Autofiction: Tasty Tasty Amitriptyline

Slightly BrokenWaiting To Sleep

Thirteen was when I first remember being unable to sleep. I suppose it coincided with the onset of puberty and all the biochemical hell that our ridiculous genetic heritage unleashes on us. If there were any doubt about the truth of evolution, suffering through adolescence should be the final nail in the doubter’s coffin. So yeah, thirteen-ish, and sleep began to elude me. I don’t recall doing anything differently. I’d already been at ‘big school’ (or secondary school as we used to call it, just before they renumbered the school years – first year secondary school became Year Seven… which was the eighth year someone would have spent at school. I never got it.) for a few years, so the grind of occasional study and the hassle of being near other humans was well established. My parents had been divorced for two and a half years which was admittedly stressful but normal.

Then I stopped being able to get to sleep. I know that’s a cliche for teenagers but I found it brutal. I would go to bed and it would take two to five hours to get to sleep. After a few days I’d get tired enough to crash out and get a full night, but it never compensated for the loss. I’d read, in hopes that it would somehow wear me out (that’s when I picked up my lifelong couple of books a week habit): it didn’t. Maybe the radio would help. Nah, I just listened to it. I became familiar with the Shipping Forecast. The music from Desert Island Discs makes me angry to this very day – its aural existence in my life meant that I still wasn’t asleep. Exercise – nil effect (I played rugby and hockey back then).

That went on for years…

Life Pillows

It’s hard to recall the full period leading up to going to university. It’s a time that overlaps with drink, drugs and abuse. I’ve no idea which, or what combination of factors might have perpetually fucked my memories, but whichever it is, I do struggle to remember. Never mind – I like to live in the present anyway. Or rather, I live in the present and have chosen mostly to like it. Some things helped with sleep over the years:

Drinking. You can always black out, it’s a bit like sleep. It’s a traditional recourse for not sleeping, but not a very good one. The relaxing aspect of it is great and it can definitely take the edge off. Sadly I needed more and more to get dopey enough to sleep. And then I tend to wake up in the night or really early. Not a great fix but a very easy one to acquire.

Weed. The wonder drug. Definitely not addictive (just a very hard habit to break, y’know- like an addiction). This I liked much more and was indeed extremely hard to kick the stuff. I realise now that it made me more tense and less likely to sleep, but I didn’t care and so wasn’t worrying so much about not sleeping. Aaagh.

The first two were easily combined at university after my sleep got even worse. I partly blame the incredibly noisy doors in the halls of residence. I could have killed people over that. I should have killed people over that. They got even worse after I started reobsessing over the abuse and all that bullshit.

Thinking seems to be the problem overall. Information gets me twitchy, and sets off that familiar mouse mind in a pointless maze. Any stress or anxiety in the evenings usually destroys a night of sleep, or at least makes it much more difficult to nod off.

Progress and Punching Sheep

Naturally I learned to live with it. My coping mechanisms of getting up at three in the morning rather than lying bed to have some whiskey and codeine in hopes of then being relaxed enough to doze off were not great. That’s all they were though – coping mechanisms. You do get used to having very little sleep and it’s amazing how much you can do without really being conscious or having time to refresh your skull sack. There does appear to be a lot of research into how badly insomnia, and the anxiety that may help encourage it are really very damaging. Memory seems to be one of the things hit hardest. Oh well.

Eventually, after more than twenty years of terrible sleep I went to the doctor’s about it and got referred to a cognitive behavioural therapy course. I have despised/feared psychiatry for many years – this is an excellent avoidance strategy. It was helpful, I learned a lot – about myself, about anxiety and depression which are likely one of the causes or strands in my sleep disorder. From that I developed a structure for the evenings – everything goes off at ten. In theory that gives me an hour of information-free downtime to read and potter about. That structure, along with getting up at the same time every day and trying to make space for scribbling or exercise in the morning was very effective for a few months.

The routine gave shape to my sleeping habits – sleep was the thing that fits into the gap between going to bed and getting up in the morning. It sounds silly to write it like that, but really that’s one of the most significant things I’ve learned. I also learned not to get frustrated when I couldn’t sleep. I was always aware that the anger, the sheer burning rage I get when something costs me sleep, also compounds the problem. I know I can survive for a fortnight on three hours a night; I just don’t want to.

Pushing It To The Next Level

The routine worked for a while, but life is busy and requires adjustment of routines. After the CBT sessions ended I referred myself on for some more serious counselling – I had realised or accepted that I had some deeper issues to resolve or figure out. That was a rollercoaster of brain-fuck-adocus. Somewhere in the middle of the CBT I got prescribed Amitriptyline as a relaxant – the counselling was stirring up too much (inevitably) and I was self-medicating cheerfully. I just added Amitriptyline to the mix. It goes down well with whiskey…

There’s no doubt that this is a bad cocktail, and it was making me really sludgy in the mornings and had trouble with affect (it’s so hard to care sometimes) which was scarily like the weed had become. After I finished my counselling in January I found my brain quite clean but I was having trouble sleeping again. So I went back to the doc and went back on Amitriptyline. I negotiated a deal – I’d stop drinking entirely for six weeks in exchange for taking a larger dose.

Well, that was a bitch. It was however and excellent opportunity to taste test a load of alcohol free drinks. It was also very good for me. The higher dose of Amitriptyline (50-75mg) taken at about seven in the evening has me relaxed and starting to feel a bit sleepy round about ten thirty. I’ve adapted to it – as long as I get between seven and a half and eight hours sleep that dosage works fine. If I get too little sleep, or take the higher dose later in the evening, or if I have an alcoholic drink before I take the early evening dose then I’ll find waking up tough. If I’m smart though, and space these things out it works really well. Most nights I don’t drink alcohol at all. Maybe a late evening whiskey and certainly a pint in the pub after improv jam, but generally my routine has changed, and for the better.

Something else that’s good – a cat. Having a cat sleeping on my bed is delightful. I find the little monsters ever so relaxing. So, a cat and drugs. And being generally happy with other things in your life. I’m happy with my partner, I’ve got stuff to do, and after twenty-two years I am finally getting more than seven hours sleep a night, almost every night. It is amazing.

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