Anonymous asked:

How to do I write a character with Insomnia? Like some general guidelines on what to do and not to do.

Here’s a few guidelines:

Keep in mind that there are multiple kinds of insomnia.
Initial insomnia (sometimes called onset insomnia) - the character has trouble falling asleep.
Middle insomnia (sometimes called maintenance insomnia) - the character has trouble staying asleep, frequently waking up during the night.
Late insomnia (aka terminal insomnia) - the character wakes up a lot earlier than they meant to, and is unable to fall back asleep.
Long term insomnia has really negative effects on your character’s body and mind.
Insomnia is frequently comorbid with, or even a symptom of, other mental disorders.
Medications are not a cure-all.
Your character can build up tolerance to hypnotic medications quickly (some in as little as three days!) and while they do make you sleep, the sleep you get is not as restful. These kinds of medications can also be addictive.
Over the counter sleep medications do not work for insomnia - they can make you drowsy but do not actually affect how much sleep you get.
Melatonin isn’t addictive and can be slightly/moderately effective, but it’s best with people doing shift work or dealing with jet lag, not as a daily thing.

Hope that helps!

#Anonymous #asks #Insomnia #sleep #sleep deprivation #medications #tolerance #psychopharmacology #how do i describe #comorbid #comorbid disorders #this is not psychological or medical advice #this is writing advice

scriptshrink

Anonymous asked:

I want to write a character (in the Percy Jackson Universe) that has extreme trouble falling asleep. However, they are a child of Hypnos, God of sleep. What illnesses would prevent them from sleeping? Insomnia or Nightmare disorder maybe? And (if you want), how would his sleep problems interact with the fact that their dad is the god of sleep?

Major Depressive Disorder has insomnia built into the criteria. Insomnia is also a possible symptom of a manic or hypomanic episode, as part of a Bipolar I or II diagnosis.

While not in the criteria, some anxiety disorders may prevent your character from sleeping because of their constant worrying. OCD could also work if your character is driven to perform time-consuming compulsions before they can go to sleep.

There is also a prion disease called fatal familial insomnia that causes insomnia; however, the lack of sleep caused by this disease is universally fatal, usually within one year after beginning to show symptoms.

In addition to insomnia or nightmare disorder, I have a bit of an unorthodox thing to suggest: central sleep apnea. Basically, the character’s brain forgets to tell their body to breathe while they’re asleep. While it doesn’t initially prevent someone from getting to sleep, it does mean that the character would be waking up frequently and not getting restful sleep. This may or may not work with your story, but I thought it’s a neat, unusual idea.

As for your last question, honestly, I have no idea. However, a certain proverb comes to mind: “The shoemaker’s children always go barefoot.”

Hope that helps!

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scripttorture

Anonymous asked:

I want to say your blog is amazing. I apologize if this is more ScriptShrink's thing; from what I've researched the effects of this are more mental than physical. My book is set in the middle ages, and characters are thrown into a dungeon, ie solitary confinement. They are around 19, so I assume they have developed nessescary social skills, so it might not set back growth as much. What effects does solitary confinement have in short term, a month or less? How would he react when rescued? Thanks!

scripttorture answered:

Aww thankyou. :)

Forstarters a month of solitary confinement isnot short term. Short term solitary confinement is probably around 3-5 days.Negative effects are apparent after 10days in all studies and get worse as it goes on.

Resultsof tests using volunteers vary. People who are told how long they’re likely tobe in solitary appear able to endure it with fewer negative effects. A 1964study (Zukerman) showed two thirds of volunteers were willing to stay isolated for3-14 days. However another study in 1959(Smith and Lewty) using a silent roomgave an average stay of 29 hours for men and 48 hours for women. The longest time was 4 days.

There aresome very good online resources onsolitary confinement. Shalev’s2008 sourcebook is available for free here. P S Smith’s2006 review article is available for a small fee here. I found them bothvery helpful.

