Sleep Disorders Answers

How can i relief my sleep disorder?

Dear I don't know where I am,   Thank you for your message and I understanding that you are having difficulties falling / staying asleep because of anxiety. Meanwhile this is a very common condition for those of us who are struggling with anxiety, you're definitely not alone.   In fact, if you are anxious all the time or suffer from an anxiety condition, chances are you don't find it very easy to fall asleep. Relaxing your mind at the end of a full day is challenging at the best of times, but when you also have anxiety to contend with, you may find yourself physically and mentally challenged when trying to convince your body to sleep. Being anxious during the day is tiring, which makes it all the more important to make sure you don't have to deal with it at night when your body is trying to recover.    The time before you go to sleep is a difficult one for anxiety sufferers, as you have mentioned. This is because all the worries you have accumulated over the course of the day choose now to float through your mind. Being alone in a dark room doing nothing but lying there with your worries allows you no distractions from them, which often allow them to seem to grow bigger and bigger and spiral out of control.    For some people, this is caused by generalized anxiety due to events occurring throughout the day, while for others it is the result of an anxiety disorder. Similarly, it may simply be your thoughts and thought patterns that keep you awake, or it may be the physical symptoms of an anxiety attack. Either way, difficulty getting to sleep can be uncomfortable, frustrating and occasionally frightening.   Anxiousness when you are trying to get to sleep causes both mental and physical struggles. Here are some descriptions of the types of problems encountered by anxiety sufferers trying to get to sleep, maybe you are experiencing some of them as well. Let's take a look.   Restlessness - You may find yourself tossing and turning as you try and get to sleep because your body refuses to relax, and must continue trying to find a comfortable position. This can make you sweaty and get you tangled in blankets or cause blankets to fall off, which can cause you to wake up from cold or not sleep as well if you do fall asleep due to discomfort. The discomfort keeping you awake will give you more of a chance to think the kinds of negative, anxious thoughts that can lead you to a panic attack.   Panic Attacks A panic attack before sleep will usually be characterized by sweating, a rapid heart rate, rapid breathing, and chest pain. These symptoms can be alarming because they mimic some of the symptoms of a heart attack, and may trigger the panicked belief that you are about to die (imagining that you are in physical danger or about to die is common during panic attacks). Panic attacks before sleep aren't as common as panic attacks during the day, but the reality of panic attacks is that they can occur at any time.   Nightmares - If you do manage to fall asleep after experiencing the above symptoms, you are far more likely to have nightmares. Nightmares can further disturb your sleep by waking you up, and if they are particularly bad, they may frighten you enough to keep you awake and cause you to have a panic attack.   Limited REM - All these effects add up to a very limited REM cycle. Most people get 80% non-REM and 20% REM sleep in a night. REM sleep only occurs after some non-REM sleep has taken place. Therefore, if it takes you a long time to get to sleep or you wake up soon after you do, you don't have as much time in the night to achieve that REM stage. Regular REM sleep is required to maintain a healthy mind and body.   Falling/Twitching - You may also find that you experience anxiety as a result of weird sensations you get while trying to fall asleep. Those with stress, for example, are more prone to this feeling as though their body is jolting them awake right before they're about to fall asleep. Scientists are not clear what causes this but know for a fact it's harmless. The belief is that your body thinks you're about to die, so it wakes you up. But since there's no danger, you get anxious from that feeling, thus increasing your nighttime anxiety and making it harder to fall asleep in the future.   So how do we minimize anxiety and maximize sleep?   To get to sleep more easily, you can try changing some of your pre-sleep habits to decrease your mental and physical stress levels. Habit-changing takes time and persistence, but if you stick to these changes, you will find yourself adapting and feeling less anxious overall in no time.   Time Travel This is a fancy way of saying that at least an hour before you want to get to bed, you should try to turn everything off and do something that engages more of your mind then, for example, gazing at your computer or the television screen. Dimming the lights helps alert your brain to the idea that it should be sleeping soon. Doing something casual that still forces your mind to engage, such as reading, drawing, or playing cards will help occupy your brain with something other than the worries of the day when it is time to lay down your head. Pictures on Instagram and funny scenes onscreen fade in comparison to real-life experiences, but the real-life experience of either winning or losing that hand at cards will stick more prominently in your mind and provide a longer-term distraction from your troubles.   Pick a Bedtime Deciding on a particular hour that you want to be in bed by will relax your body by providing it with a comforting, familiar routine to follow. It will also train your brain to get tired at a certain time of night, which will help you fall asleep sooner after you lay down to do so.   Keep a Journal Writing in a journal is another routine you can follow (and a good one to incorporate into your pre-bedtime time travel, as it doesn't involve any technology). Sometime before bed, jot down some thoughts about your day. If any worries or problems come up, be sure to write down possible solutions to accompany them. Once you do this, shut the book and imagine you are symbolically shutting away all the cares and thoughts from the day until you next want to open the journal and look at them.   Consciously Relax Your Body Once you are lying down in bed, try relaxing your body one piece at a time. You can start wherever your toes, for example, but relax each toe individually. Then move up to your ankles, your calves, your thighs, and so on. Make sure each part is thoroughly relaxed before moving on to the next. You may start to feel tingly and almost numb. This is good: it means your body is getting ready to sleep. Once you are completely relaxed, focus on breathing comfortably until you fall asleep.   Reserve Your Bed For Sleep Avoid doing non-bed-related things on your bed: for instance, texting, going online or doing homework. The more you reserve your bed for sleep, the more your mind will associate it with sleep, and the easier it will be to fall asleep on.   Get Up and Walk Around If you find that your anxiety is too strong, don't keep trying to sleep. Distract yourself for a while by cleaning the house or reading a book. Falling asleep when your anxiety is that strong is very difficult, so giving yourself a chance to relax may be beneficial.   White Noise Some type of white noise, calming music, or easy to ignore radio may also be helpful. Often these things can distract your senses, making it harder for you to focus on your anxious thoughts. Try something like talk radio, with a volume so low that you can only hear what they're saying if you try extremely hard. The noise and talking will make it much more difficult to focus on your anxious thoughts.   Avoiding the anxiety that keeps you from getting the sleep you need can be difficult, but following the above all-natural and healthy techniques may be all that you require taking back control over your sleep schedule. You can also start to make life changes that are specifically designed to help you cure your overall anxiety.    Also note that there are also a good number of meditation / guided-imagery exercises you can find on youtube, which can help us to fall asleep as well. I'd recommend that you try them for fun as well.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/21/2022

