A Nervous Breakdown

In the weeks after a dream I had (described in "An Encounter?") which seems to parallel what many people have described as an "alien abduction" experience, I kept trying to recall the events of a specific night, a night on which I'd had a date with a young woman my sister Amy had introduced me to in that spring prior to her moving to Wynn and then to Jonesboro. I kept being unable to recall details about that night, yet felt it a crisis that I do so.

I kept trying to pin "it" down. I'd focus on one article or another, would "try it on" and see if that was the thing that was causing this. But nothing really quite fit, and I could never quite get relief. I'd try to make myself believe it was some word or phrase in the articles. I'd try to pin it down; but each time I did the feeling would disappear like a chimera.

I've described the stress I experienced in trying to recall that incident, trying to recall and understand this unintelligible something. It became too much for me--on top of trying to land and keep a job, and figure out some way to continue with school. I simply reached a point where I wasn't sleeping at all.

I couldn't understand why, and came to be bewildered as much by my lack of self-understanding as anything else. What was I trying to recall? What was I trying to understand ? What was that unintelligible something that I couldn't quite recall? I tried, obsessed, didn't sleep, and finally broke down. I went to a psychologist, who got an M. D. to prescribe me a medication. But I

was too far along. I still didn't sleep; my obsessing was too strong.

As I also noted earlier (in "An 'Encounter?'") I could no longer bear to be in my room, that I'd normally gone to as a source of security. I could no longer bear to be in that house that I'd always run to as a source of refuge. My favorite place had become a hell, though all my patterns were built around it. I could no longer bear to be in it and, whenever I was, began to obsess again, to try to remember and understand that "something," that unintelligible, un-remember-able something.

I had to get out, asked to be admitted to the State Hospital and Dad obliged. I underwent three months of therapy, went to school, and after that Little Rock became home.

As much as I'd loved our house in Batesville--as much as I used to run to it, to see it as a virtual haven for my writing--I came to not even consciously miss it, even when my parents sold it in 1975. When my mother had told me they were selling it, in January 1975, I was still heavily-medicated. But I'd wanted to feel more genuine remorse, more desire to hang onto it. It didn't feel normal not to miss it: it was home. I had always hoped my parents would keep that house forever, but no more. I felt relieved at the thought that I'd never again have to set foot in it. And I was quite bewildered with myself for feeling that way.

Even more bizarre--and something I've never admitted to my parents for fear of hurting their feelings--I kept feeling a need to get even further away from the house in Batesville, and, shamefully, a few months after finishing business and accounting school at Draughon's College of Business in Little Rock, (where I received a certificate in Sales or what today would be called Marketing, which, in truth, I'd been interested in doing some months before my "dream" and breakdown), in 1976 I moved to Houston, Texas.

The "reason" I resolved to give to myself, was that I needed even more of a "change of scene" than Little Rock--one which would allow me to recover even more quickly, effectively and painlessly--hopefully--from my breakdown. I chose to block out those thoughts and feelings I was having, which were motivating me to get as far away from that house as possible. However, I remained saddened by my inability to recover from my anxiety about the house. I longed to believe that I could someday return to it peacefully, to the extent that it became a major goal that I worked on in therapy groups. (In which, it should be noted, the idea of any "encounter" never even came up or ever even entered anyone's mind.) That goal was also Tim's goal, to an extent, as we both watched our parents' home be abandoned in 1975. He, like me, was saddened that he could never "go home again."

I also resolved to believe that my "interest in politics" had been a factor in my breakdown. So at the time, in 1976, I'd let myself get only mildly interested in the Presidential election, therefore not voting in '76.

My hospitalization experience in 1973 at Arkansas State Hospital, where I'd signed myself during October of that year, had been, as such hospitalizations usually were in those day, a traumatic experience in itself. But the hospital system in the state of Arkansas in those days was one of the better ones in the nation. Certainly there were individual staff personnel who were abusive, at least on the verbal level, with the patients, and there had been a series of scandals only a few years before my hospitalization, which probably explains the relatively benign nature of the staff during my stay there. And certainly there were other incidents in the maintenance of the State Hospital system around the state--especially those aspects relating to the care of the "criminally insane"--that were of poor quality. But, on balance, thanks in part, perhaps to some remarkably mental health-oriented administrations in Arkansas, the State Hospital system had been

beneficial to me.

