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Sleep ‘Sweeps’ Mind of ‘Monsters;’ Helps Fight Dementia

March 25, 2020. Dr. Dimitriu was published in Psychology Today about the connection between sleep and dementia

“I’ve always envied people who sleep easily. Their brains must be cleaner, the floorboards of the skull well swept; All the little monsters closed up in a steamer trunk at the foot of the bed.” This simple quote from David Benioff, an American TV producer and screenwriter, is close to the scientific truth about sleep and its effects on mental and overall health. Most notable is the growing evidence of a relationship between lost, fragmented and disordered sleep and the incidence of dementia and Alzheimer’s disease, the most common form of dementia.

Click HERE for the full article.

The Erosive Power of ADHD: Tips for Adults

February 19, 2020 Dr. Dimitriu was published in Psychology Today on the topic of ADHD in adults.

ADHD isn’t just for kids. While attention-deficit hyperactivity disorder is now well recognized and commonly diagnosed in children, less attention has been focused on the fact that about half of these children carry some of the symptoms of ADHD into adulthood. What’s more, there are many adults with ADHD who have never been diagnosed or treated. Many grew up in a time when kids who exhibited the hyperactivity, inattention, and impulsiveness that characterize ADHD were labeled troublemakers, dreamers, lazy, or just “bad.”

Click HERE for the full article.

New Research Shows How Sleep Clears Toxins from the Brain

January 14, 2020. Dr. Dimitriu was published in Psychology Today about how sleep clears toxins from the brain.

We’ve long known that sleep is as important to our health as good nutrition and regular exercise. Not getting enough sleep is detrimental to daytime functioning – to our mood, energy, concentration and reaction time and over the long term, it contributes to obesity and the risk of serious illness. But research has found that sleepless nights have implications well beyond making us sleepy the next day. When we go to sleep, our brains go to work, performing critical functions that affect cognition and memory.

Click HERE for the full article.

Agitated Depression and the High Functioning Bipolar Rockstar (of Silicon Valley)

Everyone reads the words “bipolar disorder,” and immediately thinks this cannot possibly be a “disorder” that they have. And indeed, this terminology is a bit clinical for most high functioning people who let nothing slow them down and have moved mountains to get to where they are today. Think of bipolar disorder, and one immediately thinks of mania – shopping sprees, flights to Vegas, talking fast, euphoria, grandiosity, and launching the next big “unicorn startup,” of Silicon Valley.

high-functioning bipolar

Because of this classic view of mania, and its requirement for the diagnosis of bipolar disorder (per the DSM, “handbook,” of psychiatry), many people simply write this off as impossible. And most of the time they are right. Bipolar disorder is rare, affecting about 1 to maybe, 2.4% of the population. The challenge comes for people that do not clearly fit the bill for having had a manic or hypomanic (less than manic) episode. These people are left with a wide array of symptoms that no one diagnosis can explain and no standard treatment or therapy can “fix.” They are left thinking it’s their personality, their childhood, trauma, a medical condition, or even a “spiritual crisis” that just cannot be shaken off.

I have worked with several patients who had gone to the end of the earth seeking a solution. Besides countless therapists and psychiatric interventions, people have sought out ketamine therapy, LSD micro-dosing, Wym Hof breathing, ice-cold showers, ketogenic diets, silent retreats, and float tanks, to find peace. Often, to no avail.

But what exactly is the problem to begin with?

In most cases, the classic triad of symptoms I have seen is a combination of what looks like ADHD, insomnia, and severe anxiety. I call this the “bipolar trifecta” of symptoms, that when seen together, raise the possibility of more than just classic “depression and anxiety.” This is important because the treatment and understanding of one’s life is very different through a bipolar versus a depression/anxiety lens. Many subtle, unrelated things start to make sense.  When it all comes together, it can be meaningful, life-changing, and offer a tremendous amount of hope, through enhanced self-awareness.

“But I’ve never been manic.”

