Sleep Related Blog Posts – A Reference Guide

Sleeping German Shepherd

Sleeping German Shepherd (Photo credit: rightsandwrongs)

Organizing the “shelves” ūüôā

  1. Sleep.  Be a Friend to Yourself.

  2. Sleep Hygiene – My Version

  3. Self-Care Does NOT Always Mean Doing What You Want

  4. Draw Sleep Hygiene Into Your Culture

  5. Sleep Is The Vital Sign Of Psychiatry

  6. Just Go To Sleep

  7. Good Sleep

  8. You Can’t Barter With It. ¬†Sleep.

  9. Keep It Simple

  10. Regardless The Reasons Not To, Go Get Your Sleep

  11. Sleep Does Not Lose As Gracefully As He Lets Us Think

Sleep Hygiene – my version

1.  The bedroom is only for sleep and for sex.

  • If you aren’t having sex than all you get to do is sleep. ¬†No food, no phone, no TV. ¬†Only sleep.
  • The bedroom is a sanctuary for sleep. Your¬†subconscious¬†is way to powerful to toy with. ¬†When you go to bed you want it to be telling you to sleep, not read that last chapter or check the latest on @Twitter.
  • This can be a change in family culture and affects everyone in the home.

2. ¬†No naps longer than 20 minutes during the day time – Known as a “Power Nap.”

  • If you are tired and have the luxury of lying down, do it! ¬†But set your alarm to wake you up in 20 minutes. ¬†You can do this 20 times a day if you want to. ¬†But no longer than 20 minutes. ¬†Anything longer will break into your deeper stages of sleep and throw off your sleep cycle (also known as sleep architecture) at night.

3.  No caffeine second half of the day.

4.  Exercise but not before bed.

  • Exercise will help regulate your sleep cycle at night if you just give your sleep initiation some space.
  • Try to get forty¬†to sixty minutes¬†5-7 days a week of aerobic exercise to get best results.
  • Look at exercise like a pill. ¬†A prescription. ¬†Something for your medical and emotional health (inspiring to me), not necessarily for your¬†waistline (inspiration¬†notoriously¬†short-lived.)
  • Every day think, “I’m exercising so I feel good, so I sleep good, so I can do what I want in life” – what ever that may be for you. ¬†Some people will say, “…so I’m not a crazy Mom!”

5.  Keep the lights dim before bed.

  • Light turns off melatonin release from the pineal gland in our brains. ¬†Darkness releases it. ¬†Having your face 6 inches from the computer screen or TV before you lay down doesn’t give your body much time to turn itself off. ¬†Melatonin is a cornerstone in sleep architecture.
  • Some people who feel they must be on the computer or TV before bed have found that wearing sunglasses for at least the last 30 minutes helps.

6.  Go to bed and get out of bed at the same time every day.

7. ¬†If you can’t fall asleep in 30 minutes, get out of bed and do something else until you feel sleepy. ¬†Then go to bed and try again.

  • Refer back to #5 when choosing what and how to do your activities during that time.

8. ¬†If you can’t fall asleep in 30 minutes, consider taking a sleep aid.

9.  Do not take any sleep aids over-the-counter except melatonin, valerian root, or chamomile.

  • All others including anything containing diphenhydramine, block your deep sleep. You may end up sleeping a longer amount of time, but you won’t be getting restorative sleep. ¬†It is during the deep sleep that your body heals, replenishes it’s hormones and neurotransmitters, and¬†consolidates¬†memories.

10.  If you choose to take a prescription sleep aid, do not take benzodiazepines such as diazepam, temazepam, clonazepam, alprazolam, or lorazepam to name a few.  These also block deep sleep.

  • Sleep aids safe for deep sleep and sleep architecture, include atypical benzodiazepine receptor ligands – such as zolpidem (Ambien), eszopiclone (Lunesta), or zaleplon (Sonata). ¬†The main differences between these are how long it takes for them to be metabolized/washed out of the body. ¬†Some are quick and some last the full 8 hours.
  • Trazodone (Desyrel) is also safe for sleep structure and¬†maintenance.
  • Sometimes people will find that combining something like zolpidem with trazodone is most effective for them rather than using only one agent.

11.  Do not use alcohol to sleep.  Alcohol is a depressant (will make you depressed) and also blocks deep sleep.

12.  Do not smoke before bed or if you awaken from sleep.  Nicotine is stimulating.

13. ¬†Don’t sleep with your pets or children. ¬†They are disruptive.

  • It’s not personal. ¬†It’s sleep hygiene.

Self Care Tip #34 РUse these tips to decode how to sleep well.  Be a friend to yourself.

Questions:  Why do you skip the bits of sleep hygiene that you do?  What helps you in your tough work of being your own friend in regards to sleep?  Please tell us your story.  

Insight Isn’t Worth Much For Self-Care… Or Is It?

Autumn Red peach.

Image via Wikipedia

Much of self-care is about taking accountability for our choices. ¬†Choices come in deliberately¬†– “Oh my! ¬†I’m old already! ¬†It’s time to have a baby!” ¬†Or not deliberately – “Oh my! ¬† He’s hot! ¬†Whoops! ¬†I’m having a baby!” ¬†Both choices brought a baby. ¬†Both choices accountable by Me.

