My year without sleep.

A year that took several more to recover from.


Sleep and mental health are intrinsically linked. A lack of sleep impacts your psychological state, and those with mental health problems are far more likely to suffer from insomnia and other sleep disorders.

Believe me, I would know... I suffered a particularly tragic loss in my family, which impacted my mental health and sleep severely. Over time I discovered how sleep could help me get better, particularly when combined with other personal strategies. I'll share what I've learned along the way, as well as my story with you.


A large number of us are already all severely sleep deprived, it's a sad symptom of the incredibly hectic, modern lives we live, and those of us with mental health conditions are even more likely to be groggy throughout the day. Chronic sleep problems affect over 50% of people in some level of psychiatric care, compared to the one in ten adults who experience it in the general population. And whilst sleep problems are unfortunately incredibly common in patients with anxiety and depression, the root causes can be incredibly varied from person to person and make it incredibly hard to treat rapidly.



On that basis it's important to look at this issue as both a symptom and a cause, and recognise that there is no "quick fix", just a series of healthy measures that can be taken to calm the mind. Whilst clinicians have traditionally treated sleep disorders as symptoms, it's now clear that sleep problems may give rise to the development of some psychiatric disorders, so there's a clinical consideration here, and perhaps by treating a sleep disorder we can then alleviate the symptoms of a concurrent mental health issue.


My father passed away several years ago from lung cancer, the amount of time from his initial misdiagnosis and then onward to his eventual death, spanned eighteen months. As his carer, I don't think that I managed to sleep more than 2 - 2.5 hours per night in that entire period of time.

The combination of care duties, along with an attempt to work full time hours - having just graduated from university, teamed with my blind ambition and my desire to succeed, had me heading in the direction of an almighty crash. All I wanted, was to fulfil my duties to myself and my duties as a son, not too much of an ask, right? One hundred percent wrong.


It was on my birthday in 2013, when I received the call urging me to get to the hospital immediately, things were looking grim and they were about to commence pain management with a view that dad wouldn't make it through the night. On that day I was emotional and sleep deprived, so much so that I was unable to drive to the hospital from my office, having raced dad to hospital the night before.

In a weird way, those months were the closest thing I had to a close family unit in a long time, my parents had been divorced for years at that point, but throughout the entire ordeal and the preceding months, my mother was by my side as she recognised that I wasn't coping. I wouldn't have made it through without her.


When I reflect on the year leading up to dad's passing, I realise that it truly is amazing how much we can push our bodies and minds when we experience trauma or hardship, often in an attempt to gloss over things. That was exactly what I had been doing, and explains the rate at which I found myself collapsing in a heap. In the lead up, I was unable to fall asleep without the aid of medication, always hyper alert that something tragic would happen to dad in the middle of the night, and in the aftermath I recall laying there haunted by the silence, unable to forget his last wheezing breaths.


To this day I don't know how comfortable I am saying the following words, but part of me was relieved the day after he passed. I feel guilt for saying that, but then I apply logic and legitimise my thought process. Don't get me wrong, I was distraught, incredibly sad, and had no idea what to do with myself, but I was relieved that he wasn't in pain anymore, and relieved that I wouldn't have to feel the same helplessness I felt each day that I couldn't manage his pain or suffering.


For years and for a number of reasons, dad and I had a strained relationship, but that didn't change the fact that we loved each other very much. I was his son, he my father, and nothing could change the level of devotion we had to one another. I was all he had in the end, and as he had always provided the absolute best for me, it was just my time to step up. Perhaps out of a sense of duty but certainly from a place of love, I looked after dad, but what I failed to do was look after myself. With the benefit of hindsight I'd say to my younger self, be clearer on your priorities and values, listen to the warning signs from your body, and learn to pace yourself to avoid burnout.

Most of you may think, that I'd have crashed and spent the next few weeks catching up on all that sleep I'd missed out on. I slept for 14 hours the next night, and to this day it's the only time I've ever slept that long. The truth is it took me five to six years to re-stabilise and regain a 'normal' sleep pattern, and that's been rooted in a lot of hard work, and the development of some healthy habits.


