One Down …

In the opening post for this new column, I mentioned a list of goals, scribbled on a receipt in Costa. While The Great Epiphany helped to clear a lot of the negativity from my outlook it did not, in itself, provide me with any concrete plans for achieving the things on that list. There are two vying for dominance at the moment, losing the weight I have gained as a result of my bipolar, and the MEDs I now take to treat it, and the desperate need to move out of my mother’s house (much as I appreciate her taking me in) and regain my independence.

My Fitness Pal Ticker

The latter is something that now comes down to my financial situation, which is a work in (very slow) progress. The former however was something that I started working on the very same day I had The Great Epiphany. That was almost two months ago. On that day, I weighed 20 stone and 8 pounds (288lbs), the heaviest I have ever been in my life. Since then, I have successfully lost fifteen pounds, just over a stone. Of the eleven stone I had to lose, I’m one down.

That, in itself, already feels like an achievement, however it is tainted by the fact that I know I have managed to do this before—one of my recurring patterns is losing a stone or two in weight when I am feeling well, then regaining it, plus a little extra, the next time I have a bout of depression. For some reason however, it feels different this time, and I believe this to be a direct result of The Great Epiphany.

In essence, what TGE made me see was that it was okay if I didn’t drop ten stone in a month or two. While this may seem an obvious point, for me it isn’t something that comes naturally. I have always had an unhealthy relationship with food, having suffered from bulimia throughout my teens and early twenties, and retained the binge-eating habits that went with that even though I have ‘recovered’. I use inverted commas there because a person never truly recovers from an eating disorder; they learn to manage it, but the patterns are always within them and can, at any point, return. I’ve had several relapses since, and I certainly retain the tendency to binge terribly when I’m upset or stressed. As a result, I am accustomed to yo-yo dieting, rapidly losing or gaining large amounts of weight. At one point I lost five stone in less than six weeks. As a result, it’s difficult for me to accept the notion of slow weight loss, especially when I have so much weight to lose.

In recent years, as my bipolar cycles have flipped from being predominantly manic to being predominantly depressive, my weight has steadily gone up. While I continue to have spurts of rapid weight loss while manic, the amount I lose has grown steadily less, is never permanent, and I struggle to prevent additional weight going on when I flip back the other way. Due to my MEDs, my periods of mania are now getting fewer and further between, and my capacity to lose weight the rest of the time is virtually nonexistent.

I take high doses of Depakote and Quitiapine, the former being a mood stabaliser, the latter an anti-psychotic. The result is that my metabolism is through the floor, and even sticking to 1200 calories a day, and exercising, I struggle to lose more than a couple of ounces a week. This, for me, is far too little reward for the amount of energy and effort it takes. It leaves me too disheartened to stick to it. In addition, it is simply not enough to compensate for the times when I’m too depressed to maintain my diet, and the weight keeps piling on.

AlliTGE forced me to look at the long game, rather than the short term. I am a very impatient person, and often give up on things if they do not immediately go my way. I had already been discussing my weight issues at length with my doctor by the time of TGE. At my request, they had put me on a weight loss medication named Xenical. You may have seen this advertised as Alli, at the extortionate price of around £40 for a four week supply. It is the same thing, a blue capsule taken with each meal, three times a day, that absorbs roughly 1/3 of the fat you ingest. In theory, if you lose two pounds on your own, you will lose an extra pound if taking Xenical. Should you consider going onto this medication, I strongly urge you to do it through your GP. Firstly, because they will monitor you properly and give you extra advice about a diet and exercise plan that is right for you, individually, secondly because, as long as you actually are over weight, they will give it to you on monitored prescription. This means a month supply for £7.85, rather than £40. If, like me, you get a pre-paid prescription card, it is even less.

I’ll discuss the benefits and downsides of this medication in a later post, but for now suffice to say that this is not a magic bullet. It is not a wonderful fat melting pill that allows you to eat whatever you want and still lose weight. It requires a strict, low fat, calorie controlled diet, comprising a lot of fruit and vegetables, and plenty of exercise. In short, you still have to stick to a diet as difficult as any other in order for it to work.