I’llsummarise the main points.

Physical Effects

Headaches(over 80%)

Appetiteloss

Weightloss

Heartpalpitations (over 50%)

Visualdisturbances

Insomnia(over 80%)

Lethargy(over 80%)

Dizziness(over 50%)

Jointpain

Shaking

Psychological Effects

Depersonalisation

Hallucinations(41%)

Delusions

Depression(77%)

Withdrawal

Apathy

Irrationalanger

Poorimpulse control

Memoryproblems

Difficultyconcentrating and thinking

Confusion(over 80%)

Anxiety(91%)

Nightmares(over 50%)

Paranoia

Psychosis

Self harm

Suicidalinclinations/actions

Thepercentages are all from one study the Shalev quotes but it’s worth mentioningthat other studies in his report quoted hallucinations in 100% of cases studied.

Theeffects aren’t in any particular order and your character wouldn’t necessarilysuffer all of them. In a prison context self harm, irrational anger andincreased violence all seem to be quite common.

Shalev’ssourcebook is peppered with accounts from prisoners and I personally found itreally helpful for my writing. Thiscampaign group also has some personal accounts, which might be helpful.

As forhow he’d respond to rescue-

In amonth it’s unlikely he’d be suffering from the most extreme effects. Heprobably wouldn’t be catatonic, attack the rescuer or completely unable to tellfantasy from reality.

Some ofhis response is also going to depend on which symptoms you think he should show.The last time I wrote solitary confinement I used a mixture of symptoms thatworked with the narrative and those that were most common. I made a point ofstressing some of the physical effects since they’re less well known.

He’dalmost certainly be dazed and confused. The sudden rush of sensory input mightmake his headaches worse and give him vertigo, the same way it would with anormal migraine. He’s also likely to be nervous, skittish and jumpy.

Theredoesn’t seem to be a clear consensus on which (if any) symptoms persist and howlong in solitary it takes for that to start being a major risk. I’d suggestthat it would be unusual for him to have the most extreme symptoms persistingafter, say, a month’s recovery. But he might well still be depressed, anxiousand have nightmares.

I think areasonable response would be for him to follow his rescuers lead at first. Hemight be too out of it to think of anything else to do and he might also thinkit’s a hallucination or fantasy. In that case later he’d have questions for his rescuer.

He’d needsome time to recover, which in this case generally seems to mean a few quietdays getting used to being in the world again. Being able to make his owndecisions about his life is probably going to be incredibly important to him.

Hopefullythat’s given you an idea of the sort of condition he’ll be in and what he’sbeen through. Let me know if you’ve got any further questions. :)

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codedredalert asked:

Does the nightmare post apply to sleep paralysis or is that different?

Sleep paralysis is a completely different thing - it’s much more physiological. IRT would have no effect on it. Not sure about Prazosin.

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#codedredalert #asks #IRT #nightmare #nightmare disorder #sleep #sleep paralysis #this is not psychological or medical advice #this is writing advice #medication #Prazosin #short answers

scriptshrink

Anonymous asked:

I'm writing a story and the main character goes through a traumatic event and has ptsd once home, and among other things can barely sleep due to nightmares. So there's a scene where her close friend/future love interest offers to share his bed and she sleeps better due to being able to sense the presence of someone she trusts when she wakes from a nightmare. Any tips for how I can write this so it's not coming off like he's curing her?

This is really difficult under these circumstances. However, there might be a few different things you can do to keep from falling into this trope:

Make it clear that her nightmares were going away on their own, regardless of the presence of the other character.
Have the relief from nightmares be intermittent - sometimes sleeping next to the other character will help; other times it has no effect or even makes it worse.
Have sleeping with someone nearby as a pre-established thing that makes the character more comfortable, dating back before the trauma occurred.
Since the other character’s a future love interest, have the main character ask them to sleep next to them because of a desire for intimacy and an expression of support, not necessarily because it relieves the nightmares.

