The Link Between Insomnia and Mental Illness

“I’ve always envied people who sleep easily. Their brains must be cleaner, the floorboards of the skull well swept, all the little monsters closed up in a steamer trunk at the foot of the bed.”  ~ David Benioff (co-creator of Game of Thrones)

Surely you have experienced a poor night’s sleep. You wake up feeling unrested, groggy, like you got hit by a train… And the fun lasts throughout the day with slow reflexes, foggy brain, inability to concentrate, impatience, stress, worry, anxiety and even headaches. It is absolutely no surprise that sleep quality has a direct impact on your physical and mental health. Today I am going to highlight the connection between insomnia and mental illness, in hopes that those experiencing it can get the help they deserve.

Insomnia is defined as the inability to get the necessary amount of sleep to function efficiently during the daytime. It is a sleep disorder that is characterized by difficulty falling asleep, waking up often throughout the night, having trouble going back to sleep, and waking up too early in the morning. In essence, insomnia results in feeling tired upon waking. Understandably, said fatigue can lead to difficulties functioning during the daytime and have unpleasant effects on work, social and family life. 

You likely already knew all of that about insomnia. But what you may be unaware of is that insomnia can be indicative of more serious issues, including medical issues like sleep apnea, or even mental illnesses like anxiety, depression, schizophrenia, bipolar disorder, and attention deficit hyperactivity disorder (ADHD). Sleep issues can even be a sign of an impending condition such as bipolar disorder. Many existing medical and mental health conditions can be worsened by sleep-related problems because lack of sleep slows recovery from mental illness. People with depression who continue to experience insomnia, for instance, are less likely to respond to treatment for depression. They are also at greater risk of relapse than those without sleeping problems.

Many people do not know there is an undeniable link between insomnia and mental health issues. More than fifty percent of insomnia cases are related to depression, anxiety or psychological stress, and many anxiety disorders are associated with difficulty sleeping. For instance, obsessive-compulsive disorder (OCD) is frequently associated with poor sleep. Panic attacks during sleep may suggest a panic disorder. Poor sleep resulting from nightmares may be associated with post-traumatic stress disorder (PTSD). The severity of sleep issues can determine the type of mental illness a person my experience. For example, early morning wakefulness, low energy, inability to concentrate, sadness and a change in appetite or weight can be indicative of depression. A sudden dramatic decrease in sleep accompanied by an increase in energy (or the lack of need for sleep) may be a sign of mania

Poor sleep patterns can not only be indicative of mental health issues, but it can also significantly worsen them. Insomnia makes it difficult to process and react to appropriately to negative emotions. Severe sleep problems can decrease the effectiveness of certain treatments. Treatment of sleep disorders has also been studied in relationship to schizophrenia, ADHD and other mental illnesses. All of the scientific data shows the connection between medical and mental illnesses: good sleep is necessary for recovery—or prevention—in both types of conditions.

There was a research trial done where fifty-one percent of individuals who overcame depression after psychological treatment (therapy) or medication were still experiencing insomnia. Insomnia tends to persist unless it is directly targeted for treatment. Insomnia can either be short-term or long-term; short-term insomnia is very common and has many causes such as stress, travel or other life events. It can generally be relieved by simple sleep hygiene interventions such as exercise, a hot bath, warm milk or changing your bedroom environment. Long-term insomnia lasts for more than three weeks. This is when you need to be examined by a physician with a potential referral to a sleep disorder specialist (a psychiatrist, neurologist or pulmonologist who have expertise in sleep disorders) for assistance. A balanced diet, regular exercise, meditation and relaxation, good sleeping habits, herbal remedies, medication and therapy are powerful actions that can help relieve insomnia. 

Living with insomnia is hard. The constant exhaustion and inability to sleep is an ailment which may require medical attention to overcome. Remember that insomnia often comes paired with a mental illness. Only as you work through both ailments will you find lasting relief. But it is doable, and I am here to help! Please do not hesitate to contact me today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Living Your Best Life, ADHD Aside

“ADHD is not about knowing what to do, but about doing what one knows.” ~ Russell Barkley

Attention deficit hyperactivity disorder (ADHD), previously known as ADD, can present challenges for adults across all areas of life. It can be taxing on your health, your job, and your personal and professional relationships. Your symptoms may lead to procrastination, trouble meeting deadlines, difficulty maintaining relationships, and impulsive behaviors. You may wind up feeling alone, and as though friends and family do not understand what you are dealing with. Fortunately, there are skills you can learn to help manage the symptoms of your ADHD. You can improve your daily habits, learn to recognize and use your strengths, and develop techniques that help you work more efficiently, maintain organization, and interact better with those around you.

