Casualty of Meditation - Seizures and insomnia

Strike one:  Intensive meditation started my bout with insomnia back in 2003.  I’ve posted about that before, but its worth mentioning again, because just about anyone reading this (save those very few who know what kind of strange side effects meditation practice can have) will find it hard to believe.   The palpable somatic energetic sense that suppressed my ability to sleep arose directly out of meditation practice – it was (and is) an energetic sensation that I’m readily able to perceive.

Strike two:  After 15 years, meditation now appears to be producing epilepsy-like symptoms – minor simple partial seizures, and what are probably gelastic seizures (which are far more common).  They are most intense during meditation, but they now  can appear when I do yoga (especially the gelastic seizures) and even tai chi.  I’m not sure whether long-term Zoloft use has primed my nervous system for the development of these symptoms – they are exacerbated by Zoloft use.   I first started noticing them 4 years ago.  I saw a neurologist, got an MRI, had EEG’s done – all tests registered normal.  But the seizures continued (simple partials – at worst, I would fall down, unable to control at all the right side of my body, by body consumed by jerky movements, but able to control my left side a bit).  They disappeared when I stopped taking Zoloft.  But now they have re-developed despite the fact that I’ve been off of Zoloft for 9 months now.

The paradox is that I can’t put meditation aside.   Especially without the drugs, it was the one practice that worked for me.  I can’t stop – I tried for 7 days last month, and it was clear that I would not be able to continue abstaining from it.

I’ve worked with some of the most experienced zen teachers on the east coast – they had no helpful suggestions for these issues, which is one of the primary reasons why I no longer practice zen in a formal setting.  I’m between a rock and a hard place, trying to keep my life from becoming a complete wreckage from these problems that to a large degree were induced by intensive meditation practice.

Where is that Reset Button?

Over the past few months, I've been mulling over a number of strategies to re-set my body's sleep system, to return the halcyon days when the ability to sleep on any given night, regardless of circumstance, was never in question, and was never a limiting factor.

My intuition tells me that a re-set button exists somewhere, but I have at best a vague idea of how to find it.   I have two basic approaches - both involve temporary drastic changes and up to a month of time dedicated to nothing else but re-setting.

Just about 25 years ago I set out on a 500 mile, 7 week hike along the Appalachian Trail through the southern Appalachians.  I was 22 at the time, and the experience was exhilarating, mentally demanding, and physically stressful.  At the time,  this backpacking journey was in part to find a way out of the despair that I associated with the bleakness of day to day wage-earner living, suburban/urban industrialized life trappings and surroundings (I was living in New Jersey at the time), and seekign relief from introvert-brand overwhelm from trying and failing to live up to my own early 20's brand of social self- expectation.  The trip succeeded - the combination of extreme physical exertion, sublime natural surroundings, and backpacking brand social camaraderie from folks I met along the way was exactly what I was looking for.  But it was limited to the trip itself.

I've since looked to meditation practice to bring some of what I used to get from long wilderness backpacking trips into my life in a way that was not constrained by setting (I can meditate anywhere).  Which brings me to insomnia - if insomnia is indeed a side effect of my long standing meditation practice, and I am unable to put meditation practice aside because of the demands of my day to day life, maybe the reset button lies back on the trail.

If my sleep patterns were normal, I would not choose backpacking in the mountains as a way to spend a month of free time.  Been there, done that.  But under desperation, perhaps that is where the way forward lies.  On the trail, I'd experience the same physical exertion (with a body that is probably much less resilient than it was 25 years ago) in a setting that would enable me to set aside my meditation practice for an extended period of time.  So the basic ingredients are:  lots of bone-wearying physical activity, no meditation, sublime physical environment (woods and mountains) for 30 days.

The other option is a deeper dive on meditation - to go on extended solo retreat, and do nothing but sitting, yoga, and tai chi.  This by far is the riskier option, and one I am less likely to take.  A few years back I did a hermitage retreat in a small cabin on a side of a mountain on the grounds of the zen monastery I used to practice at.  I spent days alone in a 10x10 cabin - no electricity, only a small wood stove, a zafu, zabuton, and mattress (and camping gear).  Hours and hours of quiet zazen without distraction in the woods.  I slept like a baby through the whole experience (though was on 25mg of zoloft at the time).   Maybe doing something similar can push me through to the other side of this sleep issue - if there is another side.  Therein lies the risk.

