My experience of postnatal depression was largely rooted in intense anxiety. This is the first of three posts about the worst of my anxiety-induced symptoms (insomnia, intrusive thoughts and derealisation/depersonalisation) and how I managed or overcame each of them.
I’ve always slept like the dead, my hubs and I both. We are those annoying people who wake up bleary-eyed after sleeping soundly through a thunderstorm or rowing neighbours and say “Oh. What happened?”
Everyone says after having a baby you can never sleep deeply again but we can and we do. Sometimes when we wake up to Caterpillar crying we get the distinct, guilty impression that he may have already been doing that for at least a couple of minutes.
But during the hot, muggy summer of 2013 I couldn’t have slept soundly, deeply or at all for a million pounds.
It began one night when Caterpillar was around seven weeks old. He was beginning to sleep for longer periods. After his late evening feed he would only wake once for a night feed before his early one at around 5.30am. We still weren’t getting more than 4-5 hr blocks at a time but pretty good going for such a young baby. I’d gone to bed early, around 9.30pm, as I’d been doing almost since he was born to try and catch up on a little shut-eye before the late evening feed.
For whatever reason I couldn’t get off. I now know the uncomfortable, tense feeling I’d had pretty much since day one as Anxiety-with-a-capital-A but at this point I hadn’t really recognised it as anything beyond the “baby blues” because my mind was too full of “What have I done?”, “Do I love my son?” and “When do things get back to normal?” But my mind clearly wanted me to sit up and take notice so it robbed me of peaceful slumber.
I lay there and lay there. I tossed and turned. I sweated. My heart sped a little. I growled in frustration. The minutes ticked by, closer and closer to the moment I knew the sweet but alien being in the crib next to me would wake up and want a part of me, all of me, once more. I told myself once the midnight feed was over I’d finally sleep. It came and went and I didn’t.
By the time my hubs stirred to give him his night feed I was rigid and tense and shakily told him “I haven’t been to sleep yet, you know?”
“Of course you have, don’t be silly, you’ve just forgotten.”
But I knew I hadn’t. I’d watched every single hour tick by with a growing sense of dread. Eventually my body gave in for a restless hour before it was time for Caterpillar and I to start our day and hubs to head off to work.
“Please don’t leave, I can’t look after him alone. I’m too tired.”
Understandably irritated. “Don’t be ridiculous. It’s just one sleepless night. You’re fine.”
All day I obsessed. What if I fall asleep at his clinic appointment and he falls out of my arms onto the hard floor? What if I stubble down the stairs and drop him because I’m so exhausted? What if I accidentally fall asleep on the sofa and smother him?
This was after one night without sleep. That should have been a huge warning sign to me but it wasn’t. I was just obsessed with getting some sleep. There was nothing that couldn’t be cured by a full eight hours.
It’s no surprise that by the next night I was too worried about getting sleep to actually get any. I lay there and panicked until 4am again.
The next night was worse. And the next and the next. I was averaging 1-2 hours sleep a night just before dawn and perhaps ten minute snippets earlier before jerking awake and continuing to panic. It’s hard to remember in detail. Those long, relief-less nights were the worst of my life.
On the very odd occasion that I didn’t sleep in the past I’d get up and watch a little TV, or have a drink. More often, I’d read or listen to my iPod. I’d be irritated sure but not panicked. Not terrified. Now, I’d pick up a book and wonder why I couldn’t get past the first sentence, why the words on the page appeared to be written in another language. I’d listen to my favourite songs but the lyrics would all seem dark or the nostalgia and memories of my old life would break my heart and leave me crying in frustration. Maybe I can cry myself to sleep…no that hasn’t worked but I’ve now been crying for two hours.
And all the while my nemesis, that taunting presence, sat there and watched me; the clock. Those hours were relentless. I simultaneously wanted to both freeze time so I had a better chance of getting some sleep and speed it up because then it would be morning and I’d no longer be the only person awake in the world.
The nights were hell but the days were almost worse. The intrusive thoughts about accidentally killing my baby because I was too tired came thick and fast. Every day things – stairs, kettle, traffic – became villains in the vivid horror movies in my mind. Every time I walked past my bedroom and caught a glimpse of my bed a wave of panic would hit me so hard I could barely breathe.
When you’re having a terrible time people always say that you can start a fresh tomorrow, that tomorrow is a new day. But how can tomorrow be a new day when you’ve been awake since the day before? Doesn’t that make your life just one long, restless day and is there anything more scary than that? A bad day that never ends. Each morning only brought with it more dread.
After just over a week like this (can that be right? It feels like a year in my memory), with the support of my husband, family and health visitor, I got help. Along with other medication, my GP prescribed me a sleep aid called Zopiclone. He promised they were fairly light and I would be able to function the next day and he was right. Of course, sleeping tablets brought with them their own worries; what if I can’t sleep even with the pills, what then? What if I can’t get off of them? But ultimately I took them in desperate hope.
Within 20 mins of that first tablet I was asleep and I slept for four hours straight. It was heaven. Just knowing there was something that could help me was an enormous relief. However, as is the nature of anxiety, I continued to worry every night that the pills would stop working, and yet every night I slept for slightly longer each time. I was also prescribed diazapam which marginally lessened my anxiety in anticipation of bedtime.
I began turning my phone off at night so I couldn’t clock-watch. Instead I stared blankly at the green light on Caterpilar’s baby monitor and breathed deeply until sleep came and took me. During this time my poor husband was doing all the night feeds and I’m not sure how I’ll ever repay him for that.
I was under the illusion that once I had good quality sleep again all my worries would melt away. Unfortunately, even after five or six hours of oblivion I still awoke to a stomach swirling with anxiety and weighted with a lead stone of dread. But with that magical, wonderful promise of unconsciousness every night, that break from the difficult days, I felt strong enough to begin the next part of my treatment: therapy. I thought that solving the sleep problems would spell the end of the anxiety, but the truth is once the anxiety is more managed sleep improvements will follow.
After two weeks on Zopiclone I decided to begin trying to sleep without them. I had become obsessed with the idea of being reliant on them, but simultaneously nervous about going it alone. The first night was a little rough, but night by night I used the other coping strategies I had learned to get a decent, unaided rest. The success of stopping the Zopiclone gave me confidence that one day I could wean off the other medication too.
During those hot, terrifying nights I genuinely thought I would never sleep again, I thought I would have to be taken to hospital and sedated. But in a few short weeks I had used a variety of tools to begin regaining control over my body and mind:
1. A sleeping aid (Zopiclone in my case)
2. A bedtime routine. I still stick to this now. Nothing big just small beauty/personal hygiene rituals that I do in the same order every night, moments before bed.
3. Slowly but surely believing – largely through CBT – that it doesn’t matter if I don’t sleep. None of the movies in my mind are real, they are just thoughts. This was key for me – once I stopped caring if I slept or not, I slept. As part of this I even did an affirmation to myself in the bathroom mirror each night: “You will sleep. And if you don’t it’s okay.” Eventually, I believed these words.
4. Breathing and relaxation exercises, with visualisation (my therapist had me draw a rectangle in my mind, taking a breath in for the short sides and out for the long sides)
Today, I sleep like the dead once again…except I’m truly alive, and that is an awesome, wonderful thing.
If you need further advice re sleep & insomnia, please watch my video on the topic here.