After any psychologically charged event, mood and sleep may change
I am a sleep medicine specialist. The weeks after the election were from the perspective of sleep almost unprecedented. We remember where we were when JFK was assassinated, when Neil Armstrong landed on the moon, the morning of 9–11, and where we were the evening and night of November 8, 2016. We remember the really good things and the really bad things. They are etched into our minds and can cause sleeplessness. Sleep tells us a lot about the state of our minds.
Close friends and colleagues organized an emergency dinner that evening at a restaurant for eight of us. We discussed our previous night. Most had gone to bed after Pennsylvania went Republican. Most slept very fitfully that night. None slept through the night. Some awakened at 2 am and could not sleep again. Appetites were down. Sadness, a sense of hopelessness, anxiety, and anger had descended.
I teach a weekly class to 22 undergraduate students about sleep. The group is diverse: geographically (from all parts of the US); racially (Asian, African American, Hispanic and white); and academically (from the humanities and sciences). Exactly a week before, on election day, the students were upbeat. Today they were quiet. I ask the students to raise their hands if the election has affected their sleep. Three quarters of them raise their hands. I ask for reasons. Some were uncertain and fearful of their futures. Some were shocked by the outcome. We discussed the mechanisms of how insomnia could be initiated.
This email arrived from a friend:
“We have decided that, to avoid specifically identifying the event by its “proper” name, we will henceforth call what started late in the evening of November 8 the “Eclipse.”
This has an obvious advantage, apart from avoiding the NAME: An eclipse is transitory, and after it passes, it reveals a brilliant sunshine or moonshine… eventually.
True, but the damage THIS eclipse causes to the environment, public lands, civil rights, voting rights, other civil liberties, persons who are not the favored race or religion or gender, immigrants, labor, health care, education, gun safety, the Supreme Court and lower courts, economic policy and progress, relations with foreign nations, and the image of the United States in the world, may not be so transitory.”
+ 14 days
I am at a pre-Thanksgiving lunch at work. There are perhaps fifty people there. The main topic of conversation is the election. I speak to a female colleague who looks intensely sad. She was staring straight ahead and looking tired. Her sleep had not been normal since the election. She has been sleeping fitfully and has awakened some nights in the middle of the night thinking (wishing?) it had all been a dream. She had stopped watching television or reading the paper, activities that used to give her great pleasure, fearful that she might see HIS face.
It is exactly three weeks since election day. The students are in a much better mood even though the weather was miserable. Only one of the students continued to have insomnia. In the others the sleep issues had resolved.
Post-election depression or euphoria?
Are we in the midst of an epidemic of post-election mood swings? You decide. These signs and symptoms of depression are taken from the National Institute of Mental Health. I have encountered several of these in relations, friends and colleagues post-election.
Signs and Symptoms
If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in hobbies and activities
- Decreased energy or fatigue
- Moving or talking more slowly
- Feeling restless or having trouble sitting still
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, early-morning awakening, or oversleeping
- Appetite and/or weight changes
- Thoughts of death or suicide, or suicide attempts
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Why is our sleep such a powerful reflection of our mental state?
There are systems in our brain that put us to sleep, that awaken us and keep us awake, and a clock mechanism that helps control the time we sleep. The system is complex, but it works remarkably well most of the time. Its complexity makes it fragile. Events that make you very happy or sad can cause sleeplessness.
In a previous article I had written about psychologically charged events, I asked a colleague, Robert Stickgold, PhD, an expert on sleep and dreaming at Harvard, to comment on the relationship between psychological trauma and difficulty with sleep. His response:
“Psychological trauma often develops when you are confronted with an experience of threat that feels overwhelming. The mind and body respond with a fight-or-flight rush of adrenalin, and a memory of the event is created in intense detail, tagged as extremely important and unresolved. It is probably this tagging that impacts our sleep (Stickgold & Walker, 2013). One of the greatest achievements of the human brain is its incredible ability to take complex information and figure out what it means — both in the moment and for our future. In the case of traumatic events, this can take a long time. . .
More and more research suggests that much of this working-out of the meaning embedded in complex experiences occurs while we sleep (Stickgold, 2010), and during the sleep-onset period, when we’re lying in bed waiting for sleep to engulf us, our mind seems to line up topics for the night’s sleep-dependent memory processing. What didn’t I finish today, what do I need to get done tomorrow, what happened today that I still haven’t figured out? With luck, these just rumble through your mind like a distant freight train in the night. But sometimes they take on the proportions of a train wreck. . . . The result can be a rush of adrenalin that makes sleep, at least for the next while, impossible. . .
The significance for insomnia of “things unfinished” is, I am convinced, huge… Insomnia is all about not being able to say, “It’s over.” So is PTSD.”
Is it possible that PTSD with anxiety and recurrent nightmares can be an outcome for some? Again, Stickgold wrote:
I have suggested (Stickgold, 2008) that PTSD develops precisely when sleep-dependent processing fails, leaving traumatic memories in their original, painfully detailed form, without meaning or understanding.
In my experience, most of the time, sleep after a very happy or sad event usually improves within a couple of weeks, as it did in my students. The human brain is resilient. Uncertainty, however could perpetuate the sleeplessness if there is still unfinished business for the brain to resolve. If sleeplessness continues or the depressive symptoms mentioned above persist, it might be time to get help from a doctor.
Stickgold, R. (2008). Sleep-dependent memory processing and EMDR action. Journal of EMDR Practice and Research, 2(4), 289–299.
Stickgold, R. (2010). Memory in sleep and dreams — The construction of meaning. In S. Nalbantian, P. M. Matthews & J. L. McClelland (Eds.), The memory process — Neuroscientific and humanistic perspectives. Cambridge MA: MIT Press.
Meir Kryger MD FRCPC
Professor of Medicine, Yale School of Medicine, Pulmonary, Critical Care and Sleep Medicine
Originally published at medium.com