Indeed, this is when the diagnosis is often complicated. When mania is obvious, the diagnosis is easy. Classic mania will present most fundamentally with decreased sleep and increased energy. Additional symptoms may include elevated mood, productivity, speed of movement and thinking, as well as grandiosity. An easy way to conceptualize bipolar disorder is essentially as an energy problem – too little, then too much, for longer than just a day (technically at least 4 days in a row for hypomania). It is important to realize, that not all energy, on the upside, is good. Excess energy can look like ADHD, scattered thoughts, intense moods, a feeling of adrenaline, and the irritability that happens when one is driving 100 miles per hour on a highway where everyone else is driving 55.

Agitated depression, like it sounds, can often look like a combination of really intense anxiety, low mood, along with insomnia. In most cases, where the diagnosis between anxiety and bipolar disorder is unclear, it helps to look for such episodes, along with other soft signs:

Brilliance

Scary symptoms aside, it’s important to recognize just how amazing people with this condition can be. Bipolar disorder is truly a blessing and a curse, and some of the most brilliant and accomplished people in history are suspected to have bipolar. From Beethoven to Robin Williams, the passion, intensity, and brilliance of bipolar disorder cannot be overstated. Their intensity allows them to be visionary, passionate, persuasive, and effective. People with bipolar disorder are like lasers. Unfocused, they will burn themselves and everyone around them. When focused correctly, they can accomplish anything and are a gift to the world.

Childhood

childhoodBipolar (ish) people tend to have quirky childhoods and come from quirky parents. A family history of anything severe (i.e., suicide, hospitalizations, ECT, legal problems, domestic violence, drug, and alcohol dependence) always raises flags. Note that for most of history, psychiatric conditions were never diagnosed, so I always ask if someone in the family has been “intensely eccentric.” Children may have periods of obsessive behavior, intense interests, and equally intense moods. Early hyper-sexuality, substance use, and inconsistent ADHD are sometimes seen, often with strong academics. A history of significant mood symptoms as a teenager (after puberty) is often also a meaningful flag of bipolarity.

Intensity

I often use the analogy that stressors in life are like speed bumps on a road. “Normal” people will go over a bump, get knocked around a bit, and get back to driving on the same road within a few days or weeks, depending on what happened. The driver with bipolar disorder hits the bump, and takes off, airborne. Intensity. People with bipolar disorder do not get upset, they get depressed. They do not get angry, they feel blood-boiling rage. They do not get anxious, they feel panic. They are not suspicious, they are paranoid. They do not think of a good idea, they think of the best idea, and want to share it with the world.

The moment can feel critical and they cannot wait. They do not feel happy, they feel excited, euphoric bliss, and sometimes even cosmic nirvana. Intense, rapidly shifting moods can occur. But the key point here is the intensity. In any direction, good or bad, this intensity is often a lot more than average. Unfortunately, most people don’t know what “average” is.

Family, relationships, and feelings

When you feel a lot, the people close to you may hurt your feelings. Why? Because they matter, and they know which buttons to push. In these cases, the buttons are both sensitive, and the people, reactive. I will often tell my patients that their ears are too big – that they feel and sense a lot more than is usual, and it can be truly challenging to manage such intense inputs. Many people I have worked with report distant and damaged relationships, estrangement from parents and siblings, or being embroiled in intense years-long family disputes without any contact.

“Microtrauma” can also occur, though in fairness, this may be seen in non-bipolar spectrum patients as well. This is often the result of someone with very sensitive feelings dealing with a challenging situation for an extended period of time. While there is no clear “traumatic event,” the combination of exquisite sensitivity and prolonged duress can be unforgettable for years. A difficult high school experience for one person can sometimes be a cause of PTSD for another. Depending on the sensitivity and reactivity of an individual, their intensity can amplify relatively “common,” stressors into the stratosphere.

Obsessiveness

Don Quixote

A lot of people I have worked with through the years go on “crusades.” They get an idea in their head and just cannot let it go. They lose sleep, fixate, obsess, problem-solve, and ruminate. They take action, which can often be highly effective, and yet seemingly excessive to many people around them. It’s basically intensity, or excess energy applied to a target for weeks at a time. This is how symphonies get written and startups get launched. But it’s also a source of relationship, professional, and legal problems. This happens when you just can’t stop or let something go. Don Quixote comes up, with the image of a man on a horse, attacking windmills, which he perceives to be ferocious enemies. Overly determined, sometimes rooted in reality, but clearly gone too far. Friends may have commented, “you’re just too much sometimes.”

