Sleep Answers

Why can't I fall asleep easily?

A lot of different factors can affect our ability to get a restful night’s sleep. Even the continued frustration of being unable to get a restful night’s sleep can make it more difficult as it can become a preoccupation and feeling like there isn’t a solution in sight. This is especially true when it has been going on for a considerable amount of time. In the past year, many people are reporting more difficulty falling and staying asleep than usual brought on from more than usual stress, interrupted daily routines, uncomfortable work from home situations, and distractions. The constant flood of news and developments can lead to individuals feeling more hypervigilant than usual which leads them to a state of awareness and anxiety that can make it difficult to fall or stay asleep.  As always it's important to check with your primary care doctor for preventative care and yearly checkups to rule out any medical conditions that can be contributing to lack of sleep. Through discussions with an MD, you can explore other options such as medication management therapies the doctor feels may benefit you in assisting you to have a better sleep pattern.  A consultation with a psychiatry practitioner can also provide further evaluation and treatment options that can assist in addressing any mood issues that may be contributing to difficulties with sleep. After an evaluation, a psychiatrist will recommend treatment options and discuss the costs and benefits of medication management therapies.  However, engaging in therapeutic behavioral health services can help you get some of the issues you want to get off your chest that may be subconsciously nagging to address. Often unaddressed issues can manifest in a number of ways including mood disturbances and physical and somatic reactions.  Engaging in therapeutic services can allow you to identify behaviors, patterns, and other issues in your daily life that may be impacting your ability to fall and stay asleep. This can include developing a sleep plan that allows you to engage in mindfulness and track your progress on what works and what doesn’t. Through collaboration, you and your behavioral health practitioner will design a treatment plan and goals that address your difficulties with sleep alongside addressing other issues that also affect it. 
(MA, LMHC)
Answered on 09/18/2021

I have nightmare and I sleep so much I just want to sleep all the time I can't face a single problem

Hello Xamm,  Thank you for taking the time to share this question.  It sounds like you have a few things going on that are disruptive to both your sleep and mental health.  I will try to address each of the problems that you inquired about.   1. Nightmares-There are many different reasons that individuals experience nightmares such as stress and anxiety, insomnia or poor sleep quality, trauma, medications or substance misuse, or exposure to scary materials such as movies or books.  Although they can be relatively common for some individuals, there is a risk of complications such as being excessively tired during daytime hours, sleep avoidance due to fear of having bad dreams, and mental health problems such as depression and anxiety.  You should work with your therapist to determine if your nightmares are problematic.  They may have you practice deep breathing, progressive muscle relaxation, or grounding techniques to reduce your stress and anxiety.  Additionally, nightmare exposure and rescripting is one useful tool when nightmares are ongoing and disruptive.     2. Behavioral Activation-You mentioned that you want to sleep all the time and can't face "a single problem".  This often occurs as a result of depression.  Depression and low mood can result in a lack of motivation.  Clients experiencing these symptoms may become inactive and tend to isolate themselves from others.  Over time, these behaviors increase depression which further works to intensify the cycle of inactivity.  If you find yourself stuck in this cycle, work with your therapist to create a plan to include physical activities in your daily routine such as riding a bike, taking a walk, or dancing. Don't wait until you feel motivated.  The more you move the better you will feel, but it won't be easy to start with.  Motivate yourself with rewards such as taking a relaxing shower, listening to a podcast, or playing a video game.  Be creative and consistent.  Taking small steps, you can change habits and can learn to be active again.     3. Medical Management-The combined use of cannabis and escitalopram may be causing some of the problems that you are experiencing.  According to www.drugs.com, when using this two substances together, individuals may experience "dizziness, drowsiness, confusion, and difficulty concentrating" in addition to "impairment in thinking, judgment, and motor coordination."  It is important to work closely with your medical provider to determine if these two substances are safe to take co-currently for you.   Thank you again for writing. Best wishes! Julie Elizabeth Gallivan, MA, LPC
Answered on 09/18/2021

How do I fix it?

Hello, It's hard to guess what may be happening without having more information. For example, have you always moved around a lot in your sleep? Are you dealing with a particularly high amount of stress right now? It could even be as simple as you feeling too warm or being uncomfortable in bed. There are a lot of potential explanations. In a setting where you'd be participating in therapy, the first thing I'd want to look at is whether you're having nightmares. If you've experienced trauma, you could be having nightmares that you may not even remember the next day. In that event, working on addressing the trauma would be an important place to start. Also, if that was the explanation, there is a medication commonly prescribed for those who have PTSD that reduces nightmares and can reduce the risk of harming someone else in your bed.  If you are experiencing significant stress (and even if this relationship is absolutely healthy, there can be a great amount of stress associated with being in a new relationship, especially when this relationship may mean so much to you). learning to use and incorporate coping skills, mindfulness strategies, and self-care activities during the day could help you have a more restful sleep at night. I suppose there could also be medical explanations, such as sleep apnea. If you have a history of that or suspect that, you should talk with a doctor. You may also want to look at whether there are any routines before bed that could be playing a role. For example, alcohol use can reduce the restfulness of sleep. You could also get a Fitbit or a similar tool that can track how often you are waking up and how much time you are spending in each sleep stage. So again, without knowing more about your background and what is occurring in your life, I can't tell you how to fix it. If you are dealing with a high amount of stress or anxiety or may need to work through some trauma, I highly suggest getting involved in therapy. If this is not the case, you may want to talk with a doctor about having a sleep study was done which could provide more information about what is happening as you sleep. I do suggest though, especially if it appears that you may harm your girlfriend in your sleep, that until this issue is resolved that you not be in the same bed. If you are pushing her in your sleep, it could be possible that you could become more aggressive and actually cause her harm, so the priority needs to be about safety. Anyway, I'm glad you're reaching out for help. I would be happy to work with you if you chose to give mental health therapy a try. Take care. Nick 
(MRC, LPCC-S, LICDC)
Answered on 09/18/2021

Dream control

Hey Grayvorn,  Sorry to hear you dealing with bad/confusing dreams. The symptoms you are feeling are not uncommon when no longer consuming some medications. Many of my clients report similar symptoms when coming off of an array of medications, regardless of whether they are opioids or other psych meds. Everyone's brain/biochemistry is different and the types of symptoms, as well as their severity, also varies from person to person. When experiencing these symptoms (dreams) it is a sign that our brain neurochemistry is attempting to reset to the way it naturally was, prior to beginning medication therapy. Any kind of medication consumption directly alters our brain's neurotransmitters, oftentimes in radical ways. It would make sense that the brain would also make radical adjustments to our neurochemistry to compensate for no longer receiving those medications.  In regards to reducing the frequency/severity of the dreams you are having, you have options. I would first recommend using the knowledge that these symptoms you are experiencing are common amongst those who use prescription medication to help build more acceptance regarding the dreams. As imperfect human beings, there is only so much we can do to directly manipulate our brains and neurochemistry towards feeling how we would prefer. By increasing our sense of acceptance of these dreams/symptoms, we can help take away some of the frustration that often results from having to deal with the life disruptions these symptoms can cause.  I would also recommend that you engage in more physical activity, 30-45 minutes 3-5x weekly, in order to assist with obtaining a better quality of sleep. I understand that it seems confusing as to how physical activity is going to lessen my symptoms. However, physical activity will make it so that the body releases more healthy neurotransmitters, along with other biochemicals, that will not only assist with keeping you asleep but also assist with the resetting of your body's biochemistry. This is another one of the few ways that we can directly manipulate our body's neurotransmitters.  Finally, I would also recommend that you cease the cycle of getting off and then back on, pain medications. As long as you continue to cycle on and off medications, you are going to experience these symptoms. Pain medications were not designed to be used in that manner, in the first place. You are altering your body's neurochemistry in a significant manner when you consume any kind of medication, especially over the long term. If you truly wish to have permanent relief from these symptoms, you will have to stop cycling.    Understand that some of this may not be what you wanted to hear, but I want to help you. Hope you found this information useful. Let me know if you need anything else. Take care!    
(LMHC)
Answered on 09/18/2021

What are some strategies that I can use when finding it difficult to sleep at night.

Hi Lilo45,  Thank you for reaching out and asking about strategies that can help you sleep at night. Sleep is one of the foundations that our body needs to be able to function properly and when we do not get enough, it affects everything from our mood to our ability to cope with everyday life stressors.    One of the most challenging things that we are faced with is lying in bed when our body is tired but our mind won't shut off. Here's a fun fact. Playing on our phones while trying to fall asleep actually stimulates our brains more and further pushes sleep away. Essentially when the bright light from the screen hits the brain, it thinks that it's time to wake up. One of the things that can be helpful is to go into your phone's settings and find the "night shift" or similar setting. This changes the colors of the display to warmer tones and may help you get to sleep sooner. You may also want to consider cutting off your phone time at a certain time before going to bed and when in bed. When we use our bed for other activities besides sleeping, our brain begins to make an association between the bed and activity rather than sleep. When we limit our time in bed to just sleeping, the brain automatically makes a connection between the bed and sleep time. This can take a while to make the connection but will happen after a while. Think of the brain as a sort of muscle that you can train. When you are lying in bed and find that you cannot sleep try utilizing square breathing.  Breathe in through your nose for a count of 5. hold for a count of 5, breathe out through your mouth for a count of 5, hold for a count of 5. You can repeat this cycle as many times as you would like. Engaging in this exercise provides a distraction for your brain from all the thoughts that it is thinking of. This exercise also helps to send a message to your nervous system that it can start revving down and relaxing.  Another technique that may be helpful is called Progressive Muscle Relaxation. While laying in bed with your eyes either open or closed focus on the sensation in your feet. Notice how they feel; warm, cold, relaxed, prickly. After a moment begin to tense your feet by curling your toes and the arch of your foot. Hold on to the tension for a count of 5 and notice what it feels like. Then release your toes and notice how the relaxation feels.  Repeat this noticing tensing, and relaxing with your lower legs, upper legs and pelvis, stomach and chest, back, arms and shoulders, neck and head, and finally your entire body. Remember to keep your breathing even and smooth as you progress up your body.  You may find that you fall asleep before you have worked your way all the way up to your head and neck and entire body. If you do, that is absolutely ok! If you find that you are still awake and restless after trying all of the techniques, get out of bed and move to a different room if possible or even just a different place within your room to play on your phone or do an activity. Once you start to feel sleepy return to bed and lay down. This works on that brain-body connection I mentioned earlier with associating the bed as a place to sleep. I hope this answer helps to shed some light on your question.
Answered on 09/18/2021

This issue is something thats can be treated only with drugs ?

