The Paradox of Sleep

NICABM’s blog has a great post — and short video — about the importance of sleep.

What’s the big deal about not getting enough sleep? There are connections between sleep deficiency and a weakened immune system, muscle aches, headaches, nausea and, as you might know if you sometimes don’t get enough sleep, irritability.

Studies have shown that those who sleep fewer than eight hours per night are also more likely to be overweight (an inverse correlation between less sleep and weight gain). Yes, the less we sleep, the more we seem to weigh. The difference between six and eight hours of sleep will soon be measured in pounds!

Beyond that, driving while tired can be just as dangerous as driving while intoxicated. And, those who don’t get enough sleep also have higher levels of anxiety, depression, and stress.

Like I need more anxiety, depression, and stress… let alone the extra weight.

I’ve heard it said that not everyone needs to have a full 8 hours of sleep a night. But I do feel like a different person, if I get at least 8 hours — and an afternoon nap.

There seems to be a real theme emerging about sleep. Maybe it’s the summer, and how busy everyone has been. Or maybe it’s the impending drama (disaster?) of the revamped healthcare system that has everyone thinking about preventive care?

I, for one, am looking for (and developing) as many preventive measures as I can find, so I can reduce my reliance on the traditional “healthcare” system. That includes getting more sleep.

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Good progress on the insomnia front

Something quite magical has been happening in my life, lately — I’ve been getting more than 6 hours of sleep each night. To people who have no trouble falling asleep and staying that way until they get 8 hours, this might not seem like a big deal, but it is to me.

Leading up to my last MTBI, I couldn’t sleep much more than 3-4 hours a night. I got 5 hours if I was lucky. I was regularly waking up at 3 a.m. (after getting in bed around 11-11:30)… just waking up. BAM – I’d be awake – and I couldn’t get back to sleep, no matter how I tried.  My system was fried, my mind was fried, my life was fried. I was in a crazy intensely stressful job that was tweaking my PTSD off the charts. And when I fell down the stairs at the end of 2004 and hit my head hard on the top 3 stairs, it was the coup de grace (pun intended) of a long progression of gradually worsening conditions in my life.

In a way, it was a good thing that I had to leave that job within the  year after my TBI, but I really miss the money…

Anyway, after I fell, my insomnia did not improve at all. And then more crap started happening in my life — family emergencies and tragedies, medical crises, personal crises… everything got even more intense, even more crazy, and it was impossible for me to tell what exactly was going on or why things were getting so mucked up. It was like my brain was in suspended animation — nothing seemed to be firing properly, nothing seemed to be working as it should. It would have made me nuts, if I’d understood what was going on, but I didn’t.

As you may or may not know, slowly things have clarified for me, and I’ve taken a lot of steps over the past years to set things to right. But one important aspect has eluded me — getting enough sleep. I had gotten acclimated to getting maybe 6 hours a night, and I thought I was doing well when that was happening. But plenty of people have informed me that you really need 8-9 hours each night, if you’re going to function properly.

I took a good hard look at my life, and I realized that yes, I actually was usually exhausted. I was usually overly fatigued. I had just gotten used to the feel of it, I’d acclimated to the experience, to the point where I thought it didn’t bother me. It was just how it was… I had resigned myself to being constantly tired, and I kept myself going on caffeine and projects and having a jam-packed schedule all the time. I left myself no downtime at all. If I had downtime, I just felt bad, so I didn’t bother giving myself any rest.

Like I said, on a certain level it didn’t bother me. But logically, I could see that something was amiss. Everyone was telling me I needed more sleep — from friends to family to therapists to doctors — and it occurred to me that what they were saying probably had merit. They were folks I trusted, and whose input I believed. They had no reason to deceive me, and I had no reason to disbelieve them.

So, going by a purely rational approach, I decided to try to get more sleep. And I tried to stop pretending that being tired all the time was okay.

I tried:

  • Taking naps whenever I could, especially on weekends.
  • Taking Benadryl to knock myself out, when I couldn’t even begin to relax.
  • Doing very rigorous chores that wore me out.
  • Taking hot showers to relax.
  • Listening to guided meditation (Belleruth Naparstek’s “Stress Hardiness Optimization” CD, especially)
  • Doing progressive relaxation.
  • Deep breathing and counting my breaths and alternating opening and closing my eyes at longer and longer intervals, so that my body would get the idea I was going to sleep.
  • Closing my eyes and moving them around behind closed eyelids — like I was in REM sleep.
  • Sleeping in different places – in the guest bedroom, on the living room couch, in the car.
  • Meditation
  • Exercising mor
  • Tracking the amount of sleep I was getting, so that I could tell — objectively — when I was probably over-tired (when I’m over-tired, it’s hard for me to tell subjectively that something is wrong)

All these things, to some extent have helped me. And over the past several months, I’ve been able to sleep more and more. I’ve now gotten to the point where I can literally sleep 8-9 hours, under the right conditions, which is a really “new” experience for me in light of my past 6 years or so.

I have also found it helpful to learn about the parasympathetic nervous system and the important jobs it does in maintaining health and vitality. Doing things like deep breathing and relaxation to help jump-start my parasympathetic recovery from stress, has been a big part of helping me get to sleep. The more relaxed I am, when I go to bed, the easier it is to sleep.

It might sound basic and obvious, but that fact eluded me for many years.

Recording my hours of sleep each night has been really helpful, just so I can tell how I’m doing and where I need to improve. After all the last thing I want, is to undermine my health just because I can’t subjectively assess the level of my fatigue. If I can’t do it subjectively (when someone asks me how I’m feeling, even if I’m exhausted, if I’m caught up in a project or I’m “locked on target” for something I need to get done, I am honestly feeling no pain or fatigue), I can do it objectively by tracking my hours of sleep each night.

Most of all, I’ve been benefited by listening to Belleruth Naparstek’s “Stress Hardiness Optimization” CD — especially the last 2 tracks for relaxation and restful sleep. I put on my headphones and play the last 2 tracks, and I’m usually asleep by the middle of the first track. If I can’t sleep by then, I’m usually under a few minutes into the “restful sleep” track. In fact, it’s worked so well that I haven’t the faintest idea what’s at the end of the “restful sleep” track, since I’ve slept through it over and over.

