So I have started taking St. John's Wort in capsule form, 300 mg 3x/day. It can take up to 4-6 weeks to reach full effect, so I want to document that I started taking it Tuesday, Oct 16th, 2018. So, six weeks will be 11/27/18.
So far, I feel like it is working. Of course it has only been 4 days, and I have also restarted Valerian 500 mg a bedtime, as well as Sleepytime Tea Extra that has Valerian root in it along with what I was already taking: 10 mg melatonin (down from 20 or even 30 sometimes) and 1000 mg Tylenol PM.
I have also re-started using Breathe-Right nose strips that really do help me, I forgot how much. Additionally, I did make the adjustments to my environment (blackout curtain, white noise, no TV) and I have been sticking to my no eating before bed (except a snack, an actual snack, not a meal I call a snack...) And, I have been walking around the outside of the building usually twice day at work, so that is about 1/2 mile a day.
My results this week have been good. I feel encouraged. I have slept real sleep every night since I made these changes. What I am finding is I am feeling really tired by the end of the day every day, which is good for two main reasons: 1) it means I am starting to recover / sleep off some of my "banked" fatigue -- the exhaustion / stress combo we naturally shunt off for later that builds up over time in what I call bubbles or boxes; and 2) ahhhhhhhhhhhhhh....... I fucking love sleeping.
I have felt fairly good most of the week since I started being able to sleep again. I did feel a little short tempered when stressed, like more than usual or at least more than I normally allow to show. I did notice that my irritation with other drivers was a lot more mellow this week. That is something I work on all the time. I strive to be more Zen in the car, and it works better some days than others.
I have also been mindful of "excessive rumination" which I would have said is not something I do, if you had just asked me cold about it. But having read about it in several trustworthy places, I catch myself several times a day saying, "quit dwelling on shit, Kyle." It's fairly eye opening actually. And it has worked to mentally check myself. I was shocked to have clear evidence that I rehash shit in my mind all the time, and feel angry or guilty or sad or all of that over shit that is over and I've had plenty of time to work through it. As I said already, it is quite eye opening, and I feel a sense of refreshment from realizing it's just demons, just memories, and the past does not define me unless I allow it to. I am who I say I am.
OK, I have said a dozen times to myself today that I will get out for a real walk somewhere. So instead of writing this blog post any longer, I'm going to go do that.
Today I remembered that I used to take Valerian at bedtime and that breathe-right nose strips actually work for me. My ex swears by them, not for himself but because he says its the only time I didn't keep him awake snoring. I also bought some Extra Strength Sleepytime Tea. And I'm going to give St. John's Wort a try.
I need to finish up making my bedroom into a better sleeping-encouraging room. And I'm gonna hang up that blackout curtain so my neighbor's outside light isn't shining right through my curtains all fucking night. It doesn't even help when they turn it off because the change in the light disturbs me. And I need to re-position my fan so it isn't blowing on me, but I need the noise.
So I am adjusting my OTC meds. I don't take any scripts and don't want any, although I would take a Valium or a Xanax right about now, happily. I haven't slept any meaningful amount of time in deep sleep in so long I would for sure take something that was gonna knock me down for 10 hours. That black sleep I took for granted as a kid. Oh my kingdom for that again, without drugs.
Anyway, I am cutting back my melatonin. It really does help me sleep, but it also encourages dreaming somewhat and I don't need that so much as I need to stay asleep and not be so easily disturbed. The tiniest thing will send a spike of adrenaline through me and then I'm like, "Oh goody, another hour..." So I want to keep the lulling effect of the melatonin, but not so much on the dream state, I need to be able to get through the dream state and down into deep sleep, which is what is not happening, at all. I have been taking 20 mg melatonin, I am going to cut back to 10.
I am however adding both Valerian and St. John's Wort, so we'll see, maybe I can go back up on the melatonin down the road, it really does promote vivid dreams. But like I said, the dream state is not what I am having trouble with. I think I am going to go with the most common recommended for the St. John's: 300 mg 3x/day for 4-6 weeks then cut back to 2x as long as it works. And I've taken Valerian before, I know I can handle it at least 500 mg at bedtime. And yes I am still taking Tylenol PM pretty much very night. I got the rapid release gels this time and I don't love them, I'll go back to the regular tabs or if there is a gradual release formula I might even try that. The rapid release gels knock me out but they wear off too fast.
