Friday, November 25, 2011

Late Nights

It looks like I'm going to have been awake for forty-eight hours straight, and I'm terrified by this. I'm totally exhausted - physically ill - and I just can't get to sleep. In desperation I tripled the dose of the benzodiazepines I was prescribed, hoping I'd finally drop off, and... nothing. I'm woozy, I'm physically ill, and I still can't make myself fall asleep.

I think if I could finally conquer my sleep issues, I'd be able to live a relatively stable life, even with my diagnosis of bipolar disorder. Medications help, but sleep - really ironing out sleep - is so critical. It seems that sleep is the first thing to go wrong and the last thing to mend when I have an episode. Before I get depressed, for instance, my body starts to need more sleep than usual. A week or two after the hypersomnia begins, my mood starts to drop, and my sleep gets worse and worse. Meds can help fix the mood issues, but the sleep issues persist; it takes real sustained effort to get my sleep back on track.

I've been working hard - with help - to be able to sleep normally. Unfortunately, I haven't made much progress. For the past month, while my mood's been fairly stable, my body has been demanding ten to eleven hours of sleep per day. Worse, if I wake up after less than ten or eleven hours of sleep, I find it impossible to function - I can barely keep my eyes open, I'm not safe to drive, I stumble as I walk down the street, I fall asleep on the exercise bikes at the gym during my morning workouts. It's more than the usual morning grogginess, it's like being drugged.

And now, suddenly, I can't sleep. What precipitated all this was spending last night sleeping on the futon, since my brother was home for Thanksgiving and I gave him my bed to sleep on. I always have insomnia when I shift my sleeping arrangements - always. And I'd sort of forgotten this in my desire to make my brother more comfortable, and the upshot is that I couldn't fall asleep last night. And now I can't fall asleep tonight - I'm completely wired right now. And I took three Tylenol PM and three benzos, and by all rights I should be zonked out. And instead I'm increasingly clearheaded and feeling weirdly antsy and energetic, like I want to take a long walk or something crazy like that. It's two in the morning! I have to be up at six. I've been awake now for forty-two hours. And I'm not tired.

This is bad, obviously. Sleep deprivation is one of those things that brings about mania, after all, but more than that this is going to fuck up my circadian rhythm in a major way, and what progress I've made toward a regular sleep schedule is probably going down the drain.

I don't know how I'm going to get through tomorrow - there's a lot I have to get done - and I'm worried that I'm going to start hallucinating again, something that happens to me if I'm sleep-deprived. Out of the corner of my eye, things start to move that aren't supposed to move. The light switch on the wall starts to slide right and left, or to twist into shapes that are no longer rectangular. I see thousands of ants crawling out of pillows. I see the light fixture on the ceiling pulsing and twisting and throbbing. I know it's not real, but unless you've lived through it - lived through either psychiatric hallucinations or a really bad trip - it's hard to express how awful it is to have the world start to be untrustworthy. The best thing I can compare it to is being in an earthquake: the sudden panic that the rules you take for granted, ie that the earth is stable, are suddenly thrown out the window.

So yeah. I am not a happy camper.

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