I make a point of listening to the CD every day for several weeks, then I’ll take a little break, and go back to it. I’m a real believer in it, and since I’ve become  increasingly sensitive to Benadryl (it knocks me out too much over the following days – it has a very long half-life), the guided imagery has turned out to be my “prescription” of choice for insomnia.

So, now I know I have tools to help me sleep when I need it. And that takes the pressure off… which also helps me relax… and sleep.

The perils of pseudo-psychological problems

Something has occurred to me repeatedly, over the past month, as my sleeping habits have improved. Namely, that many of the “mental health” issues I’ve been experiencing over the past several years, have had a distinctly physiological component to them. In fact, at the risk of sounding radical, presumptuous, and heretical – though I’m seldom reluctant to be just that 😉 – I suspect that a ton of my “psychological” issues have actually been physical ones.

I’m sure I’m going to really piss off some of the psychotherapists in the room by saying this, but I have to say that catching up on my sleep and figuring out how to get a full night’s sleep more than one night in a row, has done more for my mental health than two years of therapy.

And no, I did not have a bad therapist. They were great – awesome – and they really helped me a great deal, if only by sitting there and not making fun of me when I talked about this and that.

But let me tell you – as a TBI survivor who had/has a whole raft of physical ailments (chronic pain, insomnia, sensory hypersensitivities, weight fluctuations, heart palpitations, vertigo, tinnitus, and more…), just living with all those issues can really mess with your head. And as long as only the symptoms of my physical distress were being addressed, not much moved.

I did get in touch with my feelings. That’s for sure. I figured out that I actually mattered, and that it was important for me to take care of my own health and well-being, not constantly do the martyr-hero thing and sacrifice my own safety for the sake of others. I had space to learn to look at myself and my life through a less negatively critical eye and consider that maybe, just maybe, I had a right to do more that survive in life. I had/have a right to thrive.

But one of the things I really got in touch with was the fact that my physical well-being is a huge contributor to (and predictor of) how well my mental well-being holds up. When I’m tired and in pain and weak, my ears are ringing like the dickens, and my head spins wildly and I feel like I’m going to fall over every time I move, it’s pretty damned difficult to maintain a positive mental outlook and count my blessings. When I’m not feeling well physically, the chances of me feeling well mentally and emotionally decrease exponentially.

There are some people who manage to keep a cheery, chipper outlook, despite significant physical issues. I’m usually one of those  people, and I usually manage to not let my physical problems bother me. But when I haven’t had enough sleep for weeks and months on end, chances are pretty good that I’m going to feel depressed, anxious, irritable, low — and show other signs of clinical depression.

Okay, so here’s the thing — when I was in therapy with my prior therapist, they repeatedly came back to the suspicion that I was depressed. They asked me a number of times if I thought I was depressed, and if I’d said “Yes,” I’m sure they would have followed up on that, however a therapist does that. And they probably would have plumbed the depths, looking for what it was that made me depressed — some repressed past trauma, some childhood violation, some incident that I’d blocked out to keep from being unhappy.

And lots of talk would probably have ensued. Talk, talk, and more talk.

Now, talking is all very well and good, but as Belleruth Naparstek said at a conference I once attended (and I believe she’s said in her book “Invisible Heroes”), sometimes talking does more harm than good, by dredging up old traumas and forcing you to relive them. That can be very unpleasant, as I’m sure everyone is aware. And for me it’s really problematic, because I prefer to dwell on problems with a solution in mind, and if I’m dwelling on a past incident which cannot be changed (it’s already over and done), I get even more agitated and irate over it.

Some people might say that I’m just not willing to deal with the emotional fallout of misfortune, but I say I’m a solutions-oriented individual and the main reason I think about things, is so that I can change them, so why in the hell would I spend all this time thinking about stuff that cannot be changed? The therapists in the room who would say I’m emotionally “blocked” would probably try to treat me… with more talking about shit that makes no sense for me to talk about.

Make no mistake — I’m not at all reluctant to discuss misfortunes I’ve experienced in the past. But any discussion that takes place with me, has to be about devising solutions and coping mechanisms for the problems I have as a result. I’ve had some really shitty things happen to me, but you know what? It’s over, and I’ve managed to forgive just about everybody in my past for their shortcomings… even myself. The problem is not that I’m represssed. It’s that people want to process the wrong type of stuff with me — problems, problems, and more problems — and my reluctance to discuss stuff I’ve already been through a thousand times in my head is interpreted as repression or avoidance or some other psychological/emotional impairment.

What’s more, when pressed to explore the nether regions of my soul with talk therapy, I tend to get turned around. As good as I am at writing, I’m can be kind of pathetic when it comes to spoken conversation. I have an intensely visual mind, which follows conversations and spoken communication with series’ of images that are like an associational, disjointed movie in my head. I literally see pictures of what people are talking about, and when people start talking about things for which I have no picture — or I have several of them to choose from — it takes me a while to catch up and keep up. It’s not that I’m stupid. Or that I’m slow. I’m just incredibly visual in my own mind, when it comes to spoken language, and visual processing doesn’t lend itself as well to spontaneous conversation.

So, when I’m talking to someone about what’s going on with me, and they start talking about things that aren’t immediately famliar to me — or that I’m not expecting them to talk about — it’s really easy for me to get agitated and introveted. I need time to catch up. I need time to keep up. I need time to translate their words into pictures and process the information visually, so that I can make sense of what they’re saying to me. But I don’t always have that much time, and over the course of my life, I’ve gotten into the bad-but-pragmatic habit of just pretending I know what’s going on, while making mental notes in the back of my mind about what was just said, so I can go back to it later and rethink it all and hopefully make sense of things.

The problem is, in a therapeutic situation where I’m supposed to be making some sort of progress and addressing issues, this really works against me. It tends to make me look reticent and/or like I’m deliberately withholding. I’m not — I’m just trying to process the information and make sense of it. Believe me, if I could answer immediately like other people, I would. But my brain just doesn’t work that way.