Anyway, I know that sounds like a lot of meds. It's really not, and they're all OTC and mostly homeopathic. And whatever. I am going to get some sleep. Like I said, I would take some (handfuls of...) prescription meds at this point, and I really really hate pharma. But it has gotten to the point that I am occasionally having a hard time distinguishing if I am asleep or awake. So really, time to kick it up a notch.
So there are somethings I know I need to do, that I was doing at various times with varying success. Gotta try to get back to them.
New Old Rules:
Reading in bed, not watching TV (Netflix)
or if I do watch TV, I have to read before I turn out the lights to sleep
I got away from this one because during the spring and summer when my living situation was in flux, my Chromebook / Netflix was my only access to TV, so I watched it in bed every night.
No eating more than a snack within 90 min of bedtime
Do my bedtime meditations
I used to do this (excuse the pun) religiously, every night for literally decades and for some reason I've stopped. I need to start up again tonight. I know now even more why it works so well for me, and screw the people who say you shouldn't meditate to fall asleep, it works for me super well.
Drink a cup of herbal tea in the evening
There really is something psychically soothing about a cup of tea, I particularly like peppermint
Don't go to bed early
I know that seems counter-intelligent, but I find a lot of times I go to bed super early and all that happens is I fall asleep early, wake up a couple hours later as though I had a nap and then toss and turn the rest of the night
No more than 9-10 hours in bed
Don't stress over problems in the evening, it can wait til morning
Sounds weird I know, but it is more about having internal control than anything else. I might have stresses to deal with, but I get to say when.
Start going for a walk
Another thing I used to do religiously every day, even if it was just walk down the road and back. Gotta do it.
At the very least, so something active every day, preferably outdoors
Drink more water
Take breaks at work, like actual short breaks where I get up from my desk and walk away for 5 minutes, other than going to the bathroom
That's enough rules for one day. None of them are new. I know how it feels to do all of them right all of the time. I don't know when I lost the sense of these things, but I want them back.
They say never to Google your symptoms. In spite of that, we all do it, right? And I say why not? We only believe the results that confirm what we already decided was wrong anyway. Same reason you're not supposed to give yourself Tarot readings, even though we all do it. It's confirmation bias at it's best because it appears legit. (Googling your symptoms and being like, "See, I knew I had Methemoglobinemia!" -- NOTE: I have no idea what Methemoglobinemia is; I Googled "super obscure disease" and that was the one that came up that looked scary enough to make my point.) My point here is we all want to know what's wrong when we don't feel good. And when you have a persistent, recurring kind of "not good" that people don't see as legit you simultaneously learn to mask it / live with it, and begin obsessively seeking a "cure." I hate labels and more than that I hate what people think about me once a label is put on me. Because I grew up gay with an un-supportive family in a rural community in the 70-80s, I have always had the subconscious pressure to conform, to hide, to excuse anything that opened me to criticism. Even illness or discomforts. What am I talking about? I have had a lifelong problem sleeping. When I was a kid my mother called me a "finicky" sleeper. I couldn't sleep away from home, anything would disturb my sleep, and I was and remain today a toss-and-turner, and it takes me upwards of an hour or more to fall asleep -- on a good night, when I'm tired. In my adult life it has gotten worse, even as I have developed skills for living with it. You do adapt to sleep deprivation, you get accustomed to being tired all the time. Also, throughout my 20s and into my 30s, I started drinking alcohol -- a lot. For a good number of years I was an every day drinker, and as my tolerance grew to epic proportions, I started drinking myself into a blackout pretty much daily. But, even for a seasoned drinker, that loses its luster after a decade or two. And, unless you literally drink yourself into a blackout alcohol fucks up your sleep patterns anyway, so it's not a long term solution. Believe me, I tried. It gets so bad sometimes that I can't go to work. And because I feel that calling out "because I'm tired" is not a good enough justification to miss work, I often embellish my story when I call. I have a migraine. I have diarrhea. Anything believable that won't trigger the almighty Doctor's Note. I don't want to go to the doctor. I want to go back to bed. But what I really want is to feel better. I want to sleep at night. I want to have energy to do things, and keep plans that I make and do my dishes. I miss the old me, the Kyle who was outgoing and social and had creative ideas that he carried out, the guy who liked people and wasn't afraid to answer the phone. The Kyle who wasn't angry and withdrawn all the time. I thought you said sleep was your problem? That sounds like depression to me. Lo and behold. 