Tuesday, April 7, 2015

Get In My Belly: Food, Drink, and Mental Health

#HAWMC Day 7: April 7th is World Health Day – so let’s talk about daily nutrition and diet. After your diagnosis, did you alter your diet or health routine? If so, how? How do you maintain a healthy regiment?

Happy World Health Day! I LOVE this prompt. I have a Bachelor's in Kinesiology, worked in corporate fitness for five years, am a certified personal trainer and group fitness instructor, and am a mental health blogger and activist. Health is, in all senses of the word, kind of my thing. 

Perhaps I'm luckier than some in that I came into my condition with some training in the body systems and how diet and exercise can affect virtually all of our organs, including the brain. Still, I'ave had a lot to learn. While my background has always made me a bit conscious of my health routine, I've had to become hyper-aware since my diagnosis, and much of it has come through trial and error. 

First off, I have to take medication three times a day. This medication must be taken with food. If not, I incur severe nausea, dizziness, disorientation, occasional vision blurriness (as if I was about to pass out), and numbness in my tongue and lips. These symptoms can last for hours, and often are temporarily debilitating. It can't just be any food either. It has to be a large enough quantity and the right kind of food. There must be enough carbs to quickly get into my bloodstream (they are broken down the quickest) and absorb the meds. I can have a buffet full of proteins and fats, but if there aren't enough carbs, I'll be ill for hours. The more meds I cumulatively take, the more I have to have eaten throughout the days, so if I miss a meal, I have to adjust my whole medication schedule, and this can affect my routine for the day. While I won't have a massive mood cycle from taking my meds an hour late, or even missing one at all, I can't do this on a regular basis.  I can sometimes start to feel the effects of a missed dose after just an hour or two, especially on a day where I'm already cycling. I'll be out doing something fun and social with friends and suddenly say, "have to get something to eat, medication time!", and it well may not be at a normal dining time (one of my doses has to be taken around 2 PM). Thankfully, if they're embarrassed, they never say it. I'm certainly not. To me it's just daily life. 

In addition to the fact that I feel I now eat like a horse in order to take meds, there are foods that bother me. Dairy, for instance, seems to make my depression worse. I don't know if this is an across the board thing with mood cycling, or just me. It may also be in part that I have a slight lactose issue and what a GI doctor once called severe IBS, and feeling like shit (no pun intended! OK, maybe a little...) generally makes people feel worse. I think it's probably a combination. Either way, I try to stay away from much dairy when in a depressive cycle. There have been studies on potential links between gluten and mood cycling as well, and though I've not read all of the research, I do keep an eye on this. I'm a vegetarian, so gluten-filled foods like seiten, for instance, are a regular part of my diet. When I can, I choose corn-based items (i.e. corn tortillas and chips) instead of flour/wheat based, but I do consume probably too much gluten. I've considered experimenting with low-gluten or gluten-free eating, but as a vegetarian with severe IBS and lactose issues, my diet is limited enough, and I'd rather not add to it if I don't need to. Going out to eat with me can already be a pain in the ass, and I'd rather not make it more so. Still, it's something I do keep an eye on. 

Coffee and alcohol are two other biggies. Coffee is amazing! I need several cups every day to function properly, and when I'm depressed and can barely pull myself from bed, it's pretty much nectar from the gods. But, and there's always a but with mood cycling, it's a slippery slope. One cup, no problem, I'm practically immune. Two, usually no biggie. But there's become a fine line between coffee-alert and hypomnia, and while I try to catch it before it's too late, I sometimes don't. Alcohol... well, it's alcohol. We have all loved our friends excessively at 1 AM, and woed our lives and ourselves an hour later when the "high" drops off.  But with mood cycling, it's not just socially enabling/embarrassing, it can bring on serious depression. I can't tell you the number of times I've thought I had a fun night out, only to wake up battling a severe depressive cycle. I have to chastise myself for thinking I can have a night of fun the way my friends do. I can't. It's not just that I can't  over-indulgence. Sometimes, it can be only a drink or two. I always have to be mindful. 

Of course, there's also the whole "my meds can cause hyponatremia (low blood sodium) and send me into seizures" thing. I experience hyponatremia on a regular basis. Luckily, I've managed to avoid the seizures so far, though I did once almost pass out at the gym in my housing complex and some old man had to carry me back to my apartment, which would be moderately embarrassing if I had any shame. Luckily, I don't. I have to ingest more sodium than the average person, though to be honest, that's not really a sacrifice. I love salt and have a palate that seemingly notices saltiness significantly less than the average person, so it's not hard to salt-load. Still, I do have to watch daily for signs of low blood sodium - and get my blood checked for this every six weeks. I'm supposed to always have tomato juice with me in case I need a quick salt fix, and I've slacked on this. I have learned to enjoy large quantities of powerade zero, though, which has a decent amount of sodium in it. I should probably just buy a diaper bag (spill proof for drinks) to fill with all the snacks and drinks and meds I need and carry it around, but I've yet to adopt this habit. 

With all of this said, I honestly don't feel like my health and wellness sacrifices are too bad. I get to eat more salty foods when most people have to buy low-sodium. I have low blood pressure naturally, so this increased sodium diet doesn't, at least yet, seem to be a heart concern for me. I have to eat more, and occasionally exercise less - increased adrenaline can worsen hypomania for me - which does make me feel a bit blah and has added to some minor weight gain, but I'm trying to adjust that with some creative healthy eating techniques. I still get to drink my coffee, I just have to watch it, and at 35, having to drink less alcohol isn't really too big of a deal - in fact, it's sometimes a nice excuse to stay home from a party when I'm feeling socially anxious, and instead do something I really want to do like read, or sleep. So really, all in all, I feel pretty lucky. I truly could have it a lot worse. 

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