Depressed or overweight?

[kimberkit]

Over the past year or so, I've noticed that either the antidepressant, or just the effect of being happier, is directly correlated with about 20 pounds more weight. That doesn't make me obese. But it does affect my clothing -- clothing that should be tailored, and isn't -- and confidence as an indirect result. I can go to the gym all I want; more muscle mass and better cardiovascular health hasn't touched the pounds. I like the feeling of having done something for my body, but it doesn't touch my waistline.

What would you rather be, honestly? Overweight and taking antidepressants, or trying to figure out how to deal with depression in ways other than with medication?

Seriously. It's easy to say, "of course you should be overweight rather than sad." Very glib. The other glib response is, "you should talk to your doctor about finding another drug." News flash: all SSRIs include a side effect of weight gain, and Zoloft is supposed to be one the of lowest on the list for causing that particular side effect. Plus it would be months more of experimenting with the right drugs and dosages.

I'm signing up for acupuncture clinic next semester, in the hopes that it'll strengthen my defensive qi, and feel more balanced, and perhaps the drugging can be eliminated altogether.

Comments

[cosmicbabe.livejournal.com]

For 9 months (a few years ago), I was on a migraine-preventative drug (Topamax) that had a side effect of weight loss. (It was prescribed off-label; the main use was as an anti-convulsive. All the drugs used as migraine-preventatives are prescribed off-label -- generally they're either anti-convulsives, blood pressure meds, or anti-depressants. Over the years, I'd tried several drugs in the first 2 categories; I wanted to avoid the last because I was extremely skittish of the sexual side effects, and only agreed to try it as a last resort about 2 years ago. Of course, in retrospect, I wish I'd tried it 15 years ago when I was diagnosed with migraine disease!)

So, on the Topamax, I lost 27 pounds in 9 months without trying (and I had at least that much to spare!). Sounds great, right? But unfortunately, the other side effects of the drug included making me batshit crazy nuts with severe anxiety attacks, manic-depressive cycles, and all-around general hysterical freak-outs & crying jags at the drop of a hat. My secondary relationship was a casualty of that drug (although it would have happened sooner or later, but I'm sure the ending wouldn't have been so gloriously psycho without the meds). Almost a month to the day that I stopped taking Topomax, I felt suddenly very normal & balanced -- it was if a miasma hanging over me for most of a year just vanished.

Now I'm on a different class of meds for a migraine-preventative, an anti-depressant so old it has a very cheap generic. I'm on half the dose that's normally prescribed for depression, and it's cut my migraines by about 80% (from 10-12 a month, to about 2 a month). I've also gained around 30 pounds since I started the drug, which is a side effect I was hoping wouldn't hit me (although I got lucky, and it's the only side effect I have). But I'd much rather be a size 16 and feeling healthier, than a size 10 and dreading my next attack pretty much constantly. I'll probably be on this drug until I'm past menopause (my migraines are hormonally-triggered), and I'll probably never be a size 10 again.

So I'm learning to embrace my new curves and not fret over numbers on the scale.

(I hope acupuncture helps you! I really, really wanted it to help my migraines, but it didn't...and it made me feel a bit too energetic overall, which was rather unnerving. Like being 10 years old on the last day of school before summer vacation every day...made me very antsy.)

[kimberkit.livejournal.com]

(I hope acupuncture helps me too... failing that, Shiatsu more often, and generic massage.)

Thoughts are scattered on the drug thing -- it's almost tempting to wish I had something as bad as a migraine, because I don't truly dread my depression. It's a part of my personality, so I've integrated some of that, in a weird way. And it's also harder to remember the truly bad attacks; it's like afterwards, I forget how seductive suicidal thoughts are, or how it felt to be in that frame of mind.

Anyway, thank you for an insightful comment.

[kizlj.livejournal.com]

I think it depends on part on how severe the depression is. A bleak outlook may be able to be controlled with therapy, self-awareness, other methods, exercise, general better life circumstances (which you have now, with job and boy you like), and in that case, it may be worth seeing about going off the drugs. But I remember some close-to-suicidal moments, and extreme blackness. And when the depression threatens your life, your livelihood, or the key relationships in your life, I don't think there's a choice when it comes to 'drugs or extra weight.'

[pallasathene82.livejournal.com]

I agree. With me the drugs are an absolute necessity. My depression is bad enough that it affects my functioning when I don't take my meds. And the extra weight doesn't affect me that much. I've come to peace with my body shape, mostly. People like/desire me for who I am regardless of my shape. Is it hard to accept being pudgy? Yes. But building your own self-esteem is always hard.
If the weight was putting you at a high risk for a heart attack, diabetes, etc. it *might* be prudent to go off them. I think talking to your doctor about the effects on your body as a result of your weight and then evaluate the pros and cons of going off anti-depressants.

