One of the main problems that comes along with depression is insomnia. I have experienced mild to severe insomnia for most of my life. I even recall being a very young boy and not being able to tell time, but watching a clock tick while my parents were downstairs still awake, and thinking to myself, “Well, it can’t be midnight yet, that would be impossible.” It likely was midnight or later, but to me it seemed careless and dangerous to not be in bed by that time.
Growing up, my brother and I shared a room and we used to do things like fight, read, play music or have the lights on after the time we were supposed to have gone to sleep. Finally my dad got sick of coming up the stairs with each noise and decided I would go to bed with my mom who always retired early to read, then when my dad came up, he would carry me to bed already asleep. It worked pretty good. I have a lot of fond memories of talking with my mom and drifting off to sleep and magically waking up in my own bed.
One of the reasons I used to have insomnia was that when I was in elementary school and part of junior high, I hated school. I loved doing schoolwork, I loved learning things, but I had bullies that made me almost afraid to return to school after a weekend. At one point I recall being in tears Sunday evening not wanting to return to school.
High school was when the real problem started, and I blame the great lineup of TV we used to have where I grew up. They had David Letterman, then The Honeymooners, then The Twilight Zone, the Phil Silvers Show and more. Soon it became hard for me to not stay up and watch these shows. I had a routine where after my dad went to bed, I would go in the bathroom, flush the toilet, and with the sound of flushing I would sneak downstairs. I would make tea, eat hot dogs, do my push-up workout routine, then as school time approached, I would convince myself I could take on some huge project like reading the encyclopedia that I never followed through with.
As an adult, after I had spent time in a psychiatric hospital, I was put on sleeping pills, along with a few other meds. After a while, I decided to wean myself off of them, which was extremely difficult. I met a doctor once who told me she had her clients not just break their pills in half to gently lower their dose, she also suggested they file them down with an emery board a little at a time. These things were powerful!
Off and on, I went through a number of periods where I would take something to help me sleep and when I didn’t. In more recent years I have found a system that works fairly well.
Before sitting down to write today’s post, I looked at the website for the Mayo clinic, and was very surprised. Just about all medications for sleep cause dependence. There was just one in a list of ten or so medications that didn’t, but it only helped people get to sleep, it didn’t help them stay asleep. At the moment, I have the option of taking a small dose of clonazepam (or rivotril) every other day to help me sleep, but it really hasn’t been enough. I now have also been given doctor’s permission to use melatonin. now and then as well. My doctor literally told me he had done a lot of research on melatonin and that he recommends it. Melatonin often helps me get to sleep, but when I wake up it is often very difficult to get out of bed. Another doctor upon hearing this has suggested I take my melatonin an hour before going to bed, I haven’t tried this to be honest.
If I can at all do it, I want to sleep without extra sedation, but sadly even my regular medications have a sedative side effect. When I take medications in this case, I often worry if I will overdose which is unlikely because I never go over the recommended amount. Then comes the worst part of sleeping medication: it can adversely affect your memory. Memory is something I have taken a lot of pride in since I was young. I have long, detailed, vivid memories of grade one, and what part of my elementary school my class was in, the first day my friends and I organized a football game in the field. But I’m starting to lose my ability to remember short-term things. It is very common for me to walk into a room and not remember why I went there. I don’t really find it that scary, but I do know I have not only had some street drugs in my past, I have suffered from concussions a few times, and that I have a family history of Alzheimer’s disease. My Uncles, and my grandfather had it, and I can see the signs that my dad is coming down with it too. So I don’t really know if any of these things, or even if there is a combination of all of them is causing my memory loss.
What I do know is that it is extremely hard for me to function when I don’t take things to help me sleep. If I don’t somehow sedate myself enough to rest, I often either sleep in or can’t function in my day to day activities. Fortunately, for some reason, I haven’t had as much trouble sleeping in. I don’t know if it is caused by my dependence to my sleeping meds, or just something that happens with age. I had looked into getting a sleep study done, but I was on a year-long waiting list, and when my appointment time came up, I was unable to make it or re-book. That is one part of Canadian Health Care I resent, the waiting times. I honestly feel that the Alberta Government, in their never-ending quest to save a few pennies on the backs of our most needy citizens, has cut funding in key places that makes these waiting lists necessary. I don’t like to talk about it too much, but my own mother passed away while just 2 days away from a procedure that would have saved her life.
One thing I do often do is try and have a ‘medication holiday’. I don’t stop any of my psychiatric medications, but I do try and fall asleep without medication. It isn’t easy, and I will often sleep much more than normal, but it often feels so refreshing that I wish I could do it all the time. In fact though, I kind of have to be very exhausted from getting poor quality sleep for this to work. This brings me to my final point about sleeping pills. I am of course no doctor and no espert, but one thing I have learned is that our bodies need REM (rapid eye movement) sleep. It is at this time that we dream and certain chemicals in our brains are renewed. I once read a study about researchers who prevented test subjects from getting REM sleep and the results were astounding. Soon, these people became unable to function and after a while longer, they could no longer be woken up. My take on this? We need to dream whether we remember the dreams or not. If we don’t dream, it is as though we didn’t get any sleep. I would like to invite any specialists in sleep to comment on this. I am currently auditing a “Masterclass” on the importance of sleep, so expect to see more of these posts soon, and sleep well and take care!
Mental Health coping skills blog by leif gregersen 