Landmines and Ballerinas: How to cope with a lack of sleep when you’ve got mental health issues

For a lot of reasons, I slept like hell last night. For me, that’s dangerous. To be clear, all of us need a good amount of sleep in order to function the next day – I need at least five hours, I’d say, to be able to fire on all cylinders.

However, and this goes without saying, there is a huge connection between mental health and sleep. A lack of sleep can hurt your mental health, and mental health challenges can hurt your ability to get sleep. I know that both of these items are true for me, and I also know that on nights where I barely sleep (like three hours or less), I can barely function. As I said to my wife today, it feels like my head is filled with landmines and ballerinas that are blowing up those landmines. I absolutely cannot think straight. Of course, that may make this blog entry kind of interesting, so if I write out CHEEEEEEESE or something with no context, just bear with me.

Anyway. If you are like me, this can be a real challenge. A lack of sleep fires every one of my depression and anxiety genes, and I feel like I lack the coping and logic skills to get those emotions back in the bottle. My head feels like it’s filled with fog and sand.

How do I deal with this? I’m not quite sure yet, to be honest. But, broadly speaking, here are some thoughts.

Treat it as a sick day

Look, when you don’t sleep, you feel like crap, right? Take it for what it is: It’s a sick day. I’m not saying curl up in bed and take the day off from work – that may not be an option – but what I am saying is you should go easy on yourself. It’s not as if you somehow asked for mental health problems or to sleep like crap. Give yourself a break, and don’t hold yourself to the same standards that you may do on an otherwise normal day.

Ask yourself what you can do

One of the more impactful moments of my life came about a year after my son was born and when my wife was pregnant with our daughter. I was much, much heavier – 31 pounds or so, depending on the day. And I was upset. I’d really let myself go. And I was complaining about it to my wife, but the complaints weren’t action-oriented. They were just me bitching. And she said the line to me:

“So, what are you going to do about it?”

I don’t know about you, but on days where I’m struggling for one reason or another, I always feel better when I ask myself that question. Look, everyone has bad days. But if they become a pattern,  you have to ask yourself that question. What are you going to do about it? And that’s a key question, because yeah, things may suck at the moment, but if you can say to yourself, “Yes, I can barely think straight and am probably less coordinated now than I am when I’ve had a few drinks, but what can I do to make sure I take care of myself?”

Nap…but…

According to sleep.org, a nap the next day can potentially be helpful, as it can help ease the impact of having trouble sleeping. However, timing is key: Early to mid-afternoon is best, as this decreases the chances of your naping hurting your ability to sleep later that night.

Ultimately, these are just some broad thoughts, and I’d be really curious to hear yours…particularly considering I’m about to go face first into my keyboard. Any advice would be appreciated!

 

This is how depression & sleep trouble are related

For me, there have always been two markers that are my “canary in a coal mine” when it comes to depression – the two factors that tell me I’m depressed even when I may not realize it right away. First is eating. Some people eat more, some stop. I’m the later. I drop weight when I am depressed.

The second, and the one I wanted to write about today, is insomnia. Simply put, when I get depressed, I have a huge problem sleeping. When I get to sleep, I usually stay asleep, but the challenge for me is that I can’t sleep when I’m depressed. I’ve never been exactly sure why. Maybe it’s because I cannot shut my mind off, or maybe it’s because there’s some unresolved conflict that is prohibiting me from sleep.

Unfortunately, I’m not the only one who gets these issues. Even more unfortunately is this: When you are depressed, you can’t sleep. And not sleeping may mean more depression.

Alright, first, the evidence. Sleep and depression are strongly connected, and it’s not just me saying that. This comes straight from the DSM-V (Diagnostic & Statistical Manual):

Insomnia (inability to get to sleep or difficulty staying asleep) or hypersomnia (sleeping too much) nearly every day

So, one of the formal criteria for diagnosing a depressive episode or illness is the above. Unfortunately, it’s a two-way street, as not getting enough sleep – or getting a poor quality of sleep – can lead to depression. From The Sleep Foundation:

The link between sleep and mood has been seen over and over by researchers and doctors. For example, people with insomnia have greater levels of depression and anxiety than those who sleep normally. They are 10 times as likely to have clinical depression and 17 times as likely to have clinical anxiety. The more a person experiences insomnia and the more frequently they wake at night as a result, the higher the chances of developing depression.

There’s so much irony in the discussion about depression and sleep it’s ridiculous. What always frustrated me the most, however, was this: When you can’t sleep, and you are having prolonged trouble sleeping, all you can think about is how YOU CAN’T SLEEP, and this will worry you/frustrate you/depress you. This, in turn, will worry/frustrate/depress you even more, and then – you guessed it – you can’t sleep! It creates a vicious lack of sleep cycle.

Do I have any magic cure? No. Heck no. While there is plenty of advice on how to sleep when you can’t, I’ve found that everyone’s experiences are deeply personal. Related to that, I can tell a story about how I broke through my sleep issues when I was depressed. There was a period where I wouldn’t be able to sleep for 3-5 days a week. Not until 3am or so, only to become a sleepy zombie the next day and not be able to sleep at all the following night, and thus, the cycle continues.

One night, I’m in Harrisburg for session. I can’t sleep, it’s 2am and I am miserable. And I remembered something my therapist said a week or so before about how he had patients who had broken through their anxiety and phobias when they accepted the worst. And as I laid there, I said to myself, “You know what? Screw it. I’m done. I’m not gonna sleep, I’m gonna have the worst day of my life tomorrow, and then when I drive back to Allentown, I’m gonna crash the car. It’s over and I accept!!”

I slept that night.

It was an interesting moment for me, so if I have any piece of advice, it is this: When you accept the worst, you can get where you need to be.

Any thoughts, tricks or tips are appreciated! Leave them below!