[kimberkit.livejournal.com]

Ack. Stacy makes such excellent points :P

I guess I could say, it's hard for me to judge how severe my depression is, from in here, or whether it can affect my life/relationships again to the point of Serious Blackness. (Not to be confused with Sirius Black.) There's less ability for depression to wreck things to pieces, now, for the moment, with a career that actively makes me feel more balanced and a good primary partner. But on reminder, you're right -- I do remember close-to-suicidal moments, and it does seem like I should wait on the fudging medication *sigh*

[greenfountain.livejournal.com]

i had similar issues with birth control (depo provera, and orthotricyclen berfore that). i'm fairly convinced that not only only did it make me gain a ridiculous amount of weight over those 3 or 4 years, but also caused pretty nontrivial depression and general hormonal bullshit.

for the past while, the choice has been easy, because, well, i haven't been sleeping with anyone. when that changes, well, i don't know what i'll do. i'm incredibly reluctant to experiment with other pills or whatever, because i know that back then, things seemed low-grade enough that i just figured i was legitimately unhappy about the actual bad things in my life, and the thought that this was at least partially a side effect of medication never even occurred to me. but pretty much magically, after i was off it, i had this epiphany, and i was like, "wow, i really am a happy shiny person who shouldn't be crying at the drop of a hat."

(i also know there are other options; i just don't know that i'm all that comfortable with them.)

[kimberkit.livejournal.com]

I *heart* you :) for the sympathy and more. Like kiz points out, depression's more of a life-affecting thing, but I totally know what you mean about the birth control. It made me crazy, too (although NuvaRing, and the lower dosages and regularity of it, really does work pretty well for me now).

It's amazing that more people aren't scared shitless by pills.

[greenfountain.livejournal.com]

Seriously. Pills are some crazy stuff. (My silliness on valium and hydrocodone last weekend further this belief for me, but at least that did exactly what it needed to do any pretty much nothing more.)

Another comment though, more related to your newer post, and possibly something you've already considered...

Do be careful that you're eating *enough* and regularly enough. I get fuzzier and less productive when I forget to eat (nothing as drastic as fainting yet, for me), and one of the results is that I keep forgetting to eat, which turns out rather poorly, as this frequently ends in me not coming anywhere near necessary nutrition levels for the day.

It's probably not a huge issue, weight-wise, done only occasionally, but if your life is hectic enough that you frequently skip meals without realizing it, blah blah blah, it's probably worth making a conscious effort to ensure that doesn't happen. That and making sure to eat breakfast and get enough sleep. These things definitely seem to affect what's going on with my weight.

My feeling is that this is all fairly person-specific; general guidelines seem to all say 1200 calories is about where your body will go into starvation mode, but I really think it's rather higher for me, especially when I'm in my exercise-heavy phases.

Anyway, something to think about.

[g-me.livejournal.com]

Speaking of scared shitless by pills, I was scared shitless by them the first time I experienced significant depression, and refused to go on them. If I could take one thing back about my health history at this point, it would probably be that. After one major depressive episode and then 3 years of being almost constantly mildly depressed and as a result, rather unable to stay on top of taking care of myself physically, I may have taken several healthy years off of my life (I'm speaking as someone with diabetes here). The worst thing that came with my depression (and which also developed partially as a result of awful things I was doing, diabetes-wise) was a tendancy to compulsively eat - I'll leave it at that. When I *finally* decided, after 3 years, to go on a low dose of Wellbutrin, I was terrified, and I wasn't thinking it would help anything except the persistent, lingering "blah" that I was feeling.

Amazingly enough, from the first week I was on Wellbutrin, I essentially got my eating disorder (which was what it was diagnosed as - "eating disorder NOS") under control. It was incredible. I ended up staying on Wellbutrin for about a year and a half, at times in combination with another antidepressant. I did get really, really fed up with the sexual side effects of the meds I was on, even though Wellbutrin isn't "supposed" to do that, so I've been off of all antidepressants since last summer. So far, so good - I haven't relapsed in any sense. What I think happened to me overall was that when I was royally screwing with my blood sugars, something got really screwed up in my brain, and I really needed the meds to put me back on track. It seems to have worked, since, for the first time since I first became depressed, I can actually take care of myself AND maintain a normal lifestyle at the same time.

This is a long story, but what I'm saying it, don't underestimate the positive effect those drugs may be having on you, and don't be too quick to go off them before you're ready. If, at some point, the extra weight becomes more of a drag than the risk of going off the pills, then you can reconsider - and that may eventually happen. It certainly did for me. I finally got so sick of side effects that I decided I would go out of my mind if I didn't at least try to come off the meds, and for me, it worked.

good luck. it's a difficult balance to strike. one thing that helped me when I was considering going off, but before i did, was to work with my doctor to half my dose, to try to help with the side effects while still getting some benefit from the meds.

[rabjeff.livejournal.com]

...as long as the wedding dress fits.

and I seem to remember some posts that scared me, had me really worried about you. Being in better shape, with love and sex and work/school that feels meaningful are all so much more important than being a model.

[entropicangel.livejournal.com]

*big hugs* I'm with you through ups and downs, through anything, regardless of your weight or anything else. You're a beautiful, amazing gal, and you make me happy. I can ask for nothing else except the chance to make you happy every day.