The Dark Night: Sleep's Hopeful Escape

Sleep is a time when people can escape from their daily struggles and find peace. However, for some, it is a constant reminder of their unhappiness, as they go to bed hoping they never have to wake up and face another day. This feeling of dread and disappointment upon waking up is a common experience for many people struggling with their mental health.

Suicidal thoughts and ideation

Those who go to sleep hoping not to wake up may experience feelings of emptiness, hopelessness, anxiety, and depression. They may feel lost, purposeless, and as if the negativity in their lives outweighs any positive aspects. This can be a result of mental health disorders such as depression, anxiety, bipolar disorder, seasonal affective disorder, attention deficit hyperactivity disorder (ADHD), or post-traumatic stress disorder (PTSD). It is important to note that these feelings can also be indicators of other underlying medical conditions, such as sleep apnea, narcolepsy, or chronic fatigue syndrome, which should be ruled out by a medical professional.

The relationship between sleep and mental health is bidirectional. Psychological disorders can often lead to sleep problems, and disturbed sleep can, in turn, worsen mental health and contribute to the development of mental illnesses. Therefore, it is crucial to address sleep disturbances as part of mental health treatment. This may involve treating the underlying mental health condition, adopting healthy habits, and improving sleep hygiene.

For those struggling with suicidal thoughts, it is important to reach out to trusted friends or family members for support and to seek help from mental health professionals. Online resources and peer support groups can also provide valuable assistance and a sense of community for those struggling with these thoughts and feelings.

Risk factors and warning signs

If you or someone you know is struggling with thoughts of "going to sleep hoping not to wake up", it is important to be aware of the risk factors and warning signs associated with these thoughts. Here are some detailed points to consider:

• Depression and Mental Health Disorders: The most common risk factor is underlying depression or other mental health disorders such as anxiety, bipolar disorder, seasonal affective disorder, attention deficit hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). These conditions can cause changes in sleep patterns, decreased energy levels, negative self-talk, and increased feelings of sadness or hopelessness.
• Chronic Sleep Issues: Disturbed sleeping patterns, such as insomnia or hypersomnia, can be both a symptom and a contributor to mental health problems. Difficulty falling asleep, staying asleep, or waking up too early can be indicative of underlying issues and should not be ignored.
• Medical Conditions: Rule out medical conditions such as sleep apnea, narcolepsy, and chronic fatigue syndrome. These conditions can impact an individual's ability to wake up and function during the day.
• Sleep Paralysis: This condition involves temporary paralysis when waking up or falling asleep, sometimes accompanied by hallucinations and feelings of dread. It can significantly disrupt an individual's sleep and cause additional mental health challenges.
• Life Stressors: Life stressors, such as work, financial problems, or relationship issues, can contribute to feelings of hopelessness and exhaustion. These stressors can lead to a desire to escape through sleep or not waking up.
• Substance Abuse: In some cases, individuals may turn to substance abuse as a way to cope with their struggles. This can include the misuse of prescription medications, illegal drugs, or alcohol, which can further exacerbate mental health issues and sleep disturbances.
• Suicidal Ideation: Thoughts of not wanting to wake up can be a warning sign of suicidal ideation. If an individual expresses a desire to end their life or harm themselves, it is crucial to take these statements seriously and seek professional help immediately.
• Changes in Behaviour: Pay attention to any changes in behaviour, such as social withdrawal, increased irritability, loss of interest in activities, or a decline in personal hygiene. These changes could indicate a struggle with mental health or a desire to escape through sleep.
• Feelings of Emptiness and Purposelessness: A sense of emptiness, lack of motivation, and feeling lost are common risk factors. Individuals may express that they see no point in their daily routines and feel unable to find meaning or passion in their lives.
• Inability to Experience Pleasure: Anhedonia, or the inability to experience pleasure in activities once enjoyed, is a common symptom of depression. This can contribute to a sense of hopelessness and a desire to escape through sleep.

It is important to recognize that these risk factors and warning signs can vary from person to person, and some individuals may exhibit only a few of these signs. If you or someone you know is exhibiting any of these behaviours or thoughts, it is crucial to seek professional help and support.

How to help someone with suicidal thoughts

If you are supporting someone with suicidal thoughts, it is important to also seek support for yourself. Here are some ways you can help someone who is having suicidal thoughts:

Ask

Asking someone directly if they are having suicidal thoughts can protect them. It gives them permission to tell you how they feel and lets them know that they are not a burden. Studies show that asking people if they are suicidal does not increase suicidal behaviour or thoughts. You could ask:

• "Are you thinking about suicide?"
• "Are you having thoughts of ending your life?"
• "Are you thinking about killing yourself?"

