Night Panic

"If I'm feeling hysterical, its usually historical." ~ anonymous

Someone once told me that nothing good happens after 10:00 at night. Of course I know that this is not a universal truth, but for anyone who is prone to worry or panic, or sleep disturbance, late night can bring anxiety to new heights.

At night, paranoid thoughts can increase, self attack intensifies, and what may have seemed like forgivable mistakes can become relentless self doubt. A friend of mine, who has some humor about her night panic, tells me that some nights she is convinced that there are goblins in her hallway, monsters under her bed and aliens on her roof. Her boss is waiting to fire her; her doctor is waiting to give her dire news and her husband has three secret other wives.

She knows its her brain on rev, but still and all she worries. And the worry is real, and it is painful. She worries about her kids, her marriage and her financial situation. Some nights the worry turns into obsession and the obsession turns into sleeplessness, and the sleeplessness turns into more self attack.

Physical and mental exhaustion, hormones, biorhythms, brain chemistry can all contribute. So can an unresolved bad feeling in a relationship. So can the darkness itself. And one's personal history, even if the connection is not readily apparent. Somehow, late at night the mind can start conjuring up a parade of bad thoughts. An attack of "what ifs" or a barrage of "awfulizing" can take over rational thought. When the anxiety gets really bad, it can leave you longing for relief, but believing that none is really possible. If only there were an ice pack for the brain.

So what helps?

Well, I think that sufferers of night panic have a few choices, and any one or a combo can bring relief at one time or another. And first things first is being willing to believe that relief is both okay and possible. If you are stuck in the thought, however subtle, that the worry is actually keeping you safe from anything bad actually happening, you may need to address this belief first. Planning, consulting and considering can bring good results but when we are stuck in panic, obsession and rumination the pain can be intense and can block the way to solving real issues or getting relief from relentless worry.

Here are a few ideas, in no particular order, that can help with night panic:

~Listen for the thoughts under the panic. Write them down in a stream of consciousness, no holding back fashion. Look over them the next day and see which thoughts are fueling the feelings. Come up with a few good reassuring answers to the panic thoughts (even if you don't believe them 100%.)

~Come up with a few reassuring mantras to say to yourself such as "this too shall pass," "the worry is always worse than the actual event," or "even if something bad happens I can find support and get help."

~Talk back to the panic. Tell it to leave you alone, get lost, that feelings are not always facts and you will not let its panic messages ruin your night.

~Go to bed earlier. I don't mean to sound glib, but for night worriers, turning in earlier can help.

~Distract your mind. Read. Watch TV. Listen to music.

~Take a personal history. Think back to what bed time was like when you were a child. What are your memories? What were your parents doing late at night? Where were they? Did they tend toward calm or toward anxious? What feelings come up? Consider connecting the dots between your experiences now and the experiences that may have shaped you as a child.

~Make a list of everything and anything that is on your mind from things to do - to things that are worrying you. Leave nothing out. Then put the list away to review during the day.

~Make a gratitude list, a victory list, a list of things that are good and right with you, and in your world.

~Follow the feeling and see where it takes you. Don't fight it, study it. Get curious and wonder if it is new or old, familiar or strange. What or who does it remind you of? Might it have a benefit, a message, or a purpose?

~Talk, talk and talk some more. Talk about the things that may be making you feel angry, frustrated or helpless.

In the back and forth between accepting and feeling your feelings and actively using cognitive or behavioral techniques to help bring on relief, consider that there may be many good roads to relief. Often times there is meaning in our experiences, and when we are willing to tap into what that meaning is, we can end up with a richer life experience and better nights.

Exhausted? What Kind of Tired Are You?

Sometimes people come in to my office and sit down on my couch and tell me how very tired they are. Exhausted, in fact. Most folks these days have busy lives, lots of things on the "To Do" list. Work, family, just the activities of daily living take up time and space and energy. Physical and mental.

But usually when folks tell me that they are exhausted -with a negative connotation - it's a cue to something deeper, something in the emotional or psychic realm. Of course, if you are having trouble sleeping, falling asleep, staying asleep, or sleeping well, exhaustion has yet another layer to it. But I have found that even when you are sleeping well enough, you can still feel exhausted.

So what gives?

Usually, when we unpack and study exhaustion we may find a few good possibilities:

~Exhaustion can be looked at as a defense - our unconscious mind's way of protecting us from something that we might not want to know - or feel, or might be afraid to know or feel.

