Greetings ! Welcome to Macka B’s Medical Monday !
Tag Archives: Sleep
“Wellness” can’t do what we won’t do for ourselves
“Despite the endless column inches devoted to how we can find balance in our busy working lives, the solution here isn’t personal, it’s political. Those of us working in the health and wellbeing industries have had our skills hijacked by commercial interests. Employee Assistance Programs, corporate stress management training and the burgeoning multi-billion dollar wellness industry all trade on, support and are supported by the culture of overwork. If we are truly committed to wellbeing, we need to remember who our clients are meant to be and be willing to risk acting in their best interests.
No amount of multivitamins, yoga, meditation, sweaty exercise, superfoods or extreme time management, as brilliant as all these things can be, is going to save us from the effects of too much work. This is not something we can adapt to. Not something we need to adjust the rest of our lives around. It is not possible and it’s unethical to pretend otherwise. Like a low-flying plane, the insidious culture of overwork is deafening and the only way we can really feel better is if we can find a way to make it stop.”
>> No it’s not you: Why “wellness” isn’t the answer to overwork, Zoe Krupka, the Conversation
24/7 : Late capitalism and the end of sleep
>> 24/7: Late Capitalism and the end of sleep, by Jonathan Crary (a Verso Book)
“24/7: Late Capitalism and the Ends of Sleep explores some of the ruinous consequences of the expanding non-stop processes of twenty-first-century capitalism. The marketplace now operates through every hour of the clock, pushing us into constant activity and eroding forms of community and political expression, damaging the fabric of everyday life.
Jonathan Crary examines how this interminable non-time blurs any separation between an intensified, ubiquitous consumerism and emerging strategies of control and surveillance. He describes the ongoing management of individual attentiveness and the impairment of perception within the compulsory routines of contemporary technological culture. At the same time, he shows that human sleep, as a restorative withdrawal that is intrinsically incompatible with 24/7 capitalism, points to other more formidable and collective refusals of world-destroying patterns of growth and accumulation.”
Pyjama Letter
“Dear Vasco,
In response to your question, “What is worth doing and what is worth having?”, I would like to say simply this. It is worth doing nothing and having a rest; in spite of all the difficulty it lay cause you must rest Vasco – otherwise you will become RESTLESS!
I believe the world is sick with exhaustion and dying of restlessness. While it is true that periods of weariness help the spirit to grow, the prolonged ongoing state of fatigue to which our world seems to be rapidly adapting is ultimately soul destroying as well as earth destroying. the ecology of evil flourishes and love cannot take root in this situation. Tiredness is one of our strongest, most noble and instructive feelings. It is an important aspect of our CONSCIENCE and must be heeded or else we will not survive.
When you are tired you must HAVE that feeling and you must act upon it sensibly – you MUST rest like the trees and the animals do. Yet tiredness has become a matter of shame ! This is a dangerous development. Tiredness has become the most suppressed feeling in the world. Everywhere we see people overcoming their exhaustion and pushing on with intensity-cultivating the great mass mania which all around is making life so hard and ugly-so cruel and meaningless-so utterly graceless- and being congratulated for overcoming it and pushing it deep down inside themselves as it it were a virtue to do this. And of course Vasco, you know what happens when such strong and natural feelings are denied – they turn into the most powerful and bitter poisons with dreadful consequences. We live in a world of these consequences and then wonder why we are so unhappy.
So I gently urge you, Vasco, do as we do in Curly Flat – learn to curl up and rest – feel your noble tiredness – learn about it and make a generous place for it in your life and enjoyment will surely follow. I repeat: it’s worth doing nothing and having a rest.
Yours sleepily,
Mr. Curly xxx
Sleep for Immunity
So winter is here and you want a strong immune system : make sure you get some good sleep first thing (quantity, quality, regularity..).
>> Sleep deprivation effect on the immune system mirrors physical stress (Science Daily)
Summary:
Severe sleep loss jolts the immune system into action, reflecting the same type of immediate response shown during exposure to stress, a new study reports. Researchers compared the white blood cell counts of 15 healthy young men under normal and severely sleep-deprived conditions. The greatest changes were seen in the white blood cells known as granulocytes, which showed a loss of day-night rhythmicity, along with increased numbers, particularly at night.