Over the last several years, awareness about ADHD has increased, and the stigma surrounding this mental health issue has decreased. There are many resources available for adults living with ADHD. Below, in the resources section, I have included links to articles that include specific tips for managing stress and boosting mood, ideas for staying focused and productive at work, suggestions for managing money and bills, advice for managing time and staying on schedule, and instructions to get organized and control clutter. In this post, however, I will share the basic, overarching principles you will find helpful to live your best life despite having ADHD.

  1. Create structure. This is possibly the biggest help to combat ADHD. Make a routine and stick to it every day. Establish rituals around meals, school, work, free time, as well as your morning and evening routines. Simple tasks, such as laying out your clothes and items for the next day, meal prepping, and daily planning can provide essential structure.
  2. Break tasks into manageable pieces. The demands of school, work and life can leave anyone feeling overwhelmed, frustrated, and hopeless. Whatever task you are faced with, break it down into bite-sized (so to speak) steps that you CAN do. Then tackle those one by one until you accomplish your end goal.
  3. Simplify and organize your life. Create order in your home or work space. Often, the tendency to get distracted makes organizing clutter difficult. But if everything has a designated place, cleaning up will be efficient and easy. This will allow you to focus on the things that really matter. In addition, having an orderly living or work space will offer you a haven from the chaos of everyday life.
  4. Limit distractions. Individuals with ADHD welcome easily accessible distractions. Television, video games, and the computer encourage impulsive behavior that must be regulated. In addition to decreasing time with electronics, I recommend increasing time doing engaging activities outside the home as an outlet for built-up energy (see next).
  5. Encourage exercise. Physical activity burns excess energy in healthy ways, which will decrease impulsivity. Exercise will help to improve concentration, decrease the risk for depression and anxiety, and stimulate the brain. Did you know that many professional athletes have ADHD? Experts believe that athletics can help those with ADHD find a constructive way to focus their passion, attention, and energy.
  6. Regulate sleep patterns. Bedtime may be an especially difficult for individuals suffering from ADHD. The lack of sleep exacerbates inattention and hyperactivity; therefore, getting quality sleep is paramount! Not too long ago, I wrote a blog post on nightly rituals that will help you “sleep like a baby.” In addition to the suggestions in that post, I recommend eliminating stimulants like sugar and caffeine, and decreasing television time to help get better rest.
  7. Encourage out-loud thinking. Those with ADHD can lack self-control and often speak compulsively, or without thinking. Try verbalizing your thoughts and reasoning. If you do not have someone supportive with whom you can confide, I recommend keeping a journal. It is important to understand your thought process in order to be able to curb impulsive behaviors.
  8. Take breaks. It is 100% normal to become overwhelmed or frustrated with yourself as you try to manage the behaviors and impulses that accompany ADHD. Give yourself breaks, schedule them (include them in step one, when you “create structure”!). Scheduling alone time is important. Good break options include going for a walk, reading a book, taking a relaxing bath, or anything that promotes self-care.
  9. Believe in yourself. Remember that ADHD causes legitimate stress. Do not minimize your feelings of anxiety and frustration. While so doing, it will be important to remain positive and hopeful. Recognize your progress. Believe that you can work through the obstacles before you. Have confidence in yourself and be positive about the future.
  10. Get help. The final suggestion I would like to allow others to help. You do not need to manage ADHD on your own! Allow close family or friends to be part of your journey; rely on them for support and to help you make progress. Additionally, get individualized counseling with a licensed, experienced therapist. I have several patients who have learned the necessary skills to be in control of their ADHD.  I am your advocate and can be you personal cheerleader! Contact me today to schedule a session. Furthermore, some individuals find that receiving medication can help immensely help them in managing their ADHD symptoms. Finally, look into local support groups near you. This is an incredibly helpful resource!

