diet – The Daily Opinion

Besotted With Psychosis

There is such a thing as being in love with your diagnosis; besotted by psychosis.

I have noticed a trend in many people who suffer from mental illnesses—including myself—to freely share with others, often people they have only just met, the fact that they are both mentally ill and taking strong medications, in particular anti-psychotics, in order to manage their condition. This does not apply to everyone (nothing ever does) but certainly some people appear to relish telling others that they are on anti-psychotics and, by so doing, that they are or have at some point been, psychotic. They wear this fact like a medal, showing with pride that they have come through something horrendous, something most people (thankfully) never have to face and can’t really understand. A war veteran, home from the front.

I believe it goes deeper than this, however, far deeper than the relatively simple need to announce to the world that yes, despite all the odds, you are still alive. You survived. I believe for many people, it is not that they are ‘showing off’ their condition, it is more that their diagnosis has become so irrevocably tied to their identity, to their sense of ‘self’, that when they are interacting with others and introducing themselves to new people, talking about their condition, even if only in passing, is unavoidable.

This is certainly not the case for everyone; many people find it incredibly difficult to discuss their condition.

I am not one of those people.

The merging of diagnosis and identity can be both a positive and negative thing. I have personally found, since being diagnosed, that knowing my condition and exploring the extreme extent to which it has affected almost every aspect of my life, for the better part of two decades, helps me to understand myself better, my past better, and to come to terms with and let go of some of the more damaging memories in my possession; memories which have, until relatively recently, refused to die. It is both comforting and enlightening to know that certain phases of my life were exacerbated by my condition, that certain decisions and situations I have never been able to understand, were actually caused by the changing chemicals in my brain, rather than a deficiency in myself, as a human being. I have become more at peace as a result of this, and find that, the better I come to understand, the less I despise myself.

These are the positives.

The flip-side (isn’t there always a flip-side?), is that I become so fixated on analysing my mind and moods and behaviour, that I often forget there have actually been periods in my life when I wasn’t either depressed or manic. Certainly in my early teens I never experience the rapid cycling moods to which I became accustomed in my late teens and twenties. I had ups and I had downs, certainly, but they were never as pronounced, never as protracted, and they almost always came with lulls in between—times when I was, for want of a better word ‘normal’. At least in so much as a young teenage girl can ever feel normal. I had problems, but they had nothing to do with my condition. Even later, there were times when I was not depressed, or manic, or psychotic, I simply was. It’s easy to lose sight of this and forget there were times when I had friends, and jobs, and hobbies, and was successful in my endeavours, comfortable in social situations, capable of functioning like most other people.

I know enough people now, suffering from bipolar or other mental illnesses, to know that this is a common development.

And it can be crippling.

It is as if being depressed, bipolar, schizophrenic, psychotic etc. has become so much a part of how we perceive and define ourselves that the notion of there being any form of ‘self’, existing without the illness, is foreign to us; it’s alien. Some people even rile at the use of the word ‘illness’. I am one of those people, at least when it comes to myself, for I do not like the connotations, the notion that being bipolar makes me ‘ill’, it makes me in some way ‘wrong’. It is the thought that other people see me as being less than I should be. It is the thought that, as a consequence of this, they only accept what I am when I am neither depressed nor manic. If I am one way or the other I am in some way ‘not myself’.

Who am I then, at these times, if not myself?

There is an inherent contradiction here in that, while I am capable of acknowledging the downsides of both depressive and manic states, while I am capable of realising they can be unhealthy for me and that I must seek help to manage my condition, while I am now, reluctantly, even willing to take very strong medication to aid me in that management, I would never, ever, think of myself as being less than myself while depressed or manic. Those states of being are still ‘me’; in fact they are the versions of me with which I am comfortable, familiar, because I understand them far better than I understand this thing called ‘normal’.

There is a famous quote from one of my favourite authors, Edgar Allan Poe: ‘I became insane, with long intervals of horrible sanity’. I have always loved this quote. Long before I was diagnosed with bipolar, a condition Poe himself is suspected of having suffered, I had that quote scribbled in my notebooks and written in lipstick on my bedroom mirror. It resonated with me, from a very young age. I think I was perhaps ten or eleven when I first came across it, and even then, I somehow felt what it meant for me.

Insanity is relatively easy to deal with, if you are as accustomed to it as I have become. By ‘insanity’ I refer to those periods when I have been either depressed, manic, or in particular psychotic, those times when others would tell me I ‘wasn’t myself’ and I would wonder who else I could possibly be. Depression is a separate kind of insanity I feel, for it is the definite negative area of the complex condition known as bipolar. Mania and psychosis are two entirely separate things, and from my own experience of them, can have both positive and negative consequences. Certainly I find I enjoy my manic phases, I experience a clarity of thought during those times which eludes me the rest of the time. The trouble comes when the mania goes beyond my own thought processes and niggling physical side effects such as keeping me from sleeping or eating, and results in some very dangerous behaviours. Psychosis is often extremely unpleasant, however it depends upon the form it takes. Many people find it comforting. Others find it is what they need to get through the day. I have found it, at different times in my life, terrifying beyond description and the safest I have ever felt in my life. Psychosis is not a thing easily explained, nor is mania, yet they are states that become very familiar to a person, and—like depression—the more familiar they become the easier it is to remain in them, even when you don’t particularly enjoy their effects.