Hi Sara,  Thank you for your question. I'm sorry you've been experiencing this trouble sleeping since you heard a ghost story two years ago. It's sometimes really unpredictable what things will stick in our minds or have long-lasting impacts on our ability to function in a particular way. This story clearly had a strong impact on you and is still getting in the way of you being able to sleep alone without anxiety. The fact that the story happened in the house that you're renting certainly factors into your current struggle. You say that you heard a lot of stories like this before and they didn't bother you, so I wonder if you heard this story during a time when you were already feeling anxious for another reason or if because it's associated with the place that you are currently sleeping it resonated in a different way. I don't think medication is the only way for you to overcome this fear and get back to being able to sleep alone without difficulty. It's possible that working with a therapist to uncover the root causes of this fear, beyond the story, might help but there are also some strategies that you can use on your own.  Background noise might help you feel less alone. A television set tuned to a channel that you don’t normally watch and left at low volume could provide a hum of human voices that mimics what you once heard from a full house. You can also download sleep music and play it through your smartphone, a tablet, or another electronic device. This will eliminate the glow of the television set, which could interfere with your quality of sleep. You may also consider a white noise machine, but that isn’t quite the same as hearing human voices. If you’re also missing a pet that no longer lives with you, consider getting a dog or cat to fill the void. Many people relieve sleep anxiety by simply granting themselves permission to sleep away from their beds. You can sleep in another room of your home, or add a couch, futon, or air mattress to your bedroom. You can also use deep breathing techniques and meditation to turn off anxiety and ease into sleep. The breathing exercises recommended for general anxiety and panic attacks are quite similar to relaxation exercises for sleep, so you can use these strategies in your daily life as well. Reach out to your support system. You may overcome the fear of sleeping alone by calling someone in your network just before going to bed. Make sure that you stay active and alert during the day so that you’re tired at bedtime, and then make it a habit to call someone comforting before dozing off. You’ll get that satisfaction of bonding with another person, which can fill the void of your empty bed to some degree. Sleeping with an oversized teddy bear or a stack of throw pillows may work as well Try practicing gratitude. When your mind drifts to fear, bring your attention back to the positive things in your life that you have to be grateful for. Think about or write down everything you’re grateful for: your loving family, your comfortable home, your pets, and your neighborhood. When you are in gratitude, you move your mind out of its negative pattern. Consider using mantras- short, positive statements repeated out loud can help you reprogram your automatic responses and improve your mood/mental state. Find a phrase that resonates for you and try repeating it to yourself before going to bed. Some examples you might try:  I am safe at home.  I feel peaceful when I am alone in my room.  I enjoy the quiet when I am at home on my own.  Overcoming any intense fear takes time so don't get discouraged if you try some of these strategies and they don't work right away. If you’re willing to do the work to face your fear of sleeping alone and change your thoughts, you can sleep peacefully, even when you’re home alone. 
Answered on 09/18/2021

What must be the reason why I am having trouble sleeping?

Hello Leigh,   Not being able to sleep at night is such a frustration especially as it seems you had it under control for a while there too!  I am glad you reached out for some advice on the BetterHelp Platform.   Active Mind Before Sleep? Here Are Strategies to Fall Sleep Peacefully   “I just can’t turn my brain off at night.” This is one common complaint among those who struggle with insomnia and others who have difficulty falling asleep. Worrying about things you need to do, daily stressors, like work and finances, counting the minutes that go by, and imagining how tired you will be in the morning - can be an irritating problem.   If your mind is active with thoughts that are keeping you up at night, the trick is to change the unhealthy pattern. I have provided some information on the cause of this problem and strategies to help you find relief from your racing mind at night.   Racing Mind and Anxiety Rapid thoughts are often a symptom associated with anxiety. They can make people feel out of control or as if they are going crazy.   When it comes to sleep, this effect of anxiety is a cyclical problem. Because your brain struggles to focus when it is tired, it often leads to racing thoughts. Anxiety and an active mind which keeps you awake, a lack of sleep is bothersome, and sleep deprivation continues to contribute to anxiety.  So, how can we break this cycle of anxiety and sleeplessness?   How to Get to Sleep when Your Mind Is Active If you are frustrated and tired, try these Cognitive Behavioral Techniques (CBT). You may discover a more relaxing and effective way to get the sleep you need.   Don’t Lie Awake in Bed This can be a very frustrating problem that seems to become worse the more you think about it. It’s imperative that you break this vicious cycle of poor sleep and worry about not sleeping. For this reason, we recommend avoiding lying awake in bed. If you haven’t nodded off within 20 minutes of putting your head on the pillow, get up. Go back to your relaxing activity – journaling, reading, meditation, listening to music.  Then, when you begin to feel sleepy, try to go back to bed.   This CBT technique is called stimulus control.  It may sound counter-productive, but many people find that engaging in a relaxing activity outside of bed helps occupy the brain in a positive way. This works to break the negative association that insomniacs and restless sleepers often develop in relation to bedtime.   Calm Your Mind Relaxation Practice or Training is what many commonly associate with calming exercises. Though these methods may feel silly at first, guided imagery, medication, and mindfulness are all beneficial for a racing mind. More specifically, you can focus on slowing your breath and using progressive muscle relaxation to take your mind off stressors.  (See below for more details).   Free Your Thoughts It’s difficult to fall asleep when you are making lists of things to do and worrying about family, work, money, and other challenges or when your mind is just busy. Rather than trying to simply ignore these thoughts, try to eliminate them from your thought patterns before bed. In the evening, you should get in the habit of identifying stressors by journaling and writing down lists for yourself. Once the ideas are on paper, you may find that you’ve freed up your mind.   Keep It Positive  To break the cycle of your active thoughts and worrying about lack of sleep highlight the positive aspects of your life. Keeping a gratitude journal can help disrupt the negative mindset. Making this type of journaling a habit, gives you the opportunity to emphasize the good relationships and features that you are thankful for in your life.   Focus on Your Senses To take the focus away from the busy thoughts, create a wind-down routine around sensorial experience. Lower the lights and consider a relaxing way to stimulate each of the five senses to find a method that works well for you. Here are some ideas. Sight – guided imagery, pictures of a peaceful place Smell – scented candle, aromatherapy Touch – warm bath, self-massage, light yoga or even a weighted blanket Taste –  chamomile tea, light snacks Hear – sound machine, white noise, instrumental music   Make the Bedroom Your Haven for Sleep It’s important to reserve the bedroom for sleep and make it a relaxing space. This means keeping it neat and furnishing it with colors and textures that you find soothing, rather than stimulating. Keep work materials, computers, and screens out of the bedroom.   Good sleep hygiene includes turning the temperature down in the bedroom and using shades or curtains to make it dark and help induce sleep. To avoid counting minutes and worrying about not having enough time to get the rest you need, keep alarms and clocks away from the bed.   Tips for Falling Asleep Faster:   10 Scientifically Proven Ways to Fall Asleep Faster   Here is our top ten list of verified tips to help you get to sleep faster. Whether you have a diagnosed sleep disorder or just occasional difficulty dozing off, this list is for you.   10. Avoid alcohol in the evening. This may be a tall order this time of year because of holiday events and parties. Though it may seem easier to fall asleep after drinking alcohol, it actually tends to interrupt sleep patterns throughout the night. With just a few alcoholic drinks, people can experience agitated or disrupted sleep. Additionally, alcohol can block out the REM phase which is key to feeling rested in the morning. For a better night, try switching to an alcohol- and caffeine-free beverage like chamomile, which has tranquilizing antioxidants that decrease anxiety and help initiate sleep.   9. Consider a new mattress. The average lifespan for a mattress is 7 - 10 years. Beyond this, you will start to notice that the bed does not provide the same support for your body as it did when it was new. Over time, it is normal for mattresses to lose firmness and become deformed and saggy in the middle. This can make it uncomfortable and cause issues with spinal alignment that lead to neck and back pain. So, if you find yourself tossing and turning at night, or waking up with pain, it may be time to replace your mattress. Be sure to find the best bed and pillow that work with your preferred sleeping position.   8. Take a warm bath or shower before bedtime. Body temperature is an important factor in sleep quality. Try warming your body by taking a hot bath or shower then lowering the temperature in your bedroom. Because the natural sleep pattern is partially triggered by a lower core temperature, this can facilitate that drop. Plus, the warm water can help relax your body as you prepare for sleep.   7. Listen to relaxing music or white noise. When your goal is to get to sleep faster, it is crucial to think about all five senses. Research has found that adults who listen to 45 minutes of relaxing music before going to bed get to sleep faster, sleep longer, wake up less frequently at night, and wake up feeling more rested. This is in comparison to nights when they do not listen to music. Slow instrumental and classical music are recommended even for people who suffer from insomnia and it also seems to help reduce depression.   For others, a good solution for sleeplessness and disruptions is white noise. It works to drown out noises that you may hear which can keep you awake or wake you up. Having a constant ambient sound in the bedroom has been shown to improve and maintaining sleep.   6. Explore aromatherapy. Another sense which should not be discounted is the smell. Aromatherapy has been shown to be a potent way to induce sleep. The scent of certain essential oils, including lavender and damask rose, can effectively help those who have trouble falling asleep.   5. Utilize a progressive relaxation technique. One helpful method of relaxation therapy is called progressive muscle relaxation. It is often recommended to people struggling with issues ranging from anger management to insomnia. Yet, progressive muscle relaxation can be used by anyone in a place of counting sheep. It involves first tensing, then relaxing individual muscles in a gradual sequence–from your feet up to your head. Each part of the body should be contracted for about 30 seconds and released.   4. Get in tune with your body & mind. Stress is one of the most common reasons that people have difficulty falling asleep. Some natural wellness activities can both reduce anxiety and improve sleep quality. Studies have found that 85% of people who practice yoga feel less stressed and more than 55% sleep better. Those who practice yoga say that it is focused on controlling breathing patterns and using specific sequences of body positions and movement to release tension.    Meditation is another form of mindfulness that helps improve sleep, in addition to decreasing blood pressure, alleviating pain, reducing anxiety and depression.   3. Discover the power of a healthy diet. We know that some foods can help us stay energized throughout the day, but a healthy diet can also help you sleep better. A well-balanced diet in terms of carbohydrates, protein, vitamins, and minerals is important for healthy sleep. Specifically, to get to sleep quicker, you should avoid eating heavy and spicy dishes or foods that are high in sugar.    Timing matters too. Doctors also recommend that you have dinner at least two hours before bedtime. Patients with acid reflux are advised to eat at least 3 hours before bedtime.   2. Shut off electronics. Screen time can be detrimental to sleep quality among children and adults. The blue light emitted by electronic devices delays the circadian rhythm and suppresses melatonin levels. Sleep experts say that you should put mobile phones, tablets, and computers away at least 30 minutes before your expected bedtime. They also suggest replacing habits, such as watching TV and playing video games, with un-plugged activities, like reading a book.   1. Create a relaxing bedtime routine. This measure is crucial for a healthy sleep routine. To support the natural sleep cycle, it is best to keep to a regular schedule of going to sleep and waking at the same time each day. You can also help your body to understand when it is time to sleep by setting a relaxation routine. Put away work and shut down your mobile apps. Then, listen to music, take a bath, meditate, practice relaxation techniques…do what makes you feel comfortable. Giving yourself time to calm down and unwind before bed can significantly reduce the amount of time you spend lying awake.   Make a Resolution for Better Health If you commit to trying a combination of the above to work on your sleep hygiene you will I am sure begin to feel better and face life with more energy, but if you are still struggling may be an important step for you is to reach out for some support from a mental health counselor who can explore some interventions and help you get on track again.  Wishing you the best of luck! Gaynor   
(MA, LCSW)
Answered on 09/18/2021