Before I end, I want to leave you with some reminders that have been helpful to those I have worked with. Be willing to make some compromises and recognize that perfection is not realistic. Remember that while ADHD may not be visible on the outside, it is real. You are dealing with a hard thing, so please remember that when the going gets tough! Third, take things one day at a time and remember to keep everything in perspective.

Take heart. You can learn to live with manageable ADHD symptoms and be in control of your life. Let ADHD be an explanation, rather than an excuse. Be patient and remember that change will not happen overnight. These ADHD self-help strategies require practice, patience, and a relentlessly positive attitude. As I always say, my door is wide open and I am here to help. I accept new clients for in-person sessions. Contact me today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

ADHD At a Glance

ADHD - Cluff Counseling - Lewisville TherapistIn November of 2013, a report was released showing that up to 11 percent of children aged 4-17 have been diagnosed with ADHD at some point in their lives–a 7.8 percent from 2003. In adults, the rate is much lower (about 4 percent), but experts caution that since adults who were not diagnosed in childhood are more likely to remain undiagnosed, the true prevalence of adult ADHD may be significantly higher than reported. If you or someone you know suffers from undiagnosed or untreated ADHD, now is the time to get help.

Many of you have likely heard of ADHD and may be familiar with some of its symptoms, but most people do not know that much about it… including what it stands for. Not only that, what causes it, how to treat it, how to recognize it in others, or how ADHD might impact the life of those it affects. This post will go over frequently asked questions to tell you what you need to know about ADHD

What does ADHD stand for?
ADHD stands for Attention-Deficit Hyperactivity Disorder.

What is the difference between ADHD and ADHD?
ADHD includes the symptom of physical hyperactivity or excessive restlessness–this is the “H”. In ADD, the symptom of hyperactivity is absent. People with ADD can be calm and serene outwardly, yet struggle to focus and not get distracted.

What causes ADHD?
While the cause is not entirely known, there are certain factors that play a part. For instance, ADHD seems to run in families; anywhere from 33 to 50 percent of parents with ADHD will have a child with the disorder. There are genetic characteristics that are passed down. Children whose mothers had difficult pregnancies, or children who are born either premature or with low birth weight run the risk of having ADHD. When the frontal lobe of the brain is affected (which controls impulses/emotions), the chance for ADHD is even greater.

Who can get ADHD and when does it show up?
Anyone is susceptible–children, teens, and adults from all socio-economic backgrounds can develop ADHD; although, studies show that the disorder occurs at least twice as often in boys than in girls, aged 3 to 17 years. Boys are nearly three times more likely to have been diagnosed with ADHD (13.2 percent) than girls (5.6 percent)! ADHD often begins in childhood and can persist into adulthood.

How does ADHD manifest itself?
Symptoms vary greatly depending on the individual but include limited attention and hyperactivity, low self-esteem, troubled relationships; difficulty with school or work; being easily distracted; difficulty paying attention or focusing; “zoning out” without realizing it, even in the middle of a conversation; struggling to complete tasks; the tendency to overlook details, leading to errors or incomplete work; poor listening skills like having a hard time remembering conversations and following directions.

Can ADHD be treated?
These disorders are chronic, meaning they can last for years or be lifelong. There are, however, several options for effective treatment, including medication and therapy. Patients often find great success coupling the two in order to achieve a refreshing level of normalcy. When ADHD is diagnosed in children, teachers and other school staff can be a great resource in educating child and parent on ways to cope with ADHD in the classroom. Look out for my upcoming post on strategies to deal with this disorder.

ADHD deeply affects the lives of those who have it. I have counseled with many clients who feel misunderstood, or as though something is fundamentally wrong with them because ADHD holds place in their lives. This disorder is real, but help and hope are available. Remember, I am your advocate and your cheerleader, and will help you find control and stability in your life. If you would like help learning how to thrive with ADHD, contact me today to set up your first session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:
ADDitude: “How Many People Have ADHD?”
ADHD Center: “What is ADHD?”
Cluff Counseling: “Choosing the Right Therapist for You”
Dr. Hallowell: “Top 10 Questions on ADHD”
Healthline: “What’s the Difference Between ADHD and ADD?”
Healthy Place: “How Do You Get ADHD? Cause of ADD and ADHD”
HelpGuide.org, “ADHD in Adults”
WebMD: “Attention Deficit Hyperactivity Disorder: Causes of ADHD”