There is a safety in being either depressed or manic. You know what to expect, and you know what is expected of you. That contradiction comes in again, for while I hate people perceiving me as being ‘ill’ and ‘not myself’ when I am in these states, it does give you carte blanche to some extent: no matter what you do, no matter how crazy you appear, no matter how little you manage to achieve, no matter what your appearance or manner, it all falls beneath that great banner of ‘insanity’. You are forgiven. You are absolved. You can screw up as much as you like, and the majority of people will understand that this ‘isn’t your fault’ because you’re ‘ill’. It is often far easier to remain in these states than it is to try and cope with the state that falls between the two poles, that elusive state of ‘normality’. That is not for one second to suggest that depression, mania or psychosis are pleasant, merely that they are familiar, more familiar than ‘normal’ ever could be because this is the state of which I now have the least experience.
Normality is what frightens me.

It is mundane, ordinary, the discovery that there is nothing special about me, something which I fervently believe when I am manic and psychotic and can even acknowledge to some extent when depressed. Normal is just like everyone else and, just like everyone else, if I am normal I have normal responsibilities: a job, rent, bills, acting in a socially acceptable manner. And if I am just like everyone else, I can fail just like everyone else, and this then might push me be back into the very states of being I both fear and oddly embrace. Mania, certainly, has its intoxicating allure. Even depression at times can feel like the safest option: shut down, stay down, it’s quiet down there, it’s immobile, you won’t move forward but neither will you move back. You can’t fail. You can’t be hurt, unless you hurt yourself. When you have lived a life of repeated failure and heartbreak the prospect of the latter is very appealing. I often find myself embracing mania, as it allows me to do the things I wish to do—I get so much work done, I embark on so many new projects, I do all the things I completely fail to do when depressed and far more than I could ever achieve if I were simply ‘normal’. The flip-side (again) is that mania for me now always ends with a crash; if I want to enjoy the manic periods, I must also endure the depression. I am only slightly ashamed to admit that at times it is only the thought of my next manic phase which allows me to make it through the depression relatively unscathed. This is the reason I refused to allow my psychologist to switch my MEDs to Lithium despite the fact what I currently take does not stop my swings in moods: Lithium would stop my depression, a plus, but it would also rob me of my mania. It would leave me permanently ‘normal’ and that is not something I am willing to become. The reason for this is simple: I would not then be myself.

What does this mean then, for my recovery? If getting ‘better’ means moving away from those states in which I feel like myself and towards the one state in which I feel like I’m ‘not myself’, how can I reconcile that? Taking the medications prescribed for me has certainly helped, I do not find myself at the very dangerous extremes I was experiencing previously, however I have found that I no longer recognise myself. Last week I talked about looking in the mirror and seeing someone else stare back. Some of this is the result of very long periods of depression, but some is the direct result of my attempts to recover from that depression.

I am currently attempting to lose weight, and moving towards living on my own again. I find, as I make progress in both these areas, that at times I am actually sabotaging my efforts. Self-sabotage. I see that my weight loss is going well, and I panic; what happens when I’ve lost all the weight, when I am healthy and back to looking like myself again? I’ll no longer have the buffer between me and socialising that currently protects me.

I often feel that I have purposefully built up this massive amount of weight around me, as a wall to shield myself from pain. In particular, a wall to shield me from people. I complain that I do not have the confidence to socialise due to my insecurities about my weight, yet I also do not want to socialise, if I am completely honest, due to a far deeper fear that things which have happened in the past will reoccur. Friends abandoning me when they see me acting in ways that are ‘not like myself’, romantic relationships going horribly wrong, and even, if I’m completely honest, the prospect that hypersexuality will once again set in. The worst period of my entire life happened when I was suffering from hypersexuality. It destroyed everything I had. It left me a rock bottom. It is the one thing about mania that absolutely terrifies me. But, if I stay so overweight, I need not fear; nobody would want me anyway.

This is a terrible thought for all kinds of reasons, but there it is. Similar to this is the thought of living alone. I’ve lived alone before, and it didn’t end well. I lost my job, found another, lost that too, found another, but still was unable to keep up rent and bill payments due to my excessive overspending and total inability to budget. The thought of that happening again, after I have spent the last two years trying to unravel the financial mess I was in, is terrifying, as is the thought of finally getting a place of my own and then losing it, is heartbreaking.

Better not to try than try and fail.