Self problem

Hello Mandy, I am glad you reached out for support at this time.  I am sorry you are struggling at this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even though you may feel like you are alone at this time.  During the therapy process, you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week.  I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through your struggles and be able to ask for support from others. After reading your questions about struggling with sleep I wanted to send you reading and skills on insomnia and how it may impact you, and how you can overcome that with some tools.  Insomnia—difficulty in falling or staying asleep—affects as many as 1 in 3 people, and almost anyone could do with better, more restorative sleep. Insomnia usually becomes a problem if it occurs on most nights and causes distress or daytime effects such as fatigue, poor concentration, and irritability.The relationship between insomnia and depression is far from simple, as insomnia can both cause and be caused by depression. Insomnia not only predisposes to depression but also exacerbates existing depressive symptoms, making it harder to pull through. Insomnia also predisposes to other mental disorders such as anxiety disorders and psychotic disorders; to physical problems such as infections, high blood pressure, obesity, and diabetes; and motoring and other accidents.Aside from depression, common causes or contributors to insomnia include poor sleeping habits, other mental disorders such as anxiety disorders and psychotic disorders, physical problems such as pain or shortness of breath, certain prescription medications, and alcohol and drug misuse. The most important causes of short-term insomnia (the commonest type of insomnia) are a stressful life event, a poor sleeping environment, and an irregular routine.If you are suffering from insomnia, there are a number of simple measures that you can take to resolve or at least reduce the problem:1. Set up a strict routine involving regular and adequate sleeping times (most adults need about seven or eight hours sleep every night). Allocate a time for sleeping, for example, 11pm to 7am, and don’t use this time for anything else. Avoid daytime naps, or make them short and regular. If you have a bad night, avoid sleeping late, as this makes it more difficult to fall asleep the following night.2. Devise a relaxing bedtime routine that enables you to wind down before bedtime. This may involve breathing exercises or meditation or simply reading a book, listening to music, or watching TV.3. Enjoy a hot, non-caffeinated drink such as herbal tea or hot chocolate. In time, your hot drink could become a sleeping cue.4. Sleep in a familiar, dark, and quiet room that is adequately ventilated and neither too hot nor too cold. Try to use this room for sleeping only, so that you come to associate it with sleep. In time, your room could become another sleeping cue.5. If sleep doesn’t come, don’t become anxious or annoyed and try to force yourself to sleep. The more aggravated you become, the less likely you are to fall asleep. Instead, try to clear your mind and relax. For example, I find that making myself feel grateful for something soon sends me off to sleep. Alternatively, get up and do something relaxing and enjoyable for about half an hour before giving it another go.6. Exercise regularly. This will also help you with your low mood. However, don’t work out too close to bedtime as the short-term alerting effects of exercise may make it harder to fall asleep.7. Reduce your overall stress. At the same time, try to do something productive or enjoyable each day. As da Vinci said, a well-spent day brings happy sleep (and a well-spent life brings happy death).8. Eat a wholesome evening meal with a good balance of protein and complex carbohydrates. Eating too much can make it difficult to fall asleep; eating too little can disturb your sleep and decrease its quality.9. Avoid caffeine, alcohol, and tobacco, particularly in the evening. Alcohol may make you fall asleep more readily, but it decreases the overall length and quality of your sleep.10. If insomnia persists despite these measures, speak to your doctor. In some cases, insomnia has a very specific cause such as a physical problem or an adverse effect of your medication that requires your doctor’s attention. Lack of sleep can have major consequences on your mood and productivity at work, and even life-threatening dangerous implications for commuters or individuals operating vehicles or heavy machinery. Lack of sleep has also been linked to the emergence and worsening of many chronic health problems, including type 2 diabetes, cardiovascular disease, obesity, and depression.How can you get better sleep to perform better at work and in life? Here are the 10 steps you can take.1. Minimize DistractionsBan TVs and computers from the bedroom. TVs and computers emit blue light that tricks the body into believing it’s daytime, making falling asleep more difficult. They are also distracting and might keep you awake even when you’re feeling tired.2. Avoid CaffeineSteer clear of caffeine in beverages and food for six to eight hours before bedtime.3. Minimize Alcohol ConsumptionDrinking may help you feel drowsy, but it has been shown to disrupt sleep patterns and create a lower quality, less restorative night’s rest. Don’t have alcohol close to bedtime— it can wake you up three to four hours later. (A drink with dinner is OK.)4. Develop a RoutinePick a bedtime and awake time and stick with them from night tonight. Signal to your body that it’s time for bed taking a shower or bath, playing soft music, doing a light reading, or eating a small snack.5. Establish a Bedtime“I’ll sleep when I’m dead” may sound inspiring, but sleep should be a top priority. Designate seven to eight hours in your daily schedule for sleep.6. Create a Safe SpaceOptimize your bedroom for a good night’s sleep by keeping your bedroom comfortable, dark, and quiet. Clean bedding, cool temperatures, and serene quiet can make a big difference in helping you fall asleep.7. Use Your Bed Exclusively for SleepJust because you are in bed doesn’t mean that you’re asleep. Many people use their beds as a comfortable place for lounging, browsing the internet on their laptops, and scrolling through social media on their phones. Reserve your bedroom exclusively for sleeping and sex. This will help you associate your bed with sleep.8. Power Down the ElectronicsTwenty to 30 minutes before bedtime dim your lights and switch off electronics. Like TVs and computers, cell phones and tablets emit blue light, tricking your body into believing it’s daytime.9. Practice Relaxation TechniquesTry relaxation exercises at bedtime if you need to unwind before hitting the hay. Some activities that can help you fall asleep include yoga, deep breathing, or guided meditation.10. Avoid Lying in Bed AwakeFew things feel worse than lying in bed for hours trying to sleep. If you don’t fall asleep within 15 to 20 minutes, get out of bed, leave the bedroom and try some of your calming before-bed activities again.   Think about all the factors that can interfere with a good night's sleep — from work stress and family responsibilities to unexpected challenges, such as illnesses. It's no wonder that quality sleep is sometimes elusive.While you might not be able to control the factors that interfere with your sleep, you can adopt habits that encourage better sleep. Start with these simple tips.1. Stick to a sleep scheduleSet aside no more than eight hours for sleep. The recommended amount of sleep for a healthy adult is at least seven hours. Most people don't need more than eight hours in bed to achieve this goal.Go to bed and get up at the same time every day. Try to limit the difference in your sleep schedule on weeknights and weekends to no more than one hour. Being consistent reinforces your body's sleep-wake cycle.If you don't fall asleep within about 20 minutes, leave your bedroom and do something relaxing. Read or listen to soothing music. Go back to bed when you're tired. Repeat as needed.2. Pay attention to what you eat and drinkDon't go to bed hungry or stuffed. In particular, avoid heavy or large meals within a couple of hours of bedtime. Your discomfort might keep you up.Nicotine, caffeine, and alcohol deserve caution, too. The stimulating effects of nicotine and caffeine take hours to wear off and can wreak havoc on quality sleep. And even though alcohol might make you feel sleepy, it can disrupt sleep later in the night.3. Create a restful environmentCreate a room that's ideal for sleeping. Often, this means cool, dark, and quiet. Exposure to light might make it more challenging to fall asleep. Avoid prolonged use of light-emitting screens just before bedtime. Consider using room-darkening shades, earplugs, a fan, or other devices to create an environment that suits your needs.Doing calming activities before bedtime, such as taking a bath or using relaxation techniques, might promote better sleep.4. Limit daytime napsLong daytime naps can interfere with nighttime sleep. If you choose to nap, limit yourself to up to 30 minutes and avoid doing so late in the day.If you work nights, however, you might need to nap late in the day before work to help make up your sleep debt.5. Include physical activity in your daily routineRegular physical activity can promote better sleep. Avoid being active too close to bedtime, however.Spending time outside every day might be helpful, too.6. Manage worriesTry to resolve your worries or concerns before bedtime. Jot down what's on your mind and then set it aside for tomorrow.Stress management might help. Start with the basics, such as getting organized, setting priorities, and delegating tasks. Meditation also can ease anxiety. How can I get a better night’s sleep?Sleeping well directly affects your mental and physical health. Fall short and it can take a serious toll on your daytime energy, productivity, emotional balance, and even your weight. Yet many of us regularly toss and turn at night, struggling to get the sleep we need. Getting a good night’s sleep may seem like an impossible goal when you’re wide awake at 3 a.m., but you have much more control over the quality of your sleep than you probably realize. Just as the way you feel during your waking hours often hinges on how well you sleep at night, so the cure for sleep difficulties can often be found in your daily routine.Unhealthy daytime habits and lifestyle choices can leave you tossing and turning at night and adversely affect your mood, brain and heart health, immune system, creativity, vitality, and weight. But by experimenting with the following tips, you can enjoy better sleep at night, boost your health, and improve how you think and feel during the day.Tip 1: Keep in sync with your body’s natural sleep-wake cycleGetting in sync with your body’s natural sleep-wake cycle, or circadian rhythm is one of the most important strategies for sleeping better. If you keep a regular sleep-wake schedule, you’ll feel much more refreshed and energized than if you sleep the same number of hours at different times, even if you only alter your sleep schedule by an hour or two.Try to go to sleep and get up at the same time every day. This helps set your body’s internal clock and optimize the quality of your sleep. Choose a bedtime when you normally feel tired, so that you don’t toss and turn. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock, you may need an earlier bedtime.Avoid sleeping in—even on weekends. The more your weekend/weekday sleep schedules differ, the worse the jetlag-like symptoms you’ll experience. If you need to make up for a late-night, opt for a daytime nap rather than sleeping in. This allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm.Be smart about napping. While napping is a good way to make up for lost sleep, if you have trouble falling asleep or staying asleep at night, napping can make things worse. Limit naps to 15 to 20 minutes in the early afternoon.Fight after-dinner drowsiness. If you get sleepy way before your bedtime, get off the couch and do something mildly stimulating, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.Tip 2: Control your exposure to lightMelatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Your brain secretes more melatonin when it’s dark—making you sleepy—and less when it’s light—making you more alert. However, many aspects of modern life can alter your body’s production of melatonin and shift your circadian rhythm.How to influence your exposure to lightDuring the day:Expose yourself to bright sunlight in the morning. The closer to the time you get up, the better. Have your coffee outside, for example, or eat breakfast by a sunny window. The light on your face will help you wake upSpend more time outside during daylight. Take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.Let as much natural light into your home or workspace as possible. Keep curtains and blinds open during the day, and try to move your desk closer to the window.If necessary, use a light therapy box. This simulates sunshine and can be especially useful during short winter days.At night:Avoid bright screens within 1-2 hours of your bedtime. The blue light emitted by your phone, tablet, computer, or TV is especially disruptive. You can minimize the impact by using devices with smaller screens, turning the brightness down, or using light-altering software such as f.lux.Say no to late-night television. Not only does the light from a TV suppress melatonin, but many programs are stimulating rather than relaxing. Try listening to music or audiobooks instead.Don’t read with backlit devices. Tablets that are backlit are more disruptive than e-readers that don’t have their own light source.When it’s time to sleep, make sure the room is dark. Use heavy curtains or shades to block light from windows, or try a sleep mask. Also, consider covering up electronics that emit light.Keep the lights down if you get up during the night. If you need some light to move around safely, try installing a dim nightlight in the hall or bathroom or using a small flashlight. This will make it easier for you to fall back to sleep.Tip 3: Exercise during the dayPeople who exercise regularly sleep better at night and feel less sleepy during the day. Regular exercise also improves the symptoms of insomnia and sleep apnea and increases the amount of time you spend in the deep, restorative stages of sleep.·         The more vigorously you exercise, the more powerful the sleep benefits. But even light exercise—such as walking for just 10 minutes a day—improves sleep quality.·         It can take several months of regular activity before you experience the full sleep-promoting effects. So be patient and focus on building an exercise habit that sticks.For better sleep, time your exercise rightExercise speeds up your metabolism, elevates body temperature, and stimulates hormones such as cortisol. This isn’t a problem if you’re exercising in the morning or afternoon, but too close to the bed and can interfere with sleep.Try to finish moderate to vigorous workouts at least three hours before bedtime. If you’re still experiencing sleep difficulties, move your workouts even earlier. Relaxing, low-impact exercises such as yoga or gentle stretching in the evening can help promote sleep.Tip 4: Be smart about what you eat and drinkYour daytime eating habits play a role in how well you sleep, especially in the hours before bedtime.Limit caffeine and nicotine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! Similarly, smoking is another stimulant that can disrupt your sleep, especially if you smoke close to bedtime.Avoid big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Spicy or acidic foods can cause stomach trouble and heartburn.Avoid alcohol before bed. While a nightcap may help you relax, it interferes with your sleep cycle once you’re out.Avoid drinking too many liquids in the evening. Drinking lots of fluids may result in frequent bathroom trips throughout the night.Cut back on sugary foods and refined carbs. Eating lots of sugar and refined carbs such as white bread, white rice, and pasta during the day can trigger wakefulness at night and pull you out of the deep, restorative stages of sleep.Nighttime snacks help you sleepFor some people, a light snack before bed can help promote sleep. For others, eating before bed leads to indigestion and makes sleeping more difficult. If you need a bedtime snack, try:·         Half a turkey sandwich·         A small bowl of whole-grain, low-sugar cereal·         Milk or yogurt·         A bananaTip 5: Wind down and clear your headDo you often find yourself unable to get to sleep or regularly waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. Taking steps to manage your overall stress levels and learning how to curb the worry habit can make it easier to unwind at night. You can also try developing a relaxing bedtime ritual to help you prepare your mind for sleep, such as practicing a relaxation technique, taking a warm bath, or dimming the lights, and listening to soft music or an audiobook.Problems clearing your head at night can also stem from your daytime habits. The more overstimulated your brain becomes during the day, the harder it can be to slow down and unwind at night. Maybe, like many of us, you’re constantly interrupting tasks during the day to check your phone, email, or social media. Then when it comes to getting to sleep at night, your brain is so accustomed to seeking fresh stimulation, it becomes difficult to unwind. Help yourself by setting aside specific times during the day for checking your phone and social media and, as much as possible, try to focus on one task at a time. You’ll be better able to calm your mind at bedtime.A deep breathing exercise to help you sleepBreathing from your belly rather than your chest can activate the relaxation response and lower your heart rate, blood pressure, and stress levels to help you drift off to sleep.·         Lay down in bed and close your eyes.·         Put one hand on your chest and the other on your stomach.·         Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little.·         Exhale through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.·         Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count slowly as you exhale.To follow along with a guided deep breathing exercise, click here.A body scan exercise to help you sleepBy focusing your attention on different parts of your body, you can identify where you’re holding any stress or tension, and release it.·         Lie on your back, legs uncrossed, arms relaxed at your sides, eyes closed. Focus on your breathing for about two minutes until you start to feel relaxed.·         Turn your focus to the toes of your right foot. Notice any tension while continuing to also focus on your breathing. Imagine each deep breath flowing to your toes. Remain focused on this area for at least three to five seconds.·         Move your focus to the sole of your right foot. Tune in to any sensations you feel in that part of your body and imagine each breath flowing from the sole of your foot. Then move your focus to your right ankle and repeat. Move to your calf, knee, thigh, hip, and then repeat the sequence for your left leg. From there, move up your torso, through your lower back and abdomen, your upper back and chest, and your shoulders. Pay close attention to any area of the body that feels tense.·         After completing the body scan, relax, noting how your body feels. You should feel so relaxed you can easily fall asleep.For a guided body scan meditation to help you wind down and clear your head at bedtime, click here.Tip 6: Improve your sleep environmentA peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses. Sometimes even small changes to your environment can make a big difference to your quality of sleep.Keep your room dark, cool, and quietKeep noise down. If you can’t avoid or eliminate noise from neighbors, traffic, or other people in your household, try masking it with a fan or sound machine. Earplugs may also help.Keep your room cool. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.Make sure your bed is comfortable. Your bed covers should leave you enough room to stretch and turn comfortably without becoming tangled. If you often wake up with a sore back or an aching neck, you may need to experiment with different levels of mattress firmness, foam toppers, and pillows that provide more or less support.Reserve your bed for sleeping and sex. By not working, watching TV, or using your phone, tablet, or computer in bed, your brain will associate the bedroom with just sleep and sex, which makes it easier to wind down at night.Tip 7: Learn ways to get back to sleepIt’s normal to wake briefly during the night but if you’re having trouble falling back asleep, these tips may help:Stay out of your head. Hard as it may be, try not to stress over your inability to fall asleep again, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, “Ahhh.” Take another breath and repeat.Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though it’s not a replacement for sleep, relaxation can still help rejuvenate your body.Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that it’s time to wake up.Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve. Similarly, if a great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive after a good night’s rest. I hope that these skills have been helpful for you in your struggles you have been facing at this time. I am going to give you my information if you are wanting to start to process through and work on your struggles going forward, please reach out to Betterhelp and ask to be matched with Crystal Westman. If we were to work together we would work on more skills and tools to help you when you are struggling and get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 09/18/2021