Paradoxical Anxiety

Paradoxical Anxiety

People with bipolar disorder are paradoxes, partly because of intensity applied in so many directions, they may *sometimes look like they have every possible psychiatric diagnosis. Most significant is the paradox of anxiety and risk-taking. “Normal” anxious people tend to be risk-averse, calculated, and even overly thoughtful. Bipolar(ish) people have what looks like a weird combination of anxiety along with impulsive, risky, or adrenaline-seeking behavior. They are nervous, yet they speed. They are careful, yet they might go sky diving. They are hyper-calculated and yet they are novelty-seeking. This ultimate paradox, of thoughtfulness along with maverick behavior, allows them to have brilliant and novel insights, along with the obsessiveness to execute and deliver.

Out of character behavior is often a hallmark. It’s the feeling of surprise when you learn that conservative “Tim, from accounting,” has been sleeping with escorts in his time off. Or when the most cautious, calculated CEO is found stealing money from the company. Certainly, these behaviors can be sociopathy or criminal to varying degrees, but in the context of all of the above (and below), it might be something else more biological.

Drugs

drugs

Whether prescribed or recreational, most people with bipolar disorder tend to learn over time, “one pill makes you larger, and one pill makes you small.” Varying episodes of drug use, with “uppers” as well as “downers,” at times can make people look like they have been abusing just about everything. Alcohol is just too readily available and many patients use alcohol to slow down and get some sleep when they are going too fast. Cannabis use is seen extensively, with patients smoking several times per hour, to slow down the thoughts and reduce the irritability, so they can interface with the rest of the world. Unfortunately, most forms of self-medication are just too short-lived to be effective. Opiates and pain medications are abused as well to “slow down.” Sleeping pills help with sleep. Stimulants help with getting out of bed during a state of depression and are also used to focus the scattered thoughts during a manic period. I’m always watchful of someone who looks “okay,” but needs a bunch of caffeine to get through the day and a handful of sleeping pills to sleep. These things help, but all too briefly.

They offer quick fixes that last an hour, or at best a night, but do nothing to fix the underlying problem. It’s like putting a Band-Aid on a broken leg or makeup on a bruise. Things might look cosmetically better, but the underlying issue persists. It’s also a terrible idea to self-medicate without external supervision and guidance. Just as dangerous as a surgeon operating on his or herself.

Sleep

Sleep is never right in someone with bipolar disorder. Part of the bipolar trifecta is sleep and insomnia. Sleep is a vital sign in my work as both a psychiatrist and a sleep doctor. Most of medicine has things that they can check and measure – ECGs, cholesterol, blood pressure. In psychiatry, it’s all self-report, and there’s a lot of recency bias. Yes, the way you felt this past week or even today may convince you that this is how the past month has been. Sleep is perhaps the only objective metric in psychiatry and the most essential restorative tool for the brain, affecting everything from mood to memory. If in doubt, look at sleep.

You might wonder if you’ve been more snappy or irritable than usual and not trust the opinions of those around you. How much sleep you are getting is not a matter of opinion. It’s a data point you can watch closely on your own these days, with whichever gadget you chose. Any period of decreased sleep and increased energy or productivity, or inability to sleep when given the chance to, is concerning. More so when it goes on for four days or more.

Patients with bipolar disorder will often report a chronic history of light, thin, or easily disturbed sleep. Trouble falling or staying asleep, waking before the alarm, being easily awoken, and generally being unable to nap when given a chance to. There is also evidence that between mood episodes, or during low moods, they can experience hypersomnia, which is being really sleepy or needing to sleep more than usual. If you remember anything from this article, remember to look at sleep.

Satisfaction

Perhaps why people with bipolar disorder can be so accomplished is because they are never quite happy. The enemy of good is better. Even in between mood states, intensity persists on some level. Patients will report vacillating between over-excitement and boredom, with the accompanying meaninglessness. As the human mind is a meaning-making machine, we will often try to find outside reasons to explain this inner unrest. A consequence of this is having a non-linear life path. Numerous changes in life, career, relationships, and even personal style and preference. Sometimes it feels as if patients have lived three separate lives by the time they are 40.  A drummer in one, a flight instructor in another, and now working as a real estate investor. Successful and “crushing it,” in each role, but quite a surprising assortment of talents.

