I had some hesitation about writing a post about my use of sleeping pills; our society continues to stigmatize mental illness and psychological problems.
Yet the ways drugs (both recreational and prescription) affect thinking, moods, and behaviour have always fascinated me. Like most people, I have friends who’ve experienced mental illness. I’ve read several books by people who’ve suffered from severe depression or other mental illnesses. These people have given me insights into how drugs have benefited them or had negative, even tragic results.
But my personal interest in the topic of psychoactive drugs also stems from the chronic insomnia that has plagued me for my entire adult life. In a sense, I view myself as a guinea pig who has an intimate knowledge of how drugs can affect not only the symptoms and underlying problem being addressed (in my case, sleeplessness), but can also cause side effects ranging from physical symptoms to changes in emotions and behaviour. Each person’s response to a drug is unique and incredibly sensitive.
My experience using prescription sleeping pills as one of several strategies for coping with insomnia has made me somewhat of an expert on the effects of several different types of sleeping pills. Side effects can be both physical and emotional; some of them are dramatic, some surprising, some unpleasant.
I suspect that many (if not all) psychoactive drugs have wide-ranging and possibly dangerous side effects that are certainly minimized or not even mentioned in advertising about these drugs. I’ve gained understanding and respect for my brain, and what a finely-calibrated organ it is. I would prefer not to tamper with it chemically at all. (Except for caffeine—please don’t take away my coffee!)
But in order to function, I’ve had to balance the benefits and costs of taking sleeping pills; a balancing exercise that is undertaken too carelessly most of the time, I believe, in our society—where “popping a pill” seems to be the easiest answer to every physical and psychological problem.
Why have I chosen to take sleeping pills for over thirty years, even though I’ve dangled on the addict’s cliff of panic many times? The tormenting loop of an insomniac’s thoughts plays over and over again through the passing dark hours:
I’m not going to take a pill tonight…I’ll tough it out…I’ll fall asleep…but now I’ve been awake an hour…all my worried thoughts are circling around and around…now I’m not sleepy, my body is instead pumping the fight-or-flight hormones of fear into me…every negative thought I’ve ever had is pricking me and laughing at me… if I don’t take a pill tomorrow will be horrible, I won’t be able to make that presentation, I’ll be dead tired at that party…if I don’t take a pill right now it will be too late, I won’t be able to get up in the morning…OK I’m giving in…
But I can’t give in too often.
What do I do if the drug stops working? Do I have the willpower not to increase the dose? Can I stand to go through the days of sleepless withdrawal again?
My insomnia began when I was in my second year of university. The three hardest exams I’d ever faced were scheduled three days in a row: Organic Chemistry, Thermodynamics, and Advanced Biochemistry. Although I had studied hard and didn’t need to cram, I found myself unable to sleep for almost 90 hours straight. Even after I’d struggled through the exams, I still couldn’t sleep. My father took me to the hospital emergency room where I was given a prescription for a drug called Halcion. I slept blissfully that night for about ten hours.
During my twenties, insomnia was a recurring problem, but it happened mainly when I travelled to races and had to face jet-lag and the anxiety of competition. I was afraid to take Halcion the night before a race, fearing it would affect my performance. I raced many times on little or no sleep and learned that I could still run well, though it was mentally tough and I had none of the eager enjoyment of the racing challenge that I felt when well-rested.
Later in my running career, I discovered that Halcion didn’t seem to hurt my racing. It was a “fast-acting” drug that put me to sleep in less than an hour and cleared my body quickly. But there were many downsides to it. First of all, though it did put me to sleep, I usually slept no more than five hours. I felt tired, mentally dull, and slightly nauseous the day after taking Halcion, but better than I would have felt after a completely sleepless night.
After my son was born, my insomnia became worse; he never slept as much as babies and toddlers are supposed to, and his sleeping schedule always seemed in direct opposition to mine. My life was stressful in other ways, too. My husband and I were never secure financially; my running career was riddled with injuries and it was impossible to depend on earning money from running.