How to get rid of dreams?

Dear Kate,   Thank you for your message and sharing.   I understand how difficult it is to try stopping your thoughts regarding your dreams. I could imagine how hard you have been trying and how frustrating to feel that nothing is working.    We can't stop our thoughts, but the more we practice being mindful of the present, the better we can catch ourselves with our thoughts and develop an alternative response to them, and learn to let go.   During moments like this I remind myself the teachings regarding worries, it is consisted with a 2 part questions:   1. Is this problem within my control? If so, then this problem will be solved given time and the right intervention. 2. Would worrying about it make any difference? If not, then is it worth it to sacrifice our time and mental health worrying over something that (1. can't be solved anyway / 2. will be solved anyway)?   This is definitely easier said than done, therefore as a fellow human being, I am working with you to pay attention to what is good, what is kind rather than our worries.   Obsessive or consuming thoughts can make living miserable when you are plagued by them, but this very situation can become the invitation to transcend mind and be free of suffering forever.   Can you stop obsessive thoughts? - If you could, it would be great, but the truth is that it's slightly more complicated than just suppressing your thoughts which at-most you can do for a few seconds. Plus suppressing thoughts is even worse than enduring thoughts. It builds up a lot of negative energy inside.   So how to stop these stops thoughts? The secret to stopping these thoughts is to detach from the mind because You cannot fight mind with the mind. Let's look at this in more detail.   What Causes Obsessive Thoughts?   If you generated the thoughts, you could've controlled them too.   The truth is that you don't generate thoughts, the mind does. And the mind is on auto-mode most of the time.   You can see this for yourself; can you predict what you will think 30 seconds from now? If you can't how can you assume that you are generating the thoughts?   If you believe that you are your mind, that's a false notion again.   If you are your mind then how can you observe the thoughts? So you must be separate from the mind to see what the mind is doing.   The mind generates thoughts, which are mostly just energy forms. These thoughts pass through like clouds. We identify with some of these thoughts and obsess over them.   So in truth, all thoughts are just neutral energy forms; it's your interest or association with the thoughts that makes them obsessive. If you can understand this truth, you have taken the first step towards getting rid of obsessive thoughts.   How to Stop Obsessive Negative Thoughts?   If you are asking this question, ask yourself another question - "is this question not another thought? It's a thought about killing thoughts".   All your attempts at suppressing and stopping thoughts fail because you are using the mind to stop the mind. The police man and thief are both the mind; so how can the police man catch the thief?   So you cannot kill the mind by force. The mind dies its own death by the poison of disassociation.   What gives power to a thought? - Your interest. If you have no interest in a particular thought then it loses its hold over you.   You can try this out now. Let the thoughts flow through your mind but don't take interest in them. Just stay as a bystander or a watcher and let the thoughts float.   Initially you might have a hard time watching thoughts because of your inherent habit of associating with each thought that arises.   It helps to know that you are not your thoughts, that thoughts are just energy forms created in the mind. Why does the mind create thoughts? No one knows - it's just something it does, why bother. Do you ever ask why does the heart beat?   With a little practice you will get really good at watching thoughts and not involving yourself with them.   You will stop giving power to thoughts by not giving them your interest. Thoughts die immediately when they are deprived of this fuel of interest. If you don't associate with the thought or give power to the thought, it will wither away quickly.   What Are Thoughts?   Past events get stored as memories. Your mind conditioning and beliefs are also stored as memories. All this is unconscious storage; the mind does all this in auto mode.   Perceptions and interpretations are created in the mind based on its past "external" conditioning and also its natural conditioning (genetics). These interpretations, perceptions and judgments come up as thoughts in the mind, and they can be positive or negative depending on the mind's conditioning.   Thoughts are generated based on the past incidents/memories, future projections and interpretations on the present life situation. It's like a computer trying to predict or conjure up projection based on the data it has collected so far.   When thoughts are negative in nature (thoughts of worry, anxiety, stress, lack, resentment, guilt etc.) they produce resistance to the movement of your life, and this resistance is felt as suffering. Negative thoughts will always stand in resistance to the movement of your life, like blocks of stone in the midst of a swift current of water.   Life is a stream of pure positive energy and hence any negative thought will stand in opposition to it, causing friction which is felt as suffering in the body.   The thoughts in your mind gain power from your attention and interest. Your attention is the fuel for your mind. So when you give attention to consuming thoughts in the mind, you are unconsciously fueling it and thus attracting more momentum for these negative thoughts.   The momentum of negative thoughts in your mind will slow down, and ebb away, automatically when you stop feeding your attention to it. Stay as an open space of awareness without focusing your attention on the negative thoughts of the mind, and soon they will lose their momentum.   You can focus on the positive thoughts generated in the mind, and thus develop a positive momentum in your mind. Every time your mind produces some positive thoughts, e.g thoughts of love, joy, excitement, abundance, beauty, appreciation, passion, peace etc, focus on it, milk it, and give attention to it.   This will cause your mind to attract more positive thoughts and thus build a positive momentum.   Whenever the mind thinks negatively, don't give it attention or interest, this will cause the ebbing away of the momentum of negative thinking. It's really that simple. Once you understand the mechanics of how thoughts gain momentum in the mind, you will be in total control of your state of being.   The Practice of Watching the Mind   All you need to do to get rid of obsessive thoughts is to watch the mind without getting involved.   You will get really good at this with just a little practice. This practice, or "sadhana" as called in Hindu scriptures, is the root of awakening from the illusion of mind.   Without trying to understand this practice just implement it. The more you try to understand the more mind gets involved. Just watch the mind and you will soon see that you are not the mind at all.   That the mind is like a machine in your head that generates thoughts based on your attention/interest. Be free of your mind by depriving it of your interest. This is the only direct path of becoming free of the mind.   Please let me know if this is helpful, looking forward to talking with you more :) Jono
(MSW, LICSW, LMHC)
Answered on 01/21/2022

I have serious problems with nightmare. The wake me up every night . Very stressful. All night long.

