sleepless Puppet – My Struggles with Insomnia
Insomnia has been my constant companion for most of my life. Sleepless nights and staying up until dawn is a normal for me. It is 3 AM at the moment. Point proven. I think most people experience bouts of insomnia because so many different things can influence our sleep: stress, anxiety, illness, heat, what we eat and drink, if our routines are being disturbed. It is something that almost everyone can relate to. But when it comes to how much sleep we need, when we sleep and what really is classed as insomnia, those things are very much down to the individual case. For me, insomnia is about not getting enough sleep, constantly waking up, avoiding sleep and not being able to fall asleep.
What is even enough sleep? I think that differs for everyone, but let me say that I don’t think I have ever had enough sleep in my whole life. Even as a child, I was always tired. I would assume I need about eight hours to feel okay, maybe even more. I have quite a few physical health conditions with fatigue as a symptom (Chronic Fatigue Syndrome, Diabetes, IBS and Hashimoto’s), so you’d think that I would sleep a lot. And my body would definitely need a long night’s sleep, and several naps throughout the day.
Only, my mental illness won’t allow me to get what my body needs. So maybe ten hours is what my body would need? Twelve? I guess I will never find out. I would assume that my average these days is about four to five hours a night. But I have also experienced long periods when I got way less than that.
A lot of my insomnia, meaning that I can’t sleep long, is linked to my mental illness. I have Bipolar Disorder. In hypomania (a lighter form of mania, which is a symptom of Bipolar Disorder type 1. I have Bipolar Disorder type 2), I don’t feel like I need sleep. I function well on an hour or two of sleep and don’t feel tired. instead I am all hyped up and I want to do all the things. All the things! Of course that doesn’t work well and eventually my mind short-circuits and I crash into depression.
Depression, by the way, doesn’t necessarily mean that you sleep a lot. You can either have hypersomnia or insomnia. I get insomnia in depression. Of course! What else, eh? The worst is mixed bipolar episodes though (when you both have the symptoms of mania and depression). You want to sleep so bad, you are so drained, so exhausted. But you cant sleep because your mind has become a race track for anxious and self-destructive thoughts. A lot of my insomnia is closely linked to my Bipolar Disorder.
When Sleep is Scary
And then there is the trauma from my past. I have both Complex Post-Traumatic Stress Disorder and Dissociative Identity Disorder, caused by long-term abuse during childhood and my teenage years. And that trauma has left me with nightmares. I don’t get them as often as in the past, but especially when triggered, I get quite terrible nightmares about past abuse. So I wake up and can’t fall asleep again. Sleep doesn’t feel safe.
The main reason for my inability to sleep long, for waking up lots, for avoiding to go to sleep and for being unable to fall asleep, is that sleep doesn’t feel safe. Most of my sleeping issues stem from my trauma, and most of trauma happened during the nights. They happened when I was in bed, when I was awoken in the middle of the night to be forced to go some place I didn’t want to go. So my brain learnt that being in bed when it is dark night, is not safe. I need to be awake to be prepared for all possible (imagined) threats. Being asleep just feels incredibly unsafe.
What I experience is called hypervigilance. I am constantly looking for a threat, I am tense, observing my surroundings. I become jumpy and the slightest sound or movement can cause me to panic. You can imagine how that makes it quite hard for me to relax and fall asleep, and to stay asleep. So I can’t go to sleep before I can barely keep my eyes open. Until then, during the dark hours of the day, I need to distract myself heavily so I don’t go into panic-mode. Right now, I am listening to music, writing, reading the news and chatting with a friend. If it were possible, I’d also have something running on the TV right now. I need to trick my brain, distract my brain, from the hypervigilance. And this can become even worse when a bipolar episode is present, because then sleepiness is hard to come by.
All this makes it hard for me to have sleep routines. I have a sleep hygiene, for sure. I don’t eat right before going to bed, I do the same things every day when I am sleepy. But I just can’t sleep when someone tells me it is time to go to bed. I need to be in the right mindspace, and my body needs to be so tired that I am passing out. Actually, I often call falling asleep passing out.
I am not someone who just comfortably lies down and then drifts into dreamland. My anxious hypervigilant brain fights sleep, it fights falling asleep. So the only way for me to actually sleep is for my body to be so overwhelmed by exhaustion, that I just pass out. That is how I take naps too. My body is so drained, that I just pass out within seconds. I don’t even plan to fall asleep or nap, it just happens.
The Need for Sleep
I get that I need to sleep. And I know that bad sleeping habits are bad for your body, and your mental health. I know that my insomnia exacerbates my mental illness. I am more anxious because of my lack of sleep, maybe even snappy. It also makes my physical illnesses worse. If I am in a particularly bad period for sleep, my blood glucose levels are higher. My IBS acts up too.
I am very fed up with people trying to give me advice on how to sleep better. I have had these issues all of my life. See, I am someone with severe mental illness, a mindfulness exercise and avoiding screens is not going to cure my insomnia. Because insomnia is such a common problem, people just assume that it is all about self-discipline. It is not. I am doing all the right things. Well, unless I am in hypomania and being awake seems like a fun thing and I drink coffee all the time, and decide to take over the world. Different story.
What I can do
I know what would help me. I need therapy that helps me process my trauma so I don’t feel the need to be hypervigilant anymore. But that is impossible at the moment, and would take many many years to tackle. The only option that has ever worked for me is medication.
You’d think that someone as mentally ill as I am, would be allowed daily sleeping medication. Well, it is not that easy. A lot of doctors are opposed to long-term treatment with that sort of medication. I had a really good psychiatrist in Sweden who saw my need for medication for sleep and anxiety and decided that if there was anyone who should be allowed regular medication, it would be me. But once I moved to Canada, it got complicated. I managed to get a few new prescriptions but was always worried that I wouldn’t be allowed a refill.
So I decided that I should taper down those meds, which I did. It was tough, and I am not sure if it was the right decision, Withdrawal from that sort of medication (I was on Zopiclone and Oxazepam) is a bitch and having that as a constant threat hanging over me was too scary. But that means that I am stuck with no medication and no help to sleep. I really miss the calm that the medication gave me. So you can imagine how my sleep has been the last few months. I am quite proud of myself to not have lost my mind yet.
The only path I can be on right now is to try to sleep when I can. These days that means going to bed at 6 AM, when it is not scarily dark outside anymore. It is about waiting until my body is so exhausted, that I am going to pass out at any second. And until then, I distract myself. It might not be the most healthy thing to do, but what other options do I have right now?