Temptation burning

Trigger warning. Trigger warning. Trigger warning.

I’m looking for something I’ve lost, and when I rummage through my desk drawer something plastic and silvery catches my eye. I pull out a tray of un-popped pills, and stare. I remember these, although I haven’t touched them in a long time. These used to be my escape. My OTC sleeping pills.

It all comes back to me: Go on MQ, take three to knock yourself out, or take five if you want to go off the rails. Put your bin next to your bed incase you puke. Go online and check for interactions with your other meds; if it’s not a huge deal, shut the door, and chug them downWatch the pretty patterns dance across the walls as you wait for sleep to find you.

I feel the shame in advance. The embarrassment at my weakness. The rolling eyes and the shaking heads of my imagined critics.

Stand strong MQ. Please don’t do it.

Empty time

My brother set off for our parents’ house this morning, so I’m house-sitting on my own again. The best way I can describe the current situation is that I’m existing in empty time. I just need it to pass, preferably with minimal awareness on my part.

I’m not doing anything useful. I’m a walking waste of space right now, and this is almost a crime given the extension I recently applied for on my dissertation. I’m reasonably sure the point of no return is around here somewhere – the point where it doesn’t matter if I complete my dissertation, because I’ll have so little time for Finals revision that I won’t be graduating anyway. Those exams are currently five weeks away. Maybe I’ve already crossed the line. I don’t know.

I’m ashamed of myself, and angry. I’m sure it won’t surprise anyone that I want to self harm, but I’m not sure what to do. The burn on the back of my hand is still one hell of an unsightly mess. If I’m honest, I think it might be infected. And my deep cutting scars bother me even more. Sleeping pills it is. And I take this as further proof of what a waste I am – how often do I do this, and mess about with meds, or blades, or lighters?

I’ll get by, for now at least. Perhaps I can sleep through tomorrow. Then Saturday/Sunday I’ll be with family, and Dr T is back on Monday. How I can even go and see Dr T I’m not sure; I don’t want to describe or explain any of this. Empty time, and empty space. Except it’s borrowed time in someone else’s space.

Ideal scenario: some kind person comes up to me, and says ‘Hey there, I’ve found this really awesome cave on a coastline in the middle of nowhere, and I need someone to look after it for me for the next few years – do you fancy moving in? I’m afraid it might be a little lonely; no one else knows this cave exists, and there’s no phone signal or internet. Are you interested..?’

Absolutely, take me there now.

So I HATE colds…but I have a new sleep aid!

As the title suggests, I have a cold. Let me take a moment to moan: my eyelids are swollen, my nose is disgusting, and despite some lemsip stuff I still feel like crap. Ugh. Okay moan over – a cold is really nothing in the world of illness and disease, but I hate colds anyway.Image

Asides from that, I’m pleased to report I’ve found a herbal sleep aid that really helped me out last night: Kalms Sleep. I’ve always been very sceptical of anything with the word ‘herbal’ and automatically assumed it’s a placebo, but I realized yesterday that that was stupid – I use natural products that affect my body in various ways all the time, e.g. tea or coffee containing caffeine that gives me an energy boost. So when I had a wander around Superdrug yesterday I spotted the box of Kalms Sleep tablets containing a blend of things like valerian, and decided to give it a try. It works! I’m not sure it sped up the getting-to-sleep process because a cold/runny nose makes that difficult anyway, but I slept incredibly well, didn’t wake up in the night once, and this morning I was quite bright and ready to go. Hopefully this can be a solution to my Nytol-abuse problem.

My plan to do some work is not happening, but maybe that’s not surprising given how yuck I feel. I have been pretty efficient though in terms of chores, and have done plenty of laundry and cleaning…okay so that’s not exactly impressive, but at least I’ve done something today… I have some babysitting this evening, and then I’m going to collapse in bed before dealing with therapy tomorrow.

Spotlight: Nytol

NytolNytol and I have a bit of a history, much of which isn’t healthy (think: overdose). For this reason, even though it isn’t a prescription med I’m going to review it like the others; I wish I could go back in time and tell myself a thing or two about Nytol, and I want to give a warning about overdosing. I’m not sure what the American equivalent to Nytol is, but I think diphenhydramine, the active ingredient (a sedative antihistamine) is found in Benadryl. In the UK it is sold as an over the counter sleeping pill, in boxes of either 2-a-night or 1-a-night tablets.

