How an offhand comment can trigger a depressive episode

I had a low day on Friday. I’ve had a persistent headache and fatigue for a few months now and a head cold on Friday brought out the worse of it. I’ve lived with depression for eight years now so I know when to have a day off to take it easy. Friday started with a 2 hour struggle to get out of bed. It was one of those days.

When I’m in these low moods my obsessive nature and harsh internal self critic can get completely hooked on little comments that people make. This blog is a reflection on this internal thought process to help you understand what might be going through a depressed person’s head.

The comment

In conversation someone mentioned something about, “… being a big girl”, it was related to me being able to look after myself. I responded with “I use to be a lot bigger” and someone else in the conversation added, “keep away from the pork and you’ll stay that way”. In the moment I didn’t think anything of it. But my obsessive nature got hooked and over the afternoon I couldn’t let it go.

The obsession

I became completely obsessed over everything I had eaten recently infront of said company. I replayed the dinner we had recently over and over and over in my head. I counted every calorie, it came out to about 2000KJ and 10gm of protein. Then my internal harsh critic got on board. It starting saying to me, “you are fat, lazy good for nothing, completely worthless, you should just curl up and die”. So now there was a battle going on in my head, the obsessor just going over and over and the critic telling me I’m worthless. Normally these thoughts aren’t that loud but they get overwhelming on low days.

My obsessor wanted to figure out how to write a response to those comments. This blog post is an attempt at pleasing the obsessor because I am still thinking about it after 4 days.

Good intentions

I know those comments come from good intentions, people say these things because they care. The only nutritional goals I stick too (under the advice of my weight loss clinics nutritionist) is to get 60gm of protein a day and to take my daily multivitamin. I’ve had a lifetime of people commenting on my weight. I thought I had developed a thick skin for it, obviously I hadn’t. Or maybe it just hurts more the closer to home it is?

Self Compassion

I’m at a stage now where I can try to practice self compassion (I try but it’s hard). I would catch these thoughts and tell myself, “that’s not a very nice thing to say Sam, you are one of most proactive people I know. You are so far from lazy and worthless it isn’t funny. Look, you even had lunch with someone who thanked you for your help with their CV recently and they are starting a new job soon because of you. Remember that Buddhist monk on youtube? Try and practice letting go.” Here is the youtube video I was thinking of:

How to be supportive

If someone has opened up about their mental health and they raise something like this with you, please don’t feel like you need to censor yourself. That is stressful and not healthy. Often when these things come up for me, I never raise them with the person who caused the trigger because I know deep down it’s just my mind overreacting. So being open and empathetic if someone does raise this is all I ask for.

Please be mindful of how your words can hurt. It reminds me of the common rhyme about sticks and stones I was told about as a kid. Here’s my new version:

Sticks and stones may break my bones 

But harsh words from a loved one

Can make me wish I was dead

I’m grateful I’ve never been suicidal but I still live with this kind of depression on a fairly regular basis. My partner has probably seen me go through about 4 or 5 episodes now over a 2 year period.

I’m grateful I can be this open about this huge cause of internal stress. A lot of people who struggle with similar things aren’t as blunt as I am and keep the struggle to themselves.

Goal setting for 2019

I’m starting my goal setting early. I wrote this blog for goal setting for 2018. On reflection; I haven’t slipped back into obesity at least, which I was super concerned about as I spent the first six months of 2018 recovering from a broken ankle. Here’s my thinking behind my goal setting for 2019 and why I’m starting early.

Brainstorm everything I want to do

As an exercise, I listed everything I want to do and then asked myself, What do I have time to do? What is more important? What aligns the most with my personal values? I’ve had to eliminate a lot of extra curricular ideas and I still feel like I have a lot on my plate ūüôĀ .

This is a handwritten note of me brainstorming everything I want to do. I have things like learning Australian sign language, Japanese, podcasting, a masters in statistics and live testing as things I'd love to do but don't have the time for.
I don’t have enough time to do all the things I’d like to do

I then came up with the following list of things that are really important to me. They are themed around personal, career, family and financial goals:

  • Beat the overweight label (personal)
  • Maintain a daily meditation practice
  • Write a book (career)
  • Teach my Nan digital marketing (career and family)
  • Launch an app
  • Pay off half of my credit card debt (financial)
  • Speak at one international conference and take my Mum
  • Brew two whole grain beers
  • Keep Sydney Testers going
  • Create enough content to run a 3 day workshop

Why start the goal setting early?