I have been wrestling with this for some weeks now. The diet which initially went so well and saw me lose over a stone hit a stall when I realised I’d lost twenty pounds and I might actually succeed. I regained five of those pounds almost overnight. I thankfully managed to recognise what I was doing and prevent the re-gain from becoming worse, but for two weeks it was all I could do to maintain my weight, there was no hope of me losing any. At the same time while everything appeared to be falling into place with my new business, and the prospect of moving out became a solid reality, within the next few months, I began to question everything, from whether or not I could cope with the business, to whether or not I should accept the Start Up loan I was offered to help me with it, to whether I should even be thinking of moving out at all, or if it weren’t better off staying with my mother.

It was the latter thought that finally broke through to me. Much as I love my mum, I do not love living with her. I have no independence. She drives me round the bend. Clearly, I wasn’t thinking rationally.

I am pleased to report that, with all this in mind, I have managed to lose just over four pounds this week. I am still afraid of what will happen if I ever do manage to get back to a state in which I feel comfortable socialising, however I am more afraid of spending the rest of my life alone and miserable. Things with my business are moving forwards, and while I’m still struggling to manage my own personal budget well enough to feel confident in living alone, I have improved considerably.

The next challenge to tackle is my PhD.

The one thing that has hit me with crystal clarity as a result of all this is that I have avoided it. I do everything I can in order to get out of working on it, because I am terrified of finishing it. I no longer feel I am capable of working in an academic setting, so much so that I didn’t even last the first year of my Scholarship living in Bangor. I took myself away from it. My former dreams of working at a University when I finish have vanished as a result. I do not feel I could possibly cope, therefore I do not want to finish my thesis, as this would mean I was expected to DO something with the qualification.

Hopefully, this realisation in itself will now aid me in getting on with it.

Running Down

This week I had a cold.

It began with a sore throat on Sunday and degenerated from there.

When I attempted to go out for something to stave off further symptoms, my car stubbornly refused to start.

I didn’t have breakdown cover.

On Monday I had a marathon, three hour therapy session with my psychologist as part of my new group therapy. Unlike the other sessions, this was a one-on-one. We mapped my ‘patterns’ and ‘cycles’, trying to understand what has caused them, and how I can change them. It was an extremely emotional few hours and I cried regularly.

I came out feeling not unlike I had been run over by a large vehicle of some description, possible a Virgin Train. Or Concord.

The fact my car had broken meant mother had kindly rearranged her day to take me all the way into Chester. She’d met up with my sister and niece and gone shopping while I was at the hospital, so I was fortunate when I came out in that I was greeted my the grinning face of my niece, who for reasons unknown always seems to find whatever I do hilariously funny. This helped considerably, as I was shaking by that point and honestly don’t know what I’d have done, had I needed to make the hour+ drive home by myself. Instead, I did a bit of shopping and actually found a nice dress that fitted (minor miracle).

This left me feeling considerably better about myself, however it had been a long day, I was starving hungry, and hadn’t had any lunch. I ended up having hot chocolate and cake in Costa and picking up a ready meal on the way home. To make matters worse, the fact that my sore throat had by this time developed into a full blown cold meant that I only wanted one thing: curry.

Don’t ask me why, but whenever I have a cold I want one of two things, curry or chilli. I can only assume it is because the spiciness goes some way towards clearing your congestion. I’ve had two lots of curry and one lot of chilli this week, and while I do have several fantastic, low calorie, low fat, curry and chilli recipes, I’ve been far too tired to cook.

I have yet to find a good, low-fat, ready meal curry. So, between the hot chocolate and cake, the curry and the (obligatory) naan bread, Monday was a total disaster diet-wise. Tuesday wasn’t much better, as I woke up feeling even worse, couldn’t be bothered keeping track of what I ate. If memory serves, I managed a relatively healthy lunch but then had cake and biscuits for dinner. Once again, a disaster.

By Wednesday morning I felt like Death.

I woke up and simply did not want to get out of bed. The light was far too bright and hurt my head, which was already killing me, I ached all over, was insanely congested, and it seemed as if I were swallowing broken glass.

Worse still, I felt depressed.

I felt the dark clouds looming, the feeling of impending disaster, and the notion that life is just plain shit.

It was at this point (around 8am) that I forced myself out of bed, suddenly terrified that all of this meant I was headed back towards a great depression.

Almost exactly the same thing happened last year, around this time, as the changing weather left me with a bitch of a cold and I felt really miserable. Determined to stave of what I saw as the inevitable period of hell, looming on the horizon, I pushed myself out of bed, forced myself to work, forced myself to walk Dexter despite the pouring rain and do an extra lap of the park, because exercise as we all know is good for the mood. The result of all this was not that I suddenly felt better, but rather that I felt considerably worse. I did not want this to happen again.

So, on Wednesday morning I did not force myself to work, I did the sensible thing, and listened to what my own body was telling me: it was completely exhausted. I went back to bed, something I try desperately not to do, because it is another thing that I equate with true depression. I woke up feeling slightly better. The day passed much like any other. I felt well enough to work, so I sat at my desk and caught up on some writing, but when I started to feel tired mid-afternoon I stopped, rather than forcing myself to continue. I took myself away from the guilt of not working by going downstairs, away from my computer, to watch Sherlock. It is not often I separate myself from my computer, however I have found that at times, completely severing the connection is the only way I can get any rest.

