Anxiety-Based Insomnia Nearly Tore My Life Apart
Fourteen years ago, I didn’t sleep for two weeks. Following my psychiatrist’s advice, I was tapering off Effexor, a medication prescribed for a bout of clinical depression eight months prior. So, over a period of a week and a half, cutting the pill into half, and then the halves into quarters, I weaned myself off the drug. Immediately following that, I suffered delusions and psychosis, which sent my whole life spiraling out of control. Sleeplessness opened up a window onto a world of moonlit walks and florid personal emails sent at midnight.
The night after I took my last crumb of the medication, I heard the sound of tin rattling in the bathroom. Perhaps it was water drizzling through the pipes, finding a cracked joint and sliding out in fits and spurts. I heard a gurgle composed of metal and breath, like something out of a horror movie. Perhaps it was my mind playing tricks on me.
Quickly, sleeplessness opened up a window onto a world of moonlit walks and florid personal emails sent at midnight. At work over the next two days, it became hard to stop talking because I found myself so entertaining: I thought I was more amusing to friends, family, casual acquaintances, and storeowners. Three days into my sleeplessness, I began plundering antique stores for expensive furniture and knick-knacks, putting more than $5,000 on my credit card. Every purchase seemed magical—each object I bought for the loft a talisman with special meaning. But on the fourth night without sleep, my reactions became erratic. There was a quicksilver in my blood. I was skating on the edge of a precipice in a state of enchantment unable to find my bearings and not caring that I couldn’t. And then somewhere toward the middle of that second week of no sleep in 2004, George W. Bush defeated John Kerry in the national election, and my delusions from sleeplessness snowballed even further.
I imagined that a small network of my cohorts controlled the presidential election. My closest friend’s name was Kerry, and I thought that her name was a sign that she was secretly campaigning for John Kerry. I believed that television shows like Dawson’s Creek were a kind of steganography; the lines of dialogue alluded to my life as clues to be interpreted like a text in a semiotics class. While watching a scene between Joey and Dawson in the series finale, I called an ex-boyfriend to ask why they were re-enacting a television show about us, and to marvel at the show within the show within the show. When he told me his mother had just passed away, I assumed what he was telling me was code for something else.
Toward the end of the second week, I became completely confused and disoriented. I lost track of time and
My imagination was on overdrive, and ideas flowed out of me at warp speed. It was clear in hindsight that this disconnection with reality was a psychotic episode due to my two full weeks without sleep. When I was finally taken to an emergency appointment with my psychiatrist, I was put on Geodon, an antipsychotic drug, and Klonopin, forcing me to sleep.
Because of this episode, I lost my job at the law firm, my live-in boyfriend, my apartment, my mentor, and multiple friends. It took me five months to recover sufficiently to find a new job, and it took about eight years after that to recover completely. I developed an understandable intensity around sleeping a full night, every night. Nothing in my prior life as a reliable overachiever, nothing I’d ever imagined or even read, had prepared me for what it felt like to endure, for years, the shame, the powerlessness, the misery, of rebuilding a broken life from scratch. But I had always had trouble sleeping.
Around the age of 8 or 9, I used to have a surge of energy just before falling asleep. I kept myself tucked inside my comforter, even on the hottest California nights, because I was worried that someone would come around at night and hack off the ends of my limbs that showed outside the blanket. I shut the window because I imagined from the rustling outside my bedroom window (in retrospect most likely squirrels or stray cats) that a prowler would cut a hole into the wire screen and climb inside. I slept with a long wooden dowel rod that I would use in case somebody managed to climb through the window.
I visualized an intruder so many times that I felt certain I could feel him breathing on my face. Sometimes I conjured him purposefully, just to pre-empt him from appearing without my permission, and once I’d gone through the ritual of imagining him and being frightened, I’d feel ready to sleep. These thoughts barraged my brain every night, and the irrational image of my limbs being hacked off during my sleep never went away: In fact, every now and again, they return to my thoughts even now, decades later.
I did nothing to address these terrifying thoughts. From childhood, I considered this kind of obsession part and parcel of being a writer. When I became a litigator, while my imagination became debilitating in a courtroom, my written work became better—cautious, checked and double-checked and triple-checked.
I thought up worst-case scenarios day in and day out. Didn’t everybody have the fear that they would fail the bar and lose their minds and become a bag lady standing on the side of the road with a cardboard sign and zero prospects? Didn’t everyone clutch the steering wheel while driving next to a big rig for fear that the rig driver was under the influence? Didn’t everybody have that surge of energy just before falling asleep? Didn’t everyone go out of their way to imagine the Worst Possible Thing? And didn’t this worrying help everyone fall asleep?
As an adult, I wore blue light-blocking glasses while watching television at night. I drank insomnia tea and took magnesium. I cut carbs and ate slices of turkey. After completely losing my grip on reality in 2004, I’d diligently taken Ambien and benzos and melatonin to get to sleep every night. However, I’d never genuinely addressed my imagination and anxiety until the sleep doctors told me it was necessary: I was dependent on too high a dose of benzodiazepines. I had been on them at that level for almost six years, ever since those fateful two weeks.
