Let’s get this out of the way up front: I’ve been treated for depression and anxiety disorder for nearly 20 years, and lived with it for decades longer than that. There. My deepest secret. No longer secret. Depression and related effects have been the number one issue for my mental and physical health, my career, my relationships, and the state of my record collection.

I’ve taken (under doctor’s supervision, naturally) a series of medications, mostly SSRIs, sometimes alone, sometimes in combination with other meds. A running joke with my family is that for any new medication, I’ll experience every side effect in the accompanying paperwork, except perhaps difficulty nursing. My focus in this post is how both the disorder and the medications can affect my health and fitness.

I’ve also worked with some very good (and one very bad) therapists over the past 20 years, and from that experience I’ve assembled a set of coping skills that help supplement the effects of the medication.

This is a huge topic, so for now I’ll just focus on my experiences with two aspects of my energy levels: mental and physical. For me, low mental energy associated with depression manifests as inertia. Low physical energy presents as hunger/low blood sugar. These two combined have played havoc with my physical health and fitness for a long time now.

Depression and mental inertia

Activation energy

It’s a truism that depression can affect one’s ability to get things done. In my experience, that’s because one of the insidious ways depression works is that it blocks the ability to anticipate enjoyment. For example, if I can’t imagine enjoying going out with friends, I’ll never be able to start getting dressed or leaving my apartment. Once I get going and join up with my friends, I can have a good time. Often, however, I just can’t start.

One way I think of it is that depression raises the activation energy needed to start something. Often to a level that seems insurmountable. In chemistry, catalysts are used to reduce the amount of activation energy required for a reaction. I think that makes for a good metaphor for depressive behavior. Searching for catalysts has been a lifelong process, whether conscious or not. Hell, maybe that should be the name of this blog.

Depression and low physical energy: mood or blood sugar?

Tired or blue?

One of the things I’ve had to learn is how to tell when my physical energy levels are low because of a depressive episode, or if I’m really in need of nutrition. Some times it can be hard to tell, despite the lack of a growling stomach.

Solving the problem wrong

This will perk me up

For quite a while, when I felt “low” I’d think I just needed to eat something. Which, depending on what I ate, would spike my blood sugar, I’d soon crash, feel “low” and eat something again. Hello rapid weight gain! And with my weight gain came pre-diabetes, a precursor to type II diabetes. I really really don’t want that. Fortunately, so far, losing weight has also moved me back out of the pre-diabetes risk category. As we’ll see, that weight loss gets more challenging as time passes.

Understanding my own blood sugar levels

Eat, drink, scan sensor, repeat

I’ll get into more details on this in a future post, but last week I started to wear a continuous glucose monitor (CGM). I’ve been obsessed about scanning the sensor at any time of the day (or night) to see the impact of the food or drink I’ve ingested. As it gets into the dark season here in Seattle, this is going to be helpful in sorting out when I’m low in physical energy or whether it’s mood-disorder-related. Having data is good for my brain.

Just exercise, right?

Meds, exercise, coping skills:
the three-legged stool

Speaking of truisms, it will surprise no one that in my experience, regular exercise addresses both mood and weight management. It’s a delicate balance, however. For example, when all is balanced, the combination of medication, coping skills and exercise will keep the demons at bay. Keeping the demons at bay can help me make better food and drink decisions. Exercise can mitigate the effects of the occasional poor food and drink decision.

But when something goes awry and tips the balance, it can be very difficult to regain. (I refuse to say impossible, though it seems it at times.) For example, a few years back when I was running regularly, I injured myself badly 6 weeks before my first full marathon (backroads half marathons can have potholes). I’d been training diligently for the 26.2 distance, was pumped full of endorphins all the time, and eating/drinking to support the weekly mileage.

But what happened when I couldn’t run for several months, yet kept eating and drinking like I was? Boom. Rapid weight gain. As for mood, without exercise to keep away the demons, I suffered a plunge in mood that the meds and coping couldn’t manage.

What to do?

In upcoming posts, I want to drill into these topics, talk about methods I’ve tried, successfully and unsuccessfully, to manage depression and physical health over the past 20 years. I’ll post about nutrition and cooking, about my weight ebbing and flowing, about exercise, about mental health coping strategies. There will probably be some off-color jokes. I hope you’ll stick around.

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