Last week was a whirlwind. I traveled to NYC for The Today Show, then to Las Vegas for the technology show CES, and finally LA for Face the Truth with Vivica Fox. I’m exhausted just writing this sentence. The upside is that I was able to catch up on my reading on the flights. I read a lot of interesting material including a recently published study which reinforces what I’ve been sharing with my patients and readers for years…which is that there are several types of insomnia, not just one
A group of Dutch researchers identified five different subtypes of insomnia in their recently published study online in Lancet Psychiatry (a very prestigious journal). This study is different than other published studies in medical literature because it goes beyond subtyping that is focused merely on the type of symptoms someone may experience.
These referenced symptoms may include:
Difficulty falling asleep
Difficulty staying asleep
Awakening too early
The Dutch researchers approached insomnia in a completely different way. Instead of categorization based on symptoms, they based their categorization on different biological traits and a person’s life history. In scientific research, this is often referred to as a data-driven or bottom-up approach.
Doctoral candidate Tessa Blaken, at the Netherlands Institute for Neuroscience in Amsterdam, utilized the Netherlands Sleep Registry for her study. She looked at data on 4300 people, of which approximately 50% had a probable insomnia disorder (according to scores on the Insomnia Severity Index >10).
A statistical analysis of these 4300 people revealed five potential subtypes:
Sub-Type 1 (19%) references Highly Distressed Insomnia. People in this sub-type scored high on traits of distress, such as neuroticism, feeling tense, or feeling “down.”
Sub-Types 2 (31%) and 3 (15%) reference Moderately Distressed Insomnia. These groups of people had less distress in their lives, but were reward-sensitive (Type 2), or reward insensitive (Type 3). This means one group experiences pleasurable emotions tied with reward, while the other group experiences no pleasurable emotions derived from rewards.
Sub-Types 4 (20%) and 5 (15%) were also characterized with less distress than sub-type 1, but they were categorized differently than sub-types 2 and 3 because of the degree to which these groups experience insomnia in relation to stressful life events. People that fit into the sub-type 4 group are highly affected by stressful life events. People that fit into the sub- type 5 group are basically unaffected by events classified as stressful.
What does that mean for you?
It means there isn’t a one size fits all solution for insomnia. Insomnia takes multiple forms and what may trigger you or affect you may be different than someone else who suffers from a different sub-type of insomnia. You may need to experiment with various products or forms of remedies. Solutions may come as a therapy or in pill form, a tincture, beverage or spray. You may even need to try more than one to find what your individual body needs.
There appear to be at least three factors for you to consider:
The level of distress or anxiety in your daily life. Is it high, medium, or Low?
Do you get pleasure from rewards?
Do life events affect your sleep?
What else can you do right now?
Maintain a consistent wake up time to keep your circadian rhythm in sync. This will also help lower anxiety.
Exercise regularly. This is a great way to reduce stress and help improve your sleep quality.
Avoid caffeine. This is especially important if you’re an anxious person. Caffeine makes anxiety worse.
Plan for potential “bad nights.” If you know you have a stressful event coming up, expect that your sleep will be impacted. Make sure you have a good sleep environment. You may even consider going to bed slightly later than normal. Sleep deprivation may help you fall and stay asleep.
Consider taking magnesium in any form including magnesium oil. You can also get it from food (I like homemade Banana Tea) to help calm your nerves before bed. Read my post about magnesium to learn more about why this will benefit you.
If you struggle to sleep, see if you identify yourself in one of the five categories above. If you do, experiment with the strategies or remedies I mentioned earlier to help you fall asleep faster, stay asleep longer and sleep more soundly without waking too early.
Emotional intelligence can mean the difference between behaving in a socially acceptable way and being considered to be way out of line. While most people will have heard of emotional intelligence, not many people really know how to spot it — in themselves or in others.
Emotional intelligence is essentially the way you perceive, understand, express, and manage emotions. And it’s important because the more you understand these aspects of yourself, the better your mental health and social behavior will be.
It might be these are things you do without even really thinking — which can be the case for a lot of people. Or it might be that these are skills you know you need to work on.
Either way, improved emotional intelligence can be very useful in all sorts of circumstances — be it in work, at home, in school, or even when you’re just socializing with your friends.
So if you want to know if you’re emotionally intelligent, simply check the list below.
1. You Think About Your Reactions
Emotional intelligence can mean the difference between a good reaction and a bad reaction to circumstances. Emotions can contain important information that can be useful to personal and social functioning — but sometimes these emotions can also overwhelm us, and make us act in ways we would rather not.
People who lack emotional intelligence are more likely to just react, without giving themselves the time to weigh up the pros and cons of a situation and really think things through.
People who are less able to regulate their negative feelings are also more likely to have difficulty functioning socially — which can exacerbate depressive feelings.
People with major depression have been shown to have difficulties understanding and managing their emotions. And research has also shown that more depressive symptoms are present in people with lower emotional intelligence — even if they are not clinically depressed.
2. You See Situations as a Challenge
If you are able to recognize negative emotions in yourself and see difficult situations as a challenge — focusing on the positives and persevering — chances are that you’ve got high emotional intelligence.
Imagine for a moment you lost your job. An emotionally intelligent person might perceive their emotions as cues to take action, both to deal with the challenges and to control their thoughts and feelings.
But someone with poor emotional skills might ruminate on their job loss, come to think of themselves as hopelessly unemployable, and spiral into depression.
3. You Can Modify Your Emotions
Of course, there are times when your feelings can get the better of you, but if you are an emotionally intelligent person, it is likely that when this happens, you have the skills needed to modify your emotions.
For example, while average levels of anxiety can improve cognitive performance — probably by increasing focus and motivation — too much anxiety can block cognitive achievement.
So knowing how to find the sweet spot between too much and too little anxiety can be a useful tool.
It is clear that moderation is the key when it comes to managing our emotions. Emotionally intelligent people know this and have the skills to modify their emotions appropriately.
And this is probably why emotional intelligence has been shown to be related to lower levels of anxiety.
4. You Can Put Yourself in Other People’s Shoes
If you are able to extend these skills beyond your own personal functioning, then that’s another sign that you have high levels of emotional intelligence.
Emotional intelligence can be particularly important in workplaces that require heavy “emotional labor” — where workers must manage their emotions according to organizational rules.
This can include customer service jobs, where workers may need to sympathize with customers — despite the fact that customers may be yelling at them.
This is why workplace emotional intelligence training is now common — with the most effective training focusing on management and expression of emotions, which are directly linked to communication and job performance.
It’s also worth pointing out that emotional intelligence is a cognitive ability that can improve across your lifespan. So if you haven’t recognized much of yourself in the traits listed above, fear not, there’s still time for you to work on your emotional intelligence.
We spend around six years of our lives dreaming – that’s 2,190 days or 52,560 hours. Although we can be aware of the perceptions and emotions we experience in our dreams, we are not conscious in the same way as when we’re awake. This explains why we can’t recognize that we’re in a dream and often mistake these bizarre narratives for reality.
But some people – lucid dreamers – have the ability to experience awareness during their dreams by “re-awakening” some aspects of their waking consciousness. They can even take control and act with intention in the dream world (think Leonardo DiCaprio in the film Inception).
Lucid dreaming is still an understudied subject, but recent advances suggest it’s a hybrid state of waking consciousness and sleep.
