Monday, July 20, 2015

Depression and Weight Loss: Is it hopeless?

For anyone who is here for the first time, today I'm writing about my struggles with mental illness, so if reading about that topic will cause you distress, you may want to come back tomorrow when I'll go back to my normal content.

Welcome to Mental Health Monday!  This regular series of articles from writers across the blogosphere was born out of a session on Depression, Anxiety and Healthy Living from Fitbloggin’ 15.  Every 1st and 3rd Monday there will be a link up for writers to share their experiences with mental illness – either from their own experience or from the experience of helping and walking with others.  The goal is to reach out to the world and let people know that they are not alone in their struggles.  You are never alone.  Join us – link up, visit new blogs, support others.  Speak out:  “I am crazy…CRAZY AWESOME!”

Since I spend a lot of time talking about weight loss here and because I know that some people with mental health challenges also struggle to attain and maintain a healthy weight, I thought I'd talk about how my bi-polar and binge eating disorders affect my healthy living journey.

I was never thin-thin (I weighed 125 pounds at 5'3" without much effort or thought throughout junior and senior high school) but I didn't develop a real weight problem until I left for college. I felt so overwhelmed by how much was expected of me - I'd always coasted through classes in high school - and by the freedom to eat whatever my heart desired instead of what my mom bought for the house, that I spent much of my freshman year shoveling Pop Tarts and the like into my mouth. I ended that first year about 60 pounds heavier than when I'd left home the prior September, so I tootled off to Weight Watchers for the first time over that summer. I lost about 45 pounds before I once again turned to food for soothing when my grandpa died just before I went back to school; by Christmas that year, I'd regained all 45 pounds I'd worked so hard to lose plus a few more for good measure. That pattern has repeated itself with regularity over the intervening 29 years, leaving my metabolism and self esteem pretty much destroyed.

Starting in January 2013, I managed to lose 99 pounds and kept off all but 17 pounds of that - I'm working on it! - since then. My regular bouts with depression certainly posed a significant challenge as I worked first to lose that weight, then to maintain the loss. I didn't have any sort of "backup plan" to deal with my uncomfortable feelings other than food, since that had always been my default.

In case it might be helpful to someone else out there struggling with the same feelings, I'm going to share a few things I've learned - am still learning, really - in the last 30 months:

