How to balance mental illness & weight loss? (details inside)

zyxst

ETA: lol MFP won't accept my tags
ETA 2: lol, forgot MFP doesn't like The Seven Deadly Words You Can't Say On Television

TW: mental health issues, talk of self-harm/suicide


I lost 183# over 5 years (2012-2017) and maintained ~135# for 2 years (2017-2019). I regained 140# over 6 years (2019-present).

As many obese people have been told, losing weight will help/alleviate physical health problems. I had high blood pressure, varicose veins, edema, joint pain, and other minor issues that would be 'fixed' with weight loss. So, I lost a lot of weight (183#). My GP said I was 'healthy'. My bp was 'normal' (~140/90 at 47 y/o), edema was minimal, and my joints were not painful.

I didn't feel 'healthy'. I was the same person as always, just a smaller size. I could buy clothes off the rack and sit in public seating with room to spare. I still have major depressive disorder, anxiety, and PTSD (officially diagnosed 5 years ago). I still had other health issues that were supposed to be 'fixed' with weight loss, just the severity was much lower.

An annual blood test showed I had iron deficiency (~2019). I had to go back on birth control even though I didn't want to (I know bc is for more than stopping pregnancy). My GP and OB/GYN offered the Depo shot or the iud. They did not want me on the pill because I would still have a period, which they guessed was the cause of the low iron. I didn't want to be a jerk patient, so I took the shot first. It made me suicidal after 3 weeks and I begged to change to the pill. This is when I found out they didn't want to give me the pill. I accept the iud. It worked for my iron deficiency, but I hated it.

Over the last 6 years, I got on anti-depressant/anxiety meds and back on bp pills. I've been eating to keep myself mentally 'sound'. I log about half of what I eat. I did a a lot of walking outside to get away from the people I live with, but I always had to go home, so it did little for my mental health.

Mental health help (therapy, counseling, etc.) is not free in Canada. I don't have money to pay and there aren't therapists accepting new patients. I don't like therapy because I feel I can't be honest (fear of being committed due to self-harm/suicidal thoughts).

Anyway, any advice on how to lose weight when my mental health is complete garbo?

inb4 go to therapy
inb4 Shia LaBeouf.gif

sollyn23l2

Having had similar experiences myself, I would recommend focusing primarily on your mental health first. My weight issues improved as my mental health improved. Keep up the walking if you can. Try tracking your calories to whatever extent you are able.

CrazyMermaid1

Here in the States we have the National Alliance on Mental Illness (NAMI) whose programs include a free support group for people with a mental health disorder. The group is called NAMI Connection and is co-facilitated by two trained volunteers with lived experience. I am one of those co-facilitators and suicide ideation is a fairly common subject. The best reason to attend is that you will be among people who understand what you’re going through because they’ve been there.

kshama2001

I can relate to so much of this that it's hard for me to start.

This really stands out to me:

I did a a lot of walking outside to get away from the people I live with, but I always had to go home, so it did little for my mental health.

Are you still living with these people?

I agree that addressing mental health first is a good idea. However, this will be extremely challenging if the people you live with are contributing to the problem. I just went through this myself and it's taken almost a year of DBT intensive, plus biofeedback and medication changes to recover.

I'm a veteran, and am friends with a number of veterans who have checked themselves into in patient treatment for mental health issues. I've heard a lot of bitching about being committed, but also gratitude for the help they got.

I wonder if being committed will not only give you the mental health treatment you need but also be a good place to make a new plan for a better living situation.

What's your anti-depressant? At this point I must have tried a dozen ADs, and the only one that works for me without unacceptable side effects is Wellbutrin, plus I take buspirone for anxiety, and this also helps me sleep.

kshama2001

An annual blood test showed I had iron deficiency (~2019). I had to go back on birth control even though I didn't want to (I know bc is for more than stopping pregnancy). My GP and OB/GYN offered the Depo shot or the iud. They did not want me on the pill because I would still have a period, which they guessed was the cause of the low iron. I didn't want to be a jerk patient, so I took the shot first. It made me suicidal after 3 weeks and I begged to change to the pill. This is when I found out they didn't want to give me the pill. I accept the iud. It worked for my iron deficiency, but I hated it.