Lucid dreaming is one of many “anomalous” experiences that can occur during sleep. Sleep paralysis, where you wake up terrified and paralyzed while remaining in a state of sleep, is another. There are also false awakenings, where you believe you have woken up only to discover that you are in fact dreaming. Along with lucid dreams, all these experiences reflect an increase in subjective awareness while remaining in a state of sleep. To find out more about the transitions between these states – and hopefully consciousness itself – we have launched a large-scale online survey on sleep experiences to look at the relationships between these different states of hybrid consciousness.
Lucid Dreaming and the Brain
About half of us will experience at least one lucid dream in our lives. And it could be something to look forward to because it allows people to simulate desired scenarios from meeting the love of their life to winning a medieval battle. There is some evidence that lucid dreaming can be induced, and a number of large online communities now exist where users share tips and tricks for achieving greater lucidity during their dreams (such as having dream totems, a familiar object from the waking world that can help determine if you are in a dream, or spinning around in dreams to stop lucidity from slipping away).
A recent study that asked participants to report in detail on their most recent dream found that lucid (compared to non-lucid) dreams were indeed characterized by far greater insight into the fact that the sleeper was in a dream. Participants who experienced lucid dreams also said they had greater control over thoughts and actions within the dream, had the ability to think logically, and were even better at accessing real memories of their waking life.
Another study looking at people’s ability to make conscious decisions in waking life as well as during lucid and non-lucid dreams found a large degree of overlap between volitional abilities when we are awake and when we are having lucid dreams. However, the ability to plan was considerably worse in lucid dreams compared to wakefulness.
Lucid and non-lucid dreams certainly feel subjectively different and this might suggest that they are associated with different patterns of brain activity. But confirming this is not as easy as it might seem. Participants have to be in a brain scanner overnight and researchers have to decipher when a lucid dream is happening so that they can compare brain activity during the lucid dream with that of non-lucid dreaming.
Ingenious studies examining this have devised a communication code between lucid dreamer participants and researchers during Rapid Eye Movement (REM) sleep, when dreaming typically takes place. Before going to sleep, the participant and the researcher agree on a specific eye movement (for example two movements left then two movements right) that participants make to signal that they are lucid.
By using this approach, studies have found that the shift from non-lucid to lucid REM sleep is associated with an increased activity of the frontal areas of the brain. Significantly, these areas are associated with “higher order” cognitive functioning such as logical reasoning and voluntary behaviour which are typically only observed during waking states. The type of brain activity observed, gamma wave activity, is also known to allow different aspects of our experience; perceptions, emotions, thoughts, and memories to “bind” together into an integrated consciousness. A follow-up study found that electrically stimulating these areas caused an increase in the degree of lucidity experienced during a dream.
Another study more accurately specified the brain regionsinvolved in lucid dreams, and found increased activity in regions such as the pre-frontal cortex and the precuneus. These brain areas are associated with higher cognitive abilities such as self-referential processing and a sense of agency – again supporting the view that lucid dreaming is a hybrid state of consciousness.
Tackling the Consciousness Problem
How consciousness arises in the brain is one of the most perplexing questions in neuroscience. But it has been suggestedthat studying lucid dreams could pave the way for new insights into the neuroscience of consciousness.
This is because lucid and non-lucid REM sleep are two states where our conscious experience is markedly different, yet the overall brain state remains the same (we are in REM sleep all the time, often dreaming). By comparing specific differences in brain activity from a lucid dream with a non-lucid one, then, we can look at features that may be facilitating the enhanced awareness experienced in the lucid dream.
Furthermore, by using eye signaling as a marker of when a sleeper is in a lucid dream, it is possible to study the neurobiological activity at this point to further understand not only what characterizes and maintains this heightened consciousness, but how it emerges in the first place.
This question came up in conversation when I was speaking with someone who has experienced severe panic attacks to the point of calling them “debilitating”, requiring inpatient care. As they were sharing about the ordeal, they told me that when they contemplate the time spent seeking treatment and the aftermath, it ramped up both the anxiety and PTSD symptoms. Even as a career therapist with decades of experience treating people with stand-alone anxiety, with no overt PTSD symptoms, I had not considered that remembering the anxiety was re-traumatizing. I have heard clients share that anticipating panic attacks was in and of itself anxiety provoking. For this person and so many others, it is hard to determine the line between the two.
As is the case for many who struggle with this condition, they experienced body memory, flashbacks and tremors, as if the events of the past were recurring. Reminding themselves, “I am here and now, not there and then,” alleviated some of the more intense indicators.
This person is also intent on taking on challenges and resilience is one of their superpowers. Overcoming life changing physical conditions were part of the symbolic exercise equipment that helped them to become stronger and more flexible. They were aware that life events happen, unbidden at times and all they can do is ride the waves, sometimes treading water, until things settle back into place. Having solid support from family, friends and professionals keeps them afloat.
Although it might be hard to acknowledge an upside to anxiety or trauma, this person and others I have encountered in both personal and professional realms have been grateful for accompanying lessons. Keep in mind, that no one is sugar-coating it, nor are they denying the pain. They are making a conscious decision to face what comes their way. Paradoxically, the one certainty of life is uncertainty. A catch-22, since anxiety thrives on unpredictability.
The field of Positive Psychology, which offers a strengths-focused perspective to recovery from traumatic experiences, was pioneered by psychologist Martin Seligman, who directs the Positive Psychology Center at the University of Pennsylvania. One concept in this approach is post-traumatic growth, which reflects counterintuitive responses to horrific circumstances. Research from Lawrence G. Calhoun and Richard G. Tedeschi of the University of North Carolina Charlotte found that survivors of trauma often experienced profound healing, a stronger spiritual faith and philosophical grounding. One powerful reframing is referring to the outcome as Post Traumatic Growth.
When survivors view themselves in that light and additionally as thrivers who give back or pay it forward, rather than as victims who have no choice but to feel as they do, healing is possible. One such thriver is Michele Rosenthal, a keynote speaker, award-winning blogger, award-nominated author, workshop/seminar leader and certified professional coach. Michele is also a trauma survivor who struggled with posttraumatic stress disorder (PTSD) for over twenty-five years. She calls herself Chief Hope Officer (CHO) of Your Life After Trauma, LLC.
Her trauma came in the form of a condition called, ToxicEpidermal Necrolysis Syndrome (TENS), which she describes as “a freak allergy to a medication that turned me into a full-body burn victim almost overnight.” This horror was followed by a series of physiological and psychological conditions that would flatten even the strongest of people. It took years of determination to recover that led her to be symptom free and now she guides others to overcome their own trauma-trials.
What helped her see her way clear to the other side of suffering is what she refers to as a “healing rampage.”
Rosenthal says, “It is an approach to recovery that is, 1) committed — we keep going no matter what; 2) consistent — we work at it every day; 3) creative — we look for new options and healing opportunities; and, 4) complex — we do the deep work rather than skim the surface as we seek relief.
These are important resiliency building skills regardless of diagnosis or symptomology, whether it falls under the umbrella of anxiety or PTSD.
Learn relaxation and breathing techniques to center yourself in the here and now.
Do grounding exercises such as walking barefoot on the grass or sand or tapping the bottoms of your feet.
If possible, avoid people, places or things that may overtly trigger reaction. Some PTSD survivors may steer clear of fireworks or large numbers of people if loud noises or crowds are related to the initial events.
Contemplate an exit strategy if you get inadvertently triggered.
Breathe in relaxing aromas, such as lavender, chamomile, vanilla or bergamot.
