August 25, 1999 (Part 2) - 14 Weeks After Diagnosis
Once I returned to 300 mg of Wellbutrin, I started feeling better right away, and since then my serious depression has not returned. Since then, too, I have visited About.com's Weight Loss and Smoking Cessation pages and gotten some encouragement and tips there. (The best tip: cinnamon sticks are very close to the same size and weight as cigarettes. You can hold one between your fingers just like a cigarette. You can suck air through it, or hold it between your teeth - I'm doing that right now! And as long as you don't start biting through it, one stick will last, and last, and last.)
Part of my problem with being so discouraged about my weight is that for the last several weeks I had been walking two to as much as four miles every day, but my weight just remained the same. Well, my research tells me that a one-mile walk only takes care of about 100 calories ... and there are 3,500 calories per pound of fat. That's discouraging! Still, I felt that after exercising for so long I should have increased my metabolism enough to be losing; but a friend informed me that when she began an exercise program, she did not start to lose weight for six months. After that time, the pounds began to come off slowly but surely. This also is somewhat encouraging, for I have not been walking daily for six months yet.
But since this medication switch I am also not walking as much. I had a bad cold the first three days, so that doesn't count; but I missed three more days last week and have already missed three this week. I just don't seem to care about much of anything, really.
I've stopped writing. I just lost interest. Just a few weeks ago I was elated to be writing again after a hiatus of more than 20 years. Now - blah, I'm not even all that upset about losing the spark again. That's sad.
Why haven't I called the pdoc? Well, I'll see him next Tuesday. I don't feel so bad now. Why bother?
What I'm going through now is called "titrating" medications: the often slow and exasperating process of determine which meds, how much of each and in what combination an individual with Bipolar Disorder should be taking. It can be infuriating, frustrating, depressing. If the process is really drawn out, it can become part of the problem, increasing the person's depression or making the person more likely to want to discard meds altogether. I have already felt that urge - because I felt going off all meds would be another factor to help me lose weight.
Understand - all my life, except when I have gained weight specifically from medications, I have been skinny, thin, or slim. I look down at my body and don't recognize it; I look in the mirror and don't know that person. And I'm not alone - weight gain is a serious problem for millions of people who are taking psychotropic medications. The SSRIs can cause weight gain; so do the tricyclics, especially amitriptyline. Lithium and Depakote can both cause weight gain, as can many other drugs commonly prescribed for Bipolar Disorder. (For more on this, see Weight Issues.)
So what I'm going through with my weight may be all too familiar to people with Bipolar Disorder (or clinical depression). I wish I knew the answer - OH, how I wish I knew it! What I do know is that I must get back on track again with my walking regimen. Last summer I was in such poor shape that I had to start my exercise program by walking just 5 minutes a day at a slow pace. Last Sunday I walked four miles at a brisk pace. I've come too far in improving my fitness to let it go to waste now. Since April I have been walking every day, until these last few weeks, and that's getting close to the six months' of exercise my friend said it took her to start losing.
What I also know is that next Tuesday I will go through all this with my psychiatrist ... again.
Next: Round and Round and Round She Goes
