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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Dinah on March 31, 2002, at 22:52:07
I am having problems with involuntary naps. I've been having more problems with them since I stopped self injuring since they seem to have the same function - to assist me in dissociating myself from my feelings.
It happens when I'm upset and agitated, but not every time I'm upset and agitated. I have no control over it whatsoever. Sometimes I wish I could bring one on but I cannot. More often I wish I could stop them. I have managed not to fall asleep while driving but it was on one occasion recently extremely difficult. After that incident I have resolved to pull over someplace safe if it occurs again.
An example would be Friday. I came out of my therapist's office and fell asleep in the drivers seat of my car while still parked in the parking garage. I could vaguely hear, from time to time, people getting in and out of their cars nearby but I couldn't shake off the drugged drowsy feeling enough to fully rouse myself. After about 30 minutes (which seems to be the minimum duration) I woke up. I stayed awake driving home, but then fell asleep at my desk. In fact I slept most of Friday. The sleep feels drugged, heavy, and definitely unrefreshing. I wake up feeling groggy and headachy.
It is starting to get in the way of my work. Other than the potential problem with driving if it gets much worse and the existing problem with work, I really don't mind it as it is relatively effective.
I was just wondering if anyone else used involuntary naps for emotional distancing, and if so, if it is possible to gain more control over the whole process.
Thanks.
Posted by Bekka H. on April 1, 2002, at 0:05:19
In reply to Involuntary naps., posted by Dinah on March 31, 2002, at 22:52:07
Hi Dinah,
Can you tell me whether you are currently on an MAOI (monoamine oxidase inhibitor), such as Nardil, Parnate, Selegiline, etc?
The reason I ask is that when I was on Parnate, I had persistent narcolepsy-type attacks (not a good thing when you're driving), as well as excessive daytime somnolence. This happens to a small percentage of people on MAOIs.
Bekka
Posted by Dinah on April 1, 2002, at 0:46:46
In reply to Re: Involuntary naps.- Dinah, posted by Bekka H. on April 1, 2002, at 0:05:19
Hi Becca,
No, unfortunately I don't think it's a medication issue. I'm currently taking only a very small dose of Depakote (125 mg daily) and 1/2 to 1 mg Klonopin as needed. The naps don't seem to have any connection to whether or not I take a Klonopin. I hadn't taken one before the Friday episode.
But they have a definite correlation to my mood. They only happen when I am extremely agitated or anxious, but they don't happen every time I am extremely agitated or anxious. It's rather obviously a way of escaping, but I would much prefer it if I had more control over it. I think my employers would prefer that as well. :(
Thanks,
Dinah
Posted by Krazy Kat on April 1, 2002, at 9:51:25
In reply to Involuntary naps., posted by Dinah on March 31, 2002, at 22:52:07
dinah:
i really had this problem on topomax, less so on depakote. i use sleep when depressed to "escape" but not when agitated or high (anymore).
i have been taking a small amount of a stimulant, provigil, to help with my 2000 mg depakote sleepiness. it's not really quite doing it for me, but it might help you, except, it causes my heart to palpitate at anything over 50 mg, and that would not be good for an already agitated state.
if it's psychosomatic, i guess your therapist should know about it. i used to get really tired when in stressful situations, but i learned to counteract that with reason - "i am Not tired, i slept well last night, this is a reaction to the situation."
what an odd situation, eh?
Posted by Ritch on April 1, 2002, at 10:20:52
In reply to Re: Involuntary naps » Bekka H., posted by Dinah on April 1, 2002, at 0:46:46
> Hi Becca,
>
> No, unfortunately I don't think it's a medication issue. I'm currently taking only a very small dose of Depakote (125 mg daily) and 1/2 to 1 mg Klonopin as needed. The naps don't seem to have any connection to whether or not I take a Klonopin. I hadn't taken one before the Friday episode.
>
> But they have a definite correlation to my mood. They only happen when I am extremely agitated or anxious, but they don't happen every time I am extremely agitated or anxious. It's rather obviously a way of escaping, but I would much prefer it if I had more control over it. I think my employers would prefer that as well. :(
>
> Thanks,
> Dinah
Hi Dinah,Have you ever had a sleep study done or an EEG? A lot of what you are talking about sounds like seizure-like episodes. Temporal lobe seizures can cause feelings of agitation and derealization. Something you might want to investigate.
good luck,
Mitch
Posted by susan C on April 1, 2002, at 13:09:12
In reply to Re: Involuntary naps » Dinah, posted by Ritch on April 1, 2002, at 10:20:52
I was going to encourage you to have a neurological workup and sleep study, too, Dinah...
