Tag Archives: Exercise

Eating problems and early pregnancy

Recovering from eating problems

Over the last year, I’ve been facing up to eating problems that have dogged me my entire life. This became particularly important as we tried (and for a long time failed) to conceive. It was really hard going but I got my cycle back and my hormones balanced – by the time we conceived my levels were fine. I gained weight until my BMI settled in the mid/high normal range that seems to be where my body naturally wants to hang out. I preferred being smaller but I was (slowly) teaching myself to feel positive about the changes.

This is what recovery looks like for me. After 24 years with these thoughts and feelings, I’ve pretty much accepted that I’m never going to be completely free of them. But I’ve learned to manage them in a healthier way, enjoy exercise and let myself eat without feeling too guilty (usually).

A naive hope for eating problems and pregnancy

I had nurtured this (naïve) hope that during pregnancy my muddled relationship with weight and eating would somehow vanish. Or at least become a lot easier as I nurtured my amazing baby growing body, forgiving weight gain and enjoying my new curves. HA. Load of bollocks.

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What I’d tell my 2015 self about dieting, body positivity and accepting medication

One year on...

One year on…

Yesterday we celebrated our first wedding anniversary. Our wedding was a magical day but, in the two years since we got engaged, life has taken some unexpected turns.

My mental and physical health has taken quite a bashing.  I’m not fully recovered – and I’m working hard to challenge and change thought patterns and reactions that have been deeply ingrained for many years. But I’m gaining more perspective with each month that takes me further from the trickiest of times.

So what would I tell the Clare who said ‘yes’ under that tree on Hampstead Heath in 2015.

You can’t control a wedding diet – change the dress, not yourself

I thought I would be able to diet just enough to feel comfortable in a gently corseted dress – and then stop afterwards. But my disordered eating lurked much closer below the surface than I realised. It wasn’t long before my eating, exercise and emotions got horribly tangled. I thought I would never go back there but I slid into militant calorie counting, restriction and purging through exercise with the excuse that it was ‘just for the wedding’. The dress was too big, I spent our honeymoon struggling to find a manageable balance and it took my periods stopping to shock me into making a change.

You need medication – and that’s fine

“You were so proud of yourself,” my mother in law said. And I was. I had been fighting my medication for years, trying to cut down and come off. Stopping was the hardest thing I’d ever done.

And when I finally fought through the initial withdrawal symptoms I thought things would get easier. Instead they got harder. More chest pain. More tears, panic and anger. Suicidal thoughts. More running. More fighting my body. It took three months to realise I couldn’t do it. That nothing was worth the destruction those months had wreaked on my body, our health and our relationship.
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We need to talk about mental health and trying to conceive #takeoffthetape

Find out more about Mind's campaign here: http://www.mind.org.uk/get-involved/take-off-the-tape/

Find out more about Mind’s campaign here: http://www.mind.org.uk/get-involved/take-off-the-tape/

Mind has been asking people to #TakeOffTheTape and share something that makes them anxious. Something they haven’t spoken about before.

I thought I would use the opportunity to write about something that’s hardly spoken about at all.

I’m finding it incredibly hard to balance trying to conceive with managing my mental health.

We don’t talk about this. We don’t even talk about the first twelve weeks of pregnancy much (as I’m well aware from my work with the Miscarriage Association). Trying to conceive often happens in almost complete secrecy. I didn’t realise how it would interact with my fluctuating mental health and I wasn’t prepared.

It’s taken a while to get to this stage. The doctor who removed my coil last year strongly implied that it would be best to continue with my efforts to come off my Citalopram. She moved me to Sertraline (it’s considered safer in pregnancy) and told me to try and reduce my dose completely over the next month.

Coming off medication

In fact it took me three more months. I’ve been trying to come off anti depressants for a while anyway (after a muddled fifteen year relationship with them) and trying to conceive gave me the strength to make it through a hideous withdrawal period. It was probably the hardest thing I have ever done. Alex didn’t have much fun either. I’ve written about it here.

I’m more vulnerable to hormonal changes now. I still have very dark times when everything seems hopeless and I can’t see a way through the next ten minutes let alone the rest of my life. Difficult images and ideas jostle with an endless repetition of fears and doubts. Sometimes the same phrase over and over again. They whisper just below the surface of my consciousness. They’re loud enough to wear me down and shrink my focus to a single point of constant worry – but not quite conscious enough for me to recognise what’s happening in a way that helps me stop.

One these days I’m separated from the world by thick glass that bounces every negative thought straight back at me, infinitely magnified. My attention is forced inwards but my mind is everywhere but present, infecting all it can with worst case scenarios. I can’t look up and out, can’t see the variety of the world and my place in it, can’t take a long deep breath. My chest physically hurts and I feel constantly sick with the fight or flight chemicals flooding my poisoned body as it tries to deal with the powerful threat of my mind.

