Friday, October 12, 2007

Writers and Depression, Part II

I've talked about my struggles with depression in previous posts. A couple of months ago after my grandmother died, I had another severe bout of it. And I found a technique to get out of it I'd like to share.

In my case, depression seems to come paired with extreme anxiety. I'd find myself sitting there bouncing my knees in a frantic attempt to burn off nervous energy. I couldn't sleep. Worse, I had the horrible feeling that my battle was pointless -- that sooner or later, I was doomed to kill myself. There was no point in even trying to fight it any more.

I was so frightened, so out of control, that I went over to my sister's. She's been my dearest friend all my life, and she knows all about the way anxiety has tormented me. So I sat down on her couch, bouncing my knees and trying to put my fear into words. And she looked at me and said "You don't have to do this. You have been through this often enough to know what you can do to regain control. You can choose to do something about it, or you can choose to let it destroy you."

It was like having someone splash cold water in my face.

She reminded me I had already found out that exercising helps the anxiety and depression. She also suggested finding a tanning bed and spending about five or ten minutes in it, being careful not to get a sunburn. And she said I could also get a massage.

These are really simple things that are very effective.

I had also just started back on Lexapro, an anti-depressant and anti-anxiety drug that, unlike some, reduces appetite and weight gain instead of causing people to put on more weight. Thing is, I have found that right after I start back on Lexapro, the anxiety and depression actually gets worse for a couple of weeks. Around a month out, it finally kicks in and stabilizes the mood, but you need to be aware of the effect, or you'll think you're getting worse.

I seized on my sister's suggestions with the enthusiasm of raw desperation. The gym is open until 10 p.m., and it was 8, so I drove over there at once and spent the next half-hour on the treadmill and the elliptical machine, working up a sweat and burning off all the agonizing stress I'd built up. That night, I was able to sleep for the first time in days.

The next day, I had an appointment with my personal trainer. I really pumped hard on the weight machines, forcing myself to push despite the pain of my burning muscles. By the end of the hour, my muscles were aching, but the anxiety had burned off again. A sense of well-being filled me.

Unfortunately, I quickly found it didn't last. Whenever the anxiety started clawing at me, I'd head for the gym and the treadmill and the weight machines. Soon the anxiety and depression began to lift, especially after the Lexapro finally kicked in. But I am truly convinced that my workouts stabilized me and got me through the worst of it.

My sister was right. I wasn't helpless. I could fight depression and anxiety. I don't have to let it kill me.

My trainer says exercise is an effective treatment because scientists have found it returns the body to hormonal balance. Someone else wrote in response to an earlier blog that one recent study compared anti-depressants, talk therapy and exercise in depressed patients. Scientists found the ones that exercised did the best. However, I think combining the three would be even more effective.

By the way, I think Lexapro also helps my creativity. I know there is a big difference in my writing when I'm taking Lexapro and when I'm not. Lexapro works by liberating the brain chemical serotonin, which is also affects mood, appetite -- and creativity. (The only bad thing about Lexapro is it tends to decrease desire because it turns testosterone into serotonin. And testosterone is the hormone that is responsible for sexual appetite. I have found I can reduce that affect with a testosterone cream prescribed by my doctor, who had used a blood test to determine that my testosterone levels were too low.)

I know, I know. People are always telling you to diet and exercise -- it's supposed to be a cure for everything from cancer to Alzheimer's. Unfortunately, exercise is also tiring, and it hurts, which is why I was never much interested in doing it. It's much easier to stay at home and eat a box of Godiva's.

But I swear to you, my workouts have made a huge difference in my mood and my stress levels. I really believe that if you're struggling with depression and anxiety, working out will help you. It won't be easy at first, but I think you'll notice positive effects on your mental state very quickly. Then, if you're still having a problem, you can try an antidepressant like Lexapro on top of that. But you need to stay on the antidepressant and keep working out two or three times a week to make sure you don't backslide into depression.

You can survive this disease, but it's like heart disease or diabetes -- you have to treat it. Ignoring it will only allow it to kill you. Exercise is one hell of a good treatment.

There are other benefits too. As of today, I have lost 137 pounds since I had gastric bypass surgery Aug. 29, 2006. I feel 20 years younger, and I'm no longer in constant pain from my knees and joints.

When I started working out, I could only bench press about 15 pounds. Now I'm up to 37, and I've increased all the other weights I use too. Because I work out, I don't have as much loose skin as many other gastric bypass patients who have lost a lot of weight. And at 46, I'm stronger now than I have ever been in my life.

On the other hand, my mother is 67, and is morbidly obese. Being overweight for so many years has destroyed her joints, and she's in constant pain. She's going to have to undergo painful joint replacement surgery. I wish it was possible for her to have gastric bypass surgery, but at her age, it's just not a good option.

I urge you to exercise and try to do something if you have a weight problem. I think you will find it's more than worth the effort, especially if you're dealing with depression, stress and anxiety.