by Deanna Kreisel (Doctor Waffle Blog)
I am no stranger to waking up in the middle of the night with a nameless feeling of dread. Like everyone else I know, I developed chronic insomnia around age 40, which was exacerbated by the “election” of Trump and the ongoing pillage of American democracy. And then perimenopause wreaked its havoc in the form of hormonal swings, night sweats, and troubled dreams. But this was different. This night—just over a month ago—I woke bolt upright out of a dead sleep, gasping for air, disoriented and terrified. I leapt out of bed and staggered to the bathroom, so dizzy I was bumping into walls. I found the toilet, closed the lid (an ongoing bone of contention in our household), and sank down with my head between my knees. I was dying. I knew, absolutely and with pure and stainless conviction, that I was dying. Dizziness washed over me, an intense feeling of disorientation, and I knew that it was my spirit separating from my body. I was swept with waves of grief. I haven’t written everything I want to write. My partner is in the next room and I don’t want to say goodbye yet. My family, my friends. Work to do, parties to throw. This toilet—it really needs to be cleaned. This is not dignified. I promise, Powers That Be, that from this moment forward I will no longer be cavalier about my life, if you just spare me now.
Suddenly a scrap of memory. A conviction that one is dying—that sounds familiar. I think … that can happen in panic attacks? Maybe I’m having a panic attack? But—how can this be? I have had panic disorder and intermittent generalized anxiety since I was 16, and have had hundreds of panic attacks in my life—never before did I become convinced that I was dying. For me the worst part of panic is the feeling of derealization, as if the world around me is fake and I am in a dream. (It’s very difficult to explain why this feeling is so horrifying to those who have never experienced it—you just have to trust me.) But that night in the bathroom I suddenly remembered that the sensation of dying is on the long list of panic attack symptoms, one I had always skipped over when reading about my disorder since it didn’t apply to me. And yet here we were.
Okay, okay. I might as well try the usual techniques I’ve perfected over the years. Deep breathing. Walking in circles while shaking my hands and feet. Splashing cold water on my face. Above all—not fighting it. Letting the feelings pass through me and trusting that I would come out the other side. It worked; I was released from the iron grip of terror; my soul returned to my body; I lived.
I did not sleep again that night.
Even as a child I was a troubled sleeper. For many years I would periodically wake before morning and lie in my bed, unable to move a muscle, while a presence of pure evil filled my room. I realize how melodramatic that sounds, and it is hard to explain how I knew that the shadowy shape in the corner of the room was the embodiment of evil, but I just did. It was akin to the purity of emotion one sometimes feels in dreams—absolute rage, absolute despair. I used to have a recurring dream that my mother had finally done something to me so inarguably heinous (murdered a pet, slept with my boyfriend) that no one could fail to see how awful she was. Finally I had my proof before the world. Then rage would fill my body, the room, the house, and it had no alloy; in waking life anger is always tempered by guilt, empathy, doubt, but in the dream it was limpid and perfect. Or other times I would dream that she had died, and my grief was also absolute; I would open my mouth and a keening wail would come out, over and over and over. (I did not feel much sadness when she actually died.) The evil presence in my room was the same: it had no admixture of anger or selfishness. It was pure malevolence, and I couldn’t move. From that point the waking dream would take different directions: sometimes the evil presence would approach my bed and perform strange surgeries on me, cutting my head open and rooting around in my skull while I lay paralyzed. Other times I would escape it by floating up out of my body and drifting out of the room, down the stairs, and into the living room where I would find my parents watching TV. Usually they were skeletons sitting in their chairs, and sometimes for an extra dollop of horror they would turn their skulls and look at me with their eyeless sockets as I hovered in the doorway.
Many years later I discovered that this phenomenon is called “sleep paralysis” and it has a fairly straightforward physiological explanation. We naturally enter a state of muscle paralysis during REM sleep, which keeps us from injuring ourselves while dreaming; sleep paralysis occurs when one awakens before the paralysis has worn off. For most people the episode of half-waking paralysis is accompanied by hallucinations, and in the vast majority of cases they are deeply horrifying. Researchers have proposed that sleep paralysis may be behind ancient myths about incubi, witches, and even alien abduction. Imagine how my sense of specialness was undermined when I learned on the Sleep Foundation website that my bizarre sleep experiences were shared by others, right down to the content of my visions: “Intruder hallucinations … involve the perception of a dangerous person or presence in the room.” Even the floating sensation is common, and has a likely physiological cause. (I suppose I could still take pride in the ghastly creativity of the “brain surgery” and “your parents are skeletons” embellishments, which I have not heard of elsewhere.) Learning about the cause of my sleep paralysis has made it go away. Now if awake and cannot move, I calmly remind myself what is happening and that it will last only a few minutes, and I concentrate on moving successively larger muscles—first my tongue and then my fingers and toes—until it passes. The evil surgeon has retreated. I no longer fly. My parents have not returned from the grave.
But sometimes I fancy I’m simply doomed to sleep badly, that each time I confront and conquer a new cause of nighttime terror, another springs up to take its place. Colic as a baby, sleep paralysis as a child, insomnia as an adult…. (In a cruel twist of irony the universe has married me to a sleepwalker; many nights I have jerked awake next to an empty tangle of sheets, heart pounding, and leapt out of bed to hunt for the somnambulist.) And now this new thing.