Mouse zzzzzzzzzzzzzzz
Posted by IsoM on April 1, 2002, at 13:32:45
In reply to Involuntary naps., posted by Dinah on March 31, 2002, at 22:52:07
Dinah, as you already know, I have narcolepsy so I tend to blame the sleepiness on that. But I did notice a few years ago when I was under a great deal of stress, my body would get very weak & I'd have to crawl into bed. I wasn't able to work then so had my bed handy when I needed it. I, too, found that sleepiness overcame me when I couldn't handle things anymore.
My body & brain shut down & I desperately NEEDED sleep. After I awoke, I'd feel a little better but until the stress was finally dealt with, my naps were very frequent & my night-time sleep was much longer.
I found no way to control it other than to deal with the sources of stress in my life, but even then, attempting to deal with it brought on more stress. It became a vicious circle.
Posted by judy1 on April 1, 2002, at 18:27:27
In reply to Involuntary naps., posted by Dinah on March 31, 2002, at 22:52:07
Personally, that hasn't happened to me- but it definitely sounds like you're substituting one coping skill for another (SI). Post therapy is a high stress time for me too, but I dissociate and lose a similar amount of time. Do you make sure you're grounded when you leave your therp's office? Do you know the grounding tricks like curling your toes frequently? I worry about you driving- please talk to your therapist and tell her/him to make sure you are grounded when you leave the office. Take care- judy
Posted by IsoM on April 1, 2002, at 19:15:14
In reply to Re: Involuntary naps. » Dinah, posted by judy1 on April 1, 2002, at 18:27:27
Judy, what's this about curling one's toes? What's it supposed to do? I'm very curious as I've read all sorts of tips & trivia to help with all sorts of problems but this is completely new to me. Thanks for answering.
About babies - I was never a baby-oriented person - didn't babysit as a teenager & had no little nephews/nieces or cousins, I just enjoyed holding & looking after my own sons. But now that some of my younger friends & my son's friends are having babies, I took an interest in them. Got to hold & cuddle a few between 4-10 months. I was surprised at how nice it felt! One baby of a friend is the most laid-back mellow child I've seen but very bright & observant. It just feels SO good to hold her & cuddle - she's nicely solid & sweet-smelling. I can feel the flow of calmnees go through me. She's so sublime! I've forgotten how it felt to hold a baby. Enjoy your little one!
Posted by judy1 on April 2, 2002, at 16:41:08
In reply to Re: curling your toes? » judy1, posted by IsoM on April 1, 2002, at 19:15:14
Hi Judy,
Try it- it's virtually impossible to dissociate if you're actively doing it- just another way to stay grounded without being obvious. I always do it when driving, even put a post-it note on the steering wheel to remind me.
Gabrielle is 2 months now- she smiles and coos. I think most women have almost a hormonal response when they hold a newborn. Now if she would just decide to sleep....
Posted by Noa on April 2, 2002, at 17:21:25
In reply to Re: Involuntary naps, posted by susan C on April 1, 2002, at 13:09:12
> I was going to encourage you to have a neurological workup and sleep study, too, Dinah...
> Mouse zzzzzzzzzzzzzzzMe too---in case it is a sleep disorder or siezures
Posted by Dinah on April 2, 2002, at 19:07:47
In reply to Re: Involuntary naps, posted by Noa on April 2, 2002, at 17:21:25
Thanks for all the responses. I've been thinking about it. I would think it wasn't physiological because it is so clearly tied into emotional excess. But I'll ask my pdoc when I see him in a couple of weeks. I rather think it is somehow tied into my skills in dissociating.
I don't remember how long I've been doing it (my memory for things like that is bad - it always feels like I've done what I'm doing now forever - mood state dependent memory). But I was enormously surprised a week or so ago when my therapist told me that no, not everyone has them.
I also find them extremely inconvenient at times. When I'm trying to drive. When it scares my son. When it severely interferes with my work. So I would like to learn how to control them.
But overall I like them. They work better than medicine. If I am upset and take a Klonopin, when the Klonopin wears off I'm still upset. But when I take an involuntary nap, when I wake up I've likely almost forgotten what I was upset about. I might remember what I'm upset about, but I see it from a different and more detached perspective. It's not like regular sleep. There's something about it that blanks my mind. Perhaps not the most mentally healthy way of dealing with things - but it works.
Unfortunately I can't reduce the stress in order to rid myself of the naps, because the things that cause them are usually internally driven. And I can't have my therapist help me ground myself before leaving therapy because I have time-released upset. I'm usually fine if a bit detached when I leave his office and then implode later. We're working on that and making a bit of progress. And of course therapy isn't the only thing or even the major thing that causes involuntary naps. I've tried my favorite grounding techniques, but they don't seem to be able to stand up against the involuntary naps. Those naps are POWERFUL.
I just read this post over and realize that it doesn't make much sense. I think my idiosyncratic use of language is getting in the way of expressing myself clearly. And I've been working really long hours to try to catch up on the mess I've let myself get into. So my thinking isn't all that clear. (My lucky employer!!) Oh well. I'm not going to try to revise this post. I'll probably just make it worse.
