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A patient recently asked me,

“Hey im tryna start this sleep program on my phone and am shooting for a time to get in and out of bed every day. If I start my earliest class at 11am every day, what do u think would be an ideal time to go to bed? When should I wake up? 8:45-50ish?”

This is one of my really cool patients who is taking classes, working, and also has a personal life, while finding meaning and also life /work balance so their question is a really good question. 

Here is my response. And some additional thoughts on the sleep wake cycle balance and the larger question of balance that each of us must seek throughout our lives. 

“That seems kinda early. Think about what time you need to be out of bed and ready to be awake and alert. I personally need 2 hours from the time I get outta bed until I’m ready to work mentally. So think about counting your sleep hours backwards from whenever you need to wake up. 

If you need two hours to transition yourself from asleep to awake and ready to work/ think/ be mentally and physically present, then you would have to get outta bed at about 9 am. So if you give yourself 8 hours from the time you do lights out to lights on, then in theory your lights out would be at about 1 am. Unless you plan on getting in a run or a bike ride or a meal with your family. Or homework assignment before start of class or start of shift.  Then count that time in too. 

So the only problem with going to bed too early is that it confuses your body and your body won’t know what to do. If you put yourself in bed too soon, your body mind isn’t ready to shut down and it will just lay there and stare at the ceiling and make you mad. 

So I recommend don’t try to go to bed too early. Your sleep drive won’t be great enough then. Our body has to want to sleep, just like you have to want to eat or want to pee. So, what I recommend is this.....  Plan on putting yourself in bed with lights out about 8 hours ahead of your realistic requirement for lights on. 

Calculate your ideal lights on time (wake up time for setting your alarm clock, iPhone or chicken 🐓 if you have one) at any time that gives you enough time to mentally and physically wake up and feel alert. You want to be as consistently in bed and outta bed at the same time each night / day as you can, which is tough if your working / going to school/ making time for friends and family. But you can do it by making it a priority that serves your goals for yourself. Each person is a little bit unique and there are very few people who sleep exactly 8 hours every night. “

That was pretty much all my patient wanted to know. More than they wanted to know, actually. But their really excellent question got me to thinking some more.  I began to reflect on what reasons exist now for my increased happiness over previous years and times in my life when I worked my ass off trying to catch up with an illusion of being constantly busy to attain happiness. 

So here are a few more thoughts on bedtimes, rising, and finding peace and balance in life..... 

A caveat: I would not have taken my own advice when I was in my twenties to slow down. Now that I’m nearing 60, I’m seeing the beauty of the natural world for the first time and I can’t waste any more time on the gerbil wheel of working for the sake of working.  

These days I have come to celebrate the quiet and the peacefulness of sitting in my yard in the company of chickens. My chickens have become miracles of nature and I watch them perform their daily rituals of chickenhood. I would rather hang out with and watch chickens than go to a mall, read a book, or meet a friend for lunch. That’s weird I know. The older I get, the more okay with weirdness I have become.  

Maybe the pandemic has created a shift in me that I have needed all my life. Slowing down and enjoying the quiet back yard has become the sweetest time of my life so far. I must be an old lady for sure now.  I hang out with chickens and this makes me totally blissfully happy. It’s a balance that complements psychiatry. It’s non-verbal, it’s real, and it’s a group of people who have feathers, who have lives, and who have friendships, animosities and goals of their own. Laying eggs is just a fraction of what they do for me. I love these fluffy little dinosaurs and their unique personalities. Some are bold. Some are shy. Some are inquisitive and friendly, others distracted and shy. Some of my chickens ask to be picked up and appreciate being petted. Others basically tell me to give them some food and then go fuck off. None of them pretend to be other than they really are. I love each of them in a unique way. Since I can’t go to a workplace that features real live human beings any more, this feels just as good or better. I love my coworkers. They happen to be chickens. Is that so wrong? 

Peacefulness in nature has become sweeter to me now than I ever imagined. Try telling that to 25 year old me. She would have said “yeah, that’s great. I gotta go.” She would have been in a big hurry to get something done before the next person comes along and takes that idea and runs off with it.  I had a few older wise people (wise asses) in my life when I was young. It’s not until you get to a slightly older phase that some of us discover our own inner wise person / wise ass is the person who has been there all along. Ourselves. 

There are night people and morning people. I’m not a morning person. I’m a coffee person. I am working on this but I’m still not a morning person. I can adjust my schedule if I need to but the cool thing about doing your own clinic is you can adjust your hours to serve patients when you know you are at your brightest and best. And by taking time off to not work like a robot day in and day out, each patient gets to see a fresh, happy doctor. Wouldn’t it be nice if everybody loved coming to work? I dream of a day when that will be possible for everybody. 

When we can get off the conveyor belt of forced labor and let ourselves have quiet time, not just work, sleep and party time, then I think we will live in a world of happier people. If you are in a stage of your life where you must work your ass off to survive (been there, done that) then do what you gotta do to stay alive. If you don’t really HAVE TO work your ass off but you are doing it anyway for no really good reason then something may be wrong. Most animals spend part of their day just chillin. Dogs like a comfy spot on the couch. Have you noticed that? They are not up running around, sniffing barking and chasing sticks from 9 to 5. 