I also tend to get really frustrated with myself and get agitated, which looks like I’m uncomfortable talking about certain things. It’s not that  I don’t want to let other people in. I do — more than I can say. But I get so turned around in my head, and I get so upset with myself for not being able to follow, that I start to flail and spin and then shut down. I feel like I’m getting backed into a corner, and I get revved… and by the end of the session, I look like a totally basket case who needs to spend years sitting across the room from someone, before I can get in touch with my feelings.

This sucks on so many levels, I can’t even begin to tell you. The worst thing of all is having someone who is supposedly trained and experienced in these matters misunderstanding, miscalculating, misdiagnosing, and mis-treating conditions which don’t even exist the way they think they do. On the surface, you’re exhibiting classic signs of clinical depression and post-traumatic stress disorder, but underneath it all you’re struggling for words that will explain exactly what is going on with you, and why you’re acting the way you do. And the bitch of it is, because you’re the (sick) client and they are the (trained, experienced, licensed) therapist, you’re not in a position to be taken totally seriously when you do manage to tell them a little bit about what’s up with you. ‘Cause they think you’re seriously mentally ill and you can’t possibly know what your real problems are.

After all, you probably have no recollection of what that nasty-ass uncle did to you as a toddler when your mother’s back was turned.

It’s a problem. I hear plenty of stories about therapists who don’t know  what they’re doing… as well as those who know very well what they’re up to but have no scruples or morals. I hear plenty of tales about over-prescription of medications, as well as  misdiagnosis of mental health issues that have more to do with fundamental differences of information processing, than pathology. The mental health profession has been pathologizing the diversity of human experience for as long as it’s been around — perhaps that’s a hallmark of any helping/caring profession that’s trying to get on its feet. Applying labels like “hysterical” or “deviant” or “sick” to people who are just different from the norm is a time-honored tradition in the mental health field, so there are no surprises there. But it’s a problem that’s been shifting and changing over the past 30 years, and that’s a good thing.

Now, if I can figure out a way to explain to my new therapist the nature and degree of my physical issues, so they can see my issues in light of my insomnia, pain, and physical sensitivities… and not spend an inordinate amount of time focusing exclusively on my past emotional trauma, that will be a good thing.

When in doubt… do nothing

I made a terrible mistake on Sunday – I ate some frozen custard. I didn’t have a whole cup — I ate maybe a few tablespoons, max. But it was enough to do some damagen.

To most, it might not seem like that big of a deal, but for me, it’s huge. When I eat dairy, including frozen custard, I tend to have a bad reaction — I get stuffy and croupy, my ears fill with fluid, and my balance gets thrown off to the point where I cannot stand up straight without holding onto something, I cannot turn quickly, and I have a hard time walking in straight lines.

I’ve never had really good balance while moving slowly — I balance better when I’m in motion, the faster the better. I tend to bump into things, run into things, knock things off counters, when I’m moving slowly. But when I have dairy, everything gets that much worse. I’d say three to four times worse. And it comes on me fairly suddenly, a day or two after I eat or drink the dairy. I like to think I can “cheat” now and then – I didn’t have that much custard on Sunday. But then my body puts me in my place, and there ya go…

It’s maddening. The associated nausea sometimes keeps my stomach in knots for days. My head spins and swirls, my body doesn’t even feel like it’s mine, and I start to get really cranky and short-fused with everyone around me. I have a hard time responding to people when they talk to me (first, I can’t understand what they’re saying at first, then I have to ask them to repeat themselves and listen closely to what they say, and then think carefully through my response, which may not even turn out to be the right thing to say). I feel awful about it, but what can I do? All I can really do is rest and drink a lot of fluids and steer clear of any junk food or processed sugar (and definitely dairy)… and make a note of it in my daily minder to track my experience.

So, today, I am staying away from the office. I’ll work from home (and probably get more done here, than I would there, where it’s very noisy and bright and filled with distractions). I am not getting in my car and driving through the rain in heavy traffic, only to arrive wet and behind schedule and bitchy as a wet cat. I’ll put on my music, pull out my to-do list, and have at it. And I’ll take a nap in the afternon, to catch up on my sleep. I was up waaaaay too late last night, doing things I love to do (but sadly not doing them very well), so I need to make up for that.

This is progress for me. Last night, I had fully intended to go into the office today. I knew I was feeling a little off, woozy, wobbly, croupy, etc. But I was determined to soldier on and put in an appearance. I had to show up, I told myself. I “had” to show up.

But y’know what? Appearances aren’t everything. And my boss doesn’t care where I am working, so long as I get my job done. Truth to tell, I don’t have to shop up. And I’m more likely to get my work done at home today, than at the office, so I’m doing them a favor by staying put.

This morning — at last — I realized I’ve got nothing to prove by driving myself through traffic, and if I intend to have a truly productive day, I have no business going into the office. I’m off balance, which makes me more prone to accidents, not to mention crankiness.  Plus, I really need to take a nap this afternoon, and I can’t do that at the office.

Well, enough said. I’m taking the pressure of and giving myself a break. And feeling good about it, which is probably the most important part.

Sleep mask + earplugs = magic

I actually slept for seven hours last night.

Amazing.  I haven’t slept that long without being completely and totally exhausted/depleted/at the end of my rope in quite some time.

I’ve been sleeping in the guest bedroom for the past few nights, so I can sleep through the night without being woken by my partner sitting up late reading, snoring, coughing, or otherwise being human. The only problem is, the guest bedroom has a great view of the back yard, and the back yard is surrounded by trees, and those trees are filled with lively birds that love to awake and sing-sing-sing at 4 a.m. I typically wake up around 4:30, when I sleep back there. I may be able to sleep uninterrupted all night, but the morning is a problem.

So, sleeping in the guest room isn’t necessarily the most sleep-conducive thing to do, unless I go to bed at 8 the night before, which is out of the question. My body just won’t do it. Nor will my mind.

