Sleep and PTSD

[deborahjross]

Juliette Wade blogs on sleep (and writers and characters...) here. Two points she makes that speak to my personal experience are:

If you are relatively rested, then you can push through a wave of sleepiness and get a second wind.

If you are extremely sleep deprived and running on hysterical or anxious energy, you may not be able to sleep when you lie down to rest - but this doesn't mean you shouldn't. Just lying still for an hour, though it seems like a waste, can get you closer to a point where your body will actually accept rest and let you sleep.

The first point is useful to me in my work. I usually experience a dip in energy in the early afternoon. Sometimes I'll cat nap (10 minutes), sometimes there's too much to do or I'm too wound up. What I need to remember is that even though that nap is refreshing, it's not necessary. I can plow on at a slower pace in the knowledge that energy and alertness will return.

The second describes what happens when my post-traumatic crap is triggered (only magnify this a hundredfold). Normal upset fades after a night or two of poor quality sleep. The crap doesn't, it only gets worse. With each round, I lose perspective and the ability to make good choices in self-care. However, Juliette's point about resting is helpful. I may not be able to sleep (without pharmaceutical intervention) but I can use what tools I have to lower the adrenalin saturation level: progressive relaxation exercises, deep yoga breathing, meditation, prayer, guided imagery. Using these techniques, even if they are not sufficient in themselves, allow me to feel as if I am still in control, I am not entirely in the power of raging crap syndrome. Then, aforementioned pharmaceutical intervention feels less like surrender or "drugging myself to sleep" and more like one piece in a coordinated therapeutic strategy.

Comments

[klwilliams.livejournal.com]

I use Xanax for the second case. It's the only thing that works.

[deborahjross.livejournal.com]

I love it. I use it to come down out of the stratosphere and have never had any problems with dependence. It helps me to slow down enough so I can put myself to sleep. For rough times, I need trazodone as well, to stay asleep.

[klwilliams.livejournal.com]

I've used trazadone for that, too, but haven't needed it for a while. Wellbutrin is my other drug of choice.

[deborahjross.livejournal.com]

If I'm too agitated to sleep, trazodone just makes me woozy. So I'm agitated and woozy, not a good solution.

I tried several antidepressants when things were at their worst, but because the underlying problem was trauma not depression, none proved as helpful as alprazolam and trazodone. It just shows that a lot of things masquerade as depression.