Listen to music that is soul soothing.
Seek support from family and friends who may understand your situation and if not, offer a listening presence.
Engage in therapy with a licensed professional.
If medications are indicated, work with a Psychiatrist or CRNP (Certified Registered Nurse Practitioner) who can prescribe.
Attend a self-help group.
Utilize the therapeutic modality of EMDR (Eye Movement Desensitization and Reprocessing).
Exercise, whether it is in a gym, or a dance floor or basketball court assists in moving the energy. I think of emotion as ‘e-motion’ or ‘energy in motion’.
Spend time in nature which is restorative.
Dig in the dirt, and plant seeds for new beginnings.
Avoid self-medicating with drugs, alcohol, gambling, work, shopping or food.
Indulge in healthy hobbies, such as reading, crafts, music, playing board games, putting together puzzles or models.
Volunteer your time in your community.
If you have a spiritual practice, use it as an additional therapeutic modality.
Determine your passion and live it as fully as you can.
Spend time with children and learn how to be silly from them.
The first sign that something is happening is Angelina’s hands. As she chats to the nurse in Italian, she begins to gesticulate, jabbing, moulding and circling the air with her fingers. As the minutes pass and Angelina becomes increasingly animated, I notice a musicality to her voice that I’m sure wasn’t there earlier. The lines in her forehead seem to be softening, and the pursing and stretching of her lips and the crinkling of her eyes tell me as much about her mental state as any interpreter could.Angelina is coming to life, precisely as my body is beginning to shut down. It’s 2am, and we’re sat in the brightly lit kitchen of a Milanese psychiatric ward, eating spaghetti. There’s a dull ache behind my eyes, and I keep on zoning out, but Angelina won’t be going to bed for at least another 17 hours, so I’m steeling myself for a long night. In case I doubted her resolve, Angelina removes her glasses, looks directly at me, and uses her thumbs and forefingers to pull open the wrinkled, grey-tinged skin around her eyes. “Occhi aperti,” she says. Eyes open.This is the second night in three that Angelina has been deliberately deprived of sleep. For a person with bipolar disorder who has spent the past two years in a deep and crippling depression, it may sound like the last thing she needs, but Angelina – and the doctors treating her – hope it will be her salvation. For two decades, Francesco Benedetti, who heads the psychiatry and clinical psychobiology unit at San Raffaele Hospital in Milan, has been investigating so-called wake therapy, in combination with bright light exposure and lithium, as a means of treating depression where drugs have often failed. As a result, psychiatrists in the USA, the UK and other European countries are starting to take notice, launching variations of it in their own clinics. These ‘chronotherapies’ seem to work by kick-starting a sluggish biological clock; in doing so, they’re also shedding new light on the underlying pathology of depression, and on the function of sleep more generally.“Sleep deprivation really has opposite effects in healthy people and those with depression,” says Benedetti. If you’re healthy and you don’t sleep, you’ll feel in a bad mood. But if you’re depressed, it can prompt an immediate improvement in mood, and in cognitive abilities. But, Benedetti adds, there’s a catch: once you go to sleep and catch up on those missed hours of sleep, you’ll have a 95 per cent chance of relapse.The antidepressant effect of sleep deprivation was first published in a report in Germany in 1959. This captured the imagination of a young researcher from Tübingen in Germany, Burkhard Pflug, who investigated the effect in his doctoral thesis and in subsequent studies during the 1970s. By systematically depriving depressed people of sleep, he confirmed that spending a single night awake could jolt them out of depression.
Benedetti became interested in this idea as a young psychiatrist in the early 1990s. Prozac had been launched just a few years earlier, hailing a revolution in the treatment of depression. But such drugs were rarely tested on people with bipolar disorder. Bitter experience has since taught Benedetti that antidepressants are largely ineffective for people with bipolar depression anyway.
His patients were in desperate need of an alternative, and his supervisor, Enrico Smeraldi, had an idea up his sleeve. Having read some of the early papers on wake therapy, he tested their theories on his own patients, with positive results. “We knew it worked,” says Benedetti. “Patients with these terrible histories were getting well immediately. My task was finding a way of making them stay well.”
So he and his colleagues turned to the scientific literature for ideas. A handful of American studies had suggested that lithium might prolong the effect of sleep deprivation, so they investigated that. They found that 65 per cent of patients taking lithium showed a sustained response to sleep deprivation when assessed after three months, compared to just 10 per cent of those not taking the drug.
Since even a short nap could undermine the efficacy of the treatment, they also started searching for new ways of keeping patients awake at night, and drew inspiration from aviation medicine, where bright light was being used to keep pilots alert. This too extended the effects of sleep deprivation, to a similar extent as lithium.
“We decided to give them the whole package, and the effect was brilliant,” says Benedetti. By the late 1990s, they were routinely treating patients with triple chronotherapy: sleep deprivation, lithium and light. The sleep deprivations would occur every other night for a week, and bright light exposure for 30 minutes each morning would be continued for a further two weeks – a protocol they continue to use to this day. “We can think of it not as sleep-depriving people, but as modifying or enlarging the period of the sleep–wake cycle from 24 to 48 hours,” says Benedetti. “People go to bed every two nights, but when they go to bed, they can sleep for as long as they want.”
San Raffaele Hospital first introduced triple chronotherapy in 1996. Since then, it has treated close to a thousand patients with bipolar depression – many of whom had failed to respond to antidepressant drugs. The results speak for themselves: according to the most recent data, 70 per cent of people with drug-resistant bipolar depression responded to triple chronotherapy within the first week, and 55 per cent had a sustained improvement in their depression one month later.
And whereas antidepressants – if they work – can take over a month to have an effect, and can increase the risk of suicide in the meantime, chronotherapy usually produces an immediate and persistent decrease in suicidal thoughts, even after just one night of sleep deprivation.
Angelina was first diagnosed with bipolar disorder 30 years ago, when she was in her late 30s. The diagnosis followed a period of intense stress: her husband was facing a tribunal at work, and they were worried about having enough money to support themselves and the kids. Angelina fell into a depression that lasted nearly three years. Since then, her mood has oscillated, but she’s down more often than not. She takes an arsenal of drugs – antidepressants, mood stabilisers, anti-anxiety drugs and sleeping tablets – which she dislikes because they make her feel like a patient, even though she acknowledges this is what she is.
If I’d met her three days ago, she says, it’s unlikely I would have recognised her. She didn’t want to do anything, she’d stopped washing her hair or wearing make-up, and she stank. She also felt very pessimistic about the future. After her first night of sleep deprivation, she’d felt more energetic, but this largely subsided after her recovery sleep. Even so, today she felt motivated enough to visit a hairdresser in anticipation of my visit. I compliment her appearance, and she pats her dyed, golden waves, thanking me for noticing.
At 3am, we move to the light room, and entering is like being transported forward to midday. Bright sunlight streams in through the skylights overhead, falling on five armchairs, which are lined up against the wall. This is an illusion, of course – the blue sky and brilliant sun are nothing more than coloured plastic and a very bright light – but the effect is exhilarating nonetheless. I could be sitting on a sun lounger at midday; the only thing missing is the heat.
When I’d interviewed her seven hours earlier, with the help of an interpreter, Angelina’s face had remained expressionless as she’d replied. Now, at 3.20am, she is smiling, and even beginning to initiate a conversation with me in English, which she’d claimed not to speak. By dawn, Angelina’s telling me about the family history she’s started writing, which she’d like to pick up again, and inviting me to stay with her in Sicily.
