When I’m feeling particularly sick with bipolar disorder I am excessively tired. From the time I wake up in the morning until the time I blessedly get to go back to bed at night, I’m exhausted; and every moment my eyes are open is a struggle. (And yes, fatigue and tiredness are symptoms of bipolar depression.)
And after more time than I can fathom feeling like this, something occurred to me. It occurred to me that I get more than tired. I get to a place where the pain is forcing me to search for a drug to escape. And sleep is my escape. Sleep is my drug.
Sleep is a Drug?
Well, yes. A drug is something that creates an escape from pain, generally with additional deleterious effects. This drug might come in the traditional form of drugs or alcohol but it could also be in the form other behaviors like self-harm or eating. What all these things have in common is that they elicit “happy” chemicals in the brain.
Sleep Changes from a Natural Need to a Drug
And of course, just like we all eat, we all sleep too, but there is a moment where sleep can cross the line from just what we do to live, to something that acts as a drug. I’d say this moment is pretty easy to pin down. It’s basically “feeling” tired every time negative emotions come out – seeking sleep any time any negative emotions are present. It’s sleeping instead of dealing with these emotions in other, more healthy, ways.
So what is seen is “drug-seeking behavior” or “sleep-seeking behavior.” You see a person who finds more excuses to sleep. You see a person who schedules sleep into the day whether the person is tired or not. You see a person letting other responsibilities and commitments slide because the person would prefer to sleep than do anything else.
Excruciating Pain Creates Suicidality
The trouble with bipolar disorder and many other mental illnesses, is that many people who have them genuinely want to die, like, all the time. The first thought many of us think in the morning when we wake up is, “damn, I’m still alive and I have to face another wretched day.” And then we all work really hard not to actually commit suicide during that day.
And sleep is one of the techniques used to avoid that suicide.
Sleep is the “Best” Drug?
And I would argue that sleep is much preferable to any other drug one might choose too. Not that sleep is perfect. For example, it’s really hard to get articles written while you’re asleep; but of all the drugs, it seems the most innocuous.
Now, don’t get me wrong, I would love it if people would find healthy coping techniques that would both facilitate life and lessen emotional pain, but that just isn’t a reality for so many of us. When people ask me what helps a suicidal depression for me, I say, “nothing.” Because seriously, nothing, save medical intervention, works. So sleep, so escape, so that drug, is the best thing I have in my arsenal, no matter how wildly imperfect it may be.
Nevertheless I do think it’s critical to recognize the behavior for what it is – it’s drug-seeking, pain-reduction/avoidance behavior. And one that, overall, isn’t desirable. But, in my experience, the only way to lessen the behavior is to lessen the agony of everyday life with uncontrolled bipolar disorder. Inordinate amounts of sleep translates into inordinate amounts of pain. And that is the real problem.
those sound we had its God himself talk with us no body under the sun can do so
When I was in a major depression with suicidal thoughts the smartest thing I did was go to bed. There were incidents where my judgement was severely impaired. The most frightening were the close calls in my car. I didn’t want to die in a car crash, or end up paralyzed from the neck down…the thought of possibly hurting someone else in a car accident was terrifying. I went to bed for three months. But falling asleep didn’t happen for me, because I had insomnia. I listened to music, curled safely under my Quilt- no longer out on the roads. Eventually I was able to get out of bed, but it was really hard to resist the temptation to get back in. Ever since the right meds and feeling better, being in bed worsens my depressions. I’m grateful because knowing it won’t work helps me to stay out of bed. Thank-You, Natasha, for writing about this subject.
What people don’t usually realise is that these conditions are painful, usually enormously painful. People are used to thinking of mental illness as a bad reflection on an individual and they don’t usually think of proffering sympathy – this is changing, thank goodness. It’s up to us not to self-stigmatise, to fight for rights and understanding, and DEFINITELY to go easy on ourselves – the mental health system is cr*p so you just have to show yourself as much love as you can in as many ways as you can. My advice is prayer and I also sometimes call phone counselling services to unburden myself although they tend not to be sympathetic about the abuses the mental health system has wreaked on me – like everyone else, they don’t quite understand. I keep an occasional diary too, to share stuff directly with God, since nobody else seems to understand. And sometimes I put a rug over my legs and eat popcorn and watch telly if I can find anything uplifting on (actually, sometime watching something ‘depressing’ actually helps) – with a similarly-depressed friend is best!