Sleep disorders - The connection to anxiety and depression.


More than 70 types of sleep disorders exist. The most common are insomnia (difficulty falling or staying asleep), sleep apnoea (disordered breathing causing multiple awakenings), and narcolepsy (sleepiness or falling asleep suddenly during the day). Personally I suffered from insomnia in the lead up to, and for two to three years after dad's passing, it severely influenced my level of anxiety and contributed to my depression.


Anxiety disorders.


Sleep problems affect more than 50% of adult patients with an anxiety disorder, often causing them to take longer to fall asleep, doing so less deeply. Insomnia may also be a risk factor for developing an anxiety disorder, but not as much as it is for major depression. Insomnia can worsen the symptoms of anxiety disorders or prevent recovery.


Depression.


Three quarters of adults with depression experience some kind of sleep problem. On the flip side, sleep problems also increase the risk of developing depression.

Insomnia and other sleep problems affect outcomes for patients with depression, with studies showing that depressed patients who continue experiencing insomnia, are less likely to respond to treatment than those without sleep problems. Even patients whose mood improves with antidepressants are more at risk for a relapse later.


How positive lifestyle changes started to turn things around for me.


What I realised over time is that for the most part, recommended treatments for sleep problems are the same for all patients, regardless of whether they also suffer from psychiatric disorders. What has worked for me over time is the limited and targeted use of medications, combined with lifestyle changes, behavioural strategies, and psychotherapy.


Lifestyle changes.


I love a good dose of coffee each day, and enjoy a glass of wine as much as the next person, but each of those pose their own issues when it comes to mental well-being. Alcohol depresses the nervous system, which can help some people fall asleep, but the effects wear off in a few hours and people wake up, often groggy. Caffeine is a stimulant, which speeds up the heart rate and thought processes. I've had to become more aware of the effects of each on my body, and put in place boundaries to limit intake. It's helped me immensely over the years.


Be Knowledgeable.


Key to my journey has been immersing myself in as many readings, experiences and therapies as possible, and over the years I've been able to work out what my core pillars are that allow me to feel level headed.

Part of my journey brought me to Julie who runs WeSleep. She's a passionate advocate for sleep as part of the broader well-being conversation and I've found personal chats with her so insightful, plus her content is super interesting as well.

Check it out! https://www.wesleep.co.uk/sleep-knowledge


Physical exercise.


I started to get into exercise more and more over the years, and found that regular activity has helped me fall asleep faster, and do so in a deeper and more restful way. Other than the obvious physical health benefits, exercise has kept me feeling more restful and less anxious for the rest of the day, and by extension more restful at night.




Mindfulness and relaxation.


Mindfulness practices have also been incredibly beneficial to me, I started out with yoga and progressively got into meditation. Whilst at first I found meditation laborious - because my mind would continually wander, I eventually got the hang of it and I have settled on yoga, guided imagery, and breathing exercises as my preferred ways of calming my mind. Its been an exercise in patience, as well as trial and error, but so worth it!

Over the coming days I'll be putting some mindfulness content onto Instagram, so please follow the @oneofmany account.


Sleep hygiene.


This is the term often used for things like maintaining a regular sleep schedule, using the bedroom only for sleep or sex, and keeping the bedroom dark and free of distractions like a phone, computer or TV.

This looks different for everyone, what's important is to understand the things that detract from you being restful and calm, and to put in place firm boundaries for yourself.


Cognitive Behavioural Therapy (CBT).


CBT is an effective way of treating numerous mental health conditions. It deals with your current problems, rather than those from your past and looks for practical ways to improve your state of mind on a daily basis. It also helps you deal with overwhelming problems in a more positive way by breaking them down into smaller parts.


So, what's next?


At the core of it all, it's important to just be kind to yourself. Start to understand how sleep and mental health are linked, and begin to explore how it affects your overall well-being.

I'll continue to focus on highlighting my story, the healthy mechanisms to manage your mental health, and also spend time curating mindfulness content that I feel would help all of you out there.


For now, thank you for your time, and much love to all!


Gerardo

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