What medicine is best to take if one can’t sleep.

Hello! I am glad that you reached out. Sleep is very important for your physical and mental health, I am sorry to hear that you have not been able the proper amount of sleep. I encourage to see your general doctor In order to know if the medication can assist you. The proper evaluations are needed before making any type of recommendation for medication.  Therapy can be an effective treatment for a host of mental and emotional problems, including reducing anxiety. Talking about your thoughts and feelings with a supportive person can often make you feel better. It can be very healing, in and of itself, to voice your worries or talk about something that’s weighing on your mind. And it feels good to be listened to—to know that someone else cares about you and wants to help. While it can be very helpful to talk about your problems to close friends and family members, sometimes you need help that the people around you aren’t able to provide. When you need extra support, an outside perspective, or some expert guidance, talking to a therapist or counselor can help. While the support of friends and family is important, therapy is different. Therapists are professionally-trained listeners who can help you get to the root of your problems, overcome emotional challenges, and make positive changes in your life. You don’t have to be diagnosed with a mental health problem to benefit from therapy. Many people in therapy seek help for everyday concerns: relationship problems, job stress, or self-doubt, for example. Others turn to therapy during difficult times, such as divorce. But in order to reap its benefits, it’s important to choose the right therapist—someone you trust who makes you feel cared for and has the experience to help you make changes for the better in your life. A good therapist helps you become stronger and more self-aware. Finding the right therapist will probably take some time and work, but it’s worth the effort. The connection you have with your therapist is essential. You need someone who you can trust—someone you feel comfortable talking to about difficult subjects and intimate secrets, someone who will be a partner in your recovery. Therapy won’t be effective unless you have this bond, so take some time in the beginning to find the right person. It’s okay to shop around and ask questions when interviewing potential therapists. As you start to resolve any past and current issues you are more likely to reduce anxiety, increase the likelihood of better quality of sleep and be on a path to a healthier future. I wish you luck as you move ahead!
Answered on 09/18/2021

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 09/18/2021

Will I ever sleep again?

A varied range of difficulties including anything from shifting hormones to a snoring bed partner to a stressful day at work can cause a middle-of-the-night wake-up call for so many of us.  I see that this has been going on for about 2 weeks or so for you, so I am glad that you have reached out to see if you can break this pattern and get yourself back on a healthy sleep pattern once again.  There is nothing worse that waking up and feeling in a fog and then trying to get on with our daily responsibilities. Read below to consider the do’s and don’ts to a healthy night's sleep: Here are your Don'ts: 1. Do not Stay in bed. You might think spending more time in bed will boost your odds of catching extra shuteye. Actually, the opposite is true. You cannot will yourself to sleep (just like you cannot will yourself to be hungry). A better option is to get up, go to a different room and do something calm and relaxing. Then, wait until you are sleepy once again before going back to bed. 2. Do Not Watch the clock. Counting how many hours you have slept or how many more you have until you need to wake up—will only add to your stress. The more worked up you get, the more difficult it will be to fall back to sleep. 3. Do Not Turn on your devices. Once you are up and out of bed, it can be tempting to check your social media page, watch YouTube videos on your phone or even catch up on work emails. However, using electronics near your eyes (e.g., phones, tablets, laptops) is known to interfere with your body’s natural inbuilt clock, making it even more difficult to sleep. 4. Do not Work. It is best not to do anything that reinforces middle-of-the-night wakefulness. Avoid work, chores, or hobbies or anything that could serve as a reward for waking prematurely and then become a habit. 5. Do not Use caffeine in the late afternoon. Caffeine may help you wake up in the morning, but avoid taking a hit in the afternoon. Caffeine can linger in your system for up to 8 hours, making sleep more restless.  Set yourself a healthy schedule and drink your last brew in good time! 6. Do not Use alcohol as a nightcap. Although alcohol can have a depressant effect and yes it can make you feel sleepy, however, it ultimately interferes with sleep. When alcohol is metabolized, it actually has an alerting effect that can lead to middle-of-the-night disruptions. Here are your To Do's: 1. Do Watch mindless TV.  This may sound counterintuitive if you have heard the advice to shut off your screens before bedtime, but if you cannot sleep, go to the living room and turn on the TV.  Here is the difference - the television screen is usually set at a distance from your eyes, its effect on your circadian rhythms - which is basically the body's body's internal clock which signals us to feel bright and awake in the morning and drowsy in the night. Rhythmic exposure to light and dark is essential to your internal clock and thus for proper health and organ function) -  is a lot weaker. Spending perhaps 30 minutes watching a mindless show even one you have seen previously, can often help you pass the time until you feel sleepy again. 2. Do Stick to a schedule. Our bodies function at their best potential when we maintain the same sleep schedule, even on weekends. If you happen to wake up in the middle of the night, avoid napping the next day so you are tired at bedtime. 3. Do Read a book. Paging through a pleasant yet not engrossing novel can help relax you back to sleep. Just do not turn on that tablet, e reader or open up an all engrossing thriller.  Select something you enjoy but that you can easily put down, and that does not emit bright light. 4. Do Create white noise. If you are a naturally light sleeper, unexpected noises—a furnace clicking on, a barking dog, a loud neighbor—can wake you up. Even a bird singing at dawn can rouse you prematurely.  So the solution is to amplify your background noise. The low continuous hum of a fan or noise machine can actually help drown out those disruptions. 5. Do Practice stress reduction techniques.  Relaxation exercises before bedtime or when you find yourself wide awake in the wee hours can help your mind wind down. A few techniques to try: mindful meditation (select one of the many apps that are available eg. Headspace or Calm) yoga, deep breathing and writing in a gratitude journal.  What To Do If All The Above Strategies Do Not Work For You: The above strategies would best apply to someone who is having a passing sleep disturbance. For example, maybe temporary stress at work or having some sort of minor illness which seems to be the route cause for you waking you up at night. The idea is to prevent these issues from developing into a long-term sleep problem.   If you think there is a more pervasive issue going on with you. So, if you indeed still stressed out about your poor sleep patterns and this persists, and you have tried the above suggestions then I would suggest you consider seeking help from a mental health professional to consider what might be causing your sleep disruptions. This guiding rule might help you decide what to do next. Consider the rule of 3's Are you waking up 3 nights (or more) each week?  Does it take longer than 30 minutes for you to fall back to sleep? Have you been waking in the middle of the night for at least 30 days? If you answer yes to these 3 questions, it may be time to see a professional counselor or even a sleep specialist.   Together you may be able to devise a plan to ensure you get the sleep you need.   Best of luck to you, Gaynor 
(MA, LCSW)
Answered on 09/18/2021

I am without work and I cannot find a job. I have gone through difficult conditions in my country an

