You were exhausted at 3 p.m. You were exhausted at dinner. You nodded off on the couch twenty minutes ago. Then you got into bed, turned off the light, and your brain opened for business. 

Now you're replaying what you said on the afternoon call, drafting tomorrow's email to the client, wondering whether you double-checked that exhibit, and trying to decode what the partner meant by "let's catch up tomorrow."

Racing thoughts at night usually happen because bedtime is the first quiet moment your brain gets all day, and it uses that moment to catch up. 

If this is a regular part of your life, you're in good company. It's one of the most common reasons people can't fall asleep, and I'd guess nearly every lawyer I've worked with has been through a stretch of it. 

The good news is that there are specific, practical ways to quiet it down. Most of them come from Cognitive Behavioral Therapy for Insomnia, or CBT-I, which major medical guidelines recommend as the first treatment for chronic insomnia.

There is a specific kind of sleep complaint I hear more than any other, and it almost always comes with the same disclaimer. "I don’t have trouble falling asleep. I’m out in five minutes. It’s just that I wake up at 3 a.m."

People say this apologetically, as though it disqualifies them from having a real sleep problem. It doesn’t. It might be insomnia and it’s not uncommon with my clients. It also has a specific explanation, which I want to walk through, because once you understand what’s happening at 3 a.m., the whole thing becomes less mysterious and considerably less frightening.

High-functioning anxiety gets missed for a simple reason: every symptom is also a job skill.

Rereading the email four times is thoroughness. Running through the worst version of the meeting the night before is preparation. Checking the document after you already checked it is diligence. Asking a colleague whether something is fine, and then asking a second colleague, is collaboration. None of it looks like a problem, and most of it gets you promoted.

I’d like to describe what depression treatment actually consists of, because I think the vagueness around it does real harm. When you don’t know what happens in the room, “you should probably talk to someone” sounds like a vague instruction to feel better, and vague instructions are extraordinarily easy to postpone. So here is the specific version, including what I’ll ask you and what we’ll do.