Saturday, July 12, 2008

It’s Not You, It’s Me

You’d think I’d recognize the signs earlier by now:
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

depressed mood most of the day, nearly every day
markedly diminished interest or pleasure in all, or almost all, activities
significant weight loss when not dieting
psychomotor agitation or retardation
insomnia
fatigue or loss of energy
feelings of worthlessness or excessive or inappropriate guilt
diminished ability to think or concentrate
recurrent thoughts of death
It’s always such a weird relief to realize what’s going on—like when you’re driving around lost and suddenly spot a landmark you recognize: I’ve been here before, and I know the way back. I have increased the dose of one of my medications on my own but have an appointment with my psychiatrist soon.

Probably the worst part of it is what a fraud I feel like when I’m counseling students and residents.

TH has not hung up his shorts (nor stopped shaving his legs), but no races in the near future and no discussion of two-wheeled conveyances. My father-in-law has donated a TiVo, so the Tour can be watched without me having to keep HB quiet.

I am running, and that feels good.

There are still things that make me feel happy. Things like this comment from Victoria:
Please count me as one of your success stories. In January, I was completely sedentary, obese, & suffering from pretty serious arthritis pain in my hips, as well as meralgia paresthetica & near-crippling referred pain from a bulging disc in my back. The orthos told me there was nothing to be done about the hips until I got old enough for a replacement (I’m only 42). I had a couple of steroid shots in my back for the disc pain, but they did nothing. The spine ortho was talking about surgery. My PCP told me that weight loss would help—but how can you lose weight if you’re in too much pain to exercise?

Then, I slowly decided to start trusting your advice that it’s ok to run even if you’re in pain. This is contrary to what the orthos were telling me, but then, they really weren’t helping me, and I knew something had to change. … I knew I had to lose weight to stop that pain.

So, I trusted you. I started running, very, very slowly (so slowly that my dog was walking on the uphill sections of our runs!), only half an hour at a time, only every other day. Running itself isn’t burning many calories, but there’s something about being active that makes every other challenge in life seem more manageable. It made me feel optimistic, and powerful.

I made a strenuous effort to lose weight. Since the beginning of the year, I’ve lost 35 pounds. I’m now “mildly overweight” instead of “obese.” Everyone keeps commenting on how different I look. But the most significant change—the one that nobody can see—is that I have NO PAIN. My hips feel tender when I run, but the rest of the time? No meralgia at all. No referred pain from my disc at all. And no arthritis pain at all (except a little bit during & after runs).

This is incredible. I would say I have a 95% reduction in my pain. Back in December and January, when the pain was at its worst, nobody was giving me any hope that I could recover from my pain. … I was panicking—I felt like a decrepit old lady with no hope. I was in so much pain that I couldn’t work. I was taking Vicodin every day, and feeling stoned all the time, and still in too much pain to think about anything else. Sometimes, I couldn’t even carry on a simple conversation with my husband about what to have for dinner because all I could really focus on was how much pain I was having … Now I am pain-free and I feel like I’m in charge of my life and my health.

I am convinced that there’s something about exercise itself (not just the weight loss) that helps my body manage pain.

Anyway, what is so incredibly helpful about your website is not only that you tell us not to be afraid of pain and not to give in to it, but also that you set really strict limits on how much we can do. In the past, I’ve always, always overdone it, gotten injured, and become discouraged. Now, doing only half an hour every other day, I have had no injuries. And I also have no excuse not to exercise. If I feel like having a glass of wine in front of the t.v. instead of going for a run, I tell myself, “Oh, come on, it’s only half an hour.” And I go.

I think of you every time I go for a run. I think you would be so happy to see what a difference your advice has made in my life.
And things like this picture of HB, HAPPY at daycare, sent unsolicited by one of his great teachers:



Note the evidence that he now chooses his clothes himself: (green) socks with sandals.

20 comments:

BethanyWD said...

Gosh, what a wonderful success story you've received - good for her! I try to say the same thing about exercising when I don't feel like it "It's just a half hour" and then I feel SO MUCH better when I just go and do it.

I, too, struggle with depression. was on meds for about 2 years (it got pretty bad - probably PPD - after my daughter was born), but I went off meds this past Christmas. I did it on my own, which isn't the smartest mood. I think I got past the medicinal benefits of the meds, and they started to just make me feel exhausted all the time (what's with modern medicine not being able to produce drugs without the side effect of tiredness??). Now, off the meds, I have more energy and am able (most of the time) to work on my depression with exercise, eating right, and getting plenty of sleep. However, I am sure there will come a time where I'll need to go back on some kind of meds - which I am totally okay with (any thoughts on an anti-depressant that wouldn't make me so sleepy? I was on celexa last time).

Anyway, I hope the increase in meds helps to to work your way out of this - and keep running!

Brenna said...

