How does sleep feature in managing our bipolar?
One week ago, at the NAMI National Convention in Chicago, I heard Jill Bolte Taylor, author of “My Stroke of Insight,” talk about how sleep figured mightily in her recovery. In 1996, at age 37, Dr Taylor suffered a debilitating stroke that left her unable to walk or talk or recall life. Her recovery took eight years.
Dr Taylor attributes a large part of her recovery to being allowed to sleep, which, she explained, went totally against protocol. Thanks to neurogenesis and neuroplasticity, individual brain cells can repair themselves and reconnect with other brain cells in repairing old and laying down new circuitry. But the process requires time and rest. Lots of it.
Dr Taylor’s endorsement of sleep really struck a chord with me. Obviously, our brains need challenge and stimulation, but this is the first time I think I ever heard anyone with a PhD or MD emphasize the vital importance of sleep, even if it is way too much by other people’s standards.
Travel and conferences are extremely taxing on my brain. The schedule is strange and exhausting, I have to be on my game, I am overstimulated, I am out of my normal environment, in a different time zone in strange surroundings, and I am all day for days on end confronted with the challenges of interacting with more people in one hour than I normally do in one month.
On a cellular level, every neuron beneath my skull is being bombarded with glutamate, the excitability neurotransmitter, which opens up the ion channels for an influx of calcium which makes our neurons zap and zing. Too much of a good thing is the ticket to mania, cell damage, cell circuitry breakdown, and no end of bad things. No surprise, our mood stabilizers work on modulating glutamate and these ion channels.
My limbic system is also on high alert, sniffing out danger and surprise, ready to respond instantly. So are the thinking parts of the brain, working overtime in coming up with coherent responses to the endless blast of my environment assailing me with all the subtlety of a nuclear bomb. Dopamine is the way our neurons coordinate all this activity. Another name for mental illness can be the “too-much dopamine” disease. Our antipsychotics are very blunt instruments in keeping our dopamine under control.
At the same time, every molecule in my system - every electrical and chemical impulse - is screaming against all the overload and activity, compensating, adjusting, stretching itself to the limit in keeping my brain in a state of homeostasis - stability - to keep it from alternatively flipping out or shutting down.
Basically, when I got back from Chicago, my brain was bruised, black and blue. No, you couldn’t physically see the damage, but I can assure you every one of my neurons looked like the face of someone who has just survived 15 rounds of Muhammad Ali in his prime.
The cure? Sleep. Lots of it. When I got back from Chicago, I went into Rip Van Winkle mode. I woke up in my own bed on Monday (nearly a week ago), and only now am I starting to come out of it. Two days ago, I took two naps on top of a full night’s sleep.
