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Hello dawn1228,
I was on melatonin until recently. I found that it -may- have helped me go to sleep quicker, but I also found that it definitely made me depressed. My mood lifted very considerably when I discontinued it.
The basic technique in ACEM is very simple. What, in my opinion, sets it apart, is the very specific way in which it is taught.
In ACEM you are given a (purposely) meaningless word to repeat in your mind, silently. Eventually you will start getting distracted from this by various thoughts, feelings, etc. ACEM instruction is concerned with your relationship to these distractions. You are encouraged to make space for them, to let them evolve and come and go without attempting to 'act' on them in some way (such as by trying to process them, 'fix' them, repel them, etc.). If you find yourself entangled in thought, the only instruction is to gently return to repeating the word, as effortlessly as possible. By doing this over and over, you gradually realise that thoughts and feelings change without your involvement, and you cultivate what ACEM instructors call a 'free mental attitude'. Very often this brings about a feeling of deep relaxation. However in ACEM you are not aiming for some specific effect or goal, since that would make you start evaluating the experience of the meditation against that goal and interfere with the 'free mental attitude'. Instead, what's important is what you do within the meditation.
ACEM is not 'spiritual' in any shape or form. Instead it is based on concepts from psychology. The idea that the problem is not the content of your mind but rather your (over) reaction to it underpins much of mainstream theory on anxiety management.
I have been to several ACEM group meetings in Old Street and have consistently found that the people who teach it are rigorously trained and often have a background in psychology, although all of them have day jobs which are unrelated to ACEM. So concerned is the organisation with teaching the method correctly that the instructors for the beginner's courses are all flown in from Norway (ACEM is a Norwegian organisation). The beginner's course itself, which is several hours long spread over two days, is an extremely reasonable £50 (especially if you compare it to, say, courses on 'mindfulness' at City Lit or elsewhere). From that point onwards the monthly group meetings are completely free ad infinitum. On top of that there are occasional presentations by meditation experts (again, flown in from Norway) for which the entry is typically £5. Generally the whole ethos of the organisation is so anti-marketing that I'm not sure how they break even. This has just made me fonder of them!
I personally do not practice the meditation itself in bed–for the above reason that, once you attach a goal to it (i.e. going to sleep), you will start testing the meditation against this goal (i.e., thinking things like “is this working? Am I falling asleep?”), which goes completely against the method. Instead I try to take the 'free mental attitude' from it into bed and think of something personally soothing.
Yes… I wonder if you could improvise an approximate version of it yourself (for those of us who are chronically single), say by setting your alarm to go every 30 minutes or so for a whole night. However being told by someone else that you have, indeed, fallen asleep, seems to part of the learning process in this therapy.
I think there is something consoling in the realisation that, in all of these treatments, sleep deprivation is paradoxically used as a tool to effect better sleep.
Hi Dozydame,
Yes the situation with “Sleep Restriction Therapy” is very interesting. It was not helpful for me, and in fact my GP–who has generally been very considerate–told me she found a study in the British Medical Journal which did not support it at all. This has put me in a debacle since, after a wait of many months, I am two weeks away from receiving treatment in the NHS CBT-I (cognitive behaviour therapy for insomnia) group, a main component of which, as I have been told, is indeed Sleep Restriction Therapy. I thus have to choose between my gut instinct, which tells me to stop heaping attention and pressure on the sleep, and a gruelling treatment which experts in the NHS insomnia clinic say is the “standard” for chronic insomnia.
I quickly looked up “Sleep Deprivation Therapy” online–when you were administered it I am sure it was analogous to Sleep Restriction Therapy but it looks like these days the term refers to a treatment for depression. I find this hard to fathom since going without sleep makes me quite depressed!
I had never heard about “Sleep Tracks” before, it sounds very interesting. I have never found relaxation music helpful–I am a musician myself and am easily put off by cheesy synth compositions!
Silent Night,
I find it interesting that you suggested Vitamin D supplements. Around the same time that my insomnia became really entrenched–autumn last year–I got some regular blood tests back from my GP and they showed serious Vitamin D deficiency. I am still on supplements. Despite this I haven't been able to find much online on a link with insomnia. What do you know about it?
Here is an interesting outline on the use of mindfulness meditation for insomnia:
As an update,
Up until about a week ago my drug regimen consisted of 2mg melatonin (Circadin) and 30mg mirtazapine (remeron) nightly. In recent weeks I experienced some brief but truly spectacular depressive episodes on top of my insomnia (crying bouts, hopelessness, etc.). As the melatonin was a relatively recent addition to the regimen I suspected that it may have had something to do with these. I discontinued the melatonin about a week ago and my mood has generally stabilised a lot.
I have come across a few more mentions of depression worsened by melatonin supplements online, so this may be something worth looking out for.
jitterbug, have you looked at any of the behavioural therapies for insomnia? They might be of help in getting you off the benzos.
Hey bigula,
It's very encouraging to hear that you reached similar conclusions. I'd be very interested to know how you get on.
Dozydame,
I'm sorry to hear you've suffered from sleep problems for so long. I did not mean to sound patronising. When I first started trying to treat my insomnia I embarked on this very focussed therapy called Sleep Restriction. It is one of the most empirically-based methods–by that meaning that, if you try to locate papers on scientifically based behavioural treatments for insomnia in a website like psycNET, it comes up a lot. However, despite sticking to it meticulously, it did not work at all for me, and the result was a redoubling of despair and depression afterwards. With the help of a counsellor I saw that there were other issues in my life worth looking at, and the sleep did start improving once I started looking at those.
As for there not being any money in insomnia… I don't know what the situation in Australia is like but the two private sleep therapy clinics in London, the Sleep School and the Sleep Centre in Harley Street, seem to be making a killing…
Hello everyone,
A few days ago I had my dose of mirtazapine upped to 45mg, which has helped pull me out of my recent pit.
Silent Night / Dozydame, I think depression and insomnia are co-morbid, i.e. if you have chronic insomnia it is more likely to make you depressed and vice versa. It is hard of course to tell which comes first because people have different things happening in their lives. I personally feel it's useful to look at how to make your life happier more generally instead of devoting too many resources on insomnia itself, as sleep does not respond well to pressure!
Silent Night, I am very sorry to hear you have had a rough month. Have you looked into counselling? You can ask for it through your GP.
Best to all
ezg
Hello Helen
Sorry for the late reply to your post, I was offline for a while. I will send you this as a PM too.
It is not true that you can't be referred to a sleep clinic with the NHS. What I have found is that it helps to be proactive. GPs are not often clued-up on sleep clinics, and you may need to find one yourself and ask them to refer you to it. An added complication is that most NHS sleep centres do not treat primary insomnia, only disorders such as restless leg syndrome or sleep apnoea. I had to dig around to locate the only suitable NHS clinic in London, which was the insomnia clinic hosted at the Royal Hospital for Integrated Medicine (UCH). Afterwards I went to my doctor and asked him to refer me to it, which is what happened.
I notice that you are in Scotland. I am aware that one of the eminent insomnia specialists, almost a celebrity really, Colin Espie, runs the Glasgow Sleep Centre. I don't know whether you find treatment through them but I strongly suspect that there are NHS clinics in Scotland that can help you. Once you have found one I would suggest getting the ball rolling quickly, as waiting lists can be very long.
Alll the best
ezgeez
Hello Martin,
To clarify,
If I haven't slept for a day or two, I subsequently experience quite a severe slump in mood that lasts for several (3-4) days. I can only describe it as depression. I feel very low, I become prone to crying, etc. I suspect that some of it may be anger or despair at 'losing control of my sleep' again.
