Weight Gain and Psych Meds: The Unholy Alliance

I have had the gamut of experiences with psych meds over the years, both the good and the bad. But a couple years ago, I was put on the controversial drug clozaril. I avoided the most dangerous and damaging of its side effects, but it nailed me with the weight gain. In a very short time my weight went from 120 lbs to 190 lbs. And it was awful.

I am still struggling with the weight daily. I do my best to diet, and I have begun doing the DVD called Gentle Yoga. But I’m still on several medications that cause weight gain. So the struggle is real.

My issues with the weight are not the issues that most women struggle with. I actually always wanted to be fat. Most of my closest friends are fat, and I love the sweep and curve of them. Of course, I didn’t get fat like that. Nope. Nope. Nope. I gained all that weight solely in my boobs and belly…no curvy plump arms and legs for me! Nope! I look like an olive with toothpicks stuck in it! I look like I am in my third trimester.

I wanted to be fat like this. I didn't get my wish.
Venus of Cupertino Ipad charger by Eaton London

The other thing is that most fat people I know grew fat over time, over months or years. I gained nearly 70 lbs in less than two months. I had no time to adjust to growing fat, I simply WAS fat in what seemed like the blink of an eye.

With no time to adapt to my new size and shape, I became even more awkward than I was before. Things I used to do with ease are now difficult or nearly impossible. I have to struggle to reach around my vast belly to put on socks and shoes. I leave toenail polish on for months at a time. Really, unless my youngest daughter visits and paints them, my toenails are a disgusting untended mess. I remain baffled at things like driving-how hard it is to fit my big awkward body behind the wheel. (I’m glad I have not had to fly anywhere!)

On my last visit to the psychiatrist, I proudly told him I was losing a little weight. I guess I was looking for praise or validation from him. Instead he looked at my medication list and told me I still should be gaining weight with my current medications. Then he said I was dieting too much! I felt crushed. I have fought, struggled, and, yes, suffered to lose 14 lbs, and here I was being told that I was dieting too much.

As a mental health patient, I have gotten pretty tough. I can stand the slings and arrows of outrageous fortune pretty well. I do not shy away from new treatments or diagnoses. But there is one thing I do not want. I do not want this psychiatrist to decide that I have an eating disorder. Patients with eating disorders get a lot of attention. They get the sort of attention that I do not want. I don’t think I have an eating disorder, not now, and not in the past.

I know, I know, from those of you who knew me then, after Tom died, I did stop eating, and my weight plummeted. I remember that too. That was not an eating disorder, that was despair and grief. After a few months I returned to eating normally, and my weight stabilized.

So here is a conundrum. If I continue with the diet and exercise, and I continue to lose weight, I run the risk of this doctor taking an interest in my weight loss. I fear getting an eating disorder label stuck to me. I do not know if my fear is rational. The doctor dropped that PTSD diagnosis on me with no warning, out of a clear blue sky. Psychiatrists are a notoriously tricky lot, and I do not wish to run afoul of this man. I might have mentioned before that I find him alarming. But on the other hand, I really do need to lose weight. We are poor. There is no money for even a trip to Goodwill to buy clothes that fit me. My closet is full of size 6 garments, but they do not fit my size 16-18 body. It is a real problem. At home I live in soft old stretchy sweatpants and pajamas, and that works okay. But since I began participating in my own mental health, my life is a constant whirl of appointments. And to go to appointments, you need to get dressed.

I see people in the waiting room of the therapist and the psychiatrist in pajamas and sweats all of the time. But I know that showing up in your pajamas is noticed. I know that not being dressed appropriately is a point of concern in mental health care.

Up until this week, I have been without a Winter coat. In Pittsburgh. In Winter. I am just too fat to fit my coats. In an awesome turn of events, my therapist found me a well-worn thin wool jacket. It won’t be super warm, but it is far better than the thin leather coat I have been wearing.

I obsessively watch the posts of my fat friends, hoping that they will say that they are taking old clothes to the Goodwill, but they never are.

So the struggles are real.

The fear is real.

The scary thing really is how profound the ‘side effect’ of clozaril was. The idea that taking a tiny pill twice a day could translate into 70 pounds in a little over a month is very scary to me. These psych meds are scary to me. I want them to help me. I have a deep need to believe that they will help me. I want to get better, and I need these pills to help me get on the right track.