The inevitable uncertainty and lack of control

These times are getting further apart and each one adds detail to our understanding of the best way to manage them. But trying to conceive has made my anxiety worse. It’s given it another peg to hang its hat on. Issues with eating and body image are often about control (with an emphasis on control over your body) – and anxiety hates uncertainty. But trying to conceive is a very uncertain time. What my body does – and doesn’t do – isn’t completely under my control.

I was managing my mental health to the extent I felt I was in a position to come off medication – in order to do something that has made the problem worse again. The irony isn’t lost on me – although on bad days it just makes me  want to cry.
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Coming off anti depressants – withdrawing from Citalopram and Sertraline

Day six in Foster’s brain and all is reasonably calm…

trainers and pillsAs I write I’m on the sixth day without any form of SSRI at all. This is new territory for me. I’ve taken them every day for 15 years (with terrible healthcare making it much trickier).

Three months ago I moved to Sertraline. Two months ago I was down to 1/4 of a tablet per day. Then I started alternating days. One month ago I moved to one day on and two days off.  Over the Christmas break I’ve been attempting one day on and three days off.  This time round when it got to day four off I decided to keep going.

It’s been a LONG time coming. I’ve been bobbing around the 20-30mg mark for years. I tried to come off them in 2008 but didn’t get below 10mg Citalopram before an abortion and a move to London meant I needed more support again. I tried in 2012 but again couldn’t drop below 10mg. In  2014 I got to 5mg before it became unbearable and ended up slowly and frustratingly working my way back up to 20mg.

Dealing with withdrawal symptoms

My chest sometimes feels uncomfortably tight and I’m still welling up at the slightest thing but I haven’t had any big uncontrollable surges of irritability (horrible), anger (scary) and panic (painful) since before New Year. The worst day was the first time I got to three days without. That afternoon there was little to be done except pick my sobbing self up off the bathroom floor and breathe deeply in showers as hot as I could bear. I would lie completely still in bed hoping for sleep but fearing the threat of my mind building, rushing and slipping away into a place of panic and pain that felt unknown and terrifying. It’s really scary to feel genuinely out of control of your mind. Luckily there was only one afternoon that bad.

I only feel completely safe when I’m exercising and in the calm and blissful hours afterwards when I’m myself again. I’ve ran hundreds of miles. When my knee gave out I cycled hundreds more. I discovered spinning. I’ve been chaining Kalms and I haven’t had a good coffee or a glass of wine in weeks (interestingly when you’re recently married and of a certain age people tend not to push alcohol on you, even at Christmas!). But I’m nearly there. I really think I might be.

Luck, love and incredible patience

I’m  very very lucky to have such supportive and loving friends, family, work and (most of all) my husband Alex. My family love me unconditionally even when I’m unforgivably difficult. My friends make me feel myself again just by being in their company. But Alex is endlessly patient. Those surges of anger and irritability disguise themselves as reactions to things happening day to day. They show their ugly faces in snippy comments, slamming doors and helpless tears. He recognises these as symptoms. He knows that deep down they’re not my fault. He doesn’t react to them as if they are.  This is perhaps the most helpful but also the most difficult thing someone can do to support your mental health. He’s an absolute hero.

(I’ve also written about managing depression and anxiety in relationships here)

New understanding and techniques to manage my mind

There’s been plenty of dramatic lows and a few proud highs in this particular journey. But a lot of the experience of living with and managing this stuff is the day to day mental grunt work. Looking after yourself. Recognising triggers and identifying negative thoughts. I’ve been doing a lot of that too.

I love a metaphor when it comes to managing my mental health.  Metaphor helps me identify Mix tapesand pin down my experiences. This is a step towards understanding and managing them. It helps me regain perspective and use the language of shared experience to transfer and talk about some pretty intangible feelings.

Over the last few months I’ve found a couple of new ways of thinking about my experiences which really help day to day. The tapes and the oil painting. I’ve written about them here: The Regret Tape and the I’m Not Good Enough Mix – new metaphors and thinking tools for managing anxiety and depression.

I don’t know what’s going to happen next and I’m going to try not to beat myself up if it doesn’t go quite as planned. But I’m cautiously pleased and proud to have made it this far. The sun is shining and I’m off out with the dog (he helps a lot too). I might even treat myself to a (decaff) coffee.

P.S – An important extra

It’s worth emphasising that I spent a long time reducing my Citalopram and then Sertraline slowly in 2015. I did the withdrawal and reduction with advice from my doctor. This is a personal account of an individual experience. Mind has a lot of great info on coming off psychiatric drugs which it’s worth looking at if it’s something you are thinking about.

