Bipolar Disorder and Weight Gain
Many of us with bipolar disorder have trouble with gaining weight due to medications. The inactive lifestyle that is often a normal part of being depressed can be a cause for weight gain as well. Mania is another problem as people are rarely hungry when manic and junk food is an easy and convenient way to eat.
After three years of constant medications from 1995-1998 I gained over 80 pounds. I don't know the exact amount because after a certain point I was so profoundly depressed and upset by this weight gain that I stopped getting on the scale. I simply had an out of control appetite for three years. I couldn't stop. I know I weighed over 250 in 1998.
I asked for help from the doctors and the only reply I received was, "We will deal with the weight gain when the mood swings are under control." I was so naïve back then. I thought I had to LISTEN to doctors. I know now that I have to WORK with doctors. This means I can fully participate in my health care as well. The truth is that my mood swings never once got under control on medications because I had to keep changing them due to side effects. I know that this constant experimentation did irrevocable damage to my brain and physical body. I can only hope that doctors today have a better idea of how to help someone like myself. There are a lot of us who do not respond optimally to medications and we need a different type of treatment plan. An 80+ pound weight gain is not healthy for anyone and has to be prevented.Anti Anxiety and Anti Psychotic Medications
No one seems to be quite sure why people gain weight on medications. There is the theory that the meds slow down the metabolism. I personally believe that they stimulate the hunger portion of the brain to the point that we no longer have a good sense of when we are full. I'm always amazed at how quickly my appetite changes when I take medications these days. I sometimes take Ativan or Zyprexa when the psychosis gets bad and within hours I'm craving junk. I crave it like I'm starving. I get images of cake, cookies, ice cream and candy. I think about it and fantasize about it. I want to eat big spaghetti dinners with a lot of bread and could literally drink Coke at every meal. It's almost exactly like the food cravings caused by marijuana. (Before anyone writes me, I don't use marijuana to treat bipolar disorder. It messes up the brain and I can't risk that but I did use marijuana before I was diagnosed.)
I've lost a lot of the weight I gained in the 90's. It hasn't been easy. I've found that consistent exercise with a lot of weight training and walking is the best way to keep my body healthy. I know that if I approach losing weight as something I HAVE to do, I will rebel and eat junk just to feel better. Instead, I approach it as just another tool to add to my comprehensive treatment plan for this illness. If I see eating healthy as a way to reduce mood swings, I am more likely to think before I put a lot of junk in my mouth.
In terms of food and weight loss, eating a protein and a fruit or vegetable in the morning with a protein snack before lunch is the best way to start my day. It keeps the blood sugar level and seems to keep the sugar cravings down. It also helps the mood a bit. I have carbohydrates at lunch, afternoon snack and dinner. If I have fruit before bed I am fine. This is not exactly a FUN way to eat, but it works. When I don't eat this way, the dark moods come back and I worry about my life a lot more. It's amazing how powerful food can be.Using Supplements to Help with Cravings
When I do have to take the medications, I can only tolerate a tiny dose before the side effects start and the food cravings get out of control. A health care professional I'm working with suggested taking L-Glutamine to help with the carb cravings. I'm going to add the powder to a water bottle and drink it when the cravings are terrible. You may want to talk with a health care professional about this and try it. Especially if your medications are making you gain weight. You can buy L-Glutamine at a health food store. (She also suggests taking Taurine for panic attacks.)Weight gain is not healthy
If the medications have made you gain a lot of weight, you have some thinking to do. This is a fine line isn't it? We need these meds to stay stable and keep us alive. And yet they tear up our bodies. My solution is to use the Health Cards to help me get as stable as possible and then take small doses of medications to treat what I can't fix on my own. You can do this as well. People often ask me how I manage this illness without medications. My reply is always the same. It's extremely difficult. Sometimes impossibly difficult. But I do it because I have a desire to live even when I'm suicidal and I have taught myself through years of mental training that this is an illness and not something I do wrong because I'm weak. I feel that using a treatment system like the Health Cards (or whatever works for you) that helps you manage the illness with a minimum of medications is the goal. Wouldn't it be great if all we needed the medications for was prevention? We could take doses that prevent the big swings and then take care of the rest on our own. As always, I am not telling you to stop taking your medications. I believe they are an important part of the treatment of bipolar disorder and I wish I could use them as part of my plan.
