Apytele

@Apytele@sh.itjust.works

I love genuine questions and people putting in the effort to love and understand each other better. If you come at me just wanting to argue I’m going to troll you back. FAFO.

This profile is from a federated server and may be incomplete. Browse more on the original instance.

Massive issues with sleep and desperate for a solution.

I’ve been struggling with sleep issues for over a decade now. My Doctor has prescribed me all sorts of medication, all of which has had many adverse side effects. What I do know that works, is Xanax. My wife was prescribed it for some stress issues and occasionally will give me one so I can finally sleep. Obviously asking my...

Apytele,

Yeah Xanax is literally the worst thing possible for this, especially as a frequent thing. It’ll significantly worsen your sleep quality in the long run. (Hi I’m a psych nurse and I meet a lot of people stuck in insomnia hell because they’ve been slapping a Xanax bandaid on it for a few years while it just continued to devolve and now they’re basically psychotic because they never actually fixed the root issue.

I’m also hearing a lot from you about medications and next to nothing about any lifestyle changes. No medication will ever actually fix this kind of problem. Medications just give you a leg up on fixing yourself.

First of all what stimulants do you use, especially caffeine and nicotine? (I would also hope you already know to avoid meth and cocaine and not take stimulant ADHD meds at bedtime.) Are you avoiding them in the last 6 hours before bed? A lot of people (especially with ADHD) will say stimulants calm them down but what they’re actually feeling is a change from their baseline restless anxious awake to a focused, productive awake. The second one feels more settled, and can actually help you fall asleep briefly if the specific problem is difficulty holding still long enough to sleep, but it’s going to completely fuck up your circadian rhythm in the long run.

Speaking of circadian rhythms, are you trying to keep your body in a steady daily routine? This includes a consistent bedtime, but your mealtimes and daily physical activity are part of your circadian rhythms too. There’s a lot of different schools of thought on how to time meals and exercise to best support sleep, but the general consensus is just don’t do either right before bed. I would also recommend adding a structured “wind-down” period to your nightly routine that takes 15-30 minutes where you do one of like three basic things:

  • something mind-numbingly boring
  • something you’ve always found soothing/comforting
  • Journaling about the day to give your brain a head start on the memory processing it’s about to do.

It’s also very helpful to create full sensory environments that you use to trigger pavlovian responses. You know how pavlov’s dog drools when the bell rings because it’s used to food showing up when the bell rings? The biggest difference between you and a dog is that you get to decide what you want to be trained to do. The downside to this is that it can take a while to train these responses into your body, so be patient and don’t just give up after like a week. So you’ll want to create at least two full and distinct sensory environments. The specifics don’t matter as much as creating a consistent routine for yourself, but here’s some examples of things I’ve tried or seen people try:

Alert

  • Sight: Curtains open / sunlight / full spectrum white light is the input that aligns most closely with most people’s existing natural rhythm.
  • Sound: Music, white noise of people talking in the background.
  • Smell: Essential oils are actually really good for training pavlovian responses in yourself because of how powerful scent memory is. A lot of people like to incorporate citrus-y smells for alertness, but personally I actually really enjoy just keeping my used coffee grounds from the morning in a cup on my desk. That also brings us to the next one…
  • Taste: Coffee has a pretty distinct taste that most people associate with alertness, and you can get a similar taste from chicory root and/or decaf coffee, but one real cup right after waking up shouldn’t mess you up too bad. Chewing gum is also an option, however.
  • Touch: The big one for me doing classes from home during COVID was still getting up and putting on “outside clothes” even if I was just sitting at the computer at home.

