1) Herbs and Supplements: Herbal formulas like Calms Forte, soothing teas before bed, melatonin, GABA, inositol, Vitamin B6 — none of these herbal/supplements treatments worked for me. Maybe they’d work for you.

2) Drugs:  Ambien worked for a time. This is the perfect drug, I thought: it does what it says it will do with no hangover. But then the horror set in – ‘rebound insomnia’ — when it suddenly stops working and in fact makes your condition worse. Sonata didn’t make a dent; Trazadone keeps you asleep for only 4 hours because of its half-life; and Ativan puts you to sleep but leaves horrible enervation and depression the next day. Hardly worth it.

3) Hypnosis: The sleep CD, “Just Relax-Relaxing to Sleep” by Gail Seymour, worked great for quite awhile — it knocked me out every time. But when it got so I could repeat every word, it wasn’t authoritative any more. I tried others but they all had a funny accent or an irritating voice. This is a good place to start if you’ve never tried them.

4) Pleasures: Bad news in this department– both coffee and alcohol seem to be big problems, even if early in the day. I’m still trying to figure out how to make this work short of quitting altogether. Eating before bed only works if it’s heavy carbs. The new thinking is that the old standby warm milk actually makes it worse because of the protein.

5) Computer insomnia: This is actually a new diagnosis.  People get so amped up being on the computer late at night that it affects their sleep. Guilty.

6) Scheduling: It seems to make a big difference to go to bed and get up at the same time. I’ve talked to people who had to start putting their sleep first, above anything else, even going out to hear music. Hmmm.

7) Exercise: Seems to help with everything. Sometimes the body is not tired enough to go to sleep.
Creating a ‘sleep palace:’ Many times we need to redo the bedroom – get light blocking curtains, white noise machines, a better mattress. Make the physical space an “invitation for sleep.”

9) Hyperarousal:  Mentally active people tend to exist in this state all the time and are consequently more prone to insomnia.  One has to start consciously relaxing hours before bedtime.  A lifestyle makeover is often required.

10) Finally, I read Dr. Barry Krakow who said that if you have insomnia, it’s because you don’t want to sleep.  (‘Sound Sleep, Sound Mind, Hoboken, NJ: John Wiley & Sons, 2007) You haven’t told yourself that the day is over and it’s time to go to sleep.

I realized this was true. I don’t want to sleep — life is just too exciting. I enjoy thinking about things, running the good parts over and over in my mind. At times the bad ones too, although that’s another story. Who has time to sleep? It’s a shame it’s so essential to good heath. If you find the magic key, please let me know.

© 2009 Catherine Auman

The therapist was looking at me intently. His hair was graying and mine wasn’t. At least not obviously. “You’ve just named your cure,” he said. “Listen to more bossa nova.”

You’d be amazed to find out how many of my depressed patients subsist on a diet of Morrissey and The Cure. Or the anxious ones who live on the most aggro Hip Hop and several grande Starbucks a day. A client I once had to intervene on so she wouldn’t kill herself? Her favorite band was the Suicidal Tendencies. (She came back the next week wearing a T-shirt she had made up that said “Choose Life.”) (Not knowing that that usually means something else.)

The other day I caught myself cursing at a #$%& driver on the freeway. When I came to, I noticed I was all adrenal-ized by the The World of Goa Trance I was listening to. Well, no wonder. I switched to Love, Peace, Chant by David Newman. The other drivers on the road sighed a silent ‘thank you.’

I’m not a trained music therapist, but it seems to me there’s a lot to be said for orchestrating the soundtrack of our lives. It’s sort of an alchemy, yes? A little of this, a little of that, until we get just the right mood.

Sometimes psychotherapy is really helpful. Nothing matches it for getting unstuck, extricating ourselves from ancient patterns we can’t see on our own. Sometimes we really need that other person in our court, someone who has already delved into realms we’re only beginning to explore. Other times what we need is a lifestyle overhaul, like some new music. Bossa Nova may not be your thing, but what if it is and you’ve been missing out all this time? Or it might be African music, which is a dependable mood lifter as well. Choose more of what makes you happy. Really happy, not just addictively high. There’s a big difference, you know.

I didn’t stay with that therapist very long, but from that one simple directive I got more than from others I stayed with for years. You should see my bossa nova collection. Getz/Gilberto, anyone?

© 2009 Catherine Auman