This small fact is the reason why many people say it doesn’t work; they don’t stick to a diet while taking it, and blame their failure to lose weight on the medication which clearly ‘doesn’t work’, and complain about the side effects which are quite unpleasant if you’re taking this and NOT sticking to an appropriate diet.

I fell victim to this myself when I first started out on it. I stuck to the diet, I took the pills, and after a fortnight I’d lost half a stone, far more than I’d have managed on my own. I was elated. Then the inevitable happened: I hit a dip. Those seven pounds went back on, and brought an additional two friends along with them. Because I was still  taking the new MEDs but no longer sticking to the diet, I experience extreme side effects and had to stop taking them. I was so demoralised I gave up on both the pills and the diet I had been sticking to fairly well before I started the pills. They had, it seemed, done more damage than good.

A couple of weeks later, feeling slightly better, I started again. Again I lost about half a stone and again it went back on again. Round and round I went, until TGE made me stop and reconsider the problem.

I was barely losing weight on my own, however with the aid of the tablets I was able to lose quite well, as long as I stuck to the diet. The issue seemed to be that my mood was only good enough to allow me to stick to the diet for a couple of weeks at a time, while the depression in between ‘good’ phases was long enough to pile on more than the weight I had lost. My weight was still going up, yet even I could acknowledge that it was only going up by a few pounds, every few months, where before it had been going up by a stone or more every few months.

If nothing else, my efforts were preventing my weight spiraling even further out of control.

Encouraged by this thought, I once again started taking the tablets and sticking to the diet. I bought a new notebook and started recording everything I ate and drank, both on My Fitness Pal, and in the notebook. I made notes on how I felt each day. I did as much exercise as I could manage, and I concentrated, initially, on just managing to stick to the diet for three weeks. In the past, I’d never managed more than two weeks at a time. Three weeks, I thought, and I’ll have lost more than half a stone.

Three weeks passed, and I was nine pounds down. Pleased with myself, I managed another week before my mood dipped and I hit a bad spell. The carb cravings hit and I was back to eating cake and crisps and huge portions of pasta. However, I continued to track what I was eating, despite it being beyond my diet, and I found that the period I was binging for didn’t last nearly as long, and by the end of it I had only regained two pounds. Overall I had still lost half a stone.

This had never happened before.

Something which TGE helped me to understand is this: I am going to have good weeks and bad weeks. There will be days when I step on the scales and I’ve lost, and days when I step on and have gained. Whichever way it goes, it doesn’t really matter, the important thing is that I keep trying to manage my weight and to improve my health and fitness. I watch as the number of pounds I have lost slowly but surely increases, and I find myself reassured in the knowledge that, the next time I have a blip, it’s unlikely any weight gain will exceed that which I’ve now managed to lose. The more I lose, the more this thought solidifies, to the point that I now feel comfortable enough to disclose my journey so far, and state that I feel reasonably confident in my ability to continue to lose the weight, albeit at a much slower pace than I would ideally like.Three weeks have passed since I got myself back on track. I’ve lost another eight pounds and have continued with my routine of My Fitness Pal, journal, pills and note taking. I’m trying to pay as much attention to what I eat as I can, and get myself into the habit of eating as healthily as possible.

I am no longer expecting to lose each and every week; I have accepted that there will be times when I don’t, and times when I gain, depending on the cycle of my moods and other far more normal concerns like holidays and meals out. The difference now is that I have myself in a place where, when I hit a blip, I can simply acknowledge it as a blip and move on. It doesn’t become a complete failure. It doesn’t push me further into a depressive state and make me think I’ll never succeed so there’s no point in trying. It doesn’t actually make the situation worse.