I used to run track in high school, which turned running into a competitive thing. I was never very good, and when track was done, I was happy not to run anymore. I exercised relatively consistently through the beginning of college (vanity), but I always seemed to eat less healthily when I was running, because running was justification to eat what I wanted. This past year (my last year of college), I decided to retrain my view of running. You were my trainer. Every other day, I ran with my boyfriend. We'd shout "geriatric sloth!" when one of us started going too fast. And we both had so much fun. Senior project hit, and we stopped running, but this summer I've been slowly getting back to it.

That story was so encouraging. I also think about you all the time when I run. It's so silly, but it's like you gave me permission to slow down and enjoy running. With the focus off of burning calories or getting to a certain level of fitness, it just seems like a relaxing thing to do that really helps my mental health as well. Thank you!

Anonymous said...

HB should come over to Scotland - it's the T in the Park festival this weekend and he would fit right in wearing that get-up - psychedelic man!

Ah, sorry you're feeling bad. I hope I can recognise the symptoms if they come back.

Glad it's all fairly quiet on the 2 wheel front!

Fiona

Sara said...

That success story has even got me thinking about running. I'm a new intern, and this never having time for anything business is really starting to get me down. (I know, I know, I'm "only" working 80 hours a week... but damnit, that's a lot!) I've got back/leg issues, and had a doc/professor of mine tell me that he thought running was stupid, so I'd pretty much written it off as something not for me, but I need to do something to combat that big ol' checklist sitting at the top of your post, (I can check off at least 5, but I think most new interns could check most of those...) and God only knows when I'll be able to get in to see a doc for my depression issues, so in the meanwhile... maybe I'll take a run. Can't hurt.
Sorry to hear your depression's got ahold again. Best wishes on a speedy turnaround.

winecat said...

Wow that success story got me inspired. Not to run, sorry but at least to walk. I too need to lose weight to reduce the chance of reoccurance of breast cancer. Maybe some day I'll work but to running but "it's only a half an hour" is a great mantra

E. said...

What a great success story. I'm glad it makes you feel good, even when you're feeling bad. And hopefully you'll soon be feeling better.

Cute picture. He does look happy, and excited.

Anonymous said...

How cute the picture of HB. I know those pictures make a momma so happy, seeing their children happy. I miss the daycare days and the pictures, but not the daycare costs.

Keep up the good work. I suffer from depression too. Right now it's good, but I had major mood altering surgery and I'm not sure what the future holds.

Jen

L. said...

I would email you rather than writing this very long comment, but can't find an address here... anyway, I too have been meaning to tell you about how you have inspired me in running. I've tried periodically throughout my life, even did C25K for a while, but I could never keep going for more than 15 minutes at a time. I'm not overweight but I am fat, if you know what I mean.

Then I came across your "maggots" post and tried yet again. This was after having a baby; I wasn't able to exercise while pregnant and so it had been about fifteen months since I'd done much of anything. I'm 32 so it's getting harder to get in shape.

This time I have been so much more successful. I can run three miles without stopping and I am trying to bump it up to four. I'm slow, I "run" maybe 3.5 mph, but I'm working on that too. For the first time in my life, I feel like I can run pretty much as far as I want, that if I work on it I could hit five, or six, or ... Not only that, but I've been sticking with it and going out often.

I frequently think of your posts on running when I'm out, and to encourage myself when I'm trying to keep going; better to slow down than stop. It's really helped a lot. So thank you, very much.

Blue said...

Hi Maria,
I've been a computer potato for so long. But you inspired me to change my slovenly ways and start trying. I tried to document my efforts on my blog, to stay accountable, and though it took me a while to get really going, you deserve full credit for instigating the whole exercise thing.

my sister noticed my preoccupation about running, and all the Sherah's who are out there doing it, and my frustration with my own abilities or lack thereof, and convinced me to sign up for a 1/2 marathon. This took her 4 hours on the phone. But finally I plunked down the money, paid for some real shoes, got video tapped by the running company to make sure I had what I needed, and found a training program to gear me up. I'm using the Cool Runnings Couch to 5K program. Today is the 1st run of week six (it's 9 weeks long), and Happy Happy...I haven't missed a single run. After I finish this program, I'll find a program to train for my 1st half that I can stick to.

If it weren't for you convincing me in the first place, I wouldn't be doing this. And the reward isn't going to be crossing the finish line...it's the fact that I posted the schedule on the wall and have gotten myself out there no matter what. And the best news? I haven't had any knee pain. That's always been my issue in the past, from the get-go.

So here's to YOU! Thanks for your help and inspiration. You're fantastic!

Anonymous said...

Oh, I'm so glad my comment made you happy! You really did help me. But I am sorry to hear that depression is revisiting you. Hang in there, and good luck with your meds. -victoria

Anonymous said...

My 6yo comes up with some clothing combinations that make me shudder... I try to view it as a demonstration of her creativity.

That story was great. Your blog has also made me think about running. My brain knows with certainty that I would feel better with regular exercise, I'm having a hard time moving from "thinking about it" to "acting on it". My dh rides his bike to work three days a week (it's about 60 miles round-trip)... it amazes me!