Thursday was far worse. I woke up with a terrible headache. Unlike the day before, a lie in did nothing to make me feel better, and I felt like Death all day. I did no work, but parked myself in front of the TV and watched Bones all day, while knitting a new cardigan for my niece. I ate what I felt like eating, which as it turned out was more curry, garlic bread and half a tub of Ben and Jerry’s. It was a day when everything hurt, everything felt awful, and adding hunger and cravings to it was the last thing I needed. The curry cleared my head, the ice cream soothed my throat; at that particular point in time those two things were of greater concern to me than my diet.

Friday I woke up at a normal time, with no headache, no sore throat, no dizziness, and only a slightly running nose and scratchy voice to show for my troubles. I went about my day as normal, getting my work done, nipping into town to sort out some things with the bank and going to the shops for some (healthy) food. I ate lunch in Costa, as I was in town at the time, but I had a skinny hot chocolate, rather than the full fat with cream and marshmallows that I actually wanted, and declined any form of cakeage (this is almost impossible for me to do, especially when confronted by coffee and walnut cake).

By Saturday I felt perfectly fine once again, all had returned to normal.

When comparing this experience to the experience I had last year—severe bronchitis and several weeks of depression, even after the bronchitis had finally cleared up, I find myself wondering. It is generally upheld that ill-health or being ‘run down’ can easily trigger depressive episodes in people who are prone to such moods; this is one of the reasons a healthy diet and exercise are extolled as being so important in treating mood disorders. If you are already feeling lousy, if your body is already vulnerable to the onslaught of a virus or disease and expending all its energy fighting off the physical, it has fewer reserves to keep the mental in check.

In light of recent events however, I believe it is more than that.

When I began to feel ill, my immediate thought was not ‘I have a cold’, but ‘oh no, I’m getting depressed. AND, I have a cold, just to make everything worse’.

In my mind, the depression comes first. The fact that I was feeling bad made me vulnerable to a cold, rather than the reality, which was the other way around. Any person, regardless of their mental health, feels miserable when they’re ill. The problem for those of us who regularly feel miserable for other reasons, is that we tend to assume that any form of misery is the mental kind; we disregard the fact that any person with a cold would feel miserable, and assume it is a sign our own private form of hell is returning.

Once the idea has been placed in your head, there’s no shaking it. You either do everything you can in an effort to stave off another depressive phase—as I did last year—and by so doing run yourself down so much that your original illness is magnified tenfold, and you do actually become depressed, or the very fact you believe you’re already depressed depresses you, and it becomes a self-fulfilling prophecy: I think, therefore I am; I think I am depressed, therefore I become depressed.

Doctors often talk about people being ‘run down’, which causes them to become vulnerable to colds and flus and various other ailments. What they mean is that these people have developed a low immune system, for whatever reason, and so are less capable of fighting off any infections they come into contact with, infections they might otherwise have been perfectly capable of fighting off without becoming ill. It’s very easy to get run down by working too hard, or even playing too hard, sleeping too little, eating unhealthily, and not getting enough of the nutrients needed to keep your immune system strong.

Doctors often talk about being ‘down’, also. People, in general, will often say that dreaded phrase ‘everyone feels down sometimes’, when talking to someone with depression. These people either think they understand, or are trying to make that person feel better. The majority of them have no idea that those words make people who have suffered any kind of depression want to kill them. Slowly. And painfully. It is perhaps one of the most unhelpful, condescending, and irrelevant things a person can say to you when you are trying to explain how you feel during your depression. The reason for this is very simple: feeling ‘down’ is not the same as feeling depressed. Depression is a clinical illness. Feeling down is not. It might not be pleasant, but it doesn’t compare. Thinking it does, generally only serves to display how ignorant you are when it comes to the true nature of depression.

That said, while there is a vast difference between the ‘down’ felt by ‘everybody’ and the ‘downs’ felt by those with mood disorders, there is one saving grace in this unbelievably irritating expression: all people, in general, DO feel down sometimes, for a variety of reasons, the majority of which are transitory. What people with mood disorders have a nasty habit of forgetting is that they are included in that general category of ‘all people’, and while their depressive episodes do not fall under this patronising umbrella term of ‘feeling down’, there is a plethora of other instances in their lives which do. Instances which are mistaken for the first signs of another depression. Instances which then become another instance of depression, for no other reason than the person is so afraid that is what they are already feeling.

It occurs to me that, since I have become more self aware where my bipolar is concerned, I have become hyper-aware of my emotional state, and even the slightest dip in my mood is a cause for me to assume I am once again getting depressed. This, in itself, stresses me, and has at times actually pushed me into a state of depression which I most likely would not have experienced, had I not been so worried it was about to happen again.

