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Anxiety and Sleep June 24, 2013

Posted by Crazy Mermaid in Anxiety, Sleep.
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The primary purpose of hospitalization is to administer powerful drugs in a controlled environment.  As the drugs begin to take effect, anxiety builds.  Most of the drugs, including antipsychotics and mood stabilizers, have anxiety as a side effect.   The resulting synergy from each medication’s anxiety side effect produces an incredible surge of anxiety, unlike anything most of us have every known.

So the secondary reason for hospitalization is to learn to control the anxiety. Learning to control that anxiety, as it builds up higher and higher with each passing day as the medications take effect, is how patients spend their time. We take classes on it, we do exercises on it, we learn various coping methods for it.  And in the end, we take medication for it.  But the medication is never enough, and we are limited in the amount that we can take. So we have to learn how to handle it ourselves, to the best of our ability.

Although some people live with anxiety their whole lives, in general anxiety is not on most people’s radar. They have absolutely no concept about what anxiety is and how debilitating it can be. It’s difficult to put into words what anxiety feels like, but I’ll try:  Stand up straight, legs slightly apart. Now, tighten every muscle in your body. Ball up your fists. Next, try sitting down. Can you do it?  Imagine feeling like this all of the time, 24/7. You can’t relax, no matter how hard you try.  If you sit down, the muscles in your legs are still tight. The muscles in your entire body remain tight.  You can bend your limbs  in the right direction, but those muscles don’t relax- ever. Your whole body, though not rigid, can’t relax. You clench your teeth. It’s exhausting.  When the anxiety gets too high, it feels like you want to crawl out of your skin.

One of the most common outlets for handling anxiety in a mental hospital is to pace the halls.  Those of us with severe cases of anxiety would walk up and down the halls, over and over again, trying to work out some of that anxiety.  We couldn’t stop walking for very long, because the anxiety would come back in full force if we stopped walking.  And so we continued to walk the hallways, over and over again.  We walked miles every day, one foot in front of the other, up and down those carpeted hallways.

Everything that we did there was structured to teach us how to cope with that anxiety. Group therapy sessions discussed and sometimes actually showed us how to handle stress and anxiety. There were physical steps we could take with our bodies- everything from squeezing the flap of skin between our thumb and index finger to massaging our finger of choice to controlled breathing. Then there were steps we could take that weren’t direct acts on our bodies. We could blow bubbles, color in coloring books or on blank white sheets of paper, watercolor, or do jigsaw puzzles. There was also aromatherapy. Lavendar was the favorite. But walking the halls was the single most valuable outlet for handling anxiety.

Unfortunately, the building’s psych ward wasn’t built with our anxiety side effect in mind.  The hallways were about 10 feet wide and about 50 feet long. So only a few of us could fit comfortably at a time.  Sometimes it got a little crowded with all the people pacing.  But when you’re that anxiety-riddled, pacing is your only option and crowded hallways are the least of your worries.

I seriously considered taking up smoking at the hospital because I heard from some of the other patients that it would help me with my anxiety. My mental hospital was the only one in the state to allow smoking, even supplying the tobacco and rolling paper for the homeless people who had no money to buy cigarettes. Anyway, once I became convinced that smoking would help my anxiety, I actively tried to take up smoking, but my nurse/guard did everything she could to discourage me.  In the end, because she made it almost impossible for me to start smoking, I didn’t take it up.  I’m eternally grateful to her.

Before my breakdown, I would go to sleep the minute my head hit the pillow. But with all the medication I was taking, sleep just wouldn’t come. The anxiety was just too powerful. Sleeping pills were discouraged long-term because they’re so addictive. So the access to them was very restricted.

When I was released from the hospital in the care of my psychiatrist, he started right in trying to treat my anxiety so I could sleep.  He pointed out that lack of sleep would put me back in a manic stage and I would have to return to the hospital.  Understandably, I became extremely anxious about trying to get enough sleep. So anxious that it effected my ability to sleep. I would lay awake until 2 am, knowing that if I didn’t get to sleep I would get manic.

The anxiety was so bad that I would lay in bed trying to get to sleep, my teeth clenched so tightly that my jaws hurt. So we (my psychiatrist and I) worked on finding a way to get me to sleep and keeping me asleep.  Over a period spanning several months, we went through about 6 different drugs looking for one that worked.  I would buy one drug and take it for a few weeks and then buy another drug and take it for a few weeks. On and on, racking up hundreds of dollars for drugs that didn’t work. Finally, we found Seroquel. It’s an anti-anxiety drug for me, and I can take up to 300 mg of it if I have to.  Although I take just 100 mg of seroquel, just knowing that I can take up to 400 mg makes getting to sleep much easier.

Fortunately for me, I didn’t become addicted to sleeping pills or start smoking.  I’m learning other ways to handle my anxiety.

P.S.  Eventually, the Seroquel caused memory problems and thought process problems, so I had to discontinue it and search for a new sleeping med.  I tried three different ones, but none of them seemed to work very good.  I finally settled on Restoril, but sometimes that doesn’t work for me.  Sleep continues to be a challenge.