Showing posts with label mood disorders. Show all posts
Showing posts with label mood disorders. Show all posts

Friday, May 15, 2020

BREAKING AWAY

May is Mental Health Awareness Month. Part of shedding stigma involves talking and writing about our experiences. In this post, I reach far, far back—well, to yesterday—to offer an illustration of how one aspect of my eating disorder and my struggles with depression play out.


More than once, my eating disorder has saved me. I know the psychiatrists, nurses, dietitians and occupational therapists who have worked with me don’t want me saying that. They’d shake their heads and mutter something about how I’m not ready for treatment. Yes, they’re right about me not being ready, but that doesn’t negate the fact my eating disorder has been a life saver.

It should come as no surprise that many people with eating disorders have concurrent mental health diagnoses, like anxiety, depression and obsessive-compulsive disorder. As someone who is bipolar II (basically that means my bouts of mania aren’t as extreme as a person who is bipolar I), my depression is a frequent visitor. (Alas, the mania doesn’t come as often. Things are GREAT when I’m manic. Until I come down from it, in one sudden crash.) I’ve come to know many people who experience depression, especially from attending a mood disorders group where people talked openly about their struggles. Through this, I’ve learned that the way I navigate through depression is atypical. And that’s because of the eating disorder.

Many people going through depression are lethargic. Hours, even days pass, shuffling from bed to sofa and back again. Sometimes there’s binge watching, but without any sense of pleasure. Letting Netflix roll into a next episode of a seven-season show is easier than lifting the clicker and pressing the power button off. Some people talk about being too tired to eat but more often what I hear is that they’re too tired to cook. A family size bag of Doritos becomes lunch, a tub of ice cream dinner. Weight gain becomes a byproduct of depression.

To be sure, I’ve had gone through prolonged periods of listlessness but they are rare. Part of my eating disorder is a compulsion to overexercise. This feeling is more urgent than anything I’m feeling—or not feeling—due to depression.

I only have to dig back to yesterday for an example. My day started off rather normal, but by afternoon, I sensed I was off. Before I knew it, I was seriously down. No reason. That’s the frustrating thing that can distinguish clinical depression from normal depression. If someone gets laid off or goes through a breakup, feeling depressed makes sense. It’s part of the process of dealing with loss: denial, anger, bargaining, depression, acceptance. I’m generally a taskmaster. Give me a problem and, after a fair bit of procrastination, I deal with it. It’s harder to snap out of depression when you can’t identify a reason for it.

By 4:30 in the afternoon, I was ready to surrender to the blues. I flopped on my bed, closed my eyes and thought, Good one, Depression. You surprised me again. You win. I became critical of my writing, my relationship, my decision-making—why the hell did I rent a place smack in the middle of a cacophony of construction booms and blasts? A nap would be nice, albeit impossible. Eyes still closed, I saw myself walking into traffic and jumping from the roof of a building. This I’ve termed “safe suicidal ideation.” I don’t have the guts to go through a violent death and I don’t want others to witness such a thing. Safe then, but dark.

And then I opened my eyes and sprang from the bed. I had to get changed and stretch before a three-hour bike ride. Eating disorder trumps depression. The mattress would still be here when I returned. And so I headed off. For the first twenty minutes of the ride, I was irritable. A side effect of COVID-19 has been that more people have sifted through their garages and hauled out bikes. My route was too crowded with too many curves that made me have to wait too long to make my passes. Everything was too much.

I pedaled on. I knew I’d soon break from the path and take the lesser-cycled roadway and eventually I’d be heading up the long climb to the University of British Columbia where many a casual rider would turn back. A guy on a fancy-schmancy road bike passed me and suddenly I had a new focus. Keep up with him. Don’t use your twenty-seven-year old squeaky eighteen-speed bike as an excuse for him to break away.

I did keep up. There were a couple of points where I could have passed him, but I didn’t. I knew he’d leave me in the dust when we reached the hill. Sure enough, my gears got fussy and I couldn’t get in the right groove on the ascent. I passed more riders but his jersey got away from me.

The good thing was that I’d shaken off depression and irritation. I felt content pushing my fitness level. I was appreciating the leafy coverage from century-old trees. I was in the moment, watching in case one of the cars parallel parked by the road might suddenly pull out, failing to see me in the side mirror (if they looked at all). By golly, a survival instinct had kicked in!

I passed a peloton of riders taking a break in a parking lot. Matching jerseys, more fancy bikes. I picked up my pace, but I knew they’d overtake me at some point up ahead. Bring it on!

Sure enough they passed me, but I implored my legs to work harder. I kept with the two “stragglers” and, in time, passed them as I had more power than them on the hills. At fifty-five, I was decades older. Cue imaginary fist pump.

Depressed people aren’t known to do a lot of fist bumps, imaginary or otherwise.

Seventy minutes into my ride, I dialed it back a bit, switching over to a shared pedestrian/cyclist greenway, deciding I didn’t want to be that guy who takes out a toddler on a tricycle. I explored new routes making my way east across the city. I stopped by the lovely blue heritage house built in 1904 that I used to own with an ex, before snapping pics in Mountain View Cemetery—research for one of my writing projects. I zigzagged along streets of a bike route I hadn’t taken in fifteen years, not since the ex and I sold that house. I dismounted and walked along a winding dirt path in a park that is but a sliver at the end of one block, a place I’d searched for to no avail last summer when I was putting together an article about Vancouver’s lesser known parks. I felt vindicated. I hadn’t imagined this spot after all! Once I reached the border for Burnaby, I turned back around, bumbling my way through detours due to pop-up construction zones. I cut through a path along Trout Lake and passed a few clusters of skateboarders in the slowly developing South Flats district before finding my way back to the seawall and reaching home.