This week I was feeling run down. I had a cold. I was, however, able to acknowledge the fact that it was just a cold, and treat it as anybody else would.

This time last year I was also feeling run down. I had a cold. I forgot that anyone with a cold would feel miserable and took it to be the first sign of another depressive cycle. As a result I became, almost instantly, depressed. I wasn’t just run down, I was running down; I felt the slightest echo of what I feel when truly depressed and, convinced I actually was depressed, ran myself headlong into a depression. That was one cycle that could easily have been avoided.

That is one cycle I have, thankfully, avoided repeating this year.

Another cycle I have is using food as a coping mechanism. I overeat when I’m stressed, I starve myself completely when I’m very upset. This week, I was so far off my diet you would think I was unaware the word even existed. I ate what I felt like eating, when I felt like eating it, be it calorific curries and chilli, cake, chocolate, ice cream or biscuits. The reason for this was simply that I didn’t have the energy to keep up the diet, and my body seemed to be screaming for certain things.

I assumed, naturally I think given what I ate in the last week, that this would be reflected on the scales this morning. Imagine my surprise when I stepped on and found—to my delight—that I had not gained a single pound. Moreover, I had not gained so much as 0.1 pounds. I had remained exactly the same weight I was last week. Given that I ate far less last week that this week, and gained 0.2 pounds last week, I can only conclude that the reason for this is that this week, while I was ill, my body actually needed the extra calories to fight off the cold.

Consequently, it is with great delight that I can record my weight has remained the same this week. It is also with renewed enthusiasm that I embark upon my diet again today, now that I feel better (both physically and mentally).

… Ten To Go

My biggest hurdle where weight is concerned used to be the pitiful amount I had lost, compared to the vast amount I still had left to lose. I mentioned this last week, and how I have begun to look at my goals in manageable chunks.

To most people, losing a full stone seems like quite a lot. If, say, you were only two stone overweight, that loss would be very obvious. You would also be able to think ‘I’m half way there’, and that thought would spur you on. When you’re eleven stone overweight however, you don’t physically appear any different with the loss of just one stone. Nobody notices, because the dent it has made is too small. You think ‘TEN TO GO’, not ‘half way there’, and the fact you still have so much to lose makes the task seem just as insurmountable as it was when you had eleven. It is very easy to get stuck in this mentality. You’ve lost fifteen whole pounds, but in the grand scheme of things, what is that? There are 154 pounds in eleven stone.

I’ve managed to lose 15, whoopdifrickin do.

This is, however, a very negative mindset. Pick up a bag of sugar and feel the weight of it. A 1KG bag of sugar is roughly two pounds. Imagine lugging seven or eight of those bags home with your from the supermarket. Even just carrying them—without the aid of a trolley or basket—from the till to your car. That’s a lot of sugar. That is the amount of weight I’m no longer having to carry, everywhere I go. So yes, it’s not a lot in the grand scheme of things, but it is still a lot.

When I consider the fact I have ten stone to go, it occurs to me that this is, quite literally, half my body weight. By the time I get down to goal, I will have lost the equivalent of a whole other person. If this isn’t a metaphor for my recovery, I don’t know what is.

I often feel like my bipolar has transformed me into a different person, both physically and mentally. The girl I saw on the street in Chester, the one that sparked The Great Epiphany, looked exactly like me. The ‘me’ I see inside my head. The ‘me’ I think of myself as being. When I look in the mirror, I see a total stranger, and this has been the case for several years. It is not only the weight gain. It is not just the fact that, in the throws of one of my worst episodes a few years ago, I cut my hair (previously very long, blonde, and my favourite thing about myself), so short it had to be shaved at the back, and has only just started to look like ‘my’ hair again. These things are disturbing to me, but they are only external changes. The worst change I see, is the look in my eyes. They are the eyes of a person I do not know and worse still do not like, staring at me from within what I have come to accept is now my body, a body in itself strange and alien.

I catch brief glimpses of my former self occasionally. Last year, one of my oldest and best friends (who happens to be a photographer) did a photo shoot for me when I needed some promotional images for my novel (at that point on the verge of being self-published, something which was put on hold when an agent showed interest). I love those pictures, because she was able to capture, be it through her own skill, or the fact that I was actually, briefly, happy at the time, a glimpse of my ‘real’ self. The photographs of me earlier this year, at the zoo with my niece, have a similar effect on me. I look at them, and I can recognise myself staring back, despite the fact I’m overweight.

I can count on one hand the number of times this has happened, in the last four or five years, when I’ve looked in the mirror.

I have become a stranger to myself and, aside from the different aspects of my personality that emerge, depending upon which way the pendulum of bipolar is currently swinging, this is the most difficult thing for me to accept about my disorder; the fact that it appears to have completely changed who I am.