  • Get regular, moderate exercise. Even when I'm fighting off a horrible bout of depression that leaves me feeling worthless and alone, I still get up and go for a walk for 45-60 minutes. By making that routine non-negotiable, I not only burn some calories but also get outside and create endorphins (the feel good hormone). It's a lot harder to feel isolated and not worth caring for when you're out in nature.
  • Remember why losing weight is important. When the depression gets really, really bad and I question why I deserve to breath air, it's all that I can do to get up and go through the motions of daily life - everything gets so much harder and resisting the darkness seems really futile. Fortunately for me, I only experience that level of depression once or maybe twice a year. Most of the time when depression hits it's a lot milder and I can recognize it much quicker, too. For those times, I can frequently stave off a binge by looking at the piece of paper with my hand-written list of reasons that I want to be a healthy weight. A picture of the list is the screen saver for my phone, so I can look at it any time I like without carrying the paper itself. Finding something more powerful than the urge to eat away the discomfort helps me a lot, and my "losing list" is really effective in that regard.
  • Seek help in advance from a mental health professional. When things get very dark, the last thing I think about doing is reaching out to my therapist, so I made sure that I found an eating disorder specialist/psychologist and established a therapeutic relationship with her before one of those super-bad episodes hit. Now I check in with her once a month and have the option of dropping her an email for an appointment in between if needed. If for some reason I didn't show up for our monthly appointment, Dr. Jennifer would reach out to me and to my husband, via electronic and voice mail, to make sure I was safe. I cannot recommend this step strongly enough: find your mental health professional while you're feeling good so that you have one less hurdle to clear when the depression hits.
  • Continue to weigh in at least weekly. For me, checking my weight on a regular basis keeps me accountable. Yes, the stupid numbers sometimes make me crazy because they don't always track to my behaviors properly. (I'll gain when I've been letter perfect all week or, equally perplexing and frustrating, I'll lose after a week with a few slips.) Scales are not the greatest measurement of how I'm doing with my journey to a happy, healthy life but it's part of my routine to check in at least weekly and keeping that commitment to myself is a way to reinforce my portfolio of lifestyle changes.
Even with those things going for me, I still sometimes fall back on food for soothing my feelings. The week of Fitbloggin', ironically, was the last time it happened. I try to remember that I'm human, that I struggle with mental illness, and that there are far worse things to do as a human being on Earth than binge eating a whole bag of granola in a sitting. Probably the most effective way I know of dealing with these behaviors is to recognize them and turn things around as quickly as possible without punishing myself. Which thought leads me to the last thing I've learned since starting on my journey this time:
  • Do not rebound from a binge or unplanned indulgence with self-hatred or a desire to "make up for" that behavior with extra strict eating or exercise. It's not easy to move forward from overeating by countering with a simple return to my normal healthy living routines but that's exactly what I've found works best for me. If I go crazy with restricting my food then I'm reinforcing the idea that my eating - and, by extension, me myself - is "good" or "bad", and that's not true. Instead, I look at what might have led to the disordered eating to see if there are lessons to be learned for next time, then I go back to eating normally with the next meal.
All of these things sound simple and easy, don't they? They aren't and I certainly do not always follow my own advice, but when I do it's remarkable how quickly I start to feel better.

If you suffer from occasional bouts with disordered eating, are there tried-and-true strategies you have found helpful when dealing with them? Share in the comments, please!

Monday, July 06, 2015

One week down: What now?

So it's been seven days now and I'm happy to report that I've done really well with my commitments this week:
  • Zero flour,
  • Nothing with more than 19 grams of sugar,
  • Three days of drinking 64 ounces of water, at least 48 ounces on the other four days,
  • Ten minutes of mindfulness on five nights,
  • and this is my third post of the week
Field of Hope
Field of Hope by Road Fun via Flickr

For the next seven days, here's what I will do:

  • Continue with no flour - I feel good and my blood sugar is starting to go back down again, so why not?
  • Continue with less than 20 grams of sugar - again, I feel great and my diabetes seems happy, too,
  • Seven hours of sleep at least four nights - I'd like to see what the extra sleep will do for my diabetes and my outlook on life in general,
  • Ten minutes of mindfulness at least five days (not nights) - being present is great for keeping me away from both doom and gloom thinking AND dark negativity,
  • Post at least three times this week - by knowing that I have to report my progress here, I'm far more likely to follow through on my commitment.
OK, what will you work on this week to improve your health?

Crazy Awesome: the inaugural Mental Health Monday linkup

For those who have been following along here from the beginning - or at least for a few years - none of the following will come as a great shock. For anyone who is here for the first time, today I'm writing about my struggles with mental illness, so if reading about that topic will cause you distress, you may want to come back tomorrow when I'll go back to my normal content.

Welcome to Mental Health Monday!  This was born out of a session on Depression, Anxiety and Healthy Living from Fitbloggin’ 15.  Every 1st and 3rd Monday there will be a link up for writers to share their experiences with Mental illness – either from their own experience or from the experience of helping and walking with others.  The goal is to reach out to the world and let people know that they are not alone in their struggles.  You are never alone.  Join us – link up, visit new blogs, support others.  Speak out:  “I am crazy…CRAZY AWESOME!”

Growing up, mental illness was something that happened to people in movies but never to anyone I knew (or so I thought). When I spent two days curled into a ball on the floor of my college apartment, unable to anything except cry and wonder why I was still alive, I figured I was overtired from all of my studying. Just after college graduation, when a close relative had what was then called a "nervous breakdown", we never spoke of it except once when my mother told me that it must have been because the relative was doing too much and "just needed a rest". Lots of tired people in my family, apparently.