The Shrink would like to note that while sleeping next to someone may help some people with PTSD in real life, I’m specifically discussing avoiding the media trope of “true love cures mental illness,” which is what anon asked about.

#Anonymous #asks #ptsd #post traumatic stress disorder #nightmare #nightmare disorder #sleep #love will heal you #love #character critique #characterization #this is not psychological or medical advice #this is writing advice #:(#cosleep ptsd anon

scriptshrink

Major Depressive Episode & Disorder - Demystifying the DSM-5

In a two-week period, the character needs 5 or more of the following symptoms. These symptoms need to be different from how the character usually acts. At least one of the symptoms has to be either 1 or 2.

The character feels depressed most of the day, almost every day. This can be portrayed by the character’s feeling sad or hopeless, or can be expressed by things such as being tearful (in children and adolescents, they might be excessively irritable instead).
The character needs to lose interest or take less pleasure in almost every activity they formerly enjoyed. This has to occur most of the day, nearly every day.
The character loses or gains a noticeable amount of weight without trying, or their appetite has either gone up or down.
They sleep a lot or have insomnia nearly every day.
The character has psychomotor agitation or retardation (see here!) nearly every day. This has to be observed by other people, not just reported by the character themselves.
The character feels fatigued / drained of energy nearly every day.
The character feels worthless or excessively guilty (sometimes to the point of being delusional) nearly every day.
The character has trouble thinking, concentrating, or making decisions, nearly every day.
The character has any of the following:
Repeated thoughts of death
Suicidal ideation (without a plan for committing suicide)
Suicide attempt
Specific plan for committing suicide

These symptoms cause the character significant stress or make their life more difficult in some way.

It’s not because of another medical condition or substance. Make sure not to include symptoms that are clearly part of another medical condition (such as excessive sleepiness due to a sleep disorder).

You’ll note that a lot of these criteria have conflicting symptoms (insomnia vs. sleeping all the time). Depression can be expressed a number of different ways, but that doesn’t make any version less valid.

There’s a distinction between grief (a normal response to a significant loss) and a major depressive episode. I’ll get into that in a future post.

Major Depressive Disorder (MDD)

Major Depressive Disorder has the same criteria as a major depressive episode, and some additional stuff.

The depressive symptoms can’t be better explained by any of the psychotic disorders.

Important – the character can NEVER have had a manic or hypomanic episode (unless it’s known to have resulted from substance use or a medical condition). If they have had one, it’s Bipolar I or II.

There are a LOT of specifiers for Major Depressive Disorder. There’ll be a future post on these specifiers.

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#scriptshrink #text #depression #major depressive disorder #suicide #weight mention #weight loss #weight gain #demystifying the dsm 5 #dsm #mdd #major depressive episode #this is not psychological or medical advice #this is writing advice #sleep #demystifying #demystifying the DSM 5

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scriptbrainscientist

arepii asked:

Hey! Thank you for this awesome blog! I have 2 characters that hallucinate. They sleep very little. Because if they do so they can disintegrate. Person A sees them and feel them. But actually everything he's seeing is not what it's actually happening. Person B only see it and is influenced by the hallucination. And hears voices. What could be a logical explanation on to why they hallucinate?

scriptbrainscientist answered:

amusingly, I just answered an ask related to this, so I’ll refer you to this as supplementary reading

But let’s try and get some good answers for yours.

If I understand this correctly, person A has somatosensory and visual hallucinations while person B has auditory hallucinations that play off of person A’s? If this isn’t what you meant, please re-ask.

The lack of sleep itself is easily a factor in their hallucinations. Sleep deprivation, especially for long periods of time, exhausts the brain- we don’t quite know why the brain needs sleep, but we know if it doesn’t get it, things get wonky really fast. Chronic deprivation will inevitably lead to hallucinations of many types and can also lead to things like paranoia and disorientation, which make the hallucinations worse, creating a sort of cyclical thing. I can see person B’s hallucinations working off of person A’s easily too, since mob mentality type things are common (though this is more psychology based), as are things like emotional contagion and unconscious mimicry.

