“Watch out,” the mental ward’s psychiatrist gently cautioned me. “It’s true that Depakote will stabilize you, but you’ll gain a lot of weight. Plus, anything you pack on will be harder to lose. Are you sure you want this medication?”
“Pish posh,” I said, manic and therefore invincible. “I don’t care about a measly ten pounds.”
At the time, I was seething. Were we, in considering my treatment plan, really going to prioritize my weight over my mental health? In the midst of my psychotic breakdown, I’d just realized that I was insane enough to need serious medical intervention. Was that really the time to caution me about maintaining thinness—especially considering I had given birth two weeks prior? And why were there no other options to treat my condition?
Sixty pounds and a few years later, I care a great deal about my muffin top. So much so that it has started to negatively affect both my health and self-esteem.
I’ve had young children ask if I have a baby in my belly. I’ve been laughed at and called “fattie!” when dancing. I’ve even had a certain insensitive business owner look at my four-year-old debit card and declare, “You used to be so skinny! You know, when you were a teen.”
No one can tell from looking at me what my diet is or what medications I may be taking. Despite that, they feel free to comment on my body. I fully admit that my new curves are not entirely due to my nightly med cocktail. I am largely sedentary and my diet consists of the three major food groups—Grease, Sugar, and Dairy—both issues which I am addressing. But even with that lifestyle, I should not have gained thirty pounds in a year.
Weight gain is a huge factor preventing people from complying with a long-term drug treatment plan. In a 1999 study of the adverse effects of antipsychotics, more than seventy percent of participants reported weight gain as “extremely distressing”—far greater than any other side-effect.
Depakote, a gold standard in the treatnment of bipolar disorder, is one of the worst offenders. Studies have even suggested that women on the drug crave carbohydrates up to ten percent more than men do, and tend to gain more.
This is a three-fold problem:
1. The mental health industry is a fledgling one, even though its business is currently booming. We just don’t know what a lot of these compounds do to the body yet, especially when blended. And not all drugs work for everyone. I myself am allergic to entire families of medications, including most of the new atypical antipsychotics and serious painkillers.
2. People stop taking their prescriptions when they feel that the diseases are easier to bear than the side-effects. In addition, this is often done abruptly, which can be dangerous as it may trigger a severe mood episode.
3. Despite not being able to tell how healthy someone is by looking at them, many cultures shame fat people.
There is a stigma against having a mental illness. There is a stigma against needing medications to survive. There is a stigma against being fat. But what if you are the first already and have to choose between the second and third?
This is the kind of choice that breaks a person.
What sorts of things have you had to deal with on your meds? If you can bear to part with the numbers, how many pounds have you gained?