I’m going to focus on developing my morning habit for the rest of this year. I’m going to get up early, meditate and write before heading off to work. If I can do this for the rest of the year, I’ll be in a good place to expand it come 2019. The green in the following table is this minimum commitment:

My ideal morning starts at 5:30, followed by exercise from 6 for up to hour. Next will be a twenty minute meditation from 7 flowwed by half an hour of writing from 7:30. I'll have breakfast at some point and be ready for work from 8:30 AM

I’ve put together an idea of what my ideal morning and ideal week looks like. If I do not put aside time to do things that are important to me, it’ll never get done. I reflected on what I could squeeze in. Unfortunately things like studying Japanese just don’t fit in financially and time wise. So here’s my ideal week to work towards in 2019:

My ideal week taken from a screenshot of a spreadsheet, please excuse the lack of transcribing here as I think the main information here is also covered in my external accountability section

There are some goals that I haven’t put aside any weekly or morning time for but they can’t easily be chipped away with a daily/weekly habit.

Keep goals measurable but hard to achieve

Everyone seems to be talking about Objectives and Key Results (OKRs) for goal setting these days. One of the important things with OKRs is that they are hard to achieve. When you reflect back on your goals you should be able to say you hit up to 80% of your objective. If you hit 100% you actually set your goals to easy. For example, I’m going to work towards beating the overweight label but I’m not going to consider myself a failure if I only get halfway there. By listing up my ideal morning/week it gives me an ideal to work towards but by highlighting my minimum commitments I won’t beat myself up if I have a bad week or two.

External Accountability

There’s no point in setting vague goals that you don’t tell anyone about. To ensure external accountability with my goals I’m going to;

  • Pay for a personal trainer for a twice a week weight lifting session
  • Go climbing with my partner every Wednesday and Saturday
  • Pay for a publisher’s time to help keep me focused on writing

How will you go about goal setting for next year? What measures will you take to ensure accountability? Please let me know.

Are you Hungry? Try the Carrot Test

Have you ever found yourself with a strong desire to eat almost anything and thought to yourself, “why do I want eat?”, “Am I really hungry?”? Often the drivers for eating are emotions; we could be bored, stressed or feeling low. We could be looking for that quick comfort and unfortunately a lot of what we eat is unconscious; we do it without even thinking. It’s habit that feeds our desire to eat, here is an article on 5 reasons why you can’t stop eating.

Afternoon Boredom

I get this desire nearly every afternoon around 3PM when I’m at work, I just want to stuff my face. Sometimes anything will do. There’s been the occasion where I’ve pigged out on plain salada biscuits before. I’ve now started bringing baby carrots and baby cucumbers to work and sitting them on my desk for when that desire hits. I call it the carrot test. If I’m not hungry enough to eat something bland like a carrot/cucumber then I’m not really hungry. Sometimes I’m just bored/tired and looking to take my mind off work. I might be thirsty and confusing it for hunger. So after eating a carrot and having a glass of water I recheck with that desire. If it still exists, I’ll reach for some fruit. Carrots are my choice because they are a low energy density food. If I binge on carrots, how much damage can I really do?

Carrot from a farm
Mmm, carrots.

The Carrot Test fails when there’s chocolate

Carrots can’t help me in the face of chocolate. I will stuff my face when there are these tasty morsels floating around. Sometimes I can’t help myself. I’ve always struggled when I’ve been in situations where there was ample food around. At a social gathering I’d be tempted to try everything and go back for seconds or thirds. Having most of my stomach removed has helped quell this desire some. My stomach physically doesn’t have the space to try everything, it has helped me curb my behaviour a little. There’s still situations where I find myself loosing control of what I eat but now the damage I can do to myself is reduced. I no longer feel guilty when this occurs, I’m trying to practice self compassion with my thinking but it’s a slow journey.

How do you control those desires? What habits do you try to form around food?

