In a very recent blog I mentioned how a good night’s sleep got me down from a potentially dangerous hypomania, where I was feeling just a bit too good for my own good. One of my readers, Michele, found the blog very interesting, but wanted to know:
“What did you do after you realized (with your wife’s help) you were hypomanic? Do you adjust your meds? What non-medical things do you do?”
Fess up, Michele seemed to be saying to me in so many words. It had to be more than just sleep. How did you REALLY get down from the hypomania?
Thank you for the reality check, Michele. You’re entitled to a thorough explanation. The short answer is that it was really just the sleep (plus taking it easy the next morning). Naturally this sounds way too simple to be true, so here’s the long explanation:
The British Association for Psychopharmacology in a 2003 treatment guideline advises, "Sleep disturbance is perhaps the most commonly described final common pathway to mania.” A 2004 DBSA survey found sleep disturbance to be “one of the most common problems associated with mental illness.” A 1998 study by Ellen Frank PhD of the University of Pittsburgh found an association between disrupted social routines (including sleep) and onset of mania.
So important is getting sleep right that Dr Frank has developed a whole new talking therapy (IPSRT) based on getting our out-of-whack life routines back into whack. Paramount among these is sleep. “There’s something about the sleep-wake cycle, Dr Frank told me in a 2004 interview. “It’s telling us something.”
Sarah Russell, PhD of the Melbourne-based Research Matters stresses that sleep is “a crucial ingredient to staying well.” She was distilling the wisdom of 100 “successful” patients she interviewed, who drove home this message to her again and again.
So bound up is sleep to mood that sometimes I’m convinced that sleep disturbance is the main illness and that the rest of bipolar the downstream effects. When I think of cycle, I think of sleep cycle before I think of mood cycle. To me, mood is just the tip of the bipolar iceberg. Sleep and stress are the major “below the waterline” issues.
I was stupid to all this back before I was diagnosed, and I paid in full measure for my ignorance. I’m much smarter now. Yes, I can still be a considerable pain to live with, but I’m a regular Miss Congeniality compared to what I used to be.
I’m not saying sleep is the fail-safe solution to bipolar disorder, but mainstream psychiatry fully acknowledges its critical importance. Virtually every one of us has been prescribed a sleep med, usually on an as-needed basis. And should we find ourselves hospitalized with severe mania, the first thing the staff there does is knock us out.
Fortunately, when I arrived home from my meeting knowing I was hypomanic I was already tired and was able to get a good night’s sleep. But I was ready to take a sleeping pill. Also, I was willing to bump up my mood stabilizer dose a notch if I hadn’t come down the next day.
So, yes, Michele. It really was as simple as getting a good night’s sleep. But the whole sleep issue is by no means simple. In future blogs, I will discuss sleep in a lot more depth. For now, I will leave you with this simple take home message: Treat your mood disorder as if it were a sleep disorder. Live well …
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Published On: June 22, 2006
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