Rest

  • Sight: usually red-yellow spectrum light, and much lower brightness around bedtime. You can turn on a red-shift filter for most electronic devices these days, and LED bulbs also often come in a yellow-orange incandescent style color (and a lot of hobby/makeup lights have multiple color settings for this reason as well, white for when you’re working, orange/yellow for resting/relaxing.
  • Sound: some people listen to soothing music, I conditioned myself to fall asleep to the sound of a raging thunderstorm because I sleep during the day and work at night, and the thunderstorm sounds easily block out daytime noises.
  • Smell: Lots of options here too for essential oils or other scented products. You could also use a specific lotion or wash your sheets in a specific scented detergent. A lot of people say they find lavender scents to be particularly soothing, but again, the exact sensory trigger isn’t important as much as you picking one to use consistently.
  • Taste: Herbal tea is my biggest recommendation here, but you could also go with a small snack/sweet as part of your nightly routine.
  • Touch: We already covered wearing different clothes, but some additional options include a weighted blanket or one of those compression sleep pods (I just got one to try out recently and like it so far!)

Anyway like I said, these can take a while to train your body to do, so pick things that will be easy for you to do, set up your space to make it as easy as possible to keep doing them, and keep at it. The most important thing is consistency and routine.

Apytele,

I accidentally took 300mg THC as my first dose ever. I remember thinking every thought possible and the opposite of each one all at the same time while I was dragged through the universe by my neck with visuals like inside the monolith in 2001. The last thing I remembered before losing consciousness was being thrown into some kind of light like a star or white hole or maybe just a really bright nebula? Next thing I remember was waking up in the ER propped up over a bucket full of puke. I’m willing to give the experience 2/5 stars just because if there is a god I probably met them in whatever that bright light was and I’d hate to be a rude houseguest by talking shit.

Apytele, (edited )

Those emergency room visits referenced were almost certainly not necessary and just the result of overly fussy parents (addendum: excluding weird allergic or idiosyncratic reactions to dyes and whatnot). It’ll do really weird things to you circadian rhythm and you’ll have some utterly surreal nightmares, but that’s not anything you can’t manage at home. It’s suuuch a light sleep aid it’s not going to sedate enough to mess with the drive to breathe and your body won’t convert enough of it to serotonin to do that either. It doesn’t really matter how much you take either.

The LD50 (average amount it takes to kill) is over a whole gram and is basically unestablished in humans. That’s an insanely large amount as far as medication dosing goes, especially since we’re talking by kilogram of body weight. The max established safe dose (no nightmares) that melatonin is routinely sold as is like 10mg total for an adult, so the person would probably need to swallow an entire 100-count bottle for every kilo they weigh. Also I almost guarantee any pediatric overdoses were the gummies (obviously), so they would have to eat a 100-count bottle of the highest dose gummies for each kg. Babies don’t even start eating solid food until around 6 months when they’ll probably weigh around 6kg, so picture an infant getting open and chugging down a half-dozen 100 count bottles. It’s a nonsensical picture.

The daycare workers should still be fired asf though that’s super weird and yeah those kids should be getting regular checkups to make sure this hasn’t messed with their growth or anything.

Apytele,

Yes and no. I’ve had to insert a LOT of meaning to get a story worth any substance, and I’ve had to do a lot of editing to get good images. It’s really good at giving me a figure that’s 90% done, but that last 10% touching up still often takes me a day or so of work.

Apytele,

Yeah if half my patients just went out and found constructive hobbies that they can do with other people I would actually be really hyped. I especially like seeing young men stop fixating on women and just go develop things about themselves that are likeable and interesting to other people in general.

The craziest part is that I’d actually kind of prefer that they do this in most cases. Half the time this will be like 75% of what the therapist will tell them to do anyway and the other 25% is stuff like “stop getting most of your hydration from diet coke” and “yeah your dad was just kind of an asshole boomer; that happens a lot actually.”

And I’ll probably get shit for it again (but maybe I’ll explain it better this time?) but it’s actually really concerning how many people are leaning on therapy right now. I’m not saying it’s their fault, but saying more people need to go to therapy isn’t actually going to fix the issue. It would be like if were constantly maiming and injuring people and saying the problem was not enough people going to physical therapy. Therapists absolutely need to be a thing, but most people wouldn’t be having these problems in the first place if we hadn’t commoditized human interaction and largely eliminated publically / benefactor hosted social spaces.

