Submitted to Atlantic Magazine’s Anxiety Chronicles, Jan 2014
Who could possibly be more anxious than a neurotic Psychologist with an anxiety disorder? How about a Jewish Clinical Psychologist with anxiety and chronic insomnia? I’m sure few people are surprised to hear that there are many psychologists, psychiatrists, and psychotherapists who sit in their cozy offices and well-worn high-back leather chairs all cool, calm and collected during work hours but later morph into Woody Allen-like creatures who roam their kitchens and medicine cabinets seeking relief from their own panoply of panic disorders, anxiety issues, and sleep problems. Dont get me wrong, I’m perfectly fine while I’m working with clients. They tell me I am a fabulous therapist who really seems to understand their emotional problems. Of course I understand. I satisfy the diagnostic criteria of just about every psychological disorder in the DSM–manual. Maybe that’s a slight exaggeration. I’m prone to exaggerating my own symptoms as I’m convinced each and every one suggests a fatal disease or inoperable brain tumor. Did I happen to mention my psychochondriasis and moderate to severe medical student syndrome?
Besides liking my clients and my job as a psychotherapist, my patients often help me to feel better about myself and whatever is wrong with my psyche, mostly by comparison to their overwhelming tsuris (yiddish for large mess of personal problems). Also, can you spell “schadenfreude” (I never can) which literally means “enjoyment obtained from the troubles of others“? I feel guilty about that but it doesnt keep me from empathizing appropriately or knowing how much of my fahklumpt and fachadick feelings are too much (negative countertransference). Yiddish, by the way, has more words for guilt and suffering than Eskimos have for snow. Having crippling guilt and high anxiety about treating people with anxiety disorders would clearly be one self-diagnosis too far, and as far as I know there’s no Yiddish term yet for that kind of uber-craziness.
In my case I dont have acute anxiety or panic attacks. While alarming to its many sufferers, I would probably prefer (in the Sophies Choice sense) to have the type of focused anxiety or phobias that respond well to cognitive-behavioral treatment, anxiolytic medications or a clunk on the head with a rubber mallet. Instead I have what we in the helping professions call generalized anxiety NOS (not otherwise specified). In layman’s terms it means there is no one specific cause to ones nervousness and more likely there are neurotic or psychological components to ones anxious feelings and negative thinking. What me worry? Yeah, that could probably be my motto after the work day is over. Over the last few years I have also developed a serious problem with sleep and I snore like a horse with a sinus infection. I know what you armchair doctors are thinking. I tried it all. I did the comprehensive “sleep study” along with all the other moderately overweight middle aged men who dutifully shlep to the outpatient medical facility/ faux hotel room with their favorite pillows in hand to be hooked up like Keanu Reeves in the Matrix. Meanwhile the wives and girlfriends were at home getting their first decent nights sleep in years. I cant say I was surprised that I couldn’t get much shut-eye that night with 57 different electrodes duct taped to my body and two stone faced lab techs staring at me through a glass window. Of course a World Class Neurotic (WCN) with anxiety such as myself spent most of my “Sleepless in the Sleep Lab” session thinking about the poor shlub on the You Tube viral video who keeled over and died right in the sleep lab…while two sleep lab technicians watched through the glass window. I guess they didn’t notice him sitting up suddenly, clutching his chest and falling off the bed in the faux hotel room.