In interpersonal exchanges this is ever in debate.  From parenting to being parented, from spouses to friendship and all up and down the Mississippi river Рthe martyrs stake rarely collects dust.

That baby keeps her awake and she can never sleep with her husband any more or else no one gets any sleep.

That’s a lot of responsibility to put on those tiny infant shoulders. ¬†Don’t you think?

Mom just runs my life!  I have things to do but every weekend she expects me to be by her side!

Mom may run your life but you are choosing for her to do it if that is true.

The scenes could continue on our imaginary screen, but our own are enough to keep us busy. ¬†We don’t need others from others to get the point. ¬†But insight only takes us so far. ¬†Sometimes I get all grumpy and say, “Insight isn’t worth much.” ¬†Because, we all know that we don’t choose many of our emotions. ¬†We are learning here at also that we don’t choose many of our behaviors. ¬†Insight sits in us like a stone fruit. ¬†Eat it up or don’t, eventually all we have left is a stone if we don’t have the biology to work with it.

Self-Care Tips in a stone fruit:  To take care of ourselves, to take accountability for our choices, to use our insight for more than a midmorning snack fruit Рwe must have the working body to turn insight into production.  One stone fruit can germinate and grow.

Question:  What relationship does insight have in your self-care?  What limitations does it have in your self-care?  please tell us your story.

Good Sleep

Naruto Sleeping

Image by lyk3_0n3_tym3 via Flickr

When our day feels out of control, perhaps our night doesn’t have to be.

During sleep, our body replenishes¬†hormones and chemical messengers that it needs so badly to cope with the many physical and emotional stressors throughout our day. ¬†If we don’t sleep well, we can’t cope as well. ¬†It is during sleep that our memory¬†consolidates¬†and we can see where that might affect us. ¬†Poor sleep means poor day time memory, concentration and focus.

Focus on the part of sleep that we can influence.  This is called sleep hygiene.  Possibly we can choose what time to go to bed, what time to wake up, what is in our bedroom and what we do before bed.

Any parent knows that there are times when these things are not in our control but they also know that without a good nights rest, parenting during the day is much harder.  Pick any one of those things to start with, such as getting to bed at the same time every night, at a time that allows us to sleep a good 7+ hours for the night.  Chart our sleep in a sleep journal for a week to get a better sense of our own sleep train and the areas we can take control over.

Taking care of others means taking care of ourself. ¬†“You can’t give what you don’t have.” ¬†And without sleep, we have a lot less to give to ourself and others.

Self Care Tip Рget good sleep.  Be a friend to yourself.

Questions: ¬†What does it offer you to know that the night doesn’t have to be another place of chaos in your life? ¬†How has that improved your ability to be your own friend.

Just Go To Sleep


Image via Wikipedia

A multitude of sins would be forgiven, pills would be forgotten, pain would be diminished, hope would be restored, brain would be healthy if we would but go to sleep.

Questions: ¬†What keeps you from self-indulging when it is time to go to bed but you’d rather not? ¬†What helps you get your¬†restorative¬†brain rest? ¬†Have you noticed that everything is better with sleep? ¬†Would you describe it to us?

Self-Care Tip РGet solid restful sleep.  Be a friend to yourself.

Grief Can Be Treasured At The Same Time That We Celebrate Life

Self-Care Tip #283 – Find the treasure in your grief while celebrating life.

Today is my daughter’s sixth birthday. ¬†If ever there was a person who doubled the love she received, it is this chid. ¬†She is all passion. ¬†Yes, both ways, but that isn’t to judge. ¬†Just, there is so little I can offer in words to describe her power of self.

They're asleep!

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Tonight, we pushed two twin beds together so she and I could sleep beside each other.  Her sister slept nearby on another twin bed.  Her brother set his bed up in the closet.  (I know.)

If I wasn’t so tired, old and broke, I might be made vulnerable by times like this to having more kids. ¬†Since that’s not going to change, these chubs are what we will stick with. ¬†Happily.

My mind is turned toward God by this girl.  I somehow arrive in the moment praying when with her, perhaps for strength and patience or for humility and gratitude.  I learn from her.

Mommy, when I’m scared I talk to Jesus.

Often in times like this, I think of my niece, dead now six years, and how her parents and we wanted what was, what was stripped.  Still grieving and still living the life with us and in us, our braided thoughts and emotions easily lose their flow.

But today I have this clarity.  My niece is gone now six years and ten days.  Today my daughter is six years old.  Today I am sleeping with my three children.  Today I know that this is precious but this is not all we want.  We want what comes after our living years.  We want to let loose to Love the grief and the life; to untangle.  Not more.  Not less.  But we want.  We want what we have, now, although still in the unknown dimension of our forever.

In psychiatry, we are alert to grief that warps the ability to engage in life. ¬†Grief that mars the connections of survivors. ¬†Grief that becomes pathology, brain disease and a medical condition. ¬†This grief disables and, for example, in the case of my daughter’s birthday today, would dissolve my ability to feel pleasure.

