A Brief History
I have struggled with capital-D Depression nearly my whole life. During my childhood, my mother tried to take me to child psychologists. It didn’t take. As a teenager, a second attempt was made, and we tried pharmaceutical therapy as well. From Zoloft to Prozac to Paxil, nothing seemed to change things for the better. So, I gave up.
By age eighteen I was habitually using methamphetamines, and all the clouds cleared away. I reflect fondly upon that part of my life, and I realized at some point in my later twenties that I was self-medicating with amphetamines. My mental illness was in remission, because of my drug addiction. Obviously, going back to meth wasn’t an option, but it gave me a real insight into the validity of my claim to mental illness.
Meth withdrawal saw my mental illness roaring back to life and making up for lost time. Between ages twenty and nearly twenty-four, I was a nightmare. It was a very dark time in my life, and that anyone who knew me then still loves me now is a miracle. By my mid-twenties, I was working hard to understand and manage my symptoms. I had a steady job, I was getting out and making friends, and I was trying to write again. Most remarkably, I quit smoking in 2012 and subsequently succeeded in losing nearly sixty pounds all on my own steam. In late 2012 I was feeling like I was on top of my game, and I packed my suitcases and moved across the country to be with my current boyfriend, a former friend for whom I developed feelings during our 1600 mile separation.
I thought I’d been through the worst, but my relationship with Daniel threw my illness right back into hyper drive. Daniel is my polar opposite, emotionally. He doesn’t worry. He doesn’t fret. He doesn’t flip. Nothing is urgent. Everything is fine. Why are you freaking out? Calm down, Chey. It’s not a big deal.
It drove me literally insane to be paired with someone for whom life just was, instead of representing a constant obstacle between one’s self and one’s happiness. I don’t know how Daniel has survived it for four years and counting, or how he continues to survive it while I work to understand, manage, and conquer what ails me. He is a blessing and a curse, and I hope we’re worth it for each other.
The Present Day
Two of my best friends also live with mental illness. The key difference between them and me is that they have had access to professional care from nearly day one, and have been medicated and treated consistently for the better parts of their lives. They are therefore very pushy about the benefit of professional help, and routinely lose their patience with my excuses for not seeing psychologists or taking pills. To be perfectly honest, I don’t want a therapist. I don’t want to spend money and time on it, I don’t want to go through seventeen people before I find someone I don’t think is garbage, and there is some stuff I really don’t care to share with a paid professional. On the other side of things, I don’t want to fix with pills. I don’t want the solution to my problems to be drugs. There has to be something in me that’s strong enough to survive myself.
In 2015 I opted for the Mirena IUD. Side effects are typically minimal, as Mirena’s influence on your body is localized to your uterus. But, because every body and every mind is different, my experience was characterized by weight gain, a spike in the severity of my illness, and a detrimental shift in my ability to rest or be active. I didn’t notice. I assumed it was all on me. I was lazy, sick, and tired and I was doing all of this to myself. By the time I scheduled my salpingectomy in early 2017, Daniel and my friend Natasha took it upon themselves to encourage me to do away with my IUD, despite the relief it gave me from my menstrual cycle. It took the two of them gently ambushing me with examples of how much worse I’ve been for the last two years, and Natasha showing me photographic proof of my weight gain, for me to finally realize Mirena and I needed to part ways. It has been bittersweet, but much should change for the better.
Although mental health and proper sleep and activity are important, it was the weight gain that upset me the most, once I realize the extent. In a previous blog I addressed the subject of my weight gain. I hovered between 200 and 205 pounds before early 2015, and when I wrote the blog I estimated my weight gain to be twenty pounds, tops, putting me at 220ish pounds. I made this estimation based on how well my size sixteens still fit, how well I could still suck in my gut, and the fact that my boyfriend didn’t seem to have anything to say about the change in my body. I’m not saying he’s the type to comment on a woman’s weight gain, but I’ve always encouraged him to be candid if he thinks something is wrong with me.