I would be concerned that your characters can’t sleep, however- that’s almost certainly a death sentence. Sleep deprivation is also associated with lack of awareness, low alertness tremors, seizures, mania, headaches, high blood pressure, and in some animal studies, sleep deprivation has been found to be potentially fatal.

Finally, just a thought- microsleep (aka tiny instances of sleep as long as 30 seconds) are inevitable when someone is sleep deprived, so even if they avoid sleep, they can’t do so forever– and eventually, if they don’t die, they will conk out and fall asleep (trust me, pulling serial all-nighters in college is some great evidence that not sleeping is 1) bad and 2) impossible for very long).

A shorter answer than usual, but I hope this and the other post are of some help. If you need something more specific or I misunderstood your question, feel free to send this again.

–Mod Nopal 🌵

scriptshrink

Check out my much less professional (but hopefully still informative) post on Fatal Familial Insomnia! You should definitely look into that disease when writing about long-term sleep deprivation.

#scriptbrainscientist #reblog #ffi #sleep #sleep deprivation #this is not psychological or medical advice #this is writing advice #fatal familial insomnia

scriptshrink

Anonymous asked:

I'm writing a character that doesn't sleep until she literally can't stay awake and passes out from exhaustion, because she's afraid of sleeping. Are there any conditions that cause this and if someone is aware of the problem, how can they help her?

Oh, boy, Anon. You have finally given me an excuse to talk about one of my favorite diseases.

So there’s this thing called “Fatal Familial Insomnia.” (FFI) In short, you stop being able to sleep. You go crazy. Then you die.

There are four stages to this disease:

4 months - First, the character gets chronic insomnia. They start getting paranoid, develop phobias, and begin having panic attacks. They start experiencing severe physical symptoms (excessive sweating, constipation, etc.)
5 months - The character begins having hallucinations and their panic attacks get much worse.
3 months - The character rapidly loses weight and is completely unable to sleep.
Over the course of the next 6 months, the character develops dementia, becoming completely unresponsive and mute.
Then they die. Do not pass go, do not collect $200.

There’s no cure. Taking sleeping pills doesn’t work. In fact, being sedated makes the disease worse, and shortens the time until death. The only thing that’s even slightly helped someone with this disease is spending nights in complete sensory deprivation chambers. Even then, they still died within a few years.

FFI is an incredibly rare disease, and it’s only found in about 40 families in the world - hence the “familial” part of the name. Only about 100 people in the world today have tested positive for this disease.

So what causes such a horrifying thing?

Prions.

What the fuck is a prion, you ask?

Well, it’s something that can spread an infectious disease, just like bacteria or viruses. But prions are different in that they’re made from something that’s usually normal inside the body - a protein - that has just been made wrong. And it begins to spread its wrongness to other proteins. These proteins basically begin to eat holes in your character’s brain.

Yes. LITERAL HOLES.

Some prion diseases are fairly well known, such as Mad Cow disease, Creutzfeldt-Jakob disease, kuru, and scrapie. But FFI will always be my favorite.

This is probably not what you wanted, but I will take any excuse I can to talk about this disease. >_> Prions are terrifying and awesome. But mostly terrifying.

Even still, looking at the symptoms experienced by people with FFI, who have severe, long-term insomnia, might help you writing your character. If that still isn’t what you’re looking for, I should have the Demystifying the DSM for Sleep Disorders (including insomnia) early-ish next year :).

Get some sleep, y’all. WHILE YOU CAN.

For more info:

http://www.bbc.com/future/story/20160118-the-tragic-fate-of-the-people-who-stop-sleeping

http://www.newyorker.com/books/page-turner/a-prion-love-story

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