Hope

hope

Hope begins with understanding and awareness. At a minimum, the awareness of one’s own intensity and how it compares to that of others. Also an awareness of the numerous disguises that intensity can wear, from rage to obsession, to brilliance. I will often advise my patients to “check their own temperature” at any given time, to know how much, how long, and why the adrenaline has been surging through their body. Tracking moods can be useful, but confusing when moods shift rapidly in a day – sometimes these intra-day shifts, or “shiftability,” are worth tracking.

Sleep. Again, as an essential vital sign of mental well-being, any ongoing insomnia or period of insufficient sleep (despite having the opportunity to do so) is important and should not be written off as “normal” or buried with sleeping pills. Exercise, the intense kind, helps too. Thirty to forty minutes, three to five times per week, can help brain health, and improve sleep and mood, by “blowing off steam.” And lastly rhythmicity, in all aspects of life, cannot be understated. Regular bed and wake times, work schedules, medication schedules, and exercise schedules, all help create a stabilizing rhythm which can counteract the underlying waves.

Getting Treatment

If the symptoms are enough to cause difficulty in any aspect of life – personal, professional, legal, etc., do consider seeking help. In this regard, suspecting the diagnosis is more than just anxiety or depression is of paramount importance. Why? Because most medications that are used for depression and anxiety (the SSRI’s, selective serotonin reuptake inhibitors), can actually worsen agitation in bipolar disorder. It’s like pouring gasoline on a fire. But this too should be taken with a grain of salt, as indeed some cases of soft bipolar are indeed anxiety and depression, which will improve on an antidepressant, like an SSRI. If in doubt, it helps to remain vigilant, and make sure sleep and anxiety get better, not worse with antidepressant treatment.

Therapy can also be beneficial in managing mood swings and protecting and maintaining relationships at work and at home. Like medication, however, therapy too is more useful when there is an accurate diagnosis, which captures the myriad of diverse symptoms bipolar can present with. Past trauma, losses, and current life stressors can all become significantly amplified during periods of agitation, which would otherwise be at bay. It helps to know when symptoms are biological, or psychological, for ideal therapy work.

The Question of Intensity for People with Bipolar Spectrum Disorder

The aim of this article is not to suggest that everyone has bipolar disorder. But like most things in nature, this may exist on a spectrum, and present to varying degrees in various people. Appropriately, most things in psychiatry are not considered to be a “problem,” until they impact our daily lives and ability to function. This is worth bearing in mind as we test when something is beyond normal and problematic.

Road rage once a year is less concerning than when it happens with every drive to work. It is also worth noting that the above findings are observational, based on patterns of patient experience, and not yet backed by research. There are existing, validated scales that can be used to screen for bipolar disorder.

The Bipolar Spectrum Diagnostic Scale (BSDS) developed by Dr. Nassir Ghaemi and the Mood Disorder Questionnaire are two excellent resources to start putting the symptoms of bipolar together.

One issue with both of these questionnaires is that, while they cover essential symptoms for the diagnosis of bipolar, they may miss the finer symptoms that are far less pathological, but very common and often missed or never connected as a whole. To this end, we are developing a “Rockstar Bipolar Questionnaire,” to shed light on the softer nuances of this condition (reviewed above). We plan to validate the Rockstar questionnaire in our practice and hope to share the questionnaire and outcomes soon.

In looking at the softer signs of bipolar disorder, we can learn a lot about various other psychiatric conditions, and also increase awareness of what is normal, what is “too much,” and what makes some people brilliant Rockstars.

 

Is It Postpartum Depression or the “Baby Blues”?

November 14, 2019. Dr. Dimitriu was published in Psychology Today about Postpartum Depression.

Giving birth is one of the most joyous experiences of a woman’s life. Everybody says so. Family, friends, books, magazine articles. Everything she knows has prepared her for the elation that will accompany the arrival of her baby.

