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[Sappho]

My constant lethargy and fatigue are nothing new. I've tried just about everything, including iron supplements. I need to get myself to a doctor to get my thyroid tested again, and to a sleep center to get a proper diagnosis of my sleep issues. I'm still facing the neverending dilemma of where to go and how to pay for it, unfortunately. : /

[scrdest]

My constant lethargy and fatigue are nothing new. I've tried just about everything, including iron supplements. I need to get myself to a doctor to get my thyroid tested again, and to a sleep center to get a proper diagnosis of my sleep issues. I'm still facing the neverending dilemma of where to go and how to pay for it, unfortunately. : /

You might have stealthy-ass breathing problems.

You don't normally notice them, but once you are asleep, your breathing is obstructed. Brain gets hypoxia alert and kicks into higher-level brain activity. Your sleep becomes shallow and does not give the benefits of a normal sleep. Then you can breathe again and fall deeper asleep. Rinse and repeat until morning.

From what I heard (from a professor in Psychiatry, so pretty credible) is that such problem is relatively widespread, especially thanks to wide range of possible causes, so it's likely it might be your problem.

[Mephansteras]

As a cheap fix, try sleeping with your head more elevated. I have issues with sleeping and waking myself up with sleep apnea/snoring if I'm fairly flat, but if I use a thicker pillow or a raised bed it fixes it. A bed that adjusts is expensive, of course, but a thicker/second pillow is a pretty cheap option and might help a good bit.

[Sappho]

I can't sleep with my head elevated. I only use a very thin pillow, or sometimes none at all. I actually feel that I can't breathe properly if my head is up, and I wake up with neck pain if I manage to sleep that way (such as when I have a cold and have to elevate my head to breathe at all). In any case, I think my sleep problems are far more extensive than that. I've had these problems since I was very young and numerous doctor visits during my teen years never helped (though the doctors never really took me seriously with my neurotic mother standing there accusing me of just being lazy and making it all up for attention). All signs point to narcolepsy, except for the strangely out-of-place fact that it takes me a while to fall asleep at night (though I regularly fall asleep during the day, especially when stressed). Hence the need for professional diagnosis.

I've gone into this in some detail earlier in the thread, though I don't remember exactly where. My general symptoms are:

consistently tired during the day, even after a full night's sleep
wake up frequently during the night
especially sleepy when I first wake up - snooze the alarm clock several times before fully waking up - often feel even more tired than when I went to bed
ALWAYS dream - always waking up from a dream, even if I only fell asleep for a few seconds
stress makes me sleepy; too much stress can trigger "sleep attacks" where I can hardly hold on to consciousness by fighting with all my might (sometimes I can't fight it and I fall asleep at work)
hypnogogic hallucinations - dreaming before I even fall unconscious - sometimes I am aware of the moment I fall unconscious because I am already having a sort of lucid dream which carries over into the sleep state
sleep paralysis - on a fairly regular basis
possible cataplexy - when stressed my muscles get very weak and my vision gets blurry

I live alone now, but when I had a roommate (and during my childhood with 3 sisters) I was assured that I do not snore or talk in my sleep. I do grind my teeth in my sleep (actually not sure if I grind them or just clench them). Often I know it's happening because in my dream I can't unclench my jaw, and my teeth are crumbling and falling out of my mouth. My jaw is always sore when I wake up.

In any case, if I dream as much as it seems I do (need a sleep lab visit to be absolutely sure), it means I'm not getting deep sleep. You're supposed to have deeper sleep before you start dreaming, then back to deeper sleep, in a cycle. My symptoms indicate that I don't have a normal sleep cycle - I'm skipping the deep sleep, going straight to REM sleep and dreams, and waking up before getting any real rest. Then my brain tries to make up for it by falling asleep during the day. The emotional trigger (stress) is another pointer towards narcolepsy... And yet, I still have trouble falling asleep at night. It doesn't make any sense.

I'm also still having the same memory problems as before, the near-constant brain fog, and the eczema has been getting worse the past few days. So... no real progress, since the start of all these experiments. My apartment is cleaner than it used to be, but not as clean as I was trying to keep it, due largely to the depression.