Am I saying everybody should just wake up, smoke a joint or flick on the TV and just zone out? No. I’m not saying that. What I am saying is this... make some quiet time, a short time or a long time, but make some quiet moment in your day where you can just think your own thoughts and be you for a minute. Find out what your own natural rhythm is. And then if you possibly can, try to live in harmony with your body’s preferred cycles. If you love being awake at night and really prefer to sleep all day, then maybe you need to get a job as a vampire? 🧛‍♀️

Just kidding. Maybe you need to get a job that allows you to work at night. I have met many nurses, doctors and even some housekeeping staff who really do feel best when they get to be up and about when the rest of us are sawing logs (snoring) in our beds. The world may not easily accommodate the vampire heroes among us. But remember, somebody needs to do these night jobs. If you love working at night, keep doing it. 

Some people like my mom are early risers. They go from zero miles per hour to 60 in about 5 minutes. These people can be annoying to some of us who are not morning people. I personally am naturally a night owl. I think my best thoughts naturally between about 11 pm and 2 am. So I build my work life around this. 

Except in the summer in Tucson when it’s too friggen hot to walk a few paces to the mailbox after about 9 am. Then, because I love chickens and gardening, I try to set my mind body clock to operate like a landscaper. They get most of their work done between 4 am and noon. I took down my dark curtains recently and discovered this lets me wake up naturally on the early side so I can have quality time with my chickens before I start my day as Dr Goldman. 

When I worked full time in a hospital, I had to make 90% of my clinical decisions before noon. Coffee, and I mean big time coffee became my close friend.  That was rough for me personally. I did it for a while and then I decided to do something else. 

I like this better. I get to have time for my amazing cool patients and also time to just hang out with chickens and watch them be themselves. Am I going to make a lot of money quick by doing life this way? Probably not. But I have decided that enjoying my life while I’m in it, well that is really just super important to me now. 

You get to choose for yourself. You can, if you wish, go ahead and work all day and all night and make money if you want to. That just doesn’t fit for me anymore. I’ll work happy, not work hard. It makes me a better doctor to my patients when I’m not in a super big hurry. 

I think patients need a doc who can slow down and listen. I think we all need to be heard. Especially by ourselves. We can’t really listen to the true inner voice of our highest and wisest selves if we are grinding away all the time. Listening to the true self requires quiet time. I have quiet time these days because I choose that for myself and I have created that. I received the teachings of a handful of persons who are, because of their experience, smarter than me. 

I chose to listen because I wanted what they had. Calmness. Relaxed alertness. Comfortable generous friendliness. When I am calm, I offer peace to the world around me. When I am hurried, uptight and a bundle of scattered energy, what type of energy can I offer to the world?  Why would I offer a scattered, distracted, less-than  -fully-present listener to my patients? What’s in it for them? I bring peaceful alertness to my patients when I find peaceful alertness for myself. 

For now, because I set my own hours and I have become my own boss, I never schedule patients before 11 am. That way every patient gets the best Dr Goldman I can give them. 

And I make sure to allow plenty of free time for myself to do my necessary slacking. Hanging out with my chickens, feeding them, cleaning their cage and tending to their emotional needs (they like to be shown affection, they are not super bright but they do have feelings) while I am collecting their eggs or just watching them be cute and chicken-weird, well this relaxes me and allows me to enter my work hours with a mind that is balanced, free from pressure and ready to listen. 

As my best Yoga teacher in the world, Yo Clark of Any Body Yoga in Memphis likes to say, “as important as effort is ease”.  I look to the wise teachers around me and learn what I can from them. I offer what I have learned by making tons of mistakes and trying different things in order to find out what works. Becoming an old lady is more fun than I could have possibly imagined. 

So, my young friend, your task is to figure out how your own body mind works, what your sleep and wake needs are and how to offer yourself the best mental physical diet of wakefulness, relaxed alertness and deep sleep. As you learn to breathe your own breaths, think your own thoughts, let the sun rise on you and let him set, learn that you too belong to nature. Learn to sleep with great enthusiasm.  And to wake up in gratitude and love of the natural world. Learn to accept the mammalian being that you are, complete with a limbic system, a sense of right and wrong and a set of likes and dislikes. Get some parts of your life right while getting other parts of your life wrong. And learn to love your own so called “mistakes” and foibles as much as you admire your own greatest accomplishments and strengths. 

The number of hours of sleep you get is measured in the dreams of your lifetime. Don’t cheat yourself out of the sleep you need and DO save time each night for dreaming your own dreams, no matter how weird they may be. The beautiful dreams you dream throughout your life are natures wise way of telling you who you are and what you are up to next. 

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Whole Human Psychiatry

If you are a healer and are suicidal call me at (515)-497-0820. If you are a doctor in crisis, call me now for a free phone consult. Not one more physician suicide!

Psychiatry for smart people.

Lisa E. Goldman, MD, MSW

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