It is difficult to gain access to treatment as many of these survivors have ill opinions about medical care. ¬†Such as; fearing medications will mute their connection with the deceased; mute their grief, or in other words, tribute/offering to the deceased; take away the personal punishment for surviving…


  • What do you say to these weeping lives? ¬†How can we¬†de-stigmatize¬†medical care for them?
  • How have you been able to treasure your grief and the life with you and in you?

Me! Where Emotions and Behaviors Come From

steps 15

Image by Erik - parked in Cairo these days via Flickr

We are doing a narrative series on understanding where emotions and behaviors come from:

  1. Emotions Are Contagious РEmotions shared
  2. Our own Emotional Junk РEmotions hidden
  3. Positive Emotions and Behaviors are Contagious Too 
  4. Our Conscious Self is Our Board and Paddle at Sea РSmall conscious self and BIG unconscious self
  5. Biopsychosocial Model РBiological, Psychological, Social selves
  6. Me! ¬†(Today’s Post)

What we have covered so far in our series is that we know emotions are contagious. ¬†We know that if we take care of our own first, we might not be as ‚Äúsusceptible‚ÄĚ to negative ‚Äúcontagion‚ÄĚ in turn and perhaps, be¬†more available to giving and¬†receiving¬†positive ‚Äúemotion-contagion.‚ÄĚ ¬†Further, we hope that if we do this, we might be able to choose to be with people we love even if they don‚Äôt do their own self-care. ¬†We can have that connection without personalizing what isn‚Äôt about us. ¬†Sigh. ¬†That is nice, isn‚Äôt it? ¬†Then ‚Ķout at sea (away from our narrative for a day,) we talked about the pleasure in engaging with what bits of biology are directly available to us and the relationship we maintain with the big expanse of our¬†unconscious¬†biology. ¬†Yesterday we reviewed our biopsychosocial model as a tool for further understanding where our emotions and behaviors come from.

Self-Care Tip #272 – If you are ever unsure about where your emotions and behaviors are coming from, it is always safe and true enough to say, “Me.”

Where do emotions and behaviors come from?


For example: ¬†Me <–> Emotions Shared <–> Me <–> Emotions Hidden <–> Me <–> small conscious self and BIG unconscious self <–> Me <–>¬†Biological, Psychological, Social selves <–> Me… round and round, starting and ending and starting with Me.

Rob and Yesenia were both breathing hard.  Rob was pale and Yesenia flushed.  Where to start?  With Me.  This is what I shared with them both.

Put your spouse down and take three steps back!  Own your own self.  Take care of your own self.  In the process, you will be able to pick each other up again and share love.

Questions:  What are you holding, carrying, using to explain where your emotions and behaviors come from?  How have you been able to put those down and hold yourself?  Please tell me your story.

Sleep Does Not Lose As Gracefully As He Lets Us Think

Cougar sleep

Image via Wikipedia

Self-Care Tip #244 РSleep when the day is over, and play another time.  Be a friend to yourself.

Sometimes it is hard to let the day end.  Michael told me that he was having trouble sleeping.  I asked him to tell me more and heard him describe fun-filled hours of movies, computer, phone-calls and late-night snacks that were disturbing his sleep-initiation.  Just listening to him, I felt a yearning catch spark in me to have the freedom to be spontaneous again.  You might know what I mean.

The opportunities to be spontaneous have shrunken up as our choices have brought us expanding fillers for time, attention, money, energy, emotion, personal resources and magic. ¬†It is no wonder that letting the day end meets reluctance. ¬†Those last few hours that sleep called shot-gun for are ours with less fist than big brother used to stage. ¬†Sleep doesn’t put up much fight …at first. ¬†At first, it concedes to us. ¬†It lifts it’s chin casually until given turn. ¬†However, much like the loan shark, sleep will never go unpaid. ¬†It will take it’s due. ¬†Maybe just not tonight. ¬†Maybe you won’t hear about it until later. ¬†And there are no promises that it won’t take by force, from one part or another of our body, our brain, our beauty, our emotions – debts are not forgotten here.

Michael says, as if he were the victim here,

It takes most people about thirty minutes to fall asleep.  But me!  It takes me hours to.  

We started talking about sleep hygiene and Michael just wasn’t interested. ¬†I asked him to simply read about it and just see what he thought he might be able to start with. ¬†One change maybe that he thought was tolerable.

These negotiations are sometimes best when the patient feels like they came up with the idea. ¬†Michael is going to read about this and hopefully become his own advocate. ¬†He will hopefully “sell” it to himself with the information both from facts but also from experience. ¬†It’s no accident that Costco sets up samples at ever turn of their superstore. ¬†Nor that we can never seem to leave without spending at least $100 in cash – not credit! ¬†Cash! ¬†(Argh.) ¬†Maybe Michael will sample and decide to sleep rather than play at night. ¬†He might have to “taste it” to believe and choose for himself.

Spontaneity will always lure us, dangle her jangly¬†jewelry, give her side-ways glance and make us long for those midnight hours to open up in playful company. ¬†However, sleep is not as gracious as it seems. ¬†Don’t be fooled.