Be There

Listening without judgment is key to learning what the person is thinking and feeling. Research suggests that acknowledging and talking about suicide may reduce suicidal thoughts. Let them know that you care and that they are not alone. You could say something like, "I can't imagine how painful this is for you, but I would like to try to understand".

Help Keep Them Safe

Reducing access to highly lethal items or places can help prevent suicide. Asking the person if they have a plan and making lethal means less available or less deadly can help the person stay safe when suicidal thoughts arise.

Help Them Connect

Connecting the person with crisis support services, such as the 988 Suicide & Crisis Lifeline (call or text 988), can give them a safety net when they need it. You can also help them reach out to a trusted family member, friend, spiritual advisor, or mental health professional.

Follow Up

Staying in touch with the person after they have experienced a crisis or been discharged from care can make a difference. Studies show that supportive, ongoing contact can play an important role in suicide prevention.

Treatment and coping strategies

If you are experiencing thoughts of not wanting to wake up, it is important to seek professional help. These thoughts could be indicative of underlying mental health issues such as depression, anxiety, bipolar disorder, seasonal affective disorder, attention deficit hyperactivity disorder (ADHD), or post-traumatic stress disorder (PTSD).

• Seek professional help: Reach out to a mental health professional, such as a therapist or counsellor, who can provide support and guidance. They can help you identify any underlying mental health conditions and develop a treatment plan.
• Treat the underlying condition: If your thoughts are caused by a mental health condition, treating that condition is crucial. This may involve psychotherapy, medication, and/or lifestyle changes.
• Build a support system: Confide in a trusted friend or family member about what you are going through. They can provide emotional support and help you through difficult times.
• Practice healthy habits:
• Take naps during the day if you are unable to sleep at night due to your mental health.
• Eat healthy, nutritious foods to ensure your body has the energy it needs.
• Engage in regular physical exercise, as this can help release endorphins, improve sleep, and increase energy levels.
• Limit caffeine intake, especially in the afternoon and evening, as it can interfere with your sleep.
• Avoid alcohol, as it can disrupt your sleep and natural hormone levels.
• Improve sleep hygiene:
• Establish a calming bedtime routine, such as taking a warm bath or reading, to prepare your mind and body for sleep.
• Maintain a consistent sleep schedule by going to bed and waking up at the same time each day, including weekends.
• Limit screen time before bed by avoiding TVs, computers, and phones for at least an hour before sleeping. The light from these devices can interfere with melatonin production and disrupt your sleep.
• Adjust your expectations: Be realistic and avoid setting unrealistic expectations for yourself, especially during tough times.
• Journaling: Keep a journal by your bed to write down your worries or make a plan for the next day. This can help relieve anxiety and make your mornings smoother.
• Use a daylight alarm clock: Opt for a gradual light-emitting alarm clock instead of a traditional alarm to wake up more naturally and feel less groggy.
• Light therapy: Use light therapy boxes, which emit bright light similar to sunlight, to regulate your internal clock and ease depression or anxiety associated with sleep.

Remember, it is important to seek help if you are experiencing these thoughts. You are not alone, and there are people and resources available to support you.

Mental health and substance abuse

Struggling with mental health and substance abuse can be a heavy burden to bear. It is not uncommon for people to experience both a substance use disorder (SUD) and a mental disorder simultaneously. According to the National Institute of Mental Health, substance use disorder is a treatable mental disorder that affects a person's brain and behaviour, leading to their inability to control their use of substances like drugs, alcohol, or medications. It is important to note that having a SUD does not necessarily mean that a person has a mental disorder, and vice versa. However, research has identified common risk factors that contribute to the co-occurrence of these conditions.

Genetics and environmental factors play a significant role in the development of both SUD and mental disorders. Certain genes have been linked to an increased risk for addiction, regardless of the substance. Additionally, adverse social environments, trauma, and stress can also contribute to the development of these disorders. For example, childhood trauma increases the risk for substance use, other mental disorders, and suicidality. People with mental disorders such as anxiety, depression, or post-traumatic stress disorder (PTSD) may turn to substance use as a form of self-medication to cope with their symptoms. While substances may provide temporary relief, they often worsen symptoms over time and increase the likelihood of continued substance use due to changes in brain structure and function.

The relationship between mental health and substance abuse is complex and bidirectional. Mental disorders can contribute to substance use, and substance use can exacerbate or trigger the development of mental disorders. This interplay highlights the importance of integrated treatment approaches that address both conditions simultaneously. Research suggests that treating co-occurring disorders together can lead to more effective treatments and improved health outcomes.

If you or someone you know is struggling with mental health issues and substance abuse, it is crucial to seek professional help. Treatment options may include behavioural therapies, such as cognitive-behavioural therapy (CBT) or dialectical behaviour therapy (DBT), and medications, tailored to the individual's specific needs and disorders. Support services, such as the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline, are also available to provide assistance and guidance.

Frequently asked questions