Exercise addiction – managing the tangle of anxiety, eating and exercise.

Last Sunday I spent all day exercising

ImageIt started when I pressed snooze at 6am and cancelled my spinning class. I’d been in the gym at 6.30 all the previous week and had just returned from a busy couple of days running and walking in Cornwall. I was exhausted. But I didn’t get back to sleep. Anxiety levels rose. Getting dressed I was acutely aware of all my clothes, how they pressed against my skin. I couldn’t find anything I felt comfortable in. My hands felt swollen and my chest tight. My mind was whirring with calculations and lists.

It wasn’t until after a session on the cross trainer, a long swim and walk with the dog that I felt like myself again. A combination of relief from thoughts about overeating and, much more importantly, relief from the anxiety that made it matter so much in the first place.photo (1)

Yesterday evening I ran a very long way* because I ate some cake and chocolate buttons at work. The morning spin class stopped being enough.

It’s not so much the calories – although that doesn’t help at the moment. It’s a craving for that feeling after exercise where your thoughts are calm and still, your body feels tired but deserving of care and nourishment and your mind doesn’t have to calculate or judge because it knows you’ve done enough to rest.

“a craving for that feeling after exercise where your thoughts are calm and still, your body feels tired but deserving of care and nourishment and your mind doesn’t have to calculate or judge because it knows you’ve done enough to rest. “

Immediate relief vs long term recovery

legs and knee supports

Knee supports – NOT the answer to EVERYTHING

My knees and hips ache and sometimes even crunch. They need a break.  I am finally cutting down the running in favour of spinning, swimming and cycling.

But the daily doublethink is still absurd. Cold baths and a knee support is not going to allow me to run miles and miles however much I wish it would. Immediate relief still trumps long-term sensible decisions too much of the time. Even if that relief is tinged with guilt and frustration.

I’m planning my next exercise session whilst I’m in the middle of the previous one. I try to be more sensible but those persistent thoughts keep popping up.

‘You could run tonight. You could just do an extra session on the cross trainer after spinning. You could fit in a swim tomorrow morning if you get up really early. Remember how good it feels when you’re done, how much more you enjoy your food when you feel you deserve it, how much easier it is to rest and to concentrate when that anxious energy is stilled’.

Once I imagine that feeling, it’s hard to turn away from it.

But that feeling is lasting a shorter and shorter time. When I’m exercising twice a day and feeling anxious and panicky when I can’t get moving it’s time to get some help.
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How can exercise help depression?

what role does exercise play in managing depression

Earlier this week, when the ‘exercise no help for depression’ stories were published on the BBC and the Guardian, I quickly pulled together some of my initial thoughts and frustrations with the way the research was reported. Since then, I’ve had a chance to think about it in a bit more depth.

The debate on exercise and depression

I watched the debate and discussion throughout the day. Those involved came from a range of perspectives and angles. Many people who got involved had experienced depression themselves. Some were in the middle of a bad episode, others had experienced it in the past or felt that they were ‘managing’ their depression to prevent relapse.

Some had found exercise improved their mood or helped them manage, others not. For some it depended on the severity of the depression experienced. For some, exercise was not considered ‘helpful’ unless it formed part of a ‘treatment’ leading to a cure. For others if it enabled them to manage better on a day-to-day basis this was enough.

What was interesting was that while some were supporting or arguing against the research itself (that one particular form of facilitated ‘encouragement’ to exercise doesn’t help in treatment) many were responding to the simplified message in the headline – that exercise doesn’t help depression.  And many responded with the simple answer, ‘Well, it helps me get by.’ While the Department of Health can conclude that TREAD, in the way it is currently delivered, does not work, the mass of anecdotal evidence that this study has generated should give them pause for thought. Continue reading

My thoughts on exercise and depression

Bad journalism

The BBC  headline ‘Exercise ‘no help for depression’, research suggests’ (note – the BBC have 

photobikequietly changed this headline now!) – and indeed Guardian headline Exercise doesn’t help depression, study concludes (note – this link has since broken and I can no longer find the article) – really frustrated me today. It’s classic bad science reporting, which we all know is nothing new, but it touched a chord with me on a personal level so I wanted to get down my thoughts and personal experiences over my lunch break.

There is a lot more to be said and I’m really aware of my own experience biasing my opinions so do add your comments and thoughts.

The headline is misleading

 

The main frustration is the misleading nature of the headline. If you read the article, what patients were actually given was “advice on up to 13 separate occasions on how to increase their level of activity. It was up to individual patients what activity they chose to increase and by how much.”. The report – which you can read in full here – is actually investigating one particular method (the TREAD method) of encouraging depressed patients to increase their activity. This is a very different study than the one the headlines lead you to believe. Continue reading