Question:  Do you consider sleep hygiene important to self-care and why?  How do you see it related to you being a friend to yourself?  Please tell me your story.

No Matter Why, Where, or What Happens, Self-Care Starts and Ends With Me

Cover of "To Kill a Mockingbird: 50th Ann...

Cover via Amazon

Self-Care Tip #158 – No matter why, where or what happens, self-care still starts and ends with Me.

It’s no secret that I look at behavior through many paradigms.¬† Most of what I’ve shared on this blog is medical because I’m a physician.¬† That’s my specialty.¬† I’m not a physicist and don’t spend my posts on explaining how physics influences our behaviors – although I believe it does. ¬†However, I don’t want you to think that I think behaviors and emotions exist within only the medical paradigm, even though that’s what you hear me talk mostly about.

According to Dr. Q, the roughly sketched breakdown of how stress intersects with medicine:

1.¬† Stress influences how we behave and feel. We “see” the stressors, and we see the emotional and behavioral responses, and we know their sources.¬† We know that emotions and behaviors are produced by a human.¬† Where else?¬† Anything magical or otherwise comes from Someone from another place.

2.¬† Stress influences our medical condition. Stress will awaken sleeping genes that carry the names of different diseases; cancer, major depressive disorder, schizophrenia, and so on.¬† Would those genes have awakened on their own without the external trigger flipping the switch?¬† We don’t always know.

3.¬† Because there are so many factors that influence the reasons a disease process demonstrates itself, we cannot say that it is causally related to the stressors.¬† Many people try to do this, and sometimes the disease’s labeled cause comes down to the jury’s decision.¬† But we don’t have to have read, “To Kill A Mockingbird” by Harper Lee to know that people’s opinions and judgments are biased.

4.  People try to find the reasons why.  This is natural and in my opinion appropriate.  However, where we look for the reasons for the feeling and behaviors is equally important.  Seeking accountability for how we feel and behave to come from outside of ourselves, to come from external reasons, to come from a source to fault is more often missing our chance to get friendly with ourselves.

“It just is,” as many say, and the 12-Steps would say “Surrender what is out of your control to your Higher Power.”¬† These are not inconsistent with owning that mental health begins and ends with Me.

Sure, there are the despicable situations of abuse, trauma, violence and other horrible biology changing events.  These are known to cause the one non-genetically related psychiatric disease process called post-traumatic stress disorder (PTSD.)  These are situations consistent with our previous post on not being responsible for our history but being responsible for our futures.

5.  Stress, other than in situations of PTSD, is not causal for the progression of mental illness.  Everyone has stress, but how we deal with it, how we cope makes the difference.  Even horrible events, such as losing ones wealth and the sequelae of it are not causal for the continuance of brain disease.

6.¬† Medications, lifestyle change, Love and various other therapies effectively influences the way genes express themselves, our biology, and our medical condition….

7.¬† …In so doing, medications, lifestyle change, spirituality and various other therapies effectively influence our emotions and behaviors.

Question: How has your understanding of how stress intersects with with how you feel and behave affected you?  Please tell me your story.

You Can’t Barter With It. Sleep.

Today, clinic was all about sleep.  Sleep being the ugly stepchild of many homes, its delicate nature is ignored, disrespected, discredited.  We are forgetting the contribution to the unit.  Every system suffers if sleep isn’t allowed to run it’s healing cycles round and round through a 7 hour night.  Medications don’t work as well if the very neurotransmitters that they work on don’t get replenished.  The meds are throwing a work-bee without the workers coming in.  Our memories drift away, unconsolidated without the deep stages 3 and 4 coming over and over to weave them into us.  Our cortisol levels don’t get staged and none of our bits and parts heal very well.

Every night we need to heal.  So much happens daily.  There is taking without asking.  We don’t know our cupboards are empty until we are down right sick.  That’s too far.  Why get to that point?

Believe that sleep is medical, structural, biological.  The results of what it does are nonnegotiable and don’t leave room for the reasons we give for why it isn’t served up.

I’m a night owl.

I take long showers.

I’m too anxious.  I can’t turn my thoughts off.

I work the night shift.

Some people think that they can fight sleep with coping skills, water, interpersonal relationships, work, arguments, computer time, hobbies, exercise, medications, and all their good reasons why they can‚Äôt get enough.¬† ‚ÄúSleep‚ÄĚ has heard it all.¬† Break it into your belief.¬† This fight is already won.¬† By sleep.¬† You will always lose.¬† Sleep will always win.¬† You must or you suffer.


It’s not personal.  It’s objective so quit making it personal.  Don’t even let yourself go to that cookie-jar full of excuses, no matter how you crave them.  Just work it out.  Work it out.  No one can really tell you how.  They’re your excuses that make sense to you, so what will you do with them?  What will you do?

Read more blog-posts on this here.

Self-Care Tip #122 РSleep well to live well.  Be a friend to yourself.

Question: ¬†Why do you buy into this or don’t? ¬†If you buy it, what will you do or have you done? ¬†Please tell me your story.

Put The Struggle Down and Take 3 Steps Back

I almost gave up on tonight’s post. ¬†But after taking a Glee break watching Kurt get bullied, get defended, then get out of his school, I felt more refreshed. ¬†Go figure. ¬†What I have to tell you about self-care tonight is to go back to the basics.