So, at the behest of my sleep doctors, I sat at the edge of the hospital bed. A technician placed electrodes and glued sensors all over my head. I was participating in a sleep study to measure what my brain did at night. They’d monitor my heart rate, breathing, and leg movements. The technician placed a CPAP mask over my face and turned out the lights. I could walk around the room and do what I liked, although I was advised that the earlier I went to bed, the longer they’d have to study me.
It took a while, but eventually, I did fall asleep, albeit briefly. The sleep doctors told me that I had mild sleep apnea, but they suspected the cause of the insomnia was mostly anxiety. I didn’t need to undergo a sleep study to tell me the latter.
My sleep doctor, in her white coat, assured me that other people didn’t spend their bedtimes getting increasingly energetic. She called this generalized anxiety. I wouldn’t have called it that—I would have called it imagination and drive. She wanted me to exercise more, but interestingly, she also wanted me to worry even more intensely.
“You need to set aside a solid block of time to really focus on your worries, and nothing else,” she said.
I demurred, noting that I was a litigation associate at a law firm and had no time.
She insisted. “You don’t have even 20 minutes?”
I acknowledged that if I really tried, I could set aside 20 minutes every day. “And I really mean nothing else,” she said. “You’re not allowed to even think of anything else during that time. And at other times of the day, you need to set aside your worries and reserve them just for your special worrying time.”
“Twenty minutes?” I scoffed. “That’s easy.” She clearly had no idea the level of sleep difficulty and anxiety she was dealing with.
“OK. If you want, you can try 30 minutes. The key is that you don’t get to worry at any other time. Thirty minutes every day for two weeks, and then I’ll see you back here. But I’ll warn you that it’s actually hard for most people to fill up 20 minutes, much less 30 minutes.”
That night, I worried for 30 minutes before bed, per the doctor’s orders. I worried mostly about my cases and my clients, about blowing deadlines, or getting some tiny minutiae about the law incorrect in a brief. I worried about not making my billable hours, and about taking too long on a particular task, which meant the insurance adjustor wouldn’t bother to pay my bosses for my hours, which meant eventually my bosses would get rid of me. I worried about the administrative assistants who gossiped about my weight and my disastrous dating life would forget to file my papers with the courthouse. I worried they would purposely not serve papers because they didn’t like me. I worried about a favorite client whose friends wouldn’t testify for him, and how disillusioned he might become about friendship. I worried that John McCain would become president and that Barack Obama would not. I worried about climate change, and about the vanishing of endangered species. I doubled back to the bag lady image and considered the possibility of never again sleeping in a warm bed, of trying to sleep with the sounds of the freeway in my ears, of what might happen financially if I quit a job I hated to pursue writing.
My imagination kept me from sleeping, but it also kept me going, kept me surviving.
As the days passed, I’d worry about slightly different things, and I’d look at the clock and it would say that 20 or 24 minutes had passed, and so I had to actively think up a few other things to focus on, and thinking of problems was not hard for me. I did this every day for 15 days straight, and just as my doctor said it would, it became fairly difficult to worry for that solid 30 minutes.
It also became easier to fall asleep, but I still woke up periodically through the night. Just when most people started to doze off, my mind kept inventing new ways to amuse itself, to replay things, particularly moments of shame, humiliation, or feeling out of place that had happened during the workday—even the weekends were workdays for me—in ways that either made things better, or made things much worse.
The following year, about seven years after my two weeks of sleeplessness, I quit litigation and I spent most of my time writing fiction. Perhaps not coincidentally, I started to sleep again. Big long sleep, big luxurious sleep, the kind where you slide into your bed, and snuggle into the clean sheets, and drift away into colorful dreams and your secret life.
In fiction, this would have been the moment when I had my epiphany that writing fiction was what I was supposed to be doing, the moment after which nothing was the same. But when I cut benzos due to my first pregnancy, my insomnia returned with a vengeance. It returned again like an old nemesis with my twins. I listened to relaxation and self-hypnosis apps in order to fall asleep. But my imagination only became worse after the birth of my children. There are so many ways things can go wrong when there are multiple incarnations of your heart walking around outside your body, and I was only more fearful that I’d have a recurrence of sleeplessness and the delusions that had brought. I kept trying to find a magic bullet for sleep. There was none.
Making things worse, most new babies do not sleep for a long period of time. It was after many sleep-deprived nights trying to coax my children to sleep and not doing a bang-up job of it that I came to understand that what caused my insomnia was as much enemy as friend. Imagining the worst in visceral sensory detail had been a crutch for me all my life.
My imagination kept me from sleeping, but it also kept me going, kept me surviving. For most people it would have been pessimistic misery to imagine all the worst things happening, but I thrived on it, I fed off it. It kept me calm knowing I’d already been through an experience in my vivid imagination and survived the terror it produced inside me.
Even at its most horrifying, my imagination had always served as a safety net. I had the power and freedom of imagining or inventing all the details of what could go wrong, to live through the worst thing in my mind, to prepare myself for it, long before it happened. Most people avoid thinking about what is tragic and what is terrifying and what is cruel about the world. But I always felt that if I can survive the horrors of what I am able to imagine in such great detail, I will be prepared for the worst when it happens. And I didn’t imagine only the worst things but also the best things and the boring things and alternate versions of myself that embodied the worst things other people had ever said about me. To know that I could live through these devastating things, as I imagined them, made me feel all right with the world, less uneasy about how utterly unpredictable life is. It all made me feel much more powerful than I was.