But last night, I had to do something to take the edge off my exhaustion. I haven’t been sleeping very well at all for weeks, now. I have been getting 5-6 hours a night, which is just murder on me, because it coincides with some intense deadlines at work. Not only does the exhaustion take a toll on my cognitive functioning, but it also erodes my mood. Whereas I’m usually pretty “up” and can-do, and my outlook on life is quite open and ready for just about anything (within reason), when I’m over-tired, my mood just spirals down, and I end up in very, very bad places, where no amount of reason or motivation will drag me out.

I noticed it especially last night

I was really feeling good all day, until late in the evening, when I was going to bed. All of a sudden, I was melancholy and blue, feeling sorry for myself and feeling lonely and afraid and overwhelmed. I just couldn’t handle much of anything, and I started to get mired in that sad-sack poor-me swamp from which no good things come. I was starting to get intensely depressed and feel like there was no hope for me at all.

I started to think about my family and how we just don’t connect. I started to think about my new therapist and get down about how the relationship I have with them is an artificial one and no matter how I may feel we’re connecting, they are essentially a professional consultant, and — for my own sake — I need to keep the relationship somewhat arms-length. I started to think about my old therapist, and wonder how they’re doing.

I was spiraling down into that place I’ve often “gone” in therapy… that place where my old therapist loved to “camp out” and plumb the depths of my past, to see what terrible hurt had been done to me. And just as it used to make me really uncomfortable to delve into all that — not because I’m afraid to explore the places where I’ve been hurt (I’m only too happy to do that at times), but because they were making flawed assumptions and reaching inaccurate conclusions about what caused that depression, what was pulling me down, what I needed to deal with.

I can think of many, many instances where I spent a whole hour hashing and rehashing crap that was dragging me down, only to get all turned around and more frustrated… then I had a good night’s sleep, and everything was miraculously all better.

Seriously. I’m not just making this up to make the psychotherapists of  the world feel inadequate. The main problem wasn’t that someone was mean to me when I was ten. It was that I hadn’t been sleeping.

Fortunately, I recognized that I was going there, last night, as all the thoughts and fears and regrets tumbled around in my head like puppies in a basket.

Thankfully I had the presence of mind to notice it AND do something about it

“This is ridiculous,” I said to myself, as I sat in the bed with my journal, ready to write some maudlin entry about the day. I had had such a great day — clipping along, getting things done, making good progress… only to crash at the end. I could tell very clearly that I needed to sleep, and I knew that I needed to do something about being woken at 4 a.m. by exuberant birds.

So, I pulled out a sleep mask and earplugs I picked up a couple of months ago. I had tried to use the earplugs before, but they felt strange in my ears, and I hadn’t tried again. Last night, I was beyond caring how they felt in my ears, and I fit them in as far as they could go. I also found an extra fan and turned it on low — to circulate the air in the room and to drown out background noise. Then I pulled on the sleep mask, laid back, and counted my breaths that were echoing loud in my ears.

One of the problems with wearing earplugs with me, is that it makes the tinnitus louder. I have constant ringing in my ears, which gets almost deafening when I stop up my ears. It’s the craziest thing, and it drives me nuts. But last night, I was in no mood to care. I just laid back, focused on my breath, and dropped off to sleep.

And wonder of wonders, I actually slept till nearly 6 a.m. A record for me lately.

And I’m feeling great. Really ready to take on the tasks ahead of me today and make some good progress. That’s a good thing. Because today is D-Day for this project. Deadline Day. And I have to be sharp. Dullness is not an option.

Tomorrow I’m going to try the sleep mask and earplugs again. Little by little, I’ll work my way back to being able to sleep. And take care of all these little niggling sleep-related problems as I go. It just amazes me, how much a good night’s sleep does for my mental health and overall performance. It’s like night and day.

Sleep matters

When I’m overtired, I become moody, can’t focus, have problems with thinking tasks, become over-reactive, and I have a tendency to melt down. It gets ugly pretty quickly, and then I have to work double-time to make up for what I’ve said and done and try to repair the havoc I’ve created around me.

But when I’m rested, I’m happy, hearty and whole, and no matter what life throws at me, I can handle it. I’m a productive, positive partner and team member, and people love to be around me. No obstacle is too much for me, when I’m rested. And no event I’ve experienced is too big to overcome.

Which makes me wonder how much unwarranted exploration I’ve indulged in, during past therapy sessions, when I was trying like crazy to understand why I was so depressed and down… why I was struggling so. I overturned all kinds of rocks and plumbed the depths of my aching soul… and was unable to come to terms with just about anything I found there.

But magically, when I slept and had enough rest, suddenly it all became clear. And I could not only deal with what I found, I was also able to use it and change it and shift it and have it be an asset, not a liability in my life.

And I wonder how many other folks have similar issues to mine — psychotherapy clients struggling with lots of stuff not just because of the nature of the events, but because they haven’t slept well in weeks, if not months and years… and psychotherapists themselves being thwarted in their work because the person across from them is physically incapable of a positive, healthy outlook on life.

If I were a psychotherapist…

One of the first things I’d do in dealing with my clients, is find out how they’re doing physically. I’d find out of they’ve been sleeping, how they’ve been eating, if they’ve had much exercise. I’d find out what their physical health is like, find out when they’re at their best and when they’re at their worst, and try to schedule time with them when they were at (or near) their cognitive peak — or at the very least, avoid seeing them when they were at a low point.

I wouldn’t waste anyone’s precious time, processing their “stuff” when they were over-tired or hadn’t been eating or exercising regularly. And I wouldn’t agree to see someone who wasn’t taking care of themself. I suppose I would start out with a new client who wasn’t in the best of condition, but if they persisted in neglecting their bodies and not getting enough sleep, I would drop them like a hot potato. Sure, they would be a natural source of unending revenue, but if I only took clients who were likely to need my help till the end of their born days, I’d be a pretty crappy therapist.

Most of all, I’d focus on the sleep thing. Especially if someone had sustained a TBI. Sleep deprivation makes you crazy, overly suggestible, unpredictable, and easily manipulated. Spy/intelligence agencies have known that for years, and they’ve used it to their advantage. But getting enough rest each night is one of the primarly building blocks of good health. If you don’t care about your health — mental or physical — then how much you sleep shouldn’t matter. But for me, it matters a whole lot.

And I look forward to getting more of it.