Hi Jack.  I agree, nightmares are very stressful... and scary!  Especially if you have no idea why you are having them.  Do they repeat or have a theme?  Have you suffered or are you suffering from any kind of trauma?  Do you have any physical ailments?  Do you live/work in a stressful environment?  Do you live alone or have some sort of emotional support person?  Do you remember your nightmares when you wake up or just wake up feeling some kind of way?  I know this is a lot of questions, but every bit of information you can present will help in recovery.  I highly recommend keeping a dream journal.  Record everything you remember, even if it is just a feeling.  If you do not like to write, draw it.  Review your journal each week to figure out if there are any sort of patterns.  The hope is that at some point you will be able to figure out the underlying source of the nightmares.  Keeping a log about thoughts, emotions, behaviors, memories, and situations each day may help as well.  It could look like, "I am (place, environment, atmosphere, around people...).  I feel ... (physically and emotionally - IE: angry, sick to my stomach, heart beating fast...).  Because ... (the reason why) or I don't know why.  The same idea is behind it, recognizing themes, patterns, and triggers... and allowing yourself to analyze where all this is coming from in order to address the issues.  Getting the information out of your head and onto paper will allow your brain to make the headspace for new memories, experiences, and feelings.  If your mind is full of emotions, there is no room to think logically (the same is true for the opposite, if you are too logical, there is no room for emotion) and it will make you ill, both physically and mentally.  If you are going to bed with a lot on your mind, it will manifest in your subconscious and affect your conscious self.  It sounds like you would benefit from some trauma processing therapy, perhaps EMDR, art therapy, or cognitive processing therapy.  The trauma will not go away, but you can learn how to better manage symptoms.  Also, you should see a psychiatrist and tell them what is going on with you.  They may be able to prescribe some medication to lessen the nightmares.  Just remember that if you do decide to take the medication, you must do therapy as well.  Medication will not work by itself, nor is it meant to be used long term.  It is merely a tool to help you get through this time in therapy until you have learned the skills to manage symptoms on your own.  It is not quick or easy work, but it is really worth your time if you are serious about improving your mental health. I hope this helps or at least gives you some options to think about.  Best wishes on your therapeutic journey.  
(LCMHC, NCC, ATR-BC)
Answered on 01/21/2022

How to stop having these reoccuring dreams?

Hi,  I am so sorry you are having this terrifying experience with sleep paralysis and recurring dreams. There are many possibilities that may be triggering these such as previous or current traumatic events, hormonal fluctuations, sleep disturbances such as obstructive sleep apnea, or other sleep-wave cycle phenomena that would need to be ruled out by a neurologist who might recommend a sleep study.  In addition, medication, alcohol, or other substances can trigger this phenomenon.   One suggestion I have for you before seeking out assistance from a neurologist to rule out something medical would be to keep a dream journal and write down exactly what you remember, what you see, what you feel, and what you interpret in those experiences--no matter how bizarre it seems.  Our unconscious state processes information in order for us to make sense of our day-to-day experiences and sometimes even gives us answers and solutions to issues that we are struggling with on a conscious level.  We also are wired to be highly intuitive beings, so there may be concerns you are processing on an unconscious level that haven't made their way to the conscious.  This is where dream journaling can really come in handy.  If it is difficult to write or type following waking up from a dream, if you have a recorder nearby, such as your voice memos or camera on your phone, you could record yourself recalling the experience and the dream imagery. Give it a few days and go back and read or listen to what you have recorded.  See if anything matches up with what you may be processing or dealing with in your day-to-day life. I know sleep paralysis, nightmares, and vivid dreaming can all be overwhelming and concerning.  The good news is that our brains are designed to help us process what we struggle with processing on a conscious level so it does work for us when we simply can't. Unfortunately, it can come out in very terrifying ways. That being said, if you are unable to come to a resolution and this issue persists or worsens, I strongly suggest seeking an appointment with a neurologist specializing in sleep disorders as it may be beneficial to have a sleep study. Additionally, if you have a smartwatch, the app autosleep is a great way to track your sleep cycle to get an idea of what your sleep quality looks like. If you have had traumatic events in your life, you might also seek assistance from a qualified trauma professional to help you unpack and heal from memories that are tormenting you in your dream and waking state.   I wish you all the best!
(MA, LMFT)
Answered on 01/21/2022

How can I stay asleep?

Hi Dude,  Thank you for writing in and I'm sorry that your sleep quality has been poor.  I have a few questions, but I'll try to help as best as I can.  It would be helpful to know your age - because sleep can be impacted by hormonal issues (spikes or drops), also what kind of work you do, or what is your family dynamics like (sleep can be impacted by stress and anxiety due to work performance or familial relationships). I'd like to know how your nutrition is because we know that poor nutrition could impact sleep as well as any kind of vitamin or mineral deficiencies.  I'd also like to know if you can remember any interactions or events that occurred in June that would set something like this off.  I'd like to know how your sleep was like before June - what time did you go to bed, how long it took to go to sleep and how many hours did you feel you had sustained sleep and rest.  It sounds like you are able to get to sleep, you just can't stay asleep.  Sometimes this happens from racing brain (too much going on in your life and you may be feeling overwhelmed) or drinking or medicating before bed (it works for a few hours but then the effects wear off and you wake up).  I would also like to know when you went to visit the doctor, what kind of exams did they do or bloodwork and also did they give you a sleep aid to try like Lunesta or did they recommend an herbal supplement to help like Valerian Root or Melatonin.  Sometimes the CBD gummies work but for some people, it doesn't have any effect at all, or some need to play with the dosage.  If that's the route that seems to work and you want something more sustainable, you might want to look into http://drbrownscbd.com  They have a love of information and have staff available 24/7 to talk to you about your specific needs.  It's fairly comprehensive.  I would also want you to look into the concept of sleep hygiene.  It's for people that are having trouble going to sleep or staying asleep.  It covers things like making sure that you don't use any electronics while you're in bed due to the white screen stimulating your brain, trying to watch tv, read, listen to music as a relaxation tool before bed, not drinking alcohol, not eating processed sugars (particularly before bed due to the sugar spikes), not eating anything past 8 at night (sometimes digestion can keep us up), the white noise machine you mentioned and mindful breathing and meditation.  You can pretty much google sleep hygiene and come up with a variety of protocols that might work for you.  Oh and they also recommend regular exercise, but not doing exercise at night.  I know I gave you a lot of questions and a lot of ideas to reflect on.  I hope you find something helpful in all of this.  Good luck . Diana
(LPC, FT)
Answered on 01/21/2022