I saw my first psychotherapist in my early 30s, when I was having a lot of trouble dealing with guilt over my recent divorce. She was a very kind woman who listened to me and told me that I was probably depressed. She never suggested any sort of medication nor did she provide anything for me to work on to improve my quality of life. As I recall, I started to feel better so I stopped our sessions. It was another few years before I saw another therapist. This time, she clearly told me that I suffered from depression (without any sort of diagnostic tools), and offered me anti-depressants to accompany the cognitive behavioral therapy we used in our sessions. Once again I attended sessions with her until I felt better then stopped. [Note that while I had some success with the second anti-depressant she prescribed - the first did absolutely nothing for me, my insurance would only pay for the generic version of that medication, which did absolutely nothing for me. I will save my rant about insurance coverage and mental illness for a future post; it will be a good one, I promise.]

I didn't see another therapist until after TCB and I were married. This time, my therapist asked me if I'd ever experienced manic episodes along with the depressive ones. At first I laughed and told her that I absolutely had not ever had a manic episode but then she told me they can be very mild and that she wanted me to see a psychiatrist for a diagnostic test. Turns out I have a mild form of bipolar (formerly manic) depression, where my depressive episodes are far stronger than the manic ones, and the transitions between the two are some of the toughest times I experience.

The symptoms of bipolar depression that I can relate to most strongly are showing poor judgment and taking more risks than normal - I spent so much of my life going through periods where both of those behaviors took over my life and I thought they were just signs of my weak character. Ten to 25 percent of those with bipolar disorder are initially misdiagnosed as suffering from depression, probably because it's so much easier to name than mania, particularly in its milder forms. Unfortunately, medicines used to treat depression can be dangerous for those suffering from bipolar disorder because, by elevating moods, they can enhance the manic behaviors. This is why it's so important to screen for bipolar with any new diagnosis of depression!

My hope is that, by speaking publicly about this part of myself, I can contribute to more understanding of a poorly understood, poorly treated disease. I'm linking up with others who are also affected by mental illness in one way or another and I hope you'll take some time and read through their thoughts and experiences, too. No one tells someone with a broken leg or the flu to "just get over it" so why is it OK to say that to someone suffering with mental illness? Because we allow it to be so. For me, that stops today.

Sunday, July 05, 2015

Day 6: Steady as she goes

As I sit here now, I'm nearly through six days of my "no flour, less than 20 grams of sugar, meditate 10 minutes every day" commitment, and I am doing pretty well.

  • No flour since Monday, not even a little bit. I really wanted a bagel yesterday when we went out for breakfast, but even though I ordered the egg, cheese, and sausage sandwich on a bagel thin and I had more than enough calories to eat it, I knew I'd committed to giving this a shot, so I tossed the bagel and ate the innards with some fruit.
  • Nothing with more than 20 grams of sugar. This one wasn't nearly as hard as the flour part but that won't always be true so it's a good habit to start.
  • I drank 64 ounces of water three of six days. If not for my commitment, though, I wouldn't have even done that three days. For the days I drank less than what I'd planned, I still got in at least 48 ounces, so I'm pretty pleased with that. The key to hitting my goal more frequently is making sure I have cold, filtered water available at all times.
  • Ten minutes of meditation is a lot tougher than you might think. I do my 10 minutes right before bed and I keep getting a horrible case of the fidgets. Still, I got in at least five minutes on five of six days, so I'm pleased with that. To increase my frequency (and enjoyment), I need to give it a shot earlier in the day, perhaps on my lunch break at work?
  • This is only my second post this week, so I'm short at least one for my goal of four before tomorrow night. Still, that's more than I've done in a while, so I'm giving myself credit for making progress.
I'll be back tomorrow with an update on the rest of today plus tomorrow, as well as sharing how I feel and what my plans are for the following seven days. I'm still thinking about what I want to do in terms of eating, exercising, and mindfulness; I'll figure things out by tomorrow night.