When you become¬†inundated¬†with all the good things out there to do, go back to the basics and let it rest. ¬†Get your sleep. ¬†Take your omega 3’s and vitamin¬†D. ¬†Take your medications regularly and step back from the struggle not to. ¬†In fact, if possible, put all struggles down and take 3 steps back. ¬†There is time enough to pick them back up when ever. ¬†Go to sleep and sleep well. ¬†If you don’t think you will, take something to help. ¬†Something safe that will protect your deep sleep. ¬†Then, get up, worship God, exercise and see what’s next.

Any time you want, any time you need, any time, you can go back to the basics any time.  These are mine.

Good night folks.

Self-Care Tip #120 – Get basic with yourself.

Question:  What are your basics?  Please tell me your story.

The Great Lie.

One of the great lies of mental illness is that, “If things weren’t so stressful, I wouldn’t feel so bad.” ¬†Look inside ourselves now and see them. ¬†All the numbered and ranked stressors we tick off to explain how we feel and/or behave. ¬†How about someone we love. ¬†Do we tell them, “Of course you feel that way! ¬†Look at all you’re going through!”

Because major depressive disorder (MDD) is mainstream enough, I’ll use it as an example. ¬†Who, when they are down, doesn’t look for reasons why? ¬†Say there is an additive effect of stressors such as home conflicts, financial duress, and poor sleep. ¬†Since these events, you haven’t felt pleasure, you’ve felt sad and depressed. ¬†You aren’t motivated or interested in your usual. ¬†And where you normally would seek people out when you felt down, to get more energy, now you just want to be alone. ¬†And so on. ¬†You are able to say that you started feeling this way progressively since triggered with those stressors about 3 months-ago. ¬†Before that you were “fine.”

Many people in your life, have told you that you are just going through a bad spell. ¬†You have believed them but say, “Even if this is a bad spell, if it goes on much longer I think I’d rather die.” ¬†Your best friend responds, “Anyone would be depressed if their boss was that evil!”

My answer, “No.” ¬†Feeling down is appropriate to stress when it doesn’t disrupt your life for more than two weeks at this level. ¬†And it is never normal to want to die. ¬†Everyone has stress but not everyone responds to stress in the same way. ¬†Not everyone if put under your same triggers would develop MDD.

Would you have developed this disease if you weren’t put under these stressors? ¬†I can’t say. ¬†We develop illnesses for many reasons. ¬†One of the many reasons is external stress. ¬†A hypothesis supporting this is that stressors trigger our genes for MDD much like we know cancer genes can be turned on by stress. ¬†However, we do not have a direct correlation to the stressors as being entirely causal events.

Even if it were, none-the-less, we are left with the disease process in progress.  It is not an adjustment reaction to stress.  It is medical illness.

Feeling this way is not normal for what you are going through.  Telling yourself that it is, that is the great lie.

Self-Care Tip #118 – Don’t believe the lie if what you’re going through is affecting your function in life. ¬†Be a friend to yourself.

Question:  What whispering lies are you struggling against?  Please tell me your story.

Regardless The Reasons Not To, Go Get Your Sleep

Newborn child, seconds after birth. The umbili...

Image via Wikipedia

Self-Care # 113 РRegardless of the reasons not to, go get your sleep.  Be a friend to yourself.

I was speaking with Sheri about her sleep problems, and we aired some of the fears that she hadn’t realized influenced her related choices.

Here’s her current scenario. ¬†She is a survivor of multiple trauma’s involving her children. ¬†Currently only 2 of her 7 member household sleep through the night. ¬†It’s been years since the rest of them did.

Sheri said,

I can’t just let them cry (speaking about her 8 month old infant and toddler.) ¬†That’s child abuse.

Now this is a smart, well-read woman. ¬†She’s read “Baby Whisperer,” “Babywise,” “Dr. Spock,” and just about every other parenting book out there. ¬†She believes her intuition however and her intuition tells her that if baby cries, baby needs her.

Sheri tells me,

On a good night, when I am woken up only 6 times or less, I feel much better the next day.

(Um, did anyone else notice what she said?  A good night.  Ok.)

Sheri says when she sleeps “well,” her thoughts are clearer, her mood is more positive, she is a more effective parent and wife. ¬†Sheri is telling me what I tell others. ¬†However information and knowledge are not always enough.

Sheri knows she needs more sleep but she feels trapped between what she knows in her mind and what her gut tells her.

Question for Sheri:  When you get up to soothe the babies, are you doing it more for you or for them?  I got no direct answer to that question and let it rest.

Suggestions for Sheri and any other listening parents stuck between their mind and their intuition:

1. ¬†Clean out the spare room and put 2 small beds in there. ¬†Nothing else in the room. ¬†(Remember sleep hygiene. ¬†The bedroom is only for sleep and for sex and if you aren’t having sex, all you get to do is sleep. ¬†Sounds silly when in context of babies? ¬†This is however true. ¬†Regardless of your age.)

2. ¬†Put a fan outside the closed door to the baby’s room.