Can counselling help my sleep issue?

Dear CM,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions, affecting your sleep.   As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress / depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result we would do everything we can to avoid / fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight / avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/21/2022

How can I get a better nights sleep?

Hi! I've worked successfully with many clients with sleep issues. When your mind won't let you sleep, it is having issues with too many brain waves stuck in beta frequency. The science of brainwave entrainment overcomes the beta wave pattern and gently downshifts your brainwaves towards calm (alpha waves) and eventually sleep waves (delta waves). Much of this technology available on music and video platforms is watered down and/or not high quality. I have my own specialty wave generator that I can customize to your needs at no extra cost as your therapist. It has been robustly successful for me and my clientele and has a mountain of research mostly supporting it's effectiveness. The presence of anxiety, worry, panic and life events tend to keep the brain in beta waves and in fight or flight or freeze and since this is mostly regulated by the autonomic nervous system which places you automatically into sympathetic response which makes any length of healthy and sustained sleep impossible. The goal is to activate the parasympathetic mechanism by reducing your stressors, having a consistent exercise program, maintaining a proper diet, receiving a regular massage, and/or adopting a lasting practice like yoga and/or meditation, all of which can help sleeping problems and disorders. Without adequate sleep, you descend into sleep deprivation, a state in which your ability to see your issues and deal with life events is severely impaired as is sound judgment and decision-making. Your cells perform a variety of functions while your mind sleeps that are essential to good health and overall body rejuvenation that if not functioning properly, usually begins a cascade and onset of more stressors in your outer world due to the compromised nature of your coping skills and reactivity, judgment, decision-making and many other abilities.  For many people, it is hard to overcome their stressors and the like through more conventional methods, which is why I advocate the use of high quality and effective brainwave entrainment utilizing Binaural beats and Isochronic beats set to nature sounds. My custom program can also use white or pink noise if you prefer.
(LPCS)
Answered on 01/21/2022

What can be done if anxiety doesn't let you sleep?

In your case the best way to overcome and deal with this bout of sleep deprivation or disorder you are struggling with is by treating the problem at the exact moments in which it is happening; those hours you lie in bed wondering. You can do this by using one or both parts of this activity I will outline for you to follow on the way to achieving better sleeping habits and longer sleep time. The first part of this activity or treatment approach is physical; please remember, do not attempt any physical activity or exercise unless you are cleared by your medical doctor or a licensed physician to do so and also to stretch and warm-up properly prior to starting any physical routine, and the second part is one or a series of mental exercise. The key to achieving success while using this method is by staying focused on the routine and not allowing your mind to wonder aimlessly about while attempting to fall asleep. You must be willing to invest the time and effort needed and not just try it one time then say it does not or won't work for you as your dedication and commitment to the process are also very intricate in making this work now and overtime. So let us begin your journey to falling asleep faster, sleeping longer and waking up more refresh and alert. When you are ready to go to bed begin by doing a physical activity you are comfortable with until becoming exhausted without overexerting yourself. Aim for at least three repetitions then lie down, inhale and exhale slowly in and out for about three seconds each breath until you begin to breathe naturally. Follow this by doing one or a series of the mental exercise; any of these can be counting from one to a hundred, reciting a poem or quote, narrating a story; fictional or otherwise, or reliving a specific pleasurable moment. Don't worry about time as you will eventually fall asleep just continue until you get the urge to begin again from step one. Please don't forget that I recommend you skip the physical activity part if you're not fit enough, recovering from injuries or medically cleared to do so. Practice this repeatedly until you begin to fall asleep without effort.
(DSW, LCSW, ACSW)
Answered on 01/21/2022

How do I deal with anxiety and insomnia ?