Shoring up my reserves

It’s been a really rough 24 hours. I finally got to a breaking point, and melted down in a huge screaming/crying jag last night. I just ended up pushed over the edge by my fatigue and exhaustion and being overloaded by a lot of extra issues, including homeowner concerns — maintenance, upkeep — and health problems.

My newest concern is not having adequate dental coverage. It’s a huge added stress in my family that I know I need to rectify. Dental bills can run into the many thousands, as Judge Sonia Sotomayor can attest (she’s got $15,000 in back dental bills according to her personal financial records), and it doesn’t feel good, even in terms of hundreds of dollars. I’m not over my head in hock over dental bills, at this time, but I could get there quickly, and I need to arrange for coverage, so I don’t get to that place.

But the prospect of doing that drives me nuts. I get so turned around and confused by all the information, and then I never know if I’ve made the right decision, and I’m afraid I’ll end up paying all this money and making decisions that can’t be reversed very easily. I know I need to keep my head on straight about this and not panic. I just need to figure out how to do it, map out my plan, and do it. But I haven’t been able to manage that. I’ve just been kind of marginal, lately, and I haven’t been able to get a lot of the things done that I need to.

So much of this TBI business really is about having adequate resources to deal with what life throws my way. Whether it’s learning new things at work, handling odd jobs around the house (which I’ve been lagging at, too),  or arranging for medical/dental coveratge, how rested I am, how involved I am, how strong I’m feeling all have a huge role to play. And my resources have been slowly but surely eroding away, over the past while. I haven’t been sleeping well for months, now, and that makes it difficult to handle much of anything. My temper’s short, I don’t get the things done that I need to, I tend to push off all but the most exciting and interesting activities (which means I push off about 85% of what I’m supposed to be doing), and I have trouble learning and processing information.

For a while, there, I was pretty intent on keeping my sleep deficit to a minimum. But then I got sick of having to live such a limited life, always going to bed at a responsible hour, sleeping a full 8 hours (or at least 7), and being very deliberate about everything I did.

How boring!!! I didn’t want to have to tip-toe through life, always anticipating everything I did and said and thought, and adusting my behavior to be nice and acceptable. Plenty of other people wing it, and they’re fine. And I’m sure a lot of people out there have sustained TBIs and don’t even know it. Does that stop them? Not always. Sometimes… maybe lots of times… But it seemed to me — and it still does — that life is a messy prospect, at best, and in the end I’ve always been more of a creative bohemian type, even if I am a software engineer, so I’d much rather enjoy my life and be flexible and keep up my activity level and have a good time and do things that interest and uplift me, instead of playing it safe all the time and being so careful about every danged thing.

It was such a relief, to just stay up past my 10:00 bed time and watch a good movie till the end, without needing to watch the clock. It felt so good to just get up first thing in the morning – around 5:00 or so – and futz around with this personal resources management program I’ve been designing. It felt so great to not be tied to a schedule, to not force myself to be on some hour-by-hour time-clock, day in and day out. Maybe that works for some people, but it doesn’t work for me. It works for maybe a few days, but then it starts to break down, and my self-management techniques turn out to be more of a burden than a help.

Of course, I’ve found out the hard way (again…) that I can’t keep driving and driving and driving myself. Even if it’s all fun(!) I need to pace myself and give myself time to recharge. Last night, I headed off to bed at 10:30, and I got to sleep around 11:00. And I slept till about 6:00 this morning. Seven hours is the longest I’ve been able to sleep in weeks — I usually clock in around 5 or 6. I don’t know if it’s that pineal cyst that’s throwing me off, or it’s my stress level, or it’s my pacing during the day.

I know I’ve been spending too much time, late in the evening, on the computer. My diagnostic neuropsych tells me that computer screens emit light that is very similar to daylight, so our bodies think it’s day, and they need to wake up. That could explain why sitting down to my laptop in the evening always makes me feel better. And it could explain why I have a hard time winding down later in the evening when I log off. I know I need to change that. It’s not like I don’t have anything else I could be doing. Relaxing is a lost cause with me — I’m also in a lot of pain, these days, so unless I keep my mind busy, I am in a lot of discomfort. But I can find other things to do that relax me, don’t get me all charged up. Things like washing dishes or folding clothes from the dryer. Things that need to get done, boring or not.

It could also be that I’m so tired, I can’t rest — which is what happens with me. I have to do something extra-ordinary to drag myself (kicking and screaming) into slumber. Left to my own devices, I’ll just keep going…

I think this weekend is going to be a Benadryl weekend. I don’t have any outside commitments that are overly demanding on my cognitive abilities, so I’m going to just take the drugs and sleep as long as humanly possible.

With any luck, by Monday, I’ll have gotten at least a little bit back on track.

Confessions of a compulsive list-maker

I admit it – I’ve grown somewhat compulsive about my list-making.

I created a “master list” that I use to track my daily productivity — and to make sure I’m doing all the things I’m supposed to be doing. I also have separate lists for work things and home things.

I have lists that track the longer-term and more complex items that are on my to-do agenda: clean my study, file my taxes, fix the broken faucet in the kitchen, sell extra items I have lying around the house online.

I also have lists that detail “big picture” things I need to do — like clarify my Life’s Work, strengthen skills I need for long-term employment, and distant goals in the future.

Now, it may seem like a lot — and on some days, it is. But frankly, if I didn’t keep these lists, things would fall off my plate and not get done. Things that need to be done — like fixing the faucet in the kitchen and filing my taxes and taking the trash to the dump. These are just things that regular people do, they’re just a part of life — and if I don’t write them down, they won’t get done. I’ll forget all about them, while I’m off doing something else that did get written down on one of my lists. Or something that looked like fun that popped up out of nowhere and pulled me off in a different direction… only to eventually dissipate and disappear into the aethers.

These lists are not only helpful in keeping me on track — they also help me monitor my fatigue level. And my overwhelm. When my lists start getting longer and longer and increasingly involved, I can tell that I’ve got too much on my plate and/or I need to spend some time catching up with myself. Having a lot of things on my list overtaxes my system, yes — but it’s not only a cause of fatigue and overwhelm. It’s also a symptom.

