In this blog post, I ‘ll talk about something personal that I’ve been going through for the past 10 months: insomnia. I’ve always been an insomniac, and usually, that meant going to bed very late. Night-time always made me anxious, and when I was young, I associated sleep with death. As an adult, I realize that death and sleep are very different, but there is a lingering anxiety when I think about sleep. Also, I’m more productive at night, which makes falling asleep a struggle. In any case, while my life-long insomnia wasn’t ideal, it was manageable. I could ”catch up” on lost sleep.
My insomnia took a turn for the worse in October: I would wake up in the middle of the night and be unable to go back to sleep. To fix the issue, I followed the typical sleep-hygiene advice, like going to bed at a precise time, not looking at monitors an hour before bed, etc… But it didn’t help. My insomnia grew worse: I couldn’t even fall asleep to begin with. At the time, I had a sneaking suspicion that I was overthinking the sleeping process, but I couldn’t figure out what I was doing wrong. After two weeks of poor sleep, not falling asleep for the last two days and uncontrollably shaking in the middle of the night, I went to the emergency room. At the emergency room, they prescribed Mirtazapine, which is an anti-depressant with a side effect of making one sleepy. They also told me I needed to see a therapist and do some cognitive behavioral therapy.
I called up the neighborhood clinic to see a therapist right away, but it ended up taking three weeks to see one. In fact, this would be a recurrent problem in my insomnia journey: the long wait times involved in seeing doctors. It seems that there are not enough doctors per capita in New York. And actually, my therapist and psychiatrist technically weren’t doctors. The therapist was an intern, and the psychiatrist was a nurse practitioner. Generally, I don’t mind seeing someone with minimal experience (we all have to start our career at some point), but it became apparent that their lack of experience meant that I wasn’t getting the help I needed.
I was routinely going two days without sleep, and when I slept, it would be for about four hours. If I was lucky, I’d maybe nap a couple of hours much later in the morning. But with the train traffic next to my apartment, going back to sleep wasn’t easy. The sleep deprivation was severely affecting my mood. It’s a hard feeling to describe because, when I’m well-rested, I don’t feel “good,” I simply feel “normal.” With sleep deprivation, I was not feeling “normal.” The insomnia was plunging me into a deep depression, the worse depression I had ever experienced (and I’ve had cancer, so that’s saying something). I felt like I was living in hell, and that death would be preferable.
I won’t go into the details of my journey through insomnia and the medical establishment. After several months, the doctors couldn’t find a biological reason for my insomnia: I had no sleep apnea, no hormonal imbalance. The therapist wasn’t doing cognitive behavioral therapy with me, and the psychiatrist didn’t prescribe me medicine that helped. I have to point out that, through this experience, I took four different medications to help me fall asleep. None of them were actual sleep medication but were prescribed for the side-effect of making one sleepy. They would initially work, but I always built a tolerance to them, leaving me back where I started. Moreover, I didn’t like being dependent on medicine for sleep. I tried everything I could think of: I joined a therapy group for anxiety, I called health hotlines, I did meditation, working out. I also went to the emergency room around every three weeks because I didn’t know what else to do. This is where I learned that it wasn’t enough for me to feel suicidal to be taken seriously, I had to have some concrete suicide plans.
One night, in February, I ran to the Emergency Room with blood running down my arm. To give a bit of background, I was doing Sleep Restriction therapy, as per the sleep doctor’s instructions. I had been sleeping, at the most, 4 hours a day, for 30 days. Consequently, my mood hit rock bottom. I would cry all the time. At the emergency room, I thought for sure THIS TIME, I would get treatment, but I actually was discharged that same day…in hindsight, I have no idea why the medical staff thought that was the right decision. After this event, my psychiatrist prescribed another anti-depressant. Apparently, all of the anti-depressant I had been taking for insomnia were “obsolete” in the treatment of depression. I get annoyed thinking that I had been seeing this psychiatrist for months and was clearly depressed, but she never thought to change my prescription until the staff at the ER suggested a prescription change. But I digress. The point is, I’m incredibly disappointed with the medical help I received.
As I was struggling with my insomnia in New York, my parents, in Miami, were worried. Six months after my ordeal started, they made me move to Miami because obviously, the New York medical establishment wasn’t helping me. I’ve been in Miami for about 4 months now. I’ve been sleeping a bit better: I don’t stay awake for two days straight, and I stopped taking the medicine I was prescribed. Actually, I occasionally take a pill when I haven’t slept well for a few days. It’s a very slight improvement. I still have difficulty falling asleep, and often wake up after four hours of sleep.
My biggest issue with sleep is that I have a hard time “turning off” my brain. I lay in bed, thinking random things, but somehow I can’t drift off to sleep. I’m not thinking particularly stressful things. If I “wake up” in the middle of the night, frequently, it doesn’t feel like I slept at all and it feels like my brain is spinning its wheels thinking the same thing over and over again. Conversely, if I’ve managed to sleep for seven hours, it’s hard for me to stay awake. Whereas my brain couldn’t shut down at night, my brain can’t “startup” in the morning…At least, this is what it feels like. Whether I sleep too little or enough, the end product is that I’m always exhausted. I’ve been having a hard time focusing on projects, I feel like I’m in a constant battle with my willpower.
So I just wanted to share with you my insomnia problems. I’m surprised that even though insomnia is common, there is still no cure for it. I’m convinced there’s a biological component to my insomnia, and not just mental, but no doctor has been able to help me figure it out.