Depression Squared: A Land of Nod
Sleep is both friend and foe in the world of Depression. As with eating, a core fundamental of daily life becomes a battleground turned upside down and inside out by this invisible but insidious disease.
I remember clearly the months of waking at 4.30am, knowing that further sleep would be impossible. It is so lonely to be awake when everyone normal is asleep, looking across at all the darkened windows. And it is so exhausting to live a day that lasts for so long, day, after day, after day.
Someone advised me to use the time, rather than tossing and turning. So I used to sit with my coffee, sipping slowly, to do the half hour of yoga to set myself up for the day even at that unfeasibly early hour, and to take the dog out for an hour long walk, all to reach the point at which lights were starting to come on in other homes and I could justify starting my day.
Those days ended when heavy-duty sleeping tablets entered my life, complete with antidepressants whose side effects included making you tired. Most gloriously, I could know that within half an hour of taking pills I would fall into a deep, deep sleep which would carry me through to a morning alarm, without interruptions. Of course, the treatment left me feeling tired all day, but it at least eradicated those endless hours of early waking.
When there is not a lot to be awake for, it can be easiest to retreat to bed. I have lived in bed for many days over these last two years. They lacked the soothing comfort of regular duvet or pyjama days, when you choose to duck out of work and commitments, and to stay put. They were more days when I simply could not drag myself out of bed to go through the normal tasks of a normal adult day.
But bed is undoubtedly a place of refuge that I seek out to comfort me on difficult days or to soak up the sheer exhaustion of getting by. Dressed or undressed, with a hot water bottle and a podcast, there is no better place to stay out of trouble through a too long day. Being in bed you can at least feel invisible. You can shut out the world and its responsibilities, dive under the covers, and hide. These are not days to reinvigorate you, but — almost as good in the circumstances — a time to pass the time without any pressure beyond the knowledge that you should be doing something else.
I have never been able to pull off the trick of sleeping for the majority of twenty-four hours, though I have often wished I could. In hospital there were people who despite physically being taken out of their beds to allow rooms to be cleaned, still managed to snooze even in an uncomfortable plastic chair for those hours they couldn’t be horizontal.
Excess sleeping is as much a symptom of Depression as too little sleep. I have gone from one extreme to the other. Having had months at the start of sleeping perhaps five restless hours a night, the medication I receive now leaves me sleeping from early evening to get my ten hours a night. To top it up I often still need a long afternoon nap too. It leaves little time to be alive and to do other things — both negative and positive.
I have still from time to time walked the corridors at night, mainly when individual medications have been changed. When I do, I find myself cohabiting with those loneliest of the lonely, who sleep all day to wake only when everyone else sleeps. Some — like one of my room mates — find company online. Others, like me on the nights when insomnia has hit me, drift from one place to another, from one activity to another, as they follow the advice not to go looking for sleep but to let it find you. In the course of doing so, I need to admit to having watched hour after hour of interminably long series requiring minimal attention that I missed first time around, allowing me finally to seem well-watched.
Being unable to sleep — whether in the afternoon or the evening — feels like the biggest punishment of all. Bone-weary and yet sleepless, forced to stack up the tiredness, is a regular experience for which there seems no trusted solution. I can be active, and so tired I don’t really know what I’m doing. Or lie still, buried in bed, working through sleeping techniques one by one, yet ending up feeling more awake than ever.
When it works, we take sleep for granted — we only comment on having a good night’s sleep when we generally don’t. We assume that sleep will keep to its place and not overspill to our busy days. We assume that when we lie down for the night we will awake however early we have to set the alarm feeling refreshed.
Depression turns that upside down, snatching away assumptions, dominating one way or another the sleeping process. It refuses to sit inside a health-giving box, and instead it forces its colour on all hours of the day and night. We can only try to manage Sleep, with or without drugs, as best we can: To accept the dominance of Depression over it, and to trust that in time we can be friends again.
