Depression, Obesity, and Inflammation

I’m going away for a few days to see the eclipse, so if you write, expect a delay in getting an answer. I love eclipses and am really excited. To make it even better, I will be with family (we get along great!) and I will meet an e-friend I feel very close to. It will be a wonderful experience.

August 
8/21 Total solar eclipse: totality visible in parts of Oregon, Idaho, Montana, Wyoming, Nebraska Iowa, Missouri, Illinois, Kentucky, Tennessee, Georgia, North Carolina, and South Carolina; partially visible in other parts of the United States, Canada, Central America, northern South America, western Europe, and western Africa.
September
9/4 S Labor Day
9/6 Full Moon
9/5 – 9/7 Marriage to the Beast (Satan)
9/7 Feast of the Beast
9/20 – 9/21 Midnight Host
9/22 Fall Equinox
9/29 Michaelmas (?)
October
10/5 Full Moon
10/13 Backwards Halloween
10/13 Friday the Thirteenth
10/22 – 10/29 Preparation for All Hallows’ Eve
1
0/31 Halloween/Samhain/All Hallows Eve/
Important dates in Nazi groups
9/1 Start of WW2
9/17 Hitler’s alternate half-birthday
10/16 N Death of Rosenburg
10/19 Death of Goering
10/20 Hitler’s half-birthday

Depression, Obesity, and Inflammation
I subscribe to the email edition of Med Page Today because I’m sorta nerdy when it comes to articles about medicine. I’m also, thanks to a statistics course in grad school, pretty good at critiquing research design and interpretation. And that is fun, especially when I am on the verge of giving up doing something I am not very good at, like learning Cantonese. (Now why would I want to do that? Because learning a new language is supposed to ward off dementia. And why am I worried about dementia? Because I am neurotic. But that is another post.)

Okay, the article that caught my attention is “Obesity and Depression Are Related — But How?: Finding physicians who can address both is a challenge” by Shefali Luthra, Kaiser Health News August 11, 2017. https://www.medpagetoday.com/Psychiatry/Depression/67216?xid=nl_mpt_DHE_2017-08-12&eun=g620615d0r&pos=2 A lot of doctors have noticed that many depressed people are obese and many obese people are depressed. I could have told them that years ago. Self-esteem goes down as weight goes up, and that is depressing. Being depressed feels awful, so people turn to food to soothe themselves and numb out. And when you are in black depression, you are barely able to do familiar things, like get out of bed in the morning, let alone take on something new and hard like going on a diet. So it is a vicious cycle.

This affects an awful lot of people. People who are obese are 55% more likely to be depressed, and people with depression are 58% more likely to develop obesity, according to “Overweight, Obesity, and Depression: A Systematic Review and Meta-analysis of Longitudinal Studies.” http://jamanetwork.com/journals/jamapsychiatry/fullarticle/210608

Exactly a year ago, 8/20/2016, I posted about the connection between depression and systemic diseases, including chronic pain. A Danish study showed that people with serious infections (read, a lot of inflammation) were apt to become depressed. My post said, “So…inflammation factors can cross the blood/brain barrier. If my body is inflamed, I get depressed. And if I am depressed, my body becomes inflamed.”

If the authors of the article I am discussing had read up on this, they might have guessed how obesity and depression are related.

The second part of the article discusses how treating depression is assigned to psychiatrists and treating obesity to nurses and dieticians. These professions, of course, don’t communicate.

Of course that is not exactly news. They never have; at best, it’s a quick referral. So there is no treatment that addresses both conditions together. The dietitians assume that you are up for cheerfully counting calories and going to the gym and the psychiatrists don’t consider weight gain when they choose medications. I know; depression meds gave me an extra eighty pounds.

And that leaves it up to us, at least for now. I think our energy would best be directed at how to cope with this double whammy and the double stigma it brings. (It’s a triple or quadruple whammy or more if other chronic inflammatory diseases like fibromyalgia, chronic fatigue, lupus, arthritis, etc. etc. are factored in.)