I'm assuming the IUD is "working" because it is a hormonal one? When is it due to be changed?

Do you have iron deficiency due to very heavy bleeding? Do you have fibroids? How old are you?

I can go on about this subject for some time, but first want to make sure my assumptions are correct.

There are many ways to address heavy uterine bleeding other that don't involve hormones. Frankly, these could be contributing to your mental health issues.

zyxst

CrazyMermaid1 wrote: »

Here in the States we have the National Alliance on Mental Illness (NAMI) whose programs include a free support group for people with a mental health disorder. The group is called NAMI Connection and is co-facilitated by two trained volunteers with lived experience. I am one of those co-facilitators and suicide ideation is a fairly common subject. The best reason to attend is that you will be among people who understand what you’re going through because they’ve been there.

Thanks. I'm in Canada and there is probably a similar program, but I haven't looked.

zyxst

kshama2001 wrote: »

I can relate to so much of this that it's hard for me to start.

This really stands out to me:

I did a a lot of walking outside to get away from the people I live with, but I always had to go home, so it did little for my mental health.

Are you still living with these people?

I agree that addressing mental health first is a good idea. However, this will be extremely challenging if the people you live with are contributing to the problem. I just went through this myself and it's taken almost a year of DBT intensive, plus biofeedback and medication changes to recover.

I'm a veteran, and am friends with a number of veterans who have checked themselves into in patient treatment for mental health issues. I've heard a lot of bitching about being committed, but also gratitude for the help they got.

I wonder if being committed will not only give you the mental health treatment you need but also be a good place to make a new plan for a better living situation.

What's your anti-depressant? At this point I must have tried a dozen ADs, and the only one that works for me without unacceptable side effects is Wellbutrin, plus I take buspirone for anxiety, and this also helps me sleep.

Yes, I'm still living with them. I can't leave because of money, which is the problem for most people.

I've worked on the other side in a health facility, not in patient care. I know how certain patients are treated regarding mental illness and I do not want that. Not being abused, just ignored and/or not believed.

AD I've been on: Prozac for 3 days (it made me not sleep for 24 hours)

Effexor for 4 years (I stopped on my own. My GP had retired and I was relying on an outpatient call line for refills. I asked to increase to 187.5 mg which the nurse okayed (she wasn't happy about it), but insisted I call after a month to discuss if this dosage was okay. I ended up having more horrific nightmares and asked for a lower dosage (from a different nurse; the call line was across the province/country). The nurse wouldn't lower the dose, so I stopped taking it.)

Wellbutrin for 9 months. It seems to be doing fine. I don't have horrific nightmares and can enjoy writing again.

TBH, I don't feel different being on meds.

zyxst

kshama2001 wrote: »

An annual blood test showed I had iron deficiency (~2019). I had to go back on birth control even though I didn't want to (I know bc is for more than stopping pregnancy). My GP and OB/GYN offered the Depo shot or the iud. They did not want me on the pill because I would still have a period, which they guessed was the cause of the low iron. I didn't want to be a jerk patient, so I took the shot first. It made me suicidal after 3 weeks and I begged to change to the pill. This is when I found out they didn't want to give me the pill. I accept the iud. It worked for my iron deficiency, but I hated it.

I'm assuming the IUD is "working" because it is a hormonal one? When is it due to be changed?

Do you have iron deficiency due to very heavy bleeding? Do you have fibroids? How old are you?

I can go on about this subject for some time, but first want to make sure my assumptions are correct.

There are many ways to address heavy uterine bleeding other that don't involve hormones. Frankly, these could be contributing to your mental health issues.

It's Mirena. It was due to come out end of May 2024. I found a doctor willing to see me to take it out in a week. I'm 53 almost 54. I don't have fibroids or any reproductive problems.

