On Sleep

The voices tend to be at their worse when I’m trying to sleep. Whereas I usually tend to hear only a dull, barely audible mumbling throughout the day (as though someone left a pair of headphones with a podcast playing across the room at low volume) when I’m trying to get to sleep the voices will oftentimes become much more prominent. It can be like trying to sleep in the middle of a dinner party – I’ll hear full sentences, though oftentimes incomprehensible even though they’re at full volume, sometimes in familiar voices (my mom’s voice is a favorite), sometimes it’s such an overwhelming din that I can’t make out individual voices – it’s like a bunch of people trying to speak over each other all at once. There are times that I can pick out phrases but the phrases never make any sense. They’ll be nonsense, something like “potatoes make great stockings while driving calypsos” or “an education makes llama confractions in the evening placating butterscotch.” And I can’t help but think they’re all talking about me.

Then there are the visuals. The swirling, teeming waves of colors that overwhelm my vision as I close my eyes and try to go to sleep. It can be like my own private light show – sometimes, and particularly when I’m in a more manic mood it’s actually darker with my eyes open than it is with them closed.

All this makes for a complicated environment to try to get to sleep in. How does one get to sleep when there’s essentially a party going on around you with all conversation (being done in nonsense no less) being directed at you? How does one get to sleep when you have your own personal light show being performed whenever you close your eyes?

Medication can certainly help and I use it to my advantage – it’s a huge benefit that my antipsychotic load is such that I’m oftentimes so tired by the time I’m ready for bed that the personal light show and nonsensical dinner party are irrelevant. But sometimes even the most heavily sedating of my medication can’t out-class the sensory overwhelming-ness of my brain. Preparation is key – my bedtime routine is quite strict and on those nights I don’t follow it I usually end up having a hard time falling asleep and therefore ruin the next morning. I use some mindfulness tricks, some meditation, as well as a few other tricks I’ve picked up through sheer trial and error to calm my addled brain and put myself in a restful state and they greatly improve the likelihood that when I finally get into bed and turn the light off I’ll fall asleep and stay asleep until morning.

Mindfulness to me might mean something different than it means to you – so here’s my definition of it: it’s a breathing technique in which one consciously accepts what they’re going through without judgement while concentrating on a external stimulus such as a phrase (e.g. a mantra), object, scene, or memory.

I use a memory of a picture from when I was about three or four and playing at a park. It reminds me of who I am at the core of my being: bright and adventurous, curious by nature, and a joy to be around. I think the “without judgment” part of the definition is without conscious judgement. Because, from a certain point of view I suppose I really am judging by not remaining neutral about my feelings toward this picture. It’s hard to avoid all judgement whatsoever and in a way I want to be reminded of my younger self – because that picture reinforces for me who I am and who I always have been – it’s a way of mustering the troops so to speak. It all depends on how you use what you choose. Only you can decide.

You concentrate on your breathing – deeply in and deeply out (I don’t think it really matters if you choose your nose or mouth for the first inhale) and concentrate on your object/mantra/memory. As you focus on just what you’re being mindful of you’ll find your head clearing, your mind becoming more relaxed, and because of that relaxation it’ll be easier to go to sleep.

Mindfulness is something I also practice before doing something which might be difficult for me – such as giving a NAMI speech or before giving an Ending the Silence speech as it helps me center myself. I’ll also use it after a psychotic episode or after dissociating to help ease myself back into reality.

Meditation is often looked at as a very specific and therefore intimidating practice – you need a special mat, you need hours of time, you need to chant special words, you need to be in nature, and so on and so forth. I’ve since learned that you don’t need to be in the lotus position, you don’t need to be in a yoga class or in a yoga pose, you don’t have to do anything fancy. I most often meditate when I find myself unable to get to sleep – I’ll be laying down in my bed, flat on my back, probably petting my dog’s soft fur and trying to clear my mind. It also helps me on walks when I start to get paranoid – clearing my head of the negative, paranoid thinking and scenarios that build up and can so easily turn into psychosis.

I was taught this particular meditation technique by my high school philosophy teacher and have been using it ever since.

The process is relatively simple, but it’s difficult to master:

  1. Close your eyes. Concentrate on your breathing and nothing else.
  2. Inhale deeply.
  3. Exhale deeply.
  4. As thoughts (or voices) enter your head dismiss them just as easily as they enter your head. I remember my philosophy teacher saying: “let your thoughts be like water, flowing continually out of your head.”
  5. Repeat until you feel ready to fall asleep.

As with anything simple, this can actually be extraordinarily difficult to actually do, to put into practice. It’s especially difficult when the voices are bad or when the visual swirling and teeming technicolor light show is at its worst. It takes a while. But with patience it almost always manages to get me to sleep.

One of the only problems I’ve found with mindfulness and meditation is how time-consuming they are. I like to read before bedtime, it’s a good way to relax myself, it’s a good way to end my day. But it takes a while to to practice mindfulness and it was eating into my reading time and thus mindfulness ceased to be a relaxing process and ended up stressing me out because I was concentrating on how it was eating into my reading time instead of allowing it to actually relax me.