And by commoditized I mean we’ve created this culture where we have all these rules for who gets to be mad or sad in each interaction and who is supposed to support who, often with the exchange of money involved. And I’m actually mostly talking about the service industry even more than I am about the mental health one, it’s just that their bullshit is seeping over to us and making the mental health (and general healthcare) industry a toxic sludgepile too. The only therapist I could get to call me back is part of a large online franchise that basically pimps them out like onlyfans models except my insurance pays and there’s no flirting or tiddy pics. I haven’t had the heart to pry into how much they’re actually making but I doubt it’s a lot.

TLDR: I don’t like modern “just go to therapy” culture because I think it’s completely missing the point. Even if we were properly staffed, the healthcare industry can’t conceivably fix the rest of society on it’s own. Also just fix housing already ffs. It will literally just put a cap on the mental health crisis. Like if we just took blackrock’s real estate and put homeless people in it the mental health crisis would just be like 80% solved. I’m not even kidding.

Apytele,

This is a very fitting reply; nobody cares when it’s causing a famine in Uganda or the ocean is swallowing the Philippines or whatever. The people with the power to actually change these things won’t get upset until hurricane tradgedeigh is stripping the siding off their mcmansion, and by then it’ll be a few decades too late.

Apytele,

For a technology that could someday help a quadriplegic interact with the world fully and independently again I’m willing to tolerate some hitches. There’s a reason they didn’t pick some full on walkie talkie for their first human trial, and there’s a reason that kid looked motherucking hyped to have brand new technology that he’s the first human to even try installed directly into his fucking brain. The problem is abled people thinking this is fundamentally for them. Bby no, they’re trying to help people walk again, even if the legs are robots. You’re looking at the wrong risk-benefit profile.

Apytele,

Even disregarding the misgendering aspect, the fact that anon thinks it would ever be ok to tell any person “hey I’m pretty sure I know what your genitals are even though you wouldn’t want me to” at any time is just… fascinating.

Apytele,

Oh hey they taught me what to tell you in nursing school! And I’m a psych nurse so I can also give tips on not going bonkers! These are all for the average person that doesn’t have any specific reason they shouldn’t do any of these; like certain gastrointestinal disorders would contraindicate the dietary fiber.

  • Get plenty of low impact exercise like biking or swimming to keep your heart healthy but avoid fucking your joints.
  • Eat a balanced diet that’s low in processed or added sugars and high in lean protein, polyunsaturated fats (usually liquid at room temperature), and especially dietary fiber. When you talk Paleolithic diet vs the modern diet, the biggest difference is almost always roughage/fiber. Whole wheat bread might not taste as good but your colon needs the scrubbin’
  • practice good sleep hygeine. This means setting a big as possible of a difference in location, behavior, and sensory input between wakey time and sleepy time. So when you’re awake, hang out in a different area, look at different things, listen to different sounds and music, apply a different smelly lotion or keep a different essential oil near you (one of the few things essential oils are actually really good for is pavlovian conditioning yourself to get more relaxed or more alert). Also have different clothes you wear to be alert vs asleep and if you drink coffee in the morning, drink a completely differently tasting herbal tea at night. Create separate and distinct sensory environments for yourself for different contexts in general: they’ll help keep your subconscious in sync with what you’re consciously trying to accomplish.
  • either a) be religious and attend services regularly or b) choose a different social ritual to engage in and form close enough bonds with those people that they will come find and help you if you suddenly stop showing up. The mental health benefits of religion go far beyond feeling spiritually connected to the world. For a lot of people their religion is their primary social support, so if you’re not religious that’s completely valid but for optimal mental wellness you need to engage in some kind of activity that will allow a similar long term bond to form with other people. The advatage to doing this with religion is that its easier to tell people they have to come back or they’ll go to hell than to explain that not engaging in regular low-key social interaction will increase their risk of dementia in like 30+ years.
  • Don’t do meth or fentanyl, and be very very careful with alcohol. Weed is less bad for you than alcohol but tbh a light mauling from a black bear is also probably less bad for you than several years of high alcohol intake. “Safer than alcohol” is not high praise. If weed starts giving you anxiety or frequently seeing/hearing things others don’t, stop the weed immediately.
Apytele,

I set mine to an innocuous background sound that only I will recognize like something small clattering on the floor or a small creaking noise. Its like a gun silencer, instead of making it silent you just make it sound like something else.

