Primary Sleep disorders are divided into two subcategories: Dyssomnias are those disorders relating to the amount, quality, and timing of sleep. Parasomnias relate to abnormal behaviour or physiological events that occur during the process of sleep. The cause of primary insomnia can be different for each individual but often involves a preoccupation with the inability to sleep or excessive worry about sleep, which in turns causes the individual to not sleep.
The criteria for a diagnosis of primary insomnia include a difficulty falling asleep, remaining asleep, or receiving restorative sleep for a period no less than one month. This disturbance in sleep must cause significant distress or impairment in social, occupational, or other important functions and does not appear exclusively during the course of another mental or medical disorder or during the use of alcohol, medication, or other substances. (DSM-IV 1999 – 2003).
‘For all the advantages of modern society, we cannot afford to ignore the rhythms of the animal brain within us, any more than we can neglect our need to breathe or eat. Without the biological clocks in our brains, our lives would be chaotic, our actions disorganised. The brain has internalised the rhythms of nature, but can tick on for months without sight of the sun.’ (Blackmore, 1988). (Richard Gross 2010).
Insomnia and Mental Disorder
Young (2009) cites a 1987 American study of 1053 male medical students who’d been followed for an average of 34 years after graduation, during that time 101 had developed clinical depression, 13 of whom had committed suicide, those that had reported suffering from insomnia were twice as likely to become depressed as those with no sleep problems; one conclusion to this data is that insomnia can predispose people to depression. Impaired sleep can also induce the manic episodes involved in bipolar disorder as well as failure of a sleep-dependant component of procedural learning, associated with schizophrenia. (Stickgold, 2004; Young, 2009). (Richard Gross 2010).
Both Stickgold and Young believe that during REM sleep the visceral component of our memories is stripped away from the more cognitive component. This happens because the neurotransmitters associated with stress, fear and the fight or flight response, serotonin and noradrenaline are shut down. Although dreams can be emotional, they gradually alleviate the emotional edge to our memories thus serving us in many positive psychological and pathological areas. (Richard Gross 2010). Bipolar Disorder (Manic-Depression)
Research has shown a strong biological component for this disorder, with environmental factors playing a role in the exacerbation of symptoms; Bipolar Disorder has been broken down into two types. . (DSM-IV 1999 – 2003). For a diagnosis of Bipolar I disorder, a person must have at least one manic episode. Mania is sometimes referred to as the other extreme to depression. Mania is an intense high where the person feels euphoric, almost indestructible in areas such as personal finances, business dealings, or relationships.
They may have an elevated self-esteem, be more talkative than usual, have flight of ideas, a reduced need for sleep, and be easily distracted. Depression is often experienced as the high quickly fades and as the consequences of their activities becomes apparent, the depressive episode can be exacerbated. For Bipolar II Disorder there are periods of highs as described above and often followed by periods of depression. Bipolar II Disorder however is different in that the highs are hypo manic, rather than manic.
In other words, they have similar symptoms but they are not severe enough to cause marked impairment in social or occupational functioning and typically do not require hospitalization in order to assure the safety of the person. . (DSM-IV 1999 – 2003). There are definitely varying degrees of this illness and it is not difficult to misdiagnose due to it’s similarity to other mood disorders. If the illness is not severe, often time’s medication and therapy can do very well in terms of treatment. And, life experience, strong support, and an openness to improve can be enough sometimes to make a difference in outcome. . (DSM-IV 1999 – 2003)