To this end, I now play soft music as I’m trying to fall asleep. It serves to drown out the voices, to give me something to concentrate on other than the dinner party and it relaxes me. It was tricky for me to figure out what music to listen to as I’m passionate and therefore extraordinarily sensitive to music – it had to be familiar enough to me that I wasn’t so interested in the music that I kept listening, got my second wind, and wound up staying up all night. It had to be low EE enough that I didn’t get all wound up from the excitement of listening to it, got my second wind, and ended up staying up all night. And it couldn’t have lyrics that I would stay up and sing along with and also risk said second wind. Basically, it had to be a lullaby; a lullaby that would work on a 29 year-old man whose more picayune about the music he listens to than perhaps anything else in his life.

The first album I ever got was a Mozart album my parents got me when they gave me my first stereo when I was in fifth or sixth grade. It’s calm enough that it doesn’t wind me up, it doesn’t have any lyrics so I don’t have anything to sing along to, and I’ve listened to it I don’t know how many dozens and dozens and dozens of times that I don’t find myself staying up to listen to it – it lulls me to sleep by the time the second track is finished.

I’ve largely replaced the bedtime mindfulness and meditation practice with music as it isn’t nearly as time consuming or labor intensive. But mindfulness, and in particular meditation are still useful when music has failed. It’s always a good idea to have multiple means of treating yourself…when one fails you just move on to the next one until one of them works. I’ve found that the music, in addition to drowning out the voices, also mutes the visuals somewhat.

Dealing with the visual spectacle comes down to concentrating on not looking at the cornucopia of swirling colors in order to fall asleep, a sort of un-focusing of the eyes and they’re veiled behind the eyelids – the eyes want to concentrate on the swirling colors and the goal is to concentrate on nothing. It’s a meditation in and of itself. When I’m sleeping at my parent’s house on the weekends I have the album on my iPod so I can play it on my dad’s stereo in the basement (where I sleep) and I also carry a pair of headphones in my bag and earbuds in my jacket pocket everywhere I go. Carrying around my music wherever I go is also useful for calming me down when overwhelmed, such as when I’m in the car, stuck in traffic or on a walk that’s gone south, or any number of other things that can suddenly happen which require immediate attention. I’m rarely without the ability to listen to music, just as I’m rarely without the ability to take medication, because it’s so easily portable and helps me so much.

Sometimes eating food helps when I can’t sleep. Or having an especially cold drink. I have what I refer to as my “Nighttime Protocol” in which I go outside for a cigarette and then come back inside for the coldest drink I can manage. I have a Brita water filter in my fridge which keeps pretty cold water, I fill a glass with ice and water from the filter and stick it in the fridge before I go outside for the cigarette and, when I come back inside, I drink the cold water as quickly as I can. I refill the water, drinking as much as I can as quickly as I can. I think it’s the coldness of the water that makes my bed seem so inviting, it makes me just want to cuddle with Kerrin in bed and go back to sleep – it could just be psychosomatic. I recently read an article which suggested that a cooler body temperature actually triggers the body to go into sleep mode, so maybe that has something to do with it. It’s a last ditch effort that has an unusually high success rate for how simple it is.

The key is to try things until you find something that works. The key is knowing yourself…making educated guesses about what might help you get to sleep. It took me a number of years of restless nights – staring up at the ceiling, trying to will myself to go to sleep, trying things that seemed to work for a while but ended up failing, doing research on the Internet and in general being willing to try just about anything.

When all else fails there’s always medication. I used to rely pretty heavily on Melatonin until my psychiatrist discovered Melatonin has a tendency to cause psychotic nightmares in people with mental illnesses that feature psychosis. I was plagued with such psychotic nightmares, so now I take a medication that helps me sleep and also helps prevent nightmares. I still rely pretty heavily on medication to help me get to sleep, but I still need to use my tricks to get to sleep as sometimes the sheer amount of brain activity caused by schizoaffective disorder can overcome even the most sedating of medication.

It’s important to know that every mental illness is unique and therefore every treatment is unique. What works for me might not work for you or your loved one. Getting enough sleep is a critical component to anyone’s mental health, especially getting quality sleep.

Our culture seems to pride itself in our ability to function on very little sleep. I can remember in high school my IB classmates bragging about how they only got four or two or no hours of sleep the night before because they were studying so much and how everyone else was almost in awe of them. There was a dedicated student! It’s rubbish.

I’ve discovered, from my own experience that the more well-rested I am, the better I function. I don’t experience anything different or new because of my mental illness. It’s the same; everything is just amplified and more complicated. It’s now become standard practice in my family that if I start to become symptomatic one of the first questions my parents ask is if I need a nap. And, in many cases, taking said nap will see me feeling a lot better. I don’t need any kind of drastic countermeasures, I don’t need to take medication – I simply need sleep. So I go and take a nap and when I wake up my condition is greatly improved.

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