Dear Introvert,  I am so sorry to hear that you're struggling with the fear of dying. It is not uncommon to meet people who are afraid to go to sleep to never wake up. Were you ever diagnosed with sleep apnea? I have met several clients who have had a similar fear. They would have suffocation dreams. When they did a sleep study, they found that they had severe sleep apnea. I would recommend that you obtain a referral to have a sleep study done. It might provide you a lot of insight. I would refer you to a medical doctor to have a full check up and obtain a referral to a ear nose and  throat specialist to rule it out. I would also discuss having a sleep study done in a sleep clinic rather than at home because they tend to be more accurate. When you sleep, if your nasal pathways are obstructed and you experience loss of oxygenation, it will impact your health tremendously. Poor sleep is often associated to high level of cortisol and weight gain. If you experience apneas, your will become anxious as it will prevent you from experiencing sound sleep. You might end up feeling irritable and depressed too as a consequence.  Do you ever nod off during the day? Do you feel tired ?  Eating right, exercising will help. You mentioned that you had a severe illness a few years back. Are you still being followed for it? Was this illness a chronic illness?  It's not unusual for people who have had severe illnesses, to experience trauma associated with dying. Especially at a time where you felt that you might die, and had to reflect upon your mortality. You most likely felt powerless. Finally, I also recommend talk therapy to support you in processing your anxiety and help you learn coping and self-soothing skills to assist you in self-regulating. I would advise you to have a sleep routine to increase your sleep regularity and establish a sense of safety. Mindfulness is also very helpful in being in the moment and lessening anxious feelings.  I wish you a good and sound night of restful sleep.     
Answered on 01/21/2022

How can I better motivated myself and get a better sleeping pattern?

Dear Dec,   Thank you for your message and sharing with me how you've been interacting with yourself, especially on how you've been handling unpleasant feelings and emotions that affects your sleep. As you said this has also affected your life significantly. Perhaps by addressing how to handle unpleasant emotions in a healthier manner, we can dive into addressing the issues in your life as well?   Often the experience we've had about anxiety (or any strong emotion such as stress/depression) was so terrible (even physically) that our body sort of become traumatized to it. We naturally become nervous about these unpleasant feelings because we don't like these sensations and experiences. As a result, we would do everything we can to avoid/fight these anxious feelings, often using numbing techniques such as using substances or distracting ourselves. Yet only to find that the anxiety gets stronger over time because we have never been able to make peace with it.   Therefore rather than trying to "change" / "fight" / "get rid of" these unpleasant sensations, perhaps the best thing that we can do is to make room for these feelings and even sensations, while staying on track to do what brings us meaning and fulfillment. Floating without judging / blaming ourselves through the anxiety experience, while focusing on making room for anxiety can be helpful.   Here is a short video put up by the author of the book "The Happiness Trap" which does a good job explaining this concept:   Please take some time to watch this and share your thoughts later :) I also highly recommend picking that book as well to supplement this therapy process.   https://www.youtube.com/watch?v=rCp1l16GCXI    We as human beings do not like sufferings, therefore often times we would be doing our best to fight it. However just like the analogy of swimming vs floating that we have talked about before, the more we fight it, the faster we sink. While if we can learn to float with these waves, we will realize that we won't sink.   Radical acceptance / Expansion is about accepting of life on life's terms and not resisting what you cannot or choose not to change. Radical Acceptance is about saying yes to life and all that life brings (including all sorts of emotions such as joy, sadness, peace, and pain), just as it is without forcing our ways into our lives.   