Dionysus in mourning; the complicated relationship of Grief Related Insomnia

Nearly 3300 years ago at the Palace of Nestor in Pylos, Dionysus met the world. Born to Zeus, the God of Sky and Thunder, and Semele, an extraordinary mortal woman, Dionysus came into the world as a happy and curious baby. No official records exist which talk about his birth weight, but we can surmise he was likely more than 10 pounds at birth: children of the Gods always excel at everything, even if unintentional.

Records of Greek mythology note that Zeus fathered more than 50 children in his lifetime. He was exceptionally proud of Dionysus, almost to the point of inattention to his other progeny. Dionysus is seen as twice-born because his mother, Semele, gave birth to him and while she was dying, Zeus saved him by sewing him to his thigh and keeping him there until he reached maturity. Zeus then ripped him from his thigh, thus making him twice-born.

Hera, both the sister and wife of Zeus, is noted for her resistance to the authority of Zeus, and for her jealousy and hatred of his many lovers, wives, and children. Her anger was such that she directed the titans to tear Dionysus apart, then cook and eat him. Zeus became furious at Hera for killing his child and punished her by hanging her off of the edge of Mount Olympus.

Archival records show that while Zeus saw many of his children as non-entities, he grieved greatly for Dionysus: his favorite daughter, Athena, notes that her father did not sleep for three years after the death of one of his favorite sons.

While Zeus is indeed immortal, humans are not and require sleep. According to WebMD (2021) after 24 hours of insomnia we see an inability to regulate emotions, a rise in cortisol levels, (the compound that allows for emotional regulation), an inability to manage core body temperature, and significantly delayed reaction time. While this may be news to many people, it’s old hat for people that suffer from insomnia, and moreso for people who cannot sleep due to grief, complicated PTSD secondary to a significant loss, and people who have some sort of mental health diagnosis such as comorbid addiction and grief, etc.

Elizabeth Kubler Ross, the grandmother of grief therapy and the stages of grief, outlined the process of healing using the DABDA model: denial, anger, bargaining, depression, and acceptance. Kubler Ross’ was quick to note that people do not always navigate the SOG (stages of grief) in a straight line as we are not machines and other issues can interfere with healing, and often do. Dealing with insomnia secondary to a significant loss of some sort makes the world untenable for most people.

Three clinicians from the American Psychological Association (Lancel, M., Stroebe, M., & Eisma, M.C, 2020) identify various characteristics relative to sleep disturbances and bereavement. While the authors are quick to note that “grief induced insomnia” has not received the kind of attention as other forms of grief therapy, they identify “an article in PubMed which gave rise to a systemic review of insomnia secondary to significant losses”. This group also identified 85 articles encasing nearly 13,000 individuals. The writer’s note they answered seven pre-defined research questions demonstrating a high prevalence of sleep disturbances in bereavement. Further, positive associations of intensified grief with significant sleep difficulties were shown to have a higher comorbidity, IE: depression, and initial evidence of casual and causal relationships between complicated grief and sleep. However, while therapy to resolve issues of grief partly improves sleep, current research does not indicate specifically targeted sleep problems in bereaved persons.

While grief generally consumes a person’s attention, efforts should be made to decrease the severity of the malady. Initial energies can include various testing mechanisms. These instruments can illuminate places that are hard-to-treat. I’m including five scales that are well-received and peer-reviewed:

· Brief Symptom Inventory

· Anticipatory Grief Scale

· The Coping Assessment for Bereavement and Loss Experiences

· The Traumatic Grief Inventory-Self Report plus (TGI-SR+)

· The Inventory of Complicated Grief

Insomnia in grief is not dissimilar to other forms of complicated grief, but for the purpose of this article, I’d like to outline some criteria that speaks to CG (complicated grief). People afflicted with CG may exhibit the following symptoms: swelling in their heart and lungs, heaviness in the chest or tightness in the throat. Additionally, when people evidence CG, as noted by Prigerson, (1995), anger, hallucinations, and disbelief are evident. Also, as noted by Prigerson, people impacted by insomnia related to grief have reported “staying up for days on end” or simply getting “significantly disturbed sleep. The Inventory of Complicated Grief consists of 19 first-person statements concerning the immediate bereavement-related thoughts and behaviors of the client. There are 5 response options, ranging from “Never” to “Always.” The US Department of Veteran Affairs also notes that complicated grief requires a more acute level of intervention, IE: additional therapy, screening for issues found in standard blood draws, support groups specific to grief and insomnia, and perhaps identifying a CBT therapist that specializes in insomnia, CBTI. While depression was a significant feature in grief-related-insomnia, researchers saw a higher-than-average admission of suicidal ideation.

Doing a cursory review of this article you could leave with the impression that this is merely “all bad news”, however, I’d like to assure you this is not the case. While the field of loss-related-insomnia is relatively new, I identified supports that I would invite you to explore.

I think it’s also important to remember than your feelings of grief when you lose a guinea pig are no less important than someone who loses a loved one: we have to be cognizant that you cannot compare pain.

I’d like to outline some suggestions you can explore should you, a friend, or loved one suffer from Grief Related Insomnia:

· Find a CBT therapist that specializes in insomnia: CBTI is the designation for this specialty. Call your insurance company or explore the Therapist Finder on Psychology Today. You can also find various CBT groups online and those groups can offer recommendations.

· Talk to your medical provider about medications for depression and loss

· If you are consuming an excessive amount of alcohol, find a way to taper down your consumption. Addiction makes your world feel small, and excessive drinking creates an inability to tolerate or process emotions. Heavy drinking, without question, interferes with sleep

· Take a gander at Prolonged Grief Disorder Therapy

· Be kind to yourself. Offer yourself gentle reminders that this, too, shall pass

· Other things that have worked: purging your bedroom, adding a light for Seasonal Affective Disorder

· Keep a regular sleep schedule, attend to sleep hygiene

· Expose yourself to morning light

· Exercise on a regular basis

If we return to our roots at the outset of this article, we can give a nod to Oizys, the goddess of misery, anxiety, grief and depression. She approached Zeus, and much like the female lead in Dances with Wolves, she told him that his time for grieving was over. This was a huge gamble — Zeus is immortal, commanded millions of deities, tons of heroes, mortals, and gods. He could have struck her down without any thought, however, according to Greek literature, he thanked her, promoted her, and gave her protection as a goddess whose life was now immortal.

However you choose to deal with your distress, good luck and best wishes on your path.