I don’t mean to be a downer. We can do that, and we are the best people to do it. We’ve shown the value of peer support in all kinds of other situations: PTSD, grief, having a hard time getting a book published, being single mothers who have to work to feed their kids. And, I am proud to say, healing from ritual abuse.

I think that what we need is a message board that accepts a large number of people with a wide range of weight and varying length and severity of depression. Then we could support each other emotionally; grieve the unfairness, rant at society’s rejection of us and at the lack of resources in the health care system, cheer each other on, and laugh together. We could share what has and has not worked for us. Knowing that so many share our struggle would make us feel less like losers and freaks.

And, just maybe, some professionals would find the message board and be open to learning from us. Because we, who have the condition, are the experts and have so much knowledge to share.

Does such a board already exist? I hope so, for I would join in a minute. If not, anybody want to start one? I just can’t – I’m spread too thin as it is, sadly. It’s not all that hard to start, and there would be a lot of people who could help you do it. I could coach you, but I can’t actually do it myself.

Any takers?

 

 

 

 

Losing Sixty-Five Pounds Gradually

You can find information on Candlemas at https://ritualabuse.wordpress.com/2012/01/21/candlemas/ and Valentine’s Day at https://ritualabuse.wordpress.com/2016/02/10/valentines-day/

I wrote this back in 2007. That’s ten years and a lot of healing ago.

A couple of months ago, my doctor told me that my blood sugars were inching up and recommended I eat lower on the glycemic index. This means eating foods that release their nutrients slowly, rather than flooding the body and causing a quick rise in blood sugar.

Choosing appropriate foods is not rocket science. Lots of fresh veggies and fruit, beans, meat, and fish. Cook only with olive oil. Reduced fat dairy products and mayonnaise. Avoid white rice and flour – brown rice and whole wheat flour is fine. Avoid fried foods and stuff made by huge conglomerates that care about their profits but not their customers’ health.

Intellectually, it’s real easy and I know exactly what to do. On an emotional level, though, it’s a different story. I just don’t understand eating. I don’t get that what I do this minute will have consequences in an hour or a day or a week. Perhaps that’s because my sense of time is so distorted that things don’t seem connected. If I plant a package of morning glory seeds, it doesn’t feel like I will have twenty magnificent morning glory seedlings in a few weeks. It feels like I’ve just wasted $2.19 by burying those little brown thingies.

My favorite comfort foods are all bad for me. Pasta, white bread with butter, donuts, potato chips, Coke. My little parts want all of those at the same meal, and lots of them.

If I get anxious, I tend to eat quickly, thoughtlessly, and therefore over-eat. If I get really upset, I just stop eating entirely. It isn’t a decision: I have no appetite and just can’t wrap my mind around the idea of putting stuff in my mouth and swallowing it. I get all freaked out by the idea that I am hollow inside. Weird, eh?

I know that many people without abuse histories have some of these same attitudes. I also know that many, many abuse survivors have far more severe eating problems than I do, often to the point of being life-threatening. But these things still bug me on a daily basis. My attitudes, beliefs and behaviors around food all feel choppy and fragmented, rather than integrated into a smoothly working process.

I’m also reminded on a daily (minutely?) basis of another result of my abuse, a life-long depression. Back in the days of tricyclics I put on eighty pounds that I have not yet been able to take off. I try to think of my extra weight as a battle scar and to remind myself I won the battle against suicide, for I am still here. Maybe I can win the battle with food, too. Of course I would rather not have battle scars – I would happily settle for a nice medal that I could wear on special occasions.

I’m proud of myself, though, because I don’t throw up my hands and say, “It’s useless. I’ll never change.” I keep on trying, meal after meal, supermarket run after supermarket run. I’m not a fanatic about eating healthily, for life without chocolate is not a happy thought, but I keep moving in that direction. It is paying off, too, because my blood sugars are normal now. I’m happy, for I sure wouldn’t deal well with diabetes.

It may be this way with most parts of healing. You just have to put one foot in front of the other, baby step by baby step. You don’t have to understand completely, you don’t have to completely believe in what you are doing. You just have to decide it’s worth a try and then keep plugging away at it. It’s not dramatic – but it’s doable.