Setting myself a more manageable goal—sticking to my diet for three weeks—proved to be very successful. The thought of losing only two pounds a week is incredibly demoralising for me, as that means it would take a year and a half to lose the weight I need to shift. The fact that it’s unlikely I’d lose two pounds every week means it would take even longer. Realistically, it’s likely to take two years to lose the weight I want to drop. That feels like a very long time. It seems impossible that I would be able to stick to a diet for that long. However, sticking to it for three weeks is manageable. The thought doesn’t terrify me, and ultimately I managed four, a whole week extra.

Similarly, the thought of losing eleven stone was completely overwhelming. However, having lost one, I can see that this—losing one stone—is an achievable goal. I am no longer focusing on how many I have left to lose, but simply on losing one more. I can do that, I know I can, because I already did.

On July 11th this year, I was 288lbs. I am now 273.4.

07/09/2013Stick to the diet for one week longer than you managed last time.

Walk with Dexter (my dog) for an extra ten minutes each day.

Lose one stone.

These are manageable goals that I have set myself, and achieved, with relative ease. All of them contribute to my overall goal, but none of them are overwhelming, none crippling in the fear they produce.

One stone down … One more to go.

The Great Epiphany

In July of this year, two extraordinary things happened in very quick succession.

July 11th 2013
July 11th 2013

I turned twenty-eight, and for the first time in as long as I can remember, I enjoyed my birthday. The smiles were not faked for the sake of everyone who expected me to be happy. I didn’t get drunk as quickly as possible, in order to get me through the day. I didn’t lie awake at the end of it all, crying silently at the wall, as the night slowly passed by and edged towards morning, the dawn of another year through which I had no inclination to live.

Birthdays are always tough for me. I’m unsure exactly why. Perhaps it is the realisation that yet another year has passed, and still I don’t feel ‘better’, still my life is not how I wish it to be, still I am not ‘happy’. Perhaps it is simply due to my seasonally cycling Bipolar Disorder and certain memory-triggers at that time of year.

I’ve given a great deal of consideration to what it means to be ‘happy’ in recent months, but I shall save those musings for a future post. For now, I want to explain what happened in July, and how it led to the resurrection of this blog.

I’m not completely sure what was different about my birthday this year: perhaps it’s that I finally have a good balance in my MEDs and am actually taking them properly; perhaps it was the fact I’d decided we must have a joint celebration for my niece, whose half birthday was two days before my own, and actual birthday is so close to Christmas I feel she deserves another; perhaps it was simply that I was turning twenty-eight and, being as I am, a little psychotic when it comes to odd numbers, the fact I had a two and an eight in one year (my two favourite numbers), both of which add up to ten (another very good one), made me feel a better about the whole thing from the outset.

Whatever the reason, the decision was made to go to Chester Zoo, as my niece (much like myself) is obsessed with penguins. This pleases me greatly. She is already showing, at six months old, many sensible characteristics, several of which are shared with me. She is, I feel, progressing nicely.

She is also a turning point in my life, for reasons so complex I can barely find the words to express them properly. For years, I have carried certain burdens, certain ghosts, one of which is a miscarriage I suffered years ago that has quite literally haunted me ever since, and is one of the memory-triggers to which I earlier referred. It happened in June, at the end of my first year at University, and for whatever reason, every June that has passed since then, I have relived the event, as if it had just happened. I have been stuck, mired in the memory of a child I never even knew, a life that had barely even begun to form, for it was so early on when it happened I wasn’t even been aware of it until after the fact. I have never understood why this affected me as much as it did. I think it has a lot to do with my deep seated need for a stable family environment, something which—unbeknown to most of my family—I hadn’t had for many years by that point.

My niece changed everything.

When I first found out my sister was pregnant I was at once delighted and consumed by grief and outrage. I vacillated between a compulsive need to do for her the things I had imaged, a thousand times, doing during my own pregnancy, and an inability to speak to her for fear of crying or screaming at her and, consequently, causing her upset. The turning point came when she developed problems during her pregnancy, not uncommon, but severe enough that she needed regular help, couldn’t walk without the aid of crutches, and, for the final three months, a wheelchair. The all-consuming obsession with my own memory was utterly obliterated out by the over-riding need to take care of my sister and her unborn child. I no longer cared about myself, what I was feeling wasn’t important; they were memories, they were past, this was happening now.