Choices - if nothing else, I am lucky to have them.

Parade of the False Alarms

There is a risk that I'm posting about this too hastily and may yet need to reverse my course again (if I should be so fortunate), but I'm laid low once again by what might be the false promise of the serotonogenic supplements.  Its baaaaack, and I am a miserable puppy for it.  I had a tear of three normal nights of sleep last week - so simple and so utterly human a pattern it was - go to bed, fall asleep, wake up feeling great.  Last sunday it returned - I was forced to practice conscious nocturnal bed laying, at least till I took a restoril to knock me asleep (probably a big mistake).  So it began anew - the next night, it was a Lunesta.  As for that medication, it has outlived its usefulness.  I've maybe averaged taking about 30 Lunesta each year over the past few years, and it has stopped working for me.  Now, I take the pill, and it takes about 2 hours for it to finally knock me out.  Then I wake up 4 hours later feeling hung-over.  And worst of all, more often than not, is that I've noticed that I become really depressed later in the day - to the tune of suicidal thoughts and utter life-negating unassailable loneliness and hopelessness.  And that is much less the case when I do not take the pill and get only 4 hours of sleep (like last night).  The pills are a psychological crutch, and most of the time make you worse off for their use than if you had not taken them at all.

Sill I'm left with a sinking abyss-like feeling, as if my life is being eviscerated and dismembered into a pile of refuse that sits and waits......for sleep.

My “a-duh” moment: Brain Damage and SSRI’s

This should not have been so hard to grasp for me.  Zoloft, which I took in large doses (200mg) for a year in 2000 and just under 6 years in smaller doses (25-50mg; 2006-2011, with a few 3-4 month “off” periods) is an SSRI.  The acronym alone is informative and should have provided a clue “serotonin re-uptake inhibitor”.   It blocks your nervous system from re-assimilating  the serotonin that your body produces.  Its effects are supposedly to help with depression.  I took it as a sleep aid, which worked for a while.

The big “a-duh” moment  is my recent  realization (epiphany even) that the body, being the adaptable thing that it is, will probably eventually produce less serotonin if its re-uptake is blocked by some ingested pharmaceutical, in a quest for equilibrium.  This is a hypothesis that is not too hard to infer with a little bit of biochemical awareness and common sense.  I should have thought of this years ago.  And just as my thoughts were turning in this direction, an Internet search turns up this article http://www.psychologytoday.com/print/68229, which suggests as much.  This may explain much about why I have such low serotonin levels.   My last Zoloft pill was July 2011 – my ability to naturally produce serotonin is probably still impaired.

Its sobering that my insomnia may be fallout from SSRI–induced brain damage, with uncertain irreversibility.  BTW, I’ve relapsed back into insomnia-land despite my new serotonogenic supplement regime – hopefully temporarily. 

Exactamundo

Not so long ago I wrote about my instinct to avoid the rat-race as a life strategy for avoidance of the worst of the stresses that our modern industrial western way of life insists upon us as "normal". 

I often read Charles Hugh Smith's Of Two Minds blog - one of the reasons why I don't write profusely is because I need to avoid as much as is possible feeling overwhelmed that he speaks of in the following link, and, simply because others such as he can hit the nail on the head much more eloquently than can I:

"But what if our state of being overwhelmed is the causal consequence of living in our consumerist-State system? What if the system itself is nothing but an overlay of sociopathologies?

The tragic irony of this is that we are all so overwhelmed by daily life in this system that we lack the mental and emotional strength to analyze its sociopathologies."

http://charleshughsmith.blogspot.com/2012/04/overwhelmed.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+google%2FRzFQ+%28oftwominds%29

Bravo!

The Serotonin Elixir

Is this the end of the road for my trial by insomnia??  I am allowing myself to hope.  10 days ago my naturopath started me on serotonogenic dietary supplements, (a test indicated serotonin levels at the lowest 2% of the reference curve!!!) and after a week on 100mg of 5HTP right before bed (along with Magnesium Citrate and a Melatonin supplement with B6) I'm starting to sleep normally again - I think.  Three nights of 7 plus hours does not yet a happy ending make, but I am feeling human again, at least for now.  My life just may begin anew - out of the darkness.

