Not *quite* clinophobic...

Here's one you may not have heard of:

Clinophobia - fear of going to bed.

Now, if you know me well you will know that I love sleeping. I'm really hard to get up in the mornings (thank you EDS and POTS) and, living with lots of fatigue, I tend to enjoy the chance for an extra nap should it present itself.

However, throughout the last 10 or 15 years (maybe more?), I have intermittently suffered from an intense fear of going to bed at night. Being on or in bed during the day time isn't an issue; night time itself is not a problem; and I'm not scared of the dark. I'm scared of going to bed at night time and having to sleep.

There are various reasons why this may start to be a problem after a period of me not being affected. The first is if my head isn't quite right. When my bipolar was not being at all well-managed, I was constantly hearing things that weren't there. Sometimes these things were quite innocuous, sometimes less so - but to be honest, whenever you're hearing something that you can't explain it's usually quite worrying. During the daytime, I found it easier to ignore the voices and noises, but at night time there was nothing I could find to block it out. These days I listen to the radio or something as I fall asleep, which helps a bit, but back then even doing that didn't work, because the voices just mangled what I heard. Shutting my door and closing out the rest of the world felt as if I were imprisoning myself in a little cell, from which I couldn't be free until morning. Sometimes, to get away from this, I would go running through the night until I had exhausted myself enough to be able to fall asleep as soon as I got back. Other times, I would stay up late talking to the night owls until dawn broke and people started to move outside again, making it safe for me to collapse into bed. Bedtime was the part of the day I dreaded most, to the extent that I was sick to my stomach. I would cry at the thought of it, and start to feel panicky. I hated it because I felt so alone and so vulnerable. I would also hate it because I knew how desperately tired I was, but I was just too scared to lie down and try and sleep. Have you ever tried to lie in bed, keep your eyes closed and stay relaxed whilst you can hear your bedroom walls closing in on you, then crashing down, whilst voices shout and scream at you, alternately compelling you to save yourself and then yelling that you deserve to die and should stay there and be destroyed? However good your 'sleep hygeine' and your routine before bed, I would challenge anyone to be able to get a good night's sleep with that going on inside their head (but sounding for all the world as if it were outside).

That was quite a few years ago now, and I am relieved to say that (touch wood, fingers crossed!) I've been stable for a long time now and since then hallucinations of that severity have not troubled me at all. Now, it's different things that make me scared of bedtime.

One of the worst things about bedtime is that you have to be quiet. This is when doubts and fears can get the better of you, or when all those upsetting thoughts that you push away during the day can come and haunt you. After a lot of work, I am actually pretty good at shoving these thoughts away (or, even better, rationalising them then shoving them away). Sometimes, though, that just isn't possible. Sometimes things have been shoved down so deeply that when they do resurface they take you by surprise, and in doing so draw more attention to themselves. That makes it harder to push them out. The fact that bedtime makes me vulnerable to this can make me quite anxious, even though, again, I'm good at controlling my anxiety.

I'm not thinking about you I'm not thinking about you I'm not thinking about you

While bedtime is excellent for bringing up mental traumas, big and small, it's also a good time for my body to remind me of physical problems. Most people find that lying in bed brings relief to an aching body, but I don't. The only difference to my joints that I have when I lie down is that they now feel awkward and painful in a different position. Since there's less weight on them, this seems unfair, but there we go! Lying in bed is really painful for my back and my legs, and without my splints on my arms (which make me quite hot) my wrists really hurt too, and for some reason my fingers always hurt when I'm lying in bed.

I know how he feels.

As well as the aches, there's the one which is causing me the biggest problems at the moment - nausea and vomiting. When I lie down flat, I only take a few seconds before feeling very sick and having to sit up quickly (trying not to faint!) before I am actually sick. Usually I can address this by propping myself up with LOTS of pillows, but sometimes that isn't enough. At the moment, I'm finding this a lot - I have to sleep sitting up in a chair, which isn't very good on the joints and makes turning over much harder. Because it's not a particularly restful position, my brain takes even longer to switch off, which means I'm left with my thoughts for longer. I also have to be conscious of the anti-emetic medication I take, which stays in the mouth and doesn't taste great (although it is usually quite effective). If I don't do all this, the consequences are pretty severe. Nausea for me rapidly escalates into severe tachycardia/palpitations, sweating, vomiting, dizziness, etc... It sounds like a panic attack but isn't as bad because there isn't the intense fear. I know that if I let myself get frightened it would be like that, but as it is I know that it's just a set of phsyical symptoms which will happen but which will pass.

I am that person with loads of pillows - one for my knees, one for my ankles, one for my shoulders, two or three to prop my head up, a couple for my feet, etc...