My GP guessed the low iron is from 'heavy' periods because I didn't have any visible/overt sign of bleeding. It was diagnosed "You are female with a working uterus. Therefore, your period is the cause." I don't think my periods were heavy. They didn't check any of the boxes on any of the online Is My Period Heavy articles.

I've had depression since I was 7 years old. I was officially diagnosed in 1993 in the U.S. after pregnancy. I had to get officially diagnosed in Canada 6 years ago. I'd started having menopause symptoms at 47, but my GP said I was 'too young'. The Canadian psychiatrist said my depression was hormonal which made sense.

kshama2001

CrazyMermaid1 wrote: »

Here in the States we have the National Alliance on Mental Illness (NAMI) whose programs include a free support group for people with a mental health disorder. The group is called NAMI Connection and is co-facilitated by two trained volunteers with lived experience. I am one of those co-facilitators and suicide ideation is a fairly common subject. The best reason to attend is that you will be among people who understand what you’re going through because they’ve been there.

zyxst wrote: »

Thanks. I'm in Canada and there is probably a similar program, but I haven't looked.

Even though NAMI is technically for US residents, perhaps one of the groups in a state that borders your country wouldn't mind you joining.

https://www.nami.org/program/nami-connection/

Here NAMI lists resources for other countries, with two specific mentions of yours:

https://helplinefaqs.nami.org/article/102-i-don-t-live-in-the-u-s-is-there-a-nami-program-in-my-country

kshama2001

zyxst wrote: »

kshama2001 wrote: »

An annual blood test showed I had iron deficiency (~2019). I had to go back on birth control even though I didn't want to (I know bc is for more than stopping pregnancy). My GP and OB/GYN offered the Depo shot or the iud. They did not want me on the pill because I would still have a period, which they guessed was the cause of the low iron. I didn't want to be a jerk patient, so I took the shot first. It made me suicidal after 3 weeks and I begged to change to the pill. This is when I found out they didn't want to give me the pill. I accept the iud. It worked for my iron deficiency, but I hated it.

I'm assuming the IUD is "working" because it is a hormonal one? When is it due to be changed?

Do you have iron deficiency due to very heavy bleeding? Do you have fibroids? How old are you?

I can go on about this subject for some time, but first want to make sure my assumptions are correct.

There are many ways to address heavy uterine bleeding other that don't involve hormones. Frankly, these could be contributing to your mental health issues.

It's Mirena. It was due to come out end of May 2024. I found a doctor willing to see me to take it out in a week. I'm 53 almost 54. I don't have fibroids or any reproductive problems.

My GP guessed the low iron is from 'heavy' periods because I didn't have any visible/overt sign of bleeding. It was diagnosed "You are female with a working uterus. Therefore, your period is the cause." I don't think my periods were heavy. They didn't check any of the boxes on any of the online Is My Period Heavy articles.

I've had depression since I was 7 years old. I was officially diagnosed in 1993 in the U.S. after pregnancy. I had to get officially diagnosed in Canada 6 years ago. I'd started having menopause symptoms at 47, but my GP said I was 'too young'. The Canadian psychiatrist said my depression was hormonal which made sense.

I'm a veteran and get my health care through the VA. They're good if not great for ordinary things, but really dropped the ball on my uterus. Also, my GP was sub-par when it came to my anemia. After I landed in the ER, she referred me to a hematologist in the VA, at which point I started receiving great care. A veteran friend of mine is also getting bad advice about her iron, I've been suggesting she see a hematologist for some time, and she finally asked for a referral and has an appt next month.

With the VA, care in the community is available under certain circumstances. I fought for years to get a referral to a fibroid specialist, and finally did, after being denied twice. It was exhausting, but I am so glad I did.

I feel angry about the sub par care you are getting for your low iron. I know nothing about what it takes to see a specialist in Canada, but encourage you to make a fuss until they give you what you want so you'll stop bothering them

kshama2001

My iron post was getting long, as it tends to do, so I split it up.