Kirsten said...

I just did my first trail run yesterday - 4 miles, more than I've ever run before. Your blog gave me the inspiration to start running in the first place, about 2 months ago. Thank you!

Stephanie said...

Oh, I'm so sorry about the depression. I know those relapses well. It's good to catch them in the early stage, as you're doing now, when you're still shrewd enough to remember that this is treatable and temporary, rather than later on when the absence of affect and inability to feel pleasure seem positively eternal. I'll bet the quick med adjustment will keep you from slipping too far down the slope. I suspect your running helps, too.

I'm a complete lazy achy thin (but fat) slacker mom afraid to run. This blog has me actually envisioning it. It's a start. I just suspect that I'll end up quitting after 2 weeks like I always do anything new I start. Sucks, me.

MedStudentWife said...

Yes - even a little bit of exercise does make a difference.

My lower back has been getting processively pianful and I know its sitting for hours on end and not doing the walking I used to do...

I found a 10 minute yoga routine, to do 1st thing in the morning. I try to do it every morning, but sometimes its every second day AND I can almost do it in my sleep now.

But you know what... lower back pain is gone :)

I love HB taste in clothing - especially the green socks and sandles... now that's my kind of dressing !!

Anonymous said...

I'm so sorry to hear that the depression has crept back in for you, but bravo to you for recognizing the symptoms and doing something about it--that's a huge first step towards feeling better again. The thing that got me through my worst relapse was the knowledge that I'd beaten depression once, and I was now armed with the tools and wisdom to do it again. Good luck, and kick some depression butt.

-Lauren

Anonymous said...

And this is where this maggot thanks you again for the inspiration to get back into running. It's keeping me sane, just. Lately, I'm running through my Dad's diagnosis of esophageal cancer, his near-death experience on the operating table, his current stay in ICU with suspected C. Diff. And I know that soon I'll be running through the big grief.

Thanks for giving me the shove off the couch and hope you feel better soon. Be gentle with yourself.

Anon/Maggot/Sharon

PS HB is so cute in that outfit!

Mignon said...

I'm jealous that your HB gets to experience such a racially diverse learning environment. That's my number 1 complaint about where I live.

Best wishes for your mental health - glad to hear TH is helping.

ozma said...

Yay you helped someone. Now she's inspiring me...I should try that. People who don't run are not all sedentary though, I must say in my defense. I exercise a lot but there's nothing like combining that with running.

Now I'm going to suggest you consider doing what I do for mental health which is yoga. When I say I could give up meds with yoga, it sounds like I must not have had a problem but of course if you read my blog, it should be pretty obvious I do. Yoga works better than medication for me. (Except for the tricky problem that it does wear off--you have to do it regularly...there's only a 10-14 day window of not doing it and then I go back to crazy.) Eventually, there will be some scientific explanation. Right now there are just various studies saying it increases GABA or some such thing. But a number of double blind studies are being done now.

It might not be your thing, of course. For some reason, you say yoga and everyone thinks you are snorting incense or something but really...many sensible ultra rational people that I know are very convinced of its ability to improve mental health.

Yoga and running are hard to combine for some reason for me because running makes me so tight and I barely have time for the yoga, which is now completely necessary for my mental health so I have to do it. But basically, the combination turned me into Buddha during the periods I could do it. (I'm still at the super slow stage of running...the barely faster than walking stage.)

Did you read the article on running in the New Yorker? I can't remember who wrote it. Some Japanese author whose name escapes me at the moment. He started out a chain smoker and ended up a marathon runner. I thought of you.

Whatever you do, I hope it works soon.

anya said...

My whole life I've seen socks with sandals and they don't offend me in the least (California). I think it's cute! What if someone wants the comfort of sandals but it's a little too cold for no socks? What if their feet sweat a lot?

Anyway, this is very inspirational. I'm 7 mos. pregnant right now and I never feel like running -- I ran sort of off and on through my fifth month -- but I actually might try it today. I have one of those belly bras that keeps everything in. Plus I am tall and not sticking out that much, and have a go from the midwives to run as long as I feel like it, since I was a runner before. However, I have been not working out at all lately, and walking leaves me out of breath. So. We'll see how it goes.

anya said...

Woohoo! I did it! OK only 20 minutes total -- two ten minute blocks separated by some yoga poses because I had a sideache (I get a sideache sometimes even when I walk these days -- it's clearly not from the uterus area, feels just like a plain ol' sideache). It felt GREAT!!! Except for the first maybe two minutes, which were sort of a shock to the system. But after that, I loooved it. I'm going to keep doing it. Every other day. 30 mins next time. When I was running back home, realizing I'd run for 20 minutes in my 7th month, and that it felt great, I felt like I was winning a marathon or something. And I still feel great. I struggle with depression, too -- actually, as long as I'm on Paxil and exercising I am just fine -- but basically I'd probably rather be dead than not on Paxil -- but I forgot how good running makes me FEEL.