Mental Health Affairs

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Insomnia. Somnolence. Soporifics. Somnambulation.

I have insomnia, and only sometimes feel somnolent. I use a host of soporifics, but never
somnambulate.

A big part of the bipolar disorder is spiraling mania. I maintain that mania is caused by insomnia. The patient stops sleeping and psychosis results. It would stand to reason that a soporific is the best defense against mania. The problem is that some soporifics aren’t strong enough.

I have a cachet of soporifics—clonazepam, melatonin, carbohydrates and alcohol.

When things are really bad there is the occasional opioid. I often sit at the kitchen table surrounded by vials of pills, bottles of alcohol, hot milk and honey, and bread or cereal. What kept me out of the hospital since 2009 is a steady ingestion of a daily dose of clonazepam at bedtime.

The importance of sleep cannot be overrated. Bipolar people might go months without sleeping. Sylvia Plath, in her book The Bell Jar, wrote of watching the clock tick out the hours for about thirty days before she was committed to the psych ward, where she played with drops of mercury, mad as a hatter.

Psychosis, disorganized thinking, and hallucinations are all part of the trip. I would suggest to medicating professionals to avoid prescribing antidepressants to their bipolar patients. Welbutrin, Prozac, etc. elevate mood and can unleash the demons of manic insanity. Depression can be bad, but swooning, spiraling mania can be positively chaotic and life-shattering, not to mention downright horrifying.

So I, the counselor-client, make sure I sleep. Sleep is the stuff that dreams are made of, and we all need to dream. These mental movies which keep us entertained in the depths of REM are necessary to stave off incoherent thought patterns, and help us problem solve in waking hours.

So I will risk being inappropriate and irresponsible and venture to give some advice to the sleepless among us.

Have a drink. Take a pill. Smoke that doobie if that’s your thing. Drift off into unconsciousness amid the pillows and comforters. Sleep the sleep of the dead, take a magic carpet ride.

Your families, doctors and society in general will thank you for it. And you, peacefully snoozing on a pink cloud amid the evening stars and moon, will be better for it. You may avoid the handcuffs, police presence and ambulance sirens so common among those who mentally disintegrate in the face of too much reality and wakefulness.