I see that you track iron in your diary. I also see lots of cereal. Is this partly because it's fortified with iron? If you find cereal filling, ignore the following - I don't find cereal filling at all. In fact, it triggers me to eat more than if I'd eaten nothing at all. I have to be very careful about my breakfasts. Without the right balance of moderate fiber, protein, & fat, and lowish carbs, I get the munchies all day.

Also, back before I gave up on cereal, some iron-fortified cereals made me feel weird. There are many forms of iron. I'm very cynical about what food manufacturers add to foods - they are just trying to hit a number and have zero incentive to do it with a high quality form of iron.

So to answer your original question of "How to balance mental illness & weight loss?" do prioritize mental health care, but also work to find what foods fill you up and focus on them.

I'm currently doing the year long DBT intensive and have learned many ways to self-soothe that don't involve food, but it's such a struggle to not use food, which is quick and works (although it causes problems in the long term.) It's like a bad relationship I just can't give up.

My depression kicked back in recently, and I was having a hard time getting out of bed and staying out of bed. I've just changed from one Wellbutrin XL 150 mg to two Wellbutrin SR 100 mg, and what a difference that makes! It's also cut down on the food noise. I hope this lasts...

Come to think of it, when I successfully lost weight in 2021, I was taking Wellbutrin SR. We made a change that summer due to increased anxiety and I've been struggling with eating ever since. Ugh.

zyxst

Thanks for responding. I'm in a mini spiral atm, making it hard for me to go back and read this thread.

Seeing a specialist in Canada requires a doctor's referral. I can't call up, say an endocrinologist, and get an appointment. There are long, long wait times, unless it's super urgent.

The iron. I don't like eating many of the 'healthful' foods recommended for upping iron. Mostly from being turned off eating them constantly. I used to eat mussels in salads, which was great, but gods I got sick of the stringy beard. Spinach was the stems. Why can't I get spinach without the stems?

kshama2001

zyxst wrote: »

Thanks for responding. I'm in a mini spiral atm, making it hard for me to go back and read this thread.

Seeing a specialist in Canada requires a doctor's referral. I can't call up, say an endocrinologist, and get an appointment. There are long, long wait times, unless it's super urgent.

The iron. I don't like eating many of the 'healthful' foods recommended for upping iron. Mostly from being turned off eating them constantly. I used to eat mussels in salads, which was great, but gods I got sick of the stringy beard. Spinach was the stems. Why can't I get spinach without the stems?

Yes, ditto with the VA. It once took me 5 visits to get a growth removed. It's a slog. I just learned the VA now does Platelet-rich plasma (PRP) injections, which I'd love for knee pain. I supposedly got a referral on May 29, but the doctor messed that up, and supposedly got a proper referral June 26, but have the schedulers called me yet? No, they have not. It's hard to follow up when I'm depressed, but now that I've thought this through, I'm angry, and that helps motivate me.

Does baby spinach have the stem issue? With Swiss chard, I cut off the stems and either sauté them or toss them.

I used to eat a lot of liverwurst, but eventually got turned off on that.

Then I got to the point where I could not manage my anemia with diet and supplements, and moved to iron infusions (with the occasional emergency blood transfusion,) and stopped worrying about iron in my diet.

pridesabtch

Does exercise help with the depression? It does with mine, but when I'm depressed I just don't want to do it. When I was losing weight I was very disciplined (read that as obsessive) and when I fell into a depression I gained most of the weight back. I'm now properly medicated and trying again, but it's hard. What worked before wasn't healthy, but I need a plan. MFP works well if you use it properly. I use it to make sure I eat enough and that I don't eat to much, so I give myself a range. 1200-1450 is my sweet spot.

