Insomnia not only leads to feelings of tiredness but also has an impact on other areas of a person’s mental health. To help understand what type of impact insomnia can have on mental health and what someone can do to get help for insomnia, I have interviewed therapist Etan Ben-Ami, LCSW.
Tell me a little bit about yourself.
I am a clinical social worker, providing psychotherapy in private practice. I specialize in providing cognitive-behavioral therapy for my clients’ problems. This is a type of therapy that emphasizes the use of techniques and interventions that have proven themselves valid and reliable in clinical trials. If you have a well-defined problem, (eg panic disorder, OCD, post-traumatic stress disorder, or generalized anxiety) I can probably come up with a treatment plan with a known response rate. This enables patients to decide whether treatment is worthwhile based on the percentage of people with the problem who are helped by the kind of treatment I offer. I think this is essential if people want to be able to make informed choices about their care.
The type of treatment I specialize in demands a very active therapist and a client who really works hard to get well. I give plenty of homework. This accelerates therapy, making it both more efficient and effective. It’s just common sense.
What type of experience do you have with clients with insomnia?
“As far as insomnia is concerned, many of my patients come in with insomnia as a symptom or problem in addition to their main problem. If you’ve been bothered by worries throughout your day, you can expect your sleep to be disturbed. However, even after an anxiety disorder or depression has been successfully treated, insomnia can continue to be a problem. It takes on a life of its own. Likewise, if your sleep has been disrupted for weeks on end by a new baby, you might find yourself waking in the middle of the night even though your child has learned to sleep through till morning. I’ve been very successful at treating insomnia using cognitive-behavioral methods, regardless of the initial cause of the insomnia.
What type of impact does insomnia on mental health?
“I’m sure all of your readers have had to function on less sleep than they’d like at some point in their lives, whether it was intentional or due to insomnia. Everyone recognizes the drop in energy, the slightly depressed mood, and the irritability that even one night of inadequate sleep can cause. Many people live their lives on five hours of sleep for days on end, either due to overwork, care for an infant, or insomnia. This results in chronic sleep deprivation. We can learn to cope with it, often with coffee or other stimulants, but its never good for us.
Sleep deprivation hurts our ability to reason and our ability to remember new things. It hurts judgment. It makes us irritable, and exacerbates any tendency to see events and the world negatively. We become more anxious or more depressed more easily than if we were well-rested. It may not be a sole cause of depression or anxiety, but it certainly makes people feel worse. I’ve never read research proving it, but I suspect that sleep deprivation (whether caused by insomnia or not) can be the starting point of depressive or anxious symptoms, which then spiral into a full blown depression or anxiety disorder.
The same applies to sleep apnea. In some people, especially middle-aged people and seniors with obesity and a biological predisposition, the tongue falls backwards and the airway closes briefly while asleep. The sleepers body reacts to the inability to breathe by waking the person up. They begin to breathe again, and usually return to sleep with no memory of waking. This happens throughout the night resulting in disturbed and inadequate rest, without any awareness of what happened. If you find yourself tired and sleepy despite adequate time asleep, or if your partner complains about your snoring, there’s a good chance you have apnea. Apnea has the same emotional consequences as sleep deprivation due to any other cause, including insomnia. It may even be worse, since there’s no explanation for why you feel so tired and grumpy, until you are diagnosed.
I’ve worked with patients who were plagued by bad dreams about being strangled, lynched, or drowned, and who thought the problem was part of an anxiety disorder. After successful treatment for apnea the ‘psychological’ problem (the bad dreams) just disappeared. If there’s any chance you have sleep apnea, talk to your doctor about having a sleep study done. Treatment can be life changing in a good way.
How can someone overcome insomnia?
Regardless of whether the insomnia is secondary to a mood disorder or anxiety disorder, the first step is always to start having good sleep hygiene. This includes going to bed at approximately the same time every night and waking up at approximately the same time every morning. Avoid caffeinated beverages for at least eight hours prior to your bedtime. Also avoid alcohol for several hours before sleep, since alcohol hurts the quality of your sleep. Don’t use the bed as a place to work, study, or watch television. Sleepiness is easily conditioned, so you need to make your bedroom a place that reminds your unconscious that it’s time for sleep.
It’s a good idea to have a bed time ritual that includes the same relaxing activity every night. It’s another way of telling yourself that it will soon be time for bed. I tell my patients not to try to sleep. If you spend more than fifteen minutes laying in bed without falling asleep, get up and do something else for approximately 45 minutes. Also, many people try to use video or online gaming as a relaxing activity before bed. These are too exciting to be used this way. They’re meant to pump you up, and they should be avoided for at least an hour before sleep.
Most people would rather take a pill than change their sleep habits, and the pharmaceutical companies have promoted a chemical approach. Using medication for a long-term sleep problem is a trap. They tend to become ineffective over time. If your doctor has prescribed a medication as a sleep aid, ask him how long it can be used for without developing a tolerance or the drug becoming ineffective. If necessary develop a plan with your doctor for weaning yourself from the drug. Do not discontinue any prescribed medication without first consulting your physician.”
What type of professional help is available for someone that has insomnia?
Though I’d like all your readers with insomnia to become my patients, I realize that’s impractical. Any licensed psychologist or psychotherapist with experience providing cognitive behavioral therapy for sleep disorders should be able to help. There are published protocols for treating insomnia (regardless of cause). Anyone who has been trained properly and who can competently provide service using these protocols should have approximately the same rate of success. It’s not rocket science; it’s not mysterious; and it doesn’t take an extraordinary degree of subtlety or intelligence to help people overcome insomnia. The whole point of cognitive behavioral therapy is to give the public the ability to go to any competent provider and know that they will get approximately the same treatment with approximate ly the same likelihood for success.
Thank you Etan for doing the interview on impact of insomnia on mental health. For more information on Etan Ben-Ami or his work you can check out his website on http://www.effective-therapy-ny.com .
Recommended Readings:
http://www.associatedcontent.com/article/6178336/insomnia_tips_to_help_you_get_to_sleep.html?cat=5″>Insomnia: Tips to Help You Get to Sleep
http://www.associatedcontent.com/article/5770066/how_to_overcome_insomnia.html?cat=5″>How to Overcome Insomnia
http://www.associatedcontent.com/article/5762184/how_to_improve_sleep_patterns.html?cat=5″>How to Improve Sleep Patterns
