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Tuesday, November 21, 2017

Sleepless in A Battle

Posted by fxckfeelings on February 6, 2017

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Good sleep, along with YouTube videos of porcupines eating and fresh mozzarella cheese, is one of life’s simplest pleasures. Unlike those other things, however, it’s not just a joy but also something of a necessity. A life without hungry porcupines or good cheese of any kind of unfortunate, but one without sleep can feel excruciating, so it’s not surprising that those who just can’t shut themselves down at a reasonable hour are so eager to figure out what’s wrong with them and so quick to blame themselves for their sleeplessness. While we now have clinical sleep specialists and a bunch of helpful theories, suggestions, and treatments, we don’t, of course, have any solid answers or cures. The answer then isn’t seeking complete control over your insomnia, but learning to manage it and find pleasure in life despite it.
-Dr. Lastname

In short, I cannot sleep. I mean, theoretically I can (because, well, biology), but practically I can’t, and I know it’s all in my head— the fact that I feel that “I have insomnia” makes it so much harder, because, obviously I don’t have any clinical disease that it’s a symptom of, just some mental block that makes sleep impossible. I really, really want to sleep and get back control over this one thing without depending on anything (drugs, diets, etc.) or anyone to fix the problem for me. My goal is to get to the bottom of whatever’s causing this insomnia and get rid of it.

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It would be so much easier to avoid the skepticism around mental illness, from its diagnosis to treatment, if it came with physical symptoms instead of just neurological ones; if depression caused a rash, or bipolar disorder caused your hair to fall out. Insomnia, on the other hand, does cause visible symptoms, from paler skin to darker eye circles, but that doesn’t make it any easier to treat than other issues in the brain.

Given how often doctors preach the necessity of a good night’s sleep and how hard it is to feel confident or ready to perform at a high level when you’re tired and irritable, it’s easy to see why the search for an easy end to insomnia still exists, either through finding a simple cure or a way around a condition that seems like “it’s all in your head.” Unfortunately, while the problem may indeed be all in your head, your head contains your brain, and most brain problems have no easy answers.

The truth is that no one has found a cure for insomnia and there’s usually no answer that will give you total control of your sleep. There are many things that may help, but nothing is guaranteed to work or even likely to work completely or all the time. So if you’re desperate to find the underlying cause of your insomnia and get rid of it, your expectations will just cause more frustration, health worries and, yes, miserable sleepless nights.

It’s also important to remember that insomnia isn’t always unhealthy. In terms of Darwinian survival, it can alert you to nighttime danger from possible violent intrusions or medical emergencies. That knowledge can be cold comfort if you’re not currently living in a cave or yurt surrounded by wooly mammoths, but it still shows that your inability to sleep comes from a would-be strength, not a mental weakness.

Your goal then isn’t to find a source and cure for your insomnia, but to see if it can be cured and, otherwise, to find out what you can do to manage it. It’s also to oppose the nasty, frightening negative thoughts that tell you that you’re helpless, to blame for your own problems and the failure of your efforts to treat them, and a failure overall who’s spoiled his ability to succeed in life or just not consistently look like a sleepy zombie.

By all means, get yourself a physical exam to see if you suffer from any of the possible, curable causes of insomnia like sleep apnea, thyroid problems, and other medical causes. If you’re also feeling low enough that your insomnia may be a symptom of depression, consider getting an evaluation and possible treatment from a therapist. While mood disorders are seldom curable, they often improve with treatment and, when they do, the corresponding insomnia may also improve.

Then read books on sleep hygiene, which can show you how to regulate your daily activities and nighttime routine in order to maximize your chance of falling asleep quickly. People always sleep better when they have rigidly repeated bedtime habits like avoiding snacks, exercise, and socializing before (a rigidly kept) bedtime in a bed that reserve mainly for sleep. A sleep hygiene book offers suggestions for creating such a routine and protecting it from disruptive changes.

An approach that addresses the fear of insomnia and overlaps with the “sleep hygiene” approach is cognitive behavioral therapy for insomnia, a.k.a. CBT-I, which can help you fight negative thoughts while creating healthy bedtime habits. You can get such therapy from specifically trained therapists or by checking out web-based programs.

Sleeping pills can also be helpful, of course, but many kinds can’t be taken nightly without becoming less effective over time as your body builds up a tolerance. If you do decide to ask your doctor for medication, don’t let negative thinking interfere with your medical decision-making, and if you do try medication, don’t lament its shortcomings or punish yourself for becoming “dependent.” Instead, respect what you’ve done to find medications that work and to develop an ability to use them judiciously and only when necessary.

Learn everything you can about managing insomnia and you’ll find at least one method that can provide help, but even if nothing seems to work, remember that you’re still better than you think at preventing insomnia from ruining your life or health. Then take each long night in stride, proud of your ability to deal with an impossible condition, instead of tossing and turning with worry as an act of self-torture.

STATEMENT:
“I may not be able to sleep tonight, but it’s certainly not because I’ve failed to create a good bedtime routine. Now, whatever happens, I’ll do a good enough job tomorrow because I’m used to working on little sleep and then, with luck, my extra fatigue will put me back on schedule tomorrow night. With all the tools I’ve learned to use, I can manage this problem.”

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