Because I hadn't been one of the persons admitted for drug abuse, I can't evaluate that aspect of the Rehabilitation programs. But some persons I knew back then who were in those programs seem to have gone on to lead more productive lives, as they say. So

perhaps that gives some indication that the system worked pretty well.

My doctors were impressed with my progress. I'd described nature of my symptoms to them. They included obsession with the opinions of "someone" I couldn't quite put my finger on; inability to remember details about something that I wasn't even sure I wanted to remember; and obsession with certain terms that seemed to indicate something traumatic but that were confusing to verbalize. Because of my descriptions, my doctors had initially diagnosed me as having a paranoid schizophrenic "episode."

Later, they would say that the consistent nature of my "progress" indicated that I wouldn't have a relapse, as, indeed, I have not. This, in turn, suggested that I hadn't had the typical biochemically induced "schizophrenic episode." In fact, in Houston, the social worker I consulted periodically referred me to a psychiatrist for "possible re-diagnosis" based on my consistent ability to avoid further hospitalization and to function without medication. On two visits to two different psychiatrists for such a re-diagnosis, a distinct impression was formed that I might be better diagnosed as having a form of "depressive or mood swing disorder," since I was no longer having any "delusions" or "paranoid" thoughts. They also indicated that my symptoms were mild to non-existent at that point.

The nature of that "dream" and the events immediately preceding and following it,

may be the key to an understanding of my "acute" episode. In "Insectivorous?" I try to write about a possible explanation for such dreams that doesn't involve the mandatory "alien abduction," but rather another event similarly previously not offered as a "conventional" explanation, although perhaps not quite as "spooky." Like Whitley Strieber in his book Communion, I have felt a need to draw on alternative possible explanations for the "experience." After all, faced with no other choice than to believe the "alien hypothesis" gives one a "boxed in" feeling that, for me--and, based on what Strieber has written, him, too--is distinctly unpleasant. I feel no desire to have someone "believe" I was abducted by aliens. I'd just as soon have some other explanation that worked.

At this point, it might be useful to summarize the medical explanations offered for some of the phenomena we've looked at, including Sue's sleep disorders and my own "encounter" experience. A common explanation offered for the encounter experience is that of sleep paralysis. This disorder is included in a group of sleep disorders. Rita Brooks, writing in a manual titled Sleep Disorders for California College for Health Sciences (CCHS), lists several types of parasomnias, the medical term for various types of "undesirable physical phenomena that occur predominantly during sleep." (43). I have taken the liberty of quoting Ms. Brooks, deleting certain highly-technical and medical specialty terms. The sleep disorder parasomnias Ms. Brooks describes include:

Arousal disorders--confusional arousals, and well known phenomena such as sleep walking and sleep terrors.

Sleep wake transition disorders that include sleep talking, as well as 'rhythmic movement disorders' such as headbanging and bodyrocking.

Parasomnias associated with REM (Rapid Eye Movement) sleep include dream anxiety attacks (nightmares), sleep paralysis. . . and REM sleep behavior disorder.

Other disorders ('other parasomnias') can include sleep bruxism (tooth grinding), sleep enuresis (bedwetting), and primary snoring."(Brooks 43-4).

In an interesting summation of these disorders, the manual continues, (in part; I delete or define highly-technical or medically-specialized sections and terms):

Arousal disorders are believed to result from an impaired arousal mechanism in the brain. Most are accompanied by a period of confusion upon awakening, and occur primarily when the person is waking from slow wave sleep during the first third of the night. The three major types are: (1) confusional arousals; (2) sleep walking; (3) sleep terrors . . .

Confusional arousals consist of episodes of confusion which occur following an arousal from deep sleep in the early part of the night. They occur most commonly among young children, and typically disappear during later childhood. Confusional arousals are rare in adults (Brooks 43-4).

During a confusional arousal, says Brooks, although a child's eyes may be open, there is poor or inappropriate response to questions or commands, but no evidence of fear, as with sleep terrors or sleep walking behavior. And, she says, there is no evidence of acting out a dream (as in REM behavior disorder). There is usually no memory of the event, either, paralleling Sue's "Marooned" dream. Some aspects fit, though some don't.