>> Sleep and Immune Function, (Critical Care Nurse)
Abstract:
Scientists are only beginning to fully understand the purpose of sleep and its underlying mechanisms. Lack of sleep is associated with many diseases, including infection, and with increased mortality. Lack of proper sleep is an important problem in the intensive care unit, and interventions have been designed to improve it. Sleep is associated with immune function, and this relationship is partially based on the physiological basis of sleep, sleep architecture, the sleep-wake cycle, cytokines and the hypothalamic-pituitary axis.
Sleep is one of the biggest riddles known. The knowledge that all animals sleep implies that sleep fulfills some basic physiological need. Yet, scientists are only beginning to fully understand the purpose of sleep1 and the underlying mechanisms.2 Lack of sleep is associated with many diseases and with increased mortality1,3 and is an important problem in the intensive care unit (ICU).4–8
In this review, I describe the relationship between sleep and immune function. Understanding this complicated association requires knowledge of the physiological basis of sleep and the basic elements of immune function as applied to sleep. Therefore, I briefly review sleep architecture and the sleep-wake cycle. I also discuss immune function and cytokines and the hypothalamic-pituitary-adrenal (HPA) axis.
Although evidence linking sleep and immune function has come from studies of the sleep-wake cycle, cytokines, and the HPA axis, most investigators have relied on 2 basic approaches. In the first approach, laboratory animals and human volunteers are deprived of sleep and the consequences of the deprivation on immune responses, bodily systems associated with the immune system, and/or immune products are measured. In the other approach, laboratory animals or human volunteers are infected with pathogens or given substances that challenge the immune system, and the effects of these interventions on sleep are determined.9 I present evidence provided by using both of these research strategies. Finally, I describe how sleep in the ICU affects patients’ immune function and suggest interventions to improve patients’ sleep.
Self-care in times of psychological distress
Some states of psychological distress can be more severe than others. Some might not require that you seek assistance from friends and/or health-care professionals, some can wait a little before you do, others are emergencies. Some might require medication, even hospitalization, others not necessarily or better not.
When / if your physical and mental integrity are critically at stake, you should seek competent assistance immediately (If you are a friend of such person, stay with them always and seek assistance ASAP). For example, you have been experiencing symptoms such as delusions, hallucinations, depersonalization (feeling of being unreal), you have attempted suicide, are thinking about it, or have engaged in other self harming/ dangerous behaviors. A variety of symptoms can come with psychological distress, affecting your overall state, from insomnia to lack of appetite, to apathy, agression, lack of enthousiasm, increased vulnerability to infections, memory loss and other forms of cognitive impairement, and more… Your need for outside help will of course depend on the intensity and chronicity of these manifestations (or the absence of thereof, for that matter). In any case, you should maybe start taking (extra) care of yourself.
Following are some advices for self-care (still valid even if someone else is also taking care of you) to go through such times, based upon my knowledge and experience with myself and others. Please bear in mind that I am NOT a doctor nor a psychology clinician. Like I said, if your symptoms are very intense and/or long going and your mental and physical integrity are at stake, you should seek competent assistance immediately.
For more informations about mental health and what to do in specific situations, you can also look for mental health care “educational” handouts that I have posted from specialized organizations (it can be a good idea to distribute them in your community).
Mental health first aid guidelines, by MHFA Australia
Mental health care handouts, from Icarus project.
SO, WHAT CAN YOU DO NOW TO HELP and CARE FOR YOURSELF IN TIMES OF PSYCHOLOGICAL DISTRESS ?
