Tuesday, June 24, 2008

TO READ: Is Exercise the Answer?
If it wasn't clear to me before that the obesity-depression relationship is a big issue for many of us, it is after your comments on my recent post on the topic. But what do we do about it?

As everyone knows, diets can be very tough. And if you're already depressed, you may be fighting with low motivation to eat more healthy stuff and less junk food. You may also be one who turns to comfort food when your mood drops, despite knowing that those calories add up quickly. It's not easy for me today, but earlier in my life I diet easily, drop a few pounds, then forget about it. Now, with bipolar disorder (mostly depressions) and its attendant medications, I'm really struggling. I still haven't gotten off all my Clozaril pounds, despite being off of that drug for years. Sigh. But. . .

Then there's the other side of the issue: exercise. Unfortunately I nearly stopped my exercise program last year as I focused on writing my book. And boy could I feel it. Several weeks ago, however, I got back on that horse, joined a small women's gym near home, and I've been taking exercise classes there. The classes work for me because they obligate me to be there at a certain time, so I can't procrastinate the entire day long. After the first two, I came home, sat down, and literally didn't know if I could get up a few minutes later. But, those sore exhausted muscles at least told me I was doing something.

The exercising is getting a bit easier now, and those jeans are in fact fitting a little better already. But can it really help me overcome my weight gain? And do I have to diet too? Hundreds, if not thousands, of studies demonstrate that regular exercise is the key to preventing and healing nearly every ailment. And we all know that those endorphins it produces are mood-lifting. We know we should do it, but it's still tough when you're depressed.

What do you do about exercise -- and how does exercise interact with your depression and your meds? Does it help you lose or maintain weight? Does it help you feel less depressed? More energetic? Proud of yourself? Let me know what you think -- I can use all the opinions I can get as I still have to push and push to get my shoes on and get to those aerobics classes three times a week.

Friday, June 13, 2008

TO READ & WRITE: Shockingly Great News!
We're still stunned. But happily stunned. My husband and I are in the very, very long process of adopting a little girl. . . .

As you may have read here in early April, our hearts were broken when, after receiving an assignment to a lovely 18-month old whose photos we fell in love with immediately, we learned that her medical report showed that she was not healthy, as we had been led to understand. Instead, she was at serious risk of severe health and developmental problems and in fact should have been considered a "special needs" child. We were neither trained nor authorized for an SN child. Our adoption agency very firmly recommended that we not accept this assignment. And after days of research, multiple medical experts' reports, counseling and soul-searching, we made the gut-wrenching decision to refuse the assignment. We did this with the understanding that she would be quickly adopted by a special needs family. (And we remained at the top of the list for a new referral.) We continue to mourn her -- she will always be in our hearts.

Now, two months later, we have received a new assignment. On Tuesday we learned that her file had arrived; on Wednesday morning it had been translated and completely reviewed and approved by the adoption pediatrician; at that point only were we ready to make the dash to San Francisco to see the file and the precious photos of our new daughter-to-be. She's gorgeous! She's eight-months-old and looks healthy and alert.

We are very, very happy. And we are still feeling stunned too. Parts of our hearts are, even now, guarded until she is in our arms at home. It's been an unbelievable 72 hours in our house. But shock that after three years this could really come true, and that we could possibly be so fortunate, is slowly ebbing -- and joy is rising, pure and clear.

TO WRITE: Shocked!?!
I've just written about the amazing swirl of emotions I've been in in the last few days since receiving our adoption assignment. Shock has been a big one. After three years of working toward this and waiting and waiting and one serious problem, our wish seems within reach. We hope we'll have our little daughter in our arms within the next couple of months. Yet I'm surprised.

I suppose I've guarded my heart and turned off a lot of feelings over this time, just in order to write my book, keep my mood stable, and basically function. But still, I'm rather shocked at how shocked I am, and I'm slowly working this through so that I can focus more completely on more important emotions, like being thrilled.

Play with this. . .
Write for 20 minutes about a time you were shocked by something. It may have been a good big surprise, or something less welcome. How did you feel at the time? And were you still feeling it later? How have you processed it, or is it still a pressing issue for you?

Saturday, June 07, 2008

TO READ: Depression and Obesity. . . and Depression

"Theory and research suggest that obesity and depression may be causally linked," says the summary of a new study in the journal Clinical Psychology: Science and Practice. If you are living with depression, chances are that you've already made that connection on your own -- after all, while some of us tend to eat (and sleep) less when we're depressed, there is also a substantial proportion of us who tend to eat and eat and sleep and sleep to try to ease the pain.

I happen to be an eater and sleeper; I especially crave carbohydrates (i.e., cookies and scones from Starbucks) when I'm way down. And, despite being a healthy weight until taking an atypical antipsychotic (which shall go unnamed) a few years ago when absolutely nothing else was helping, I'm now 20-30 pounds above where I'd like to be. It was much worse for awhile -- I gained 80 pounds in less than a year on this stuff. Very fortunately, when I finally got off of it to try a newly-released alternative, 40 pounds evaporated on its own. I've dieted to get rid of some of the rest, but it comes and goes and comes and stays -- and it's somewhat "depressing." And it often does feel like there's a chicken-and-egg quality to the situation.

So when I saw this research study suggesting that depression can lead to obesity and obesity can lead to depression, I took note. Long-term studies show that obesity predicts later depression. The authors propose that this may be due to either health or appearance issues. Meanwhile, there's some data showing that depression increases the risk of obesity, likely due to lack of exercise, negative thoughts or lack of social support. The suggestions for treating both of these include, not surprisingly, "behavioral activation" (diet and exercise) and cognitive-behavioral therapy -- but the scientists emphasize that no one's really studied how to treat both together yet.

What do you think? If you're living with both these conditions, which came first, and to what do you attribute the other? If you've recovered from one or both of these, how did you do it? I myself consider my bipolar disorder (mostly depression) well-managed now, but when I'm even slightly down, I judge myself harshly for my excess pounds. I can imagine these problems going either way.

For more info: Clin Psychol Sci Prac 15:1-20, 2008.

Monday, June 02, 2008

TO WRITE: Waiting and waiting. . . and waiting

I just spent a good five minutes on hold with a national company I do business with before hanging up in disgust. (I know, I know, you've spent 15, 20, 30 minutes in such situations. Still, I say anything over 10 seconds starts to get miserable.) And why don't they just play some dignified classical music instead of old Neil Diamond hits of the '70s?

Waiting can be tough, whether its for customer service or for something much more serious -- getting a call about an adoptive child (We're still waiting!) or a hint of relief from severe, chronic depression symptoms.

Play with this. . .
A writer friend of mine recently challenged her students to write on the question: What are you waiting for? Take 20 minutes to answer that one, writing continuously without stopping to edit yourself a lot.

Are you waiting for the confidence to register for that class you've been wanting to take? Is it the nerve to ask him or her out to dinner? Is it the energy to pick up your pen and write? Are you waiting for that last 20 pounds to disappear? After you've written, take five minutes more to consider what you might be able to do to either make the waiting end sooner or to better get through it. In my experience, my mental health depends upon this.