Sleep walking. . .episodes can range from simply sitting up in bed to walking or even running behavior. Sleepwalking is most common in children between the ages of 4 and 8, and usually disappears by adolescence. Fever, sleep deprivation, obstructive sleep apnea syndrome, or external stimuli, such as noise, may cause, or increase, frequency of sleepwalking episodes.

Waking the sleepwalker is difficult. Confusion is common on arousal, and may result in violent behavior. Falling down stairs, walking into the street, or running through a glass door in an attempt to escape can result in serious injury to the sleepwalker. The most important response to sleepwalking is to make the environment safe for the sleepwalker. Generally guiding the sleepwalker back to the bed is often all that is necessary to terminate the sleepwalking episode. The patient does not recall the event.

Sleep terrors . . .disorder is characterized by the sudden arousal from slow wave sleep with a piercing scream or cry and the appearance of intense fear. The patient usually sits up in bed, screams loudly, and is unresponsive to arousal attempts. If arousal is attempted, confusion and disorientation are common, and combative behavior may also occur. Tachycardia [rapid heart action] and tachypnea [abnormally rapid breathing], along with sweating and, sometimes, enuresis, may accompany sleep terrors (Brooks 43-4).

Brooks says here that there is rarely any memory of the event. (43-4). Did we see this, therefore, in Amy's "Little Bill" dream? Yet Amy does recall it. Brooks continues:

Sleep terrors occur most commonly in children between the ages of 4 and 12, and usually resolve spontaneously. Sleep terrors also occur in adults, most commonly between the ages of 20 and 30.

Sleep terrors should be differentiated from temporal lobe epilepsy, confusional arousal, and nightmares. Diagnosis is based on episodes of intense fear occurring during first third of the night, with no memory of the event. Severe sleep terrors may occur almost nightly, and may be associated with physical injury to the patient or others.

Sleep wake transition disorders. . . occur during the transition from wakefulness to sleep or from sleep to wakefulness. These disorders commonly occur in otherwise normal individuals, and are not considered pathological unless they occur with significant frequency or severity. Sleep waking transition disorders include sleep talking and rhythmic movement disorders such as headbanging, bodyrocking, and headrolling, which are all common in children.

Sleep talking. . .is defined as talking or making sounds during sleep without significant awareness of the event. It may occur spontaneously or may be triggered by initiating a conversation with the sleeper. Generally, episodes are sporadic and short. Sleep talking may occur during all stages of sleep. However, it occurs most commonly during REM sleep (Brooks 43-4).

Sleep talking, says Brooks, often occurs in conjunction with other sleep disorders, such as REM behavior disorder, sleep walking, or sleep terrors. In patients with obstructive sleep apnea, (an intermittent cessation of effective repiratory gas exchange during sleep), sleep talking may occur during arousals (43-4). We seem to have seen this with Sue.

Rhythmic movement disorder is characterized by repetitive stereotyped movements, usually of the head and neck, which occur immediately prior to sleep and as the person moves in light sleep. Rhythmic movement disorder occurs most commonly in infants and children under age four, usually begins before age one, and resolves spontaneously.

Headbanging is the most common form of this disorder. The child may bang his head into the mattress or pillow, rock on his hands and knees and bang his head into the headboard or wall, or rock sitting up and bang his head against the headboard and wall. Bodyrocking consists of similar movements, without headbanging. Headrolling occurs with the child lying on his back, and consists of rhythmic side to side movements of the head. When they occur in adults, these disorders are usually associated with autism or mental retardation.Polysomnography during a rhythmic movement episode usually shows movement activity occurring during wake or light sleep, says Brooks (43-4). It's interesting that my "head being moved" sensation occurred as I came out of a deep sleep, though. However, she notes that "movements may occur in any stage of sleep." (Brooks 43-4). There would be no evidence of seizure activity in the EEG, says Brooks, for this to be a mere sleep disorder ( 43-4). She continues her list of "parasomnias":

Parasomnias associated with REM sleep:

Nightmares are frightening dreams which usually awaken the sleeper. Nightmares occur most often during the second half of the night, when REM sleep periods are longer. The dream content is usually long and involved, and increasingly frightening. The sleeper commonly awakens from REM sleep and recalls the dream content. Nightmares occur most commonly in children between the ages of 3 and 6. They may occur for only a few weeks or months, or they may persist into adulthood, usually becoming less frequent and less intense with age. Nightmares are not usually associated with sleep walking. Significant stress or traumatic events may increase the severity or frequency of nightmares. Upon awakening from a nightmare, the person may note other aspects of REM physiology. These include feeling cold, due to REM hypothermia . . . (Brooks 43-4).

