Depression and Weight Loss

Depression has affected my life for quite a few years now. I recently wrote about my experience with Depression on my Madam Sarcasm blog. After I wrote that, I began thinking about the effects it has on me that I didn't realize it had and also how depression affects my attempts at weight loss.

One question I wonder is: Has depression always been there and was it the cause of my obesity, or am I depressed because I'm fat? OR, would the depression have been there any way whether I was fat or thin? Hmmm, things to ponder.

Most people who are overweight eat because food gives them a "high" and a sense of comfort. Depression can make weight loss harder because of the constant mood swings. I can be "up" one minute, and then "down" the next. I have bad days where I'm just sad and everything makes me cry and I need that one thing to give me some comfort: food. How do I learn to find something else to give me that same comforting feeling that won't add calories to my diet? Is this a demon that I am going to have to fight for the rest of my life?

I was reading another blog about depression a few weeks ago. This woman talked about social problems depression has caused her and that when you are depressed you can't or don't want to deal with emotions. It really made me start thinking.. a lot. I've always been extremely shy. I have gotten better as an adult but it's still there. I feel uncomfortable around people that I don't know and I always feel like people are laughing at my behind my back because I'm fat and that everyone is staring at me. I have a problem starting up conversations with strangers or even keeping up with conversations as sometimes I just can't think of anything else to say. I've always been the quiet, shy one that just stood on the sidelines watching everyone else.

This blogger talked about how we run when we are faced with a lot of emotions. I never thought of this until I read her post. For one thing, when someone cries in front of me, it's almost as if I freeze and don't know what to say or do. I know I should reach over and give them a hug and tell them it's alright but I just freeze up... except when it comes to my kids. When my husband and I argue, I also freeze up. I don't like any type of confrontation. I become tongue tied and I lose my thoughts and don't know what to say, so I usually leave the room. I have a horrible anger problem.. sometimes I am just so mad it feels like my chest is going to explode. I feel like I have rage inside of me that I don't know how to get out and when I'm pissed.. I AM PISSED! I will also say a lot of horrible things that I don't mean in the heat of an angry moment. I never thought of all of these things being a sort of disconnection due to depression. I many times don't know how to deal with my emotions whether they are angry or sad. Is there some connection with my depression and being overweight?

Has anyone else experienced real depression? 

Could You Be Bi-Polar?

By Dee

What is bipolar disorder? What are some symptoms?
Bipolar disorder is a psychological disorder in which a person experiences an abnormally elevated mood and behaviors for a period of time before unexpectedly shifting into a depressive state. Chemical imbalances in the brain are considered a cause of bipolar disorder, often with some sort of genetic inheritance. Anecdotal reports suggest that knowing someone with bipolar disorder is similar to riding a roller coaster: the person's mood changes irregularly and without much warning, and that in one moment the person seems charged, happy, and excited, and the next, unexplicably down. In more severe cases of bipolar, individuals might suffer from psychotic episodes -- breaks with reality, disorganized thoughts, delusions, and hallucinations.

Signs of the depressive component mimic other forms of clinical depression: persisting sadness and anxiety, hopelessness, guilt, fatigue, interruptions in sleep patterns, loss of appetite, a resistance to be around other people, and so forth. I'll talk about mania more in the next question, but basically it means that a person is really keyed up, hyperexcited, and elevated. Sometimes, clients present "mixed" episodes in which they experience signs of depression and manic behavior simultaneously.

As with any psychological disorders, the symptoms are severe enough to impair work, school, relationships, and practicing daily routines and self-care. For a person to be diagnosed with bipolar disorder, there needs to be enough evidence to suggest that the individual has experienced both manic and depressive symptoms over a period of time.

One of the symptoms of bipolar disorder is mania. Can you explain what exactly mania means?
"Mania" comes from a Greek word meaning "to enrage" or "to be furious." Imagine what your life would be like if you were hopped up on coffee all the time. You feel super-energized and jittery, are unable to concentrate, experience racing thoughts and actions. Maybe these sensations feel good to you; maybe you feel like Leonardo DiCaprio's Jack in Titanic -- "I'm King of the world!" This is what life is like in a manic episode: always on the edge, always on the go, rushing everywhere and feeling like you do it nonstop (unlike coffee would eventually cause you to crash).

Not all episodes of mania look the same. Sometimes, it appears as if the individual is in a particularly good mood. Other times, it looks very much like the theatrical behavior I told you about a moment ago. Clinicians differentiate between two types of mania: the balls-out, no-holds-barred manic behavior which features elevated mood and some kind of risky, compulsive behavior like overspending money, hypersexuality, or increased risk-taking; and the lower-level, feel good and super happy behavior (without the risky business) called hypomania.

