On the Brink

This is the 17th installment in the series Chronicle of Sleepless Nights

It was now months since I had felt strong and fit, exercising every day and eating a low-fat vegan diet. Michael thought that my exercise, diet, and thyroid had caused my sleep problems. Now I hardly exercised, I was eating most foods again, and my thyroid medication had been lowered from the equivalent of 100 mcg a day down to 50 mcg, as I had once again requested a lower dose from my endocrinologist. I was not sleeping much on Ambien and Valium, despite the large doses I took.

CT Scan and a New Drug

The 4 mg of Valium I took in the early morning stopped working, so I had increased my dose to 6 mg. But that gave me only one extra hour of sleep after the Ambien wore off. I felt like a drug addict. I had tried melatonin as Dr. K had advised, as well as several other suggested supplements, and none had helped. I stopped all my vitamins and supplements because they did not seem to be affecting me and in case, they were interacting with my sleeping pills.

I made an appointment to see Dr. K. This time, in addition to informing him about my increased dose of Valium, I had a new symptom. When I put on a bra, it hurt my chest and back. I tried all different kinds, but they all hurt. It was painful to wear a bra. I now realize it was probably due to my thin body and loss of fat to cushion the edges of the bra. But at the time, it seemed to be something else wrong with me. And I experienced this discomfort constantly.

I told Dr. K that I still I had symptoms of hyperthyroidism despite twice lowering my daily thyroid medication. Since my recent T3 blood test was low, the endocrinologist did not want me to further lower my medication. However, I still felt as if my body were speeding. I was eating a lot but losing weight. At this point I weighed 113 pounds. I had not weighed that little since junior high school. I was still having diarrhea throughout the day, as well as frequent urination.

My body felt as if it were in overdrive. In addition, I felt that my body was working against every drug I tried. I wanted to be tested to see if I had some type of hypermetabolic problem that was causing me to burn up the drugs before they could do their work on my brain. I also wanted to find out what was also causing me to eat constantly and still lose weight. I told Dr. K that I had seen the sleep doctor four times and that he said I should be getting better, not worse. Something else seemed to be interfering. Dr. D, my sleep doctor, had told me that most people gain weight and are sleepy during the day on the sleep restriction plan. But I was losing weight and feeling like I was speeding, which is why I went to see the endocrinologist. As I went on and on with my story, I am sure that I appeared anxious and a little crazy.

Dr. K listened with his usual kindness. He suggested I try yet another drug, Ativan, to replace the Valium. I was so tearful in describing my belief that something was wrong with me that he reluctantly ordered a CT scan. I feared that I had a tumor or something else that was affecting my thyroid and metabolism and also causing the pain from wearing a bra. Michael and I waited for hours at Regions Hospital in downtown St. Paul, but eventually I was given the CT scan. The results came quickly via my online portal: everything appeared to be normal.

After so many visits and drugs prescribed, Dr. K told me that he did not think he could help me anymore. After prescribing Ativan, which I was supposed to take for a short time, he told me to see a behavioral doctor, i.e., a psychiatrist. I was dismissed. I never saw Dr. K again.

I called my clinic and then their partner clinic, but could not get an appointment within the next month, which Dr. K had requested on his referral form. Once again, I felt desperate and impatient. How could I wait months to get help? My referral noted that I needed to see a psychiatrist for anxiety and medication. Most of my anxiety was about the drugs I was now taking and wanted to stop taking. And I still had tremendous anxiety about how I would ever begin to sleep regularly again. I knew I had to start getting off Ambien but was afraid of becoming psychotic during the process. I kept counting the weeks and months I had been taking this drug, and knew it would be very difficult to wean myself off of it, since most nights it helped me fall asleep and allowed me to sleep up to four hours.

The first time I took Ativan it gave me 2 hours of additional sleep, which made me feel almost euphoric. But I knew Ativan was very addictive and even though it is an anti-anxiety drug, I also started to feel anxious during the day.

