WHY YOU CAN’T STAY AWAKE:   IDENTIFYING NARCOLEPSYDiagnosis of narcolepsy is sometimes slow to occur. Until recently the average interval between first appearance of symptoms and diagnosis was as long as thirteen years. During that time inappropriate therapy, such as psychotherapy, may have been attempted, usually to no avail since such an approach obviously does not address the cause of the problem. Sometimes the symptoms of narcolepsy are mistaken for withdrawal from society, lack of motivation, poor or negative attitude, hostility, or just plain laziness. Hallucinations are occasionally misinterpreted as stemming from a psychological disorder or, in some cases, use of drugs. Depression is a factor for one out of three narcoleptics, primarily because of the disruption in their lives and the feeling that they are denied the right to enjoy many of life’s experiences.Diagnosis is made more difficult by the wide range of severity of the disorder. As I noted earlier, some victims do not exhibit cataplexy, the one telltale sign that the disease is present. What’s more, patients may occasionally experience a temporary or partial remission in their condition. However, if I suspect that narcolepsy is present, I may refer the patient for a multiple sleep latency test, which records sleep patterns during several daytime naps over the course of a few hours. Such a test is easy, convenient, inexpensive, and very informative. As we have seen, sleep patterns, especially the presence of the REM phase immediately after onset of sleep, can help confirm the diagnosis.*153\226\8*

We have learned to do the exercises with pinpricks and the burning string in the calm and relaxed state of mind that we have learned to induce in ourselves. Now we practise the same exercises in our normal everyday state of calm and relaxation, without any of the regression which goes with the mental exercises. We learn to do this gradually. First we do the pinpricks exercise in deep relaxation; then we do it with ourselves still relaxed, but less regressed. We are more alert; our eyes are more widely open, and we are much more aware of our surroundings and what is going on. By doing this gradually we find that these stimuli, which at one time would have been quite painful, now cause us no discomfort. In other words, our threshold of pain has been raised. When we can do this with pinpricks, we proceed to practise in the same way with the burning string.

We are now bringing the effect of the exercises into our everyday life. We find that minor incidents which in the past would have caused us pain or discomfort are now no worry to us at all. When such incidents arise, we are less easily disturbed because of our increased tolerance of pain, and if the stimulus is sufficiently severe that we find we are on the verge of pain, we quickly relax in the way that we have learned, and the threat of pain passes off.

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For some people unemployment may be an overriding problem. There is the loss of income and the social stigma. This may cause significant stress. For others, dropping-out and consequent unemployment may be an inferior way of coping with the stress of work. The student of marginal ability is always hard put to it in his studies, and exams become a problem which produces all the unpleasant symptoms of stress. Dropping-out removes the problems and stress is reduced.

As with his father, who does the same thing in early retirement, the youngster is able to support his decision to drop out with a whole series of rationalizations: ‘What is a degree? A piece of paper! Let’s get our values right.’ ‘I am going to drop out. See a bit of the world. Then come back to it, maybe.’ ‘Life is for living. I am going to camp with the others up in the northern beaches. There is plenty of pot. They are all so unconcerned. That’s what life should be.’ ‘Sweat all night for a piece of paper! Tell me, where does it get you?’ So he drops out. His level of stress is reduced, so he likes to stay that way.

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«I was silly, stupid, foolish. I simply did not think it through. So unlike me. Usually give these things a lot of thought. Get advice. Talk it over quietly with someone I trust. Leave it a day or two before giving an answer. Just didn’t do those things. Rushed off and committed myself. Didn’t think it through. Now I’m in one hell of a mess.

‘I have not been myself since this other trouble began. All on edge. But I did not think it would affect me like this. »

In stress the over-alertness of our brain cells may manifest itself in irritability, so that we react too quickly to minor stimuli. The same principle may apply to a major stimulus of decision-making. The over-alert nerve cells respond too quickly. We come to a hasty decision, and make a rash judgment on some important matter without fully thinking it through.

This is a common cause of errors in judgment in business. It means that if we are under stress from some other cause, we should be particularly careful about making quick decisions.

There is another area in which this reaction may produce quite disastrous results. It applies to young people. Man and girl going together. Everything has been fine between them. One of them comes under stress from some outside major problems, maybe the job, maybe the exams. Some incident crops up between them. The one under stress reacts too quickly. ‘If that’s how you feel, we’ll break up.’ And a good relationship is lost, perhaps forever.

Insomnia

«You only know the value of things when you have lost them. Something as simple and natural as sleep. Had never thought about it. Now I’ve lost it. That’s all I think about. Will I sleep tonight?

‘Toss about for hours. Have moved to another room. No need for the two of us to go sleepless. Sit up and read. Get up and make myself some tea. Take some pills, and hate myself for it. Thoughts run round and round. Will they never stop? »

The over-alert brain cells produce the restless movement of our body, and the persistent activity of our mind, and prevent our natural sleep.

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