* NURTURE YOUR BODY, don’t let it down or put extra stress on it by neglecting your “vitals”. Make sure you get what you need in water, nutrients, sleep, rest / activity. Don’t tire your system more with junk food, excitants, alcohol. Re-install regular cycles for eating, sleeping… Wash. Change clothes. Get some fresh air and light. Get a massage. Use your senses, smell good smells, listen to good sounds. Get moving if you’ve only been resting, get some rest if you’ve only been running. If possible, don’t drop out of your favorite sport or hobby; that is of course, assuming you are eating, drinking water, sleeping, and that you have no injuries or disease (otherwise, physical activities might actually be harmful). In any case, don’t overdo it, your body is probably weaker. Also, in times of adversity, certain holistic disciplines (like yoga or others), practiced safely and softly, can reveal their core-lessons: your learn that you can carry yourself through life. If it has become impossible to look after yourself, consider moving in with someone nice whom you can be inspired by, and or having good people over (for example for meals), until you are able to take good care of yourself and/or taken care of by a professional.
* BE WISE ABOUT (FURTHER) ALTERING YOUR STATE OF CONSCIOUSNESS Consider strong psychological distress as an already altered state of consciousness, a painful one, with its own special chemistry. Maybe it is wiser not to fiddle with it more, at least without competent supervision. Avoid self-medication. Beware of alcohol. Remember what Bob Marley said ? Alcohol just gets you drunk man. Be wise with psychedelics: If you are unexperienced and/or without the supervision of someone who is (preferably not just in the recreative department), then you should maybe avoid them altogether (you can also look for psychoactives / psychedelik knowledge and wisdom through MAPS and/or Erowid resources). If you’re already with a habit of say, smoking pot or drinking, try not to do more, and beware of taking on a new habit you didn’t have before. Also, know that lack of sleep can play serious tricks on your mind too. Careful with sur-stimualtion of your intellect and senses. Get a rest once in a while from your computer (or other sources of mental input) and all it is feeding your burned-out-intellect with.
* IDENTIFY AND STOP SELF HARM. You are aching. You are vulnerable. With vicious logic, you might engage in behaviors that will, more or less directly and quickly, lead to more harm to yourself. Like what ? Like intoxicating yourself, not eating, over-eating, over spending, betting, taking stupid risks, cutting yourself, punching doors, being aggressive towards strangers, driving fast, not wearing a helmet, trusting the wrong persons, disclosing information, lying about your health, sabotaging or destroying your work etc. These behaviors will only make things worse. All aches will ache more eventually. You may be depressed, but if you don’t limit self-harm, then one morning you wake up and you still have a depression + liver damage + weight loss + infection + injuries + brand new addiction + no friends + your work has disappeared + god knows what. Disengage from this process.
* COME OUT about your psychological distress. Say how you are feeling, what your are going through, to your family and/or friends and/or co-workers, without ambiguity, in your own simple words, without minimizing nor exaggerating. You need not go into details, certainly not with everyone. What you want is to make sure that the persons around you and/or whom you trust, become aware that your condition is serious and that you are engaging in a process of taking extra care of yourself. If they are smart and they care about you, from then on they will not take you on crazy binge-drinking sessions on saturday nights, or drop pills down your throat screaming “you gonna be oookaay “. They will not say “I hear you”, then hand you a ten tons file to work on over the weekend. If they still do that after you’ve told them how you are, they might be ignorant/stupid and/or toxic to you, at least for now (see below): Make yourself clear once more and/or maybe avoid them…
* CAREFUL WITH THAT EXTRA LOAD OF WORK / DECLINE MORE RESPONSABILITIES ? Note -and make others note- that if you are not well, it could be irresponsible on your part to accept more responsabilities, especially when OTHER people depend on your good shape for their health and safety. Desist. Don’t raise the probability of “human-error” being made, it’s bad enough as an expression.
* ACCEPT GENUINE HELP from others, whether your know them well or not, when it comes your way. It can be that someone you didn’t think cared about you proposes to drive you somewhere you need to go. It can be a smile or a conversation with a stranger. Something warm, simple, gently destined to you. How do you know if a helping gesture is genuine and good for you ? You feel it, mostly. Of course it has a certain consistency with observable facts. As for feeling, you should feel more free, a little more alive, when you accept/receive the gesture coming from that person, not the contrary. You can know when a hand is lifting you up, or pushing you down. Trust your instinct. That said, beware of full-on saviors invading your life/privacy, especially if their personal life is a total mess !