I can tell I’m getting over-tired and not taking quite as good care of myself as I should, if I start listing an increasing number of small steps in between big ones… or I list things that really don’t need to get done. When I start micro-managing myself and adding things to my plate “for the fun of it,” I can tell I’m getting off track, and I need to step back and reassess where I’m at — not just in relation to my tasks, but in relation to my life.

Here’s a healthy list:

  • Clean my study
  • Work on taxes
  • Fix faucet in the kitchen
  • List items for sale online

Here’s an un-healthy list:

  • Clean my study
    • Find bank statement folders for 2005
    • Organize letters from family
    • Collect all journals since 1994 and organize
    • Vacuum and dust
  • Work on taxes
    • Clear workspace on dining room table
    • Gather calculator, scrap paper, pencils with erasers
    • Defrag computer
  • Fix faucet in the kitchen
    • Locate wrenches
    • Buy parts at hardware store
    • Clear out sink to make space
  • List items for sale online
    • Take pictures of items
    • Download to computer
    • Crop and edit photos
    • Write up text for ad
    • Research comparable prices
    • Check email regularly after listing to see if there are any takers

It’s not that these steps aren’t all appropriate. Some of them are, and some of them aren’t. The point is, when I get to the point where I’m writing down every last little thing I need to do (sometimes I go so far as to specify which jeans and boots I’ll be wearing when I mow the lawn), it’s an indicator that my brain is not trusting itself with relatively basic details and it is compensating in advance for problems it’s anticipating. That means it has an inkling that it’s having problems, and I need to listen to that – pay attention to the signals and signs, and adjust accordingly.

The way I adjust is by taking time off. Stepping back and pacing myself. Not getting so wound up and frantic over every little thing that I can’t function unless I’m giving myself explicit instructions down to the most minute detail, but breathing deeply and relaxing and just thinking things through, before I get started with them. When my brain is in decent working order, I don’t need to have every little action item outlined for me. I can identify the big things, the main activities, and then work from there, stopping frequently to check in with myself about how I’m doing… and not being afraid to step away for a break, because I know I’ll come back to finish the job.

I suppose it’s about trusting myself… knowing my limits… and recognizing the signs of overwhelm — while it’s happening, while it’s building, and before it snowballs into a massive Sisyphusean boulder of hurt-in-the-making.

Yes, those lists do come in handy… so long as I don’t  become too dependent on them and let them take over my life.

‘Cause when the lists do take over my life, I end up being so busy keeping them updated, that I actually get less done. And then I’m upset with myself at the end of the day. And that’s not good. The point of the lists is to get things done, not keep more lists. The point is to live life, not just observe it. The point is to establish a real connection with what I do, how I do it, and why I do it, and inject some consciousness, already, into the whole act of living. It’s about turning work into art, life into art, and using extra tools — in this case, lists — to deepen my involvement in my daily life, which can (when I ignore it or gloss over it) can rapidly get away from me.

Anyway, last night — after not getting much of anything done and realizing I’d spent a whole day tracking my progress, instead of making progress — the following occurred to me about my lists. And I quote from my journal:

It’s quite simple, really.

It’s (list-making) not just about keeping lists and checking off items and critiquing myself at every turn.

It’s much more about paying attention to your life. Not taking things for granted. It’s about participating in your own daily activities with full consciousness and mindfulness.

And learning along the way.

It’s about having a fully involved life that you live by choice, not by default. About being open to experience and not falling back on rote repetition of someone else’s ideas about what your life should be like and what should matter to you.

Indeed, tracking what I’m doing, how well I’m doing it, and understanding why I’m doing it in the first place gives me a safe and convenient and tangible connection to my life. It relieves me of the pressure of keeping everything up in my head, and it helps me see — right there in front of me in living color (green for success, orange for still-in-progress, and neon pink for rats-didn’t-work-out-I’ll-try-again-tomorrow) — how my life is shaping up, where I’m doing well, where I’m falling down, and how I can do better next time.

Ultimately, this record-keeping compulsion serves a very useful purpose, in showing me where I’m at… Where I’ve been… How I got here… And where I think I should go next.

Onward…

Yesterday was a wash

… Just about.

I had carefully made up a list of all the things I needed to get done — I’m on deadline at work, and it’s vital that I get the things done that I started, and that I do them on time. But I never checked my list until about 3:30 p.m., and then it was too late to do a lot of it.

I was just exhausted from the weekend — lots of activity and staying out too late. It was fun at the time, but it took its toll. And the people I’m working with are not pleased.

I’ve just got to let it go. I can’t start out today feeling bad about yesterday. It’s a new day. And I also have to remember that I’m not the only one in my group who’s struggling with work, right now. We all are, pretty much. We’re a challenged bunch of people with divided attention, conflicting interests, and way too much going on in our lives, overall. We’re also getting used to working together in new ways. There’s old bad blood that keeps people stuck, and there’s new opportunity to move forward. Main thing is, keep moving forward. But yesterday that didn’t happen nearly as much or as well as it should have.

I have to do something about this. I have to get out in front of my tasks. I know better than to do this. But the part of me that was playing all weekend wanted to keep playing, so I ended up messing up some stuff — and feeling badly about it.

More than anything, what takes the biggest toll is the emotional stuff. Feeling badly about myself. Feeling badly about how I’m doing. Feeling incapable and incompetent. And then, even if I’m doing okay by most people’s standards, my performance is thrown off even more. Because I’m feeling badly about myself and my abilities.

But it’s a waste of time to feel badly. My brain is just different now, than it was before my fall in 2004. It just has different needs and inclinations, which I have to factor in and accommodate/adjust to, if I’m going to have the level of ability that I desire. If I’m going to accomplish what I set out to, I need to use my tools — my planner, my notebook, my to-do list.

And I need to have just enough things on my list to keep me moving, without overwhelming me.

The thing about lists, though, is that I have to keep all the items I have on my plate (short- and long-term) in front of me in some way. I have to keep all my priority items in plain view, or I just forget about them. Other people look at my list, and they get all freaked out.  They tell me “It’s too much!” But for me, it works. I don’t mind all that stuff in front of me. I’d rather have it there, than forget about it — which is what I’ve done in the past … only to remember that I’d forgotten things I seriously needed to remember.

