Blog

comorbidity
  • What does Size have to do with it?

    I was never the thin girl. I have been thinner or larger at various stages of my life. High School. College. Pregnancy. Post-pregnancy. Working girl. All a stage associated with a various size and a healthy dose of self-hatred to boot. I was the thin girl for approximately 8 months – so thin I was accused of an eating disorder – during my mania and initial recovery. A healthy dose of self-hatred still accompanied me everywhere I went. It turns out the thigh gap and the clothes do not make the girl. 

    What does though? I identify myself as a mother, wife, nurse practitioner, writer, and teacher. Size is not a factor in self-identity. It is everything I see however when I look in the mirror.

    I am presently at my largest size ever. Part of it was medication weight gain and part of it is self-medication with food. Eating increases dopamine in my brain and allows me to feel gooooooooooood. While I’m eating. When I am done, I am left feeling sad and miserable and full of shame. The transient increase in dopamine, a powerful neurotransmitter, creates a vicious cycle with my brain always seeking more. Unfortunately it is usually craving more Cadbury Mini Eggs and not tuna with avocado mayo. 

    I’m bringing this to attention since as of late I have been trying to highlight the risk of cardiovascular disease in those with mental illness. My annual physical is coming up and I have to admit: I am terrified. I had high triglycerides once before. I also reversed it with lifestyle change. I am not so optimistic this time. I am scared to my core my lipids will be high, my blood pressure will be high and that I will not be able to reverse what has begun. 

    I need to finally admit it. When I am happy, I eat. When I am sad, I eat. When I am bored, I eat. When I am tired, I eat. It is equally as destructive as my bipolar disorder at this point in the game. Turning 42 this year, there is not a “tomorrow, I’ll change” anymore. Tomorrow never comes presently. 

    Fit Bit, exercise, increasing activity, giving up dairy, eating paleo, food diary. Nothing is exciting enough to create lasting change or prevent me from getting bored. I stay sad and full of self-loathing. 

    Not looking for advice. Just being honest today. My shit is real.

  • Saying Goodbye to an Icon and Lessons Learned

    Everyone, and I do mean EVERYONE, has had an opinion or thought on the loss of Carrie Fisher suddenly last week to a heart attack. Myself included. However, before taking my thoughts public I needed time to process the loss, what it meant and what message was getting lost in the coverage.

    Carrie was an OG mental illness advocate. She spoke openly and frankly in a time that was unpopular to do so.  She wrote with right balance of passion, gravitas and humor regarding the subject. She talked about her disease, her addiction struggles and her experiences with ECT. She talked about her family relationships for better or for worse.

    “We have been given a challenging illness and there is no other option than to meet those challenges. Think of it as an opportunity to be heroic – not ‘I survived living in Mosul during an attack’ heroic, but an emotional survival. An opportunity to be a good example to others who might share our disorder. “ (November 2016)

    She was (and still is) everything I yearned to be, as I related to her story on so many levels. For starters, I once fancied myself Princess Leia as most little girls in the late seventies, early eighties did. However it runs much deeper than that. I saw pieces of my story run parallel to hers. The period in which we are unable to accept the illness, the drinking, the ECT. The courage to say, “hey, I’m having a relapse and shit happens”.

    When I found my feet, my voice, and gained confidence in both myself and my abilities, she spoke to me once more. “Stay afraid. But do it anyway. What’s important is the action. You don’t have to wait to be confident. Just do it and eventually the confidence will follow”. (April 2013)

    Her death stings me. It hurts more than the loss of Robin William’s laughter. Carrie was everything I wanted to be and now in death, everything I hope I’m not. She lived her life exactly the way I hope to live the remainder of my days. Her death, while it has called to attention the differences in heart disease between men and woman, has the ability to shed light on a greater issue: the decreased mortality of those with serious mental illness. 

    Mary Lou Sudders, the Massachusetts Secretary of Health recently remarked those with serious mental illness have a decrease in mortality of 25 years compared to their peers. If we expect to live until 85-90 years of age, then Carrie was right on schedule at age 60 according to that statistic. Countless studies published in journals highlight this issue along various themes. What all the data agrees on is cardiovascular risk is the highest and cardiovascular disease is the most common co-morbidity / cause of death.  Journals agree providers miss the mark in treating co-morbid illnesses in the mentally ill whether it is difficult to suss out a real versus somatic complaint, patient misinterpretation of symptoms, or bias against the patient for their psychiatric diagnosis to begin with.

    I am stung by Carrie’s death as it is too soon. It is my reality without vigilant care on my part. It is my reality unless I insist my PCP and my psychiatrist work as a team. It is my reality unless I change very stubborn habits. I have a lot to live for. And I intend to savor every year I have.

    Perhaps the best way to honor Carrie is talk about mental illness and medical co-morbidities.

    “I am mentally ill. I can say that. I am not ashamed of that. I survived that, I’m still surviving it, but bring it on”.   (December 2000).