It is very interesting - in 2006, after a failed attempt at CBT for insomnia, I went on 50mg of zoloft.  Zoloft immediately restored my sleep, but its sleep inducing effects waned over the years.  I got off it for good last summer.  Since zoloft is a serotonin re-uptake inhibitor, I wonder if my body decided that since the serotonin that it was producing was not being readily re-absorbed, that it did not need to produce any.  So after ceasing zoloft - whammo - full scale insomnia (though it took a good 4-5 months for it to develop into its most acute form).

What do I care about theories though if I can now return to the land of the living?  Onward.

The Race Avoided

Even as far back as in high school (circa 1980), I can remember looking around at how people lived their lives (in suburban New Jersey outside of New York City) within the dominant work/consume/commute/procreate paragdim, and having a visceral reaction of aversion.  I had a clear sense that something was profoundly awry with what I was seeing, so at the time, I had a telling vision of what I did not want out of life.  This perception was the starting point for a winding and unconventional route of rat-race avoidance, filled with its share of success, failure, joy, and angst.  While I have found a livelihood solution that works for me (for as long as it lasts!), I can easily recount multiple blog-pages worth of tradeoffs along the way.

Things would have been far worse had I not had this sense.   My bell curve tail-end degree introversion and sensitivity served me well in this regard.   I’m certain I otherwise would have been chewed up and spit out by now had I wholeheartedly entered the race in camp real world.  The lifestlyes we have created and find so seductive are ever- increasingly out of alignment with the underlying perceptual and cognitive dimensions of mind-world interaction.

Reading this article triggered this train of thought, which is a particular type of reflection that I find useful to revisit when I focus on the more problematic aspects of my current experience of life. 

http://www.guardian.co.uk/commentisfree/2012/apr/09/america-prescription-drug-addiction

No end to it

So what to do when it seems like there is no way out?   If anything, my ability to sleep has diminished in the past two weeks to the point that every night  is a replay of wakefulness and light if any sleep, and every day is a despair filled pit.  It honestly feels like my life is over.  I can't plan to do anything, I don't socialize, I barely scrape by at work.  And on weekends, I sit at home in a sleep deprived stupor. 

I continue to force myself to do sanity-saving activities.  Yesterday I went on a hike in the mountains, though it took me 2 hours of stumbling around to get my day hike stuff together.  This morning, after another piss-poor 4 hours of sleep, I grogged myself up, forced myself to do 40 minutes of yoga and a little meditation, which helped immensely, before I commenced with trying to slog through the rest of the day. 

Paperwork accumulates, I no longer clean my apartment, I'm no longer interested in playing music, and the near sleepless nights play out one after the other in agonizing succession.  I feel like the end of the rope is near.  I have no ability to think or interact with people, so my isolation in insomnia is almost perfect.

I have no control - I do all I can, have tried almost everything there is to try to remedy the issue.  I feel like all I can do is surrender to the black hole. 

I Remember......

Tantalizing memories of evenings full of the unspoken and implicit assumption that I would be able to sleep:  Of being able to plan to participate in social events without reservation, taking the ability to awake in the morning after a full night slumber very much for granted; of falling asleep once at my desk at work, unable to resist the pressure to sleep; of falling asleep during long drives to field sites in my consulting days; of going to conferences and sleeping fine on the floor of a motel room between beds in a roomful of people........

My life was once like this, until the fall of 2003, when it all changed for reasons that I don't quite understand.  Now most mornings are accompanied by the thought of "how much longer can I keep this up", driving to work trying to strategize the path of least resistance to get through the day.  Though I am single, have no family responsibilities/kids, have no money or debt worries, work no more than 40 or so hours a week, my time is still not my own.  My time by necessity is dedicated to self maintenance rituals that theoretically maximize my body's ability to sleep, but in reality fall well short of the mark.  Yesterday:  1 hour of intense weight training after work, drive home for dinner, some e-mail correspondence.  Then 30 minutes of tai chi, 1 hour of listening to a meditative drum CD while in supported shoulder stand, then under the sheets for what seems to be my latest pattern - 3 - 4 hours of fitful sleep with relatively rapid onset, then awake and strung out.  I did an hour of meditation between 4-5 AM (which turned out to be unusually deep), hoping that would enable me to get some more sleep, but nothing more than 2 hours of subsequent wakeful bed laying ensued.

Sigh..........is there any other option other than trying to get as comfortable as possible within this abyss?