Tuesday, June 30, 2015

Day 1 of my no flour commitment is in the books

Today was a vacation day for me and, with TCB off at work, I was pretty much left to my own devices, which made it much easier for me to focus on making healthy choices.

Progress report on the items I committed to in yesterday's post:

  1. Today I ate no flour;
  2. I also ate nothing with more than 20 grams of sugar;
  3. I drank 48 ounces of water (my goal was 64);
  4. I meditated for just short of 10 minutes last night (my monkey brain was on overdrive);
  5. I'm back here, writing, today
I had a check-in with my Weight Watchers Coach today and I told her about my commitment to giving up flour for a week. While the Weight Watchers program allows for a variety of food options, she was very supportive of my choice, especially when I explained why I'm doing this. I know I'll feel better without eating baked goods and high sugar foods, plus I need to get a better grip on my emotional eating and that's nearly always centered on those highly processed foods containing flour and sugar.

I don't know if I can or will do this forever, but a week feels very achievable; I'll evaluate and adjust at the end of the week if needed.

Monday, June 29, 2015

Knowing and doing are two different things

We've already established that I know how to live as a happy, healthy person who maintains her weight. I lost the weight and maintained within 10 pounds of my lowest weight for 8-9 months, so I know what needs to be done. Right now, however, and for the last few months, I have been eating crazy amounts of food and making food choices that include way too much sugar and flour, and as a result I now weigh 25 pounds more than I did at this time last year.

I keep "starting over", telling myself I'll stick to my eating plan: lots of lean protein, good fats, low glycemic fruits and vegetables, limited amounts of naturally occurring starches like garbanzos, black beans, sweet potatoes, and corn, plus even more limited amounts of whole grains like quinoa and brown rice. And then something happens at some point - possibly the first day, possibly after five days of eating well - and I have "just one" treat. That one treat becomes a day of poor eating, sometimes several. (Once it was even a week long sugar/flour/simple carbohydrate fest.)

My blood sugar doesn't like these transgressions. My waist line does NOT like these transgressions. My self esteem isn't fond of them, either. I KNOW what to do but actually doing it is not easy - it never was and dealing with this wretched regain is not helping at all.

I need to stop moderating sugar and flour for a while, sort of like a detox, to see if going cold turkey will help mute the cravings. To help keep me accountable, I'm writing my plan down here so that someone else will know what I'm committing to for the next week:

  1. Nothing containing flour;
  2. Nothing with more than 20 grams of sugar;
  3. Drink at least 64 ounces of water each day;
  4. Meditate at least 10 minutes each day
  5. Come here to write 4 times this week
We shall see how this goes. I'm hoping to re-start my healthy eating and start rebuilding my self esteem by proving to myself that I still want to be happy and healthy.

Anyone want to join me? Leave a comment with your commitment(s) for this week and we'll keep each other accountable.

Sunday, May 31, 2015

Setbacks and lessons

You might have noticed that I haven't written in about a week. I have a pattern with this blogging thing, though, don't I?
  • When I'm doing well, feeling strong, I write
  • When I forget how important eating properly is for my long-term health, I disappear
Sometimes I disappear when I'm not on a hiatus from healthy living, too, but most of the time when I'm not actively writing, on some level it's because I don't want to shine a light on the way I'm living.

No shocker then that last week wasn't my best ever in terms of my commitment to improving my physical and mental health. It started when I weighed in on Sunday morning, after a week of absolutely perfect adherence to the super-strict first week of South Beach, to find that I'd gained half a pound. Seriously? I didn't eat a single piece of fruit, nothing processed, no flour, minimal sugar, and I stayed within my caloric limits, too, every single day, even when it was tough. And still I gained. To say that I was upset would be an understatement.