I was terrified that, once the baby was born, I would go back to how I had felt before, that I’d find it difficult to connect with her baby, that I’d resent my sister, for having what I didn’t. Instead, the most bizarre thing happened.

I completely fell in love with the child. I was utterly besotted. And, more confounding still, I found I was no longer clinging to that memory. The anniversary of the miscarriage came and went this year with comparatively little in the way of reaction. I had slightly higher anxiety levels than usual, but we had anticipated this reaction, and my psychiatrist had given me additional MEDs to combat it, a step which worked like the proverbial charm. And so it was that I reached my twenty-eighth birthday, a point in the year that is usually my second worst, feeling very good.

The fact that I had broken what I thought to be an unbreakable pattern was something of a revelation.

The second peculiar thing to happen in July was one of those incidents which, to anyone else, would have seemed so mundane you would think me crazy to say it was such a defining moment in my life. I have often found however, that the greatest insights come from the most trivial of situations.

Costa CoffeeIt was not long after my successful birthday trip to the zoo. I was sitting in WHSmiths in Chester, at a table in Costa overlooking the street below. I love Chester. It’s a beautiful city, not to mention one of my favourite shopping destinations. I was idly reading a book, but mostly looking out of the window and watching the passage of life beneath the window. People watching is a hobby of mine. I try to figure out what makes the rest of the world tick, what it is that allows them to do all the things I can’t seem to manage, and often do them with ease.

On the street below I noticed a cute little mosha girl. I could tell she was cute, even though her back was to me, and there was something very familiar about her. She was skinny but with a decent set of hips, swamped by a black hoody, and maroon cords flared so wide they swallowed her feet, trailing the pavement. She had long, straight, dirty-blonde hair, and as I stared at her I realised she could be me, aged eighteen or so, back when I still thought—at least occasionally—that the world could be mine; when I believed, wholeheartedly, that by the age of twenty-eight I’d have my shit together.

I stare at the girl and remember being her; the confidence, the friends I’d had, the way the bipolar (then un-diagnosed) only reared its ugly head occasionally, and the damage was relatively minimal, compared to the havoc it would wreak in my twenties. I recall with perfect clarity what it was to be in love for the first time and never question how that would play out: together forever, marriage, a house, a child eventually.

Barely a year later, all these things were stolen from me. I was never the same after the miscarriage, perhaps due to the changing hormone levels in my body as a result. The cycling of my moods became permanent, pronounced and rapid. I had no idea what was happening to me and neither did anyone else in my life. Those who loved me most stuck around, bewildered, but always there, even if only on the sidelines while I tried to figure it out, but as the years passed and I became ever stranger to them, they seemed to lose hope I’d ever go back to being that girl again, the girl who was standing beneath me as my latte cooled in my hands.

After that I lost almost everyone and everything I cared about. For the most part these losses were permanent. Those who remained in my life seemed so far away I could never touch them, never reach them, and certainly could never explain what had happened to me. My decisions went from bad to worse, and somehow, through it all, I was eventually diagnosed and began treatments, MEDSs and therapy. The first real turn came, ironically, when my house burned down at the end of 2011, and I was forced to move back in with my mother (more on that later). The second and infinitely sharper turn came this July, as I sat at that table in Costa and tried to puzzle out what I was feeling, as I stared at that girl.

I was sad.

Not in the usual, desolate, soul destroying way to which I’ve become accustomed, but in the transient way that everyone feels at various points in their life, when they are confronted by something unpleasant. Ironically, the fact that I was feeling sad in the ‘normal’ manner pleased me, because I had the distinct sense that it would pass. It wasn’t permanent. It wasn’t going to keep me awake for weeks, or months, wasn’t going to prevent me from functioning like your average person does. It was a sadness from which I would recover.