Anyone who is in pain needs help. Unfortunately the mental health system is not helpful – drugs are fine but they are not the milk of human kindness. Nurture yourself and get through any way you can – people care, even if they don’t know what to do to help. Mental health systems are becoming more humane all the time, especially now that the UN has demanded that they do so. Keep on hanging on and hanging in and DO NOT forget the power of prayer. All your posters are here for you, Natasha Tracy – you’re our ‘poster girl’! Telephone counselling lines can be good and keep fighting to get through. Sleep can be good – hug a pillow while you sleep and try some drops of lavender oil on the pillow. Try sleeping to soothing classical music (mozart, beethoven or baroque [baroque music is meant to be especially good for people with mental illnesses for some reason]). A friend of mind actually agreed to climb into bed next to me and hold my hand while I fell asleep when I was feeling particularly bad once – see if you can make or find a friend like this. Never give up. Appeal to the divine for help x :)
I thought I was just being lazy (after all, that’s what my mom has told me all these years!)
I’m going to email her this RIGHT now. I just had this major aha moment. It really is a drug and the more I sleep sometimes, the worse I feel.. I end up feeling even more lethargic.
Thank you so much for posting this Natasha!
Speaking of meds I was wondering if you had done any articles on Canadian Pharmacies. Looking for a cheap and reliable source for medications since my insurance is running out. I appreciate your time and any knowledge you may share.
Thanks EJ
From what I have been told the fed are trying real hard to stop that practice and in many cases are winning. SOme FDA Bs that they dont know where they are manufactured. Big Pharma owns this country. Thats the reason. we need to underwrite them selling a drug for 5 dollars in Canada by paying 200 dollars here. Where is my bucket?
Just out of curiosity when you are feeling depressed do you force yourself to go to work?
Do u recommend it or not recommend it?
I’ve been told i should force myself to get out of bed when all I want to do is stay in bed.
Then my instincts tell me to go easy on myself and I feel guilty sometimes if someone says I’m going too easy on myself.
I think that for many people, too much sleep can increase depression. (one of my psychiatrists called anything over 8 hours a night depressogenic). So it can become a vicious cycle. Sleep because you are depressed, become more depressed. And then too little sleep can cause mania. My last psychiatrist thought that regulating sleep patterns was the most important thing to do for someone with bipolar. I think there is a lot to that. But easier said than done.
Bipolar Disorder is a biological illness which is a collection of a wide array of symptoms that are catagorized and collected under the label of bipolar disorder -whatever that term bipolar means. The cause is unknown and effective medications are few and far between. Forcing yourself to go to work when you cannot physically do so would be akin to forcing some one that has a serious illness to do the same. Oversleeping due to a biological malfunction such as a biological urge to sleep excessively may not be depressogenic and a way for the sufferer to cope with some biological malfunction.
I’ve noticed this in both myself and my sister. Before her new job, my sister was talking suicidal and slept all the time. Days, nights, weekends. I couldn’t get her to go out or anything. I’ve been stressed and have been sleeping a lot lately. I took some 5htp (which increases seratonin) and realized I’ve been depressed. it is slowing bringing me out of the depression I’m in and I’m starting to sleep more regularly now.
People who had manic-depression prior to the 70’s seem to have the typical few months out of the year where they either get manic episodes or depressive episodes- but they get out of it and have many months of normal lives and moods. Yet these days bipolar disorder seems to either have gotten worse since people are having chronic episodes that last years and decades! What ever happened to the many months in between where people got back to their old selves?
Now my life had turned into a nightmare and horror movie that I am forced to live through. Extreme fatigue, tiredness, brain blanking out, brain fog, makes live a struggle to get through each minute unless I am asleep. I got sick early at the age of seven and it steadily got worse and hit a the ceiling at 15 years old. I recall as a child that life offered so much and it was promising and beautiful and I was looking forward to living. What we have is more than just a psychiatric disorder. It is caused by a physical problem. I never imagined that a human being would have such a horrible life as I do. Never. Life offers so much there are so many opportunities out there. What a shame I can’t live. This is not a life worth living! Right now I sleep 16 hours a day and am not depressed? Go figure that. If my symptoms were extreme like Callahan then maybe I would get a spinal tap and discover that I had an autoimmune illness. Since 2011 patients who were wrongly diagnosed as bipolar and schizophrenia were tested and found to have anti-nmdar encephalitis. It was thought that it only effected a minority of people now it is in the thousands.
You are correct that episodes come and go, and there are many baseline periods for most people. I don’t think it’s any different now than it was back then. The course of recovery is different for everyone because their lives are not exactly the same. I think of Vivien Leigh sometimes, because despite how bad her symptoms were, there were always people around who loved and supported her (I don’t mean financially. I mean they just accepted her).