I think I can get a thyroid test from the "foreigners' clinic" doctor that my insurance covers, so I might take a day out of taiji training and do that this week. At the very least it would explain the low blood pressure, brain fog, memory issues, maybe even the fatigue. I have to stop saying "I'll do it soon" and actually just DO it. While I'm there I can ask about sleep center options.

Anyway. Today was a mostly-depressed day, though I did get some writing done, about 800 words. Any suggestions for experiments I could do to try to fight the depression? Exercise is not really helping. When I can focus on something for a while, it fades away, but as soon as I'm idle the depressed feelings come rushing back, and I'm not able to focus on things consistently enough for that to work.

[Shakerag]

How about sleep paralysis?  Any of that?  I know that's another thing often associated with Narcolepsy.

I'd recommend getting the sleep test as soon as you can.  That's how I got diagnosed. 

When you say it takes you a while to fall asleep at night, about how long are you talking about?

Maybe try and read a little bit in bed.  That always gets me tired at night -_-

[GlyphGryph]

That's awfully familiar to my own sleep pattern. (except I DO sleep walk and sleep talk, and I don't get sleep paralysis or cataplexy so I doubt it's narcolepsy)

I've never understood how people can use those big pillows without feeling like they are suffocating. >_>

Anyway everyone tells me it's just sleep apnea, but maybe it's something more.

[scrdest]

Oh. If you are depressed, one issue leads to another. The question is, which one is the core problem.

Abnormal sleep over prolonged periods may lead to assorted mental issues, like depression, so fixing abnormal sleep might help with the depression.

On the other hand, depression leads to abnormal sleep patterns (insomnia and hypersomnia, mainly).

If you have problems with sleeping at night but easily fall asleep during day, disturbed circadian rhythm seems to be a possibility.

[Sappho]

How about sleep paralysis?  Any of that?  I know that's another thing often associated with Narcolepsy.

I'd recommend getting the sleep test as soon as you can.  That's how I got diagnosed. 

When you say it takes you a while to fall asleep at night, about how long are you talking about?

Maybe try and read a little bit in bed.  That always gets me tired at night -_-

Yes, I get sleep paralysis. It's on the list above.

I want to get tested but my insurance won't pay for it, and the people running the few sleep labs in Prague don't speak English, so it's complicated.

It can take me many hours to fall asleep. But only at night. During the day I can fall asleep pretty much anytime, anywhere. And actually, even at night, I can usually fall asleep quickly if I'm not in my own bed - visiting a friend, for example. I've tried moving my bed, changing my sheets, etc., but it doesn't help. I had insomnia for years starting when I was about 5 years old, and the other issues started around puberty. It's possible I just associate my own bed with "not sleeping" and my crazy brain fights off the need for sleep just out of habit. Also, time to go to sleep also means time for everything to be quiet and calm, giving my brain free reign to go crazy with all my anxieties, which might also be keeping me up. Have to talk to an expert about this.

You might want to read through more of this thread, since you seem to have missed a lot. I am autistic (it used to be asperger syndrome but apparently that doesn't officially exist anymore so it's "high-functioning autism" with severe sensory issues now) so that affects everything else. A lot of people accuse me of hypochondria, and I understand why, since I'm always going on about these abnormal things, but my investigation into my physical and neurological issues is not based in anxiety. I do not have anxiety about my health. I simply want to understand my brain and body, and if it's possible to help some of these things, I want to do so. I have no idea what is normal and what is abnormal, so I ask people - they mistake this for anxious obsession and accuse me of hypochondria.

There are only 2 conditions I am certain I have: autism and HPPD. I have anxiety issues, but they are based in logic: I have difficulty with social situations and I am extremely hypersensitive, so I have a great deal of anxiety about going out into the world and dealing with people and anticipating social situations. If I can understand the logic behind something (like my health), I no longer fear or worry about it.

