Fiction: The Sleep Junkie
By Alex McMillin
Dr. Zhang is the fourth psychiatrist I’ve seen this year. When I tell her this, she just nods slightly and scribbles something on her notepad.
Her office is pretty much identical to the offices of every other psychiatrist I’ve been to — motel art on the walls, furniture in neutral colors, etc. There isn’t a speck of dust anywhere. The air conditioner is set to room temperature.
She looks up and brushes back a lock of graying hair.
“And why do you feel that is?” she asks, peering at me from behind thick wire-framed glasses. Not “Why is that?” — “Why do you think that is?” Psychiatrists are always subtly letting me know that my reality cannot be trusted.
“Well, two of them just weren’t very good and the other one told me to stop coming.”
“Why did they discontinue treatment?”
“He wanted me to make some lifestyle changes that I wasn’t willing to make. When I told him that, he said there wasn’t any point in me coming if I wasn’t going to follow the treatment plan.”
I can see Dr. Zhang zero in on this last remark. “What were these lifestyle changes that you weren’t willing to make?”
“Well, he wanted me to cut down on the amount of time I spend playing video games, which I actually was willing to do. But he also wanted me to drastically alter my sleep schedule, which I wasn’t willing to do.”
“How did he want you to change your sleep schedule?”
“I usually sleep like 12 hours a night, and he wanted me to sleep more like eight hours a night.”
Dr. Zhang’s neutral expression betrays nothing. She simply makes another note and asks, “Would you say that maintaining your current sleep schedule is important to you?”
“Yeah, I guess so.”
She rubs her chin, her eyes half-closed in concentration. “Would you say that sleeping is simply a necessary part of life, or is it something that you actively enjoy?”
I have to admit that I’m impressed by Dr. Zhang’s insight.
“I do actively enjoy sleeping, yeah.”
“What do you enjoy about sleeping?”
I take a deep breath and sigh heavily. “I have some really intense dreams. From what I’ve heard, this is pretty common for people on antidepressants.”
Dr. Zhang frowns. “Yes, though… you’re on escitalopram, 20 milligrams, correct?”
“Escitalopram is an SSRI. Generally, SSRIs cause unpleasant dreams.”
“Well, these dreams aren’t entirely pleasant. They all seem to be… sad in some way. But they aren’t nightmares, exactly.”
“I see,” Dr. Zhang says. She starts writing.
After a moment, my eyes start to wander across the room, finally falling on a large painting hung on the otherwise-bare wall to my left. The painting is an amateurish watercolor done in a bland earth-tone palette. It seems to depict an idyllic beach scene, but the closer I look, the less idyllic the painting becomes.
The bird’s-eye perspective makes me feel as though I’m hanging on thin air several hundred feet above the beachfront. The beach is backed by a titanic cliff wall that runs from the left edge of the canvas to a distant promontory near the right edge. The beachgoers, rather lazily depicted as semi-articulated beige smears, seem trapped between the cliffs and the roiling gray sea.
Dr. Zhang turns a page and continues writing. I’m flattered that she finds me to be such an interesting case.
The artists that create these paintings must hate every second of their working lives. Or maybe they’re making so much money that they just don’t care. After all, there are quite a few motels and doctor’s offices in America.
“Could you describe one of these dreams for me?” Dr. Zhang is looking at me intently, her pen poised above her notepad. “Maybe a recent one that you remember well?”
Though it was obvious that this question was coming, I still find myself reluctant to let a stranger into my subconscious. It feels like showing someone one of my poems for the first time. I don’t know how to lie because I don’t know how that might warp Dr. Zhang’s perception of who I really am.
“Ummm… okay,” I say. “I did have a pretty memorable one a few nights ago.” I glance at Dr. Zhang, who nods in encouragement.
“So I was playing some weird card game in a casino. The table wasn’t in the pit with the rest of the tables. It was in a dark back room. Maybe the high rollers room or something. The guys I was playing with were all speaking a language I didn’t understand, maybe Vietnamese? Anyway, I was losing a lot of money, so I decided to cash out what chips I had left.”
I pause until Dr. Zhang stops writing.
“I had to pass through the pit on the way to the cashier. I noticed a pretty female dealer closing one of the tables and…” I sighed. “... a polar bear cub sitting next to her. I was so distracted that I tripped and dropped my chip racks. The dealer helped me pick up my chips. While she was getting the chips together, I looked up at the polar bear. He told me that he had been taken from his mother two years ago, and I felt bad for him.”
I look up at Dr. Zhang. “That’s where the dream ended.” She nods and continues writing.
“So what’s it all mean? Or do psychiatrists not do the Freudian dream analysis thing anymore?”
A slight smile flashes across her face. She finally finishes writing and looks up at me. “Dream analysis is uncommon in mainstream clinical psychiatry these days. What I’m interested in is the intensity of the dream and how disturbing you felt it was.”
“Well, I didn’t really feel that the dream was disturbing, but it was intense in the sense that I felt emotions during the dream.”
“Are your dreams usually emotionally charged?”
“Would you say that you feel stronger emotions while you’re dreaming or while you’re awake?”
“In my dreams.”
Dr. Zhang nods and takes a note. “And you find that desirable? That’s what you enjoy about dreaming?”
“Well, it’s better than being numb. Which is how I feel when I’m awake most of the time.”
She takes another note and asks, “How long have you felt this sense of numbness?”
“Since I started taking the antidepressants. Although being numb is still better than what I felt before I was on the antidepressants. Back then, I was just in agony all day, every day.”
If Dr. Zhang pities me, she doesn’t let it show. “I see. We could reduce your dosage of escitalopram. Twenty milligrams is a fairly high dose. I think that ten milligrams would still be effective, and you would likely have less severe side effects.”
I sigh and rub my forehead. “I was on ten milligrams originally, but I had a breakdown and they increased my dosage to twenty milligrams.”
“When you say ‘breakdown…’”
“ I committed myself to a mental health crisis center for one night because I was suicidal.”
“Okay. How long ago was this?”
“About two years ago now.”
“And you’ve been stable since then?”
“Yes, but I feel that I’ve been stable because I’m on a higher dosage.”
“So you don’t feel comfortable with a reduced dosage of escitalopram?”
“I don’t mean to be difficult, but no, I don’t.”
Her expression remains neutral. “If reducing your dosage is out of the question, then our options are limited.”
I nod. “Yeah.”
“Though I do think that you could benefit from weekly therapy sessions. As far as your sleep schedule goes, I think that if we work on the underlying issues in our therapy sessions you won’t want to sleep quite so much.”
I fidget a little and look at the painting. “Yeah, I guess that makes sense.”
“Why don’t I pencil you in for next Friday at 3? You can cancel if you decide against it. There’s no cancellation fee as long as you give us at least 24 hours' notice.”
My insurance will cover it anyway. It’s not like I have anything better to do.
“Alright, you can put me down for next Friday. I’ll call if I decide to cancel the appointment.”
Dr. Zhang makes a quick note and underlines it twice. “That’s fine,” she says. She looks at her watch. “I think we’re off to a good start today. I look forward to meeting with you next Friday, and thanks for coming in.”
“Thanks for your time,” I say.
I leave her office and walk slowly through the strip mall’s half-empty parking lot. A light breeze carries the scent of exotic spices from the Indian restaurant on the corner. Rain is coming—I can smell it in the air. I stop and look across the lot to my little white hatchback. The raindrops will start falling any second now.
Alex McMillin is an American fiction writer. He's currently working on a collection, which will include this story. Follow him on Twitter @McMillin_Writer.