How could something as simple as staying awake overnight bring about such a transformation? Unpicking the mechanism isn’t straightforward: we still don’t fully understand the nature of depression or the function of sleep, both of which involve multiple areas of the brain. But recent studies have started to yield some insights.
The brain activity of people with depression looks different during sleep and wakefulness than that of healthy people. During the day, wake-promoting signals coming from the circadian system – our internal 24-hour biological clock – are thought to help us resist sleep, with these signals being replaced by sleep-promoting ones at night. Our brain cells work in cycles too, becoming increasingly excitable in response to stimuli during wakefulness, with this excitability dissipating when we sleep. But in people with depression and bipolar disorder, these fluctuations appear dampened or absent.
Depression is also associated with altered daily rhythms of hormone secretion and body temperature, and the more severe the illness, the greater the degree of disruption. Like the sleep signals, these rhythms are also driven by the body’s circadian system, which itself is driven by a set of interacting proteins, encoded by ‘clock genes’ that are expressed in a rhythmic pattern throughout the day. They drive hundreds of different cellular processes, enabling them to keep time with one another and turn on and off. A circadian clock ticks in every cell of your body, including your brain cells, and they are coordinated by an area of the brain called the suprachiasmatic nucleus, which responds to light.
“When people are seriously depressed, their circadian rhythms tend to be very flat; they don’t get the usual response of melatonin rising in the evening, and the cortisol levels are consistently high rather than falling in the evening and the night,” says Steinn Steingrimsson, a psychiatrist at Sahlgrenska University Hospital in Gothenburg, Sweden, who is currently running a trial of wake therapy.
Recovery from depression is associated with a normalisation of these cycles. “I think depression may be one of the consequences of this basic flattening of circadian rhythms and homeostasis in the brain,” says Benedetti. “When we sleep-deprive depressed people, we restore this cyclical process.”
But how does this restoration come about? One possibility is that depressed people simply need added sleep pressure to jump-start a sluggish system. Sleep pressure – our urge to sleep – is thought to arise because of the gradual release of adenosine in the brain. It builds up throughout the day and attaches to adenosine receptors on neurons, making us feel drowsy. Drugs that trigger these receptors have the same effect, whereas drugs that block them – such as caffeine – make us feel more awake.
To investigate whether this process might underpin the antidepressant effects of prolonged wakefulness, researchers at Tufts University in Massachusetts took mice with depression-like symptoms and administered high doses of a compound that triggers adenosine receptors, mimicking what happens during sleep deprivation. After 12 hours, the mice had improved, measured by how long they spent trying to escape when forced to swim or when suspended by their tails.
We also know sleep deprivation does other things to the depressed brain. It prompts changes in the balance of neurotransmitters in areas that help to regulate mood, and it restores normal activity in emotion-processing areas of the brain, strengthening connections between them.
And as Benedetti and his team discovered, if wake therapy kick-starts a sluggish circadian rhythm, lithium and light therapy seem to help maintain it. Lithium has been used as a mood stabiliser for years without anyone really understanding how it works, but we know it boosts the expression of a protein, called Per2, that drives the molecular clock in cells.
Bright light, meanwhile, is known to alter the rhythms of the suprachiasmatic nucleus, as well as boosting activity in emotion-processing areas of the brain more directly. Indeed, the American Psychiatric Association states that light therapy is as effective as most antidepressants in treating non-seasonal depression.
In spite of its promising results against bipolar disorder, wake therapy has been slow to catch on in other countries. “You could be cynical and say it’s because you can’t patent it,” says David Veale, a consultant psychiatrist at the South London and Maudsley NHS Foundation Trust.
Certainly, Benedetti has never been offered pharmaceutical funding to carry out his trials of chronotherapy. Instead, he has – until recently – been reliant on government funding, which is often in short supply. His current research is being funded by the EU. Had he followed the conventional route of accepting industry money to run drug trials with his patients, he quips, he probably wouldn’t be living in a two-bedroom apartment and driving a 1998 Honda Civic.
The bias towards pharmaceutical solutions has kept chronotherapy below the radar for many psychiatrists. “A lot of people just don’t know about it,” says Veale.
It’s also difficult to find a suitable placebo for sleep deprivation or bright light exposure, which means that large, randomised placebo-controlled trials of chronotherapy haven’t been done. Because of this, there’s some scepticism about how well it really works. “While there is increasing interest, I don’t think many treatments based on this approach are yet routinely used – the evidence needs to be better and there are some practical difficulties in implementing things like sleep deprivation,” says John Geddes, a professor of epidemiological psychiatry at the University of Oxford.
Even so, interest in the processes underpinning chronotherapy is beginning to spread. “Insights into the biology of sleep and circadian systems are now providing promising targets for treatment development,” says Geddes. “It goes beyond pharmaceuticals – targeting sleep with psychological treatments might also help or even prevent mental disorders.”
In the UK, the USA, Denmark and Sweden, psychiatrists are investigating chronotherapy as a treatment for general depression. “A lot of the studies that have been done so far have been very small,” says Veale, who is currently planning a feasibility study at Maudsley Hospital in London. “We need to demonstrate that it is feasible and that people can adhere to it.”
So far, what studies there have been have produced mixed results. Klaus Martiny, who researches non-drug methods for treating depression at the University of Copenhagen in Denmark, has published two trials looking at the effects of sleep deprivation, together with daily morning bright light and regular bedtimes, on general depression. In the first study, 75 patients were given the antidepressant duloxetine, in combination with either chronotherapy or daily exercise. After the first week, 41 per cent of the chronotherapy group had experienced a halving of their symptoms, compared to 13 per cent of the exercise group. And at 29 weeks, 62 per cent of the wake therapy patients were symptom-free, compared to 38 per cent of those in the exercise group.
In Martiny’s second study, severely depressed hospital inpatients who had failed to respond to antidepressant drugs were offered the same chronotherapy package as an add-on to the drugs and psychotherapy they were undergoing. After one week, those in the chronotherapy group improved significantly more than the group receiving standard treatment, although in subsequent weeks the control group caught up.
No one has yet compared wake therapy head-to-head with antidepressants; neither has it been tested against bright light therapy and lithium alone. But even if it’s only effective for a minority, many people with depression – and indeed psychiatrists – may find the idea of a drug-free treatment attractive.
“I’m a pill pusher for a living, and it still appeals to me to do something that doesn’t involve pills,” says Jonathan Stewart, a professor of clinical psychiatry at Columbia University in New York, who is currently running a wake therapy trial at New York State Psychiatric Institute.
Unlike Benedetti, Stewart only keeps patients awake for one night: “I couldn’t see a lot of people agreeing to stay in hospital for three nights, and it also requires a lot of nursing and resources,” he says. Instead, he uses something called sleep phase advance, where on the days after a night of sleep deprivation, the time the patient goes to sleep and wakes up is systematically brought forward. So far, Stewart has treated around 20 patients with this protocol, and 12 have shown a response – most of them during the first week.
It may also work as a prophylactic: recent studies suggest that teenagers whose parents set – and manage to enforce – earlier bedtimes are less at risk of depression and suicidal thinking. Like light therapy and sleep deprivation, the precise mechanism is unclear, but researchers suspect a closer fit between sleep time and the natural light–dark cycle is important.