3. ¬†If you hear the baby crying, get up and help. ¬†If you don’t, than sleep, and baby can teach¬†themselves¬†to fall back to sleep without your help.

If you don’t do this already reader in your own bedroom, don’t feel too bad. ¬†I remember giving a lecture to a room full of physicians and asked them, “Who had their bedroom set up this way?” ¬†Not one of them raised their hands.

Changing our bedrooms to be appropriate for good sleep hygiene is a cultural change for the family. ¬†It moves activity out of the bedroom obviously and into the home’s community space. ¬†Everyone has to renegotiate that space. ¬†A personal hide-out can be harder to find.

But it works! ¬†Just Google “sleep hygiene” and you’ll read oodles on this. ¬†You don’t have to believe me.

I’ve worked with disabled kids even, who have a ton of biological reasons not to be able to sleep through the night. ¬†However, many of them did once their parents helped them with their sleep hygiene. ¬†This method can crack some of the hardest cases of insomnia. ¬†If these kids can do it, we can too.

If you can’t easily get into the groove of good sleep hygiene, you are not alone. ¬†Keep trying. ¬†It will be worth it.

Question:  What are your barriers to getting good sleep?  Or, what has helped you do whatever it takes to get your sleep?  Has either choice been worth it to you?  Please tell me your story.

Escape Self-Loathing

Self-Care Tip #91 РPut the fight down and take 2 steps back.  Be a friend to yourself.

He came in looking really good. ¬†Chris had seen me for many years and he hasn’t always looked this way. ¬†I said

You look great!

Chris shrugged and told me he had just had a long messy argument with his partner and somehow still felt alright.  In the past, after they fought and the self-loathing set in, he might have hurt himself Рlike using alcohol or cutting on himself to

…just feel something different.

I was ready to move past the story as he sounded like he was ok with it.  We talked past each other.  Me asking about his sleep, and Chris telling me clips and phrases from the argument.

But amazingly I’m fine! ¬†If he wanted me out today, I’d be out of there, no problem. ¬†He just needs to say the word!

Chris was sitting back in his chair, relaxed until then.  His hands came up and took control of his space, thrusting as he spoke.

Being a psychiatrist, my expertise kicked in and I realized I should turn back. ¬†Chris wasn’t ready to talk about sleep. ¬†You see what all those years of school can do. ¬†Not everyone knows how to pick up on such subtleties.

Chris, maybe you aren’t so happy you argued.

We talked more about his energy, appetite and motivation.  Then we came back to his argument.

It’s none of his f—— business where I am during the day! ¬†I’m not his child. ¬†I’m his partner! ¬†I told him…!

And so on. ¬†Chris still looked better than when he was in the grip of post-traumatic stress disorder symptoms, or when he was catatonic. ¬†But he didn’t sit comfortably with himself. ¬†And I thought, Chris has fought so hard for himself, why can’t he handle what I want to say? ¬†And I did. ¬†And he did. ¬†Beautifully. ¬†He was a brave knight on a black steed holding his wounded sides. ¬†Life had been a battle for him, but he was making choices to fight less and live more.

“Ok. ¬†Yes. ¬†You’re right. ¬†I will next time. ¬†That makes sense.”

When you’re about to engage in something that in the end will make you loath yourself, choose not to. ¬†That’s friendly to you and your other. ¬†Say something like,

When I was gone you felt jealous?

Give over stage and anger and open windows and breath.  Just choose not to hurt yourself.  Winning or losing the argument, in the end, you hurt by your own choice.

Biologically and probably spiritually Chris wouldn’t have known what to do with that years ago. ¬†But he did now. ¬†I saw him relax again and put his hands away. ¬†I knew Chris had a love for Love and this clicked for him.

I can’t describe how happy I was/am. ¬†Being a part of his journey is a great honor.

Question:  How have you escaped self-loathing and your mean self in the heat of the moment?  Please tell me your story.

Taking Care of Yourself Is Not Selfish

The line between self-care and self-centeredness is a thin line.  We are part of the narrative.  We are not the narrative.

I’ve got some heat lately folks for talking about “Me” in a way that excludes the import of “You.” ¬†How does anyone talk about the importance of the self without sounding seriously¬†arrogant, disinterested in others, egocentric, ungrateful and rude? ¬†Clearly it’s a learning process. ¬†That’s something of what I’m hoping will evolve this year as we journey together. ¬†Please let me know what you think on this subject.

I was very excited about having a morning to myself today and had built up a storybook page turning space of time for me. ¬†However my night went bad, and like opening the oven door too soon with the bread still rising, I just didn’t get up well. ¬†Partly in denial that the day was already slipping away, I kept going towards my hopes. ¬†The clock sped up and I finally got out the door with the kids buckled to where they needed to go. ¬†And then I realized I forgot my computer and phone. ¬†Not so easy to work without those.

I live in the hills and although I’m not far from street lights and normal trafficked buildings, getting between me and them takes me through many blind 25 mph corners, steep hills over narrow roads. ¬†Today I felt like I got caught in those hills. ¬†My mom-van felt off-balance and the tight corners treated my tires¬†cruelly. ¬†I went back home to get my computer and back down to town finally.

