Go Home You’re Drunk: What Insomnia + Compassion Fatigue Have in Common

The past couple of months have been, er, challenging.

Short story: My two beloved cats died. In between their deaths I managed to break out in a full body rash that lasted 4 weeks.

Between grief and non-stop scratching I got almost no sleep.

Let me tell you something: heartbreak + hives + insomnia = one hot mess.

Have you met Depression Kitty? Accurate.

Thanks to time, tears, therapy, journaling, and two million anti-histamines, I feel really good now. I’m myself again. 

But more than anything, the single biggest factor in my mental health upswing was being able to sleep again. 

Fun fact: Did you know that insomnia and depression are pretty much interchangeable in terms of how they present?

“Mood and sleep use the same neurotransmitters. It’s very hard to tell if someone has sleep loss or depression.” says Dr. Joyce Walseben, psychiatrist and former director of Bellevue Hospital’s Sleep Disorders Center.

Sleep regulates a bunch of feel good chemicals, like serotonin, that are closely associated with our mood and behavior. When we’re not sleeping enough our brain’s emotional center is 60 percent more reactive than normal. 

You might be thinking, I don’t have insomnia so this is dumb and I want a snack. 

Hold on! The CDC defines adequate sleep as at least 7 hours a night. 

Sleeping less than 7 hours per day is associated with an increased risk of developing chronic conditions such as obesity, diabetes, high blood pressure, heart disease, stroke, and frequent mental distress.

Are you getting 7+ hours of sleep on a regular basis? 

Many of us don’t even come close (if you do, high five!)..

For some people, that’s a point of pride. We brag that we don’t get or need a lot of sleep.

Exhaustion is a status symbol in our culture.

It’s “proof” that we’re busy doing important stuff (and therefore we’re important).

That being said, you probably do have a lot on your plate and not enough support to help you handle the load. 

No wonder sleep isn’t a priority. 

You might be thinking, the CDC is bananas. I really am fine on 5 hours a night. 

Fun fact: We can’t accurately perceive our sleepiness.

Professor Sigrid Veasey of the Center for Sleep and Circadian Neurobiology, has said that lack of sleep skews our self-awareness. In the podcast Hurry Slowly she talked about a research study that looked at how people perceive themselves when they’re only sleeping 4 hours a night.

After the first night, when asked how they felt, they reported they felt terrible and sleepy.

But once the third night rolled around, they started reporting that they were feeling back to normal. 

They said they had “adjusted” and no longer reported feeling sleepy. 

But the objective tests they were taking showed a different story: with every passing day their performance was getting worse and worse. 

You make think you’re doing great on just a few hours a night, but you can’t accurately perceive yourself homie.

Kind of like when you’re drinking. You think you sound normal, but you’re slurring your words while slowing sliding off the bar stool. You’re not fooling anyone.

Go home, you’re drunk.

There’s a strong parallel here with our experience of compassion fatigue. 

It’s hard to perceive ourselves accurately when we’re experiencing CF.

We may acknowledge that the work we do is sad and hard, but overall our self-awareness is pretty low. We think we’re doing fine.

But if we’re experiencing CF there’s a good chance we’re not seeing ourselves accurately, that our outlook on the world is skewed, and that our behavior at work is impacted. 

Here’s what I mean:

Compassion fatigue is a normal, predictable consequence of working in a helping profession. But the symptoms of CF (which can include anger, exhaustion, hyper-vigilance, apathy, lack of empathy, excessive complaining, and rigid thinking) do impair our ability to do our work well. 

We’re so busy taking care of everyone around us that it can be hard to recognize how we’ve changed and how the quality of our work might be slipping.

Just like sleep deprived folks, we think we’ve adjusted well. 

But we’re drunk and we need to go home, before we unintentionally cause harm to ourselves or those we serve.

That’s why compassion fatigue education is so important. It helps us to see ourselves clearly. What we notice we can change. 

So let’s get practical: what’s one thing you can do today to help manage the impact of compassion fatigue?

Get some frigging rest.

Every other thing you need to do to be well, like spending time with friends, upholding your boundaries, resolving a conflict, processing your emotions, or getting some exercise, is so much harder to do when you’re sleep deprived.

Not to mention we need sleep to heal from our work – when we’re asleep our body has the chance to repairs itself and our brain is busy processing memories and trauma. 

So how do you know how much sleep you really need?

Listen to Veasey: “What is the amount of sleep you need not to exist but to thrive? What’s the amount of sleep that you need to feel energized, excited, enthused about your life, your family, your friends? What’s that amount of sleep?”

For me, thriving is 8-9 hours a night. Sleep is the foundation of my well-being. 

Everything, including writing this newsletter (the first one I’ve written in nearly two months) is 10 billion times easier, more enjoyable, and of much better quality when I’m well rested. 

So please, I’m begging you, get some rest. It can help lift your mood and perspective, improve your physical health and relationships, and address compassion fatigue too. 

Sleep can be complicated, so if you need some help, listen to the podcast!