I'm working on a new insomnia drug. I mean, I'm not working on the drug itself, but I'm working on the promotional launch campaign. We'll premiere the TV commercial sometimes next year - probably in June. That seems like a long time away, but with all these meetings and having to prepare the pre-production materials for approval and then to enlist vendor-partners to produce the campaign, it will keep us occupied. At any rate, this has given me an opportunity to think more about stress and depression and how that is intertwined with sleep issues, and also learn and reflect a bit on brain chemistry.
There are a number of types of over, behind and under the counter medications that people use to help themselves fall asleep. Many of them have a broadly sedating effect and just help us relax. But this new medication - if you're going to believe the press - precisely targets the wake signals in your brain that are keeping you awake, so that you can fall asleep more easily and naturally and one's natural sleep architecture isn't disrupted. This is a departure from old-school medications, which basically just knock you out and leave you feeling like you need something stronger than a cup of coffee to get up the next day. (See the Judy Garland story for reference.)
I mean, seriously what class of drugs - besides painkillers - has a worse track record than those we take to help us sleep? Ever since the cavemen first looked up at the stars and said, "I wonder if there's any one out there ... who also can't sleep ..." people having been grabbing plants, drinks and pills to help them doze off. Alcohol, weed, Valium, and lately of course the craze for Ambien, with it's stories of creepy sleepwalking etc. So while I'm a pretty holistic medicine kinda guy, and I do believe that most health issues can be addressed by less bad food and moving your body more, I do think that this new kind of more-dialed-in, safer, non-addictive, non-psychotropic type of sleep aid is a huge step in the right direction.
It remains to be seen if people will like taking it, and how they will react if they do not immediately feel "knocked out" - it's my instinct that people equate effectiveness with how a pill makes you feel -- in other words, if I can't feel it, is it working?
I've had the opportunity to watch the preferred messaging evolve over the last year or so. My gut instinct is that people will feel better about having Insomnia, if treat it like a condition and sort of let them off the hook in terms of personal responsibility. "You have insomnia. It's a condition. It's not your fault - it's part of your neurological makeup. What you need is something to calm down, suppress your wake signals, and then you'll be fine."
The more traditional way to approach this of course, is that I can't sleep because I'm worried about ______________ fill in the blank. Kids. Money. She looked at me, what he said that night. Losing my job, not getting the job. Etc.
There are of course myriad other tools to deal with sleeplessness. Cognitive Behavior Therapy is of course the first recommend, but the last one people turn to. After they've had the warm milk and lavender and turned off the blue light, etc etc.
Without passing judgment for a moment, let's look at some analogs.
Alcoholism, for instance. Drinking too much was of course seen as a weakness of will, but was given disease status at some point. It certainly kills a lot of people and the addict/alcoholic body and brain has been scientifically proven to be different than your average temperate drinker.
How about depression? People that are long term depressives don't have the same seratonin, dopamine and norepinephrine levels that are usually dished out to humans. And then of course these conditions, all of them, can be co-morbid and intertwined so maybe one causes or exacerbates another, or on the other hand, maybe you treat the alcoholism and the depression and insomnia goes away. Or, once you're able to sleep, the depression and compulsive drug use go away.
So last night I was talking to a close family member and they shared how they been prescribed sertraline hydrochloride, a generic form of Zoloft, because of general anxiety associated with an overfull life, and body chemistry changes due to midlife changes. You can really tell the difference since she's been working again with a therapist - they sound much less dark and overwhelmed. In her words, I can't run, or meditate this away.
One of my kids is dealing with some of the same issues right now. They've had two visits recently to the ER because of anxiety attacks.
And we all share the same DNA, body chemistry, which has made me shall we say, ponder these things afresh.
I'll share some of my experience.
Two years ago, I was deep down a dark well with no idea how to climb out - and no real urge to, honestly.