I had great intentions for today. ¬†However, I got stuck and stuck again. ¬†That is what it can be like when we try to treat ourselves well. ¬†It can feel like the roads swallow us up and we just can’t get there.

As my husband says, “That’s how it rolls!”

Question:  How do you see self-care differently from self-centeredness?  Please tell me your story of friendship.

Self-Care Tip #77 – Don’t get confused. ¬†Taking care of yourself is not selfish. ¬†Be a friend to yourself.

Claim Your Brain

My mind, like rusted gears, was not moving well. ¬†It hadn’t been really since my 1st pregnancy 8 years ago. ¬†There are few things that dumb us down as much as pregnancy and children! ¬† Hormone changes, lack of sleep, fluctuating from 145-200-145 pounds three times, and then the subsequent growing beloveds around me to contribute to mental¬†dissociation. ¬†Simple sensory overload from talking, yelling, crying, petitioning, inquiring kids factors in. ¬†You may read more about sensory issues here.

Daily writing, like a staunch governess, found my brain under cobwebs, bug carcasses, and musty stench.  (Hello old friend!  There you are!)  This helps to explain the joy gripping my hand, like girlfriends on the playground, when I sit down to write!  The world is active to me, including rather than excluding me. My in-between moments used to hang like an old woman’s breasts.   Now much more time full of nourishing thoughts bless me.  I am in awe.

My patient came in sighing deeply.  He wasn’t better.  No, he said.  He lacked motivation and interest and connection from the world.  He felt selected out to suffer.  A dumping ground for misfortune and misunderstood.  Efforts through medication, after medication changes were like looking for love in all the wrong places.

We talked about cognitive distortions, tapping into things that used to make him happy, road-blocks in poorly designed¬†neurological grooves – volunteering at the library or animal shelter, journaling, sharing his life story with others, exploring his spirituality. ¬†No. ¬†No good. ¬†Nor could he consider psychotherapy as he’d been through too much of it already to consider it again. ¬†And he just couldn’t get interested in groups such as through NAMI.

His brain, assaulted by stressors, disease, and disuse was growing silent.

Being a friend means yelling, fighting to reclaim your journey, finding something to connect you to your process of life.  My patient was letting squatters take his property simply by being absent.

Self Care Tip #60 РClaim your right to health.  Be a friend to yourself.

Question:  What has helped you connect with your own journey in life?  What do you think?  Please tell me your story.

Look Around At The Other Reasons – Depression

Flagellants mortifying the flesh, at the time ...

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“I’ve done some bad things.” ¬†Patient tells me she can’t sleep well, is nauseated, depressed mood, worried with perseverating thoughts about acts that shame her and ramifications, doesn’t feel as much pleasure in life, isolating, tearful and more. ¬†I was alarmed! ¬†What could she have done that deserved this kind of self-flagellation? ¬†When she told me, I didn’t realize it.

I was still waiting for the rest of the story. ¬†I got caught up in her own self-judgment and found myself sitting beside her “in court.” ¬†Once I realized what I was doing, I was¬†chagrined. ¬†Here I was collaborating with her in her inappropriate guilt. ¬†It took me too long to register that her reaction was not proportionate to the offense. ¬†I told her I was sorry she was going through all this emotion. ¬†She said, “It’s my own fault.” ¬†Is it though? ¬†We needed to start looking at additional reasons that might be influencing the way she felt.

Start looking at other paradigms when the emotional response is out of proportion to the event(s).

An analytical approach would look at¬†unconscious reasons, such as other personal choices that¬†conflict with a core beliefs. ¬†Or perhaps, something like unresolved anger coming out in physical and emotional symptoms. Ask about our “closets,” peel away pretense and let your flawed self into the air. ¬†Keep it real.

Another paradigm is medical. ¬†Inappropriate¬†guilt is a symptom of Major Depressive Disorder, a debilitating disease process of the brain that affects the whole person/body systems. ¬†When distorting things out of proportion, personalizing too much, we must ask if there is a depression going on. ¬†Ask yourself. ¬†Ask others. ¬†But don’t let it continue if at all possible. ¬†Major Depressive Disorder is a progressive disease that does more damage to the brain the longer it goes untreated. ¬†In other words, the brain is affected more over time, it is harder to treat and it is more dangerous to the person. ¬†The average length of an episode is 2 years and the more times it returns, the more chance to have the disease process continue for life. ¬†Treating sooner and for longer, decreases the chance of relapse.

Excellent for us are the many treatment options for this potentially devastating disease. ¬†Even in the “lifer,” when staying on medications, the relapses are much easier to get through and shorter in duration. ¬†The medication has a protective effect on the brain. ¬†Prophylactic against further insult.

In the woman I told you about, there was another emotional spectrum disorder, anxiety. ¬†Anxiety and depression are like brother and sister. ¬†They often go together. ¬†But for today, we’ll leave it on the symptom of inappropriate guilt and let it rest on the reminder that the brain is human, mortal, attached to our neck and not an aura. ¬†When the brain gets sick, it shows how it is doing the only ways it can, often through emotions.