* ACCEPT THAT HELP MIGHT NOT COME FROM WHERE YOU THOUGHT IT WOULD. We are all different, and all striving at times not to lose it. Your intense state of distress might be to hard to deal with for some, who will tend to protect themselves from it. And maybe they should, so respect that. Let them be, let go of any resentment or disappointment. Who knows, they might start providing help at other stages of the sometime long process of psychological recovery, they might help in ways you don’t recognize yet, they might not help at all. You’ll see if you can catch up with them later. DO KICK them out of your life, though, very far, if they start attacking you, being nasty or clearly disrespectful to you (see below “avoid toxic people”).
Know that when you start REDEFINING yourself, for example through therapy or even self-care, it is not unusual that your relationships, the world around you, start redefining themselves too. It can be an interesting, healthy, and pacific process, with familiar faces moving a bit afar and new faces entering your life. It is OK, it is often for the better, and it doesn’t mean the end of old good things/partnerships. Everyone gets an opportunity to change/update when you do (that they will or will not take, it’s not your call).
* SEEK GOOD COMPANY especially if being alone makes you more at risk of neglecting/hurting yourself. Ask if you can stay with someone close and/or have someone stay over and/or come for meals with you (that will make it easier to actually think about eating). Surround yourself with good harmonious lovely loving beings, inspiring, talented, and caring. Yes, some persons have all qualities and some of them are even your friends. Rub your face in these friendships. Tell them you love them.
* AVOID TOXIC PEOPLE.
I have already mentionned above the full-on savior-invader with fucked-up personal life, well, that’s one type of toxic people. There are plenty. They feed on you, they parasite or pollute you, they irritate, manipulate, exhaust or confuse you, or they make you feel like shit when you’re trying to feel better. Generally, you recognize that someone is kind of toxic to you when you feel somehow worse after they’ve “helped” you or after you’ve been with them than before. And maybe they, on the contrary, strangely look all pumped up, kind of invigorated, by your torments…
* IMPROVE / CARE FOR YOUR IMMEDIATE SURROUNDINGS/ HOME: Keep or make a clean, tidy home. Take the trash out. Open the windows once in a while, let light and air in. Have distinct spaces for distinct activities, if possible (if not possible, you can invent some sort of code/ritual to transition between space/activities). Remember what grandma said: You make the bed you wake up in. You don’t need to master Feng-shui or even “believe” in it to understand that a certain state of things in the house creates a certain flow, a certain circulation, a certain vibe, around the house, around you, that will both reflect and affect you, that will “attract” certain situations, thoughts, feelings, more than others. Well, you know what to do. Help yourself, materialize well.
* PROJECT YOURSELF, VALUE LIFE. You like what you do ? If you don’t like what you’re doing with your life well then, no wonder you are distressed… Maybe it should be the first thing you consider changing ?! But let’s assume you really like what you do, and maybe that you are even very good at it, and maybe that you know it is very important for others – You want to be able to keep doing it, right ? As best as possible ? Is that very clear to you ? I repeat, is that very clear to you ?
* BE COURAGEOUS ! Yes, it takes a load of courage, patience and dedication to get oneself through a crisis, and grow from it. And your own demons and weaknesses can be real hard to face. But guess what, once you start doing that, caring for yourself, you will have plenty more energy free to fight other fights. You will become able to help others better, and maybe in more ways, both simple and sophisticated ways. Remember : COURAGE IS CONTAGIOUS. Help yourself, help others.
(This article was reviewed 06/05 by a friend qualified psychotherapist – It was not changed after except the section avoid toxic people was just shortened a bit not to inspire too much “paranoid” feelings – THANK YOU/HER)
Art ©Michelle Blade – gathering into being
Dangers of Sleep Deprivation infographic
“Navigating the space between brilliance and madness” : The Icarus Project
The Icarus Project is a “radical mental health support network, online community, and alternative media project by and for people struggling with extreme emotional distress that often gets labeled as mental illness.” You can read their mission statement, here. Principles like access, transparency, looking beyond the medical, self and/or alternative education, all guide a relaxed yet resolute, diffracting yet convergent, initiative for the well-being of extra-ordinary people. Browsing through their pages you’ll find they provide a lot of resources (articles, forums, etc.) to help one “navigate the space between brilliance and madness”. It will speak to whoever is confronted to “madness” at some point in their life, one way or another, in a world that is constantly LOSING IT in many aspects.