Not that recovery is wholly dependent on that, but it surely lessens the stress. And in between those periods, she was able to accomplish much.
http://www.ncbi.nlm.nih.gov/pubmed/23547920 According to Robert Whitaker’s chapter on bipolar disorder in his book “Anatomy of an Epidemic” the outcome of bipolar patients has gotten much worse despite all the drugs for the illness. He cites studies showing much better outcomes and much more functional life for patients prior to the 70’s. He cites numerous M.D.’s in the field. If you go to pubmed and type in Psychiatric illness and neuroinflammation you will see that this so called bipolar illness is due to some over active immune system. yet researchers refuse to look in that area because blockbuster drugs cannot be created and sold. It is all about $$$ not people anymore. Just treatment without regard to over all outcome long term. It is about symptom reduction and symptom repression. I don’t have control of my energy levels, cognitive function, mood… it fluctuates and I cannot plan my life. I have no life. I slept 7.5 hours last night got up this morning and from 7am-10am I felt like I was under water and brain dead then soon after I feel better only to dip again eventually?
Here recently, my mind is seeping in the suicidal thoughts again. It happens when stress and life, that I am continually under and well, continually living… seem to collide and overwhelm.
When I’m in this state of being… I am exhausted by ever living thing. Even supposed GOOD things, exhaust me and leave me weary.
I too find that negative emotional responses leave me drained as well as negative seeming random incidents in life, leave me drained.
Like just glancing behind your living room sofa, sat against a wall, and finding food wrappers stuffed behind from which your daughter (or her cat) had left. Suddenly, this all consuming and literal draining exhaustion hit me. Eyes closed, deep breathing commenced, mood sank, limbs felt as though they turned loose of my skeleton and I had to go and sit down. Just because I found empty food wrappers stuffed behind my couch.
I then went into a rage… it swirled up within me and forced itself out. I hate my house, I hate my poverty, I hate this economy, I hate and hate and hate. I DO NOT hate my daughter. Yet, there I was… venting and raging, which then left me further drained and I needed to go and lie down.
It’s a different type of exhaustion, a different weariness. It’s so deep and so permeating, so infiltrating. It colors and changes and flavors every literal and psychological thing, at the moment or hours or days that it hits.
All you want to do, is just lie down and sleep… a long and deep sleep.
“Bipolar disorder” is my opinion not just a mental disease but an auto-immune illness for which medicine has not found a test or cause. I read Susan Cahallan’s book Brain on Fire and she finally was diagnosed with anti-nmdar encephelitis even though many of her symptoms were psychiatric by nature. It is a physical illness organic, neurological not psychiatric. They thought the same thing about syphilis before antibiotics and labeled them schizophrenics. Now symptoms are catagorized and you are labeled bipolar. Endless treatment with the majority not getting better but worse.
I read the book ” Brain on Fire ” and watched the Netflix movie based on Susan’s story .I think there are two different things , bipolar :the psychiatric disorder and the described auto-immune illness Susan suffered with .The first one does not really occur suddenly ,there are about 10 years of episodes of depression and at least one hypomania happening before the diagnosis the latter happens with no warning to the most stable individuals who never had serious issues with their mental health .For the first one there is no cure but treatment available for the second there is intense treatment with chemotherapy ,steroids and antibiotics (etc ) with total cure possible .
I’m the same way… when I’m depressed. And therefore, tired.
I go through horrible mixed phases/manias that stop being fun and become frightening, when I have to sleep but I’m plagued by insomnia (3+ nights)…eventually I have to take some kind of antipsychotic so that I will sleep. My brain is reset when I wake up, except I’m depressed, either in reaction to the end of the mania or (MORE LIKELY) the lowered level of dopamine in my brain from the antipsychotic.
I HATE having to do this to myself.
But I do it often. Sigh.
Jen (practiceofmadness.com)
Ahh glorias sleep! I remember those days! That is before Geodon. When I was first diagnosed with BPD I was already depressed. The diagnosis sent me crashing. I lie in bed for about a year and deconditioned my back and neck (deconditioned is the word used by the physical therapist). Basically it means that my neck and back muscles became weakened from under use.
I had to have therapy twice for my back and once for my neck and it was excruciating. Five years later and I have a hard time walking down the hallway at my school. I have to wear a back brace to walk for exercise.
When my doctor put me on Geodon, I would take it at night and the next day it was impossible for me to take a nap, (weird) He said it was paradoxical symptoms. I had actual withdrawal from sleep. That is the way I coped and passed the day before I was on Geodon.
It was hard to give up sleep because it was always there for me when I needed an emotional break. It was a difficult decision to stay on Geodon because I would have to deal with all of my stresses and fears. The depression was gone thankfully but the urge to sleep was still there. It was my coping skill.
