Hello again everybody!
Today I thought I’d take a bit of a break from ‘Things I wish I’d Never Done’ and go back onto the mental health side of things to talk a little about an issue that’s been causing me a fair amount of trouble recently. Scumbag brain has been up to his usual tricks and sleep (or the lack of) has become a real problem for me.
Depression/anxiety and sleeping problems usually go hand in hand and either one can sometimes become the cause of the other developing. For me, my sleeping problems began just after my Dad died as a result of my anxiety over death. For months on end, after I turned off the lights and lay in bed, the first thought that would come into my mind was that I was going to die and there was nothing I could do about it. I would freeze in terror, just staring wide-eyed at my bedroom wall for hours. Sometimes I’d cry and in doing so I’d tire myself out enough to sleep. It’s no surprise that I also had a lot of nightmares, however it was also around this time that I started to experience night terrors and sleep paralysis. I read up on some information on this so here’s a brief explanation about what each of those things mean.
Nightmares are frightening or upsetting dreams that happen during the REM stage of sleep, when normal dreams would occur. They can disrupt your sleep by making you wake up in a state of distress. An example of one of my nightmares; being hunted by man-eating panthers around my house.
Night terrors are dreams that occur during the deeper part of your sleep and are much more vivid and scary than nightmares. They have a much more physical effect on the body causing an increase in breathing, increased heart rate and sweating. The person can thrash about, scream or cry out in their sleep. An example of one of my night terrors; in my night terror I hugged my sister so hard I snapped her neck and killed her, causing me to bolt upright in my bed screaming out her name, something she didn’t enjoy as we were sharing a bedroom at that point.
Sleep paralysis is thought to happen due to disrupted REM sleep and can happen either while you are falling asleep or waking up. It occurs as a result of you still being awake while your muscles are under the control of hormones designed to stop you moving about during REM sleep. Quite often I experience sleep paralysis on nights when I have night terrors, mostly when I’m trying to wake up. I’ll find that I can open my eyes but I can’t move any of my body and I can still hear what’s happening in my dream. If I don’t manage to move my muscles I can slip back into the night terror. An example of some of my sleep paralysis; being unable to wake up from a dream for a very long time which made me become increasingly more and more panicked until I was convinced if I didn’t wake up I would die.
More recently I’ve started to experience something which is apparently called ‘Exploding head syndrome’. Not quite as fun as it sound. Exploding head syndrome again usually occurs before I have a night terror. As I’m starting to fall asleep I’ll suddenly begin to hear agonisingly loud noises and feel my body tense up as if I’m entering sleep paralysis. One of the worst ones I ever had was like the sound of a chair being dragged across a wooden floor for ages. At the time it really feels as though it’s causing excruciating pain but if I manage to wake myself up again it completely disappears.
My issues with sleep have always become worse when my anxiety or depression is particularly bad, like when I’ve had exams or been very upset over something. Or, because I’m such a special case, after your well-meaning boyfriend buys you a zombie survival experience for Christmas where you have to run away from people pretending to be zombies trying to eat you.
Over the past several months though my sleeping problems have become more and more extreme. It’s gotten to the point where I’m having very bad nightmares every night with the odd night terror thrown in once in a while. This really affects my sleeping pattern as I find I can’t fall asleep very easily because I’m on edge about what will happen. When I have nightmares I often wake up feeling extremely upset about what I dreamed and completely unrested. I’ll be extremely tired and down during the day as a result but when it comes to bed time, yet again I have trouble sleeping.
I’m sure you all can relate to feeling tired, everyone knows that horrible sicky feeling when you’ve had to get up early after being up too late the night before. But this has been happening to me for AGES now and it’s really beginning to have a severe impact on my mental health. Every night I have nightmares that replay over and over again all the horrible experiences I had during my Dad’s ill health and death. I’m also confronted with my own fear of failure as I relive leaving vet school and the heart ache it caused me. Every single night my brain forces me to see these things and every morning I begin the day already defeated as I wake up crying or panicking.
