Thursday, August 2, 2007

Sleeping and Work

Kira has a question that I'm attempting to answer but perhaps others have suggestions as well.

Susan,
What do you do when you notice that you are becoming hypomanic? I'm feeling frustrated because I can't do anything about my two main triggers for hypomania right now (job stress and insomnia), so the symptoms just keep getting worse and worse. I'm afraid that it will turn into agitated depression soon, and I don't know what to do to prevent a full blown episode. My current situation at work prevents me from taking any time off, and I can't sleep no matter how hard I try.

Kira

Dear Kira,
Sleep is a big problem during a hypomania. My doctors have always said it's very important to get at least 8 to 9 hours of sleep each night, and I've religiously followed their advice. Of course, it's very difficult during a hypomania.

There are some natural ways to try to fall asleep, including making sure you exercise during the day so that you're more tired, taking a walk after dinner to calm down, meditation, and deep breathing exercises before you go to sleep. There's also calming music to listen to and trying to engage in "peaceful" activities at night to try and bring yourself "down."

I've also taken homeopathic remedies that were supposed to work as well as drinking tea that was supposed to be calming. If you've read my blog for awhile, you'll know that I'm medication resistant so that I've tried everything and very little of it has been effective. I've also tried a slew of alternative treatments and they haven't worked either. That's not to say that they won't for you...but that's been my experience.

The only thing that's worked for me is "sleeping pills." These days I take Ativan (which is prescribed for some people for anxiety but for me, it's always been prescribed for sleeping). If the hypomania isn't a bad one, I can take 1/2 mg. and fall asleep within an hour. Lately, I've had to take 1 mg.

Over the years, my doctors have prescribed other pills for sleep, including Ambien and Klonopin, but both were way too strong for me and had a residual affect in the morning. But, medication affects everyone differently. For me, a little goes a long way--and always has.

I don't know what to recommend if you can't get medication. In the comment you left yesterday, you said you're living in an ashram and can't afford medication. I think it's really important to find a mental health facility nearby where you can get medication for free.

For most people, the mood stabilizers work to level out the highs and lows and anti-depressants work for depressions. And sleeping pills work when you're need to sleep but can't. If you haven't tried any of these drugs, you should. But I'm not sure where you can get them in your current situation. Perhaps someone else knows more.

Anybody got advice here?

In terms of stress at work, that's a tough one and I'm not the best person to answer this. In my younger years, I worked without difficulty. Once I started taking medication, I had a lot of problems with stress causing depressions.

These days, I'm semi-retired. However, I know there are people who read this blog who are working and I'm sure they have good advice for you. I'm rushing off and wanted to respond to you before I leave. I have three important appointments today and I won't be home until this afternoon. I live in Los Angeles so there's a time difference as well.

So...I'm turning off the "comments moderation feature" so other people can respond directly to you. When I come home, I'll read what they've said, and see what I might add. Hang in there!

Susan

5 comments:

BamaGal said...

Aaahhh sleep---sleep or the lack of go hand in hand with mania---it is a case of which came first---did the manic episode cause you not to be able to sleep or lack of sleep cause you to be manic.
I believe the inability to sleep is more a symptom of mania--the mania comes first.
I do all sorts of things to help with myu sleep patterns---the best is to establish a routine. Always go to bed at the same time and get up at the same time, even on off days. Never use your bed for anything but sleep. Turn the lights down in the house at least an hour before going to bed. This gets your mind in the sleep cycle mode. Refrain from napping during the day. Do some relaxation exercises before bed. I use yoga. Also if you can't sleep---get up---don't lay there tossing and turning. I'll go into another room and trying reading for awhile---then return to bed. Something I have to work on is NOT getting involve in a project close to bedtime. I tend to get caught up in it and before I know it, it is the wee hours of the morning.

Daily Dose said...

This may sound weird, but read a very boring book...I am not kidding.

Or get an iPod or a CD player and play some soothing music that sounds like the ocean waves, rain, dolphins, and so on...it will truly put you out.

Don't watch TV in bed...in fact, take the TV out of the room if you can.

Since I rearranged my bedroms and took the TV out of my room..I sleep really well.

Kira said...

Thank you, Susan, for addressing my current problem on your website. I've been intuiting the need for exercise, meditation, talking walks outdoors, etc. The hypomania tends to cause me to neglect my health and body in many ways, especially as it creates such a strong urge to spend all my time mentalizing, planning and creating instead of taking care of my body. I am going to make a serious effort to change this tendency, for my wellbeing. Thank you so much for encouraging me in this direction!

I actually meditated on my break during work and it did calm me down quite a bit. I am so grateful for your advice, and am going to try and implement many your suggestions. Thank you also, bamagal and Tery for your tips about sleeping better! I am going to start doing yoga, and listen to soothing music before bed to calm myself down. While I am able to fall asleep without any problem, I wake up super early and cannot fall back to sleep no matter what I do. I've tried deep breathing and meditation upon waking to try and get myself back to sleep, but it doesn't work. I've tried natural herbs but they didn't help keep me asleep, and the otc sleep aids only work sometimes and make me feel groggy the next day.

I want to apologize for the misunderstanding I caused by my lack of clarity in my initial post. I am not currently living in an ashram, so I do have access to both a pdoc and meds. I've been procrastinating due to a fear of medication and the feeling that I should first try natural treatments before seeing a doctor. I used to live in an ashram, and hope to return there soon if and when I can get my illness under control.

Thank you again for all your help and support! I've lived with this disorder for most of my adult life and until now, never had the opportunity to connect with others who understand me and have gone through similar experiences. It is so comforting and encouraging to know that you can relate and empathize with what I'm going through!

Gratefully,

Kira

Susan Bernard said...

Dear Kira,
You're welcome. Before writing this blog, I, too, had never met anyone who was bipolar. Yet,it's so difficult to live with this illness in isolation.

I'm glad you have medication available. But I must say that if I've learned anything these past 14 years, it's that medication--even for those for whom it works-- doesn't solve all the problems.

I think that many of us tend to spend time indoors when we're hypomanic or get caught up in projects or blogging when the best thing for everyone is probably to spend more time outdoors.

While there is little research discussing the positive aspects of exercise, personally I cannot tell you how important it is for me.

And I actually play music as a form of meditation. A few years ago when my doctor of integrative medicine prescribed breathing exercises, and I found them so boring, I decided to do the same exercises blowing in and out with my harmonica. It worked much better and made me smile.

So, I guess the best advice of all is to keep your sense of humor. And know that we're all here to offer support and advice.

Warmly,

Susan

marja said...

Sleep was the very topic I wanted to deal with next on my blog. It was the topic for our Living Room meeting last Friday. There is a spiritual angle to consider. Do have a look at my August 4th post.