Taking care of oneself or helping someone in a psychological crisis can be tricky. Not everybody is experienced or comfortable in dealing with different, awkward, or extreme states of consciousness. As a matter of fact, many people it seems become clueless when confronted to psychological distress, even their own… Some psychological states are indeed impressive, and some can actually threaten a person’s mental and physical integrity. But with appropriate reactions (often rather simple ones, like keeping the voice down or introducing oneself), informed attention, kindness and clear intentions, a little help can go a long way in supporting recovery or preventing harm. Even better is the care we can provide as a group, attentive, resilient, aware and creative, because it will be more sustainable, and so the recovery or at least the safety of the person will stand more chances too in the long term.
So how to take care of oneself when the mind is troubled ? How to take care of friends, of strangers, of friends who suddenly become strangers ? Breaking the taboo around “madness” in one’s community can be a good start, making a safe space, becoming a bit more literate in psychology / caregiving, aware and confident… By not being afraid to do good ?
Following is a small selection of handouts, information sheets, guides and zines I found on Icarus website relative to psychological care. They are all interesting to read, print, post, share. They can give you insight and clues and confidence. All Icarus Project material is licensed under Creative Commons BY-NC-ND.
* NAVIGATING CRISIS handout
“Someone’s personality starts to make strange changes, they’re not sleeping or sleeping all day, they lose touch with the people around them, they disappear into their room for days, they have wild energy and outlandish plans, they start to dwell on suicide and hopelessness, they stop eating or taking care of themselves, or they start taking risks and being reckless. They become a different person. They’re in crisis. The word “crisis” comes from a root meaning “judgment.” A crisis is a moment of great tension and meeting the unknown. It’s a turning point when things can’t go on the way they have, and the situation isn’t going to hold. Could crisis be an opportunity for breakthrough, not just breakdown? Can we learn about each other and ourselves as a community through crisis? Can we see crisis as an opportunity to judge a situation and ourselves carefully, not just react with panic and confusion or turn things over to the authorities? “
* CRISIS PLANNER pdf
“Noticing and responding to symptoms early reduces the chances that you will find yourself in crisis. But it is important to confront the possibility of a crisis because in spite of your best planning and assertive action in your own behalf, you could find yourself in a situation where others will need to take over responsibility for your care. (…) Writing a clear crisis plan when you are well, to instruct others about how to care for you when you are not well keeps you taking responsibility for your own care.”
* HELP GETTING TO SLEEP information sheet
“Not sleeping for long periods of time is extremely dangerous for physical and emotional
* FIRST AID FOR EMOTIONAL TRAUMA information sheet
“Trauma (or post-traumatic stress disorder) is the emotional “shock” after a life-threatening, violent event. Anything that makes our body panic and go into a fight/flight/freeze response can leave us traumatized. The effects may be immediate or take time to surface, and can be felt for the rest of our lives. “
* HURTING YOURSELF zine
“how to take care of yourself when you feel the urge to hurt yourself ”
* HARM REDUCTION GUIDE TO COMING OFF PSYCHIATRIC DRUGS
Excerpt : “Applying harm reduction philosophy to mental health is a new but growing approach. It means not always trying to eliminate “symptoms” or discontinue all medications. It recognizes that people are already taking psychiatric drugs, already trying to come off them, and already living with symptoms — and that in this complicated reality people need true help, not judgment. It encourages balancing the different risks involved: the harm from extreme states, as well as the harm from treatments such as adverse drug effects, disempowering labels, and traumatic hospitalization.
Making harm reduction decisions means looking honestly at all sides of the equation: how drugs might help a life that feels out of control, how risky those same drugs might be, and the role of options and alternatives. Any decisions become a process of experimentation and learning, including learning from your own mistakes and changing your goals along the way. Harm reduction accepts all this, believing that the essence of any healthy life is the capacity to be empowered.”