Why do we want to accept life as it is? Because with anything that we do in life that brings us meaning and fulfillment, it always accompany a wide range of emotions, we can't possibly just choose the ones that we like and fight/avoid those that we don't like. Learning to experience all emotions as they are, is a sign that we are living our lives to the fullest.   To do so we must learn to accept (and make room for) any unpleasant sensations, feelings, or thoughts that we experience.   We don't want to fight it because the more we fight, the stronger they will come back.   We don't want to avoid it either because the more we avoid, the more we'll be afraid of it.   So the key here is to make room for these sensations, feelings and thoughts, while continue to do what brings us meaning and fulfillment in life.    Learning to "co-exist" with these feelings will naturally reduce the intensity of them.   Floating, is a form of learning to accept these feelings and make room for it.   Let me give you some practical guidelines on what I mean by accepting these feelings and make room for it.   You can look up "expansion technique" under Acceptance and Commitment Therapy (ACT) for more information as well.   How to accept our emotions (and make room for them):   1. OBSERVE. Bring awareness to the feelings in your body.   2. BREATHE. Take a few deep breaths. Breathe into and around them.   3. EXPAND. Make room for these feelings. Create some space for them.   4. ALLOW. Allow them to be there. Make peace with them   Some people find it helpful to silently say to themselves, 'I don't like this feeling, but I have room for it,' or 'It's unpleasant, but I can accept it.'   • When you're feeling an unpleasant emotion, the first step is to take a few slow, deep breaths, and quickly scan your body from head to toe.   • You will probably notice several uncomfortable sensations. Look for the strongest sensation - the one that bothers you the most. For example, it may be a lump in your throat, or a knot in your stomach, or an ache in your chest.   • Focus your attention on that sensation. Observe it curiously, as if you are a friendly scientist, discovering some interesting new phenomenon.   • Observe the sensation carefully. Notice where it starts and where it ends. Learn as much about it as you can. If you had to draw a line around the sensation, what would the outline look like? Is it on the surface of the body, or inside you, or both? How far inside you does it go? Where is the sensation most intense? Where is it weakest? How is it different in the center than around the edges? Is there any pulsation, or vibration within it? Is it light or heavy? Moving or still? What is its temperature?   • Take a few more deep breaths, and let go of the struggle with that sensation. Breathe into it. Imagine your breath flowing in and around it.   • Make room for it. Loosen up around it. Allow it to be there. You don't have to like it or want it. Simply let it be.   • The idea is to observe the sensation - not to think about it. So when your mind starts commenting on what's happening, just say 'Thanks, mind!' and come back to observing.   • You may find this difficult. You may feel a strong urge to fight with it or push it away. If so, just acknowledge this urge, without giving in to it. (Acknowledging is rather like nodding your head in recognition, as if to say 'There you are. I see you.') Once you've acknowledged that urge, bring your attention back to the sensation itself.   • Don't try to get rid of the sensation or alter it. If it changes by itself, that's okay. If it doesn't change, that's okay too. Changing or getting rid of it is not the goal.   • You may need to focus on this sensation for anything from a few seconds to a few minutes, until you completely give up the struggle with it. Be patient. Take as long as you need. You're learning a valuable skill.   • Once you've done this, scan your body again, and see if there's another strong sensation that's bothering you. If so, repeat the procedure with that one.   • You can do this with as many different sensations as you want to. Keep going until you have a sense of no longer struggling with your feelings.   • As you do this exercise one of two things will happen: either your feelings will change - or they won't. It doesn't matter either way. This exercise is not about changing your feelings. It's about accepting them.   Looking forward to talking with you more, Jono
(MSW, LICSW, LMHC)
Answered on 01/21/2022

