I’ve had some excellent medical care over the years, but when it comes providing help for insomnia, many doctors are out to lunch. They grab hold of a single idea about insomnia—it’s due to poor sleep hygiene, it’s due to stress, or it’s due to psychic damage that needs to be sorted out—and treat insomniacs as if we’re all alike.
I’ve spoken with several other insomniacs who feel the same way. Especially irritating are the doctors convinced that every person with insomnia has a mood disorder.
Jennifer, whom I interviewed a few years ago for my book, had tried several drugs to combat the sleeplessness she’d been plagued nearly all her life, and her doctor finally referred her to a psychiatrist. But the psychiatrist’s attempts to peg her as a depressive contradicted her belief that, apart from her sleep problem, she was basically a happy person.
“He was like, ‘Oh you look depressed today, I think you’re depressed.’ He kept trying to convince me I was depressed.”
“I’m like, ‘I’m not depressed.’ It was really annoying.”
“If I moved my fingers around at all, he was like, ‘Oh, you’re fidgety, you’re fidgety.’”
“I’m like, ‘OK.’ So I learned to keep my fingers still when I was around him.”
“And he’d say, ‘Oh, you’re calm today.’ He was just so eager to think he was doing something right. I stopped seeing him because it got to the point where he was trying to convince me that I was depressed when I was not.”
“I’m not depressed,” Jennifer continued. “Most people think I’m the cheerful one, open, outgoing. I don’t sit at home and cry. I’m not sad about things. I don’t have one single symptom except that I can’t sleep.”
Bill had a similarly negative experience with doctors who he believed had misdiagnosed his sleep complaint as depression:
“The doctors want to suggest that I’m depressed, and I deny it. I say I’m exhausted,” he said when I spoke with him on the phone. “The only time I really admit to something approaching depression is when you guys [the doctors] start trying to pin a DSM cultural label [a mental disorder] on me.”
Not All Insomniacs Are Alike
It’s true that many people with insomnia are also afflicted with mood disorders, but not all of us. The causes of insomnia are many and varied, and while sleep experts now acknowledge this, many other doctors are still in the dark.
Peter Hauri, a pioneer in sleep research who died two months ago, said in an interview in 2010 that one of the most important things he learned from his research was that every sleep problem was unique. “There is no one set of rules that can be mimeographed and given to every patient who comes into the office,” Hauri said.
Amen, I say. But how long will it be before medical schools start turning out doctors who are similarly savvy about insomnia and sleep?