The thing is recently, by trying to do something positive for my depression, I’ve actually made my nightmares worse. Just before Christmas, I decided to go to the doctor to discuss going on to medication. The drug he chose for me was Citalopram, a selective serotonin reuptake inhibitor (SSRI) which is good for helping both depression and anxiety. At the time the doctor was fully aware that I struggle with sleep and he did fore warn me that this particular drug can cause vivid dreams. However he decided that the possible benefits outweighed the possible negatives so we went ahead with it.
Unfortunately, I did begin to experience more vivid dreams. However in my case it was more vivid nightmares. Usually when you wake from a dream it seems to have happened in a rapid confusion of colours and events but it slips away a little bit more every time you try to think about it until it’s impossible to recall. Now, nicely drugged up on my Citalopram, I’m treated to an all-night blockbuster nightmare marathon in high definition which I can remember perfectly, to the last detail of the exact wording of an imagined conversation I had with a fictional creation. The realness of my dreams is so much so that I sometimes find it hard to differentiate between what is real and what’s just imagination. My reoccurring vivid dreams of the brakes failing in my car and causing it to spin out of control are so real that I’m becoming scared to drive. Recently Burly bought me my favourite mushroom soup from Tesco as a treat (he really hates mushrooms so it was a big gesture of love from him). Then one night I had a dream that my emaciated, skeletal, deathly ill dad was begging me for something to eat. I gave him the mushroom soup and he was so grateful for it as he managed to eat a couple of spoonsful. I woke up the next morning, went to the fridge for breakfast, saw the soup still sitting there and burst into tears. I hadn’t given it to my dad, I hadn’t been able to offer him comfort. The soup is still there now getting increasingly mouldy as I can’t touch it without feeling sad and Burly can’t touch it without feeling sick.
You wouldn’t believe how severely the lack of good quality sleep over a prolonged period of time can affect you. It’s not just that though, it’s that every night the sleep I have is like a kind of torture. I liken it to a really bad break up. You’re trying to get over your ex and get on with your life, but everywhere you look you see your ex with their new partner. It wrenches your heart and sets you right back to square one living in your onesie, singing ‘All by myself’ into a tub of Ben and Jerry’s. I’m trying so desperately to move on with my life and leave my memories in the past, but every night I’m forced to relive the trauma of my Dad’s death and the unhappiness of vet school. My stupid brain waits until I’m asleep and vulnerable, then it starts the same old slide show of misery. How am I supposed to escape from my own head?
So right about now I’m feeling that I’m long overdue a decent night’s sleep. So I went to the Mind website to see what they recommend. I thought going to a mental health charity page would be a bit more specific for helping with my sleeping problems because they are linked to my depression and anxiety. They have some brilliant information about it all and I found a list of suggestions to help have a peaceful night.
1. Establish a routine.
Yeah, I’m pretty poor at this but only because my sleep is so broken. I’m so tired at night but sometimes I can’t get to sleep until four or five am and then after that I don’t much fancy getting up at half past six with Burly. So then I sleep in till about ten and it starts all over again. Burly and I have started to try to have a little bit of a bed time routine with a cup of sleepy time tea before bed but I know we need to start establishing an actual time to be in bed before. And I need to really give myself a kick up the bum and get out of bed with Burly in the morning.
2. Make sure where you sleep is comfortable.
THIS. THIS RIGHT HERE. Burly’s bed has been the bane of my life for a couple of years now. The mattress is extremely thin, so much so that it can fold in half (Burly’s excuse, “I couldn’t have fitted it in my car otherwise!”) and the slats underneath the mattress aren’t fixed properly so often they’ll slide apart and I end up sinking down into the gap between with the slats digging into my back. It’s only slightly more cushioned than the floor so my hips ache when I lie on my side or back from it being so firm against me. I really don’t look forward to getting into the bed so I don’t give myself time to relax before the lights go out. I’ve spoken to Burly about this and he agrees that we should do something to help me out so I can sleep better. So hopefully soon I’ll be sleeping on something a lot softer which will help me drift off at night 🙂