I was sad for the girl I used to be; the girl who could be standing on the street beneath me, as I stare out of the window. She had so many hopes, and so many dreams, and I have accomplished none of them. I am, in fact, stalled in a situation she would find utterly abhorrent: I am overweight (at that point eleven stone overweight), unemployed, struggling to finish the latest draft of my novel, struggling to finish my thesis, single, lacking any form of social life that doesn’t involve Facebook, broke, and, as the cherry topping the multi-tiered cake of despair, living with my mother.

The latter point alone would have been enough to send my younger self completely over the edge.

It was then that I realise something that had been blindingly apparent for a while: it’s time to change.

It’s time to change everything.

And this is The Great Epiphany that has led me to the point I am at today. It may seem ridiculous: surely everyone who is even remotely unhappy with their lives must think this on a regular basis. It is, however, one thing to say it’s time to change, even to realise it’s time to change, to want, desperately, more than anything else in the world, to change, and another entirely to actually do it.

Change, is bad. Change, is scary. Change is exceedingly difficult to accomplish in any true form.

Not only that, but there are so many things that need changing. It isn’t just one, incredibly difficult thing I have to achieve. In my imagination I see an infinite string of impossible to achieve goals, all of which alone are enough to cripple me. This string has tied me down. It has me bound so tightly I can’t even breathe. And yet, there is this girl on the pavement below me, and she is constrained by none of these things.

She is free.

I wish to be free too, and suddenly that wish, that desire to achieve these goals seems like the most important thing. Maybe it doesn’t matter if I never have everything I want in life; maybe the only thing that matters is that I continue to try, no matter how impossible things may seem. In the past when I’ve decided I’ll lose the weight, I’ll find the perfect job, I’ll get my novel published, I’ll find a new place to live, I have felt like an utter failure because, a few weeks or a few months later, the scales are telling me an even higher number, I’m still signing on at the job centre once a fortnight, every time I try and finish the new draft of the novel, something distracts me, and I haven’t managed to save so much as a penny towards a deposit on a new flat. I become despondent, I feel I will never succeed at anything and, more often than not, I stop trying.

Trying, however, is the important thing. Success is great, achieving your goals is admirable, but it is also something that people spend a lifetime doing; they don’t obtain everything they want in a few weeks, or even a few months.

Blog 0001 Just Keep SwimmingI want my life to change, therefore I must try to change it, and i must keep trying, no matter how many times I have failed in the past, no matter how many set backs I encounter in the future.

It is at this point that I begin to hear Dory from Finding Nemo chanting ‘Just keep swimming, just keep swimming’, and the image looms in my mind of a giant shark.

In this metaphor, Bruce the shark is playing the part of my my failures, past and present, lurking behind me, and looming ahead. This is a particularly poignant image for me, as I have a pathological fear of sharks (seriously, even cartoon sharks scare the crap out of me).

Dory, however, has a point. My efforts and how successful they are will not be measured by how quickly I reach each goal, how many goals I cross off my list, or even if I reach them at all, but by the fact that I continue to try to change those things in my life I do not like, and that I am, as a result, as happy as I can be in the moment.

I spend a great deal of time thinking ‘I’d be so much happier if …’ that I almost always forget to think ‘I am actually happy right now because …’

It occurs to me that perhaps I am never happy because I am consumed by the pursuit of happiness, something which I have convinced myself I will only feel if I achieve all these apparently unattainable goals.

And so I made a decision: to no longer wait until I have achieved everything before I feel happy; to allow myself to pursue my goals at a reasonable pace, rather than expecting them to come to fruition immediately, then abandoning them when they don’t; to continue to try to improve those thing in my life with which I am patently unhappy; and, perhaps most importantly, to be realistic about the fact that, because I am bipolar, my approach to these goals and problems may have to be a little different.

