Day 10 Day 10

I am supposed to write about how I am doing thus far with my treatment.
I would say that I am making slow progress as I start to pair emotions or thoughts with my symptoms. I still get confused at times since I really feel that certain foods set off my GI symptoms. Although, I have recently noticed that I get the symptoms at times that are not related to food intake. I do notice that if I have fear about a future event then my symptoms do return. My insomnia is the same....I woke up at 3 am today with my heart racing. I am trying a few breathing exercises to help relax me back to sleep. I had two issues that looks like they are resolving or might be completely resolved. I am excited about that. However, I also developed an intermittent eyelid tic of my left eye around the same time (is that the TMS moving around?). I have been journaling and I am trying to be more open about exploring my emotions. I spend most of my time in my head and not my body. I am trying to change that through meditation and yoga. I really need to be more present. In my mind, I am usually in the past or the future. Thanks to all of you for your support. It really helps motivate me to complete the program. There are definitely days where I feel inhibited to journal or post on the forum, but I am trying hard to stay on track.

 

Hi, aa3405.
You may be having sleep problems because you're thinking about your pain and TMS too much. We can over-do it.
Steve Ozanich says try to think about pleasant things and not your pain or wondering if the eyelid tic is TMS.
TMS symptoms definitely move around.

It's good that you're resolving some issues that may be causing TMS.

Try not to take any worries to bed with you. They will keep you awake. And don't lie in bed trying to think of
what repressed emotions you have. Dr. Sarno says that we don't even have to specifically identify our repressed
emotions. We just have to tell ourselves (our unconscious mind) that we believe they are causing our TMS.

And Steve and others also say, take a day or two or weekend off from thinking about TMS.
Give yourself a mini-vacation to do things that bring some joy to your life. Find something to laugh about.
If you're journaling, and I hope you are, write about some funny things in your life, past or present.

Try not to be in the past or future. Stay in the present moment.

Be kind to yourself. Be good to yourself.

 

I still spend a great deal of my thinking in the past, reviewing what i did, critiqueing all my actions, how could i have done better, how could i have been more perfect, who was unhappy with me..... what a waste of time but years of repetition have made me an expert in evaluating myself and rarely in glowing terms. But now I know how to change. Now i know how hard i am on myself....unrelenting. i can stand back and say stop it. And i can do it and you can too.

Right now my sinuses are very tight. it's winter time... it is not allergies..... it is TMS. Of course i think allerges are TMS too. And i have a really tight glut. Famiy issues are bubbling up this week. The symptoms are jumping all over the place. My left thumb is aching. All these symotoms are alarm bells going off.

Meditation, physical exercise, journaling and affirmations are all tools in my tool box. aa, you are pulling the pieces together. You are building your tool box. You can do it.

 

Hi, Stella. Winter and sinuses go together.Maybe TMS triggered by the family issues.

There are some easy things to do besides meditating and other TMS techniques.

Maybe get a humidifier for your bedroom. Dry indoor air can cause sinus tightness.
Also, look up "alternate nasal breathing," a yoga technique. You close one nostril and breathe out, then close the other and breathe out.
A Yeti pot also helps. Very similar with water.

Family issues can cause lots of TMS symptoms.

 

A new article about insomnia research:




November 18, 2013
Sleep Therapy Seen as an Aid for Depression

By BENEDICT CAREY

Curing insomnia in people with depression could double their chance of a full recovery, scientists are reporting. The findings, based on an insomnia treatment that uses talk therapy rather than drugs, are the first to emerge from a series of closely watched studies of sleep and depression to be released in the coming year.

The new report affirms the results of a smaller pilot study, giving scientists confidence that the effects of the insomnia treatment are real. If the figures continue to hold up, the advance will be the most significant in the treatment of depression since the introduction of Prozac in 1987.
Depression is the most common mental disorder, affecting some 18 million Americans in any given year, according to government figures, and more than half of them also have insomnia.

Experts familiar with the new report said that the results were plausible and that if supported by other studies, they should lead to major changes in treatment.

“It would be an absolute boon to the field,” said Dr. Nada L. Stotland, professor of psychiatry at Rush Medical College in Chicago, who was not connected with the latest research.

“It makes good common sense clinically,” she continued. “If you have a depression, you’re often awake all night, it’s extremely lonely, it’s dark, you’re aware every moment that the world around you is sleeping, every concern you have is magnified.”

The study is the first of four on sleep and depression nearing completion, all financed by the National Institute of Mental Health. They are evaluating a type of talk therapy for insomnia that is cheap, relatively brief and usually effective, but not currently a part of standard treatment.