3. Relax before going to bed.
So as I say, Burly and I have started to try and relax a bit with some calming tea but I really think we need to do more. Apparently it’s best to stop looking at lit screens such as TVs, laptops, tablets and phones for an hour before you try to sleep as these stimulate your brain and so make it harder to switch off. The Mind website recommends baths or doing something calming and creative before bed so I might invest in a dot-to-dot…
4. Avoid doing stimulating activities in the bedroom.
No but I know what they mean, like doing work or watching TV in there because then you don’t associate it as a relaxing room. I am very bad for watching YouTube videos in bed (I’m addicted to pewdiepie!) but I’m going to try and limit myself a lot more and move to the living room if I do want to watch videos.
5. Don’t force yourself to sleep if you can’t.
They are very right about this point. The times when I feel at my absolute worst is when I’ve been lying in the dark just staring at the ceiling for ages, sometimes hours, while Burly is snuggled up snoring away blissfully beside me.
I get so frustrated and agitated by it that I sometimes start crying from anger because all I want is to sleep! But obviously none of this is very good for relaxing and having pleasant dreams. I’m going to try to get up and do something to help tire me out when this happens in future and hopefully I’ll be able to stop myself from getting wound up.
6. Catch up on missed sleep.
I’m not too sure about this step because I don’t want to end up sleeping too much during the day so I can’t sleep at night. I trust Mind though so I’ll remember it in future just in case.
7. Diet and physical exercise.
I know that exercise is meant to be a brilliant way to help combat depression but as a depressive it can sometimes be extremely hard to find the motivation to care enough to do anything. My anxiety also hinders me from going outside sometimes. I have been a lot better recently and even plucked up the bravery to drive out to some animal shelters last week. I also found a really nice picturesque park very close by to my house at the weekend so I’m going to push myself to pop out there from time to time for a little walk. I do think that this is a really good sign that my citalopram is beginning to work in the way it’s supposed to so that’s a really positive sign!
8. Regulate light exposure.
As it explains on the Mind website, exposing yourself to natural light during the day is helpful for making you sleepy at night when it gets darker. It also recommends not having too many bright lights on in the house in the evening to help you wind down. See I know a little bit about this because there’s a hormone called melatonin that controls your sleeping cycle which is affected by light levels. Not getting enough daylight or having lots of lights on late into the night interferes with the natural levels of melatonin and so effects your sleep pattern. So again getting out of the house and exposing myself to some sun light will be good for me.
9. Keep a sleep diary.
Keeping a diary would help to identify nights where I struggle to sleep and might help me figure out why. I did at one point start keeping a diary of my nightmares to help me assess how many I was having but it was just pages full of varying kinds of zombie apocalypses.
10. Try to resolve stresses and problems.
Oh if only it were that easy! However, I am going to (hopefully) be starting some therapy soon so I’m optimistic that as it progresses it’ll help me to deal with my demons and sleep might start to come more easily.
11. Try herbal remedies.
One of my friends suggested spraying lavender scent on my pillow which actually sounds like a lovely idea that I’m more than happy to try, Burly will just have to put up with smelling flowery!
12. Recognise and challenge unhelpful thought patterns about sleep.
This is a bit like cognitive behavioural therapy where you learn to break out of a vicious circle of bad thoughts by changing your approach. So instead of thinking ‘I’m afraid to sleep because I might have a nightmare’ instead you think ‘I’m looking forward to sleep because it gives me a chance to relax’. That breaks the circle and so it’s more likely that you’ll have a positive outcome. Much easier said than done, I know from experience, however I also know it does work.
So yeah, I’m going to give all of these steps a go. I’ll give you an update to say how it’s going a bit further down the line and say what steps I found particularly useful in case you find yourself in a similar situation to me. I am SO READY for a good night’s sleep so fingers crossed I’ll soon be dreaming sweet dreams. Preferably that include Burly. And Simon Neil. Smothered in chocolate.