I'm falling apart when tired
June 13, 2012 7:33 AM   Subscribe

When I get very tired my normally well under control anxiety goes through the roof. Can you help me understand what is going on and what I can do about it?

I have been aware for a long time that tiredness (I'm not talking half an hour past bedtime - I mean really tired, four hours sleep in a night type thing) is a strong trigger for my anxiety. So, as you'd expect, I try to avoid getting absurdly tired. Life is complicated though and sometimes enough sleep isn't possible. I'd like to be able to deal with that without little hiccups like the panic attack I had on a train yesterday. It's way, way worse than just being tired and cranky.

I feel that it is a chemical issue, as once I get a night or two of good sleep the anxiety responds to my normal management. (No drugs anymore, a lot of self-talk though and a lot of therapy in the past.)

Does anyone know what may be occurring in my brain? What other ways can I cope when it happens?
posted by anonymous to Health & Fitness (10 answers total) 13 users marked this as a favorite
I expect others will have more substantial suggestions but what about coffee? I don't get anxiety when I'm tired but I do wind up being really emotional and crying at everything, and caffeine can take the edge off that.
posted by mlle valentine at 7:47 AM on June 13, 2012

I think that we all perform at our best when we are well rested. It's just part of the natural rhythm of life. So when we don't sleep, or eat for that matter, we are not working at peak performance, and our issues, like anxiety (or temper, etc.) can creep in.

The fact that you can expect it in advance, and just tell yourself "oh this is anxiety because I am tired" can really help you deal with it when it happens. I would even go so far as to take a few minutes in a morning after you don't sleep, where you sit and meditate for a few minutes about how later in the day you will get anxious, and envision yourself being able to ignore the anxiety since you know it isn't real, rather lack of sleep induced.
posted by joshfeingold at 7:47 AM on June 13, 2012

Here's a coping mechanism -- take B vitamins (especially B1 and B12). They sell liquid B12. They help with many things, including emotional stability and energy. That's why some of the "energy shots" contain a lot of B vitamins -- but by taking the vitamin by itself, you're avoiding all the other crap they put in there.
posted by DoubleLune at 7:47 AM on June 13, 2012 [1 favorite]

Two things:

Sleep deprivation increases secretion of cortisol, a stress-related hormone. It may also alter the functioning of your sympathetic nervous system - the system responsible for breathing, heartbeat, and sweating - in other words, the system that turns a panic attack from a mental experience into a physical one. So there could very well be physical changes that make you more anxious, or heighten the impact of anxious thoughts.

Additionally, the techniques you use to keep your anxiety in check are learned techniques that require cognitive effort. On some level, your brain is working all the time to remember to keep calm. Sleep deprivation hinders those 'higher' cognitive functions.

Unfortunately, sleep is probably the only way to address these issues.
posted by Ausamor at 7:50 AM on June 13, 2012 [3 favorites]

Poor sleep exacerbates many issues. There's been numerous studies in people that show fatigue leads to difficulty concentrating, making decisions, operating machinery, etc and that's without the added fun of anxiety. This is a common issue.

Because this is such a clear trigger for you, I think you need to "tough love" yourself into adhering to strict sleep hygiene. You need to buckle down and commit yourself to this at least on a trial basis. There are tons of resources out there on creating a sleep plan for yourself (you've probably seen them). Really set a plan and stick with it, for at least a few weeks. This might be something you just have to do and be aware of, same as a person with a peanut allergy would avoid peanuts.
posted by Katine at 7:51 AM on June 13, 2012

When you're tired you have less resistance against whatever sort of psychological weirdness you happen to suffer from.

For people who are prone to depression, exhaustion can set it off. For people who are prone to mania, exhaustion can (counterintuitively) set that off. It's a standard piece of Alcoholics Anonymous lore that recovering alcoholics are more likely to slip back into drinking if they're tired. People who wouldn't cheat on their spouse at two in the afternoon just might at two in the morning. And so on, and so on.

(It occurs to me that A.A. lore might also be a decent place to look for coping strategies, if you can stomach the clich├ęs and the occasional preachiness.)
posted by nebulawindphone at 7:51 AM on June 13, 2012 [1 favorite]

Sleep deprivation is used as an actual torture device, because it's fucking horrible. Can you grab a 30 minute nap or two during the day? I have the same issues and caffeine only makes it worse, but sneaky naps in the server closet are making me slightly more sane.
posted by elizardbits at 8:08 AM on June 13, 2012 [1 favorite]

Vitamins! Mutlivitamin, b12, fishoil.
posted by k8t at 8:55 AM on June 13, 2012

Depending on what it is you tend to be anxious about (like if it's a certain thing you have to do at work or you have to talk to somebody or clean the cat litter before you go to bed or something), it's worth trying as best as you can to get those things out of the way as soon as possible, so that you can give yourself time to just be tired and not worry about everything that you have to do but that's going to be awful because you're tired. Obviously, that method isn't effective for the anxieties that aren't tied to things that can be resolved short-term. It's also the hardest thing to implement when you're tired and anxious, but I've had moderate success with it by writing a note to myself that says something like "hey, Awake You is smarter than Tired You so when Awake You says that you'll feel a shit-ton better if you get all of those little annoyances out of the way in spite of the fact that you feel too tired and flustered to even know how to start, then you should listen to Awake You." I find that forgetting how well a method has worked before to improve my mood is a big factor in my failing to implement it the next time I feel awful.
posted by invitapriore at 12:16 PM on June 13, 2012 [1 favorite]

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