heyy, do you subscribe any medications to your patients? What is your success rate?

Hi Mica, I am a licensed psychotherapist. We are not trained to be able to prescribe medications. Only doctors or nurse practitioners are licensed to do that. It might be helpful to look into the community mental health agency in your county. These agencies are in every county in the country and receive both state and federal funding to support everyone in the area, regardless of ability to pay. Often their case managers or billing offices will help you to pay on a sliding fee, or obtain low cost insurance, or Medicaid (insurance for low income folks).  At community mental health agencies the therapists, case managers, and prescribers provide a team approach, which I've found is very helpful in treating bipolar disorder. You didn't mention where you go to school. If you are in high school, please seek support from your guidance counselors around credit recovery for your grades, and counseling support. If you're in college, even online college, please look into student supports through your school's website. I'm hearing that some colleges are providing BetterHelp as part of their supports to students, especially in this pandemic year. If you're struggling with a mental health condition, 504 Plans are available to provide accommodations during challenging periods. Your mental health provider will need to write a letter to document need, so this is again a good reason to build a relationship with a local provider, whether in the community or on campus. There are some things you might be able to do yourself, and resources available online, although medication often plays a big role in managing bipolar disorder. First to consider would be a solid sleep routine. We humans require a daily routine to help our bodies wind down for a good night's sleep. Electronics at night is a big culprit. Put them all outside your bedroom at sleep time. Doing some stretching exercises before bed, or taking a hot shower, relaxes muscles and relieves tension for sleep. Be good to yourself at night, and settle in for a restful sleep. There are some apps, some free, that will help you to sleep at night. Look around for apps that can help you to monitor moods too. This can be helpful in providing the support you may need at times. Reach out to family and friends you trust who can support you as well. We all need each other to get through our daily challenges! I hope this has been helpful! I'm wishing you the best as you move forward in managing your wellness. Practicing various strategies will take time and commitment, but the positive results will definitely be worth your time.  
(LISW-CP, LICSW, LCSW)
Answered on 01/21/2022