A lot of this relative calmness I have to the severe nausea comes from my first year at university. Going up to university for the first time, one of my biggest fears (top 2 or 3) was what would happen if I were sick. Not sick with a cold, or EDS sick, or anything, but actually physically sick. Ever since I was a kid, I was severely emetophobic. I was absolutely terrified of feeling sick, and the mere thought of being sick reduced me to a quivering and crying wreck! I was very scared, therefore, when I contracted (mild) norovirus at the end of my first term. When, after that, I just didn't get better, and continued to be very sick every single day, it was my worst nightmare. My terror at being sick was compounded by being away from home - I felt that if I were at home with my parents I was somehow safer than if I were away, even if I were in a hospital. Eventually, that's where I ended up - after a few months, I still hadn't stopped being sick. I was seriously underweight (BMI <13) and very, very weak. I had endless blood tests and scans, with X-rays, a gastroscopy, a barium meal - all sorts - added in. Doctors had endless suggestions but couldn't find what was wrong. All they knew was that everything I ate either came straight back up or went straight through. I was living with constant and severe nausea and stomach pain. After several admissions (with one particularly memorable trip in an ambulance in which all my vitals were dreadful but they still had no idea why) they finally found out my severe lactose intolerance. The best thing of all of this? Exposure therapy TOTALLY works! I wouldn't say that nausea or vomiting are things that I enjoy, but they're certainly not things I'm scared of anymore - or rather, not in an irrational way. After 6 months of suffering, I had achieved one thing - I had kicked my dramatic phobia of being sick.

Take that, emetophobia!

Now, I'm so glad I did! Being sick is a part of life. If I don't eat enough at night, I throw up my pills in the middle of the night. It turns out that 'enough' is actually quite a lot, and I've thrown those pills up several times. Nausea is also a daily symptom for me. I don't like it, but I can live with it.

So, if I can live with it, why am I still scared of it come night time?

I think it's just the fact that at night time other people are asleep and you're not meant to bother them if you feel rubbish. Night time can feel very long. I know that if I try to stay up to delay the inevitable, I just end up feeling even worse, because delaying my evening pills and being too tired are both things which make me feel really sick. I think I dislike the way that I am being pulled in all directions by body and mind. I dislike the way that everything is a compromise - from when I go to bed and what I eat beforehand to what position I try and sleep in. Every morning I rejoice in the new day because although days are hard and getting up is nigh-on impossible, nights are so much harder.

Nights have got easier as I've got better at dealing with nausea. They have got easier as my bipolar has become better controlled. They have got easier as I've got better at controlling anxiety and not letting worrying thoughts spiral out of control. They have got easier now that I live with my lovely (and long-suffering) boyfriend. They have got easier now that I have learned what things will guarantee a bad night and what things will predispose a good one.

The problem is that there is still a lot of inbuilt fear and I still find it difficult to overcome that sometimes. When I've had an especially bad day, or when the night before was especially bad, I'm correspondingly more afraid the next night. I have to use all my CBT powers to keep myself as calm as possible so as not to create problems merely out of anxiety. 

As well as the weapons mentioned just above, I have one talisman. It got me through those six months of sickness, where I went from terrified to resigned. It gets me through all the worst moments of whatever I'm doing - be it a difficult night or troubling hospital visits, or just a traffic jam or an hour-long erg! It helps me because I know, from experience, that it is true, even though sometimes my head wants to make me think otherwise. It is a double-edged sword, as you shall see, but that isn't necessarily a bad thing, and in times of trouble, it's the best. It comes in the form of a story...

King Solomon's Parable (possibly not actually anything to do with Solomon, but we'll ignore that for now!)

King Solomon was the wisest, wealthiest, and most powerful King the land had ever seen. One day, he decided to teach his advisor, Benaihah, a lesson in humility. He set him the task of finding a magic ring - a ring which would make the happiest man in the world sad, and the saddest man happy. Solomon did not believe that such a task were possible, but Benaihah left the palace and went in search of this ring. He searched for many months before finding an old man in a market place. He described the ring that Solomon wanted, and asked the man if he had ever seen or heard of such an item. In answer, the man reached into his pocket and extracted a gold ring. Without saying anything, he began to engrave words into the outside of the ring. When he had finished, he handed it to Benaihah. Behnaihah had been worried throughout all the months that he had searched for the ring - he feared that Solomon no longer trusted him, and he feared that this testing time would never come to an end. However, as he read what the man had engraved into the ring, a smile broke on his face. Thanking the man, he hurried back to the palace as soon as he could, and burst into the court were Solomon was standing. Upon seeing Benaihah, Solomon smiled a welcome, asking if he had found the magic ring. Benaihah handed the ring to Solomon, who turned it over in his hands and read the engraving. In that instance, his smile vanished, and he looked troubled. Then he looked at Benaihah, and said, 'I was wrong to doubt you. Come back and live in the palace again. What I have here is fleeting, and I will not send you away again.'

Cos this is totally what someone living in Israel in the 10th century BC looked like.

The words on the ring were those which make the happiest man sad, and the saddest man happy. In a secular context, they promise no eternity, no permanence of relief or of trouble. They merely promise hope: "This too shall pass."




Footnote.
But...I'm still scared.