Trotting out the pseudo-diognosting language, here: Suicidal ideation, depression, anxiety and to be more human about it, just deep self-loathing and general world-weariness to the point of not giving a rabid rodents ass. It got so bad that I was delusional - I think - in a mental and sensory way, and legitimately did not know real from imagined, or true from false. I was obsessed absolutely obsessed with visions of monks on fire. I constantly imagined dousing myself with gasoline and lighting a match. Another dominant image was simply opening up a vein and bleeding out. As my blood left me I could feel all the anxiety and pressure leaving too; it was so relaxing like slipping into a bath. I would audibly "ahhh ..." with the thought. At other times, I had the near constant sensation of knives plunging into me, over and over again. Quite literally my neurological skin had been ripped off. I started feeling other's people movements as if they were inside my own body and their moods as if they were my own. If I saw a street person smoking, I would feel their sickness and feel the smoke hurting my lungs. If someone sneezed or stood up rapidly or was physically manifesting craziness on the streets of Manhattan, or anger, impatience or physical discomfort in my home or at work, I felt that too. There was no separation between me and others. I could not protect myself. I did some searches online of articles, books and resources and discovered a condition called Mirror Touch Synesthesia. I asked long time meditators that I know if they had similar experiences. I reached out to the meditation center I attend and a person I really respect likened it to stigmata and told me that I needed to stop going deep and consolidate my practice. (As a side-note, this person never followed up - really crazy stuff, honestly. Hey, did you kill yourself? Stop having the crazy stuff happening? How's the wife and kids? Happy New Year! Don't forget to honor our founder's birthday with a generous, tax deductable gift) I honestly don't know if the meditation had anything to do with it, or if it was a combination of depression, new city, new job, body chemistry changing as I aged, plus sensitivity from years of (half-assed) meditation practice. etc. Maybe all of it. At any rate, as I pushed through this period, I came to identify closer with what people traditionally call an empath. My general understanding is that we all have mirror neurons, for one reason or another, mine are at times, more sensitive. Along with the sound sensitivity thing, and my lack of linearity // whatever. I'm different. Every one's different. That's what makes us the same.
At any rate, I had no idea what was going on. It was like someone else had taken over my body. The phrase "losing your mind" is so commonplace, that we don't consider it's actual meaning as a phrase or root significance, but that's exactly what it felt like - my mind, which is my tool I work with, my buddy, the?"Me" who I have conversations with and observe the world around and read books and bat around ideas, etc etc my mind had broken its leash or whatever tethers it to reality and taken off and I had no idea where to look.
Along with a mind that simply wouldn't behave and kept seeing and saying things that could be true or maybe not or distorted or who knows, I had physical sensations that were out of control - extreme off-the-charts sound sensitivity (misophonia), nausea when confront with sick street-people, uptight people at work, an understandable upset wife, teenagers; I became two separate people inside, each with complete and inclusive non-intersecting belief systems. Both made sense. One was dark and the other, I guess the "True Me" richer and more variegated in feeling, more open, fun, positive and healthy. And I would toggle without warning between the two. It was literally like being the Hulk, excepted without super strength or really any redeeming qualities as tall. I could remember what one did, but each did not seem real to the other. What I mean by that, is that when I was "Dark" I couldn't ever imagine being Light again, and if I was Light, I couldn't ever imagine going down again. "That will never happen." "I'm fine now."
And then something would set me off and I would be the Other.
I was seeing a therapist - which is a whole 'nother ball of wax, and tough on it's own, because I can't sit in proximity with someone for any length of time without "reading" them and becoming them at some point.
At any rate, this therapist sent me to a Dr. - someone I believe is a very accomplished Columbia educated Clinical Psychologist. And after patiently listening to me for an hour and a half tell her honestly what I was thinking in a pleasantly clinical Q & A format, she recommended that I check myself into an in-patient facility and go on Lithium. I shouldn't have been shocked but I was. Maybe it was dark me that had talked for 90 minutes or whatever, two sessions worth, and then Light me said "Wha?" I think I said something like, "That sounds like a pretty severe diagnosis for someone who's having a bad day, and or just hates their job." And I walked out there and said I'd think about it.
She called my therapist. She called my wife. They got the big warning. Odds were I wasn't going to make it. People like me never get better without help. Over time, they get worse.
[There's fucking construction noise going on outside; feel like my skull is being sawed into.]
And I saw my future stretched out in front of me like a huge U curve. I would take the required time off from work, they are legally obligated to not tell my job what condition I was suffering from but there would be gossip., I would go into treatment, talk to other people in group therapy, have my feelings evened out by a drug that takes the edges off, I would them come back to work, put the pieces of my life back together; put on weight, be eternally under the microscope of clinicians, doctors and therapists. They would share responsibility for my well-being. I would no longer be on my own. I would have help. A lot of it. As much as middle class success could buy. In other words, I would complete the project I'd embarked upon. I would have my nervous breakdown, fully and clinically complete, and but I would not kill myself but I would come back. And then I had a moment of clarity - what if I just cut across the U and just went straight to now. What if I took killing myself off the table. The goal was to be at work, not on drugs and functioning. Maybe I could just pretend to be normal - and in the meantime, utilize more tools - and so I dug into finding new ways to be of service. Attempted to pretend to believe in a purpose for myself and life. Made new friends and reconnected with the ones I already had. Leaned into the mediition. Accepted the existence of my dark side and just stopped stopped trying to reason with it, analyze it, figure it out, get down to causes and conditions, understand the why. I stopped trying to placate it, or even listen to it. I put it back in it's box and went about my business. And slowly ever so slowly I walked out of the woods. Nothing has been more real in my life than this internal battle.