I told myself that I would take this little setback as a sign that I needed to "lean in" - recommit and go after it even stronger for the second week. I told myself it was probably just water weight and that another on-plan week would take that half pound and more off of my abdomen. I told myself all of that and then I spent that day plus five more on an emotional eating bender; if there was a starchy carb within a mile, I stuffed it in my mouth. Not my best week ever, to be sure.

At the end of the second day of doing this, I noticed how horrible I felt - not just emotionally but also physically: bloated, stomach ache, no energy. Noticing it didn't stop me, though, at least not until Friday night after work when I stopped to evaluate where I was and where I wanted to be.

By the time I left for my Weight Watchers meeting early Saturday morning, I realized that my body's reaction to my poor food choices was actually a gift because it's further motivation for making changes. If I'd never had a six day food bender, I'd never have realized it because it took forsaking all of those sugar, starch, and carbohydrate-laden foods for a week and cleaning out my system for me to appreciate how yucky they make me feel.

So this morning, during a conversation with my Weight Watchers coach, I committed to writing up my Losing List - reasons why I want to lose these last 20 pounds - so that I stay focused on why this is important to me in the long run (instead of solely focusing on the short-term gratification of sugary treats.

Why I want to lose weight:
  1. to keep my diabetes under tight control, avoiding complications;
  2. to avoid feeling bloated and nauseated from processed foods;
  3. a smaller body makes practicing yoga and running easier;
  4. I want my clothes to fit properly again;
  5. to have a healthy level of body fat (25% or lower);
  6. to inspire people around me to make their own positive changes.
The actual, physical list is handwritten and will travel with me throughout the next week and beyond. Will this magically keep me from turning to food when I'm tired, angry, or sad? Probably not, but I'm hoping that by reading it regularly I'll at least be mindful of what I'm trading off if I choose to eat starchy carbohydrates and refined sugar.

Sunday, May 24, 2015

Learning patience

I have been in pain for quite a while. The pain started in earnest when I began to increase my running mileage during my 20 weeks of training for the Tinkerbell Half Marathon; anything over four miles left me sore for several days. The pain starts in my lower back, extends through my left gluteus, down my left hip, and along the side of my left quadricep to my knee.

I have been seeing a massage therapist and chiropractor every other week since late February/early March hoping for a miracle cure but needing at least some relief from the pain. Now that my half marathon is over and I don't need to start training for my next half marathon until the end of June, I have gone back to walking every day instead of alternating walking and running on alternate days, and on Thursday I went to my first appointment with a physical therapist.

The therapy session was painful, to say the least: stretching and deep tissue massage of muscles that are nearly fused solid hurts a lot. I also have stretches to do twice a day at home; those are painful as well. In addition, the therapist told me to avoid running if it causes any pain, so that's pretty much confirmed my decision to focus on walking for a while instead of trying to keep up a regular running schedule.
Patience is not about how long you can wait, but how well you behave while you're waiting
Photo by BK, via Flickr
The problem is that I don't want to wait, or rather, that I'm scared not to run for fear my body will forget how to do it and I'll be put right back to the very beginning of my running journey. That fearful part of me wants to lace up my running shoes and go for a quick 3-mile run three times a week, as I'd planned to do several weeks ago when I was trying to plan for my post-half marathon routine. I'm trying to treat this whole situation as a great opportunity to cultivate greater love, compassion, and gratitude for my body and all of the amazing things it does, but that is easier said than done.

In the meantime, I do my stretches, as prescribed, twice a day, and breathe deeply as I do so. I enjoy my walks and the solitude of walking along in the cool morning air, and I know that doing that helps burn calories, maintain my healthy blood sugar levels, and keeps my anxiety under control. None of this is as planned but then life seldom is. Not every part of the journey to better health is something fun, so I keep my "why" front and center, for those times when gobbling down a dark chocolate peanut butter cup sounds like the best thing in the world, because it's not.