~Exhaustion can be looked at as a messenger, nudging us to pay closer attention to our mental and physical health.

~Exhaustion can be a spiritual experience, alerting us to the idea that we may need to slow down and tune into our deeper selves or our spiritual life.

Often, exhaustion is a signal that we are angry, or feeling frustrated, hopeless or resigned about something, or someone. Sometimes it's a way of rebelling against a routine we don't like, but don't think we have a choice about. Sometimes, we may be exhausted because we are busy - on an unconscious level - fighting off a feeling, or trying not to feel it.

It may take some real reflection to discover what kind of tired we are when we feel exhausted.

Yes, maybe we are working long hours, or are busy with life, going through hormonal changes or seasonal allergies, but often, exhaustion has a deeper meaning. We may need to sit quietly, write freely, talk it out with a trusted other, to let the possibilities surface. When they do, we can find relief, renewed energy, and of course, hope.

The Hate that Keeps You Up at Night

"Over half the females between the ages of eighteen and twenty-five would prefer to be run over by a truck than be fat and two-thirds surveyed would rather be mean or stupid." ~ Perfect Girls, Starving Daughters

I just think this is telling. I think its one chunk of the problem. Our fear of fat, of the fat that represents so much. Of the symptom that eclipses our deeper fears. Over the years that I have worked with women and men, teen-agers and kids who are living with, battling, holding on to, trying to oust bulimia, anorexia, food addiction, compulsive eating, and all shades of food disorders, I have become acutely aware of how relentlessly those who suffer go after themselves. ED folks certainly don't hold the monopoly on self attack but it never ceases to amaze me how big the bat is for certain people.

A guest of mine recently told me that she was having trouble sleeping at night. The therapist in me went ahead asked what was keeping her up. She told me that she was busy hating herself for all the things that feel wrong about her. Not what she did, but for who she is. I hear about this often in my office. I hear about the hate after a binge, or a razor to the thigh. I hear about the hate after a fight with a parent, boyfriend, or friend. It starts off being about the action, (or the fat) and turns into being about the whole self. As if this is all there is to a person.

And often times, I hear this: "If I give up the hate, there will be nothing there. Nothing. And that will be worse than the hate." So then I think: following the hate is fear. It's always interesting how sufferers tell me that it is themselves that they hate, though. Not the one who they are really angry with. As if to say that they really do believe that they are at completely at fault. That when things go wrong in a relationship, including the relationship they have with themselves, that they are expected to have known better, or done better. So therefor they are hateful. Even if there is some truth to this (we can always own our part of things), the hate and blame go inward with a vengence.

Sure on the surface self harmers hate the disorder, or the symptoms, or the one who has hurt them, but peel back the layers, and (often) it's the self hate that is throbbing underneath.

There is some deep belief that mistakes are not allowed, that they are somehow deserving of all the suffering. Even that they bring it on themselves.

True its good to take a look at your own side of the street, but what of all this hate? What of this broken record of "I can't stand myself!"

I think there is a way out. Not that I want to interfere with someone's self hate if they really think its serving a good purpose. But I think it's worth a try. I won't say moving away from it is fast, or easy, but I do believe there is a door. I have seem many of my clients unpack the hate, stop the attack and drop their weapons. And sleep at night.

It begins with these questions: What purpose does the hate serve? What will happen if I stop? What's my philosophy on mistakes? Of course there may be a lot more to it after this, especially for those who are pummeling their bodies to save their souls, or caught in the spider web of addiction, but it's a start. It's one piece of the puzzle.

Sitting Still

Sometimes in the midst of emotional pain, especially hurt and anger and grief, some folks get antsy. I often get asked, "Why does this still bother me so much?" or "Shouldn't I be over it already?" The need to get past the feeling, to move on, is urgent and strong. And they are off and running. Brain and body on rev. Especially at this time of year, when everyone is so very busy. Buying, and partying, and running from task to task to get ready.

For those who are hurting, all of this running around can be very productive. Too busy to think. And a lot gets done. I am all for distraction. It's a good day then, if you take care of your responsibilities and have not given way to whatever emotional pain is following you around like a kite at your back. If you keep on keeping on.

But then again, there is the idea of just sitting still. Of stopping the middle of all the rush. I know that sometimes sitting still can feel impossible. Especially when you are busy. Both practically and emotionally. A thousand thoughts racing through your mind, and a thousand things to do. And what if you stop and you can't start again? And what if you don't really know how to do anything but rush? And what if you stop and all the bad feelings you have been running in front of come slamming up against you like a herd of elephants? What if it's raining what if's?