Self Care Tip #46 РLook at all the reasons influencing the way we feel.  Be a friend to yourself.

Question:  What do you think?  Agree or disagree?  What is your story?

Freud Did Not Know

Bad dreams. ¬†Just woke up from one. ¬†There’s a lot out there on dreams in mental health. ¬†After all, they come from the brain. ¬†When Freud was looking at things, he saw dreams as “unconscious wish fulfillments.” ¬†However since Freud rocked our world, we’ve learned so much more about brain biology and Freud was wrong. ¬†Oochie ouchie. ¬†Just saying that makes me feel like his still very much alive reputation will come at me like an angry ghost and be mean!

Dreams are just that, dreams. ¬†Sometimes they are good, but often they are scary, bad, and even terrifying. ¬†Why? ¬†According to Dr. Quijada ;), yours truly, they are commonly symptoms of emotional disease or side effects of medications, etc…. ¬†In anxious states, we dream. ¬†After going through life threatening events to ¬†ourselves or witnessing it in another, we get nightmares. ¬†When there is a disconnection is our sleep architecture, we can get “parasomnias” such as night terrors. ¬†Some medication such as Trazodone can cause vivid dreaming where people say they dream “in color.” ¬†And on and on.

Freud didn’t know this, so no offense taken. ¬†However, we do. ¬†Enough with the hocus pocus moral dilemmas that are discussed in our own¬†thoughts and among some ongoing therapies. ¬†First look to biology to give us the answer. Even after having a nasty scream-your-lungs-out dream, remember that your brain is mortal, human, made up of carbon and not aura.

Sometimes even that much information can help people sleep better.

Self Care Tip # 43 – Don’t make too much out of your dreams. ¬†Be a friend to yourself.

Question:  Do you agree or disagree?  Did this help you in any way?  Please tell me your story.

Keep It Simple

Being a friend to yourself is obviously a changing effort, depending on your needs. It includes many intersecting paradigms including physical health and biology, genetic predisposition, coping skills, what you do to your body, what is done to your body (such as trauma), emotional triggers, spirituality. I’m sure there are more that we will continue to learn about through the ages.

Deciding where your energies will go can be more objective when we tease apart these paradigms. For example, if I’m tired during the day, have irregular sleep hours, feeling emotional and irritable, I’d start with sleep hygiene. This basically says that if you aren’t having sex in your bed, all you get to do is sleep. No food, no phone, no tv, no reading; just sleep.

Where you are going to spend your energies should be as basic as possible. As preventative as possible. As elemental as possible to start out with. Although the efforts you make shift with your needs, being friendly with yourself means picking your battles wisely. You only have so much energy. Keep it simple.

Self Care Tip #13 – Keep it simple. Be a friend to yourself.

Mother’s and Sleep

Mother’s and Sleep

I was speaking with a friend, mother of 3, including a new baby of 3 months. ¬†Any on-looker could say she had it all. ¬†However, she wasn’t feeling happy. ¬†Looker’s¬†on could also guess just as well some of the reasons why. ¬†Especially those of us who’ve raised infants. ¬†It’s called sleep. ¬†Sleep, the elixir of good living. ¬†Without it, color fades. ¬†Sounds and voices take on an edge like the underside of a long fingernail. ¬†Our thoughts swim about in a mire. ¬†Finding words is confusing and speaking them reduces us to… to what? ¬†Well you’ve been there where my friend found herself struggling to say why she wanted to cry and beat her children. ¬†Just to hear her is enough to make your milk let down.

Hearing someone say get sleep is uncomfortable. ¬†It brings up all the cultural reasons why we don’t get sleep, the emotional reasons, the relationship reasons, and the reasons around discipline. ¬†Well, whatever it makes you feel or think, it comes down to biology. ¬†You won’t feel good and be healthy emotionally and be able to do things you want to do for others if your body and brain isn’t getting restored at night. ¬†So losing sleep may feel like a sacrifice you’re doing for your new baby or husband who wants to stay up and watch movies together, and it may. ¬†However it is also other things. ¬†Losing sleep is taking yourself away from them tomorrow. ¬†It takes from your own journey, disconnects you from your own self. ¬†Losing sleep is a biological cascade that leads to deteriorating¬†goals, including your ability to give well.

There is sacrifice also in letting your child cry for 5 more minutes before going to him at night. ¬†There is sacrifice in going to sleep instead of staying up to play with someone you love. ¬†Don’t be fooled in to thinking that you’re getting your child from her crib when she cries for 30 seconds for her sake. ¬†Don’t be fooled into a mother’s martyrdom. ¬†Babies are also healthier when allowed to self soothe. ¬†Babies are healthier when they learn to put themselves to sleep if they awaken at night. ¬†To get good sleep, look past the guilt, look past the immediate pleasure, look past the distraction, look past and see yourself as you will be tomorrow. ¬†Let that be the sacrifice in your life. ¬†A healthy mom, a healthy wife, and healthy individual for those you love. ¬†Sleep for your own valuable self. ¬†You have a chance to live well.

Self Care Tip #3:  Get sleep for any reason that makes sense to you, but sleep.  Be a friend to yourself.