When polysomnography is hooked up to a patient during a nightmare, says Brooks, it shows "increased REM density, increased heart rate variability, and an increased respiratory rate." (43-4). The nightmare also usually terminates with an abrupt awakening out of REM sleep, says Brooks (43-4), the way Amy woke up from her "Little Bill" dream, which fits the age range; but which is also the way Sue woke up from her "potato sack man" dream, which doesn't.

Sleep paralysis disorder is characterized by inability to move upon awakening or at sleep onset. Eye and respiratory movements are intact, but skeletal muscles are paralyzed briefly. Dreamlike imagery may accompany sleep paralysis, and episodes may be frightening. Episodes can last from one to several minutes, and they may disappear spontaneously, or with stimulation (such as a touch). An isolated episode of sleep paralysis, usually occurring upon awakening, is not uncommon and is considered normal. Sleep paralysis is common in narcoleptics, and usually occurs at sleep onset.

Polysomnography. . . may be useful to determine if episodes occur in association with REM sleep, and to differentiate isolated sleep paralysis episodes from narcolepsy. . .

REM Sleep Behavior Disorder. . .is characterized by an absence of REM sleep. . . resulting in movement activity associated with dreaming. For example, a sleeping patient exhibiting fighting or kicking behavior when awakened, may state he was dreaming of fighting or running. Movements which occur in association with dreaming may include punching, kicking, or jumping up and running from bed. Episodes are frequent, and may result in injury to the sleeper or to others. REM behavior disorder is more common among the elderly, and may occur as a result of neurologic disorders. . .

Polysomnography often shows persistent, increased muscle tone during REM sleep as well as periods of limb and body movements associated with dream content. . .

A diagnosis is based on the presence of limb or body movements in association with dreaming, resulting in harmful or potentially harmful sleep behaviors or sleep disruption. REM sleep behavior disorder is considered severe when episodes occur more than once per week. . . associated with physical injury to the patient or bed partner. . . (Brooks 44-50).

In another section, Brooks cites a group of "proposed sleep disorders." These are disorders which "have not been unequivocally determined to be distinct disorders." They include terrifying hypnagogic hallucinations:

. . .[T]errifying dreams that occur at the onset of sleep. They are indistinguishable from dreams that occur during sleep. They cause awakening with anxiety and the patient reports the occurrence of bad dreams. There is immediate alertness on awakening, and no evidence of confusion and disorientation. Sleep onset nightmares may occur as a result of withdrawal from Rem suppressant medications. They occur as an atypical form of hypnagogic hallucinations in 4-8% of patients with narcolepsy. (Typical narcoleptic hypnagogic hallucinations do not cause awakening with anxiety.)

Polysomnography shows abrupt awakening from. . .REM [sleep]. Mild tachycardia and tachypnea may occur. . .[N]o evidence of seizure activity. Terrifying hypnagogic hallucinations should be differentiated from night terrors and sleep related complex-partial seizures with vivid hallucinations (Brooks 66).

The above information is included to help the reader be better informed on some of the several sleep disorders. If the reader has "related" to some of the experiences described, they should know they may have a possible sleep disorder. They should also know that some sleep disorders (including many not named above) are associated with serious medical conditions. I suggest further reading and a possible consultation with your physician for more in-depth information. The reader should also know, as Brooks notes, that "Hypnagogic hallucinations are vivid, dream-like episodes which occur at sleep onset. (Sleep paralysis is the inability to move during a transition between wake and sleep.) Episodes of sleep paralysis. . . usually short . . . may occur in conjunction with hypnagogic hallucinations. . ." (Brooks 8).

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