I have dealt with depression since I was very young (around the same time the insomnia started, about age 5). There are many reasons for how it started. I was autistic but undiagnosed and constantly accused of making up my problems or doing things wrong just to get attention. My apparently high-functioning but mentally-ill mother verbally and emotionally abused me and my sisters every day of our lives (constant accusations of being horrible, evil children whose only goal in life was to ruin her, screaming that we were so terrible we made her want to kill herself, responding with any suggestion that she wasn't a perfect parent with the fiery-eyed and cold statement that she had "never laid a hand on us" and therefore no one would ever believe our lies, etc.) and whenever I did something imperfectly, I was severely punished and accused of messing it up on purpose. I had no friends and no help. So the beginnings of the depression were hardly irrational. It's possible that over the years until I moved away from my mother (at age 23), it developed into a default state which is now extremely difficult to break out of. I have tried antidepressants a few times but I always reacted very badly to them - they always made me feel worse - so I decided I will not use them ever again.

Anyway, sorry for the tangent. I'm getting pretty sleepy but I'm afraid to go to bed because I know I won't be able to sleep, and I have to get up early for training tomorrow...

What I was trying to get to is the list of things I still need an explanation for, which are not explained by autism or HPPD. This includes the sleep symptoms listed above, as well as:
low blood pressure and poor circulation
near-constant brain fog
poor memory (I can memorize things by rote very well but never remember that I've made tea until I walk into the kitchen for something and notice it on the table hours later, can never remember where I put things, forget what I'm saying in the middle of talking, never remember that I've already said something and am repeating myself, etc.)
inability to concentrate/focus
depression, in case it is (at least partly) the result of some larger, possibly treatable condition (I hope so)
terrible eczema rash on my left leg that's been there for years and isn't responding to steroid cream (probably unrelated to the other things but it's still unexplained)

Hyperactive thyroid would explain most of this. My thyroid was tested many times growing up because doctors were concerned that I was so underweight despite eating loads, and with such low blood pressure. They always told me the result showed that my thyroid was more active than usual but "not dangerous," so they never did anything about it. Maybe it's time to do something about it. Maybe it's gotten worse, or maybe the doctors were wrong and it should have been treated when I was younger. It was hard to get doctors to help me with anything when I was under 18 and my mother could stand there telling them I was making up stories for attention.

Actually, I have to say that it sort of gives me hope that my depression is so bad despite all the positive steps I'm taking against it. If it were normal clinical depression, it should improve with loads of exercise and sunshine. Since it's not, maybe it's actually being caused by something physical, something that can be treated physically...

[scrdest]

Clinical depression is caused by something physical. It's a chemical imbalance, there's not enough neurotransmitters such as Dopamine, which generally manages motivation - if you don't have enough, apathy, too much - autistic-like obsessive behaviors and the like;

Serotonin, which manages things like sleep and appetite - too much is classical stoner behaviour - and too little causes insomnia (!), low body temperature, low blood pressure (!)...

Finally, Norepinephrine (noradrenaline), the stress hormone, which, if insufficient, manifests as, quote, 'severe sluggishness, chronic and abnormal fatigue, and mental cloudiness'.

Fun fact: I knew the exact symptoms of respective deficiencies in broad strokes, and all the interestingly fitting things were found accidentally.

[Sappho]

Yes, you're right, depression is often a neurological issue rather than purely a psychological one. When I say "physical" I mean to distinguish it from "neurological," as in I'm thinking it might be caused by something outside the brain which can be treated without directly messing with brain chemistry. The thing is, I've tried several types of antidepressants in the past and they have only made me worse. Yes, it's possible that this is clinical depression, but if that's the case then I'm in a lot of trouble, because none of the treatments so far have helped at all.

If I go to a shrink, they will diagnose me with depression, tell me to do the things I'm already doing, probably try to give me more antidepressants. If I go to a physician, they will look at other possibilities first. They will test my thyroid (which can also cause all of those things and which has been hyperactive in the past) and other physical (non-neurological) issues that could be causing all this, including the depression. (I was hoping it might be simple B12 deficiency, but after a month of taking moderate doses of supplements there was zero improvement.) I've had low blood pressure since I was a young child, so it's unlikely that was caused by depression. Much more likely the depression is caused by something else. I think a lot of people suffering from depression go straight to a shrink for help and miss the fact that there are other things that can cause depression which are far easier to treat than pure clinical depression.