And yet, within days of giving birth, most women find themselves teary, sad, anxious, and fatigued. The “baby blues” affect as many as 80 percent of new mothers and its typically mild symptoms dissipate within a few days or a week with adjustment to new motherhood and with support from a partner, family, and friends.

Click HERE for the full article.

Is It Bipolar Disorder or Borderline Personality Disorder?

10/22/19. Dr. Dimitriu was published in Psychology on the topic of bipolar vs borderline personality disorder.

Diagnosing psychiatric illness isn’t easy. There’s usually no lab test, physical indication, or quantitative measurement that can distinguish one illness from another and often no magic bullet that can ensure effective treatment. Clinicians are dependent on a description of symptoms and patterns over time to make a diagnosis and these often appear similar even when the underlying illness is very different.

One example of this difficulty is in the incidence of borderline personality disorder being misdiagnosed as bipolar disorder. Both are characterized by impulsive behavior, mood swings, and suicidal thinking but have different causes and different treatments. Only an experienced medical professional can make the right diagnosis and determine appropriate treatment, but patients and their families can help by paying attention to their own thoughts and feelings and describing them accurately.

Click HERE for the full article

Is “Ego Fatigue” Sabotaging Your Willpower?

9/24/19. Dr. Dimitriu was published in Psychology on the topic of Sleep and Memory: How They Work Together.

For many people, just getting through the day is a monumental struggle. Those suffering from anxiety, depression, and ADHD must fight to control their impulses simply to function and stay on task through a day of work or school when they’d rather be home in bed or playing video games. Having held it together all day, they then find those impulses even harder to control at the end of the day. Twenty years ago, a series of experiments demonstrated that impulse control is a finite resource that can be depleted – that suppressing impulses and feelings for some length of time can eventually make those impulses and feelings harder to resist. This phenomenon, known as “ego fatigue” or “ego depletion,” is recognized as a problem for those struggling with anxiety, depression, and ADHD as well as for people battling substance abuse and binge eating. The effect is similar to the depletion of physical and cognitive energy at the end of a long, busy day when all you want to do is relax and do nothing. Saying “no” to your urges all day makes it harder to control those urges in the evening when your store of control has been used up.

Click HERE for the full article

how much sleep do teens need?

How Much Sleep Do Teens Need?

When you look at your teenager, try to soften the lens and view him/her as an oversized toddler. We say this because the developmental changes taking place in a teen’s brain and body as the result of puberty are equivalent to the changes that take place as infants transition into toddlerhood. With that perspective, it’s easier to understand why teenagers need more sleep than they did just a year or two younger.

So just how much sleep do teens need? On average, teenagers need between nine- and 10-hours of sleep per night (the average is about 9.25 hours), but that varies from kid to kid. Keep in mind that things such as involvement in sports, academic drive, or teens experiencing a higher-level of stress or anxiety may require even more sleep to feel and perform their best.how much sleep do teens need?

Photo by Giftpundits.com from Pexels

Help Your Teenager Establish Healthy Sleep Patterns

One of the best ways you can support your teenager is to help him/her establish healthy sleep patterns. A synchronized circadian rhythm has a myriad of health benefits, including getting better sleep, being more alert and attentive in school, supporting healthy metabolism, and minimizing depression, moodiness, or irritability.

Here are some of the things you can do:

Understand their internal sleep rhythm

If you have a teen who is early-to-bed and early-to-rise by nature, lucky you! Most teens experience a shift in their circadian rhythm when they hit puberty, and won’t be sleepy until about two hours later than their previously scheduled bedtime. This is good to note if you have younger children because syncing their sleep times to 7:30 or 8:30pm means they’ll be ready for bed by 9:30 or 10:30 pm when they enter their teens.

Since most junior high and high schools start between 7:30 and 8:30 in the morning, this natural shifting of a teen’s circadian rhythm leaves most teens sleep deprived – they simply aren’t able to get the adequate amount of sleep they need each night.

This explains why so many teens can sleep for up to 12 hours or more on the weekends; they’re not lazy – they’re simply making up for all that lost sleep during the week.

