Since my mid-twenties, I’ve had problems with sleep.  It seems to be at least partly a matter of an unusual kind of “sleep architecture,” where instead of first going into deep, non-dreaming delta sleep and only beginning to dream much later, as most people do, I start seeing the eyelid movies before I’m fully asleep.  Some of it has also been due to hypoglycemia, which I long ago got under control, to the point where I rarely feel symptoms anymore.  The rest of it is…well, I don’t know.
 
Neither have any of the doctors I’ve seen.  But finally, when I was feeling unbearably raggedy and jumpy virtually all the time, a doctor tried a chemical approach.  He started with barbiturate sleeping pills, but they left me too groggy in the morning.  Then I asked if he had anything about the strength of two beers, and he prescribed something called Ativan, whose generic name is lorazepam (which to me still sounds like some kind of cough drop you might put in a skillet in place of a pat of butter, to keep your food from sticking).
 
While the name didn’t impress me much, the results definitely did. The first time I took it, my sleep problems vanished.  And since my condition is chronic, I naturally kept on taking it.  Over time, I built up a tolerance to it, which meant my regular dosage had to be increased in order to be effective. I didn’t make these adjustments casually—I waited until my problems sleeping returned for a week or so before slightly increasing the dose.  But over the course of more than ten years, my dosage multiplied several times.

One day I saw a specialist about something that seemed to possibly involve my kidneys.  He asked me what medicines I took, and how much.  When I told him what my nightly dose of Ativan was, he shook his head in disbelief.  “I have no idea what that much would do to your kidneys,” he said, “but we’ve got to get you off it right away.”  He immediately established some sort of pharmaceutical block on any more refills, notified the doctor who prescribed the drug for me, and referred me to a detoxification and rehabilitation program.

I did the detox on an outpatient basis, because my kids needed me—and as it turned out, I needed them just as much.  It wasn’t an experience I’d want to have again, but I ground through it, and after a week, I felt good enough to go back to work.  (Later, the people in the detox/rehab program would tell me they hadn’t believed anyone could actually do it as an outpatient, and they’d essentially just humored me.)

The last step of the process threw me a vicious curveball, though.  As I steadily reduced the dose of Librium, the substitute drug they had given me to temporarily cushion the shock of withdrawal from Ativan, I found I was a bit too sleepy.  I was still taking another medicine for a prostate condition that had a known side effect of causing drowsiness.  I went to the doctor who had prescribed it and asked if he could switch me to something else that didn’t have this effect, and he did. Things were fine while I still had a tiny bit of Librium in my system, but when I completely stopped taking that, my nervous system went haywire.

I felt constantly like I was about to jump out of my own skin from nervous panic.  My brain was also profoundly addled, to the point where I often misheard or couldn’t understand simple statements.  And when I ate my first meal in this condition, I had the bizarre experience of feeling like I was swallowing with somebody else’s throat. I had to struggle to operate this suddenly-alien body part, all the while desperately afraid that the food would go down the wrong pipe and choke me to death.

To make matters worse, right after that meal, I had to go back to work for the first time, on a project where the client was paying a great deal of money for my now-sputtering and misfiring mental abilities.

In the short term, I just had to get through it, somehow.  I was glad the addiction doctor had coached me that to deal with physical symptoms, light aerobic exercise worked best.  Walks saved me.
 
The first one of these I took was in my own neighborhood, just after dawn.  My brain was so scrambled that I was terrified I would lose my way and not be able to get back.  I managed to get through it, though, and it did bring my jumpiness and confusion slightly closer to a bearable level.  I got into a pattern of walking at home in the early mornings, at work in the middle of the day, and again at home in the evenings—ten to twelve miles every day.