46 years of trying and I finally Googled the right thing. I woke up this morning, if you can call what happened "waking up," since I didn't feel like I had slept to begin with, and got out of bed and went directly to my phone and called my boss and said I was not coming in today, I don't feel good. I am lucky at this moment in my life to have a boss who will accept that simple reason. I have also struggled with supervisors over the years who put forth the attitude that you need to be missing a limb or have had a heart attack to be forgiven for missing work. And that has made me develop even deeper denial that anything other than insomnia might be wrong with me, or maybe I'm an alcoholic. Or worse, maybe I really do have some horrible disease that is underlying it all and I just need to bite the bullet and see a doctor. Fuck that nonsense. I know what's wrong. I just don't like the answer. It's a terrible label. And people will make fun of me, or not believe me, or treat me like I have mental disorder. And wow have I had enough of that in my life, starting with the first time a family member noticed me acting too much "like a girl." I've known for a long time that if anything is wrong with me, it better be a migraine or that stomach flu that's going around. Not depression. Not bad feelings. Feelings are bad. Regardless, today I Googled, "My dreams are so real I don't feel rested," which is what is symptomatically wrong lately. It has been getting worse. I am now, every night, feeling like I am not sleeping. My dreams are so real -- and by that I mean so mundane and believable -- that I wake up without realizing I was even sleeping to begin with until I realize what I was just "doing" was in fact a dream. Fucked up, I know. So, my Google rabbit hole led me to The Clinical Depression Learning Path, and I actually read it instead of dismissing it instantly because the stuff about sleep described my problem exactly. I've Googled it all. Insomnia. Alcoholism. GERD. I thought I was Autistic for a while. COPD. Every time I have heart burn I think I'm having a heart attack because I'm a fat guy over 40. Maybe it's Diabetes or my thyroid. Maybe I need a C-PAP, I do snore really bad. Maybe I need another mattress. Or maybe:
Holy Shit. Maybe DEPRESSION is fucking up my sleep cycles which in turn is exacerbating every other small discomfort. And this little revelation allowed me to be open minded enough to read some more signs & symptoms of depression:
Exhaustion on waking
Disrupted sleep, sometimes through upsetting dreams
Early morning waking and difficulty getting back to sleep
Doing less of what they used to enjoy
Difficulty concentrating during the day
Improved energy as the day goes on
Anxious worrying and intrusive upsetting thoughts
Becoming emotional or upset for no particular reason
Shortness of temper, or irritability
Really? Every. Single. One.
Then some symptoms, and this really messed with me because -- well, almost every one. I don't have suicidal thoughts, never have. And I wouldn't say that I feel overtly sad.
You feel miserable and sad.
You feel exhausted a lot of the time with no energy.
You feel as if even the smallest tasks are sometimes impossible.
You seldom enjoy the things that you used to enjoy - you may be off sex or food or may 'comfort eat' to excess.
You feel very anxious sometimes.
You don't want to see people or are scared to be left alone. Social activity may feel hard or impossible.
You find it difficult to think clearly.
You feel like a failure and/or feel guilty a lot of the time.
You feel a burden to others.
You sometimes feel that life isn't worth living.
You can see no future. There is a loss of hope. You feel all you've ever done is make mistakes and that's all that you ever will do.
You feel irritable or angry more than usual.
You feel you have no confidence.
You spend a lot of time thinking about what has gone wrong, what will go wrong or what is wrong about yourself as a person. You may also feel guilty sometimes about being critical of others (or even thinking critically about them).
You feel that life is unfair.
You have difficulty sleeping or wake up very early in the morning and can't sleep again. You seem to dream all night long and sometimes have disturbing dreams.
You feel that life has/is 'passing you by.'
You may have physical aches and pains which appear to have no physical cause, such as back pain.