Hello, I am glad you reached out for support at this time.  I am sorry you are struggling in this moment.  I would encourage you to start to work with a therapist to help you learn skills to help you overcome your struggles.  If we were to meet I would first talk to you about the counseling process through our site and how together we could help you obtain your goals going forward, how I work as a counselor and how I would try to help you through the counseling process.  I would also take the first session to get to know you by asking you a few questions to get a better understanding of your struggles so that I am able to focus on a plan and goals to work on going forward. I want you to know that you are not alone during this time even though you may feel like you are alone at this time.  During the therapy process, you can have support 100% of the time as you are able to reach out and talk to a therapist 24 hours a day 7 days a week. I am going to send you some skills and tools to help you during this time of struggle you are having.  If we were to work together we would be going over these and more tools to help you through your struggles and be able to ask for support from others. Insomnia—difficulty in falling or staying asleep—affects as many as 1 in 3 people, and almost anyone could do with better, more restorative sleep. Insomnia usually becomes a problem if it occurs on most nights and causes distress or daytime effects such as fatigue, poor concentration, and irritability.The relationship between insomnia and depression is far from simple, as insomnia can both cause and be caused by depression. Insomnia not only predisposes to depression but also exacerbates existing depressive symptoms, making it harder to pull through. Insomnia also predisposes to other mental disorders such as anxiety disorders and psychotic disorders; to physical problems such as infections, high blood pressure, obesity, and diabetes; and to motoring and other accidents.Aside from depression, common causes or contributors to insomnia include poor sleeping habits, other mental disorders such as anxiety disorders and psychotic disorders, physical problems such as pain or shortness of breath, certain prescription medications, and alcohol and drug misuse. The most important causes of short-term insomnia (the commonest type of insomnia) are a stressful life event, a poor sleeping environment, and an irregular routine.If you are suffering from insomnia, there are a number of simple measures that you can take to resolve or at least reduce the problem:1. Set up a strict routine involving regular and adequate sleeping times (most adults need about seven or eight hours sleep every night). Allocate a time for sleeping, for example, 11 pm to 7 am, and don’t use this time for anything else. Avoid daytime naps, or make them short and regular. If you have a bad night, avoid sleeping late, as this makes it more difficult to fall asleep the following night.2. Devise a relaxing bedtime routine that enables you to wind down before bedtime. This may involve breathing exercises or meditation or simply reading a book, listening to music, or watching TV.3. Enjoy a hot, non-caffeinated drink such as herbal tea or hot chocolate. In time, your hot drink could become a sleeping cue.4. Sleep in a familiar, dark, and quiet room that is adequately ventilated and neither too hot nor too cold. Try to use this room for sleeping only, so that you come to associate it with sleep. In time, your room could become another sleeping cue.5. If sleep doesn’t come, don’t become anxious or annoyed and try to force yourself to sleep. The more aggravated you become, the less likely you are to fall asleep. Instead, try to clear your mind and relax. For example, I find that making myself feel grateful for something soon sends me off to sleep. Alternatively, get up and do something relaxing and enjoyable for about half an hour before giving it another go.6. Exercise regularly. This will also help you with your low mood. However, don’t work out too close to bedtime as the short-term alerting effects of exercise may make it harder to fall asleep.7. Reduce your overall stress. At the same time, try to do something productive or enjoyable each day. As da Vinci said, a well-spent day brings happy sleep (and a well-spent life brings happy death).8. Eat a wholesome evening meal with a good balance of protein and complex carbohydrates. Eating too much can make it difficult to fall asleep; eating too little can disturb your sleep and decrease its quality.9. Avoid caffeine, alcohol, and tobacco, particularly in the evening. Alcohol may make you fall asleep more readily, but it decreases the overall length and quality of your sleep.10. If insomnia persists despite these measures, speak to your doctor. In some cases, insomnia has a very specific cause such as a physical problem or an adverse effect of your medication that requires your doctor’s attention. Lack of sleep can have major consequences on your mood and productivity as work, and even life-threatening dangerous implications for commuters or individuals operating vehicles or heavy machinery. Lack of sleep has also been linked to the emergence and worsening of many chronic health problems, including type 2 diabetes, cardiovascular disease, obesity, and depression.How can you get better sleep to perform better at work and in life? Here are the 10 steps you can take.1. Minimize DistractionsBan TVs and computers from the bedroom. TVs and computers emit blue light that trick the body into believing it’s daytime, making falling asleep more difficult. They are also distracting and might keep you awake even when you’re feeling tired.2. Avoid CaffeineSteer clear of caffeine in beverages and food for six to eight hours before bedtime.3. Minimize Alcohol ConsumptionDrinking may help you feel drowsy, but it has been shown to disrupt sleep patterns and create a lower quality, less restorative night’s rest. Don’t have alcohol close to bedtime— it can wake you up three to four hours later. (A drink with dinner is OK.)4. Develop a RoutinePick a bedtime and awake time and stick with them from night tonight. Signal to your body that it’s time for bed taking a shower or bath, playing soft music, doing a light reading, or eating a small snack.5. Establish a Bedtime“I’ll sleep when I’m dead” may sound inspiring, but sleep should be a top priority. Designate seven to eight hours in your daily schedule for sleep.6. Create a Safe SpaceOptimize your bedroom for a good night’s sleep by keeping your bedroom comfortable, dark, and quiet. Clean bedding, cool temperatures, and serene quiet can make a big difference in helping you fall asleep.7. Use Your Bed Exclusively for SleepJust because you are in bed doesn’t mean that you’re asleep. Many people use their beds as a comfortable place for lounging, browsing the internet on their laptops, and scrolling through social media on their phones. Reserve your bedroom exclusively for sleeping and sex. This will help you associate your bed with sleep.8. Power Down the ElectronicsTwenty to 30 minutes before bedtime dim your lights and switch off electronics. Like TVs and computers, cell phones and tablets emit blue light, tricking your body into believing it’s daytime.9. Practice Relaxation TechniquesTry relaxation exercises at bedtime if you need to unwind before hitting the hay. Some activities that can help you fall asleep include yoga, deep breathing or guided meditation.10. Avoid Lying in Bed AwakeFew things feel worse than lying in bed for hours trying to sleep. If you don’t fall asleep within 15 to 20 minutes, get out of bed, leave the bedroom and try some of your calming before-bed activities again.   Think about all the factors that can interfere with a good night's sleep — from work stress and family responsibilities to unexpected challenges, such as illnesses. It's no wonder that quality sleep is sometimes elusive.While you might not be able to control the factors that interfere with your sleep, you can adopt habits that encourage better sleep. Start with these simple tips.1. Stick to a sleep scheduleSet aside no more than eight hours for sleep. The recommended amount of sleep for a healthy adult is at least seven hours. Most people don't need more than eight hours in bed to achieve this goal.Go to bed and get up at the same time every day. Try to limit the difference in your sleep schedule on weeknights and weekends to no more than one hour. Being consistent reinforces your body's sleep-wake cycle.If you don't fall asleep within about 20 minutes, leave your bedroom and do something relaxing. Read or listen to soothing music. Go back to bed when you're tired. Repeat as needed.2. Pay attention to what you eat and drinkDon't go to bed hungry or stuffed. In particular, avoid heavy or large meals within a couple of hours of bedtime. Your discomfort might keep you up.Nicotine, caffeine and alcohol deserve caution, too. The stimulating effects of nicotine and caffeine take hours to wear off and can wreak havoc on quality sleep. And even though alcohol might make you feel sleepy, it can disrupt sleep later in the night.3. Create a restful environmentCreate a room that's ideal for sleeping. Often, this means cool, dark and quiet. Exposure to light might make it more challenging to fall asleep. Avoid prolonged use of light-emitting screens just before bedtime. Consider using room-darkening shades, earplugs, a fan or other devices to create an environment that suits your needs.Doing calming activities before bedtime, such as taking a bath or using relaxation techniques, might promote better sleep.4. Limit daytime napsLong daytime naps can interfere with nighttime sleep. If you choose to nap, limit yourself to up to 30 minutes and avoid doing so late in the day.If you work nights, however, you might need to nap late in the day before work to help make up your sleep debt.5. Include physical activity in your daily routineRegular physical activity can promote better sleep. Avoid being active too close to bedtime, however.Spending time outside every day might be helpful, too.6. Manage worriesTry to resolve your worries or concerns before bedtime. Jot down what's on your mind and then set it aside for tomorrow.Stress management might help. Start with the basics, such as getting organized, setting priorities and delegating tasks. Meditation also can ease anxiety. How can I get a better night’s sleep?Sleeping well directly affects your mental and physical health. Fall short and it can take a serious toll on your daytime energy, productivity, emotional balance, and even your weight. Yet many of us regularly toss and turn at night, struggling to get the sleep we need. Getting a good night’s sleep may seem like an impossible goal when you’re wide awake at 3 a.m., but you have much more control over the quality of your sleep than you probably realize. Just as the way you feel during your waking hours often hinges on how well you sleep at night, so the cure for sleep difficulties can often be found in your daily routine.Unhealthy daytime habits and lifestyle choices can leave you tossing and turning at night and adversely affect your mood, brain and heart health, immune system, creativity, vitality, and weight. But by experimenting with the following tips, you can enjoy better sleep at night, boost your health, and improve how you think and feel during the day.Tip 1: Keep in sync with your body’s natural sleep-wake cycleGetting in sync with your body’s natural sleep-wake cycle, or circadian rhythm, is one of the most important strategies for sleeping better. If you keep a regular sleep-wake schedule, you’ll feel much more refreshed and energized than if you sleep the same number of hours at different times, even if you only alter your sleep schedule by an hour or two.Try to go to sleep and get up at the same time every day. This helps set your body’s internal clock and optimize the quality of your sleep. Choose a bed time when you normally feel tired, so that you don’t toss and turn. