Help please.

I have been in a similar situation. Several years ago I lost [a shocking amount] of weight the wrong way due to an eating disorder, then entered therapy and went on anti-depressants and gained around 60lbs in a year. The shock of how people treated me differently (before and after) plus the emotional and mental taxing of being "tiny" and then "huge" put me into a tailspin and I considered very bad things. At this point I was not in therapy, because I thought I could handle it alone and didn't like therapy, and I was truly struggling.

I did contact a therapist again and I think that is one of the first important steps for you. You do not deserve to be alone with this struggle. A therapist is someone who is professionally trained and also not connected to anything in your current life -- your own personal confidante who won't judge, shame, or make catty remarks about you, and who is charged with being an honest reflection of you so that YOU can see it and decide where, what, when, and if to address, change, or change your thinking.

You stated you do not want to go to your doctor because you are there a bit already. I am not sure if/where you work, but perhaps your workplace has a liason for mental health services? You can also call your insurance company or contact a locator service like http://store.samhsa.gov/mhlocator You do not necessarily need to go through your general practitioner for this and, if your insurance requires it, having documentation of your inquiries (or even an appointment lined up) might lend credence.

I know you stated you lost your confidence in your therapist because you gained weight on the antidepressants she recommended. I should note that the weight gain I experienced was not due to the SSRIs alone. I wanted to believe that, of course. My point in saying this is not to criticize you, but point out that weight gain is not something your therapist can control. Prescribing drugs is an "exact" science based on percentages and statistics-- drugs such as these are always going to have different effects on different people, and no one can speak in absolute certainties - not even the people you pay to make those decisions. The weight gain associated with these drugs is usually about 10lbs (unless you are taking about steroids, which can cause significant water retention, etc.). I speak for myself in saying those extra 50 on me were a result of laying around, eating what made me feel good, and feeling bad for myself (perhaps, in part, because the SSRIs didn't make me feel as good as they were supposed to). Again, I am just trying to clarify that, in my opinion, it would be throwing the baby out with the bathwater to dismiss the wonderful advantages a therapist can offer you because the drugs s/he recommended did not turn out the way you and s/he hoped. Also, there is always hope in trying a different drug. I am not a pharmacist, so I am not recommending anything, but Lexapro is *unlikely* to lead to weight gain and, if you are one of those people who react to it unfavorably, adding Welbutrin usually helps that.

Beyond that, one of the things you can change is your friend base. These friends do not seem supportive. This may seem harsh, but out of 16 friends, there are certainly a few who you can take a vacation from temporarily. I'm not advocating giving up on these friendships because it is very important to maintain social connections - just taking a "time out" because they are not giving you what you need right now, and you are not in a state to brush off their nasty complaints. It won't make you a bad friend to take care of yourself.

Also, out of 16 friends, is there one or two who you feel closer to? How would you feel about calling or meeting one or both of them for a small chat/lunch/etc. and explaining how these comments affect you, and how you are not in a positive place right now and may need additional support and understanding for a while. It is difficult to do; if you are not comfortable doing this in person, perhaps a letter, or a phone call in which you read from a script you've already written. You may consider doing something similar addressed to your husband.

In the everyday, make it a point to do one thing per day. One! Get out of bed and paint your toenails (why? Because there is nail polish whose very purpose in life is to make someone's toes bright pink...you can't deprive it of its one goal in existence!) Put the dishes away. Put on one favorite song and dance to it. Then you have permission to go back to bed...and maybe you will, maybe you won't.

Write down 3 things you are grateful for. Maybe it's the feel of your sheets, maybe it's your husband, maybe it's the fact your husband is gone for a couple hours... Take the time to recognize something that is good, even though everything else feels bad. It is VERY HARD to do this sometimes. Be gentle with yourself in making your list. The point is not to make a good list or a commendable list or to be grateful for Dr. Jonas Salk curing polio...the goal is to remind yourself of three tiny points of light at the end of the tunnel.

Good luck. You are a person who is worth every single one of these actions, and you will be okay.

M.