Also, autistic people tend to have a deficiency in certain dopamine receptors, so even though our brains are producing enough dopamine, we're still not getting enough of it where it needs to be, which means we tend much more strongly toward depression and anxiety. We also seem to have higher levels of cortisol (stress hormone). There are a lot of other neurological issues linked to autism that are still being studied and are not yet well understood. If you're interested in neurology, there's plenty of material there for you to look at. This blog isn't a bad place to start, and has helped me understand several things about how my brain functions that I didn't understand before: http://snakedance.tumblr.com/

One thing I forgot to mention last night was the pain. That's a good sign, actually. I don't think about the pain except when I'm feeling it, and I (thankfully) don't feel it all the time, although I used to. It has gotten better with all the exercise I get, which is good. I get nerve pain up and down my spine and neck, radiating out from a point about 2/3 of the way up my spine and slightly to the right. It hurts the most if I have to stand up for long periods of time, more painful if my posture is good than if I slouch. I also get strange shooting pains from my left shoulder down to my elbow when in certain positions. My knees, ankles, and wrists tend to ache as well, in the muscles and connective tissues around the joints. Finally, in certain positions I get tingling in my extremities and sometimes my hands and arms or legs even fall asleep. This pain has been present for so long I don't even remember when it started - probably when I was a young teenager. (Doctors, of course, ignored my complaints until I was 18.) I'm also incredibly sensitive to pressure - kneeling on the floor for just a minute hurts my knees for a long time afterward, sitting cross-legged even on a carpet hurts the part of my ankle that's touching the floor, trying to sleep on a mattress that isn't really soft hurts whatever hip and shoulder are touching the mattress. About ten years or so ago I got diagnosed with fibromyalgia - I had all the symptoms, and when the doctor pushed on all the relevant spots, all but one of them hurt. At the time there were no treatment options other than an antidepressant I had already tried without success, so the doctor pretty much just shoved me out of the office and wished me good luck.

I'm still not convinced that I actually have fibromyalgia. The pain is not as consistent as it used to be, and the other symptoms (sensitivity to pressure, depression, anxiety, sleep problems, fatigue, bowel issues (which I have but not severely), constant brain fog, numbness and tingling) can all be explained by other conditions.
sensitivity to pressure - autistic hypersensitivity to touch
sleep problems/fatigue/brain fog - narcolepsy, anxiety issues
depression/anxiety - autism, traumatic childhood
bowel issues - can be caused by anxiety/stress
numbness and tingling/nerve pain - pinched nerve

Also, one of my taiji teachers is also a skilled masseuse who uses many different methods for rehabilitation, and when I got a massage from her, she stopped at the spot in my spine where the pain originates and asked me what was going on there. I told her about the pain and numbness and she said she wasn't surprised - there was something "off" about that vertebra and it looked like something might be pinched there. She worked on it a bit but said she couldn't fix it on her own (and anyway I had asked her to focus on working some of the stress knots out of my neck and shoulders). It was quite a relief to be told that there is a clear physical origin of the pain, it's not just psychological or induced by depression, even though I don't yet know how to fix it.

The good news is, I've just learned there is now a blood test for fibromyalgia! No more "diagnosis of exclusion" - I can go to the doctor and find out once and for all if this is my problem. It is still a possibility, even if it's not the most likely possibility anymore. And once I have a clear answer about that, I can stop wondering.