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock, you may need an earlier bedtime.Avoid sleeping in—even on weekends. The more your weekend/weekday sleep schedules differ, the worse the jetlag-like symptoms you’ll experience. If you need to make up for a late night, opt for a daytime nap rather than sleeping in. This allows you to pay off your sleep debt without disturbing your natural sleep-wake rhythm.Be smart about napping. While napping is a good way to make up for lost sleep, if you have trouble falling asleep or staying asleep at night, napping can make things worse. Limit naps to 15 to 20 minutes in the early afternoon.Fight after-dinner drowsiness. If you get sleepy way before your bedtime, get off the couch and do something mildly stimulating, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may wake up later in the night and have trouble getting back to sleep.Tip 2: Control your exposure to lightMelatonin is a naturally occurring hormone controlled by light exposure that helps regulate your sleep-wake cycle. Your brain secretes more melatonin when it’s dark—making you sleepy—and less when it’s light—making you more alert. However, many aspects of modern life can alter your body’s production of melatonin and shift your circadian rhythm.How to influence your exposure to lightDuring the day:Expose yourself to bright sunlight in the morning. The closer to the time you get up, the better. Have your coffee outside, for example, or eat breakfast by a sunny window. The light on your face will help you wake upSpend more time outside during daylight. Take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night.Let as much natural light into your home or workspace as possible. Keep curtains and blinds open during the day, and try to move your desk closer to the window.If necessary, use a light therapy box. This simulates sunshine and can be especially useful during short winter days.At night:Avoid bright screens within 1-2 hours of your bedtime. The blue light emitted by your phone, tablet, computer, or TV is especially disruptive. You can minimize the impact by using devices with smaller screens, turning the brightness down, or using light-altering software such as f.lux.Say no to late-night television. Not only does the light from a TV suppress melatonin, but many programs are stimulating rather than relaxing. Try listening to music or audio books instead.Don’t read with backlit devices. Tablets that are backlit are more disruptive than e-readers that don’t have their own light source.When it’s time to sleep, make sure the room is dark. Use heavy curtains or shades to block light from windows, or try a sleep mask. Also consider covering up electronics that emit light.Keep the lights down if you get up during the night. If you need some light to move around safely, try installing a dim nightlight in the hall or bathroom or using a small flashlight. This will make it easier for you to fall back to sleep.Tip 3: Exercise during the dayPeople who exercise regularly sleep better at night and feel less sleepy during the day. Regular exercise also improves the symptoms of insomnia and sleep apnea and increases the amount of time you spend in the deep, restorative stages of sleep.·         The more vigorously you exercise, the more powerful the sleep benefits. But even light exercise—such as walking for just 10 minutes a day—improves sleep quality.·         It can take several months of regular activity before you experience the full sleep-promoting effects. So be patient and focus on building an exercise habit that sticks.For better sleep, time your exercise rightExercise speeds up your metabolism, elevates body temperature, and stimulates hormones such as cortisol. This isn’t a problem if you’re exercising in the morning or afternoon, but too close to bed and it can interfere with sleep.Try to finish moderate to vigorous workouts at least three hours before bedtime. If you’re still experiencing sleep difficulties, move your workouts even earlier. Relaxing, low-impact exercises such as yoga or gentle stretching in the evening can help promote sleep.Tip 4: Be smart about what you eat and drinkYour daytime eating habits play a role in how well you sleep, especially in the hours before bedtime.Limit caffeine and nicotine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! Similarly, smoking is another stimulant that can disrupt your sleep, especially if you smoke close to bedtime.Avoid big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Spicy or acidic foods can cause stomach trouble and heartburn.Avoid alcohol before bed. While a nightcap may help you relax, it interferes with your sleep cycle once you’re out.Avoid drinking too many liquids in the evening. Drinking lots of fluids may result in frequent bathroom trips throughout the night.Cut back on sugary foods and refined carbs. Eating lots of sugar and refined carbs such as white bread, white rice, and pasta during the day can trigger wakefulness at night and pull you out of the deep, restorative stages of sleep.Nighttime snacks help you sleepFor some people, a light snack before bed can help promote sleep. For others, eating before bed leads to indigestion and make sleeping more difficult. If you need a bedtime snack, try:·         Half a turkey sandwich·         A small bowl of whole-grain, low-sugar cereal·         Milk or yogurt·         A bananaTip 5: Wind down and clear your headDo you often find yourself unable to get to sleep or regularly waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. Taking steps to manage your overall stress levels and learning how to curb the worry habit can make it easier to unwind at night. You can also try developing a relaxing bedtime ritual to help you prepare your mind for sleep, such as practicing a relaxation technique, taking a warm bath, or dimming the lights and listening to soft music or an audiobook.Problems clearing you head at night can also stem from your daytime habits. The more overstimulated your brain becomes during the day, the harder it can be slow down and unwind at night. Maybe, like many of us, you’re constantly interrupting tasks during the day to check your phone, email, or social media. Then when it comes to getting to sleep at night, your brain is so accustomed to seeking fresh stimulation, it becomes difficult to unwind. Help yourself by setting aside specific times during the day for checking your phone and social media and, as much as possible, try to focus on one task at a time. You’ll be better able to calm your mind at bedtime.A deep breathing exercise to help you sleepBreathing from your belly rather than your chest can activate the relaxation response and lower your heart rate, blood pressure, and stress levels to help you drift off to sleep.·         Lay down in bed and close your eyes.·         Put one hand on your chest and the other on your stomach.·         Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little.·         Exhale through your mouth, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.·         Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count slowly as you exhale.To follow along with a guided deep breathing exercise, click here.A body scan exercise to help you sleepBy focusing your attention on different parts of your body, you can identify where you’re holding any stress or tension, and release it.·         Lie on your back, legs uncrossed, arms relaxed at your sides, eyes closed. Focus on your breathing for about two minutes until you start to feel relaxed.·         Turn your focus to the toes of your right foot. Notice any tension while continuing to also focus on your breathing. Imagine each deep breath flowing to your toes. Remain focused on this area for at least three to five seconds.·         Move your focus to the sole of your right foot. Tune in to any sensations you feel in that part of your body and imagine each breath flowing from the sole of your foot. Then move your focus to your right ankle and repeat. Move to your calf, knee, thigh, hip, and then repeat the sequence for your left leg. From there, move up your torso, through your lower back and abdomen, your upper back and chest, and your shoulders. Pay close attention to any area of the body that feels tense.·         After completing the body scan, relax, noting how your body feels. You should feel so relaxed you can easily fall asleep.For a guided body scan meditation to help you wind down and clear your head at bedtime, click here.Tip 6: Improve your sleep environmentA peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses. Sometimes even small changes to your environment can make a big difference to your quality of sleep.Keep your room dark, cool, and quietKeep noise down. If you can’t avoid or eliminate noise from neighbors, traffic, or other people in your household, try masking it with a fan or sound machine. Earplugs may also help.Keep your room cool. Most people sleep best in a slightly cool room (around 65° F or 18° C) with adequate ventilation. A bedroom that is too hot or too cold can interfere with quality sleep.Make sure your bed is comfortable. Your bed covers should leave you enough room to stretch and turn comfortably without becoming tangled. If you often wake up with a sore back or an aching neck, you may need to experiment with different levels of mattress firmness, foam toppers, and pillows that provide more or less support.Reserve your bed for sleeping and sex. By not working, watching TV, or using your phone, tablet, or computer in bed, your brain will associate the bedroom with just sleep and sex, which makes it easier to wind down at night.Tip 7: Learn ways to get back to sleepIt’s normal to wake briefly during the night but if you’re having trouble falling back asleep, these tips may help:Stay out of your head. Hard as it may be, try not to stress over your inability to fall asleep again, because that stress only encourages your body to stay awake. To stay out of your head, focus on the feelings in your body or practice breathing exercises. Take a breath in, then breathe out slowly while saying or thinking the word, “Ahhh.” Take another breath and repeat.Make relaxation your goal, not sleep. If you find it hard to fall back asleep, try a relaxation technique such as visualization, progressive muscle relaxation, or meditation, which can be done without even getting out of bed. Even though it’s not a replacement for sleep, relaxation can still help rejuvenate your body.Do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, get out of bed and do a quiet, non-stimulating activity, such as reading a book. Keep the lights dim and avoid screens so as not to cue your body that it’s time to wake up.Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve. Similarly, if a great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive after a good night’s rest. I hope that these skills have been helpful for you in your struggles you have been facing at this time. I am going to give you my information if you are wanting to start to process through and work on your struggles going forward, please reach out to Betterhelp and ask to be matched with Crystal Westman. If we were to work together we would work on more skills and tools to help you when you are struggling and get back to a positive space.  I encourage you to reach out for support at this time to help you get to the best version of yourself.
Answered on 09/18/2021