Over the years, I had counseling with three psychiatrists. I believe the second one, whom I saw at the highly renowned sleep disorders clinic at UBC, caused me lasting damage rather than helping me. After many appointments with me over the course of a couple of months, she told me (though not quite in these words) that I was a hopeless case. She took me off the drug she had put me on and I went through two weeks of almost no sleep. It was during the same summer (1994) that I ran one of my last 10,000m races on the track (in about 33:30) and failed to qualify for the Commonwealth Games.
By the time I was about 40, my doctor wasn’t happy about my taking Halcion, as the evidence about its bad side effects (particularly its ability to cause suicidal impulses) was mounting. He put me on a different kind of drug in the class known as diazepams. This type of drug is often used to treat anxiety and depression. Valium is a well-known example. (In fact, the first psychiatrist I saw about my sleep problem prescribed Valium for me. I took it once, and it made me feel so heavy and lethargic that I refused to ever take it again. I couldn’t believe that anyone would choose to take a drug that made them feel like that. )
Oxazepam worked very effectively for me as a sleep aid. It reliably gave me seven or eight hours of uninterrupted sleep. I’ve tried other sleeping pills over the years, but this is the one that works best for me and I continue to take it intermittently to this day.
Yet in addition to being highly addictive, Oxazepam has a variety of (potentially) dangerous, disturbing, and mysterious side effects. I’ve been amazed that one drug can cause such changes not only to my sleep, but to my personality and behaviour.
In contrast to Halcion, oxazepam is a long-lasting drug. That means I can’t run the day after I take it. It makes me feel so heavy and lazy that I don’t even want to run. I found out at a bad time that it has a devastating effect on physical performance. I had started to take it occasionally just before going to Japan as part of a Canadian Ekiden team. This was my second time competing as a masters (over 40) athlete on an Ekiden team. The first time, I had run respectably, with a 10K leg of 34:35. On this team, I was running a 5K leg.
Predictably, the lengthy trip to Japan gave me severe jet-lag and I slept poorly every night. The night before the race, I couldn’t stand it any longer and took oxazepam, hoping that, like Halcion, it wouldn’t hurt my running the next day. However, as soon as I tried to warm up I knew I was in trouble. Even jogging seemed terribly difficult. A huge pre-run surge of adrenaline helped me a little, but despite giving 100% I ran a mediocre 17:09 for 5K. A month or two later I ran back-to-back 16:24s one weekend in two different 5K races, showing just how much the drug had slowed me down in Japan.
The other main negative effect of oxazepam, in addition to the lethargy it causes, is a mental one. I soon learned that events of the morning after I took it could be completely erased from my memory, or would be recalled in a hazy way. Sometimes the days after a full dose would pass with a kind of dream-like quality.
A positive side effect of oxazepam for me is that it seems to relieve my natural level of anxiety. I feel relaxed the day after I take it. Also, I’m more at ease in social situations, whether they are important ones (such as a job interview) or trivial ones (such as making small talk with strangers or acquaintances). I feel as though my personality has been subtly altered. I lose some of my edges, my doubts, my cynicism, my shyness.
Yet, paradoxically, my emotions can get out of control while I’m on Oxazepam—especially negative emotions. Tears come easily, and if my anger is provoked my temper can explode ferociously. The drug seems to have a disinhibiting effect similar to that of alcohol.
I’ve noticed other manifestations of this loss of my natural inhibition. First, when I go shopping (for clothes, for example), I’m more likely to buy something or spend more than I usually would. It’s not that I make completely foolish or extravagant purchases; but the decision to buy comes more often and more quickly than it normally would.
I’m less inhibited in my writing as well as my shopping behaviour. Whether I’m writing an email to a friend or publishing a blog post, I might say things that I normally would consider unwise to reveal. Yet the disinhibition of my normal reserve can be a boon to creativity, too, and sometimes important insights come out when the contents of my subconscious mind rise more easily to the surface of consciousness.
My conclusion is simply that the decision to take any drug, but especially drugs that affect the brain, should never be made lightly. Our bodies and our brains are wondrously complicated systems. We now play God with them—with life-saving and life-enhancing outcomes—yet we are not gods, and like Prometheus, we are playing with fire.
For a related post about the effects and side effects of Prozac, an antidepressant (which I have not taken), please see my post “Listening to Prozac after twenty years”.