Too fat to climb

Have you ever thought, “I’m too fat/injured/old/lazy to do that thing”? “I’m too fat” is still a pretty common thought that I have even after losing nearly 50kg with the help of weight loss surgery. My partner suggested rock climbing as an activity we could do together. We were both obese when he put forward this suggestion and my initial thought was, “I’m too fat for that, I’m just going to fall but I guess I’ll give it a go”. I wasn’t very good on my first session but atleast I didn’t fall off the wall. I enjoyed it so much that I signed up for membership and I’ve been climbing now for 3 months. The progress is slow, I’m still on mostly level 0, I’m often the fattest person in the gym and I’ve even seen many first time climbers make more progress in their first session than I have seen in 3 months.¬†But I try not to care and I’m still enjoying it.

Another activity that I’ve been exploring is running. I don’t like it much yet but I’ve heard people grow to enjoy it. I’m exploring the Nike Run app. I’ve had many failures trying to start this program but that’s ok. The first set back was a foot injury that’s pretty common with being flat footed. Went to my podiatrist, got some new inner souls and stretches for the injury. The second time I started the program I had too many other things happening that it just wasn’t sticking. This third time I started I got through 2 weeks of the program, dropped off a little in week 3 but atleast picked it back up for week 4. Talking about being too fat to run, I was researching tips for getting started. I came across a support group for fat people wanting to get into running. Once I get through this Nike Run getting started program I’ll look into joining¬†too fat to run. Today my run involved running to grumpy doughnuts for a passionfruit filled doughnuts. OMG, was so yummy. Check out their Instagram¬†here.

There are no secrets to living a healthy lifestyle. Try a bunch of activities to see what you enjoy. Get friends and family involved. The list of things that I’d like to try include; pole dancing, rowing, roller derby and swing dancing.

So if you find yourself saying I’m too fat, just give it a go and listen to your body. Don’t push yourself too hard and you might surprise yourself with what you can do.

The 5 elements of my health

I have 5 elements of health/well-being that are important to me and that have a huge impact on my overall well-being when just one is lacking. They all have cascading effects on my overall enjoyment of life.

First up is my physical health. To me this is what I eat, how well I poop, how much I exercise and how well I’m sleeping. One of the easiest ways for me to experience a minor relapse of depression is not getting enough sleep. My menstrual cycle creates natural high’s and lows that impact my physical health, e.g. some women get less sleep/irregular bowel movements during PMS or during menstration. It’s not generally a fun time. My bad ankle/sciatic nerve injury have contributed negatively to my physical health. I’ve caught a cold recently which is putting a little downer on this part of my health.

Next is mental health. This can be general satisfaction with life but is more often associated with depression. When I’m not going through a bout of depression I would say that I have good mental health. Mindfulness therapy has helped me develop my mental health but it’s something I can always work on improving this. My period is a good time for a mental health check, if I’m in a poor mental state I’m more likely to turn into a blubbering mess around that poor time of month.

I also have financial well being, social and sexual health in my list. I could classify sexual health as a sub component of physical health but I find it important enough to mention on it’s own. I feel really lucky to have a partner where I’m comfortable exploring this side of me, I will save you the details but it has been rare for me to find a partner that I can explore with ;). When I don’t have my financial well being under control I’m more stressed and can’t function as well. Social well being comes from friends and family. I have worked hard to develop my sense of community and I’m grateful for it.

Since my weight loss surgery I have generally felt more in control of my life and all elements of my health have improved. It’s pretty amazing. Now I’ve still had some hiccups and I’m working on some behaviour that I’d like to tweak but these hiccups haven’t caused any long term downward spirals yet and I hope that I continue to take life’s bumps and hiccups in my stride.

Some people might also consider spiritual health to be important but it’s not critical for me. What other elements of health are important for you?

Sammy’s dieting rant

TL;DR:
Try to eat a mixture of less processed fruit/vegies with less processed meats, try not to over do it with fats/carbs/sugar and you should have a pretty balanced diet.¬†Also check out CSIRO’S total well being diet.

Now I don’t diet, it’s such a horrible word. I do try to live a healthy lifestyle and try to make healthy food choices, there are times where I go “F it, I want chocolate” and it’s ok to have those moments and not feel guilty about it. As long as I don’t do too much damage which having a smaller stomach helps control.

Lots of things are marketed as “healthy” when they aren’t. Learning how to read food nutrition labels is a good start. I look at ratios of fat to carbs to protein. I also look at ratio of carbs to fibre to assess if something really is “high fibre” if it’s trying to market itself as that.

Knowing that 1 tablespoon of sugar is 20 grams is a good guide for measuring how much sugar is in things e.g. fruit juice is horrible for sugar.

