I have not been sleeping well lately. TMS seems to have worsened my insomnia such that I’ve slept five hours a night, give or take an hour, for the last few weeks. It’s not so little that I was dramatically impacted right away, but the cumulative effects are becoming apparent.

For one thing, if I stray below 5 hours of sleep at this point, everything looks like spiders. Little clumps of dirt, loose threads on a napkin, you name it – if it’s small, dark, and in my vicinity, I think it’s a spider. It startles me, I flinch away from it, and then I feel stupid when I realize it’s just a particularly grainy spot on my wooden desk or some other innocuous thing.

Anything in my peripheral vision that seems at all unusual catches my attention. I was sitting at my desk on Friday, trying to work when I got this feeling that someone was standing in the hallway to my left. I looked – nothing there. It happened again, so I looked again – nothing there. I think I was seeing the hinge on my glasses against the empty hallway. The dark spot somehow got turned into a vaguely person-shaped image in my mind, and it unsettled me. Information coming in through my senses feels chaotic, and I find myself being jumpy and on edge.

Trazodone helps me fall asleep, but I continue to wake up after 4 or 5, sometimes 6, hours of sleep. Five hours is unpleasant, but the world looks mostly normal. Four is when things get wacky, and six seems to restore my sanity somewhat. I’ve definitely gone long periods of time on 6 hours a night before and been free of spiders and other illusions, so I guess five hours most nights with occasional dips below that is my limit.

I think it’s interesting that creepy crawly-related hallucinations/illusions/perceptual mixups are so common. Some of my ketamine infusions resulted in hallucinations of insects when I went home. (It is not supposed to do that.) One time, I was transfixed by some bug-inhabited cobwebs that weren’t real, and another time, I mysteriously hallucinated for three days. Small, black bugs scurried from one side of my visual field to the other and sometimes took up residence on tangible objects. I slept about two hours a night and found myself unreasonably motivated to complete tedious jobs like pruning our overgrown grapevines and reorganizing the hall closet.

That incident happened after I had been taking 12 mg of Emsam for a few weeks. My post-ketamine experiences started to become more and more bizarre and culminated in the three-day…whatever that was. I decreased the Emsam back to 9 mg, and my ketamine infusions went back to how they used to be.

Months later, I ran out of 9 mg patches and decided to use leftover 12 mg patches until I could get my prescription refilled. It was an informative experiment. I had horrible insomnia and felt similar to how I feel now. Inanimate objects started to sway back and forth in my peripheral vision, white noise sounded like music, and small, bug-like dots explored the world to my left and right until I looked at them directly. Then, they would disappear.

However, all of those incidents were different in that the insects were completely fabricated; my current spiders are actual things in the real world that my brain is transforming into momentary terrors. Thanks, brain.

I haven’t noticed any benefit from TMS yet, but we’re adding an off-label priming protocol to my regular treatments. Maybe I’ll just be a late responder. I’m trying not to feel discouraged, as I know it’s not a helpful state of mind. I’ve been feeling worse the last few days, which isn’t making it easier to be optimistic about TMS. I suppose I’ll just keep at it.