A mission for the groggy

I suppose one of my motivations for posting here is to unequivocally lay to rest the assumption that all cases of insomnia are a state of mind rather than an affliction.  I'm sure that many cases are, but mine clearly is not.  After 8 years, I've tried just about anything and everything that I've heard of, and have come firmly to rest on the conclusion that my sleep mechanism is in a state of physiological/biochemical dysfunction that started when I was 39 years old.

So, for the record, I've tried and given good faith efforts to:

• Sleep Lab/ apnea assessment
• Cognitive Behavioral Therapy
• Pharmaceuticals
• Talk therapy
• Diet restrictions (gluten, sugar, caffeine, etc)
• Sleep psychologist
• Acupuncture (3 different occasions)
• "energy work" and massage
• Ayurvedic assessments
• EEG and MRI assessments (assessed because of association with problems with simple partial seizures)

And I continue to engage in, with persistence of my insomnia:

• Meditation (1-2 hrs/daily, 14 years of practice, over 10,000 hours of cushion time logged over the years)
• Weight training (2x/week, total 2 hrs/week)
• Cardiovascular exercise (4-5 days a week: hiking, running, biking, exercise bikes, xc skiing, swimming, etc)
• Yoga (2-3 times/week)
• Tai chi (1x/week)
• Gluten free diet, vitamin supplements, avoiding alcohol, avoiding TV (I don't even have one) or computer time before bed.

I have a low-stress job that I enjoy (for the most part), and because of a habitual money saving habit, I have a decent financial cushion, no debt, and no money stress.  I don't have a family to take care of, so no family-related stress.  I live in a rural area and take frequent hikes in the mountains.

I am not depressed - I have been depressed before in my life and now it creeps back in when I am completely hamstrung by insomnia (and, after effects of medications like Lunesta clearly make me depressed).

My life-maintenance activities are beneficial, and maximize my ability to function given the amount of sleep deprivation that I deal with, but they don't "cure".

If my insomnia is anything but an affliction, I have a huge cognitive or conceptual blind spot that I'm unable to see.  I am convinced that this is not the case.

My latest theories of causality:

1. low testosterone (recent blood test was not below reference level, but was low for my age)
2. benign brain tumor (glial cells in hypothalamus)
3. poorly understood side effects of spiritual practices (chi/prana imbalance, kundailini, etc)

Scary Good

Just to be sure, this is not an April fool's post:

I typically to get enough sleep to feel well rested 2-3 days out of the month - I only sleeps well enough to feel "normal" after I have accumulated via my brand of insomnia a staggering sleep deficit that overcomes my sleep mechanism dysfunction. 

I would be in total despair over the lack of effect on my sleep patterns of all the good-faith self maintenance efforts that I engage in (yoga, tai chi, meditation, weight training, hiking, bicycling, running, gluten free low sugar diet, regular bed times, managing excess stimulation, vitamin supplements, etc etc.) except that the benefit of all these activities on the days when I happen to sleep well are remarkably apparent.  Simply put, when I am blessed by minimally sufficient sleep, I feel scary good.

Engaged, energized, enthusiastic, friendly, sharp, resilient, optimistic - and more even - all are apt descriptors of how I feel when the sleep gods decide to smile ever so slightly upon me.  It lasts only until the next restless night, which is usually  only a mere hours away.  And it is marked by a bit of confusion on what to do with all the energy I have.  My sleep-deprived life is a study in isolation - no energy to do hardly anything except drag myself to work, stagger through my self maintenance activities, and then stumble around my apartment like a zombie.  My days are habitually structured to reflect my energy levels - avoiding all but the essential.  But it all gets turned on its head when the sun briefly shines - playing music, contradancing, writing, socializing, seeking out friends and looking for dating opportunities.  I want to do it all at once, but then the sun sets and and I'm back to rattling around in this infernal abyss of sleep deprivation.

The scary good part is enabled, I suspect, by the gluten-free diet and Vitamin D supplements that the naturopath that I've been working on my insomnia with has proscribed.  I've been gluten free for 8 months now, and have been on Vitamin D over a month, which a blood test revealed that I was highly deficient in (18 of whatever units Vit D is measured in).  Before these dietary measures, even when I did manage to sleep, my life was still a slightly more leavened version of dragging myself around.  So in some ways, I feel like I've reversed 15 years of the aging process.  Its too easy to torture myself over thinking about  sleep related  "what ifs".