Beyond the sleep lab testing I also tried many of the tried and true methods for dealing with night time anxiety and insomnia. I kept a sleep diary, ie. Monday- no sleep, Tuesday-no sleep, Wednesday- delirium and possible psychosis…and no sleep, etc. I used relaxation tapes. I engaged in progressive muscle relaxation, auto-suggestion, and cognitive therapy, ie. “I am a wonderful, incredibly tired human being and my left leg is getting very heavy and going numb. Wait, do I have MS??” The basic problem with neurotic anxiety is that certain people just plain and simple think WAY too much. While other people accept many things as they are in this world, I often keep questioning out of force of habit both as a therapist and as a constitutionally curious and highly skilled neurotic person. But WHY am I aging more toward the top of my Baby Boomer body and much less toward the bottom? How is it possible to grow so much hair on my back and shoulders and butt but not at all on my head? Is my muscle soreness from the Statin drugs I take or from Lupus? I know it cant be from exercising too much. These are just a few of the questions that preoccupy me while the rest of the world is sleeping soundly. It’s not easy for a Ph.D. in Clinical Psychology to finally bite the bullet and call his colleague the medically trained psychiatrist and fess up to having an anxiety problem and less REM sleep then my 15 year old client with ADD who accidentally took his Ritalin at midnite thinking it was Ibuprofen. It was from my shrink that I first learned about the wonders of Ambien.
Have you ever taken Ambien, the popular sleeping pill and gotten a good nights sleep only to wake up to mounds of garlic bread crumbs, a stop watch, an empty carton of orange sherbet and one of your neighbors you never met before in your bed? Ok, I am exaggerating again about the neighbor but the rest is the Gods honest truth. Ambien can have some interesting amnesiac-like side effects for a certain number of people. However, the good news is that the magic little pill works well if you dont overdo it (and be sure to hide your car keys from yourself if necessary).
Benzodiazepines (Ativan, Klonopin, Valium, Xanax) are sometimes useful for the more crippling forms of anxiety but also have a noteworthy downside. Once on a high enough dose it is probably easier to get off heroin or Krockodil than taper off Benzos. In other words, the pharmaceutical companies at that point have claim to your body and soul for life as well as your first born anxious-neurotic child. Ambien (Zolpidem), which is only used as a sleep aid is not quite as bad, addictively speaking, and works for many of us who just cant do as Samuel L. Jackson so eloquently narrates in his audio rendition of the childrens book, “Go The F#%$ To Sleep!” Caution: Never take an Ambien during the day by mistake. You will engage in strange behavior such as my son Eli who ended up having a deep conversation with the fresh vegetables in the produce drawer of the Sub-zero refrigerator. I kid you not.
There are a million reasons people cant fall asleep or stay asleep. As my friend the shrink explained it, the older you get the harder it seems to turn off the mental computer and go into “sleep mode”. I’m sure the 32 different digital devices in my bedroom all blinking out of synch and beckoning my immediate attention dont exactly help either. Daytime anxiety and nighttime neurosis only makes the whole thing worse. “Wait, it’s 3:25 AM, I better check my Facebook page to see if anyone else liked my most recent status update”…….or “hey, I wonder if somebody has linked to my blog (otherwise known as my undiscovered posthumous memoirs) in the middle of the night….?” Bottomline, the more you think, obsess, or do late at night, the less you sleep…. and the less you sleep the more anxious and neurotic you get the next day when you wake up. Sometimes I just stay up all night and count vicious circles.
Riiight, so here’s what made me anxious last night and kept me up after I wrote this article about my anxiety. In my final paragraph was it more correct to say awaken, awoken, or ewok (the latter only out of complete frustration and mild psychosis due to sleep deprivation) ? The grammatical as well as literary arguments online about this obscure topic are endless and inconclusive. Insomniacs apparently debate with each other about such things when they are not busy watching the QVC channel and buying stuff while high on Ambien. Eventually I gave up and just said “wake up”. Honestly, I wish I could sleep and wake up normally and I also wish I could NOT end up ruminating about furry Star Wars characters at 4AM. Meanwhile, I couldn’t go the f@#% to sleep and now I worry if this article will ever get published…and if it does will it be good or bad for business…..Oy Vey!
Cliff Mazer Ph.D. is a Clinical Psychologist and humorist who lives and works in Sandy Springs, Georgia. He has a thing for Pirates and other people with ADHD and insomnia. He blogs fairly anonymously on Facebook and WordPress at https://captaincliff.wordpress.com/ Contact: 404-932-7193
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