So what was the process like? If I remember right, I didn’t lose very much the first few years. I know for sure I didn’t make a lot of big changes all at once. I just sort of chipped away at it.

The first thing I tackled was potato chips. I told myself I would eat fewer, not that I would never have another potato chip in my life. The less I ate, the less I craved them. Today I have them once or twice a year at somebody else’s house. They are just as delicious as ever, but the next day I have forgotten all about them.

The next project, sugar, was much more ambitious. It’s one thing to eat fewer potato chips but more crispy, salty, yummy tortilla chips. It’s another thing all together to eat less ice cream, fewer donuts, fewer M&M’s, and even, believe it or not, less tomato ketchup. I had to start reading labels seriously, for who knew high fructose corn syrup was added to so many products?

I just found out that loving sugar is not my fault, it is because of some bugs in my digestive system that live on sugar and ask for it. The more I eat, the more they reproduce, and so there are lots more of the little buggers telling my brain to eat sugar. When there are very few of them, their pleas are much fainter and therefore easier to ignore. How smart of my unconscious to decide to work on all products containing sugar, not just one or two!

For several months I would stop concentrating on eating less of things and just add healthy stuff to my meals. After a while I developed a taste for spinach and broccoli. Now I have a salad every single night. My physical therapist says, “Do less of what feels bad and more of what feels good.” I don’t think of pasta and sourdough bread as feeling bad, but I get the idea.

Another thing has helped a great deal. I had my knee replaced and, with less pain, I can move more easily. Comfort foods aren’t as enticing. I started going to the gym and now, after a few years, I really enjoy it. Exercise apparently doesn’t make you lose weight by itself, but it makes you healthier and helps keep the weight off. And since muscle weighs more than fat, I can stay at the same weight but be thinner.

It also makes me more conscious of my body. I am beginning to see how moving one muscle affects another one and this makes me feel less fragmented physically. Somehow, I have gained some idea of how eating works. I now understand that there are, indeed, causes and effects. If I consistently pig out, I will gain weight. If I eat healthy most of the time and only pig out occasionally, I will be fine. What is really neat is that getting in touch with the way eating affects my body has taken no conscious effort. It just happened.

I love looking back and seeing where those baby steps have taken me!

Treating Eating Disorders

Upcoming Satanic and Nazi holidays – sundown 6/11 to sundown 6/13 (Nazi) Shavuos (commemorates the giving of the Torah at Mt. Sinai): 6/19 Fathers’ Day (US, Canada, UK, and South Africa): 6/20 is both a full moon and the summer solstice: 7/19 S Full Moon: 7/29 (Nazi) Hitler proclaimed leader of the Nazi party: 8/1 S N Lamas: 8/18 S Full Moon: 8/15 Assumption of the Blessed Virgin Mary: sundown 8/13 to sundown 8/14 (Nazi) Tisha B’Av: (Day of Mourning)

Prior posts on eating disorders – 4/10 Eating Disorders (Introduction): 4/20 Over-Eating: 5/10 Ritual Abuse Issues and Eating Disorders: 5/20 Anorexia and Bulimia

Resources: The Eating Disorders Catalog site has a list of workbooks at http://www.edcatalogue.com/recovery-workbooks/. Something Fishy at http://www.something-fishy.org/ has helpful articles but some pages are under construction and other have mostly broken links.

Researched eating disorders, I found that there were two approaches to treating them. One is based on a blend of behavior modification and Cognitive Behavioral Therapy (CBT). The other is psychodynamically oriented and trauma-informed; it considers the eating disorder a result of and/or defense against dangerous feelings or memories.

CBT is based on the premise that our thoughts determine our emotions and behavior and that thoughts can be consciously changed.  If I think I am ugly, I slouch, dress without care, avoid mirrors and people. But we can think of a thought as a hypothesis and test it with facts. The new thought, or hypothesis, can then be the basis for our feelings and behavior until it is time for another reality check. If I think I am normal, I come out of my shell. If I look around and look at others my age, I may revise normal to pretty damn good-looking.