August 2012

I cling to those photographs, because they show me that it hasn’t changed who I am, it’s simply taken over the steering wheel for a while. I look into the eyes in that picture and I can see ‘me’. For that day (right) I was, however briefly, myself again. I’m not ‘gone’. If I can get back in control of that steering wheel, I can get back to being myself, and somehow I feel if I can do that, the swings in mood will be easier to handle. If I’m dealing with them as myself, and not this stranger I’ve become, I’ll know better how to handle what comes and how to deal with each situation and difficulty as it arises.

The problem I have is that I’m unsure exactly how to go about this. If I know one thing, it is that I’ll never be the same as I was when I was eighteen, no matter how much weight I lose. That, however, isn’t the point. I don’t want to regress, I want to regain the feeling that I know who I am, what I am doing, what I am capable of doing and, I suppose most importantly, regain my confidence. Between the depressive phases I have suffered and the cataclysmic mistakes I have made during my manic periods, I have lost all confidence in myself. My weight also has a lot to do with this, as I feel I am both unattractive and perpetually judged for being so large. It is virtually impossible to find something to wear that I actually like; I can’t even dress like myself most of the time. I think it’s important, however, to note that, while my personal journey requires me to lose all this extra weight, all this extra baggage, that is not the case for everyone.

I hate being overweight. I hate the way it makes me look, I hate the way it makes me feel, I hate the fact I can’t walk my dog properly, or run like I used to do on a very regular basis. I hate the fact that my knees and ankles click alarmingly, and painfully, whenever I walk up or down stairs, and I hate the fact that I struggle to cook properly, because it means standing up for so long, causing me excruciating back pain. This, in large part, is what stopped me properly cooking for so long, and relying so much on ready meals and junk food, which only worsened my weight problem. I am worried about diabetes, heart troubles and, if I’m 100% honest, I do not feel there is even the slightest chance of me ever finding a healthy, happy relationship, while I am overweight. On the latter point, I really must stress that this is not because I believe overweight people are un-lovable. Rather, it is because I have learned from past relationship mistakes, and I know now that I need to be comfortable with myself, before I can make sensible decisions regarding romantic involvements. My last relationship was a train wreck from start to finish, for one reason, and one reason only: I picked the wrong man. This was mainly because I really didn’t believe I deserved anyone better, and that was down to confidence.

I was only five stone overweight at that point, not ten, so you can see how this is a problem.

This, however, is just me. There are a lot of people who don’t feel this way about their weight. They don’t tie their self confidence and self worth directly to the number on the scales. They don’t feel as if they are judged by their outward appearance, and they don’t feel completely incapable of any kind of face to face social interaction because of their size. I genuinely applaud these people, I wish I was so enlightened, however after a lifetime of food and weight related issues, I have come to accept that, where my confidence is concerned, this is THE BIG ONE. By which I mean, this is the one big thing that, if resolved, will allow me to build my confidence back up and feel like a real person again, instead of just a ridiculously large shell, harbouring the desiccated remains of what was once a person.

So, I aim to continue in my efforts, no matter how long it takes, no matter how difficult it is, no matter if I find, after losing eight stone that I hit a really rough patch and put four back on again. I no longer see this as a task to accomplish and check off a list, but rather as a lifelong effort, much like my efforts to manage my bipolar; there is no ‘cure’ for either, they are both simply things that you need to accept, and learn to manage as best you can. For me, managing my weight means first getting it down to a healthy level, a level at which I might feel more like myself again.

On Tuesday morning I hopped on the scales and was utterly delighted to find I’d lost just over five pounds since my weigh in on Saturday. I was, quite literally ecstatic. I had gone from a total weight loss of fifteen pounds, to twenty. TWENTY WHOLE POUNDS. That’s one stone and six pounds, only one pound away from a full stone and a half. I was no longer thinking ‘Ten to Go’, I was thinking ‘Nine and a Half to Go’, and I was feeling very much like I could achieve that goal: I’d managed one and a half in five weeks, nine and a half should only take another thirty or so weeks … that’s not even a full year! Right?

Right?

Wrong.

As you can see from my daintily painted toenails (no, I did not do them myself, it’s a while since I’ve been able to reach them myself), I have slid back up to where I was last week, plus a little extra. When I saw this was this case this morning, I was in tears. Then I took a few deep breaths and tried to remember The Great Epiphany. I tried to remember that it was going to be something that was up and down, rather than constantly down. Then I thought about the week I’d had and realised that, yes, it has been a very stressful week since Tuesday (the last time I was on the scales and, really, the last time I logged into My Fitness Pal and kept track of what I was eating). I’ve started a new group therapy on a Tuesday which I am not liking at all. It threw me a little last week, the first meeting, this week it threw me a lot. Then my Pop had a fall, and while it wasn’t a bad fall this is a very bad trigger for me as it was a fall that caused all the problems my Nanny had which ultimately led to her death.

When I am stressed I eat. I know this. This has nothing to do with being bipolar, nothing to do with my medication, this is simply a fact. If I feel stress, I often reach for something to eat because, like many people, I find it soothing. I don’t even realise I’m doing it until after the fact.