I turned to Nytol as a sleep aid when I was taken off zopiclone, and initially I went for the herbal pills. I didn’t find them to be of any use, so the next day I headed to my local pharmacy and slightly nervously asked for the real thing (I was semi sure my GP wouldn’t approve and I guess the paranoid part of my brain was scared the pharmacist would know that). I left with a box of the two-a-night pills, which are 25mg each. The idea is you take one a little before bed time, and if that isn’t enough to help you sleep you take another one. The maximum recommended dose is 50mg per night.

Initially I was really disappointed with this sleep aid, but with hindsight I was asking too much of it. 50mg guarantees me a few solid hours of sleep, but it doesn’t help me get to sleep any faster, and unfortunately that’s my biggest problem. When I bought Nytol I was hoping it would knock me out, and it didn’t. But that was my only complaint; Nytol helps me sleep better, and I haven’t experienced any drowsiness the following morning (unlike zopiclone), which is a big positive. However it has to be said that the effects reduce pretty quickly with time, and I’ve found these pills to be semi-useless after about three days. Nytol is certainly not a long term sleep improvement aid.

Summary

Pros: Nytol certainly improved the depth and quality of my sleep, without leaving me feeling awful the next day.

Cons: It didn’t help me with my main problem of taking forever to fall asleep.

Conclusion: When used correctly as a short term sleep aid this OTC medication can do an excellent job.

Overdoses

Unfortunately there have been occasions where I’ve been in bad enough places to want to be knocked unconscious, and at these times I’ve turned to Nytol. I’m not at all proud of this, and given what I wrote above about how this sleeping pill doesn’t speed up the falling-asleep process it was pretty stupid. If anyone reading this has ever considered overdosing on these pills, please read what follows and know that you’re potentially making a big mistake if you take more than the recommended 50mg. It won’t knock you out, and not only will it make you feel ill, but it could also endanger your life. I’ve been suicidal, and trust me, I wouldn’t choose to go this way.

250mg (5x recommended dose) = hospital admission

The first time I overdosed on Nytol I was desperate to knock myself out, so I took five 50mg tablets. Despite the flood of antihistamines into my brain it still took me ages to fall asleep, and the following day I couldn’t stop shaking. I had a routine appointment with my CPN that morning, and when she saw me shaking she spoke to a consultant who told me to go to A&E. I was 99% sure I hadn’t taken a particularly dangerous dose so thought that was a bit of an overreaction, but I wasn’t in a position to argue so I did as I was told. I expected to be assessed, have a blood test, and then be allowed to leave. More fool me.

The triage nurse did a couple of tests, and when she put the blood pressure cuff and heart rate monitor on me, some kind of alarm started to sound off. I didn’t think anything of it until the nurse quickly re-did the tests, and then marked me on the computer as being an urgent patient needing to be seen by a doctor within the hour. To my absolute shock and horror the nurse said she needed to take me to the major incident department, and explained that my heart rate was dangerously high, so I suddenly found myself having to change into a hospital gown and wait on a bed. I had a cannula put in and enough blood drawn that I almost fainted, and a nurse gave me a syringe-full of mystery fluid (I really wish I’d asked what it was). As we waited for the blood test results a doctor came over and explained the various things he’d do if my heart rate didn’t naturally slow back down soon, and attempted a psychiatric evaluation. Since I’d come to A&E directly from a psychiatric hospital under the instructions of a consultant psychiatrist he let me off.

A few hours later my heart rate came down and I was discharged with a warning not to do that again. That experience haunts me, a) because I hadn’t expected what I had assumed was a ‘safe overdose’ (NO SUCH THING) to be so dangerous, and b) because the staff were not exactly friendly. The A&E receptionist treated me like an unbelievable moron when I explained my situation to her, and the nurses in the department I was sent to didn’t disguise their (reasonable) dislike of me wasting their time.

