Narcolepsy and Stress-Induced Sleepiness and Cataplexy
Excessive daytime sleepiness is a symptom experienced by everyone having narcolepsy type 1 (with cataplexy and hypocretin deficient) and narcolepsy type 2 (without cataplexy and not hypocretin deficient).
This profound sleepiness can interfere with activities of daily living, social life, work life, moods, feelings, and attitudes. Another symptom of narcolepsy is disrupted nighttime sleep, which in turn increases the sleepiness experienced during the day. This poor sleep quality causes a decrease in positive emotions and an increase in negative emotions.1
This vicious cycle is my reality as a person having narcolepsy type 1.
Our emotional experiences and dreams
People with narcolepsy type 1 and narcolepsy type 2 have different emotional experiences, even during sleep than healthy subjects. The research indicates that people with narcolepsy use coping strategies to avoid unpleasant thoughts and emotions in the form of lucid dreaming.
The emotions during sleep are also different than control groups with people who have narcolepsy experiencing more vivid, frightening, and bizarre dreams.1
Emotions impact symptoms and mental health
Symptoms are exacerbated by emotional responses and emotional responses are exacerbated by symptoms. This applies to daytime sleepiness and most definitely to cataplexy which is a sudden loss of muscle tone triggered by emotions such as laughter, excitement, and anger. Sleepiness brings on a heightened emotional state which in turn increases the likelihood of a cataplexy episode.
Research shows that people with narcolepsy have a high incidence of psychiatric conditions with depression (57 percent) and anxiety disorders (53 percent) having a particular strong co-morbidity. It is unclear whether these higher incidences are the result of the chronic impact of the condition, shared causes, or a combination of the two.1
Comparing the neurological similarities and pathophysiology is beyond the scope of this article, but understanding these conditions underlies the strong emotional impact of living with narcolepsy.
Disrupted nighttime sleep and depression
“The relationship between sleep and depression is bidirectional, complex, and apparent across the course of depression.”2 Cognitive behavioral therapy has been used to treat insomnia seen in depression. Disturbed sleep has been shown to increase the risk of depression for years after the episode of insomnia.
Finding a way to address disrupted nighttime sleep is imperative. I have developed coping strategies to more effectively deal with the emotions associated with narcolepsy, and thereby reduce symptom intensity. It took many years of counseling and small groups to learn how to process through the sadness and frustration of life.
These tools have equipped me to persevere in the darkest of days. Daily exercise has been another great benefit to my overall mental health.
Coping with challenges in my life
Since my diagnosis in 2007, my family and I lost everything in the Nashville Flood of 2010. This resulted in a transient period of our life where we bounced around between 5 residences in 2 years. Losing all our possessions while raising a 4-year-old daughter and 5-year-old daughter caused a substantial spike in my symptoms.
During 4 months in 2012: I found a friend deceased in his home, I was terminated from my full-time employment, my son was born, and I lost my best friend to brain cancer. Each one of these events was incredibly stressful. Each one of these events required a proactive approach that involved counseling and groups. In 2018, my marriage of 17 years ended. One year later, I became the primary residential parent for my 3 wonderful kids.
I am no stranger to adversity, but I am also no stranger to overcoming adversity. Everyone will face adversity in their life, it is how one chooses to respond that defines their character. There is no way to avoid stress. Even now, unemployment unseen since the depression and our current recession has affected all our emotional states.
As people with narcolepsy, we are at a risk for increased symptoms and for psychiatric disorders. The benefits of small groups, as offered by Wake Up Narcolepsy and Narcolepsy Network, have been essential to me navigating challenging times.
Counseling and therapy are effective tools that I incorporate into my mental health approach. I may have a condition that makes my muscles weak and promotes sleep attacks, but that does not mean I cannot be mentally and physically stronger. The World’s Strongest Person having narcolepsy with cataplexy approved this message.
What have your experiences with narcolepsy been? Share your story below.
Do you feel that your doctor understands narcolepsy?