But sleep phase advance has so far failed to hit the mainstream. And, Stewart accepts, it’s not for everybody. “For those for whom it works, it’s a miracle cure. But just as Prozac doesn’t get everyone better who takes it, neither does this,” he says. “My problem is that I have no idea ahead of time who it’s going to help.”
Depression can strike anyone, but there’s mounting evidence that genetic variations can disrupt the circadian system to make certain people more vulnerable. Several clock gene variations have been associated with an elevated risk of developing mood disorders.
Stress can then compound the problem. Our response to it is largely mediated through the hormone cortisol, which is under strong circadian control, but cortisol itself also directly influences the timing of our circadian clocks. So if you have a weak clock, the added burden of stress could be enough to tip your system over the edge.
Indeed, you can trigger depressive symptoms in mice by repeatedly exposing them to a noxious stimulus, such as an electric shock, from which they can’t escape – a phenomenon called learned helplessness. In the face of this ongoing stress, the animals eventually just give up and exhibit depression-like behaviours. When David Welsh, a psychiatrist at the University of California, San Diego, analysed the brains of mice that had depressive symptoms, he found disrupted circadian rhythms in two critical areas of the brain’s reward circuit – a system that’s strongly implicated in depression.
But Welsh has also shown that a disturbed circadian system itself can cause depression-like symptoms. When he took healthy mice and knocked out a key clock gene in the brain’s master clock, they looked just like the depressed mice he’d been studying earlier. “They don’t need to learn to be helpless, they are already helpless,” Welsh says.
So if disrupted circadian rhythms are a likely cause of depression, what can be done to prevent rather than treat them? Is it possible to strengthen your circadian clock to increase psychological resilience, rather than remedy depressive symptoms by forgoing sleep?
Martiny thinks so. He is currently testing whether keeping a more regular daily schedule could prevent his depressed inpatients from relapsing once they’ve recovered and are released from the psychiatric ward. “That’s when the trouble usually comes,” he says. “Once they’re discharged their depression gets worse again.”
Peter is a 45-year-old care assistant from Copenhagen who has battled with depression since his early teens. Like Angelina and many others with depression, his first episode followed a period of intense stress and upheaval. His sister, who more or less brought him up, left home when he was 13, leaving him with an uninterested mother and a father who also suffered from severe depression. Soon after that, his father died of cancer – another shock, as he’d kept his prognosis hidden until the week before his death.
Peter’s depression has seen him hospitalised six times, including for a month last April. “In some ways being in hospital is a relief,” he says. However, he feels guilty about the effect it has on his sons, aged seven and nine. “My youngest boy said he cried every night I was in hospital, because I wasn’t there to hug him.”
So when Martiny told Peter about the study he had just started recruiting for, he readily agreed to participate. Dubbed ‘circadian-reinforcement therapy’, the idea is to strengthen people’s circadian rhythms by encouraging regularity in their sleep, wake, meal and exercise times, and pushing them to spend more time outdoors, exposed to daylight.
For four weeks after leaving the psychiatric ward in May, Peter wore a device that tracked his activity and sleep, and he completed regular mood questionnaires. If there was any deviation in his routine, he would receive a phone call to find out what had happened.
When I meet Peter, we joke about the tan lines around his eyes; obviously, he’s been taking the advice seriously. He laughs: “Yes, I’m getting outdoors to the park, and if it’s nice weather, I take my children to the beach, for walks, or to the playground, because then I will get some light, and that improves my mood.”
Those aren’t the only changes he’s made. He now gets up at 6 every morning to help his wife with the children. Even if he’s not hungry he eats breakfast: typically, yoghurt with muesli. He doesn’t take naps and tries to be in bed by 10pm. If Peter does wake up at night, he practises mindfulness – a technique he picked up in hospital.
Martiny pulls up Peter’s data on his computer. It confirms the shift towards earlier sleep and wake times, and shows an improvement in the quality of his sleep, which is mirrored by his mood scores. Immediately after his release from hospital, these averaged around 6 out of 10. But after two weeks they’d risen to consistent 8s or 9s, and one day, he even managed a 10. At the beginning of June, he returned to his job at the care home, where he works 35 hours a week. “Having a routine has really helped me,” he says.
So far, Martiny has recruited 20 patients to his trial, but his target is 120; it’s therefore too soon to know how many will respond the same way as Peter, or indeed, if his psychological health will be maintained. Even so, there’s mounting evidence that good sleep routine can help our mental wellbeing. According to a study published in Lancet Psychiatry in September 2017 – the largest randomised trial of a psychological intervention to date – insomniacs who underwent a ten-week course of cognitive behavioural therapy to address their sleep problems showed sustained reductions in paranoia and hallucinatory experiences as a result. They also experienced improvements in symptoms of depression and anxiety, fewer nightmares, better psychological wellbeing and day-to-day functioning, and they were less likely to experience a depressive episode or anxiety disorder during the course of the trial.
Sleep, routine and daylight. It’s a simple formula, and easy to take for granted. But imagine if it really could reduce the incidence of depression and help people to recover from it more quickly. Not only would it improve the quality of countless lives, it would save health systems money.
In the case of wake therapy, Benedetti cautions that it isn’t something people should try to administer to themselves at home. Particularly for anyone who has bipolar disorder, there’s a risk of it triggering a switch into mania – although in his experience, the risk is smaller than that posed by taking antidepressants. Keeping yourself awake overnight is also difficult, and some patients temporarily slip back into depression or enter a mixed mood state, which can be dangerous. “I want to be there to speak about it to them when it happens,” Benedetti says. Mixed states often precede suicide attempts.
A week after spending the night awake with Angelina, I call Benedetti to check her progress. He tells me that after the third sleep deprivation, she experienced a full remission in her symptoms and returned to Sicily with her husband. That week, they were due to be marking their 50th wedding anniversary. When I’d asked her if she thought her husband would notice any change in her symptoms, she’d said she hoped he’d notice the change in her physical appearance.
Hope. After she has spent more than half her life without it, I suspect its return is the most precious golden anniversary gift of all.
This article first appeared on Mosaic and is republished here under a Creative Commons licence.
Amanda Leventhal who is an undergraduate student at the University of Missouri has recently explained in an article how depression is underdiagnosed and overlooked in high functioning individuals. Her article has inspired a host of online discussions regarding the complex nature of depression and why it is so important to talk about this epidemic problem. Even in today’s societies, the causes of depression remain unknown and mental disorders such as manic-depression (bipolar disorder) are still unfairly stigmatized making mental health still a taboo topic that needs to be clarified and brought to light.
What is Depression?
Most guidelines today define depression as a mental disorder marked by low mood, aversion to activity and that also affects a person’s thoughts, behavior, and well-being. The exact causes of depression are unknown but possible triggers are stress, trauma, low self-esteem, chemical imbalances in the brain, prolonged illness, loneliness, and lack of light. Brain scans of depressed persons show that certain regions of the brain such as the frontal and temporal cortex, the insula, and the cerebellum are hypoactive. Furthermore, a growing number of studies have found a link between illness-caused inflammation and the development of depressive symptoms. What this means is that depression can no longer be considered an invisible illness but a very much palpable disorder that definitely requires treatment.
