Are you struggling to sleep? Or are you sleeping too much? Our mental health can affect our sleeps in all kinds of ways, Kate Lucey, author of Get a Grip, Love can attest to that. Read on for an extract from the book, about the science behind why our mental health might be buggering up our sleep.
There was a time when I would sleep straight through a day if I could. I would nap after work. Constantly at the weekends, and go to bed early so I could quickly absolve myself to darkness. But then that gift of oblivion left, and sleep – or the lack of it – turned into something I then feared. Sleep didn’t come. When it did come, it didn’t last. When it broke I would wake slick with cold sweat and gripped by a thick elastic band of searing pain around my jaw and skull after relentlessly grinding my teeth. Sleep wouldn’t come back. Even as I lay in bed, eyes closed and utterly exhausted, sleep eluded me.
‘Have you tried using lamps and relaxing for a while before you try and go to sleep?’
Is a real question that a doctor asked me. Omg! A lamp! You mean I shouldn’t be running around a floodlit room and shining torches directly into my eyes and wondering why I’m not switching off? NO SHIT, SHERLOCK. The same doctor told me to look into ‘sleep hygiene’, which – spoiler alert – is a twee term for ‘common fucking sense’.
Who are these people sitting bolt upright in a room full of LED disco lights, scrolling through a beaming feed of access to all the world’s knowledge in their palm, with the TV blaring death metal in the background while they’re necking a pint of Red Bull, claiming that ‘they just can’t get to sleep!’. Actually, there are loads of these people who are doing the rest of us actual sleep-deprived insomniac wasters a disservice by claiming lack of sleep when they’re realistically doing nothing to encourage it.
Depression and sleep have a very Ross and Rachel style of relationship. Being depressed can make you need to sleep for seventeen hours a day and make you unable to pull your lead-like limbs out of bed for an entire (not so fragrant) week. Being depressed can also leave you lying wide awake at night while the rest of the country snores, and you’re unable to get a wink of rest and your eyes are burning and your heart is racing and your gut is hollow and aching.
How can one illness have two such contradictory effects? I spoke to a psychiatry registrar, Dr Ken Adams* who told me that sleep and depression have pretty interesting links:
‘Many people with depression also have anxiety, and the negative cognitive biases that come with depression (negative thoughts about the self, the world and the future) lend themselves easily to rumination – an anxiety presentation.
‘Needing to sleep for days will come from a lack of energy, which is one of the core symptoms of depression. There may, I suspect, also be links to dysregulation in the hypothalamic-pituitary-adrenal axis.’
Um, sorry, what?
Sure, we’re all familiar with our hippocampus and its judging panel making ‘executive decisions’ for us, and how the depression demons just big fat swoop on in there and cause everything to shut down. But now, brain fans, we’re onto a different part of our grey matter: the hypothalamus.
The hypothalamus is positioned towards the base of our brain and about the size of a 5p coin. Although teeny, it’s super-important. Maybe a bit like Napoleon, or Kylie Minogue. The hypothalaminogue is essentially the teensy traffic controller, helping to regulate hormone release from our pituitary gland and generally quite interested in emotions, body temperature, appetite, sexual behaviour, and the wily minx of sleep.
Serotonin helps regulate our sleep, and seeing as you’re reading this joyful book of unbridled bliss, I’m gonna hazard a guess that your serotonin levels could also do with a re-stock, so I’ll just move quickly on from that. Thanks, hypothalaminogue, for holding back on the good stuff.
Research has suggested that people with depression have a hypothalamus up to 5 per cent larger than people without, and that the severity of the depression can even directly correlate to the size of the hypothalamus. [30]
I went through a time of waking up at 3.42 a.m. every single night for what seemed like a year but was probably a couple of months. It was bizarre, like some kind of tragic, sad alarm clock injecting my chest with gas clouds of despair that woke me up as they billowed around the rest of my body, spreading a palpably painful toxicity through my veins. I would wake up with physical pain in my chest and a tyre-sized rock in my stomach, and lay awake crying silent, hot tears for hours.
I went through another time of having to call in sick to work because, well, it was 11.30 a.m. and I wasn’t at work yet because I’d gone back to sleep. Not hungover, not with the flu, I went back to sleep and stayed asleep for the next eighteen hours. This happened every day for a week. Then we’re in some kind of blame-game again: do you sleep or wake because you’re depressed, or are you depressed because your sleep is so messed up that your mind can’t handle it any longer? Is it even possible to have a sleep disorder without being depressed? Is it possible to be depressed without your sleep being affected?
Perhaps more immediately pressing; how do you get to sleep when you’re finding it impossible? Of course, different things will work for everybody and I’m not going to insult you with basic top tips like ‘get to bed and read before you sleep’ or ‘no caffeine after 4 p.m.’, but here are some other potential solutions I’ve gleaned from others:
• Listen to Stephen Fry narrating Harry Potter, even if you don’t care for it.
• Recount all the exact things you did in the day and try to think of exactly what they were to the tiniest detail. Your mind will get bored and shut off.
• Concentrate on breathing and breathe all the way in for five seconds, and then all the way out for five seconds. Keep doing this until you sleep.
• Harry Styles on the Calm app (this sounds like it would keep me quite awake tbqh but at least you might get a saucy dream out of it if you do nod off).
• An audiobook of something you’ve already read, so you’re not engaged but are relaxed instead.
• Listen to the soybean forecast. It’s an actual thing and dull as hell.