Go figure. I spent many years, many dollars, and went through many doctors to get my medical cocktail correct. I finally found a doc I connected with who really listened, was timely in making adjustments and seems interested in my health. Of course, her office doesn't accept my insurance, but sometimes it's worth it if you can manage to find that right connection. For me it takes a combination of medications to stabilize me. My diagnosis is different, so sharing the details may not help. The AD's though are Wellbutrin & Trintellix and I use Propananol for anxiety as needed. In the US there are coupons for Trintellix because it is expensive, but the Wellbutrin & Propananol are pretty affordable.

I've also found that speaking of self harm usually won't get you committed against your will, though they may give you the option. Suicidal ideation vs suicidal planning gets tricky for professionals. Maybe if you are walking that tightrope an in-patient stay might help. If nothing else it will give you access to care and away from your toxic living environment.

I guess my main advice is that you need to get right in your head before you can work on your physical self in a productive manner. That and use the tools you have, like MFP.

Best of luck!

AdahPotatah2024

I' d suggest researching problem solving. There's actually a lot of good books on this! Problem solving methods and setting up good routines for daily life will do wonders for mental health, trust me!

CanadaGracie

zyxst wrote: »

CrazyMermaid1 wrote: »

Here in the States we have the National Alliance on Mental Illness (NAMI) whose programs include a free support group for people with a mental health disorder. The group is called NAMI Connection and is co-facilitated by two trained volunteers with lived experience. I am one of those co-facilitators and suicide ideation is a fairly common subject. The best reason to attend is that you will be among people who understand what you’re going through because they’ve been there.

Thanks. I'm in Canada and there is probably a similar program, but I haven't looked.

What province are you in? In Ontario you can see someone through the virtual urgent care service at CAMH (Centre for Addiction and Mental Health) and that’s fully covered by OHIP. They can set you up with a referral to a psychiatrist for therapy that is paid for by OHIP. If you’re in another province let me know which one and I’ll find out which resources are available to you there.

Mithridites

CanadaGracie wrote: »

What province are you in? In Ontario you can see someone through the virtual urgent care service at CAMH (Centre for Addiction and Mental Health) and that’s fully covered by OHIP. They can set you up with a referral to a psychiatrist for therapy that is paid for by OHIP. If you’re in another province let me know which one and I’ll find out which resources are available to you there.

This gave me hope and I tried to make an appointment only to see that it's booked solid for more than 10 years.Thanks for trying.

zyxst

kshama2001 wrote: »

zyxst wrote: »

Thanks for responding. I'm in a mini spiral atm, making it hard for me to go back and read this thread.

Seeing a specialist in Canada requires a doctor's referral. I can't call up, say an endocrinologist, and get an appointment. There are long, long wait times, unless it's super urgent.

The iron. I don't like eating many of the 'healthful' foods recommended for upping iron. Mostly from being turned off eating them constantly. I used to eat mussels in salads, which was great, but gods I got sick of the stringy beard. Spinach was the stems. Why can't I get spinach without the stems?

Yes, ditto with the VA. It once took me 5 visits to get a growth removed. It's a slog. I just learned the VA now does Platelet-rich plasma (PRP) injections, which I'd love for knee pain. I supposedly got a referral on May 29, but the doctor messed that up, and supposedly got a proper referral June 26, but have the schedulers called me yet? No, they have not. It's hard to follow up when I'm depressed, but now that I've thought this through, I'm angry, and that helps motivate me.

Does baby spinach have the stem issue? With Swiss chard, I cut off the stems and either sauté them or toss them.

I used to eat a lot of liverwurst, but eventually got turned off on that.

Then I got to the point where I could not manage my anemia with diet and supplements, and moved to iron infusions (with the occasional emergency blood transfusion,) and stopped worrying about iron in my diet.

Baby spinach has stems. I eat what foods I like (can tolerate) that have a 'decent' amount of iron, hence cereal and dark chocolate.

zyxst

pridesabtch wrote: »

Does exercise help with the depression? It does with mine, but when I'm depressed I just don't want to do it. When I was losing weight I was very disciplined (read that as obsessive) and when I fell into a depression I gained most of the weight back. I'm now properly medicated and trying again, but it's hard. What worked before wasn't healthy, but I need a plan. MFP works well if you use it properly. I use it to make sure I eat enough and that I don't eat to much, so I give myself a range. 1200-1450 is my sweet spot.