Now, I hadn’t been weighing myself for years. I don’t really believe in it. But, when I ditched the Mirena and decided I needed to get back on track, I started using My Fitness Pal again to get an idea of how I was eating. The thing about My Fitness Pal is it really only works if you tell it how much you weigh. Otherwise, its predictions about your progress have no basis in fact. So, I asked a coworker to bring me her scale from home so we could keep it at the office. Word of advice: Don’t bring a scale to the office. It makes everyone insufferable.
When I stepped on the scale, I nearly wept. The actual damage? 243
To be clear, when I was at my heaviest I was 260 pounds, and I lost sixty of that in a year. How I gained thirty-five pounds back in two years and couldn’t see it for what it was, I have no idea. Seriously, where on my body am I hiding it?? I am devastated, and thoroughly confused.
So, What Am I Gonna Do About It?
With the combination of weight gain, depression, generalized anxiety, and life altering insomnia breaking my body and my spirit, I finally decided I needed to reach out to my doctor for help. Because all of my complaints cooperate mutually to ruin my life, I asked if there wasn’t something we might be able to do to address all of my issues at once, instead of prescribing me several different pills I don’t want and won’t remember to take.
I made the biggest fuss about the weight gain, appealing to my doctor for a depression/anxiety/insomnia solution that wouldn’t put me further into the red. Understanding my concern about anti-depressants and weight gain, my doctor recommended Wellbutrin, which is more notorious for weight loss than gain. Obviously, I was thrilled.
As with most anti-depressants, it takes up to six weeks to really see the changes Wellbutrin promises. In an effort to give me relief right away and during the interim, my doctor also prescribed a 90 day supply of Ativan for sleep. Technically you can take Ativan up to three times a day as needed for anxiety, but my intention is to limit it to bedtime. I really, really, really need to sleep. We all know sleep is important, but what we don’t think about enough is how much impact sleep has over the rest of our lives. A tired body is not a healthy body, and a healthy body is not a productive one. Even if I am eating right, for instance, if my body is not rested, it will not burn fat. Furthermore a tired body is a tired mind, and a tired mind does not manage its defects gracefully. Worst of all, my insomnia has gotten to a point over the last couple years to where I wake up almost hourly, and sometimes leave my bed entirely because I’m restless and in pain. During these nightly wanderings through my apartment, I sleep eat. Daniel has told me a few times that when he sleeps over, he has witnessed me standing in the kitchen with the lights off, eating over the sink without appearing to really notice him. Putting the dots together, it’s clear the pattern of behavior that has led to my current misery.
Last night I took my first dose of Ativan for sleep, like I’m about to do in about fifteen minutes for tonight’s rest. I plan only to use Ativan to sleep on Sunday through Thursday. I sleep in on the weekends anyway, and I don’t want to make Ativan something I can’t do without. The idea is to be able to give it up after the prescription runs out, so I may not even take it on nights that I’m especially tired. Right now, for instance, I’m feeling pretty groggy, so I may rethink Ativan for tonight.
Yesterday, I woke up knowing I’d slept. There was no evidence to suggest I’d left my bed, and my neck and head were killing me from being in the same position all night. Because Wellbutrin can sometimes cause sleeplessness (or sleepiness, depending on you), I elected to take it in the morning before leaving for work. I felt fine until about halfway during the way, at which time I had to sleep during my lunch hour just to keep going. I had coffee at 2PM, which is typically a huge no-no for me, and I still feel groggy now. I think the lesson to be learned here is that a sudden change takes a toll on me. I’m going to give Ativan a week to show me it can level out. If not, I may call my doctor and ask if she wants to adjust my dose, or consider another drug. It is worth mentioning that I also experienced some feelings of depression today, but that they did coincide with some legitimate negative experiences I’ve been having at work, so I’ll dog ear that and see if it becomes a pattern. One risk with Ativan is depression or suicidal ideation, so both of those are things I need to monitor.
I am hopeful about Wellbutrin. I hope it can help me find and maintain some peace. I want to be calm, rested, and vibrant. If I can achieve good rest and keep an even keel, I believe I can get back to the person who lost all of that weight, who loved riding her bike, and who felt no desire to seek solace in food.