If that’s a lot of detail about a single bike ride, it’s intentional. There was plenty to fill my mind along with a few adrenaline rushes. Sometimes the exercise is but a reprieve from depression. Nothing conquered, but a welcome distraction. Other times, like last night, it comes early enough in a depression cycle that the deeper malaise fails to take root. Last night, I felt satisfied and, yes, a little exhausted. It was a good kind of tiredness, body moving, mind in the moment, three hours away from my bed and the mindlessness of scrolling internet feeds with too much snarky political commentary and snippets of unsolicited porn.

This time I did it. I dodged depression. Hats off to exercise. Thank you, eating disorder. I’m still trying to learn effective strategies, still taking medications that I feel offer more side effects than solutions. For now I’m just grateful something works.

Wednesday, May 30, 2018

DOUBLY DISORDERED


Sometimes you get towed in with an ignition problem only to be told you need a whole new engine. Or something like that. I really shouldn’t use car analogies. I’m not even sure I know how to put air in the tires for the one I’m driving these days.

Last fall, I was admitted to hospital for acute depression. I went in voluntarily but they immediately certified me as involuntary. An unnecessary and highly unappreciated step, as you might imagine. I was already there and I wasn’t going anywhere. But that maneuver by some presumably well-intentioned doctor after a five-minute conversation with me made my eighteen-day stay so much more complicated. To say I was being admitted involuntarily when I’d gone to see my psychiatrist, discussed the decision to admit myself, waited for him to type a supporting letter, then stopped back home to pack for my stay and walked into ER,…well, that was rubbish.

I already knew this wasn’t going to be anything like those sojourns in lovely white mansions with grand porches surrounded by fields of green grass where patients dance about waving butterfly nets. I’d seen that in old movies. That kind of place would’ve made me feel better (as long as I didn’t get tangled in the butterfly nets too often).

No, this would be unpleasant. This would be an ongoing battle to regain my rights…and a writing pad…and my clothes. I could go into extreme detail about everything wrong with the experience. I journaled what I could, first with crayon because it was all I could find, then with one of those stubby mini golf pencils because it’s all they’d offer when I begged, all on scraps of paper—the backs of the menu sheet that accompanied each food tray meal, a torn out magazine page with an abnormally large amount of white space. It’ll make a memoir one day. Or maybe not.

Feeling like I had no control over my environment, I did what I always do when I am overwhelmed. I began to starve myself. I ate and drank nothing during my first day in a holding pen of sorts, the Acute Behavioural Stabilization Unit, where patients are expected to calm down as the heavy locked doors constantly slam while hospital employees use the room as a shortcut corridor from one place in the hospital to another. Zero food, zero sleep.

Once transferred to a “regular” psychiatric unit, I first refused food because it wasn’t vegan. Then, I refused what I deemed as being too high in sugar and fat. Then, what was too discolored to actually be an edible version of the food they said it was. (That’s why the tray came with a coveted sheet of paper listing of what was on it: to clue you in that a mini tray of sliced something was actually zucchini.) The expectation was that all of us had to report to the “dining room”, a sad open area with bright florescent lights, to eat at the same time. That didn’t work for me. I didn’t want to socialize. I didn’t want people seeing what I ate or didn’t eat. As I took my tray to my room, a nurse stopped me and said it was against the rule. My shoulders tensed. Rules. Fine. I left the tray and headed back to my room, stomach empty, the growing gurgles strangely satisfying as a sound of defiance.

As I had a different psychiatrist each day, I had to constantly rehash my cycle downward and explain my food issues. A doctor overrode nurses’ objections to me eating in my room and I faced icy looks from Food Traffic Nurse for the rest of my stay. There was a mouse problem in the unit. Indeed, I saw several during my stay. Cute critters. And smart. Based on my observations, many psychiatric patients are too highly medicated to really care about keeping food on the tray. The dining room surfaces areas were regularly a sticky, crumb-strewn mess.

I still refused to eat most of what was served. A dietician became a daily visitor. Nurses were instructed to do daily calorie counts regarding my intake. Once I was allowed to wear my own clothes and I got passes to leave the hospital, I was permitted to buy my own food—nonfat cottage cheese, nonfat yogurt—and keep it in a locked fridge that I could only access when my assigned nurse was available.

I was a problem patient. Depressed with too many extras. I rapidly lost significant muscle mass just as I did during my previous hospitalization. But this time something different happened. As part of my discharge, they referred me to an eating disorders program. I cried when the dietician asked if I’d be amenable to that. I’d struggled with disordered eating for at least thirty-five years, mentioned it to doctors and, being as I was a guy, nothing ever happened. Finally, an opening!

After an ECG, bloodwork and a two-hour assessment and my diagnosis as being anorexic was official. Add it to my résumé. I cried again. Relief. Even triumph. I’d lived with this for so long on my own, its intensity varying during various periods in my life but it’s presence always there, always taking up so much thought and time each and every day.

Help maybe. A new motor perhaps.

I’ve been going to weekly courses and meetings for five months now. No change in my behaviour. I still restrict food and occasionally binge. I still over-exercise. I still spend an inordinate amount of my time thinking about what will and won’t be my next snack or meal. I wonder if, after all this time, thoughts and habits are too entrenched. I’ve created a warped version of a safe, controlled environment for myself.

For now, it’s a victory that medical professionals have identified another male as having an eating disorder. I’m convinced this is still woefully underreported amongst men and, particularly, with gay men. Eating disorders can look different for men, with the obsessions over protein and muscle gain. I witness the same guys at the gym going to extremes with their bodies and talking to strangers ad nauseam about tuna and oatmeal consumption as they log hours doing dumbbell curls and stealing glances of themselves in the mirrors. Is it healthy? Can they stop?

For now the focus is more confined: Can I?