Maybe I Need to Check into a Hospital

I was still attempting to go to work on Wednesdays, to meet with my advisees. I tried to concentrate on what they had to say at each meeting and to produce coherent answers to their questions. Sometimes they asked how my sleep was going, and I would start to cry. Then they would start to cry. Often I would sit at my desk talking to them, while at the same time, I was thinking about my problems. One day at work I realized that all I was thinking about was going to a hospital and being drugged to sleep. This is what I had requested earlier when I visited the ER, but had been turned down.

I turned to my computer and began to research hospitals or treatment centers that would help people sleep and get off sleeping pills. I looked up Hazelden, our world-famous addiction treatment center, but I did not seem to fit into any of their programs. I even looked up the famous Betty Ford Center. Again, I found nothing for sleeping pill addiction or sleep problems. I knew that my friend M had been in a hospital for a few weeks when she suffered from depression and anxiety. Sometimes I imagined cutting off my head to stop it from aching and tormenting me. Was I suicidal? I wasn’t sure. I had never felt such despair flooding over me. I wanted to run away but realized that no place I could go to would fix my problems. I wanted to be heavily sedated and then helped to get off sleeping pills. I wanted more help than I was getting.

I emailed M that afternoon from my office and asked her what hospital she had gone to and what it was like to check into a hospital for psychiatric help. It seemed like a quicker way to get to see a psychiatrist than waiting months for an appointment. Upon getting my email, M immediately called me. I talked to her for quite a while. She described what it was like to go to a psychiatric inpatient facility. She gave me a realistic idea of what to expect if I checked myself in. There would be group therapy sessions and only a short meeting or two with a psychiatrist. She did not think I would be able to get the kind of drugs I was looking for, to knock me out for at least a full night and maybe more. Most importantly, she helped me realize that checking into a hospital might not help my sleep problem. She advised that such a visit would only get me through a crisis. I also learned that a hospital would send me home when stable, but not necessarily sleeping or off pills. When I got out, I would still be dealing with the same issues and problems. It would just put me in a safe setting so I would not harm myself. It might even prolong the problems. I thanked her for her frank and helpful advice, and hung up the phone. Although I was anxious and full of despair, I concluded that it did not seem appropriate for me to check into a hospital.

Finding a Psychiatrist

I decided to find a psychiatrist in private practice since I could not make an appointment at my clinic. I remembered that I had been given the name of a psychiatrist, Dr. P, by a friend at the Y who knew I was having problems sleeping. She had told me that Dr. P had helped her sleep again by prescribing effective drugs. I decided to call Dr. P and make an appointment.

Before my first appointment I had set up a session with Dr. D at the sleep center. I had not seen him for weeks while dealing with my thyroid issues. I was ready to restart sleep therapy and get his advice on the sleeping pill issues.

I felt that I was starting to move forward by seeing a psychiatrist to help me get off drugs, and returning to Dr. D to retrain by brain to sleep. I also decided to see a naturopath, Sydney, to discuss herbal supplements to help lessen the effects of drug withdrawal. My endocrinologist, Jill, had referred me to Sydney, as they had worked together with a previous patient who had thyroid issues.

I now had three appointments to help me move forward: Dr. D, Dr. P, and Sydney. Surely they could pull me out of this mess. I had moved beyond feeling suicidal to feeling hopeful again. Fortunately, many times in the past several months when I started to feel hopeless, something would miraculously happen to lift my spirits. Sometimes it was a warm and loving message from my sister Ann. Sometimes it was a visit from my daughter Rebecca with her little daughter Addie, an exuberant ray of sunshine. Sometimes it was my bathtub talks with God, where I searched for my purpose in life and vowed to serve others. And sometimes it was Michael’s steadfast encouragement that we would get through this together. And so we did.

Next post: On the Path to Recovery



Professor Emeritus of Educational Psychology at the University of Minnesota, author or editor of books on teaching and learning statistics, as well as cooking.

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Joan Garfield

Professor Emeritus of Educational Psychology at the University of Minnesota, author or editor of books on teaching and learning statistics, as well as cooking.