Anyway. I guess this is something I have known all along, but I always wanted to look at it from the other direction -- that depression was a symptom of insomnia or poor health choices, not that depression was the cause of those things.
I know I have had depressive episodes, and I can see over my lifetime how those cycles look. I know what it means when I don't clean my house for a month and don't change my sheets for 6 and start drinking 3 or 4 nights a week. I know that I am going to be sorry when I start to let my bills and commitments pile up, but I do it anyway. I know there is going to be a big collapse if let things go unaddressed, and I tell myself I won't let it happen, and it happens anyway.
Oddly enough, for someone who doesn't sleep for shit at night, one of my strongest reactions to anxiety is to sleep. After something really triggering or really stressful happens to me, be it physical or emotional, I often find myself unable to keep my eyes open. And I'll pass out within a few minutes of laying down, which I will do no matter what sometimes -- even if I have plans I an excited for, I find myself falling asleep. And I'll sleep for 20-30 min and wake up feeling way more refreshed than you would think a 20 min nap could do for you.
I've begun to recognize this for what it is. On Sunday this past week I was feeling really exhausted all day, and had no idea why. I had slept somewhat okay for 2 nights, got to sleep in, etc. I ended up taking a 3 hour nap that was really not restful. I dreamed almost the whole time, woke up a lot, never felt like I had gone down into the deep, black sleep you really need to rest. (non-REM) But, when I woke up, I did the dishes, cleaned up the kitchen, changed the litter box and took out the trash. And when that was all over, I realized I felt better. And for some reason right in that moment it was clear as day to me that it was not one or other that was making me feel better -- the sleep or the chores, but that it was interconnected. My anxiety over how gross my house was getting was making me collapse into sleep, but I had to pull myself together enough to do the chores so the trigger would go away. Shitty, self-perpetuating cycle right there, huh?
So, it's depression.
I feel like I can deal with that. Not "deal with it" as in find a way to live with it, but I actually feel like I can address that and maybe do something about it.
It's ironic that I have had an episode so intense right now. I am actually in a really good place that I have worked hard to get to, and really got myself through a very shitty year. I got through my relationship falling apart last year, having to move three times, and having to make the decision to have my dog euthanized. I bought a house. I got a promotion that I worked hard for and kept my eye on the prize when I didn't get it the first (or second...) time. I am actively working on getting out of debt, with a real plan I can do, and am doing.
And.... in spite of all of that, my sleep problems have become so bad that I finally had to admit it's not insomnia. I take enough sleep meds for 3 people and it barely touches my symptoms. And it's not like I'm so physically exhausted I can't function. I called out of work today because me mental state is so broken down I just can't even imagine having to tolerate the atmosphere at work. I would have a breakdown. I would cry or freak out on someone or end up in the bathroom shitting out everything I've eaten -- another gross symptom of whatever the fuck happens to me when I'm over-stressed: I get the shits. At home, with the blinds drawn and the cats checking in on me every few minutes I still managed to get some projects done, did the laundry and wrote this blog entry. But that also reinforces my self-doubt anxiety, "If you can do all that stuff why can't you go to work?" Which in turn makes me have to reinforce my story -- oh I had a terrible headache all day (I kinda do, but some ibuprofen is managing it...) and I just felt awful (at least that's true, and they can think whatever they want about exactly what it means, I don't elaborate, ever.)
But, here's the rub: the good patch in life is the trigger.
I've been here before. Good job, good life situation, no big problems. But it never lasts. Something is going to fuck it up. I'm always waiting for "what next." That's the depression talking. And guess what? There is going to be a next thing. And a next thing, and probably a few next things all at once that feel like a conspiracy against me.
The difference this time, and I don't know what made it this way other than providence, is that I've had a few next things come along lately and because I have actually made sustainable changes in my lifestyle, they didn't wreck the whole scaffolding of my life. I made it through a few problems that would have been catastrophes before, mostly intact. The good patch is starting to be more like a good garden.
And for whatever reason, it has triggered my biggest symptom -- not sleeping - over the top. But I guess it also has a good outcome: I finally figured out what's wrong. And it turns out it's something I know I can fix. Isn't that ironic?
So I wrote this blog post. And hopefully I'll write some more as I work out some depression issues.