500mg (10x recommended dose) = very ill

Being an unbelievable moron (yes, that receptionist was right), I didn’t learn my lesson, and the next time I felt really low I reached for the rest of the box. Initially I took 300mg of Nytol and sat watching TV, waiting for it to kick in. After an hour I didn’t feel any different, so I took another 200mg. Even as I write this I can’t believe how stupid I was…

It turned out that I hadn’t noticed any differences because I hadn’t moved much – a little while after reaching the 500mg dose I tried to stand up to go to the bathroom and WOAH the world span. My legs didn’t seem to be working either, and I decided I was going to have to crawl to my bed. To be honest I don’t remember an awful lot about what happened between standing up and falling asleep, but when I woke up I found a saucepan next to my pillow, so I’m guessing I felt sick and put it there as a precaution. I also remember hallucinating, seeing moving patterns across surfaces I knew to be plain.

I felt very, very ill the next day. I threw up many times, and it’s probably a miracle that I didn’t vomit in my sleep and choke. My movements were very sluggish, and there was a couple of seconds delay between seeing something and my brain actually registering it. I felt awful, and I thoroughly deserved that. I managed to visit my GP (a friend in the waiting room asked me if I was drunk when I staggered in), and to my relief he didn’t think I needed to go back to hospital. I spent the rest of the day in bed, and it was at least 48 hours before I felt well again.

Please, please don’t make the same mistakes I did.

Spotlight: Zopiclone (Imovane/Zimovane)

ImageFor my next medication post I’m going to look at zopiclone (Imovane), a sleeping pill that I rate pretty highly. It actually does what it’s supposed to do! Standard warning: all the information given here comes from my personal experience of zopiclone. It may work differently for different people.

For as long as I can remember, I’ve had issues with falling asleep. With therapy I’ve come to realise that it’s because when I was young my Dad would pop his head round my bedroom door and check on me before he went to bed, and I couldn’t fall asleep until he’d done that; I didn’t like the idea of him judging/looking at me without me knowing. The upshot of that is that it usually takes me an hour or two to get to sleep, and if I’m particularly stressed or low it can take a lot longer.

When my depression/anxiety began to attract medical attention in the ‘crisis days’, my psychiatrist decided my safety could be improved short term by giving me something to help me sleep. I left my emergency assessment with a rather optimistic prescription for 6 half dose pills (3.75mg each), intended to last me at least three nights. 3.75mg didn’t really do anything for me so I took the standard dose of 7.5mg, and that was perfect. I was asleep within half an hour which was a real novelty, and I slept deeply for at least eight hours. After the first night of using it I felt mildly drowsy the following morning, but I haven’t had that problem since then.

Unfortunately zopiclone is thought to be quite addictive, so I’ve only ever been given a maximum of a weeks’ prescription at a time, and the longest period of continuous use I’ve been allowed was three weeks. When I stop taking it I immediately revert back to having my age-old difficulties with falling asleep, but I don’t find them to be any worse than they were before. I also haven’t found zopiclone to become less effective with continuous use which is a definite plus compared to Nytol (diphenhydramine), which is effectively useless to me after a day or two unless I seriously ramp up the dose.

Summary

Doses (nightly):  3.75mg, 7.5mg

Positive effects: Definitely helped me fall asleep significantly faster than usual, and almost guaranteed a deep, uninterrupted night’s sleep.

Negative effects: Left me a little drowsy the morning after I first used it.

Conclusion: I love zopiclone!! It’s just a shame it’s only prescribed as a temporary/short-term sleep aid.

Check in: Peering out of the hole

Last night was just weird, full stop. I think I had three or four hours sleep, max, and spent my morning buzzing with nervous energy despite being really tired. Fortunately my therapist helped me to start climbing out of the dark hole I was hiding in; we didn’t really identify why I’m so low at the moment, but it was good to talk about the symptoms and open up a little bit.

I bought some sleeping pills this afternoon, and I intend to take a few and start over tomorrow (yes, this is a stupid idea, but no, I don’t care). That means I’ll probably feel ill in the morning, but I’d rather that than risk having another crazy night ending in me making the cut across my hand even worse – I can already see that the skin isn’t knitting together right, so that’ll be another scar to add to the collection. Yay…