So I think that you will be okay. I think that at first it will feel really strange. To just pick a quiet spot and sit down comfortably, and close your eyes, (or keep them open and take in the scene), and just be. For, lets say, five whole minutes. No TV, computer, book, magazine, mail, telephone, blackberry. For those of you who are practiced at meditation or yoga, this is easy. But for lots of folks, this feels like climbing a mountain.

I am not going to write too much about what to do with your five minutes of sitting still, other than to say that once you do it, you may be surprised at what you learn. Of course you could do almost anything. Travel to an exotic place, list your gratitudes, listen to the sound of your breathing, let your thoughts tumble. You may find out that they are more bearable than you imagined, and more gentle than you thought. Or you may find that things still hurt, but that you are in one piece and in this very moment, you are in tact.

It's good, I think, to check in with yourself. To slow down in the fast race to get to somewhere else. Could be that being in the moment is better than you think, and that pause, even brief, is restful and restorative.

A Lot vs. Enough

Sometimes in my office folks will say to me, "I have talked about this a lot already!" Sometimes this is a complaint, meaning they would like to be able to move on, and talk about a new topic. Other times it's a question. They are wondering if I am tired of hearing about whatever it is they are talking about. (Which I am usually not because I am trained to listen for as long as need be. And even if I were, then so what? I can keep listening anyway. Though I always like hearing what people think, or think I am thinking).

What is really being asked, at times, is, "when will I get over this?" Or: "When will I be sick of talking about this already, and ready to move on?" So sometimes I encourage people to say something new, or different, even about the current problem or hurt. But lots of times you just have keep talking until you have said enough.

A lot is not always enough. And vice versa, enough is not always a lot. Sometimes you do have to say a lot to get to enough. When it comes to grief, or betrayal, or anger. Ditto for difficult relationships, love, disappointment and fear. Sometimes it takes a lot of talking until you know, until you feel, that it's enough.

And not just "I am sick of this problem already!" or "Nothing feels different yet." or "Talking just drags up all the bad feelings." Enough is enough when relief comes quietly through the door of your heart and you can breath better. When you don't find yourself living in the eye of the storm anymore.

This can take hours, or days, or months or years. It takes as long as it takes. That's not to say that there is not progress in life in the meantime. Of course there can be forward movement, good times, good decisions. New insights, sure. New ideas, yes. And breaks in the hurt, definitely.

And even when enough really is enough, there can be times where the need to say more, to talk more, comes up again. And then you say more, until enough becomes enough again.

If I sound like I am making a case for obsession, or for not letting go, or not moving on, or not "getting over it," as they (whoever they are) say, I am not. I am making a case for living life, for forging forward when you hurt and don't know how, or don't feel like it, or don't want to. And talking about things to a good ear for as long as it takes. This, I think, is better than some of the stuff that we do, some of actions we take that end up making matters worse. For ourselves or others.

I vote for words. And lots of them. Speak them. Write them. Pray them. Until you are done.

Walk

It's not new. Though I think it's really worth a mention. Whenever I write about depression, or grief, or anger or pain of any kind, I always have in mind how hard it sometimes is to push ourselves over the hill to do whatever may help us to feel better. Even when we are fairly certain it will help.

Of course the medical evidence and studies abound about the benefits of exercise. The mind, the body, the soul, all are recipients of movement. But walking I find is in a category all it's own. Deep strides, or a meandering stroll, fresh air on your face, in your lungs. Your eyes to the sky. You can clear your head. For those of you that are already sold, you know what I am talking about. But for those of you who think about walking and just have not gotten out the door yet, or for those of you who have not tried it, or who put it in the category of "have to exercise" or tedious chore of the day, I am suggesting you give it a chance.

There are of course all the facts about how it lifts vital hormone levels in your brain, and how it gets your blood going, carrying better mood lifting chemicals throughout your system. Maybe that's the science of it. I suppose I am not really so interested in that part, though I am a believer. The part that I find worth writing about is the relief part. The part where you can actually walk off pain, frustration, anger, fear. Okay, it does not disappear, but I can almost guarantee you that if you get yourself to go out and stride, you will, after a time, feel better.

It's like shaking off dust that you did not know was there. Certainly, for pent up hostility and anger, it's great. But I am thinking more along the lines of thinking. Of having a rolling space to let your thoughts tumble, to let you head clear. To think. Or to just stare at the sky and remember that there are things bigger and more vast then what you can see. Explanations that go beyond. And calm that can come forth.

