Sleep Disorders

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Self-Care Does NOT Always Mean Doing What You Want

The Red Kangaroo is the largest macropod and i...

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Self-Care Tip #132 – Remember, you are your own friend.

So today up up up like a ghoul that wouldn’t die, came this confusion over self-care v. selfish-care.  Somehow, intuitive, or what, we see that word “self” and throw up our hands.  There always seems to be that guy, or it could be that girl, let’s call her Terri, who acts like a two-year old, who can’t think about anyone but herself and does what she wants.  She is toxic to her family and throws her perceived needs in their face faster than they can turn their heads.  That’s not good for them or for her.  That’s not friendly.

Self-care may or may not be doing what we want, Terri.  If we are fortunate enough to have it be what we want, great.  If not, the end goal is still the same, and still great.  It is friendly to us.  Self-care does just that, cares for us responsibly.  We don’t need a mother or a police officer or the government to strong-arm us to do it, because we WANT to take care of ourselves.

Self-care may or may not be doing what is consistent with our temperament.  Achilles taught us that.  The grazer may never want to get in the barn, but in the end, find herself at the jaws of a wolf.  The barn animal may never want to graze and, well, you get it… fill up the barn with poop and such.  It’s just not good.

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Let’s use sleep as an example.  Just as a generalization, grazers tend to enjoy the late hours.

I don’t get any time to play if I don’t stay up and that’s not good for me.  If I plan my play, it loses spontaneity and then it’s not play any more.

You don’t have to be a grazer to think this sounds delightful.  But here’s the thing about this.  If we don’t get our deep sleep, our sleep hours, do sleep hygiene, in short – if we don’t sleep well enough and long enough we don’t heal.  We don’t replenish our hormones and neurotransmitters which predisposes us to mental and physical illnesses and decreases our ability to respond to psychotropic medication.

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I’ve seen regular, restorative sleep bring someone from a place of mental decline to no longer needing psychotropic medication.  Everything works better with sleep.

Ah today I drift some.  Point being, doing what we want is not the same as being friendly to ourselves.  It can be a VERY different thing, or not.

Questions:  How have you found that self-care has been what you wanted to do, or what you didn’t want to do?  How did you overcome those barriers to getting friendly with yourself?  Please tell me your story.

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Are You a Victim or What?!

 

 

Number Two of Bella’s List – victim or what!?:

Last night I took my 5 year-old daughter on a sleep-over date at a hotel.  Generous I thought …and boy was it!  To me!!  I couldn’t believe how much fun I had.  I quickly realized why I had done this.

A bit of me still wants to float away on wings of the modern-martyred-Mom, and I can, because it did take a lot of time and money and energy and….  But it’s not too friendly to me.  As attractive as that flight may seem, I’ll lose air at some point and take a big fall.  Ouch.  I might fall on my kid too which is against my intuitive effort here.

Being a victim is attractive at some level, no?  My story is a softer example, but we all have tougher ones.  Like Bella’s when “she spoke of her injury.”  The gravity of her injury was created by her perception of things.  Our perception makes our emotional success.  My story about last night with my daughter sounds pretty because that’s how I perceived it.  However, I have other stories that have negative power over me as Bella’s had on her and as yours have on you.

The key here is that when we take the victim role, we aren’t just telling our story or venting.  We are feeling self-pity. But venting is not necessarily self-victimization.  Venting can be healthy.  Venting can be done without taking a victim air-bus to no-where good.  Venting can be a way of being present in your suffering, of going where the pain is and letting it lose power over you.  Self-pity only gives the suffering more power.

The great novelist and philosopher, David Foster Wallace, who courageously lived and died with major depressive disorder, encouraged,

To be just a little less arrogant. To have just a little critical awareness about myself and my certainties.

The willingness to learn or grow is the foot-path away from victim-ville.  Could we even say that being a victim is “arrogant?”  We – Me, my patient Bella, you – have we taken steps to tell our story, to be present, to live with the humility it takes to look at ourselves and not escape/fly-away?

Whatever it is you are going through, it might help to vent it!  Grow and learn and get bigger than that experience.

Self-Care Tip #94 – Get in your own space to choose freedom from self-pity.  Be a friend to Yourself.

Question:  What barriers have you felt to telling your story?  What has made it difficult to be in the space of your own feelings?  Please tell us.

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Afraid of Meds

A colleague told me,

I want to get off my sleep meds because I don’t want to be dependent on anything.

Dependence.  Lazy, pass-the-buck, unimaginative, immoral, chemical abuser.  Maybe even doctor-shopper depending on who is speaking.  When someone says it, before we talk about medication use, biology, etc… we need to know what is behind that word.  Working with the tip of an iceberg of prejudice might sink us before navigating much treatment.  Even physicians after 25+ years of education and more of medical practice, find it hard to shed these cultural prejudices about psychotropics (medications used in psychiatry).  What does the word dependence mean to you?

To psychiatrists, substance dependence means that the body has become accustomed to something.  We don’t get as much physical or emotional boost we used to using a substance, such as to nicotine, alcohol, illicit drugs, or prescription medications.  We now need more to get the same effect we would have gotten before with less amount.  It includes physical and emotional cravings – like sweating, shaking and yearning.  A lot of time is spent to do whatever it takes to get it.  Can’t cut back.  Keep doing it even though spilling into personal and professional space.  Keep using even though aware body and mind are worse for it.

Was this a description of my “dependent” colleague?

How about abuse?  Substance abuse is when we do dangerous, mean, and/or irresponsible things when using.  Was he hitting his wife when he was under the influence of a sleep medication?  Was he taking sleep medications when he was at work because he liked how they made him feel?  Driving with them?  You get it.

This guy is no dummy.  Yet he felt guilt and shame about appropriately using a medication for a medical reason.

I was seeing a woman for the first time in my clinic.

“Doctor is this medication going to make me addicted?”

We spoke about her fears.  Turns out, she thought her medication would prejudice the world against her.  Change her personality.  Make her crave it if she ever wanted to stop.  Steal from her geriatric mother and eventually, who knows?  Panhandling?  Now how am I supposed to work with that?  How she ever got the courage to come and see me in the first place with all that on her back, must be pure grit.

So here’s the dirt.  Some medications have no dependency risks.  Some medications do.  Some people abuse any medication they can get their hands on.  There are rave parties where there is a kitty – a bowl full of whatever pills anyone in attendance donates to.  They take them out randomly and swallow to get whatever surprise awaits them.  Is one class of medication more often abused than another?  Yes.

As a prescribing physician, I have sworn to not intentionally do any harm.  As a patient, you contract with me to take your medications as prescribed and safely. We’re in this together.  We will talk about any recommendations and you will hear the risks and benefits to treatment.  You will decide.  There is no conspiracy to turn Americans into bad citizens through psychotropics.

Self Care Tip #52 – Find out where your fear is coming from.  Be a friend to yourself.

Question:  What are your fears about psychotropics?  Agree or disagree with this post?

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Mother’s and Sleep
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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.

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