Shortly after I was diagnosed with bipolar disorder, my psychiatrist told me that he thought it would be a good idea for me to sleep between 10 p.m. and 6 a.m. every day, even on the weekends. I was a 19 year old college student and I knew that would kill my social life. He tried to convince me that nothing good happens during the hours he thought I should sleep, but I knew that was not the truth. Even dinner parties often lasted until at least 11 p.m. My psychiatrist's unrealistic sleep suggestion is part of the reason I was, for the most part, a non-compliant patient until I was 24.

Even though I chose not to sleep between those restricting hours, our talk about sleep did make me think of the importance of sleep, but I didn't change my sleep habits much. It wasn't unusual for me to go for weeks just sleeping 3 or 4 hours a night. I would often go to sleep around 2 a.m. and wake up at 6 a.m.

As a college student, I was hospitalized for one serious psychotic break. There were a few days when I thought I was going to another planet. I was making preparations and going through elaborate rituals in order to hasten the time that I would go to The Great Unknown, as I was calling it. I also did a few things I don't remember, like walking around the neighborhood naked, knocking on neighbors' doors, also while undressed, and trying to jump off of my friend's deck.

Although they lived in another city, my parents sensed that something strange was going on, so they took out a mental inquest warrant and the police came for me and took me to the hospital, where I was locked in a room by myself for three weeks, and given major doses of multiple medications. When I finally came to my senses, and was released from solitary confinement, I couldn't believe the extent to which I had lost control. I got back to normal, but I was haunted by the memory of having completely, but temporarily, lost my mind.

Near the end of my college years, I found a psychiatrist who specializes in treating athletes and musicians. She is one of the rare psychiatrists who prescribes medication as well as providing talk therapy. I told her that I was afraid for my future. I wanted to know how I could ever trust myself not to break down like that again. We thoroughly discussed the details of my breakdown and she asked me if I could see a connection between my lack of sleep and my psychosis. I couldn't really. I told her that I thought that lack of sleep would just make someone tired and irritable, but not psychotic. She then explained that I had been seriously sleep deprived. She told me that, in their training, Navy SEALS are kept awake for 36 hours and made to complete strenuous missions. She said that many of them experience hallucinations and delusions, and that is expected, and considered to be part of the training. That information provided a moment of clarity for me. Instantly, I realized that I could have more control over my bipolar disorder, and I was no longer afraid of having a psychotic break at any moment. That story gave me a lot of hope.

After I graduated from college, and began working, I realized that I needed more structure in my life than I had provided for myself as a student. I worked as a student, but only in restaurants and other casual settings. Professional environments are much different. In the real world, I realized that I would have to work regular hours and be consistently dependable and polite. It was at this point that I decided to start taking my medication as prescribed. And since I knew that sleep was so important, my medication included sleeping pills. I took Restoril for many years. An older pharmacist once smiled and winked at me and said, "Restoril is great, and it's cheap. I've been taking it for 30 years." One day though, my psychiatrist said, "There's a new sleeping pill I want you to try. It's called Ambien. It works really well." I asked him why I couldn't continue to take Restoril and he said that he was concerned that it could be habit forming. So I started taking Ambien. It put me to sleep, but it didn't give me the pleasant feeling that Restoril had. I took it every night, just as I had done with Restoril.

For the past year, I have been seeing a psychiatrist with a different perspective on sleep. She doesn't prescribe any sleeping pills. She believes that if you're not sleeping well, your other medication needs to be adjusted, or you need to change your lifestyle. I was worried after she told me that she wouldn't be prescribing sleeping pills. As it turned out, I was hospitalized for mania last fall, and was then depressed for about three months, but, since then, I have been sleeping well. I have cut down on my caffeine, am getting regular exercise, and keep regular sleeping hours. On weeknights, I  am always in bed by midnight and, on weekends, I am always in by 2 a.m. This sleep routine is working out well for me. It has taken 20 years, but I have finally learned how to sleep!

1 comment:

  1. Anonymous8/28/2011

    My Mary speaks about sleep. It is the one biggest issue for her. She has asked her psychiatrist about a med, and the emphasis lately has been to pump her full of firstline meds. In all the research I have seen, dealing with the underlying issues is the foremost need. Unfortunately, the system she has had to be involved in does not help with that. Thank you for this, I will let her read this when she is at a place to process. She reads and appreciates help, fortunately...