Understand that we are horrible at guessing how much we eat, even when calory counting we will still grossly underestimate serving sizes. You can combat this by using smaller plates and weighing out recomended serving sizes. We also have a tendency to eat more when we think something is healthy.

Fats and sugar aren’t really the enemy and protein is not this amazing thing just because everyone keeps raving on about it. Over consumption is the enemy, your body is an amazing self regulating machine.

Every cell in body needs sugar to survive, your body will convert carbs/fats/proteins into sugar (in that order) to support your body. Eat too many fats/carbs and your body will store it as fat, eat too much protein and you’ll have smelly expensive poo.

It doesn’t really matter if/how you skip meals. Intermittent fasting is a tactic that lots of people use to keep their overall food consumption low and stomach capacity down. E.g. I’ll often skip breakfast if I haven’t been to the gym in the morning. It doesn’t matter when you eat your large meals. There is a lot of misinformation out there around this though so tread carefully.

There are some things you can only get from your diet and they usually start with the name essential, e.g. essential amino acids (the building blocks for protein) can not be created in the body and need to come from your diet. This doesn’t mean essential oils are essential in any way though, that’s just misleading marketing.

Try to eat a mixture of fresh-ish fruit/vegies (nothing wrong with frozen) with less processed meats, try not to over do it with fats/carbs/sugar and you’ll have a pretty balanced diet. Processed foods tend to have higher amounts of fat/carbs because these are really tasty and these tasty enhancements help companies sell more food. If you need recipe ideas check out CSIRO’s total well being diet, it’s backed by science and isn’t the latest fad.

You can even try cutting out meat/dairy for a little bit if you are up for it. I’ve seen many people have success on the vegetarian/vegan diet. You don’t need to worry about protein if you are eating a mixture of things (e.g. peas, beans, legumes and nuts have some protein). Be careful with nuts though, it’s easy to over do because of the high fat content. I’ve challenged myself with periods of vegetarianism.

It’s easier to overconsume when alcohol is involved. I’ve challenged myself with dry periods when I’ve wanted to focus on my health.

40 kg down

I had weight loss surgery just over 5 months ago. I’m now down to 87kg which equates to 40kg lost. I’m starting to notice a bit of loose skin but I’m ok with that. This is what 40kg weight loss looks like in photos:

40kg down

40 kg loss side view

I still have another 8kg to go before I beat obesity and another 20kg before I’m no longer considered overweight.

Weight loss, where does that weight go?

Have you ever wondered when we lose weight, where does it go? Turning it into energy¬†is the common preconception but chemistry doesn’t work that way, you can’t create energy from mass (easily). Have a read through this article by¬†science alert.

Turns out we breathe out most of our weight as Carbon Dioxide(CO2). This is probably why high intensity cardio vascular exercise is encouraged for weight loss, you breathe more and therefore expel¬†more carbon. If you are weighing yourself as an indicator of weight loss, it’s generally recommended to weigh yourself at the same time of day under roughly the same conditions. For example, I weight myself in the morning, after I’ve gone to the toilet and just before I jump into the shower (so I’m naked). Have you ever weighed yourself during the day and observed the fluctuations? Or if you are female, have noticed a few kilo’s creep on just before that time of month? Our weight varies, alot.

We breathe in oxygen and out comes CO2, where does that carbon come from? Nearly everything we eat is based on carbon. CARBoyhydrates get their name from CARBon. Sugars are simple, short chained and are easy for us to turn into fuel for our bodies to do things with, that’s why we think they are tasty. Alcohol is like a sugar but with an alcohol molecule added to the end of it. Fat’s are more complicated but still based on carbon chains just linked together a little differently. Proteins are even more complicated (your DNA helps create proteins and that’s pretty complicated stuff). The field of science that is based¬†on the study of carbon based chemistry is called organic chemistry and we aren’t just talking about organic fruit and veg¬†here either. Plastics and fuel for your car also fall under organic chemistry.

Trees consume CO2, so by losing weight you are encouraging trees to grow. Fancy that.

Salts are an example of chemicals we consume that aren’t based on carbon and they are useful for many other things in your body; from you heart pumping to your nerve’s transmitting pain¬†signals. Think; anything electrical needs salt. While I’m on the subject of salt, there is actually no conclusive scientific information that too much salt is bad for you, don’t believe me? watch¬†this.

