Thursday, January 15, 2009

The Human Experiment

There are things to do about symptomatic distress in addition to medications and therapy. I often encourage people to make themselves their own human experiments. There are a few things we can change easily: we alter our diets, sleep, exercise, and the assorted "substances" we ingest. I sometimes suggest to people that they do 2 week trials and see if something helps. Is your life better if you stop drinking for a couple of weeks, exercise mor or less, give up food additives, decrease the carbs in your diet, cut out or add caffeine? Pick a variable, change it for a time, and see if you feel better.

That being said, I've been having some trouble sleeping. I decided I'd take my own advice and change some things. Oh, but you know, I'm an impatient sort of soul, and I decided to change a few things all at once. They didn't seem like big things: I decided to cut out all alcohol and caffeine from my diet, to set the alarm for earlier in the morning and get up and exercise in the hopes of exhausting myself. I started on a Monday, not a day of the week I typically drink alcohol anyway, and also not a day I usually have time to exercise. And caffeine, well...a cup of java in the morning, maybe two, and a Diet Coke with dinner, maybe another during the day or maybe not. And I've gone months at a time without Diet Coke. I like it, but it's not the hardest thing to give up. Have I noticed that I feel better or sleep differently without soda? No. But this time, I'm giving up coffee, too.

5:45 AM, the alarm goes off, and 4 miles later, I begin my day, without coffee. No caffeine. No chocolate. No diet coke.
6:15 AM Tuesday, and this is a day I normally exercise. Only I'm dragging, and it was an uninspired work out. By afternoon, I'm feeling really lousy. My head aches. I'm tired and fatigued, and I really can't sleep that night. It's the sleep deprivation, I think, getting up earlier than I usually do, after a night when I've had trouble falling asleep. Ugh.

By Wednesday morning, my head has ached for 2 days, and while I'm caffeine & nutrisweet free, I'm now downing Tylenol and Motrin but my head still hurts. It finally occurs to me that I'm in caffeine withdrawal. But I was never addicted! How can I be withdrawing? I look this up and realize this can last for up to 9 days. Suddenly it seems sort of ridiculous that I've changed multiple variables at once, and even worse that I've given up caffeine cold turkey.

So Caffeine Withdrawal is an official DSM psychiatric diagnosis. From the Johns Hopkins Medicine:

The researchers identified five clusters of common withdrawal symptoms: headache; fatigue or drowsiness; dysphoric mood including depression and irritability; difficulty concentrating; and flu-like symptoms of nausea, vomiting and muscle pain or stiffness. In experimental studies, 50 percent of people experienced headache and 13 percent had clinically significant distress or functional impairment -- for example, severe headache and other symptoms incompatible with working. Typically, onset of symptoms occurred 12 to 24 hours after stopping caffeine, with peak intensity between one and two days, and for a duration of two to nine days. In general, the incidence or severity of symptoms increased with increases in daily dose, but abstinence from doses as low as 100 milligrams per day, or about one small cup of coffee, also produced symptoms.

Wednesday morning, I have a half a cup of coffee. Within a half hour, my headache is gone and my energy level is normal, I feel like myself again. I go for a swim and sit in the hot whirlpool for a while, ahhhhh.....

I've learned a thing or two about being my own human experiment.