So, this week was a wright off in terms of weight loss, however I did reach an important conclusion regarding my new group therapy: it is having the opposite to the desired effect. It is making me feel horrendous. Having discussed this with my sister (a clinical psychologist) I have decided to ask for one on one therapy. My sister was actually astonished that I was having this form of therapy (Cognitive Analytic Therapy a.k.a. CAT), in a group; she couldn’t understand how the model could possibly work, as it is very personal and involves extensive mapping of your own experiences. Next week I’m seeing my psychologist on my own and shall be talking to her about this.

I am however, quite pleased, despite all of this. I’m determined to get myself back on the diet wagon, and step on those scales again next week to see they have moved in a downwards direction – it doesn’t have to be a huge leap of five pounds, or even two, so long as it’s moving, and in the right direction, I am happy.

My Fitness Pal comes with a ‘ticker’, which keeps you updated on how much you have lost, and how much you have left to reach your goal. My butterfly is currently enduring a rather unpleasant thunderstorm; I’m not worried though, because soon she’ll be closer to the sunshine, and I always deal with things better when the sun is shining.

One Down …

In the opening post for this new column, I mentioned a list of goals, scribbled on a receipt in Costa. While The Great Epiphany helped to clear a lot of the negativity from my outlook it did not, in itself, provide me with any concrete plans for achieving the things on that list. There are two vying for dominance at the moment, losing the weight I have gained as a result of my bipolar, and the MEDs I now take to treat it, and the desperate need to move out of my mother’s house (much as I appreciate her taking me in) and regain my independence.

The latter is something that now comes down to my financial situation, which is a work in (very slow) progress. The former however was something that I started working on the very same day I had The Great Epiphany. That was almost two months ago. On that day, I weighed 20 stone and 8 pounds (288lbs), the heaviest I have ever been in my life. Since then, I have successfully lost fifteen pounds, just over a stone. Of the eleven stone I had to lose, I’m one down.

That, in itself, already feels like an achievement, however it is tainted by the fact that I know I have managed to do this before—one of my recurring patterns is losing a stone or two in weight when I am feeling well, then regaining it, plus a little extra, the next time I have a bout of depression. For some reason however, it feels different this time, and I believe this to be a direct result of The Great Epiphany.

In essence, what TGE made me see was that it was okay if I didn’t drop ten stone in a month or two. While this may seem an obvious point, for me it isn’t something that comes naturally. I have always had an unhealthy relationship with food, having suffered from bulimia throughout my teens and early twenties, and retained the binge-eating habits that went with that even though I have ‘recovered’. I use inverted commas there because a person never truly recovers from an eating disorder; they learn to manage it, but the patterns are always within them and can, at any point, return. I’ve had several relapses since, and I certainly retain the tendency to binge terribly when I’m upset or stressed. As a result, I am accustomed to yo-yo dieting, rapidly losing or gaining large amounts of weight. At one point I lost five stone in less than six weeks. As a result, it’s difficult for me to accept the notion of slow weight loss, especially when I have so much weight to lose.

In recent years, as my bipolar cycles have flipped from being predominantly manic to being predominantly depressive, my weight has steadily gone up. While I continue to have spurts of rapid weight loss while manic, the amount I lose has grown steadily less, is never permanent, and I struggle to prevent additional weight going on when I flip back the other way. Due to my MEDs, my periods of mania are now getting fewer and further between, and my capacity to lose weight the rest of the time is virtually nonexistent.

I take high doses of Depakote and Quitiapine, the former being a mood stabaliser, the latter an anti-psychotic. The result is that my metabolism is through the floor, and even sticking to 1200 calories a day, and exercising, I struggle to lose more than a couple of ounces a week. This, for me, is far too little reward for the amount of energy and effort it takes. It leaves me too disheartened to stick to it. In addition, it is simply not enough to compensate for the times when I’m too depressed to maintain my diet, and the weight keeps piling on.

TGE forced me to look at the long game, rather than the short term. I am a very impatient person, and often give up on things if they do not immediately go my way. I had already been discussing my weight issues at length with my doctor by the time of TGE. At my request, they had put me on a weight loss medication named Xenical. You may have seen this advertised as Alli, at the extortionate price of around £40 for a four week supply. It is the same thing, a blue capsule taken with each meal, three times a day, that absorbs roughly 1/3 of the fat you ingest. In theory, if you lose two pounds on your own, you will lose an extra pound if taking Xenical. Should you consider going onto this medication, I strongly urge you to do it through your GP. Firstly, because they will monitor you properly and give you extra advice about a diet and exercise plan that is right for you, individually, secondly because, as long as you actually are over weight, they will give it to you on monitored prescription. This means a month supply for £7.85, rather than £40. If, like me, you get a pre-paid prescription card, it is even less.

I’ll discuss the benefits and downsides of this medication in a later post, but for now suffice to say that this is not a magic bullet. It is not a wonderful fat melting pill that allows you to eat whatever you want and still lose weight. It requires a strict, low fat, calorie controlled diet, comprising a lot of fruit and vegetables, and plenty of exercise. In short, you still have to stick to a diet as difficult as any other in order for it to work.

