The Sandman Cometh: Sleep and Depression

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Those who have suffered from depression – and by this I mean any form of depression not only bipolar disorder – will likely know that changes sleep patterns are often a symptom. I have always seen the excessive amounts of time I spend sleeping while depressed, as one of the signs that I am depressed and indeed I still think that is true. On the flip side, I greatly value those times when I do not appear to need a great deal of sleep, yet I’m highly functional. As a consequence, sleep has became a bad thing, at least to my mind. If I fall asleep before 11pm I panic, thinking it means a depressive episode is imminent. Likewise if I wake up after 10am I am convinced I am on the slippery slope downwards.

A while ago I was beavering away on a new novel. This was before Chasing Azrael (or anything else bar archaeology papers) was published, when I was still quite ill and prone to bouts of serious catastrophizing followed by bad depression.

Mania and ProductivityThis novel came to me in a sudden flash one Friday, fully formed in my head. With the exception of going to Group on the Monday morning I’ve been able to do nothing since then other than work on this new novel. I haven’t slept, I’ve barely eaten, and at one point when I felt myself going literally giddy while talking to a friend about it, I commented that I might be slightly high. I didn’t care though, because I was being productive. Productivity is something I desperately need in my life, or I feel overwhelmed, useless, and become convinced my entire life will be a pointless waste of time punctuated by periods of loneliness and despair.

It is fortunate that when in the throes of my better moods I become super-productive, otherwise I would never get anything done and the misery would become endless.

So there I was, quite happy, until one instant, one tiny instant, when the thought slipped into my head that I might never publish a thing.

Perhaps my writing is terrible.

Even if it isn’t, that doesn’t mean it’s worth publishing.

Even if it is, that doesn’t mean it will be published.

Even if it were, that wouldn’t mean I’d earn a living from it.

What was I doing?

I was wasting all this time, there was no point to it, I should have been working on my thesis, or a paper at least, something that would be useful to my actual career.

But who was I kidding? Even if I finish my thesis and get my PhD, even if I write paper after paper, that won’t give me a job, or earn me a living, there are no jobs, and even if there were I’m not capable of doing them…

On and on the thought ran.

In the space of two seconds I went from elatedly typing away, to staring absently out the window without moving a muscle. I sat like that for some time, before I realised what I was doing. I got up to put on a DVD, something to distract me from these thoughts, but as soon as I moved, the anxiety started to build.

I realised I had nothing to watch that I’d not already seen at least once, and of all the ones I had already watched, I couldn’t think which one would be distracting enough.

I spent a considerably longer time crouched in front of the DVD player staring at nothing, before concluding that my whole life was meaningless and I was going to die alone, penniless, and unsuccessful, having spent my entire life feeling like this.

Sleep and Depression

At that point (which was around 7pm) I decided to go to bed. I was too tired, I could barely keep my eyes open, and really what was the point of staying awake anyway? Due to my ‘no sleep before 11pm’ rule, I forced myself to stay awake another half hour or so, and then gave up, took my tablets, and went to bed, convinced this marked the beginning of another long period of HELL.

I had only just climbed out of the last one.

I slept through to about 9am, and guess what?

I woke up perfectly fine.

This makes me wonder if perhaps the reason for so much sleep during depressive periods is that, as the old adage goes, it is ‘the best healer’. Much as we find ourselves sleeping endlessly when we are physically ill with an infection or something similar, perhaps the body reacts in the same way to changes in the brain chemistry that cause depression: the body fights it off as it would fight off an infection, and while it’s doing so, we sleep – because we literally don’t have the energy for anything else.

Sleep and Depression

One of the things we hit on in Group therapy that very same week was that periods of physical illness, especially infection, can often be followed by periods of mania. I’m sure this is not true for all those with bipolar, especially as not all suffer manic periods, however it is certainly true for me. The two worst and most prolonged periods of mania I have ever suffered came immediately after I had severe infections, and had to be placed on multiple courses of antibiotics. Not being a chemist, I have no idea how antibiotics affect brain chemistry, or even if they could affect brain chemistry, but I think the point is not so much the drugs, as the body’s reaction to the infection. When we’re suffering from such an infection, we sleep a great deal as the body rights whatever is wrong. When we are depressed, it would also seem we sleep a great deal while the body rights whatever is wrong.

Several years ago, after a suicide attempt, I found myself talking to a hospital shrink. I do not have pleasant recollections about this man, beyond the fact that he was quite attractive and this annoyed me – we were well before the days of Grey’s Anatomy, and I did not yet realise that all doctors should be stunning. He told me several things: don’t fall asleep before 10pm; don’t stay in bed until after 10am; make sure you leave the house at least once a day; and oh yes, I never want to see you again.

Perhaps it was his derisive attitude, but the advice on sleep stuck, and since then I have always tried to be awake as much as possible, even when at my absolute worst, because I was convinced that sleeping would make me worse and activity would make me better.

I have since reassessed this conclusion and deduced that – at certain times – the reverse is actually the case. There is a danger, when you have been depressed and needed sleep for a very long time, to continue to sleep a lot and do very little after the point you’ve come out of the depression. This is what I refer to as wallowing, and I have no truck with it.

It’s a waste of the precious days when you don’t feel like crap.

Sleep and DepressionI’m not talking about that now though. Now I’m talking about those times when you feel perfectly fine, until suddenly you’re utterly overcome by exhaustion. You think you should force yourself to stay awake, and you do, pushing yourself further and further into exhaustion and lowering your mood further and further until you slip once more into depression.

I wonder, if you had just fallen asleep when your body told you to, and slept it off, might you have avoided that particular period of depression? Might you have, at the very least, lessened it?

Don’t fight the Sand Man; he is your friend.

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