Is taking quitapine for having sleeping problems/insomnia ok?

Quettiapine is a medication used to treat mood disorders such as Bipolar Disorder and depression or mania associated with Bipolar Disorder. It is an anti-psychotic medication used to treat Schizophrenia as well. It helps by restoring neurotransmitters in the brain. This medication can help one stay focused, decrease anxiety, and improve mood, appetite, and energy levels. It is very helpful in preventing mood swings and decreasing how often they occur.  The Food and Drug Administration (FDA), has not approved Quetiapine to treat insomnia. The drug does have sedative effects and is prescribed sometimes as a short-term sleep aid. Studies were done on using this drug for insomnia vary and you can research the different studies online. As with any medication, there are risks for side effects. For this particular drug side effects include constipation, upset stomach, slows metabolism , weight gain, and dry mouth. When you start taking the medication dizziness or lightheadedness may occur. If your doctor does prescribe you Quetiapine make sure to tell him/her if you are taking any other medications. Sedative effects work almost immediately. It is because of these potential side effects that many researchers agree that one should think very hard about using this medication for insomnia. Many are in agreement that other alternatives should be tried including over-the-counter (OTC) sleep aids before using Quetiapine. Many others say that it is okay to use for short-term but not long-term use.  Doctors may prescribe this medication for sleeping because they have realized that drugs in the benzodiazepine class can cause dependency when used regularly. Other types of medications have been sought and Quetiapine has filled that gap and need. This drug is then prescribed off-label. Off-label prescribing is when doctors prescribe medications for uses outside from its original intent. This is very common in Psychiatry and is used when individuals may not have responded to standard treatments. As with any drug, the experience is different for each unique individual. What might work for 10 people may not work for another. As with any decision the choice is up to you. I recommend doing some research to come to an informed choice. Speak with your doctor who can discuss the situation with you and help you come to an educated choice. I hope this was helpful and good luck to you!    
(LCSW-R, CLC)
Answered on 09/18/2021