The trick is getting yourself out the door. And for this I say can only say what everyone else says. You just have to do it. Do it and you will see. You will see that it's one easy, free, access able tool for soothing your tired weary heart.

Walk. Breath. Rest. Think if you want to, but get outside and go. No offense to the treadmill or elliptical. But there is no substitute for space. If you can get to a park, great. If not, any sidewalk will do.

Forrest Gump fans may recall that he had to run the whole country (sometimes, you gotta run too). Sometimes I hear about pain so great that it seems like it would take all 3000 miles to walk off the hurt. Betrayal is up there with the worst feelings. Forrest had to cover a lot of ground. But we don't have to do all 3000 miles in one shot. We may get relief in bits and pieces.

And I find that giving yourself permission to wander is a way of finding yourself amidst all the confusion.

You will most likely come back a little lighter, a little safer and a little more contained, which I think is a good thing. I think we all need a little wind in our hair, and, on lucky days, sun on our face. These are the good and simple things in life that can hold us until things get better. And carry us along right in the moment, when things seems upside down, but may actually be okay in some meant to be, but not yet known kind of way.

Walk on!

Bed Dread and the Day Ahead

O bed! O bed! delicious bed!That heaven upon earth to the weary head.~Thomas Hood, Miss Kilmansegg

Or not.

Some mornings some people wake up with a racing heart, and a feeling of being entombed under a wall of heavy concrete. Even the idea of getting up seems too much to bear. The day ahead seems so awful and daunting that it's hard to imagine even putting a foot out front under the blanket. Sometimes it just seems impossible to even want to think about getting up.

Add to that if it's cold. Add to that if it's dark out. Add to that if you did not sleep well. Or at all. Add to that if you are sad about something. Add to that if your mood swings from the trees like Tarzan. Add to that if you hate your job. Or hate your school. Or don't feel like you are particularly connected to anyone in particular.

And then there is the opposite of not wanting to get out of bed. Not wanting to get into bed. It's not the bed itself that's the issue usually. It's the sleep thing. If you have trouble doing it. Falling asleep. Staying asleep. Resting.

Different versions of bed dread. So there is the usual cast of suggestions for each side of the issue. Can't get up? You are suppose to try to find something in your mind to latch onto that is good. Some detail of the day you could look forward to. Anything. Even if it means getting some sun on your face, or watching the leaves fall. A stretch, I know, but when there are warm blankets between you and the cold world, you gotta give yourself a chance. Sometimes you just must tell yourself that all you need to do is get to the hot shower. You can dive back in after that if you don't feel any better. You can tell yourself that you are some stellar star for heaving yourself up when brain tells you that you can't. And that somewhere in the day, your efforts will be rewarded. And that you dread is not a fact, just a feeling. And feelings pass. The next right thing.

And the usual suggestions for sleeplessness. You've heard them. Write a list of all that's on your mind and put it in a drawer. Give yourself permission to rest, if not sleep. Forget the sheep. Try imagining redecorating a room, making up a good juicy fantasy. Take yourself to a tropical paradise for the night. Talk to G-d. Or get up. And don't go back until you are falling on your face. Read. Forgive yourself.

Truthfully, I did not mean to be talking about sleeping better. Though we all know that it's the cure for many an ailment. I really just meant to offer up some nuggets about how much we deserve to rest. Not just physically, but mentally. And that the two really do go together of course.

I think that somewhere is our psyches, especially when we are hurting about something, or in the throws of some addiction. Binging, cutting, purging, drinking, we just forget how to stop. Just stop.

And then the cycle. We get bed dread of one form or another. We can't get out: too much panic and mood drain. Or we can't get in. Too much too much. No way to settle.

It has to be that way underneath all the tricks of how to get up, and how to sleep, lies our beliefs about rest, and about life on rev, and about how we deal. If the backdrop of bed dread is our unquiet mind, then we have to cooperate with the small piece of our intellect that just knows that somehow someway we have to practice restfulness. That we don't have to solve all of our stuff, we don't have to have answers. And that really either which way, we don't have to be afraid to be calmer. We can manage with whatever comes our way. We can push ourselves gently to get up when we don't feel like it, and to lie down when our brain says to keep going.

And we can talk it. If we just can't figure out how to get restful, we can talk it out until we figure it out. That and some good deep breaths can go a long long way.