But the pills are terrifying. They really are.

When you start swallowing the pills, you really never know who you will be, or how you will be when they kick in. I have had pills change my entire personality. This clozaril changed my entire body. I fear taking a pill that might change my entire soul.

I have a mantra. I say it daily, as often as I need to. My mantra is ‘consciousness is not fragile.’ But as I contemplate how easily the meds alter my consciousness I wonder if my mantra is true.

To Feel, or Not to Feel, That is the Question

I talk a lot about what I experience, I talk a lot about what I think, I don’t like to talk about how I feel so much. But I know that talking about the emotional impact of mental illness makes it a bit more personal, it is simply easier to relate to how a person feels, as opposed to what they think.

So I am going to see if I can write a bit about how I feel, but I know it won’t be easy.

Living with mental illness is a short hand way to way to say that someone’s emotional state is a hot mess. It truly is. Often I withdraw from my emotional state and try to live my life in a more detached fashion. It is easier than poking around at my feelings.

I feel like living with schizophrenia is a lot like living with a dysfunctional parent: you love it, you hate it, you cover it up as best you can, and you clean up a lot of messes. But first and foremost, you feel shame. Often I feel ashamed that I am not strong enough to beat this on my own. Often I feel judged by invisible others-I feel like they find me lazy, like they find me weak, like they find that I do not try hard enough-I feel deeply ashamed when facing this invisible jury. So before any other feeling, there is this feeling of overwhelming shame.

Feelings are different from reality
The illness feels much bigger than me.

Following close behind the shame comes the love, and its shadow, the hate. There are parts of me that truly love the schizophrenia. When everything becomes too much, schizophrenia swoops down upon me like my guardian angel; it swirls me in its hallucinatory robes and hides the things I can not cope with. And I know that I should not love the schizophrenia for that. I know that it would be better to deal with reality instead of checking out and trying to put my reality back together later. But I still love when my illness saves me from the reality that is often too much. But I hate my illness for the very reasons that I love it. That’s why I think it is like a dysfunctional parent.

I hate my illness when I feel like I have a grip on something, and it inexorably pushes me under. I hate my illness when I fight with it, but can not struggle free. I hate my illness when I gasp and choke and can barely draw breath. I hate my illness when I want to do something, but it dictates that I must stay in a darkened room huddled on the bed. I hate my illness when I realize in how much of my life that it dictates I be a non-participant. In other words I love my life, I hate my life, and I am deeply ashamed of my life.

This is hard to write. I do not feel good about living with the stigma of mental illness, it makes me feel unworthy of any good things in my life. I feel that being sick renders me unlovable. I fear…oh how I fear, I fear, I fear. I fear that I will lose the esteem of those who I want to think well of me. I fear that I will never wander free of this illness. I fear that people fear me, are afraid that I might become violent, I fear that I and my illness are socially unwelcome. I fear that writing my truth will stigmatize me further, I fear that writing my truth will isolate me more. I fear that writing about my schizophrenia will somehow fuel its fire, and that it will grow stronger.

Mostly, though, I try to live cut off from my own heart, and that might be the worst of it all. I do my best to keep my heart sealed away from myself and everyone else. I do not trust myself to love properly. I am guarded, untrusting and untrustworthy. My heart is an abused dog cringing in the corner of its kennel, it does not come out of the corner for threats or kindness, it bides its time awaiting euthanasia. My illness and my emotional unease around my illness have essentially killed my heart. I deeply regret that, for I did believe that it was the finest part of me.

The strongest criticisms I have faced in recent memory are that I am too guarded, too secretive, that I do not open up. Those criticisms were offered very gently, very kindly. And they are all true. The people who offered those criticisms were trying to help me and my heart take a step out of the corner. But my truth is valid too. My truth dictates that rolling around in madness and mire should not be a price someone has to pay to be near me. My truth suspects that madness might be contagious. My truth is that a clean person who sits in something dirty will become unclean. My truth declares that my heart has suffered enough, and has earned the right to hide in a corner.

The ultimate thing I feel is that parts of me have had enough once and for all, and that I am entitled to feel that way. I feel that I can not take too much of my emotions, and that I and everyone else has a right to be protected from them. I feel that I can work toward health a long time without bothering my feelings. Perhaps in time my feelings and I will both heal. But, for now, perhaps my feelings have earned a rest in a quiet place. I think they have.