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 09/18/2021

Burnout since march 2020

Hi Thank you for reaching out to Betterhelp.I would suggest reaching out to your primary care physician for a regular exam and blood work to rule out and medical problems and explain your concerns. The primary care physician can then refer you to a specialist based on your lab and exam results. If there are no medical problems I would reach out to a clinician on Betterhelp to assist you with sleep habits. I can assist you with some suggestions through this message. Here are some tips: Do not drink caffeine: no tea, coffee, energy drinks or soda after 4 pm. Limit sugars later in the day. Do not eat a big or spicy meal late in the evening. Do not go to bed hungry. Avoid alcohol as it can interfere with sleep.  Try to get physical exercise/outdoor time daily. Taking a walk in the late afternoon can help to make your body tired and help you sleep. Sleep only at night time and do not have day time naps no matter how tired you feel. Naps will keep the problem going by making it harder for you to go to sleep at night. Have a regular bedtime routine to teach your body when it's time to go to sleep. Have a soothing drink such as chamomile tea or a milk. Have a warm bath/shower or a routine of washing your face and brushing your teeth. Try using relaxing body wash in the shower/bath/or face wash. Go to bed at the same time each night. Wake up at the same time each morning. (There are applications on your phone such as the iPhone health application that can assist you with a sleep schedule) When in bed think of positive things such as 5 nice things that happened that day, positive mantras, etc. Avoid tv/looking at the computer or phone screen before bed. Try a breathing exercise for relaxation (such as triangle breathing) or progressive muscle relaxation. Make your bedroom a pleasant place for sleep. Keep it clean and neat. Only use your bed for sleeping. Try lavender oil or other natural essential oils for relaxation. If you cannot go to sleep within about 30 minutes of laying in bed then get up and do an activity somewhere else such as reading a calming book or listening to calming music with minimal lighting. Then try going back to sleep in your bed after about 15 minutes. Repeat this if necessary. If these do not work after being done consistently you could consult your primary care physician or a psychiatrist for medication to assist with sleep. I would try to make serious life changes before trying medication.  Best of luck!
(LMHC)
Answered on 09/18/2021

How do I get back to sleep?

Hi,   First of all, congratulations on quitting smoking! That is a huge step to take for your own health and wellbeing. If you haven't done so lately, give yourself a pat on the back!   Restful sleep/REM sleep is essential to our health, both emotional and physical. I suspect that once you are sleeping well, you will feel better overall.   What you want to put into place are some practices referred to as "sleep hygiene." Here are some suggestions that could help. I would recommend trying as many as you can. If you still don't have success, you could speak with your doctor about whether a natural supplement such as melatonin might be helpful to you.    - Get at least 30 minutes of exercise during the day. - Get at least 20 minutes of sunlight during the day. - Avoid caffeine (coffee, energy drinks) after 3 pm. - Avoid large meals after 7 pm. - Try a hot bath 1-2 hours before bedtime - Try relaxation techniques such as hatha yoga or progressive relaxation (there are many examples available on YouTube). - Abstain from drugs and alcohol and processed sugar (they tend to make sleep quality worse). - Keep the room dark. - Read a book instead of watching television or using the phone. - Try a white noise machine.   There are also a number of apps that claim to help with sleeping, but to my knowledge none are research-based. You are certainly welcome to try them, however! My motto is "Whatever works."   If you find yourself up at night worrying, you might try writing down your worries and putting them in a box. You could write a journal entry or message your counselor on the BetterHelp platform to try to get things out of your head. I always recommend writing a gratitude list at night. In fact, one fun trick for insomnia is to try to make a list of things you are grateful for in alphabetical order: one for A, one for B, etc. It's difficult enough to keep your mind busy and you will almost definitely find yourself drifting off before Z!   I encourage you to continue to seek support for your symptoms. You are definitely on the right track. Hang in there!
Answered on 09/18/2021

How to cope with invasive / intrusive thoughts ?

Hello and thank you for reaching out to Betterhelp with this question related to your mental health. It sounds like evening/night are difficult times for you and transitioning from your daily life to tranquil time for bed is not coming easily. When you are constantly plagued by your past, there is probably a lot to talk through and process in order to give yourself a better sense of closure. Regardless of what you have experienced and endured before, we are all survivors of our own circumstances. You are allowed to work towards closing chapter and finding forgiveness in others and within yourself, and you don't need the feedback of anyone else to do so. When it is specific thoughts that come to mind, it can be useful to try journaling prior to sleep as a means of giving your mind permission to put those thoughts on paper and cleanse them from your head before trying to sleep.  Routine and consistency are most important when it comes to creating a stable sleep environment. If you give yourself a 3 step plan and then try to keep it going throughout the week evenings, it can help your mind transition over easier. Whether that include reading, listening to soothing music, speaking with a loved one, journaling, etc. Anything that will help you leave those negative thoughts behind is useful. A cognitive behavioral technique is when these specific thoughts come to mind, visualize a Stop Sign and internally tell yourself, "Stop!" Then implement a replacement thought in it's place. Sometimes we just have to be creative and seek control for what we are allowing to ruminate in our mind.  If there is much that has happened in your past, I would also suggest participating in therapy if you have the means as a way of talking through and finding acceptance for what your journey has included. Avoid caffeine past the afternoon and practice compassion for yourself. People can develop sleep anxiety just in fear of not being able to fall asleep but hopefully with some routine changes, cognitive strategies and implementing relaxation more effectively it can have a positive impact for you. 
(LMHC, CRC)
Answered on 09/18/2021

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 09/18/2021

What is the best and most effective way to stop masturbation!

Hello! Thank you for your question. Masturbation is a sensitive topic for many people because of its connections to social customs and taboos, religious and spiritual beliefs, and uncomfortable emotions. It seems important to begin by saying that masturbation is a completely normal, healthy part of human sexuality. Planned Parenthood outlines several of the benefits of self-pleasure, including reduced feelings of stress, improved self-esteem and body image, and increased self-knowledge regarding sexual pleasure and preferences. According to an article from Psychology Today, a study by Tenga conducted in nine countries found that of 10,000 adults surveyed, 84% of respondents reported masturbation. For something so common, it's a little surprising that we don't talk about it more often! It sounds like you might be worrying that you masturbate too frequently, so let's address that next. When it comes to how much masturbation is "normal," the simplest answer is that there isn't really a normal amount. Every person's level of sexual desire is different and may vary depending on a number of factors including age, body chemistry, and life stressors. Some people masturbate multiple times a day while others may enjoy self-pleasure a few times a week, a few times a month, or a few times a year. Some may not masturbate at all, also for a number of possible reasons. Masturbating once or twice or more a day is not necessarily a bad or unhealthy thing. You say you mostly masturbate before sleeping, which is also a normal thing to do. During orgasm, the brain releases hormones such as oxytocin and endorphins which help the body feel good and relax. The chemicals released by orgasm also seem to help reduce stress and feelings of anxiety, which can help to promote sleep. Many people use masturbation as a natural sleep-aid. Again, this is not necessarily a bad or unhealthy thing. You note that sometimes you can't sleep without an orgasm, which could be due to a few different causes. I am wondering if you had problems with sleep before a year and a half ago, or if you sometimes have trouble falling asleep even after an orgasm. Do you notice any other commonalities about times when you have difficulty sleeping? Feelings of anxiety or worry, feelings of depression, and stress about things like performance at school or at work can all contribute to insomnia. If you notice ongoing problems with sleep, it may help to talk to a medical provider who can help figure out if there might be a medical or mental health issue which masturbation alone is not going to fix. Another thing to be aware of is that humans tend to be creatures of habit - we get into routines which fit our needs and help us to feel safe and comfortable. When those habits get disrupted, it can feel strange, disorienting, and wrong. If your body and brain are used to having that surge of feel-good hormones just before sleep, it makes sense that it might be difficult to sleep without them. If it is important to you to develop some different habits, you might work on developing a routine which helps you to feel relaxed and ready for sleep. Many people enjoy warm beverages, light stretching, meditation, listening to gentle music, brushing their teeth, and washing their faces as parts of these routines. The Mayo Clinic recommends cutting back on caffeine later in the day, leaving some space between a big meal and going to bed, minimizing exposure to blue light from electronics, sleeping in an environment which is dark and quiet, and keeping a consistent schedule so that the body gets used to winding down at a particular time. It may take some time for a new routine to become habitual, so it is important to be flexible and patient with yourself. If you are feeling a lot of guilt, shame, or anxiety about masturbation, it might be helpful to talk with a therapist about what you are going through. It can really make a difference to have some help with exploring and resolving these emotions. It might also be important to talk with a counselor if you have noticed that masturbation is getting in the way of work or school, relationships, and other interests, as this could a be a sign that you no longer feel fully in control of your masturbation.  If you need more reassurance regarding the normality of masturbation, there are of course many resources on the internet. Links for the sources given above are: -  Planned Parenthood: https://www.plannedparenthood.org/learn/sex-pleasure-and-sexual-dysfunction/masturbation/masturbation-healthy -  Psychology Today: https://www.psychologytoday.com/gb/blog/sexual-self/202106/why-some-people-never-masturbate -  The Mayo Clinic: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-do-you-practice-good-sleep-hygiene/ Thank you again for reaching out! Kate
(MA, LPC)
Answered on 09/18/2021

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 09/18/2021