Managing the anxiety/insomnia cycle

A crucial part to managing anxiety is getting good sleep. A low-sleep you will be a more anxious you, no matter what you do to treat the anxiety. It's been my experience that most women who struggle with anxiety also struggle with insomnia and that the two are related: disturbing thoughts and images come with great intensity while trying to fall asleep or during the middle of the night.

For me, using ambien or other sleeping pills made sure I stayed asleep- but my sleep quality was synthetic and my dreams were useless. Plus, I eventually could not fall asleep without an a pill. So I stopped entirely for 2 weeks (during which time I rented a bunch of low-stim old movies and stayed up a lot) until the ambien was out of my system.

Then I switched to 6 mg of melatonin right at bed time, the very last thing I do before I turn out the light. In about 3 nights, the melatonin was opening a sleep window for me. Not a big window, mind you, not like the ambien vortex of sleep, but still a window. If I was all brushed, peed, and ready to roll over, that window was big enough. After about 5 months, I switched to 5 mg, and then to 3 mg.

When disturbing thoughts or images come into your mind, it takes simple discipline to think of something else. It can sometimes feel that our thoughts are out of control when in fact we are in complete control of where our brain goes, at least when we are awake! Here are things I do to get control of my thoughts:

• imagine tying knots, imagine each thread, try to follow it through the knots, try to imagine a knot that represents peacefulness... what does it look like? how would you tie it? untie it?
• try to remember exactly what I was thinking about what I fell asleep last night
• think of a happy place (beach, childhood home, my own bed, etc. etc.) and go through all my senses: what do my eyes see, what does my nose smell, what does my heart feel, etc.

If I just cannot manage and am feeling like I am going to jump out of my skin:

• get up and turn on lights, read a distracting book, take a bath, check on my kids
• call my friends in other time-zones and chat
• have hot milk or cold beer
  
• I do NOT go online (always end up looking at depressing things)
• I do NOT eat (reinforces anxious thinking behavior), although once I am not stressed out anymore I'll have a night-snack

Usually one of these tricks has my anxiety managed in an hour or so.

And last, but not least, consider that you may have a legitimate reason to feel anxious. Maybe taking a moment to feel gratitude for your nerves can help- as in, thank you anxiety for giving me a bearable vehicle to express my unbearable feelings.