Depression in High-Functioning Individuals
Depression, just like the majority of all illnesses manifests with many symptoms. The most common symptoms of depression are low mood, apathy, a lack of motivation, troubles concentrating, problems with memory, sleepdisturbances, etc. The symptoms of depression tend to affect almost every aspect of a person’s life making this illness quite debilitating. An article published in the Canadian Journal of Psychiatry found that 79% of people with depression report that their illness has interfered with their ability to function at work. Since depression is considered a disorder that affects a person’s ability to function in life, we have to wonder if it is possible for people to be high-functioning and depressed at the same time? The short answer is yes as there are different types of depression. According to Harvard Health Publications, there is such a thing called dysthymia which is low-grade depression that lasts five years on average. The disorder is not as crippling as major depression but is a risk factor for episodes of major depression and it is probably under diagnosed in the general population.
The Stigma of Mental Illness and Why It Is a Problem
The stigma of mental illness causes a great deal of suffering and missed opportunities for those afflicted. Unfortunately, the invisibility of mental illness makes it harder for people to emphasize with a person suffering from mental disorders such as schizophrenia, major depression or manic-depression, and many often see the illness as made up or all in their head. The stigma may make it harder for people with mental illness to find employment, housing, and build secure relationships. People struggling with depression are very well aware of the stigma that surrounds mental illness and those going through depression may ignore their symptoms believing they have everything under control. This creates a problem that could lead to depression becoming worse with time and leading to poor health and even suicide if left untreated.
What You Can Do
Knowing the nature of depression can help friends and family recognized atypical symptoms in loved ones. High functioning depressed persons may be better at hiding their symptoms, but behavioral and personality changes are usually good indicators something is going on. Irritability, anger, and a morose attitude is a good sign a person is depressed. Another sign could be increased sleepiness, weight gain, moodiness, and excessive fatigue. Asking the person that you believe is depressed about how they feel may help them understand that their behavior and mood is not normal but a result of depression. We have to understand that depression tends to skew a person’s view of themselves and the world and they may not recognize this as a sign of illness but rather as a normal reaction to a seemingly gloomy reality.
Although we tend to associate depression with low levels of functioning, some people may develop atypical symptoms of depression that can make it harder for them to believe they need help. The problem with mental illnesses such as major depressive disorder and manic-depression is that they often go unrecognized until a person develops severe symptoms that interfere with everyday functioning. The stigma attached to mental illness complicated matters further by making people already struggling with their mental disorder deal with feelings of shame and guilt. The result is often missed opportunities and low quality of life. Recognizing the symptoms of depression even in high-functioning individuals is something we need to take notice of today.
How many times do you catch your mind wandering when you’re plodding through your day’s activities? As you slip into reverie, for example, do you see yourself relaxing at your favorite beach resort? How about imagining the big event you’re attending next weekend? Are you starting to think about who you’re going to see there, and what you’ll wear? After a few seconds, you snap back to attention and focus your mind back on what you’re supposed to be doing. Perhaps you were in the middle of a meeting and realize that everyone is waiting for your answer to a question posed to the group. It’s also possible that you were trying to finish a repetitive task on your desktop, and while clicking through an endless number of cut and paste operations, you started to time travel back to the weekend before. Maybe you’ve just gone to the gym for an hour and spent most of the time thinking about a problem in your relationship.
The effects of daydreaming or mind-wandering are generally thought of as negative. When attention is diverted, you’re more likely to make a mistake — and while driving, you certainly do need to focus all of your senses on what’s going on around you. Apart from all the other potential hazards that can come from distracted driving due to cell phones, GPS, and even the car radio, drifting off into oblivion should certainly rank high on that list of dangers. At work, though, or while involved in your household routines, is it really all that bad to retreat into your thoughts, if only for a moment?
Georgia Institute of Technology’s Kelsey Merlo and colleagues (2019) decided to take a new approach to studying the age-old question of why people daydream, and what effects daydreaming can have on people’s productivity. The authors note that despite how common it is to think about something other than what you’re doing (they claim perhaps as many as half of all waking moments), the work and organizational psychology literature virtually ignores the phenomenon altogether. Most studies of daydreaming have a cognitivefocus or pin the activity down to the brain’s “default working network,” which produces internally generated activity. As in that example from the gym, your mind dissociates relatively easily when you’re involved in automatic activities. This is when the default working network allows you to split your consciousness.
Other terms refer to daydreaming in a more negative light, noting its repetitive nature in the form of rumination or worry. From the standpoint of the Georgia Tech researchers, mind-wandering or daydreaming can be defined as being stimulus-independent, in that the content of the thoughts are not a reflection of sensory input or related to the task being performed at the moment. Such thoughts can be fanciful, such as imagining yourself winning the lottery, or pragmatic, as in planning what to make for dinner. They can be related to work, as when you try to plan out your schedule for the day, and they can be triggered by stimuli such as the phone ringing, which reminds you that you have an important call coming up later in the day.
The comprehensive study conducted by Merlo and her associates took a person-centered approach in which participants provided, in their own words, the causes of their daydreaming, the content of their daydreams, and the results they felt followed from the mind-wandering interlude. The authors focused, as they stated, “on the lived-through experience of a mind wandering episode as that episode is experienced subjectively, by the worker him/herself” (p. 3). They also wanted to allow participants to experience mind-wandering in real situations rather than in the artificial conditions of a lab. They wanted to see, as they proposed, “the dynamic nature of mind wandering as part of work experience” (p. 4). This approach allowed them the flexibility to study daydreaming in its natural environment, while also maintaining scientific rigor. According to “grounded theory,” it’s just as valid to analyze open-ended responses (if done in a systematic manner) as it is to apply the methods of survey research and quantitative analysis.
Participants in the Georgia Tech study, then, were all working adults, obtained from two university sites, whose average age was 40 years old. They represented a diverse set of occupations, and half were white/Caucasian with the remainder identifying as African American (45 percent) or Asian (5 percent). In the open-ended interview that the participants completed, the less technical term “daydreaming” was used rather than “mind-wandering.”
The analyses, then, rather than representing statistical tests, reflected the broad themes that emerged across interviews, divided into the three areas regarding the onset, ending, and outcome of daydreams. Looking first at onset, or triggers, these ranged from internal states (sadness, fatigue, or boredom), direct prompts (looking at something or someone), an internal progression (thinking about one thing that then leads to another), being in a meeting, and just taking a natural break (such as being in between projects). You can enter a daydream at work, then, either because you’re inwardly triggered to do so by a mental state, externally stimulated by something that happens to you, or by being in a work situation that naturally fosters daydreaming.
People snapped out of their mind-wandering, the authors reported, for similar reasons. They can be faced with external cues, such as the “ping” of an email landing in their inbox, internal cues, or becoming aware that they were daydreaming, or by the daydream reaching its natural conclusion, and there being nothing left to daydream about. You might wake from your daydream, then, because someone is standing in front of you and demanding your attention, or because you realize it’s time to get back to what you were doing.
Most interesting from the standpoint of daydreaming’s effect on your mental health and productivity were the responses that participants provided about the perceived outcome of a mind-wandering episode. They described some negative impacts, such as feeling guilty about having drifted off from their work tasks, or continuing to experience a negative mood state from the daydream if it involved worrying or reliving a sad event. However, many of the participants believed that daydreaming had benefited their emotions and their work performance. One software consultant noted, “Because they are so short, and I find them to be pleasant, they never hurt me.” Some noted that they worked harder after the daydream ended to catch up any lost time or effort. A financial administrator started making fewer mistakes after a daydream break, “because I was getting bored with the task.”