Until I find a way to remember everything — or hire a secretary/executive assistant to do the remembering for me — the stuff I need to do eventually is going to stay on the list.

But back to yesterday. What did I do which didn’t work, that I can do differently today?

  1. I didn’t check my list, first thing in the a.m. — I’ve checked my list for today already, so I’m good with that.
  2. I got down on myself for falling behind — I’m not going to do that today… get down on myself. I’m going to try the best I can, and leave the rest to fate.
  3. I thought the whole problem was me — I know I’m not the only one having issues. It’s just that the other folks I work with are really good at covering up their shortcomings and problems, and so of course (since I’m very open about the areas where I am lagging), I end up looking like the one who’s bringing everyone down. Matter of fact, I’m not — in fact, one of the reasons I’m behind on my tasks is that the folks I’m working with made a total friggin’ mess of it before, and nobody bothered to sort it out, till I came along and said, “This will never do!”
  4. I didn’t take time to plan my day and catch myself up — Today I am taking the train to work, so I can read and prepare.
  5. I let myself lollygag around in the afternoon, when I was tired –– Today, I need to pace myself and do at least something in the p.m, when I hit my low point (as I always do). If I plan for my lull, and I do something like walk around the office or take a break away from my desk when I’m tapering off, I may have better luck. There is a common work area I can go to that’s far away from my desk — I’ll try going there today and see if the change of scenery helps.

These are just a few of the things I can do differently today. I already feel better.

I was afraid this would happen…

I am tired. I am so tired, in fact, that I cannot rest. It’s not good. I haven’t had 8 uninterrupted hours of sleep in I don’t know how long. I haven’t had seven hours at a time in a while, either. Right now, I’m averaging about 6 to 6-1/2 hours of sleep a night, which is not good.

I’ve been going on adrenaline for a week, now, but it’s taking a toll. I spent the long weekend — all three beautiful days of it — laid up in the house, fighting off an infection that really dragged me down. What a waste. Then again, I did need to rest, so it was probably my body’s way of getting me off my feet.

Things have been going pretty well at work. It’s a mixed bag. On the one hand, I’m pretty freaked out at how much I have to learn. A lot of this is new to me — the aspects of this advanced technology I have to master are specific to the company I’m at, so I have to learn it even more specifically. And there’s a lot going on, so I have to learn a wide range of of specifics. Part of me is petrified. I really want to do my best at this job, and I will. But what if my best is not enough? What if I’m not nearly as proficient as I think I am?

It’s happened before. Lots of times. My brain has told the rest of me that it “got it” just fine, when it was way out in left field. It’s been a recurring problem.

Another issue is that I’m not following what people are saying to me. I’ll be sitting with someone, going over issues with them, and all of a sudden, I’ll notice that I am not understanding a word they’re saying to me. Somewhere, back a few minutes before (and I can’t remember when), I stopped listening. My brain quit on me. It just dropped out and ceased to function. Bye-bye. This is not good. I need to be able to pay attention when I’m talking to people. I need to be able to listen to them the whole way through. And I need to remember what they said to me later on.

This has me very concerned. Very worried. Very uptight. I’m getting that sick, sinking feeling in my stomach around my inadequacies and shortcomings. And I’m starting to get really worried that this is going to impact my ability to do my job — and my reputation. It feels like people I’m working with are noticing that I’m spacing out… that I’m getting lost. And my interactions with them are faltering, especially later in the day.

The people who brought me on board took a bit of a gamble with me, when they hired me. They brought me on based on what they knew of me in the late 1990’s. It’s now almost 10 years later, and I’m trading on a ten-year-old reputation. I can’t let these people down. I can’t let these people down. I can’t embarrass myself. I just can’t.

What to do…

Ah-ha! I’ve got it! I’m brilliant! I have a solution! It’s so common-sense, it’s almost frightening — use “assistive technoloy” I have (literally) at my fingertips, every day: My laptop.

My laptop is my lifeline at work. It plugs me into the network, it connects me with people near and far, so I can do my job. It’s my soother — the rhythmic action of typing really chills me out. And it also paces me, makes me do things systematically. And it’s a great prop for me to hold onto, whenever I’m getting tweaked and nervous and agitated.

I’m going to take my laptop with me, whenever I go out and consult with people who need my assistance, and I’ll use it to record what’s going on in our conversation. I’ll take my laptop with me to meetings, and I’ll have it logged into the network to check on various pieces of information that come up. I’ll always have it with me, and I’ll make a point of “capturing information” at the time I’m meeting with people, whether it’s one-on-one, or in a meeting. This is brilliant on a number of levels.

First, it makes me look like I mean business. I do mean business, but having my laptop with me bumps up my appearance by several orders. It makes me look like I take the situation seriously, by getting a computer involved. It’s true — I do take the situation(s) very seriously, and this communiates that to others.

Second, it slows down the action. Typing takes time to do. The computer has to run its programs, which tend to slow things down. Reviewing my notes in the moment also takes time. It basically keeps the action from getting way out of hand, and when it does, it gives me a great reason to circle back and recap. I’ve noticed that when I’m talking to people, I’ve been losing information, which is not good — and they’re smart, so they see it. Now, if I can type while I’m talking, I can find some middle way to keep up and get others to slow down. So many people I work with are very verbal, very interactive, and when we start writing things up, they have to slow down.

In a way, we’re inversely speedy — They’re as fast when they’re talking, as I am fast when I’m typing. They’re as slow when I’m typing, as I am when they’re talking. So, if I can type things up, I force them to slow down, which has to start happening.

Third, it speeds up my interaction. For some reason, when I’m typing things up and “thinking on paper or on-screen” I’m better able to collect my thoughts and communicate. I see issues and come up with ideas that are buried in the information. Writing things up and typing them out helps my brain organize the ideas that just get jumbled around when I’m talking and listening to people talk. I can really fly. And I type very fast, which makes me look good. I look even faster than I am, because I’m typing as I talk — highlighting my skills and abilities, rather than getting bogged down in my limitations.