My sleeping habits have made me frustrated

Hello:  Thank you for feeling comfortable with reaching out for support regarding your sleep.  A good night's sleep happens when a few variables come into play as it is important for both your physical and mental health.  Proper sleep can have many benefits it.  It can help to improve mood, productivity and actually overall quality of life, though it requires developing healthy habits and sticking to them.  Small changes, to begin with, can lead to lasting changes in the long run.  The first thing to explore is adopting a regular sleep schedule.  This is considered one of the most important steps in working on sleep hygiene.  We normally do our best with getting between six and nine hours per night of sleep.  Going to bed and waking up at the same time every day trains your body to sleep and will help to regulate your internal clock.  There may be times that you want to sleep later in the morning, but resisting this will help you to gradually work toward your goal of consistency.  The second area to explore is to look at limiting nap time.  If you do find yourself needing a nap for some reason try to keep it short.  A quick nap of 20-30 minutes can improve your mood and make you more alert, but any longer may interfere with your nighttime sleep.  The third area to explore is trying to get regular exercise.  Even 10 minutes can have a positive effect on your overall well-being.  Exercising regularly can also lead to high-quality, and continuous sleep.  It is best to try and aim towards exercising in the morning or early afternoon as exercise does release endorphins, which are good for you, but endorphins may keep you awake if you do too much strenuous exercise during the evening.  The fourth area to explore is to try and avoid nicotine, and or alcohol before bedtime.  Both of these substances are stimulants, which means that they are most likely to interrupt your sleep.  The effects of caffeine, which is found in not only coffee but also tea and some chocolate can interfere with sleep.   Another area that may be interfering with your sleep is worry thoughts.  It is important to try and not work on areas of concern as you are approaching bedtime as it keeps the mind active and becomes difficult to shut thoughts off.  Many times I suggest that someone pick a time to work on "worry thoughts" during the day, allowing them permission to work on areas of concern, but also giving them permission to shut thoughts down as bedtime approaches.   The following tips can be accessed through the American Sleep Association and summarize some of the above suggestions: *Maintain a regular sleep routine. *Avoid daytime naps. *Don't stay in bed awake more than 5-10 minutes. *Don't watch TV, use the computer, or read in bed. *Drink caffeinated drinks with caution. *Avoid inappropriate substances that interfere with sleep. *Try to have clean fresh air in the room. *Try to have a quiet, comfortable bedroom. *Try not to be a clock watcher when sleeping. *Try taking a warm bath or shower prior to bed. *Try to quiet the mind with gentle meditation. In regards to concerns with your weight, getting a good night's sleep by developing better habits will allow more energy and motivation during the daytime which can also allow more focus on eating habits and exercise.  Everything starts with a refreshed mind which comes from a balance in all areas of your life.
Answered on 01/21/2022

Any tips for coping with ptsd flashbacks?

The key to the healing for this client is trauma treatment. EMDR would be a very effective intervention and could diminish or eradicate the flashbacks in a brief period of time. In person therapy would be preferred as we are not on a platform yet that can use EMDR. Flashbacks are symptoms of post traumatic stress disorder and the unprocessed emotions of the trauma. EMDR helps with the completion of processing the emotion connected to the trauma and lessens the intensity of the flashback and can sometimes give the patient more control over the situation. Journaling is also a helpful tool for flashbacks, documenting as many details as possible to be followed up with a therapy session. Trauma treatment needs to be done by someone who specializes in this type of intervention and a therapist who is also able to manage dissociation and abreactions to a situation. It can be detrimental and cause more damage if the therapist is not well trained to manage the potential fall out from the interventions that can be quite common. I generally recommend that a client view videos of patients in an EMDR session to demystify the process and also give them the basic theory behind why EMDR works. Like anything else the therapist and the client need to have a trusting relationship as EMDR involves the client being able to follow direction without question or discussion during the process. I have seen EMDR work amazingly well for many different types of clients both children and adults and in most cases immediate relief can be experienced. Again a lot has to do with the skill of the therapist. In addition to EMDR, Trauma ART Therapy is also a helpful intervention again processing the situations through pictures and words, the therapist must alleviate any concerns that the client has related to being some type of an artist so to not impinge the flow of thought. Stick figures and shapes are fine what is more important are the words that the client can put to the illustrations. Again this is a process and should only be used by a therapist trained in the intervention.
(LCSW)
Answered on 01/21/2022