I have also found it important to either control which apps can send me notifications or control which apps are on my phone in the first place.

Apytele,

Newly admitted psych patient who was seriously invested in getting their personal sheets out of the belongings that came in with them. I didn’t really get it but I don’t understand like half the things that supposedly make people happy so whatever. I go to inventory the belongings real quick so I can get their sheets before they go to sleep.

So it turns out the family sent them with a full set of queen size silk sheets. We had to wrap the fitted sheet around the mattress and then some to get it to fit. Also in the bag were several (understatement) brand new brand name electronic devices. The clothes were also brand new and when I had the secretary look them up and there were several items that each could have paid my rent.

I had no idea what to do with all of it. Most of the clothes and the sheets were fine for the patient to have, but we don’t allow electronics out on the unit. We have a safe for valuables like phones and wallets and stuff but it was only a little bigger than a microwave and this person’s valuables would have filled it several times over.

It was like a real-life version of that scene from spaceballs where they find out they’ve been lugging the princess’s hair dryer across the desert. Not the indignant yelling obviously but just the first part where they open it up and just need to comprehend what’s going on for a second. It was especially jarring considering that most of my patient population is homeless. So like they’ll bring in everything they own (they don’t really have anywhere to leave it) but even when it doesn’t fit well in our storage it’s not usually 20 pounds of luxury goods that I have to figure out where to safely put before I’m on the hook for whatever the fuck all that cost.

Best part about the whole thing was that the chief complaint was capgras delusions. This family set this person up with all of this stuff to send them to the hospital and the pt literally thought they were all fakes. Like literally fake aliens or clones or whatever. Like damn that was some irony.

Apytele, (edited )

This is me every single gotdamn night I work. Everything will be fine then BAM the patient who constantly pees everwhere is logrolling down the hall coating the entire communal area in urine because no one would give them a hug while they’re covered in pee. The worst part is I’m not even describing any particular patient. If I had a dollar every time a hall is convered in some kind of bodily fluid or other excretion I’d be making 3-5 cents more hourly which is coincidentally the exact size of my last raise.

Apytele,

I feel like I would reply this way less out of cockiness and more just out of my innate drive to bring more chaos to this world and saying things people won’t know how to coherently respond to is a tried and true method. One of my classics is telling people “have fun; make friends” when they excuse themselves for a bathroom break.

Apytele, (edited )

From inside the mental health industry it doesn’t feel like we’re pushing drugs because we’re too hooked on this model and afraid to be scrutinized; we all know none of this is actually getting solved until there’s widespread social reform. Being able to hand out the drugs just feels like the only tool we’ve been handed.

It’s like being on a tiny life boat boat full of life jackets in the middle of a sea of people thrown into the ocean. I could start pulling people onto my tiny boat but eventually that’ll sink it. I do have all these life jackets I can throw at them though, which will buy a little more time for somebody with a bigger boat to come along and scoop them up. I don’t think it’s the people in tiny boats handing out life jackets that’s the issue; I think it’s whoever actually does have the resources to actually come get them and just won’t. I also think I would be generous to say it’s that they don’t care when the truth is they’re actively benefiting from people being afraid of falling getting pushed into the water. And yeah, nothings really going anywhere until we stop dumping people overboard in the first place.

I’m going to abandon that metaphor before it loses its usefulness. But yeah TLDR, I don’t hand people drugs because I think it will fix them, I’m just trying to buy this person time until they can either fix themselves, or until someone cares enough to give them the support they truly need and that I don’t personally have in me right now. I guess I can’t speak for everybody in the industry but all my coworkers seem to know we’re at best just handing out life jackets and its ultimately on the patient and particularly society at large to not waste that extra time bought.

