I remember hearing a horror story about a woman who had gone in for surgery. The anesthetic had not worked properly. She could hear and feel everything going on during the procedure, but her body was completely paralysed. She was unable to tell those operating to stop. The pain was excruciating. She tried screaming. She couldn’t. Everyone thought she was asleep. In a normal surgery, she would be. But this was not a normal surgery. She was very much awake. Feeling everything.
This is how I would explain insomnia. Those who have experienced it would understand. Those who haven’t, may not be able to… and that is ok. I don’t expect you to understand. I do, however, ask that you try.
For one minute, consider this. It’s 10pm. While the world sleeps, you lie awake. Time doesn’t pass in minutes at this time of night. It passes in thoughts. Ruminations. Worries. The minutes become hours. It’s pitch black. No TV. No internet. You reacquaint with your 8-year-old self and count sheep. You’re so desperate for sleep. Nothing. Suddenly, it’s 2am. You think back to last nights’ broken sleep. You were woken by debilitating flashbacks and aroused by immense fear and anxiety. By the time you realised you were safe, your alarm was going off. Just as it is right now. 5am.
I have been contending with this sleep pattern for a long time now. Only in the last year or so, however, have I accepted that there is a lot more going on for me than just being ‘a bad sleeper’. In and of itself, this has been a challenge.
Being trained in psychology and having worked in and among ‘the helping professions’ for as long as I can remember, I don’t like to ask for help. I am a helper. So when it first occurred to me that all this work I was doing to try and help others with anxiety, depression, trauma, was actually eliciting these same responses for me, it was really hard to take. I didn’t understand. I am not sure I wanted to understand. I didn’t know how I felt about acknowledging that I may help myself with the very things I was working to help others with. I was getting less and less sleep, and feeling more and more alone. I needed to do something.
I had a word with myself and realised that it was time to put my big girl pants on. I decided to accept that we cannot help anybody else in this life until we actually help ourselves, and so I sought help. I found a great psychiatrist with whom I felt comfortable enough to begin psychotherapy. Soon after starting though, I stopped. He challenged some thoughts of mine that made me really uncomfortable, and the sessions had elicited some memories and feelings I wasn’t ready to deal with. Essentially, he had been too good at his job, and I never went back. Big mistake. As you can imagine, I became completely overwhelmed by all the feelings and emotions that I was now contending with on my own, and my sleep became the worst it had ever been.
It was at this desperate moment, without psychiatric support and surviving on little to no sleep, that I went to a GP. And was utterly disheartened. I would’ve hoped that presenting to a GP and telling them I was almost certain my insomnia was caused by ill mental health would warrant, at the very least, a mental health check. Instead, I was half-heartedly encouraged to go back and see my psychiatrist and handed a script for Temazepam (after disclosing I have a highly addictive personality and sleeping tablets had not worked for me in the past). I felt not only helpless in myself at that stage, but completely hopeless. If the GP wasn’t hearing my struggle, and could not help me, then who could?
Discouraged, I went home and had a double dose of Temazepam… with some wine (please don’t try this at home). Funnily enough, it worked. But here’s the thing. I did the same thing the following night, and could not sleep. I thought about why it had worked the first night, and not the second. What I realised was I had been acutely anxious and suffering low affect the night it worked, whereas I had been feeling fine on the night it hadn’t. It became obvious to me that it was the disinhibiting effects of the wine, which had temporarily disabled the anxiety and depression, that had allowed me sleep, and not the medication.
There has been lots of discussion recently around the importance of sleep, watch Mamamia's own Monique Bowley, Kate De Brito and Mia Freedman discuss.
Moral of the story… I’ll manage my sleep only if I learn to manage the things going on inside of my head. Mr. Psychiatrist, I need to make an appointment!
I think it is important to note that many comorbid sufferers of insomnia and mental health conditions may never make this connection themselves. This puts them at very high risk for addiction and worsening mental illness. It is the responsibility of health professionals to provide competent and reliable assessment and treatment. Always.
Alexandra works for the Black Dog Institute. You can find out more about their work here.