Fourth, it creates a record for me to refer to. I can not only keep up while I’m meeting with someone, but it captures what we discuss, so I can come back to it later. This is huge with me. I lose so much, when I’m talking to people, and what I do retain, tends to get “filed” in different places in my brain.

The inside of my head feels a bit like my home office looks — papers and books all over the place, artwork and supplies and various items left here and there, in no particular order. Some of the mess is hygienic — just plain laziness keeping me from putting things in order. But some of it is necessary — one of my vexations is “out of sight, out of mind” where I literally lose things I cannot see. I forget that they exist, and then they get lost for long times, when I really need to keep them in mind. Like one of my W2’s that went missing in the past month. I distinctly remember getting it in the mail and putting it with my tax forms. But now it’s gone. And I have to file for an extension and request another copy. I searched high and low for it, but it’s nowhere to be seen, and I may have accidentally thrown it away. There’s a very good chance I did just that.

To avoid completely screwing up my new job and pissing everyone off and wrecking my future chances at employment, I’m going to just write everything up for myself — and others, so I have it to refer to. Just because my working memory is for sh*t, doesn’t mean my career needs to be trashed

Fifth, it chills me out with the typing. Something about the rhythmic tap-tap-tap soothes me and quiets my nerves. It’s an outlet for my nervous energy, I suppose. And I’m notorious “tapper”, anyway. For some reason, I tend to tap away at things, when I’m nervous. So, typing gives me a way to get that out of my system in a productive and positive way.

Sixth, it helps me think better. I do so much better in writing, than in speaking, so why not make that work for me? Writing things down lets me process information more quickly. And my typing is way faster than my handwriting — and it’s easier to read — so what I come up with is shareable. I can seriously come up with some great solutions when I’m working on-screen. I don’t know what I did before I had computers to help me out. Actually, I do know what I did — I floundered and foundered and made a mess of things. I made plenty of notes that were no use to anyone, including myself. Something about the keyboard helps me think more clearly. That’s a good thing.

So, I don’t need to get all tweaked and freaked out over the difficulties I’ve been having with listening to people. I work in technology, with computers. I use a laptop at work. I can use that laptop over and above its customary use by others. And I can make it work for me in lots of new ways.

This is good. This is so very good. Not only is it a workable, pragmatic solution, but it takes the pressure off my worried brain that has been sweating big-time over these difficulties. One less thing to worry about. Lots less things to worry about.

Now, I just need to take care of my wrists.

And make sure I start getting to bed sooner each night. That part is critical.

Getting to Sleep… a meditation of sorts

I have a lot of trouble getting to sleep, some nights. A lot of nights, in fact. I have trouble relaxing, and once I am in bed, I have a hard time turning off my head and relaxing my body. Here is a kind of “meditation” I use to relax myself, stimulate my rest-and-recuperate parasympathetic nervous system, and eventually get to sleep. It incorporates pieces from guided imagery I listen to, techniques I’ve learned over the years, and elements of neuroscience.

Try it… you might like it.

First, lie down flat on your back in bed. Make sure your head and neck and spine are all aligned and well-supported by the bed beneath you. Shift your body a little bit, so that you release some tension and are better able to let your body rest fully on the bed beneath you.

Now, feel your body from head to toe. Feel how tense it is in places… Imagine that you are encased in a hard shell of tension…

Now, taking a deep breath, imagine that you are sending a deep breath down into your feet, into the very tips of your toes… As you inhale, imagine your skin is like a balloon, and your breath is expanding it around your toes and feet, inflating the “balloon” of your body…

Imagine the pressure of your expanding shell cracking the hard “case” of tension that’s surrounding you. When you have inhaled fully (and comfortably), hold your breath for just a split second and feel the little crackles of broken-up stress float free in the breath “in” your feet.

Now, exhale slowly and comfortably. As you do, imagine the little crackles of stress being carried out of your body on your breath. Exhale fully and comfortably, and when you are done, rest for just a split second before inhaling again.

Feel how relaxed your feet are, from your toes through the arches of your feet, up to the tops of your feet. Feel how relaxed your muscles are… how warm and soft and comfortable they are…

As you inhale the next time, send your breath down into your ankles, and “inflate” the “balloon” of your body around your ankles. Feel the warm breath warming your feet and ankles, and feel the rigid tension of your body breaking up into little pieces…

As you exhale again, slowly and easily, imagine the little free-floating pieces of tension being carried out of your body by your breath…

Feel how relaxed and comfortable your ankles are… Feel how warm and soft they are… almost as though they are falling into a sound, peaceful sleep…

Now, take another long, slow, deep breath, easily sending the breath down your legs to your shins, where they “inflate” the tough shell of tension around your lower legs. Feel the breath expanding the space around your calves, your shins… crackling the tension into tiny little pieces, so it can be carried out of your body…

As you exhale, feel the breath carrying the tension far, far away from you, leaving only warmth and relaxation behind it…

Keep moving up your body, “breathing into” the different hard places that are surrounded by a shell of tension, and letting the out-breath carry away those little broken-up pieces. Work your way up your body, from feet to legs to torso to arms, to shoulders, to head. Take your time and breathe deeply and comfortably. After each out-breath, let the parts of you that you breathed into relax fully and fall into sleep. Don’t worry about going to sleep yourself, just let your body relax and let all the tension fall away… It’s all good.

I have been doing this meditation a lot, lately, and on a good night, I can get to sleep before I’ve gotten past my thighs. The progressive relaxation helps me let go of the tension, and the deep breathing helps to stimulate my vagus nerve and the parasympathetic nervous system in general. Focusing on my breathing and my body keeps my mind from being driven to distraction when I’m trying to sleep. And just lying still and letting my body sink into the bed makes it possible for me to just… let… go… which is oh, so hard for me to do under waking conditions. Also, I have read that 15 minutes of conscious relaxation — not sitting around doing nothing, but actual relaxation, is like taking a 30-minute nap.  So, even if I/you don’t fall asleep right away, at least the body is getting some benefit from the experience.

I hope you find this helpful as you try to get to sleep.