Create a teen-relevant “bedtime routine”

The bedtime routine you created to help your baby, then toddler, then child calm down, relax, and fall asleep probably faded or ceased entirely when your son or daughter hit about 9-, 10- or 11-years old.

Now, it’s time to re-establish some sort of routine to help him/her get into bed early enough to get at least 8 hours – optimally 9 hours – of sleep each night.

Examples include:

  • Ceasing all screen activity at least 30-minutes before lights out (more on this below)
  • Creating a more relaxed and sleep-friendly atmosphere in the home for the 30-minutes or so before bedtime
  • Drinking herbal tea or warm milk or some other non-caffeinated, soothing beverage that signals “wind downtime”
  • Installing dimmer switches in main living areas and bedrooms so lights can be dimmed before bed
  • Taking a shower or bath
  • Playing relaxing music (if they’re up for it – some teens balk at his one)
  • Giving them a foot, back, or shoulder rub on the couch

The first week or two is the most important because once the routine is established, it creates an automatic response in the body; the brain and body establish that Steps 1, 2, 3…etc., mean it’s time to go to sleep, making it easier for your child to relax and drift easier into sleep.

Establish set bedtime & wake time

Rule #1 of any “how to get healthy sleep” guidelines is to establish set sleeping and waking times. Again, this is trickier for teens on the weekend. However, if you’ve stuck with it and created a system for weekdays, your teen will more naturally adhere to the same patterns on weekend nights at home.

Turn off screens at least 30 minutes before bedtime

It’s scientifically proven that the blue light emitted from TV, computer, gadget, and phone screens disrupt the brain’s natural melatonin cycles. That makes it notably harder to fall asleep – and stay asleep.

Everyone in the family should turn screens off at least 30 minutes before bedtime, and then dim the lights to mimic the setting of the sun. These two simple steps allow your brain to create the biochemistry required to facilitate sound sleep.

Read this article (as a family!) from Harvard Health about the dark side of blue light.

Don’t allow phones, gadgets, or computers in the bedroom

There are multiple reasons that go far beyond healthy sleep for why phones and other computer-like gadgets have no place in teenagers’ bedrooms – especially during sleep times.

Want some proof? Check out, Teenagers’ Sleep Quality & Mental Health at Risk Over Late-Night Mobile Phone Use.

Good ol’ fashioned alarm clocks (with red light digital displays) work just fine. You can be the best model of this by creating a set “charging station” in a common area where everyone docs their phones/tablets at night. This prevents your teen from countless social media alerts and the temptation of the phone during sleep time.

Do you or someone in your family suffer from insomnia or anxiety? Contact the compassionate team at Menlo Park Psychiatry & Sleep Medicine at 650-326-5888. We’re dedicated to treating any issue as part of a whole, and for finding the most natural and healthy, long-term solution(s).

Sleep and Memory: How They Work Together

Dr. Dimitriu was published in Psychology Today on the topic of Sleep and Memory: How They Work Together.

Medieval philosopher Thomas Aquinas once wrote that “sorrow can be alleviated by good sleep.” Now, scientists are learning he was not far from the truth. 

A study published in July 2019 in the journal Current Biology indicates a poor night’s sleep—specifically, restless rapid-eye-movement (REM) sleep—negatively impacts brain function, including the work of amygdalae. These are almond-sized clusters of nuclei located deep within the brain’s temporal lobes and responsible for the consolidation of memories for long-term learning, as well as the processing and storage of memories associated with events that elicit strong emotions like sorrow, embarrassment, fear, and anxiety.  Upon awakening, study volunteers who experienced disrupted REM sleep remained reactive to emotional events from the previous day while well-rested individuals labeled prior-day events as being of lesser emotional significance than they originally thought, according to the researchers.

Click HERE for the full article.

Night and Day: The Essential Role of Sleep Medicine

Dr. Dimitriu was published in Psychology Today on the topic of The Essential Role of Sleep Medicine.

