Dear Counsellor:

I am having difficulty falling asleep and remaining asleep. I wake up early and am unable to go back to sleep. I feel tired and sleepy in the daytime. I need some help.

- Joan

Dear Joan,

Sleep problems are very common among Jamaica's population. Many people have a variety of sleep problems similar to yours. In assessing someone for sleep problems, we need to get a detailed history. The onset and frequency of the insomnia are important.

Insomnia is lack of sleep. Daytime sleepiness is an important symptom. The occupation of the individual is also important, as some people work at nights and this upsets their sleep cycle. We need to know the treatment the individual is taking to cure insomnia. Many people are using a variety of herbal preparations. Sometimes the individual develops tolerance to medication and needs new prescriptions.

Depression and anxiety are some of the conditions that present with insomnia. Depression and anxiety are easily treated with medication and counselling. Depression also presents with hopelessness, helplessness, tiredness, poor appetite and suicidal ideation. See your doctor urgently if you have any of the above symptoms. These days, many people are feeling stressed, and depression is the result.

Positive thinking will help you to get better sleep. Negative thinking will impair your perception and cause the hopelessness to worsen. You have to think that you will be able to get adequate sleep. Keep a sleep diary and document the times you fall asleep and your thoughts at those times. Keeping track of your thoughts and responses will help you to instil positive thinking in your schedule. Your schedule should include a time for sleep onset. You should try to go to bed at about the same time each night.

You can read your Bible and pray just before you fall asleep. If you are worrying about anything, make jottings on paper as to the problem and the possible solutions. Go to your bed believing that the solution to your problems will materialise.

Remove the television from your bedroom and make your bedroom sleep-friendly with pretty sheets and soft pillows.

Go and see your doctor for a physical examination to identify the possible cause and effects of the insomnia.

Dear Counsellor:

I am an alcoholic and it is difficult for me to quit. My family has ostracised me and my wife is threatening to divorce me. I need some help.

- James

Dear James,

Alcoholism is a condition in which relapses are common and the individual may feel challenged. The challenges can be overcome with support and supervision. You need to join an Alcoholics Anonymous (AA) group which will provide you with a sponsor. The sponsor will give you support, encouragement and supervision.

Many people have been able to stay sober through joining AA. It is good to get yourself detoxified at a rehabilitation centre. Whenever an alcoholic stops drinking, his body goes into a reaction called delirium tremens and he will need medical assistance to deal with this.

You will need rehabilitation to help you stay on the path of abstinence. Many people drink alcohol to help them cope with life's challenges. Sometimes they may be depressed or anxious, and the alcohol causes them to be temporarily numb to the problems. Individual counselling or couples and family therapy is critical. There are support groups for children and spouses.

The family is important in the life of an alcoholic. Relatives are affected by the alcoholic's behaviour and he or she is sometimes isolated and ignored. Alcohol is legal and easily accessible, and alcoholics find it challenging to remain abstinent. It is possible to be abstinent with God's help and the support of others.