The authors were struck not only by these positive outcomes, but also by the fact that mind-wandering seemed to be a process that the participants stated they could control. They could decide to avoid an aversive work environment with a brief mental wander somewhere else, and when they wanted to end the daydream, they could readily do so. As a result, the authors concluded, “mind-wandering may be able to be used strategically to enhance work experience” (p. 12). The micro-break which the daydream provides can help to combat fatigue and strain during the day, because “it allows individuals to cognitively and affectively disengage from their work demands” (p. 13). You don’t need to wait until the weekend or your next vacation, the findings suggest, to get the mental health benefits of a break. Although mind-wandering seems “mindless,” at another level, using your daydreams to enhance your well-being can be an exceptionally mindfulness-boosting experience.
To sum up, the Merlo et al. findings suggest that the occasional daydream, especially the one that allows you to unfocus and then refocus, can be one of the best ways to become better at what you’re doing. The associated feelings of being refreshed and ready to tackle your next task can become just the antidote you need to lower stress and boost your feelings of day-to-day fulfillment.
One of the greatest challenges to keeping an empty head is maintaining the drill of processing our interactions to closure. In the course of our day, we often generate much more value-added thinking and agreements with ourselves and others than we realize, especially in the context of conversations and communications.
Whom have you talked with in the last 24 hours—personally and professionally? What did you tell yourself (or any of them) that you or they would/could/should/ought to do, in any of that? Any ideas, information or perspectives show up that could be important downstream?
Sources of Free-Floating Anxiety
I still have to work with myself to ensure I’ve captured, decided, and tracked all the commitments and creativity that happen with phone calls, meetings, social interactions, and even random communications in passing. I do know that this is one of the sources of much of the free-floating anxiety many professionals experience relative to the gnawing sense of overwhelm that is so pervasive. It seems that there is an unconscious part of us that hangs onto all of those incomplete creations. It is a part that will not let go until it can trust those agreements have been kept or re-negotiated with ourselves.
At this moment I notice in my in-tray two pages of random notes I took on a conference call yesterday, regarding our upcoming GTD Summit in June. There’s a little part of me that resists engaging with them, because I know it’s going to require thinking (which is hard!). But because I’ve got the habit of getting “in” to empty, those notes will trigger the things I need to do, to get that sucker empty! I hate it, and I love it.
Take Time to Process
And, the number of interactions we handle in a day is more than ever. This is why it is critical that we all take time every day to process this stuff. What did I tell Luca I was going to do? What did Kathryn say I should bring back from the store? Who’s got the next action on the project we decided needed doing at the last marketing meeting? Review the day, capture what needs tracking, and then get some sleep.
Insomnia, or the lack of sleep, may lead to medical and psychiatric conditions. In some cases, it is these medical and mental issues that actually cause sleep problems. But whether insomnia is the cause or the effect, difficulty sleeping is definitely a sign that something is wrong with your health.
The National Sleep Foundation says that it’s always a good idea to have a general check-up with a health care provider if you have trouble getting regular sleep. It is important to determine if you have underlying health issues or sleep disorders because insomnia can affect the quality of your life.
1. YOUR THYROID IS OVERACTIVE
You have a condition called hyperthyroidism if you have an overactive thyroid. This occurs when there’s more production of a hormone called thyroxine in the thyroid gland.
When you have hyperthyroidism, you could experience symptoms that seem to mimic other health conditions. Thus, it’s not always easy for doctors to catch the problem. Aside from insomnia, you may also experience the following symptoms of hyperthyroidism:
Change in appetite
Frequent bowel movement or diarrhea
Heart palpitations, rapid heartbeat, or irregular heartbeat
Muscle weakness and fatigue
Light menstruation and missed periods – for women
Hives and itching
Oversensitivity to heat
Swelling of the neck base
If your weight loss is sudden and you have two or more of these symptoms, it’s important to see a doctor for an assessment. Don’t forget to describe the changes you’ve noticed in your body to the doctor so that you can get the right diagnosis.
2. YOU’RE HAVING ANXIETY ISSUES
What may be keeping you up at night are your concerns in life. Have you been going through something lately that’s causing a great deal of anxiety? Experts say that your mind can’t rest if you’re always anxious. If your mind cannot rest then you’re likely to sleep lightly and develop insomnia.
But the problem is that your sleeping brain cannot distinguish what’s happening compared to your waking brain. The neurotransmitters that send the signals in your brain won’t be able to cope with the threats that anxiety causes in your sleep. So, even if you think you’re making it through day by day with little or light sleep, it will eventually take its toll.
You have to see a therapist as soon as possible in order to sort out your anxiety issues. You have to find positive coping mechanisms that help calm your mind when you’re going to bed. For some people, these coping tools may include meditation, light exercises, and other soothing activities.
3. YOU’RE PHYSICALLY STRESSED OUT
Just like mental stress or anxiety, physical stress may also lead to light sleeping. This is because your body’s temperature, heart rate, and adrenaline are higher, which affects your ability to engage in deep sleep, also known as REM sleep. REM sleep takes 25 percent of your sleep cycle. Its main functions are:
To store your brain’s long-term memories
To aid in your learning
To stabilize, enhance, and balance your mood
You lose the benefits of having deep sleep if your body can’t complete the REM phase of your sleep cycle. So, you wake up feeling more groggy and tired because your body didn’t actually get a good rest.
Thus, creating a relaxing routine for bedtime may help regulate your sleep cycle. You must also avoid doing heavy physical workouts two hours before you go to bed.
4. YOU’RE EXPERIENCING ACID REFLUX
You won’t get a good night’s sleep no matter what you do if you’re suffering from acid reflux or heartburn. Diseases affecting the gastrointestinal tract can influence the quality of sleep because the acid contents from the stomach may rise back when you’re lying down the bed, according to the American Sleep Apnea Association.
You’re standing or sitting during the daytime so acid reflux won’t have much impact. When you’re reclining, however, the stomach acid can’t be pushed down to your stomach so you end up having interrupted sleep with a burning sensation in your chest and a sour taste in your throat. It’s an unpleasant feeling, to say the least.
There are over-the-counter medications to take care of this problem. You should see a doctor right away for the proper diagnosis or treatment. Apparently, 60 percent of patients with gastro issues suffer from sleep problems.
5. YOU’RE HAVING HUNGER PANGS
Your bouts of insomnia might be related to your eating habits. If you have an irregular dinner schedule and you suddenly ate earlier, say between 5 p.m. to 6 p.m., then by 2 a.m. your brain triggers your body to demand fuel or food.
You get these hunger pangs because of a hormonal imbalance. This, once again, highlights the importance of having a routine so that you can be assured of a good rest. Try as much as possible not to mess with your dinner times so that it won’t also ruin your sleep cycle.
6. YOU’RE DRINKING TOO MUCH COFFEE THROUGHOUT THE DAY
Do you know that coffee takes an average of eight to 10 hours to be completely eliminated in the body? If you drink a cup or two early in the day, at least 75 percent of it will be gone by the time you go home for dinner.
But if you drink coffee in the afternoon or less than six hours before you go to bed, then you may have problems getting decent sleep at night. Since caffeine is a stimulant, it can impede your sleep routine.
Ironically, if you’re trying to cut down on the coffee drinking, you might also experience insomnia since your body will go through withdrawal as an automatic response. You may also experience increased heart rate, headaches, and jitters that could impact your sleeping patterns.
But be patient as you get through the withdrawal stage. It’s much more positive to restore your sleep quality than continue to suffer from the effects of insomnia.