The new report, from a team at Ryerson University in Toronto, found that 87 percent of patients who resolved their insomnia in four biweekly talk therapy sessions also saw their depression symptoms dissolve after eight weeks of treatment, either with an antidepressant drug or a placebo pill — almost twice the rate of those who could not shake their insomnia. Those numbers are in line with a previous pilot study of insomnia treatment at Stanford.

In an interview, the report’s lead author, Colleen E. Carney, said, “The way this story is unfolding, I think we need to start augmenting standard depression treatment with therapy focused on insomnia.”

Dr. Carney acknowledged that the study was small — just 66 patients — and said a clearer picture should emerge as the other teams of scientists released their results. Those studies are being done at Stanford, Duke and the University of Pittsburgh and include about 70 subjects each. Dr. Carney will present her data on Saturday at a convention of the Association for Behavioral and Cognitive Therapies, in Nashville.

Doctors have known for years that sleep problems are intertwined with mood disorders. But only recently have they begun to investigate the effects of treating both at the same time.

Antidepressant drugs like Prozac help many people, as does talk therapy, but in rigorous studies the treatments, administered individually, only slightly outperform placebo pills. Used together the treatments produce a cure rate — full recovery — for about 40 percent of patients.

Adding insomnia therapy, however, to an antidepressant would sharply lift the cure rate, Dr. Carney’s data suggests, as do the findings from the Stanford pilot study, which included 30 people.

Doctors have long considered poor sleep to be a symptom of depression that would clear up with treatments, said Rachel Manber, a professor in the psychiatry and behavioral sciences department at Stanford, whose 2008 pilot trial of insomnia therapy provided the rationale for larger studies. “But we now know that’s not the case,” she said. “The relationship is bidirectional — that insomnia can precede the depression.”

Full-blown insomnia is more serious than the sleep problems most people occasionally have. To qualify for a diagnosis, people must have endured at least a month of chronic sleep loss that has caused problems at work, at home or in important relationships. Several studies now suggest that developing insomnia doubles a person’s risk of later becoming depressed — the sleep problem preceding the mood disorder, rather than the other way around.

The therapy that Dr. Manber, Dr. Carney and the other researchers are using is called cognitive behavior therapy for insomnia, or CBT-I for short. The therapist teaches people to establish a regular wake-up time and stick to it; get out of bed during waking periods; avoid eating, reading, watching TV or similar activities in bed; and eliminate daytime napping.

The aim is to reserve time in bed for only sleeping and — at least as important — to “curb this idea that sleeping requires effort, that it’s something you have to fix,” Dr. Carney said. “That’s when people get in trouble, when they begin to think they have to do something to get to sleep.”

This kind of therapy is distinct from what is commonly known as sleep hygiene: exercising regularly, but not too close to bedtime, and avoiding coffee and too much alcohol in the evening. These healthful habits do not amount to an effective treatment for insomnia.

In her 2008 pilot study testing CBT-I in people with depression, Dr. Manber of Stanford used sleep hygiene as part of her control treatment. She found that 60 percent of patients who received seven sessions of the talk therapy and an antidepressant fully recovered from their depression, compared with 33 percent who got the same drug and the sleep hygiene therapy.

In the four larger trials expected to be published in 2014, researchers had participants keep sleep journals to track the effect of the CBT-I therapy, writing down what time they went to bed every night, what time they tried to fall asleep, how long it took, how many awakenings they had and what time they woke up.

When the diaries show consistent, seldom-interrupted, good-quality slumber, the therapist conducts an interview to determine if there are any lingering issues. If there are none, the person has recovered. The therapy results in sharp reductions in nighttime wakefulness for most people who follow through.

In interviews, several researchers noted that the National Institute of Mental Health had sharply curtailed funding for work in sleep treatment. Aleksandra Vicentic, the acting chief of the agency’s behavioral and integrative neuroscience research branch, said that in 2009 the funding strategy changed for sleep projects.

In an effort to illuminate the biology of sleep’s impact on behavior, the agency is now focusing on how sleep affects the functioning of neural circuits. But Dr. Vicentic added that the agency continued to fund clinical work like the depression trials.

Dr. Andrew Krystal, who is running the CBT-I study at Duke, called sleep “this huge, still unexplored frontier of psychiatry.”

“The body has complex circadian cycles, and mostly in psychiatry we’ve ignored them,” he said. “Our treatments are driven by convenience. We treat during the day and make little effort to find out what’s happening at night.”