And honestly if you want one issue that I think will legit just solve about 3/4 of the mental health crisis it’s housing. It’s literally just housing. And not shelters, I’ve never met anyone who really feels safe in one, they all tell me they got beat or raped or stolen from in one. No we need to just start putting people in houses. But I could write a wholeass Manifesto on this (and I think I may have somewhere in my comment history).

Apytele,

Stop explaining shit. Show them a fucking picture. They’re artists more than engineers, they’re visual/spatial people. Find a picture online of what you want. Once you’ve gotten a really good, absolutely chefs’ kiss prefect cut, take a picture each of all four sides and the top, then start showing barbers those instead.

Apytele, (edited )

I’m a psych nurse now and have been personally hospitalized 4 times and have had over 300 hours of outpatient therapy, but I’m not actually sure what your specific questions are. Here’s some example ones but you’re free to ask more if you like. (also this is my night of and I’m a bit schwasted so this is gonna be slightly stream-of-consciousness).

Are you asking for the nuts and bolts of how to get it done with the highest likelihood of actually getting your loved one help without getting them shot by the cops? No idea. This is highly dependent on what resources are available in your specific area, what criteria they use to triage the needs of the people they serve, and the local legal system, both as it’s engrained in law and how that law is typically interpreted/used. The best way to find out more about this is to join a support group for family/loved ones of people with mental illnesses in your area. Even if you go to a zoom or other virtual support group, try really hard to find something very local. People who have been doing this in your area for years are going to know waaaaay more about the nuts and bolts of this situation than some internet rando who doesn’t know shit about the specific place you live in. (They’ll also probably know which providers in the area are the least sketchy.) Therapy for you is also a great option if that’s accessible to you.

Will being hospitalized traumatize your loved one: almost definitely. Even when it’s completely necessary it sucks, and honestly the more it’s needed the more it sucks. At best, it’s soul-crushingly boring. The worst depends on where you live and which things that area considers “human rights,” as well as the overall quality of the specific facility and the overall acuity/severity of the mental health crisis in your area. I was happy to work for a place that I considered decent quality for a while, but things have been degrading for a bit now and I’m on the hunt for greener pastures. I also work probably one step below what would be considered a “psychiatric ICU” in that I have some very sick patients who often require some very intensive and invasive care. A couple nights ago my coworkers had to forcibly get shit and piss covered clothes off a patient because a) the acidity was starting to burn/dissolve their skin and b) they wouldn’t willingly stay in their room and we can’t legally lock them in, but it’s also not fair to the other patients for them to spread their shit and piss all over the communal areas. And that’s not even unusual. We’ll probably have to do it with an entirely different patient within the next month. I really hope your loved one does not require that level of care, but if they do, there’s very little I can do to keep it from traumatizing them, and I have a bunch of education and experience specific to this area.

Will this damage my relationship with my loved one? again, almost definitely. You will need to decide if you think the possible benefit is worth being the bad guy in your loved one’s story. I’m the bad guy in a lot of people’s stories; some people just need them for what they’ve been through to make sense. I do my best to form that helping relationship, or get it back when I lose it, but sometimes it’s just not possible and if I’m given a choice between being liked versus every employee and patient on the unit getting through the night safely, I’m taking option 2. The difference is I usually don’t have to see the person again or even interact with anyone they know or who knows them. The patient gets to remember me as that awful bitch who drugged them and stole their shit covered clothes (even if we did give them back after washing and a spare set to wear in the meantime) and never have to even look at me again. If they do see me again, it’ll probably be purely within the context of them being acutely ill and they’ll still be able to leave me behind again and go make the best of their life outside the hospital. Having a loved one be the bad guy, or to be the bad guy to your own loved one, is an entirely different animal.