My mistake, in the past, is setting out to change something while feeling well, then finding I am unable to continue, or at least less capable of continuing, during periods of illness. It is easy to allow these times to make you think you cannot achieve your goals, you cannot make changes, you cannot ever be happy, because you are bipolar. But bipolar is not an excuse to never achieve, to never try, to never be happy, nor is it something that is ever going to simply go away. It is simply an extra obstacle (albeit a very large and complex one) to navigate; for each of the things I want to achieve I must find a way that accommodates my bipolar. It is a matter of accepting the fact that my progress in all endeavours will—much like my mood—suffer from peaks and dips. I need to learn to anticipate these as much as possible, and build mechanisms into my approaches that accommodates them, so they do as little damage to my overall efforts as possible.

As I sit in Costa, musing on just how to accomplish this, I blink, and the girl in the street is gone.

Two Point in Space and Time that should never have touched ...In all likelihood she simply moved on. However, being as I am of a certain mindset, I like to think that, for one instant, two points in space and time that should never have touched, pressed together, so that I might be granted The Great Epiphany I so desperately needed.

On the back of my Costa receipt I scribble a list.

I use the list as a bookmark, and transfer it, as I finish one book and begin another, finish that and start another, so that I don’t forget what I saw and what it made me realise.

That very day I begin to go about changing the things in my life I do not like.

It isn’t easy. Nothing dramatic happens over night. I don’t suddenly drop four dress sizes, loose all my social anxieties and stumble upon a dream job with outrageous pay, which allows me to move into a little cottage with roses over the door and a ridiculously attractive neighbour who, as it turns out, happens to be the love of my life; this isn’t a Sophie Kinsella novel.

No, as I write this I am still, to all intents and purposes, in the same place I was two months ago. I am still overweight (at this point ten stone), still struggling to finish my thesis, still single, still lacking any form of social life that doesn’t involve Facebook, still broke, and, as the cherry topping the multi-layered cake of despair, still living with my mother.

And yet, I have finished the latest draft of my novel and sent it safely back to my agent, and no longer unemployed, but self-employed as a freelance writer, editor, proofreader and artist, with a sideline in publishing. My first book was released last Saturday (31st August 2013), and although it is an edited art volume rather than a novel, I am incredibly proud of it.

The resurrection of this blog came about as I realised two things: firstly, my online network of friends is one of the very positive things about my life, and I wanted to give something back (even if it is only material for them to use in relentlessly mocking me); secondly, and to my pleasant surprise, I am finding that some of my strategies are actually working well. As such, I want to keep a record of them, one that other people, in similar situations to me, might use. One of the worst aspects of bipolar disorder—and I imagine most other mental health conditions—is the loneliness. The feeling that you are completely alone, that there isn’t a single other person alive who has felt the way you do, and so you have nobody to advise you as to how to go about making yourself feel better.

I have felt this way often. When I was first diagnosed, it was a permanent, insidious presence in my mind, this thought that I was utterly alone. I read book after book about bipolar, and depression, even schizophrenia and psychiatry in general. Nothing helped. Everything was either written by people who were professionals discussing it clinically, or people describing their life events, but offering no true commentary on them, no real understanding of the why and the how and the WHY? No suggestions as to the cause of these incidents and how other might avoid such situations, no account of the way they have improved their own mental health since then.

The issues of ‘why do I feel this way?’, and perhaps more importantly ‘when will I stop feeling this way?’ are questions which still, for me, lack answers. Certainly medication has helped. Some of my more recent interventions seem to be beneficial also. As a result, I felt it important to share my thoughts, silly as they may be, in the hope that others suffering from that crippling sense of loneliness might know that they are not, as they fear, completely alone.

I intend to share with you my research into bipolar, my thoughts, my personal experiences and my experiments with various treatments and methods. I hope along the way to get closer to achieving my own goals. At the very least, I hope the expectation of weekly posts forces me to do the one thing The Great Epiphany showed me was most important:

Keep trying.