Years later I developed Narcolepsy (as if BPD, OCD and ADD wasn’t enough life dealt this blow). I still can’t take naps but I can’t sleep at night either. Yes that sounds like an oxymoron to have Narcolepsy and Insomnia but it is a symptom. I take a stimulant during the day for that and I haven’t had any “all nighters” where I am up for 48 hours straight since then.
We just have to find what works best for us. Keep talking to your doctor and if he or she doesn’t help you find someone else.
I have a friend, who has Bipolar and she has no “purpose” each day in order to be awake and functional (her words, not mine)… no job to go to, husband is at work and children go to school. So, she sleeps. She sleeps ALL DAY, every day.
Other “non-bipolar” friends, get on her about her being lazy and aimless. They tell her to stop wallowing and to find something, anything, to do. She is too young to sleep her life away and too good to be so lazy.
She is also, most often, suicidal and she self-injures.
Life moves along with the time lost.
I have Bipolar, have for some years now and if it is not the prescribed drugs that – overall – promote and encourage sleeping nearly all day…. it’s the “natural” inclination to just sleep life away. We are SO much more manageable, mood & behavior wise, when we are asleep.
Only “others” can’t seem to be happy with us sleeping. We are more manageable and we afflict their lives less often… but then we are labeled lazy, for well… sleeping.
Spouses comment of how the home isn’t up to par, dinner not on table, not going to work today, not seeming to get the yard work done… we are sleeping, be it chemical induced or natural inclination due to episodic symptoms. Yet, if we are up all the time… with the mood swings… then we are chided for being difficult – they having to walk on eggshells all the time – temperamental..
Course, when your mind is screaming DIE DIE DIE and yet your “life” is screaming DON”T DON”T DON”T… and the mental & psychological pain is searing cause the meds are just not denting the pain…. one just wants to sleep… sleep to make life go away.
It’s okay though, life moves along with the time that is lost.
The time we can never gain back.
This blog rang bells for me too. I still have this tendency after almost 50 years of bipolar. I guess it has become a habit now lol!
I have had dipolor and depression. Have attempt suicide many times, hospitalizd 3 times. The last 4 years I have been seeing psychiatrist. Today I have just now starting to do research. I hate the fact that I am afraid telling friends, because fear of weaknesses, and failure and come across happy, volunteering to cover my pain. Kinda lost.
This is more of a question How Long have you “been ” bipolar. I have had the disorder for 20yrs and use escape sleep alot
Hi Phyllis,
Well, the beginning of any illness is arguable, but I’ve been in treatment for about 15 years.
– Natasha Tracy
It’s the best medicine. I have to use it often. It really helps.
In the past, I jokingly called myself Ripina Van Winkle (older people may get this), because I slept soooo much. My over sleeping was influenced by overeating, depression, avoidance,habit , side effects from meds,etc. There’s an actual medical term for it, hypersomnia, if I recall.
Since diagnosis and treatment, I do my best to have good sleep hygiene….but sleep calls me sometimes in a very seductive way….and I yield. Difference is now I am almost 60, and if I don’t take really good care of myself, I can really feel and see the effects. :)
Yes, sleep is a gift. My comment: Drug seekers are considered those who go to one doctor after another seeking new prescriptions of sedating medications etc. It’s just something to remember. I know many who have fallen into this. Sleep seeking, I believe, can be a good remedy. Thank you.
yes. The pain is so severe we want to get out of it. And that’s self preservation. Unfortunately, psych meds though helping, aren’t helping me enough. and it’s been tending to weaken me. . .And my using sedating drugs when I can hardly keep my eyes open is also not working for me. So I’ve cut down to lithium and small amounts of marijuana. It does ease the pain for me. and my moods have been steady, much to my relief.
I’ve lived through this for 35 years. And I needed to feel better. And I do. And thank God isuch treatment is cheaper, cuz psych drugs sucked up my retirement funds. so don’t scold so much, Natasha. I’m getting by. I’m doing my best.
I definitely do that, and I’m also aware that it’s not the best thing to do, but it has helped me avoid things when it was impossible for me to deal with them at the time. I wish people didn’t think I’m just “lazy” because there are a ton of reasons behind my apparently lazy behavior.
I thought I was the only one! Took forever for me to realize it. Most of my depressed adolescence was spent asleep – hiding in plain sight, hiding behind expected “teen sleepiness/laziness”. But then it reoccurred without fail everytime I went home, even as an adult. I literally could not stay awake.
I much more aware of it now; I fight the urge more often. But it’s tough to balance listening to your body and what may be real fatigue and what is “disassociation via sleep”. Still, I completely agree that if sleep keeps you from acting on suicidal thoughts, then it’s certainly one of the least harmful options.
Truly I’ve never heard another bipolar express their relationship with sleep as I’ve experienced it. Thanks for posting!