But is there any way I can talk them into this willingly? maaaaaaaybe. And if there is, the only person who would know is probably you, or someone who’s even closer to them if that person exists. I don’t know your loved one from Adam, so I don’t know what motivates them or what’s important to them. If I talked to them personally and at length I could probably make some educated guesses, but if there’s something important enough to them to confront this issue the way they would actually need to to recover fully, you’re the one who probably knows what it is. Those support group people or a therapist may be able to help you phrase it better.

Apytele,

…and that’s why I’m getting it done next month. I’m genuinely worried it’s now or never.

Apytele,

My partner just said Bezos and its a terrifying symbol of what this world has become that that’s even a possibility. He’s like a real life Lex Luthor.

What's the most interesting traditional or formal politeness behaviour or table manners in your culture? Or for any service personnel, in your restaurant?

I love all the ritualized behaviour, secret meanings and unexpected taboos - standing up when someone of higher status stands, elaborate rules for serving and eating, tapping the table to thank the server, never refuse a toast from a superior, stuff like that....

Apytele,

Funny story: guess who populated a bunch of the Midwest?

Apytele,

https://sh.itjust.works/pictrs/image/f7ed2277-fd94-4c38-ac34-f10321d077c9.jpeg

Apytele,

In their defense, we really shouldn’t be doing chemo on dogs for the most part anyway. A big part of getting through chemo as a human is rationalizing the pain, nausea, and other discomforts. Humans can rationalize that those discomforts are saving their life, or at least helping them live long enough to go to their kid’s wedding or see the first grandbaby be born or whatever. A dog can’t rationalize or look forward to the future, the dog just knows it feels like hell today. It seems rather cruel when you consider it that way.

That’s just a medical ethics debate though, the financial aspect of this is cockamamie.

Apytele,

I have a lot of really REALLY fucked up ones. I’m an acute inpatient psych nurse but I’ve also had 4x inpatient stays of my own so I have a bunch of jokes that would leave my patients AND my coworkers speechless.

“Well I had a nuchal cord x4 (umbilical cord wrapped around the neck 4 times) so if you think about it, I’ve actually been trying to kill myself longer than I’ve been alive.”

“So then they restrained me and gave me a B10&4 (twice the amount of medication usually given for agitation) and I woke up in a state hospital with my back seized up from the Haldol and anyway that’s how I found out they were hiring!” 🎉

“I’m almost definitely more suicidal than my patient right now.” - Me (who’s had chronic low-grade suicidal ideation since I was like 12, sitting “suicide watch” on a patient who most likely just said they were suicidal so they didn’t freeze to death overnight on the street. Honestly I respect the hustle, if the psych hospital counts as comfortable to you I probably don’t even wanna know what your other option was. The mental health crisis in America won’t go anywhere until the housing one does).

Apytele,

It’s also completely undetectable to a reproductively abusive partner (clinical term for baby trapping). This allows the person to get their ducks in a row to leave the abusive relationship safely and for good, without alerting the abusive partner OR being trapped into being in some kind of contact for 18 years. By contrast, the closest women have is the depo-provera shot which only lasts 3 months and is arguably the harshest of all hormonal birth control options. RISUG is one of if not the best birth control method we’ve invented to-date, and we’re sleeping on it.

Apytele,

I said what normies will perceive not what is actually true. Although I will mention that gratitude is actually clinically proven to improve quality of life, but people also tend to frequently confuse it with toxic positivity. The example I have above is technically toxic positivity, but you’re doing little enough of it that the cost benefit analysis works out.

Apytele,

B-E-A-U-tiful

  • All
  • Subscribed
  • Moderated
  • Favorites
  • •
  • JUstTest
  • kavyap
  • DreamBathrooms
  • cisconetworking
  • khanakhh
  • mdbf
  • magazineikmin
  • modclub
  • InstantRegret
  • rosin
  • Youngstown
  • slotface
  • Durango
  • tacticalgear
  • megavids
  • ngwrru68w68
  • everett
  • tester
  • cubers
  • normalnudes
  • thenastyranch
  • osvaldo12
  • GTA5RPClips
  • ethstaker
  • Leos
  • provamag3
  • anitta
  • lostlight
  • All magazines
    •