Go figure. I spent many years, many dollars, and went through many doctors to get my medical cocktail correct. I finally found a doc I connected with who really listened, was timely in making adjustments and seems interested in my health. Of course, her office doesn't accept my insurance, but sometimes it's worth it if you can manage to find that right connection. For me it takes a combination of medications to stabilize me. My diagnosis is different, so sharing the details may not help. The AD's though are Wellbutrin & Trintellix and I use Propananol for anxiety as needed. In the US there are coupons for Trintellix because it is expensive, but the Wellbutrin & Propananol are pretty affordable.

I've also found that speaking of self harm usually won't get you committed against your will, though they may give you the option. Suicidal ideation vs suicidal planning gets tricky for professionals. Maybe if you are walking that tightrope an in-patient stay might help. If nothing else it will give you access to care and away from your toxic living environment.

I guess my main advice is that you need to get right in your head before you can work on your physical self in a productive manner. That and use the tools you have, like MFP.

Best of luck!

Exercise doesn't do anything for my mental health. I don't get that 'natural high' people talk about. I get sweaty, bored, and tired.

12 years ago, I was fine with weight loss. I did the food tracking, exercise, weighing, etc. and it all worked to get me to a 'normal' weight. After 2 years of maintenance, I realized all the things medical people said would happen when I lost weight never happened. I was the same person inside, just in a smaller package. I still have the same health problems (which were supposed to be 'cured') along with bonus problems.

My fear of being involuntarily committed if I talked about self-harm/suicide was filed away until I went to a Planned Parenthood clinic and filled out paperwork. They're mandatory reporters for self-harm, among other things.

zyxst

AdahPotatah2024 wrote: »

I' d suggest researching problem solving. There's actually a lot of good books on this! Problem solving methods and setting up good routines for daily life will do wonders for mental health, trust me!

By problem solving, do you mean this? https://verywellmind.com/an-overview-of-problem-solving-therapy-4767991

It kind of sounds like what I do all the time. I don't understand how that will help me. I'm not so depressed and anxious that I can't function (ie the depressed stereotype).

zyxst

CanadaGracie wrote: »

zyxst wrote: »

CrazyMermaid1 wrote: »

Here in the States we have the National Alliance on Mental Illness (NAMI) whose programs include a free support group for people with a mental health disorder. The group is called NAMI Connection and is co-facilitated by two trained volunteers with lived experience. I am one of those co-facilitators and suicide ideation is a fairly common subject. The best reason to attend is that you will be among people who understand what you’re going through because they’ve been there.

Thanks. I'm in Canada and there is probably a similar program, but I haven't looked.

What province are you in? In Ontario you can see someone through the virtual urgent care service at CAMH (Centre for Addiction and Mental Health) and that’s fully covered by OHIP. They can set you up with a referral to a psychiatrist for therapy that is paid for by OHIP. If you’re in another province let me know which one and I’ll find out which resources are available to you there.

Newfoundland and Labrador. I guess I didn't make the connection with CAMH and NAMI. I looked up the website. I've used 811 before and am turned off using it for a long time. I have to jump through the same hoops every time I call, it's super frustrating. Now I sound (read?) like a drama queen with 'help me, but not t hat kind of help'.

AdahPotatah2024

I didn't even know problem solving therapy was a thing! No, I just meant basic problem solving skills.
(I definitely would not give you any medical advice except to reach out to an educated professional.)
To make a long story short-defining problems or just areas in life you're not happy with-formulating solutions-turning one solution into a goal(a positive and realistic goal for the future)-and then breaking that goal down into small, doable tasks. I don't think a person has to be at a nonfunctional state for this to help! A lot of people do this, but not effectively and that is where the books helped me out. For me, it's been useful in losing weight and stress management, in general. & especially, in not letting overwhelming circumstances or other people dictate my future.