I have a friend that: has insomnia which gets worse with work-related stress, and can't sleep at night for more than an hour or so at a time when she's alone pathologically blames herself for her percieved incompetence, e.g. "I keep sleeping because I'm too weak to stay awake" sleeps maybe 26-28 hours in a week. "Three hours is enough for one night" she recognises that this is ruining her health but she won't do anything to stop it, instead citing other factors (I eat too much, I'll switch to a healthy diet, I need to exercise more so I bought some equipment online) which can't be realistically implemented can't stand student-teacher conflict. she still gets angry/vents stress at teachers by talking to fellow students, but she won't express her opinions directly she's an exceptionally diligent student, but she gets sick very often (she blames this on genetics) and won't listen to anyone telling her to sleep more or slow down. she's permanently sleep-deprived and stressed all the time. she has high expectations for herself and justifies them by saying that's what the teachers want from her downplays the bad things that happened to her (listed below), generally seems to care more about other people's well-being than her own Notes on her past and present home situation: she is currently a 12th grade (senior year) boarding student in a IB international school in asia, redoing the year because of a eye injury her parents don't know about her situation, she tells them she's going to sleep and then she doesn't. she goes to sleep at 9pm, wakes up at 12am, and works till 7am she lived in Canada for a year with her little brother in a abusive boarding situation (the boarder had a daughter who she repeatedly beat with a metal pole, kicked her out / refused to give her money for food, and took her phone away from her so she couldn't contact her parents). she told her parents about some of it (they threatened to sue but never actually went through with it) but not everything. she's more concerned that her time spent in Canada stunted her brother's development rather than what it did to herself had a friend in Canada who secretly confided in her after being sexually assaulted, which she says contributed to her being sex-repulsed (she's uncomfortable even with talking about sexuality in English class). she's been in two car accidents. the latter was severe enough to give her a lasting neck injury and ptsd symptoms (triggers, anxiety, etc) she has many friends, but "only feels close to a few of them". This is the first time I've posted on this forum and I've never asked for advice online before, but I'm seriously worried she's going to burn herself out within the month, let alone before Finals. I would really appreciate some advice as to what to say to her so she can sleep more or at least stop stressing out to the point where it's clearly unhealthy. Things that haven't worked: "Please sleep for God's sake" (from various classmates) "Did you know people can go insane if they don't sleep enough?" / "Do you want to borrow my prescription pills if you have trouble sleeping?" (from me) and "More sleep = more studying" infographics and pep talks (from various teachers) Thank you for your time!
This is difficult, because if it was a case of 'My friend can't sleep but wants to' that would be one thing. But if she's accepted the insomnia as a thing to be encouraged... Will she be getting any breaks before her exams? It sounds like she's in dire need of a holiday of some sort, even if that's just back at home with her parents. Did she sleep better when she wasn't at school? Others might have a different opinion on this, but from my own experience: when friends of mine have been absolutely determined to continue down a path that isn't the best, and all other interventions seem to have failed, sometimes you need to just let them carry on and be there to pick them up at the end. It really sucks, because of course you care about them and don't want them to continue with behaviours that aren't good for them. But at the end of the day they're the one calling the shots on their own actions. It might be that gentle reminders that sleep will help her achieve the things she's aiming for are the best thing you can do for her. Though what might get through more than that are reminders that she deserves to practice self-care. So ideas for things that aren't sleep related, because that seems to be a major sticking point, but are still little things she can do to look after herself. Having a bath or shower with nice toiletries, having snacks she likes, going for walks, etc. She can take those on board or not as she sees fit. It sounds like she's been focusing a lot on what she can do for other people (reassuring her parents, looking after her brother, etc) which are generally nice things to do, but become problematic when you're doing them at the expense of your own mental wellbeing. She's already got a good thing going for her in having a friend like you looking out for her. Please do remember though that whilst looking out for her, you also need to look out for yourself too. Self care is important for everyone involved.
Having known people like this, and having even taken on some of these behaviors in undergrad - this sounds to me like it might actually count as a form of self-harm (or at least serious self-sabotage) at this point. Knowing something is destructive, knowing it isn't healthy, but getting to take a perverse sort of pride in how much more you're doing regardless, not trusting other people's assurances that it's okay to take care of yourself, feeling close to few people (so you have fewer people to fail and fewer people whose advice it feels like you have to take)... I think it probably goes deeper than just "being stressed" or "having high expectations" at this point. It sounds like she might really want to have control - if she can control how little she sleeps, or her diet, and is doing so much all the time that she doesn't have time or energy to confront the scary things in her life (unexpected bad things happening to herself or other people, how other people will react if she confronts them), then she never has to feel like anything is out of her control. I can't really say, not knowing her, how her past of trauma and desire to take care of others plays into this. But trying to regain a sense of control after traumatic experiences does seem to me like it could be a connection. It's a high-achiever's mentality that she's found a way to use to be really destructive. As for what to do, I wish I knew :( For me, it was ultimately realizing I was making myself miserable (after three years) and going into therapy that helped me. But it sounds like it's clear, whatever the problem is, that she's not yet at the step of "admitting this is really hurting me." I think the idea above, of suggesting relaxing things to do that aren't sleep, is a really good idea - maybe in time she can learn to expand the "taking time for me" part of self-care into the fundamentals of "eat regularly, take care of your body even when it's hard and you don't like yourself" that she seems to be lacking. Also, I'd suggest: Remind her frequently how much you like her as a friend, independently of anything she does for you - show her love when she's beating herself up for her own incompetence, without making your love contingent on her changing her behavior. Instead of saying "No, you're not weak/stupid/incompetent!" when she kicks herself, let it go by - just respond with an "I love you," or "I'm worried about you." Telling her she's not weak/stupid/incompetent could feed into a destructive loop of I can't let anyone know I'm weak and struggling, they only like me because I'm meeting expectations. When she talks about how high her teachers' expectations are, bring it around to, "Well, I'm really only concerned about how you're feeling right now" and then move on. Be honest about your feelings towards her behavior; don't try to convince her to behave differently (it sounds like she doesn't really want to make a change right now); always, always emphasize how much you like her, regardless of what she's doing. The hope is that eventually, she'll be able to normalize to some degree the belief that the world will not come crashing down if she slows down, and you will never like her less. And, of course, make sure to take care of yourself, too. As the above person rightly said - hard as it is, sometimes it's best to let someone come to the breaking point once, and help them back up from the bottom. Maybe experiencing what feels like a real failure and realizing that she still has people on her side, people who don't calculate her self-worth by how much she's working, would be really good for her in the long run.