CBT is educative: the therapist teaches the client how to apply the techniques and assigns homework in the form of workbooks, journals, etc. The client sets the goal, and therapist and client together agree on a time frame for the therapy. Once learned, clients can apply those techniques by themselves for the rest of their life.

There are lots of variations on CBT; for example, DBT is Dialectic Behavioral Therapy and incorporates mindfulness and meditation. They all stem from Aaron Beck’s work in the late 60’s and early ’70’s. I remember reading “Cognitive Therapy of Depression” and “Depression, Causes and Treatment” and being very disappointed. Guess I wasn’t ready back then!

Behavior modification is based on B. F. Skinner’s work with animals and also with patients in a Massachusetts State hospital. Desired behaviors are reinforced with rewards and undesired behaviors are extinguished with punishments or lack of rewards (ignoring them). You can find examples of behavior modification in popular literature: every time you behave in the desired way, put money in a piggy bank and, after a set period of time, reward yourself with a movie or a piece of clothing – not a pizza.

Neither of these approaches takes into consideration where the behavior come from and what function it serves. When you look at it with complex trauma in mind, eating disorders can be seen as a protective mechanism, just like any other symptom.

The trust and stability of the therapist-client relationship is the basis for forming alliances with alters as well as the “apparently normal person” who came into therapy. In time, the alters will describe the meaning of the eating disorder. It can be an attempt to control one aspect of life, an attempt to disappear, or an attempt to become unattractive to avoid abuse, among other things. These beliefs can be challenged by teaching the alters about the passage of time and that there is no longer a need to use the eating disorder in this way.

It can also be a way of suppressing memories. “Don’t remember, don’t tell” programming is very powerful. Creating a serious present-day problem that takes up all one’s energy is a great distraction and all other goals and problems fade into the background.

If you have a therapist who is skilled with working with ritual abuse survivors, you will probably go back and forth between working on internal issues and attending to the eating disorder. If your therapist does not have this knowledge, see if they are willing to learn. If not, you might consider finding another therapist more tuned into the effects of trauma.

There are some things you can do outside of therapy. Probably the most helpful thing I did was accept the excess weight I had gained from antidepressants. Rather than feeling shame, I started to see my weight as battle scars – scars from wounds I never would have had if I had been born into a healthy family. Once I felt this in every part of my mind and heart, I could start changing my behavior. I am still working on it, and I am sorry I couldn’t have started sooner, but they were deep wounds and I believe they could have killed me without the antidepressants.

Trying to force yourself to give up a protective behavior before your system is ready will create internal chaos or lead to the substitution of another protective behavior. It’s not such a great idea to trade an eating disorder for an addiction to heroin or crystal meth. Communication and trust between alters has to come before an agreement to work on the eating disorder or you won’t get very far.

Journaling to increase internal communication can be extremely helpful. Alters can get to know and trust each other and learn to decide on mutual goals and co-operate in working towards them. Once everybody is on the same page you can turn to the techniques that non-dissociative eating disordered people use; CBT, nutritional programs, the Twelve-Step programs Anorexics and Bulimics Anonymous or Eating Disorders Anonymous.

It’s possible to give up a small part of the eating disorder temporarily, as an experiment, so that all alters involved can see what happens. If you don’t die and the abuse doesn’t escalate, everybody inside may be reassured. (This is assuming you are not still being abused.) A different approach is called for, though, when alters react to the experiment by flooding everybody with memories or threats because they are petrified that, without the eating disorder, the system will be destroyed. You need to calm those alters, strengthen communication, search for still unknown alters, and find out what everybody thinks will happen without that protective shield.

This post seems quite abstract to me. I think I was hoping to find something spectacular that will work tomorrow no matter what is going on internally. Instant relief! Of course it doesn’t exist. Dealing with eating disorders requires time, dedication, and a lot of hard work and courage. There is no magic wand and not a lot of helpful short cuts, either. It does help to know it isn’t your fault and that you aren’t the only one. If I do come across a magic wand, you guys will be the first to know!