Manic symptoms never appear by themselves. It wouldn't make sense, and it certainly wouldn't gel with reality. Everyone, psychologically healthy or otherwise, can't run on feeling good forever and ever. Emotional states fluctuate. However, persons with bipolar disorder can experience wild and unpredictable mood swings (this is called "cycling") and cannot control their feelings in either state.

I've read that there is sometimes a bit of confusion between being bipolar and manic depressive? Is there a difference? If so, what are they?
Bipolar disorder and manic depression refer to the same psychological disorder. Bipolar disorder is used today because people with the disorder transition from manic to depressive states and back -- thus, two "poles" of dysfunction. This is distinct from clinical depression, a "unipolar" disorder.

How does a doctor diagnose bipolar disorder? Can a medical doctor diagnose it or only a psychologist?
Medical doctors and psychologists can both detect bipolar disorder so long as they both have appropriate clinical, psychological training.

Bipolar disorder is very difficult to diagnose properly. At minimum, the professional needs enough evidence to conclude that the client has been cycling back and forth between manic and depressive states with each state lasting most of the time, daily, for at least one week. The ideal diagnosis would involve the professional meeting with members of the whole family and getting each person's point of view on the client's behavior over a period of time in addition to any client self-reporting. Diagnostics may be extended. Even in the cases of standard clinical depression, professionals need to ask about manic episodes to be sure of a correct diagnosis. If bipolar is treated with the same medicines as clinical depression, bipolar symptoms can actually worsen. Diagnosis may take as long as several months, even years, to complete.

Bipolar is classified as Bipolar I or Bipolar II, depending on the level of manic symptoms. As stated earlier, manic symptoms alert clinicians to the presence of bipolar disorder even without depressive symptoms attached. Think of it like this. The downer will come eventually; our bodies can't stay keyed up indefinitely. Bipolar I is more intense than II, since type II tracks hypomanic signs. There's another type of bipolar called Cyclothymia in which clients alternate between hypomanic behavior and depressive behavior that does not meet the full list of symptoms for major depression. There is also a diagnosis called Bipolar NOS (Not Otherwise Specified) to describe bipolar-like behavior that does not meet the full list of criteria.

Clinicians also try to rule out other competing disorders like schizophrenia, borderline personality, schizoaffective disorders, and substance intoxication.

What are some treatment options for bipolar disorder?
Bipolar disorder requires medication for treatment, usually in the form of mood stabilizing medications and anti-psychotic medications to calm manic episodes. Antidepressants are not recommended because they trigger and exacerbate manic behaviors and may cause suicidal thoughts and ideation, while mood stabilizers tend to relieve both manic and depressive symptoms equally well. Clients should be urged to resume medical treatment even in the absence of symptoms in order to prevent relapse. Side effects include mood blunting (that is, difficulties in feeling or interpreting moods). Psychotherapy and counseling are effective in helping clients recognize mood changes and shifts and managing relationships. It is also recommended for friends and family to seek counseling of their own to learn more about the disorder and how to address changes in behavior, whether or not the client is treating bipolar with medication.

**Again if you have any questions about Bi-Polar, Depression or any other mental disorder feel free to ask in a comment and I will have Dee answer them for you!