It seems that my new nighttime terrors are a nasty little gift that Covid left behind, like a half-dead mouse dropped on the stoop by your cat. No one fully understands how it all works, but it seems that the virus can deplete your serotonin levels and mess with your vagus nerve regulation, locking you into a protracted “fight or flight” state that can awaken you in the middle of the night with your heart pounding in terror. In my case (and, anecdotally, for several friends I’ve spoken to as well), Covid has also left me more irritable, jangly, on edge, and unable to handle stressors that I would have taken in stride a couple of months ago.[1] A memorable recent evening found me awake in the middle of the night, on my knees by the side of the bed, pounding the side of the mattress in rage as I revisited an email I had received earlier in the day. Granted, the email was bad—and would also have upset me in my “normal” state—but even at the time I recognized the nocturnal fist-pounding as completely over the top. For the first time in my life I finally understand what all those nineteenth-century novelists were getting at when they wrote about a character’s “nerves.” The examples are too numerous to list—Clarissa Dalloway leaps immediately to mind—but here is a choice example from Charlotte Brontë’s Villette, a novel in which the word “nerves” appears 21 times: “At last a day and night of peculiarly agonizing depression were succeeded by physical illness, I took perforce to my bed…. I lay in a strange fever of the nerves and blood. Sleep went quite away…. A rattle of the window, a cry of the blast only replied—Sleep never came!”
“Nerves” or “nervousness,” in the nineteenth century, were all-purpose terms corresponding both to our sense of “disposition” or “personality”—a general predilection toward anxiety or moodiness—and a temporary state of heightened irritability. Victorian and early 20th century authors often ascribed the latter to viral illness.[2] In Wuthering Heights we learn that “Catherine had seasons of gloom and silence now and then: they were respected with sympathising silence by her husband, who ascribed them to an alteration in her constitution, produced by her perilous illness.” For some reason, this understanding that viruses can affect temperament for weeks or months after recovery[3] seems to have been lost to popular consciousness; only very recently has the idea resurfaced here and there, in the context of discussions of long Covid. As we are all aware, we 21st-century Americans are fixated on the idea that we are in control of our mental and physical health. Even anxiety and insomnia are conditions to be “managed” with breathing apps, herbal and prescription medications, exercise regimes, tinctures and teas. The idea that a virus could alter your personality—and that that alteration is beyond your power to fix or control—is unbearable.
While the irritability part feels unfair, it seems fitting that the particular form my Covid sequelae would take is interrupted sleep. Perhaps there are simply people not meant for restful slumber. I can’t run a marathon, understand quantum physics, or manage to clean the toilet regularly—these are not mysteries. (Okay, the toilet thing really is a mystery. That said, housecleaning is always at the bottom of my To Do list, a place permanently obscured by heavy mists.) So perhaps I am simply not a “sleeper.” Maybe being skilled at sleep is a gift of good genetics, a nurturing family of origin, a trauma-free history, an easy mind.
And, of course, safety. In order to relax into sleep, you need to accept being utterly vulnerable—which means you have to believe that you’re safe. In the fascinating polemic 24/7: Late Capitalism and the Ends of Sleep, the art critic Jonathan Crary discusses the paradoxes of the social contract as imagined by Hobbes and other Enlightenment writers; for Crary, the fantasized originary moment of mutual aid was occasioned by the need for nightly sleep. Because we are vulnerable when asleep, we needed to devise social systems to protect us not only from actual nighttime dangers, but also from anxieties about those dangers. If you’ve ever tried to fall asleep while worrying, you understand the crucial role of anxiolysis in enabling restful slumber. Of course one of the cruelest ironies of insomnia is that often the anxiety keeping you from drifting off is your worry that you won’t get enough sleep. “If I fall sleep RIGHT NOW I can still get four hours…. RIGHT NOW—there’s still three and a half hours before my alarm. Okay, do it—now, right NOW—fall asleep! Do it!” This always works.[4]
But for some people the anxiety is less coyly recursive; it’s not just “all in their minds.” In order to relax into sleep you need to believe, to feel, that you won’t be rousted from your cot by soldiers, that your house is a safe shelter against storms and bombs, that a tiger won’t snatch you as you dream, that there is no dybbuk in the room. As Megan Garber notes in a recent review of Marie Darrieussecg’s Sleepless: A Memoir of Insomnia, the author rightly acknowledges “the totalizing exhaustion that comes from having no bed, no home, no protection, no peace…. [I]n the contrast between her own plush insomnia and the wakefulness of others, Darrieussecq suggests a sharper, and timelier, metaphor. Rest and its deprivation, here, become proxies for inequality.” The alienable rights to freedom, liberty, and the pursuit of happiness might be tidily summed up as the right to fall asleep unmolested.
As I lie in my warm bed that my beloved partner built with his own hands, afloat on a thick mattress topper and swaddled in softest cotton flannel, with two purring cats curled around my legs, a sturdy house all around me, a world to wake up in full of meaningful well-paid work and plentiful nourishing food and loving friends and family, I wonder why I can’t drift off. What terrors are there? What watchful evil requires such vigilance? Why can’t I trust the universe to care for me, when it has heaped such gifts around my feet my entire life? What is my problem? The only answer I can come up with is my poor addled brain, riven by grooves of ancient trauma burned deep in its folds, too deep to be erased by therapy or meditation or drugs—and now etched a little bit deeper by a motherfucker of a virus that finally caught up with me. I guess if this is my only cross to bear I will take it. It’s not really all that bad. It’s just my nerves.
[1] This feeling is often accompanied by strange new neurological symptoms I’ve never experienced before, including a feeling that my hands are shaking violently on the inside, even though they are not moving at all. (I told you they were strange. Oh look, I just Googled it and of course it’s a thing.)
[2] Or rather, illnesses that we now understand are caused by viruses. The Victorians tended to think they were caused by “miasma” or getting caught in the rain out on the moors.
[3] Apparently even “normal” viruses like the flu wreak havoc on your serotonin system.
[4] My partner, also a terrible insomniac, once had a dream in which George Carlin cracked to him, “Sleep—it’s the only thing you can get worse at with practice.”