Anyway, thanks again. I will print out my post and some of my responses and see if my pdoc thinks I need to look into it further. My therapist doesn't seem to know any cognitive behavior techniques to deal with it, because he just hasn't seen many (or any - he didn't make it clear) people who do it. I'll try to pin him down on that too.
It's kind of hard to do research on things like CBT techniques, because I'm pretty sure the official name for the problem is not "involuntary naps" and I just have no other words for it.
Sorry. This is long. And rambling. And not terribly coherent.
Posted by Fi on April 4, 2002, at 14:41:34
In reply to Re: Involuntary naps, posted by Dinah on April 2, 2002, at 19:07:47
You *are* making sense.
I'm not sure CBT would help as this is involuntary, but I'm not an expert. It sounds from this message (more than your first one) as if the naps can be useful?
I would add to what others have said re the need to get it checked out, though. Particularly if there is *any* risk that you may do this while driving- it would be incredibly dangerous.
There's probably a whole range of possible physical or psychological reasons for the naps- dont just ask your therapist, but a doctor too?
Fi
Posted by Alii on April 23, 2002, at 20:25:02
In reply to Re: curling your toes? » judy1, posted by IsoM on April 1, 2002, at 19:15:14
> Judy, what's this about curling one's toes? What's it supposed to do? I'm very curious as I've read all sorts of tips & trivia to help with all sorts of problems but this is completely new to me. Thanks for answering.
>IsoM--
I don't know if any of this pertains to you. The following list can help with trance/dissociation feelings. At first I thought this list didn't 'speak' to me as I was not having flashbacks but now after many yrs of therapy I can see how I have dissociated and 'tranced out' in the past.
--Alii
>>>>>If you are having a flashback, and you know that this is happening, try some things on this list. If one doesn't help, go on to another. They are all designed to break a trance state and to get you back in touch with the present.
Many of the suggestions are taken from Chrystine Oksana's 'Safe Passage to Healing.' Others come from a many different survivors and therapists, including Erikson, Kluft, and Napier.
Tips for containing a flashback:
Blink hard. Blink again. Do it once more as hard as you can.
Change your body position.
Breathe slowly and deeply.
Go to a safe place.
Say your name out loud.
Drink a glass of ice water.
Tell someone what you need.
Move vigorously to release energy.
Name people or objects in the room.
Hold something that is comforting.
Listen to a tape of something soothing.
Make tea. Drink it.
Call a friend.
Eat a snack.
Jump up and down waving your arms.
Lie down on the floor; feel your body connecting with it. Keep your eyes open. How does it feel? Describe it out loud to yourself.
Make eye contact with your pet. Now hold it.
Clap your hands.
Breathe deeply. Keep breathing. Pay attention to your every breath.
Hold a stuffed animal, pillow, or your favorite blanket.
Alternatively tense and relax some muscles.
Try and "blink" with your whole body, not just your eyelids.
Move your eyes from object to object, stopping to focus on each one.
Wash your face.
Go outside for sunshine or fresh air.
Repeat to yourself: "I am safe. This is (month, day, and year). I am ___ years old. I am a big person. I can protect myself."
If you are so caught up in the flashback that you have no sense that you have already lived through the event, you may not be able to do any of the things suggested above.
Here are some techniques that your therapist, your SO, or a friend can use to help you re-connect to the present. (They are written for the person not having the flashback.)
Introduce yourself, explain it's a flashback, explain where the person is. Give reassurances of safety-'that's old stuff'-'you are not alone now and are much bigger and stronger now'
Use a magical eraser on the remembering.
Using an imaginary plastic spray bottle of water, spray the remembering until it dissolved away.
Put a TV screen around the remembering and then turn down the sound, turn down the brightness, switch channels.
Look at the remembering with binoculars turned around and adjust the picture to make it smaller.
Project the remembering on a wall/dry erase board, then 'erase' it with back-and-forth movements of your finger.
Suggest that the person remember or imagine a very safe place, go there, and bring all senses to bear in the imagining (seeing, hearing, smelling, touch, etc.)
Have the person draw the remembering on paper. Then erase, scribble over the drawing, flush it down the toilet, rip it up, etc.
With crisis telephone calls, when the person seems barely coherent, do most of the talking in your calmest, strongest, most reassuring voice. Say things like
'You can hear my voice, you have a firm grip on the telephone receiver, you are safe, you can have control over your breathing.' Then ask them to tell you what they see around them or to just name 'safe' objects in the room.
Tips from Readershold ice in your hand
take off shoes, put feet on the floor
wear a rubber band on your wrist and snap it a few times
concentrate on slower, longer breaths
alternate nostril breathing techniques
frequent intake of drinks of water
clean house<<<<<
This is the end of the thread.
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