Right now I'm missing the start of taiji training for the morning. It's a gorgeous day outside but I couldn't get out of bed this morning until the cat spent some time lying on my chest swatting at my face because he wanted breakfast. (For everyone who gets depression, I strongly encourage you to get a cat or even a dog.) It wasn't a motivation problem today - I just couldn't shake myself out of my dreams. Even turning off my alarm clock was something I only half-remember doing. Now I'm sluggishly trying to catch up, slowly waking up all the way. I'm already late and the training goes for 3.5 hours, and I don't like the first part of it anyway, so I'm not rushing. I will go for at least the second half - that's got all the stuff I'm really interested in anyway, the single-posture practice in the short form and learning a new part of the refined simplified (Master Huang) form, which is my favorite part. Maybe I will also catch the applications practice, where we take a small posture from the form and practice using it in real self-defense. It's so much fun to knock someone to the ground using almost no effort! Everyone who never has should try out some kung fu at some point in their lives. SO empowering.

Jesus, this thing has turned into a blog. That was never my intention here. This is a place for data and experiments! I need to find a way to deal with this using charts and graphs. Maybe I'll make up some new tables. I can keep the old ones and add a spot for pain and numbness. (For all who are just starting to read this, go back a few pages to see some of the data I collected during the last month of work before the school year ended.) I also need to fix up the first post of the thread again, since it's quite out of date.

As for the strength training, I have missed a few days but mostly I'm keeping up with my pushups. I stopped doing the dips because I think they were what was causing the pain and numbness in my left shoulder and arm (not sure what I was doing wrong - have to remember to ask my teacher to help me with that). I graduated from 3 sets of 10 "girly" push-ups (on the knees) to 3 sets of 5 proper push-ups (on the toes). I have most definitely gotten stronger. I could hardly do 1 or 2 push-ups on the toes before, and now I can do 5 without too much difficulty. I think it's worth doing the proper ones even if I do fewer of them, because I can clearly feel that I'm using far more of my body to do them. After the first day of proper push-ups, I had incredibly sore abs for 2 days! I never realized you used your abs in that exercise, but I'm happy to make them stronger.

[DJ]

Have you tried leaving the TV on when you go to sleep? It might simply be too quiet in your bedroom, as all the places where you have no trouble falling asleep seem to have more background noise.

[Sappho]

Thanks for the suggestion. I don't have a TV. : ) When I was younger and living with my mother I did leave the TV on at night sometimes, but it didn't help. I would focus on what was on, which kept me awake. It didn't simply become background noise. Also I felt guilty and anxious about wasting electricity, so that only made it worse.

By the way, last night I fell asleep pretty quickly. I don't always lie awake for hours with thoughts racing through my head. If I manage to get into bed during a moment of drowsiness or fatigue, I can usually pass out pretty quick. Or if I'm sedated in some way, such as with alcohol or certain herbal teas (I had a cup of Melissa tea before bed last night so that probably helped). Unfortunately if I try to use tea every night I build up a tolerance pretty quickly and it stops working. : /

[DJ]

Yeah, I guess TV won't help if you actually watch it. It needs to be some kind of repetitive noise you don't pay much attention to. Hm, how about turning on the washing machine? It's cheap electricity at night too, so it's a win-win. Though I doubt you have enough laundry to do this more than once a week if you live on your own.

[Sappho]

I can't run the washing machine at night because it is extremely loud and disturbs the downstairs neighbors. I only do laundry maybe once per week and a half anyway. I don't really have anything that I can use to produce background noise which wouldn't be overly loud or a huge waste of electricity. In any case, I don't really think it's the lack of background noise that causes the problem (although it is true that sometimes white noise makes me sleepier). I think it's a psychological association of my bed with "processing." This is my space, my time, and my brain uses it to process all the backlog from the day and consider the possibilities of the next day, even when I don't want to. It's worth noting that I have a much easier time falling asleep when I *don't* have to get up the next morning. When I have to get up early the next day, I get anxiety about oversleeping, which keeps me awake, and I hate the knowledge that my next conscious thought will be about having to get up and go to work, so I think I keep myself awake just to have more "me time" without responsibility. If I know I can sleep for a long time and I'll still have "me time" when I wake up, it's usually not difficult to sleep.

Not sure what to do about all that.

[DJ]

Yeah, I have similar issues. Еspecially the part about thinking how I'm wasting "me time" sleeping. You just need to find a way to clear your mind. Personally, I light a joint and masturbate (I apologize for being so uncouth, but it's the truth).