Sleep is truly the other half of our waking lives, as well as an essential half of modern psychiatry. During sleep, our brains recharge the neurotransmitters that are so important to our mood and thinking—dopamine, norepinephrine, and serotonin, to name a few. Training in both psychiatry and sleep medicine has allowed me a unique perspective on these two highly related fields of medicine, which, unfortunately, tend to be practiced in isolation of each other. Through this unique perspective, I have seen some truly remarkable breakthroughs in difficult, treatment-resistant cases. A careful analysis and understanding of sleep and sleep architecture has made this possible. “If there is no gas in the tank, you can’t push the gas pedal,” is something I often say to my clients, because indeed, if you are not well-rested and recharged, not much will work.

Click HERE for the full article.

 

 

Shocking Sleep Statistics

Sleep is truly the other half of our waking lives as well as an essential half of modern psychiatry.

During sleep, our brains re-charge the neurotransmitters that are so important to our mood and thinking – dopamine, norepinephrine, and serotonin to name a few. “If there is no gas in the tank, you can’t push the gas pedal,” is something I often say to my clients, because indeed, if you are not well-rested, recharged, not much will work.

This article points to the alarming sleep epidemic that we have seen over the past several years, where indeed, most of us, may not be getting enough sleep. The good news is that it is indeed an alarming article. A 2015 study of preindustrial societies, living without light, heat, wifi, and Netflix, show that sleeping 5.7 to 7.1 hours per night may actually be quite “normal,” and natural. The long lines at Starbucks, and marked increase in stimulant prescriptions, do point out, we could all sleep a little more.

If you tell people they can sleep 7 hours, they tend to sleep 6. So be alarmed.

Sleep Statistics Infographics

When Sleep Won’t Come…Do You Need Help?

By Dr. Alex Dimitriu, July 11, 2019

We all have occasional trouble sleeping. Anxiety, jet lag, something we ate, or any number of other things can have us tossing and turning restlessly now and then. Most of the time, these episodes of sleeplessness are of brief duration and with resolution of the root cause we once again sleep for seven to nine hours a night. But for millions of Americans, a night of restorative sleep is elusive and with prolonged difficulty sleeping they suffer both immediate impairment to daytime functioning and long-term risks to health and cognitive function. Read more

smiling depression

Smiling Depression: Masking the Pain

Smiling depression isn’t an oxymoron. It’s a serious atypical manifestation of depression in which the sufferer masks typical depressive symptoms like sadness and lethargy with the outward appearance of a happy, successful, productive life. While approximately 10 percent of the U.S. population suffers from depression, not all sufferers experience it in the same way. Typically, depression is associated with a deep sense of sadness, despair, and lethargy, a figurative and sometimes literal inability to get out of bed that depletes energy and impacts all aspects of life. In contrast, someone living with smiling depression feels the same sadness inside but is able to function normally and present a facade of contentment and happiness to the outside world. Read more

Overcoming Insomnia Without Drugs

By Dr. Alex Dimitriu, March 12, 2019

Sleep isn’t optional. It is one of our most basic physiological needs, right up there with air, water, food, and shelter. It isn’t heroic to go without sleep and it isn’t true that many people need only four or five hours a night. Most of us need seven to nine hours. Critical functions needed to maintain life and health occur while we sleep and insufficient sleep doesn’t just cause daytime fatigue, irritability, and sleepiness but is associated with a broad range of health risks including heart disease, obesity, diabetes, and a weakened immune system. Sleep is a natural function and critical to our health yet millions of people struggle to get to sleep, stay asleep, and get sufficient restful, restorative sleep. Read more

Sleep Restriction Therapy

Sleep Restriction Therapy for Insomnia: Can Spending Less Time in Bed Help You Sleep More?

By Dr. Alex Dimitriu, March 12, 2019

Insomniacs know all about good sleep hygiene. They’ve lowered the temperature in the bedroom, hung room-darkening shades, eliminated nicotine, caffeine, and liquids before bedtime, taken warm baths, and banished electronic devices from the bedroom. Many have tried prescription sleeping pills but were groggy the next day. Natural relaxation and sleep remedies may have been calming and soothing but otherwise unhelpful as regular nights of restful, restorative sleep have remained elusive. Trouble falling asleep or long periods of wakefulness during the night or too-early awakening or combinations of all three persist for millions of people. These sufferers from chronic insomnia may be candidates for a seemingly contradictory therapy known as “sleep restriction.”  Read more