Some great Depression information

Our guest writer Dee and I discussed writing our posts in an "interview" style instead of an article style. this way we can make sure that he focuses on the sort of information that a lot of us are looking for! If you have ANY questions on depression or any kind of mental health feel free to post it in a comment and we will answer it soon in this blog!

~~~~~~


How can someone know if they are just having seasonal depression or a phase or depression or if it is something they need to get help with?
I think we should back up just a little bit and get clear about what depression means first. What we mean when we say someone is "depressed" in everyday talk may differ quite a bit from what a psychologist or a counselor calls "depression." In everyday language, depression usually refers to a state of feeling sad, down, "blue," or ho-hum, which is usually brought on through everyday hassles, stressful situations, or problematic relationships. Feelings like these are rather common and natural; we all become saddened at some point or another, and we usually snap out of it. People facing depression aren't as quick to shake it off and may find themselves acting out in ways that aren't typical of how they have behaved in the past. For example, a generally upbeat and optimistic person who enjoys being around his friends may find himself alone on the weekends, choosing to ignore phone calls and sleeping frequently. Or, someone who is really good at keeping a busy schedule and being on time for appointments and meetings may start missing days of work without a reasonable explanation. In any case, when these feelings of sadness and despair become so strong that they start getting in the way of how we interact with people, or how we perform in work or in school that people may need to seek some help. Some people dealing with depression recognize that they are out of sorts and refer themselves to professional care, while other people are so bogged down mentally and emotionally that a trusted friend or loved one will have to make the call for them.

What are some things that people can do to help get through depression on their own?
First things first. I think people have to recognize that if depressive symptoms are really severe that they can't fight them on their own. So I think that we need to be clear that, whatever someone is going through, whether it's just a minor setback that can go away with a bit of effort or if it's more serious than that.

For now, let's just assume that we are dealing with some minor stuff. I recommend doing a couple of things. Whenever I'm working with a client, I want to help that person get to the root of the problem. Whatever the situation, it is good to explore what's going on and see what's going on that may "trigger" these negative feelings. Another good thing to hunt down are "patterns" of the problem. For instance, if someone reports that they feel used all the time, I would ask about the people that tend to take advantage of the client and how they go about doing that. When clients start digging a little bit and making connections, then we can work together to build up some solutions. So, after exploring feeling used and abused, I learn that a client feels like she can't say no when asked to do a favor because she wants to be a good person. Quite simply, we would practice saying "no" and rehearsing situations in which it's okay to say no, and we would correct the mistaken idea that people can only be good to one another if they overcommit themselves. Therefore, the everyday troubles that we all go through can be worked on if we step back a little bit and try to figure them out in greater detail, looking out for patterns, and then working on solutions to correct those problematic patterns.

Some people don't believe in taking medications for mental disorders. What are the pros and cons of taking them? How do doctors decide who needs to be on medication for it and who may just need a little bit of therapy/counseling?
The simple answer is that talk therapy can do quite a bit of good so long as the client is into it, and the professional does therapy with care and in the best interests of the client. However, some professionals recognize that talk therapy has limits. For the really deep, serious problems, therapy might not deliver solid outcomes, and it's at that point the professional offers a referral. I think it's difficult to answer how doctors choose medication versus therapy because, really, it largely depends on how they're trained. Some doctors think medication can solve everything. Others politely disagree, and still others take a middle-road approach. Rather than take a stand on either-or, I honestly believe that a good intake session and early therapy work needs to get a complete a picture of what's going for the client, and that that picture will guide accordingly.

As with any medication, people need to know how to use the medication properly and to be aware of any side effects. Common side effects of anti-depressant medication include headache, dry mouth, restlessness, changes in sleep patterns, and sexual side effects (e.g. lack of arousal, lack of libido, decreased performance). Within the past couple of years, medications advertised on television warn clients to discontinue medication if they experience thoughts about committing suicide. There's a really great article on Wisegeek.com that describes symptoms associated with different types of medications like SSRIs and tricyclic medications. The pro- of taking medication, of course, is that, if taken correctly, they are helpful in alleviating symptoms. Clients should expect a period of trial and adjustment to medication. It will take some time for it to work, and in the early stages, the attending psychiatrist may change dosages or medications in order to get at the right dose. Some symptoms may feel uncomfortable. Clients should be warned about what to expect, urged to pay particularly close attention to how they feel on medication, and to report it during the course of therapy.

Do you think it would be better to fight depression with medication AND therapy both? Or could one or the other help on its own?
Personally, I don't think it's an either-or question. I think good counseling considers the advantages of both medication and talk-therapy as well as the client's needs. Depression situations differ greatly from case to case, and getting the full picture of what's going on with the client can really help solve the dispute.

Do you think the amount of people afflicted with depression has increased with how the economy is this year?
Excellent question. I'm not sure, actually. I suppose I say this because people can cope with being broke and struggling to find gainful employment, and that depression is as much a situation problem as it is the biochemical and physical goings-on in our bodies. That said, I would not be surprised if being broke is that proverbial straw that breaks a camel's back.

In any event, I wanted to wrap up with one thing. We have been talking about depression and treatment options today, and one thing I hope is that people do not feel ashamed about seeking professional help for problems. I think there is still a troublesome stigma about mental health treatment: that the only people that get help are truly "crazy," that people should be able to fix their own problems without needing help from other people, and that if you do seek help you're weak or helpless or incapable of handling your life. The truth is, people pick up and learn different coping mechanisms to adjust to the difficulties of life. Some things work; others don't. When you run out of options, you can look up self-help literature, or talk with friends and family. What's the difference between that and counseling? Ultimately, at the end of the day, people are making informed, conscious decisions to do better for themselves, and as long as you get something beneficial from it, then there's nothing wrong with it.

~~~
Don't forget, Dee has his own blog called Brainspitter! Be sure to check it out and show him some support and appreciation for his valuable information!