People tend to weigh less in the morning then at night time. This means most of your weight loss happens when you are sleeping. What’s happening when you sleep? Your body is repairing itself. In the brain there is a build of chemicals during they day that can be toxic if they aren’t cleared out of the system on a regular basis. Listen to Tell me something I don’t know from 22:41 to listen from a sleep doctor about this.

When you are sleeping, it’s like your body does a stocktake of it self. It goes, “hmm, how much fuel¬†do I need to do stuff with?”. If you have consumed excess fuel, your body is going to store it for later. If you haven’t consumed enough fuel, you body will breakdown fuel¬†from storage, use it and breathe it out. It feels like there is a preference to store fuel, evolutionarily speaking¬†this is easy for us to do and it has helped us survive¬†as a species. Our bodies have many different tactics it can deploy¬†to ensure survival. For example, starvation mode is a state your body can go into to preserve energy. E.g. with my recent rapid weight loss from surgery my menstrual cycle was out of whack. It’s like my body went, “CRISIS, CRISIS, we are in starvation mode, we do not have enough resources to sustain another human being, put the breaks on the baby making machine NOW”. My menstrual cycle seems to be back to a regular rhythm now.

So “burning energy” is not really an accurate scientific term but it’s all chemistry.

6 weeks post surgery

wow. Things are starting to feel more “normal” now. I’ve had some hiccups along the way but overall I’m very pleased with my recovery. I’m now down 20kg. I was meant to take 2 weeks off after surgery to recover but I was feeling well enough to get back to work after 1 week. I was up and walking about my ward just a few hours after surgery, I was discharged after 2 nights in hospital. I had some yoghurt a few days after surgery and it was the nicest yoghurt I had eaten. ever.

In the first few weeks after surgery, I found it uncomfortable to sit down. I had pinched a standing desk at work and was doing a lot of walking.

My first slip up happened a week after surgery, we were having a diwali festival at work and I made some gulab jamuns for it. My downfall was I like to sample my food as I bake. So I had 3 gulab jamuns and I had to lie down and moan for a bit because my stomach was too full. I felt like chundering but I didn’t. It was like when you eat too much at christmas time and you feel like lying down and moaning afterwards but it was a tiny amount of food that made me feel like that. My next slip up was Melbourne cup, at work we had everyone bring in a plate of food. I find it hard to want to sample everything. I overate a little and had to lie down for half an hour afterwards.

The post surgery diet hasn’t been horrible. On an average day I now have some yoghurt for breakfast, a tin of tuna for lunch, some sort of protein beverage during the day and dinner is more varied. Some days I’ve forgotten to eat breakfast. I’m not really hungry much. When they remove that much stomach they remove a large portion of the cells that produce the hunger hormone ghrelin.

In 2 weeks in back to “normal” food but I will always have to prioritize protein and nutrient rich vegetables. I’ve still had some emotional lows but I hope they get less intense as time goes on. I’m glad now that I’ve gone through the procedure. I feel like I’m taking control of my health rather than letting my emotions dictate my health. It’s still hard though, there’s many habits I still need to break. The idea of many sweets now grosses me out, it’s the idea of “if I ate all of that I would feel physically sick”. I’m happy to sample sweets but the size of dessert servings almost makes me feel ill. It’s a lot easier for me to waste food now.

1 day before surgery

I have my first ever surgery tomorrow. I’m nervous yet excited. The pre surgery diet has been ok. When I was in Melbourne 2 weeks ago for a conference I slipped up and I didn’t stick to the diet completely. Part of me feels like a failure for needing to rely on surgery to get on top of my health, it feels like I didn’t care enough about my health to want to do anything about it. But a few months ago, I tried a liquid food diet with the idea of , “if I can keep this up, I don’t need surgery” but I couldn’t keep it up and that was a realization for me.

I’m an emotional and experience eater. When I’m upset I often want to eat my emotions, I didn’t sleep very well while in Melbourne and I was a bit pre menstrual. So we can say my emotions were running high. I also find it hard to walk past a new experience, one of my undoings on my road trip was wanting to try all of the country towns pies. If I’m surrounded by a feast of food, I want to try everything at least once.

other than the slip up in Melbourne I’ve been ok with the diet. At least I’m not a boredom eater or an over obsessive clean eater. What type of eater are you?