“Sleep is one of the most important things you need in order to stay balanced,” said every psychiatrist who’s treated me over the 16 years that I’ve been seeing psychiatrists. Because it’s true—as a bipolar person, if I don’t get sleep, not three or four or even five or six hours, but eight to nine straight hours of shut-eye, I turn into an emotional basket-case.
Now getting sleep would be an easy enough task if I hadn’t inherited insomnia from both of my parents. In fact, I just spoke to my father about it the other day.
“Oh, I’m up all night,” he said. “I got to bed around 10 pm, wake up at about one in the morning, read for a bit, go back to sleep, wake up at three, read or go on the computer, then go back to bed, then wake up at five. Then, I take a nap during the day.”
Lucky for my father, he’s one of the sanest and most balanced people I know and lacks a mental illness. So, it’s no big deal that he lives on this polyphasic circadian rhythm.
It is a big deal for me, however, and without any medication, I can rarely sleep straight through the night. Yes, I drink coffee during the day, but even when I took a three-month hiatus from caffeine, I still woke up over and over throughout the night, then jolted wide awake at 4 am, unable to doze off again.
And if there’s noise in the background, like during my freshman year of college when my roommate would pull all-nighters, clacking on her keyboard until six in the morning or humming along with whatever Garbage song blared from her headphones into her ears, I’m extra-screwed.
Perhaps it should come as no surprise that my first real mental breakdowns and stints in psych units kicked off that first year of college. Because when I don’t sleep, I either crash into major depression, spike up into mania, or, more often and more dangerously, enter a mixed state where I’m hopeless and miserable but also wired-up and raging, a bipolar phase most responsible for suicides.
In short, taking medication to help me get solid shut-eye is in fact a very wise—and medically necessary—move.
But not everyone in AA agrees.
When I first got to the program in 2007, after overdosing on a cocktail of pills and wine that left me unconscious in Cedars Sinai for nearly a week, the docs insisted I take Lunesta, a non-narcotic sleep aid, to keep me sane.
It knocked me out for eight hours, gifting me with a stable and positive mood. And thankfully I didn’t suffer from morning-after hangovers like drowsiness and stupidity.
But when I shared this with my new sponsor, who ironically suffered from a mild form of bipolar disorder known as cyclothymia, she told me I needed to nix the pills and learn to sleep on my own.
“Sober people don’t take sleeping pills,” I remember she said to me, practically yelling. I really didn’t understand why she was so pissed off, but I was new to AA and hadn’t experienced the bad-dogging that often takes place in the program.
“But I can’t function if I don’t sleep,” I said.
“Well, no one ever died of not sleeping.”
I should have told her that not sleeping threw me into those mixed states, but at the time I decided that she was right and I was a jerk, a pussy, and a failure for wanting to take the pills and refusing to suffer like all the other poor sops in AA who chose to toss and turn at night rather than get a little help from pharmacology.
So I went without them for over eight years—until I finally left AA.
Here I need to mention that when this sponsor was no longer my sponsor, she called me out of the blue and made an amends for scolding me about the Lunesta. It turns out she’d gone without sleep for about two days, got manic and wound up having a massive seizure in the emergency room. So she’d changed her sleeping pill tune.
I also should add that the wise, 33-years-sober, 75-year-old sponsor I had prior to leaving AA—a woman I still love and who has absolutely nothing against psych meds—suggested I take melatonin for sleep.
She added, “You might have to take three or four for it to work. I typically take around four, ha ha ha!”
She has the best sense of humor ever.
But melatonin just isn’t strong enough for me, and it also makes me depressed for some reason. I tried it when she suggested it, but nothing changed.
So I resigned myself to the agony of waking up over and over and rising before the sun was up, even though it disadvantaged me professionally and made me insane.
But about two months ago, I’d just had enough. I mentioned my sleep problem to my new psychiatrist and he mentioned I might try Trazadone, another non-narcotic sleep aid that is technically an antidepressant, to knock me out.
I’d used it about 10 years earlier, and it did help me but it wasn’t until I left AA that I felt totally free to use the stuff. Now that I’ve been taking the Trazadone, I sleep a good eight hours, wake up refreshed and don’t have to take a two-to-three hour nap every day. It’s worked so well that I’ve started taking it every night, which I just don’t have a problem with. I’ve learned that many people have “med shame”—they don’t want to rely on any medication, and though I can appreciate that, it’s not something I’ve struggled with.
Since I’ve sunk to devastating lows, since I’ve seen the insides of eight psych units, since I’ve had breaks with reality that terrify me, since I’ve hurt the shit out of my friends, family, and boyfriends during mental breakdowns, since not sleeping well nearly ruined a vacation with my boyfriend and has seriously crippled my career, I think it’d be utterly delusional if I had any med shame.
In fact, I’m sort of offended at the idea. Ultimately, it’s mental illness shame. The age-old argument of “Would you feel ashamed taking insulin if you were diabetic” is still a good corollary, and I don’t view non med takers as any stronger, better, or healthier than me.
Trazedone, like my psych meds, gives me a better quality of life. I’d like to think I’m entitled to that.
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