7. YOU’VE GOT BAD SKIN, ESPECIALLY UNDER THE EYES
When you suffer from insomnia, your eyes turn puffy and the skin around it appears darker. This happens because sleep deprivation triggers your body to work double time to bring oxygen to your vital organs to prevent a breakdown, according to the experts via Telegraph.
But in doing so, your body doesn’t draw enough oxygen to the skin. So, in due time, the skin around your eyes grows darker because of the deoxygenated blood that flows through it. The dark circles also become more obvious because the skin around the eyes is thin.
Ever wonder why they call it beauty sleep? It’s because sleep has a positive effect on the health of the skin. Proper sleep allows:
Development of healthier hormones
Stimulation of the cells
Repair of body tissues
Formation of more collagen that will reduce skin aging
8. YOU’RE LESS SHARP AND LACK FOCUS
Insomnia can lead to the deterioration of your cognitive function. You lose the ability to concentrate on a task. You also experience slow mental processing that could impact your ability to make decisions or solve problems.
The lack of sleep will dumb you down and affect your efficiency at work. You’ll be less sharp, less focused, and less alert. You won’t be able to grasp instructions or reason and state your case well because your cognition is impaired.
If you work at a high-risk job, where accuracy, vigilance, and safety are important, being an insomniac can definitely matter to your performance. A faulty brain function puts you and the people around you at risk. Thus, you need to see a doctor before you create a major blunder or accident that may hurt someone.
Long-term insomnia that’s not addressed or treated can lead to memory loss. This is because the lack of sleep doesn’t give your brain the chance to recover, recoup, and organize itself. There have been studies showing the improvement of memory recall following a night of good sleep. So, don’t delay finding a positive and doable solution to this problem.
9. YOU’RE MORE PRONE TO COLDS, COUGH, AND FEVER
Do you always catch a cold or cough? Are you always the first one holed up in the bedroom during flu season? If you’re an insomniac, you’ll often find yourself with colds, cough, and fever because your body’s defenses against virus and bacteria are low.
A prolonged state of sleep deprivation is a lot similar to your body experiencing high levels of stress. As a result, your body’s immunities lower so you’re more vulnerable to getting sick.
Good sleep helps your body produce proteins called cytokines that help with infection and inflammation. When you’re not sleeping well, however, the level of this protein in your body drops so your antibodies weaken.
10. YOUR BEDTIME ROUTINE AND SLEEPING CONDITIONS NEED TO BE IMPROVED
Your lifestyle plays a vital role in how you stay healthy. Perhaps the reason you’re having insomnia is that you don’t slow down from your activities even when you’re in bed. You also don’t make it a point to create a healthy environment for sleeping.
Do you still use gadgets minutes before you shut your eyes? Studies have proven that this habit can disrupt your sleep cycle. Is your bedroom too messy or overly warm? The physical conditions around you can impact the quality of your sleep.
Make an effort to have a healthy routine and sleep conditions and see how much difference it will make in your sleep patterns. Don’t get used to the disorder and dysfunction; instead, listen to the signs your body is telling you.
FINAL THOUGHTS ON THINGS INSOMNIA CAN TELL YOU ABOUT YOUR HEALTH
People spend nearly more than a fourth of their lives in bed but most don’t really make an effort to make their sleep quality count. If you make positive changes to how you sleep, you should see improvements right away if you’re suffering from acute insomnia.
But if your insomnia still lingers for weeks and months, you need to get a proper medical diagnosis for the disorder that’s really ailing you. There are individuals who don’t actually know that they’re not getting good sleep or suffering from insomnia. For this reason, a visit to the doctor or a specialist will be a big help.
There are many times in life when a person with a sense of humor lightens the mood of a meeting, family gathering, or party. You may actually look forward to going to work if you know you can count on having a good laughor two at some point during the day. The endless meetings or tedious job tasks that are part of your workload are made more tolerable if these witty folks infuse their observations into the situation. If the person is the boss, even better. You can’t help but admire leaders who don’t take everything all that seriously, including themselves. Similarly, outside of work you may highly value your friends and family members who can either tell a good joke or make light of what might otherwise be a serious occasion, at least from time to time.
In a new study, University of Arizona’s Jonathan B. Evans and colleagues (2019), noted that although humor has the potential to create an environment conducive to positive outcomes, at work and elsewhere, this potential may fail to be realized. If a joke falls flat, the person telling it can look inept or even cruel. Telling jokes can also influence the way you’re perceived by the people who you’re trying to entertain. Based on a model known as “parallel-constraint-satisfaction” theory, which proposes that stereotypes affect the way people interpret the behavior of others, Evans and his colleagues hypothesized that men would benefit and women would be penalized when using humor specifically in the workplace. Men will gain status when they make jokes, and women will lose.
This proposal may ring true if you think about comments over the years suggesting that women can’t be funny. Rather than add to this debate, however, the Arizona researchers looked not at what’s funny or not, but how telling jokes affects they way the joke-teller is perceived which, in turn, influence the joke’s impact. Think about times when you’ve been in a meeting or group setting in which a man constantly makes wisecracks while everyone else is trying to stay task-focused. Try as you might, you find yourself unable to suppress a giggle now and then. You don’t think any less of the jokester and, in fact, find your estimation of him rising as he shows his humorous side. Now imagine that it’s a woman in the role of jester. Do you still think of her as gaining in status, or does she just seem silly?
Parallel-constraint-satisfaction-theory (PCST) proposes that people evaluate a target along multiple dimensions simultaneously, influencing the way they evaluate others. With humor, the joke-teller can be seen as either serving a positive purpose by alleviating tension or as disruptive by distracting people from the task at hand. Gender interacts with this dimension, with male stereotype of a man being high in agency (individual drive) and rationality with women seen as low in personal agency and rationality. Men therefore have the humor-as-functional perception working in their favor but women, seen as irrational and flighty, are perceived as disruptive and even non-funny.
In the first of two studies, Evans et al. asked 96 online participants to rate the disruptiveness and functionality of humor as shown by either a male or female manager performing in an online video. The manager was described in the research materials as a highly successful and talented individual. As the research team predicted, participants rated as more disruptive and less functional the same jokes expressed by women as by men. In the second study, 216 online participants watched videos of either a man or a woman either telling jokes or not telling jokes. Following the presentation of the video, participants then rated the managers on their status, performance and leadership capability.
As the authors predicted, participants rated female joke-tellers as lower in status, which in turn led participants to view them as lower in performance and leadership capability than men. They note that, like an elbow nudge, humor’s meaning can be ambiguous. We impose onto that behavior, they maintain, our stereotypes about the joke-teller. There is no reason that the same jokes, whether told by a male or female, should have the same impact on those hearing the jokes. By supporting the PCST approach, the Arizona researchers showed that humor’s perception is bent by the gender of the joke-teller.
Thus, being sarcastic and teasing violates the female gender stereotype but fits perfectly with that of the male’s. Evans and his fellow researchers maintain that they have added to the literature regarding the lower proportion of female than male CEO’s. If men can get to the top by being funny, but women lower their status potential by engaging in the very same behavior, this would provide yet another cause of the glass ceiling for female executives.
To sum up, humor’s ability to provide fulfillment should be gender-neutral, but since the Evans et al. study suggests it’s not, perhaps there can come a time when, in the words of the authors, “increased awareness can help reduce its occurrence.” Give the female joke-teller some slack, and you’ll be part of that long-overdue impetus for change.