I will try the new meds that come out because this is an illness and the medications work for many people. But I will not put medications in my body that cause me to gain 80 pounds. I will have to find safe alternatives. I keep hoping that as technology improves, the researchers will find more natural ways to treat the illness and we won't have to take so many pills. I personally am trying some of the newer techniques for managing mood swings. I sleep on a magnetic sleep system that is made by a Japanese company called Nikken and I have started Neurofeedback with some excellent results. I will write more about my results with these treatments once I have used them for at least six months. I am very hopeful with the path I am on right now, but want to do some more personal and professional research before I put the information on the web page. The good news is that there is hope!What About You?
I talk about physical health in all of my books. Medication treatment for bipolar disorder is chemotherapy. Yes, just like cancer therapy. It's that serious and can't be taken lightly. You have one body and one brain. The more you can do naturally to treat this illness, the better chance you have for a long and healthy life. Most doctors today would agree with this, but few have the time to teach you how to do it.Here are some of the things I do today to keep my body and mind in shape:
Walk. This is absolutely the best way to stay healthy and get the sunlight your brain needs. Join a walking group if you won't walk alone. Make it something you want to do, not something you have to do. In the US there is a program called USA Fit. It starts in the spring and teaches people how to walk a marathon. I will write more about it next year. I'm sure that no matter where you live, there are places to walk and people to walk with. This really can make a difference with bipolar disorder. Many people never start a walking program because they are waiting for the DESIRE to walk. The truth is, you don't have to want to do something in order to do it. Depression will tell you it's pointless anyway. You simply have to say to yourself, I am going to walk and then wait for the good feelings. They come after the walk is over.
Hire a trainer. If you have the money, hire a good personal trainer. One who lives what they preach. A Pilates trainer, a professional body builder (natural, not one who uses steroids) or a really dynamic private yoga teacher can make all of the difference. When you pay good money for something there is a chance you will take advantage of it more than if you just have a monthly membership to a gym. If you don't have the money for this, find your least expensive local gym and see what they have to offer -then really take advantage of their services. Become a regular at your favorite class and meet others who want to stay in shape. And then get a training partner. It's too hard to stay in shape alone for most people. We need help and encouragement from someone.
Eat a protein breakfast. Eggs (mostly egg whites will help you lose weight) with some meat and a nice fruit. It works. This is not too hard to do and can make a real difference with your blood sugar. You can do this at most restaurants. I will have eggs, bacon, fruit and skip the toast. Sometimes I really miss the toast, but it's getting better. I remind myself this is not for dieting, but for brain health and that helps. If I approach it like a diet, I will get frustrated and quit. But when I say Julie, if you eat that chocolate donut you WILL get sick, I often listen to myself and make the better choice. This may always be a struggle for many of us, but we can't give up!
Get high on exercise. I mean that. Just a half hour of movement can change your brain, but it takes time to build to that half hour for many people. Just keep going. I started walking 30 minutes a few times a week. I can now walk for a few hours. It took time, but I can do it. When I work with a trainer, I do a half hour of cardio, weight train for an hour and then do another half hour of cardio. I'm just like anyone else and know for a fact that I would never do this if I were not paying for it. I need the regimentation of a trainer. The cost is a problem and I have worked out a deal with my trainer. I see this as a part of my treatment system and know that I save money because I don't have to go to the doctor and I definitely stay out of the hospital. Even if you see someone once a month and then work the rest on your own, it's worth it. Explain your situation. I told my trainer about the bipolar the first day I met him. He now knows that the down days are a bit more challenging for me, but he never lets up!Encouragement
If I can go from an overmedicated, sick and despondent 250 pound woman to someone who is at least alive and kicking and getting on with her life, you can do it as well. Give it time. This has been a five year odyssey for me. The Health Cards gave me my life back, but now I have to use them daily to stay well. It's a struggle compared to what my other friends go through. I wish that my life were about work, relationships, spirituality and other similar crises instead of always having to monitor for mood swings. I think I could handle that. But unfortunately my life is about managing bipolar disorder. Then I can move on to the other crises! Do you sometimes feel it's too hard to deal with all of this? Well, you are not alone. It is very hard, but it can be done. If you have weight gain from medications it only adds to the problem, so take charge of that area of your life today. And in five years you can be in a different place. The years are going to pass anyway. Let's make the most of them.