As I walked I realized that there were things I liked about being crazy that I had become so used to that I didn't really even note them as extraordinary. One, was that when I started swinging out of the darkness and back into the light, it was a fucking rush. It was like doing drugs and I liked it. Secondly, my sex drive was obsessive and off the charts. Basically, my body chemistry was just super wacked, and like a good little drug addict, I was protecting the high. It was thrilling actually, and much like accounts of mystical experiences I've heard and read. I would feel myself become hollow or diaphanous and the wind of existence blew through me; I ceased being me and would transcendently blend with nature and all people and feel a sense of ecstatic Oneness.
So I walked away from that BS too. The lows were in no way worth the meager rewards of the highs.
In a way, I'm really lucky that the pandemic hit - it allowed me to be isolated and heal and not be triggers by reading people or overwhelmed by irritating noises I can't control - which, I know it sounds silly, but trust me, that was a big part of it.
In addition, I discovered yoga. Along with a proper diet, my body chemistry has evened out and I'm not bushwacked or overwhelmed by dark thoughts or the other personality as much. Mornings are still rough. I've studied and earned an advanced degree in manipulating my own body chemistry utilizing only coffee, cacao, water, ibufrofen, Meloxicam and food with it's various combinations of nutrients. Protein, sugar, and carbs are seemingly the main mood drivers.
I no longer wish to be "psychic" in any way. To be clear, I've never felt like I could read people's minds. Rather, I can't protect myself from their moods and physical presentation. But it's not a special thing. It's hell.
I no longer wish for sweeping "spiritual experiences" -- you can keep it, friend. I just want to be even-Steven.
And I do still wonder though -- if a less extreme medical answer had been offered, or if maybe I had appropriately reached out at the beginning, had a better support system, and caught my condition at an early stage -- I could have saved myself and more importantly a lot of other people a lot of suffering and trouble. At this point, I've given up grandiose ideas of being or doing good, really. I just want to do no harm - to myself or others. Be a good father, husband, colleague, employee and most of all be a good friend.
On the one hand I could say damn, whew! Glad that's over. On the other side, the depressing side, (and I try not to go there) a sad little dark voice says "Yeah, you're better now but look at you, you old fuck, you threw your fucking life away. You've hurt yourself and so many with your stubbornness and inability to ask for help - your inability to communicated anything of depth, and never hardly any strong feeling at all without anger.
This is the Llewyn Davis moment, right.
Not to be defensive, but I will say in summary: In the same way that there are some people who never get over their alcoholism, they don't like meetings, they can't get the spiritual shit, it just doesn't work for them, there are certain ways that I relate to myself and the world and the people in it that make me, shal we say "resistant to treatment" by either therapy and drugs.
1) Therapy. As mentioned, any significant time I spend with anyone, over time, becomes about them, and not me. I'm a sponge, a chameleon and in a weird way for someone who seemingly has such a strong personality, I do not have strong or stable sense of self. I am my environment.
2) Medication. Everything has side effects. I'm very body aware and I know how my body feels right now and I know how to deal with it. It's familiar. Oh, and for a 56 year old man, I'm really quite vain. I don't want to take anything that makes me less sharp, makes me put on weight, makes my mouth dry, backfires and makes me even more depressed, keeps me up at night, makes me sleep during the day. And so on. Don't like side-effects. And, in addition to that, it's a genuine effing possibility that maybe, just perhaps, I'm conjecturing here people, but just MAYBE being a fucking moody edgy depressive is so much a part of this mind/body mechanism that others call Max, that I don't want to give that up. Like an old jacket, it's my fucking jacket, holes and all. And I'll wear it anywhere, anyhow I want. I like me and get off on me. I've put a lot into this jacket and maybe it's not what's exactly appropriate to wear circa 2021 but I say, you know what? I've got a sense that at the bottom of it all, the problem isn't me. The reason my sibling is anxious, the reason my daughter can't sleep, the reason I'm a crazy aging ex-drug addict manic depressive isn't because there's something wrong with me - there's something wrong with the world. People should be allowed to be who they are. It's society that needs to change, not my brain.
As an addendum, how do I deal with insomnia? I listen to tapes of my meditation teacher. Eknath Easwaran might be the most well-documented mystic of modern times, in terms of audio and video tapes of his talks. Because he speaks from such a deep place, his words and sheer presence has a soporific effect. I'm not unaware of the humor of this, and for the heretical nature that this observation might engender among the dwindling true believers. But in my case, I choose to see it as a positive. At night I listen to Eknath Easwaran -- or EE as we affectionately refer to him. If I'm awake, then I'm taking in wisdom and nourishment for the soul. If I fall asleep, it's with the voice and words of an illumined man in my ears. On nights when I'm up alot, Easwaran voice, words, my mantram and the words of the inspired passages that I use in meditation are my constant companions. And most of the time, nowadays, the dumb things that happen at work don't have a chance.