This small fact is the reason why many people say it doesn’t work; they don’t stick to a diet while taking it, and blame their failure to lose weight on the medication which clearly ‘doesn’t work’, and complain about the side effects which are quite unpleasant if you’re taking this and NOT sticking to an appropriate diet.

I fell victim to this myself when I first started out on it. I stuck to the diet, I took the pills, and after a fortnight I’d lost half a stone, far more than I’d have managed on my own. I was elated. Then the inevitable happened: I hit a dip. Those seven pounds went back on, and brought an additional two friends along with them. Because I was still taking the new MEDs but no longer sticking to the diet, I experience extreme side effects and had to stop taking them. I was so demoralised I gave up on both the pills and the diet I had been sticking to fairly well before I started the pills. They had, it seemed, done more damage than good.

A couple of weeks later, feeling slightly better, I started again. Again I lost about half a stone and again it went back on again. Round and round I went, until TGE made me stop and reconsider the problem.

I was barely losing weight on my own, however with the aid of the tablets I was able to lose quite well, as long as I stuck to the diet. The issue seemed to be that my mood was only good enough to allow me to stick to the diet for a couple of weeks at a time, while the depression in between ‘good’ phases was long enough to pile on more than the weight I had lost. My weight was still going up, yet even I could acknowledge that it was only going up by a few pounds, every few months, where before it had been going up by a stone or more every few months.

If nothing else, my efforts were preventing my weight spiraling even further out of control.

Encouraged by this thought, I once again started taking the tablets and sticking to the diet. I bought a new notebook and started recording everything I ate and drank, both on My Fitness Pal, and in the notebook. I made notes on how I felt each day. I did as much exercise as I could manage, and I concentrated, initially, on just managing to stick to the diet for three weeks. In the past, I’d never managed more than two weeks at a time. Three weeks, I thought, and I’ll have lost more than half a stone.

Three weeks passed, and I was nine pounds down. Pleased with myself, I managed another week before my mood dipped and I hit a bad spell. The carb cravings hit and I was back to eating cake and crisps and huge portions of pasta. However, I continued to track what I was eating, despite it being beyond my diet, and I found that the period I was binging for didn’t last nearly as long, and by the end of it I had only regained two pounds. Overall I had still lost half a stone.

This had never happened before.

Something which TGE helped me to understand is this: I am going to have good weeks and bad weeks. There will be days when I step on the scales and I’ve lost, and days when I step on and have gained. Whichever way it goes, it doesn’t really matter, the important thing is that I keep trying to manage my weight and to improve my health and fitness. I watch as the number of pounds I have lost slowly but surely increases, and I find myself reassured in the knowledge that, the next time I have a blip, it’s unlikely any weight gain will exceed that which I’ve now managed to lose. The more I lose, the more this thought solidifies, to the point that I now feel comfortable enough to disclose my journey so far, and state that I feel reasonably confident in my ability to continue to lose the weight, albeit at a much slower pace than I would ideally like.Three weeks have passed since I got myself back on track. I’ve lost another eight pounds and have continued with my routine of My Fitness Pal, journal, pills and note taking. I’m trying to pay as much attention to what I eat as I can, and get myself into the habit of eating as healthily as possible.

I am no longer expecting to lose each and every week; I have accepted that there will be times when I don’t, and times when I gain, depending on the cycle of my moods and other far more normal concerns like holidays and meals out. The difference now is that I have myself in a place where, when I hit a blip, I can simply acknowledge it as a blip and move on. It doesn’t become a complete failure. It doesn’t push me further into a depressive state and make me think I’ll never succeed so there’s no point in trying. It doesn’t actually make the situation worse.

Setting myself a more manageable goal—sticking to my diet for three weeks—proved to be very successful. The thought of losing only two pounds a week is incredibly demoralising for me, as that means it would take a year and a half to lose the weight I need to shift. The fact that it’s unlikely I’d lose two pounds every week means it would take even longer. Realistically, it’s likely to take two years to lose the weight I want to drop. That feels like a very long time. It seems impossible that I would be able to stick to a diet for that long. However, sticking to it for three weeks is manageable. The thought doesn’t terrify me, and ultimately I managed four, a whole week extra.

Similarly, the thought of losing eleven stone was completely overwhelming. However, having lost one, I can see that this—losing one stone—is an achievable goal. I am no longer focusing on how many I have left to lose, but simply on losing one more. I can do that, I know I can, because I already did.

On July 11th this year, I was 288lbs. I am now 273.4.

Stick to the diet for one week longer than you managed last time.

Walk with Dexter (my dog) for an extra ten minutes each day.

Lose one stone.

These are manageable goals that I have set myself, and achieved, with relative ease. All of them contribute to my overall goal, but none of them are overwhelming, none crippling in the fear they produce.

One stone down … One more to go.