Meet Anxiety & Insomnia, Pain’s Evil Night Time Sisters.

Dear Audy,

Bedtime is one of those everyperson things that happens every day. When we’re kids, we fight it off as long as possible, desperate to discover the intrigues of the adult world and to be sure that we don’t miss anything important. When we’re adults, we crave the peaceful escape of unconsciousness, the intriguing and important things that we get up to during the days and nights leave us always longing for ten more minutes on the pillow.

Bedtime, for me, has gotten to be a bit scary. It’s not the monsters under the bed that I’m afraid of, it’s the one called CRPS that’s going to torture me upon waking. Fear about sleeping is not a good emotion to indulge, without sleep I would simple cycle further and further in to anxiety and depression, therefore I must do all I can to try and get around the frustration that comes with waking in so much pain.

20100204 Insomnia & Anxiety

Sleep disorders are vast and varying, they cross-breed symptoms, create chaos and can mostly be found walking around wearing a t-shirt with an ‘Insomnia’ slogan. A common cause of insomnia is anxiety – the brain runs in circles trying to solve problems that cannot be solved or escalating worries until you want to don a sandwich board and walk the streets, crying to warn the people of some upcoming devastation. Anxiety is kind of a subset of stress. You’ve probably heard that a little stress is a good thing, people claim that they ‘work well under pressure’ or how they were able to climb great mountains driven by a powerful, pulsing, determination that they could not ignore. Stress is overstimulation, the brain in overdrive, propelled by external or internal stressors and can affect a person in both a positive and negative manner.

Stress often gets used as a nice little blanket word to cover up anxiety, which I can’t help thinking shows that there is still, sadly, stigma attached to suffering anxiety. Anxiety is about the most negative type of stress there is, it creates a state of constant nervousness, it’s the flight or fight response on repeat. Anxiety is linked to depression and whilst society is coming to accept this as a physical disease, many still feel ashamed of their condition and disinclined to talk about it. Ever known a drama queen? That friend who always seems to have big problems, or only pops up in your life for minutes at a time and often claims to be stressed if you press for information. Ever think of him or her as a jerk? Anxiety is not a choice, it’s possible to be suffering and not even know yourself, although the people around you probably have words for it – ‘lazy’, ‘fickle’, even ‘selfish’. The longer I suffer my own medical burden, the more I realise how many people are walking around with these little weights on their waists and how these are perceived by the people around them.

Suffering from anxiety creates thought cycles that can turn even a tiny, insignificant event into a devastating blow. Anxiety is the consummate actor, it loves to put on the stress costume and stage its own version of Much Ado About Nothing. There are many people going about their lives not knowing that the worries that consume them are irrational. The anxiety becomes so good at playing the part of reality that the sufferer is unaware that the show has begun, even though they are racing through the script, desperate to solve the mystery and end the drama. A lot of hurt and anger can be generated from undiagnosed or untreated anxiety, it’s always good to keep an eye out rather than jump to any conclusions about the changes in a friend’s behaviour, or to ignore changes in your own.

Anxiety and chronic pain go hand in hand, it’s pretty hard to suffer the latter without it getting blended up with the former. If you are healthy, think about the last time you were really ill or got hurt badly, do you remember how stressful it was? Pain is biologically designed to make us stress, it’s there to tell us something is wrong with our body and that we need to worry about it. With chronic pain, there is rarely something immediate that can be done to relieve it. Our modern day assumption that pain should be relievable through medical treatment develops cracks as the days drag on and on with no end to the firing of nasty nerve signals. Despite their malfunctioning, those pain signals still manage to get our anxiety motor running and since we can’t solve the pain problem, our minds just love to find another focus for us to worry about irrationally. I find it a constant battle to try and recognise when I am actually upset with a loved one and when it’s simply anxiety making a big deal out of nothing.

In previous posts I mentioned that I have been taking mirtazapine to help me cope with my anxiety. After a couple of weeks, I’m pleased to say that it is helping greatly and I’m feeling more clearheaded for more hours in the day. The drug has made getting to sleep an easy thing, however the recent flaring of my CRPS pain has made waking the most awful part of the day. I am waking with burning in all four limbs and through my shoulders, neck and jaw. The pain strikes before my rational mind kicks into gear and I am usually moaning or crying before I ‘come to’, as I think of it. I have a well supported bed and pillow and try to sleep on my back, it seems that no matter what position I sleep in, I am waking up in agony.

So, what is the point of this post? I’m trying to figure out how to make bedtime less scary. I have my nightly ritual like most people, exciting things such as brush teeth, wash face, fill water glass and then escape into whatever story I am reading until my eyes blur and I know I’ll be asleep moments after the lamp is switched off. The scary part comes later. Microarousals start waking me from around 3 or 4am and the restless sleep from then on in is laced with pain. Morning after morning of pain is making it harder to file these niggling and negative thoughts of ‘bed is painful’ under ‘unhelpful’.

Whatcha thinking, Audy? What helps you to get out of the bed in the morning, even if you are in pain? How do you stay focused on getting well and doing your best when your body and mind seem to be plotting against you? I’m still far from the end of my rope, trying this new thing of attacking the problem before I am swinging off that rope and clutching on for dear life.

Love & Sweet Dreams,

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