This Could Be the Day

My weight has always been a problem. Only twice in my life have I ever felt like my weight was easy to control: once with pneumonia, and once with altitude sickness. In both cases, my weight dropped quickly without any effort. At every other time in my life, my weight has been a struggle.

About five years ago, I got REALLY aggressive with trying to control my weight. My wife was pregnant with our first child, and my weight was as high as it’s ever been (close to 300 pounds). It was time to change.

My doctor wouldn’t even discuss other health issues with me as long as my weight was in the “obese” range. The mentality seems to be that fat people can’t have any non-weight-related health issues. Everything that could possibly be wrong would be fixed instantly with a BMI of 24.9.

I tried to lose weight on my own, measuring and recording every bite. Then came Weight Watchers, My Fitness Pal, and FitBit. Along the way there was near-starvation, regular exercise, low-carb, gluten-free, dairy-free, and vegetarian. I saw several doctors and a dietitian. My weight went down, my weight went up; nothing seemed to work for any length of time. Despite my best efforts, my average weight loss was around four ounces a week.

Weight loss can be a brutal struggle for anyone, and even more so when clinically depressed. Feelings of failure, guilt, hopelessness, frustration, and despair come naturally to both the dieting and the depressed.

After a while, I was essentially starving myself. At my lowest point, my intake was around 700 calories a day. Exhaustion and hunger were my constant companions, but the weight just kept coming. My weight became something of an obsession, and all my precious free time was dedicated to researching causes and solutions.

It turns out, gaining weight on an extremely low-calorie diet is actually pretty common. The solution seems to be “re-training” the body to burn calories instead of trying to cling to every morsel of food. It would mean gaining some weight in the short term, but starting to eat a reasonable amount of food again and losing weight over time.

So, I gave it a shot. Vowing to avoid the scale for a few weeks, I re-committed myself to eating a healthy, well-rounded diet in line with my basal metabolic rate. My pants got a little tighter, then they started getting a little looser again. I felt pretty good; this seemed to be working.

Well, it wasn’t. Combined with the weight gain from a couple weeks before the re-training, I was up thirteen pounds. At four ounces a week, that’s an entire year of torture negated in about six weeks.

I completely lost my mind. This could be the day. I seriously started considering the best way to die. A huge breakfast, a couple cigarettes, and a jump into the icy river ought to do it. I did not want to live anymore.

Pain. I hated myself so much it physically hurt. My stomach clenched; my chest was tight. I tried to cry, but I couldn’t, so I screamed instead. My daughter was terrified, so I hid in the basement.

After a while, my wife came down to check on me. She tries so hard to be supportive, but she just doesn’t know what to do with me anymore. She’s currently helping me navigate our insurance so I can try to get on medication again, but that’s its own form of torture.

Something set me off. In hindsight, I don’t know what it was, but I’m sure it was irrelevant. For whatever reason, it seemed like a good time to pick a fight with my wife. I remember screaming “Every day I wake up and pray to god that this could be the day that I just die!” and storming out of the house.

Now I hated myself even more. On top of everything else, I had just screamed at the one person trying to help me. Thoughts of dying started running through my head. Not suicide, but just dying. I ended up buying a cup of coffee and my first pack of cigarettes in a decade. I went to the park and stood on the dock, looking out at the frozen lake, sipping my coffee and smoking.

The ice was pretty thin. Probably wouldn’t hold my weight. I wonder if I could pull myself out? Probably not. Probably wouldn’t matter after a minute or two. God, I missed cigarettes. Nobody else out here; probably wouldn’t get any help. Maybe. Maybe not. I don’t know.

Then came thoughts of my children. They love me, most of the time. They’re still young enough, they don’t really know what that means, but they love me with complete abandon. I have to do what’s right for them, even if that means not being around anymore.

Then came thoughts of my wife. She loves me, most of the time. She’s intelligent, she knows what that means, and she loves me anyway. She’s an amazing mother, and I have to do whatever I can to support her, even if that means not being around anymore.

I know what I think, but I can’t make that decision for them.

[Note: I started writing this piece right after the new year. Since that time, I started seeing a new psychiatrist, got back on medication, leveled out a little, had to stop seeing the new psychiatrist thanks to an insurance screw-up, and am now looking for another new therapist. I spent (and continue to spend) a lot of time processing the feelings and emotions of this period, and felt it was important to finish telling the story. This was most definitely a low point for me, possibly my lowest, and I am glad to say I have stepped back from the edge at this point.]

My Mask Is Stuck

Choosing a therapist is tricky. There are so many considerations: gender, age, style, location, insurance network, availability, and would you like drugs with that? Then, you need to have a session or two before you can even begin to decide whether or not you made the right choice. If so, great, but if not, then it’s back to square one.

But, there’s another side to therapy: the person receiving the treatment. More specifically, I mean me.

Therapy depends as much on the person receiving the treatment as it does on the one giving it. A patient’s ability to share information honestly will have a huge impact on the results. Yes, an observant therapist can read between the lines and ask the right questions, but ultimately, what the patient shares is up to that patient.

I started seeing a new therapist a few weeks ago, my third since starting therapy about four years ago. So far, it’s very promising. She managed to cut through a lot of garbage pretty quickly and give me some completely new insights. It is my sincere hope that I can be honest and share the right information with her.

In the past, that hasn’t always happened, and it doesn’t come naturally to me. For one thing, there’s a lot more that happens in a week than can possibly be shared in 45 minutes. Most of it is irrelevant (I made a sandwich. I put mustard on it. The bread was a little dry. I added bread to the grocery list.) But what about the rest? It can be very difficult to choose what to share, which stories are most important, and what relates to the topic we last discussed.

Even more limiting, there’s my own personal editing. After years of carefully selecting what I tell (and don’t tell) my friends and family, of pretending to be “fine, just tired,” I’m not always sure who or what I am. Am I feeling pretty good, or just less terrible? I’m not as well-adjusted and content as I want everyone to believe, but am I really as screwed up as I think I am? How much of this is me and how much is the mask I wear and how much is there even a separation?

Then of course there’s the big question: if I actually tell my therapist everything, am I going to be tossed in the loony bin forever? Or, perhaps even worse, will she come to the conclusion that there’s nothing wrong with me at all?

I want my therapist to think well of me. I care what this complete stranger getting paid to listen me thinks about me personally and professionally, so I try to put a positive spin on everything. I’m so desperate for adult conversation that I want to keep it fun and light. I want my individual struggles to be meaningful, so I try to choose my deepest thoughts to share. I want to get better, so I try to include what I think is important, but I also want to edit out my most embarrassing thoughts.

It would be so much easier if I could just be myself all the time, but I can’t. I’ve already alienated so many important people in my life that I can’t stand the thought of losing any more. So, I wear my happy mask.

Generally, this is harmless, at least to others: small talk with the cashier or a friendly chat with a neighbor. These times are enjoyable and a chance to give normality a try. When a stranger asks, “How are you today?” they rarely are looking for an in-depth answer, so it’s an opportunity to not give one.

With friends and family, it can be more insidious. It starts innocently enough: glossing over a few details, not mentioning a new medication. But, the more you don’t talk about it, the easier it becomes to not talk about it. After a while, you never talk about it, except in therapy.

But what happens when these habits creep into therapy sessions? That’s what happened to me. I grew so accustomed to not talking about it that I started not talking about it in therapy. Oh, I still talked about my depression, but I polished it first. At that point, therapy—arguably the most important tool for treating depression—became essentially useless to me.

Now I have a chance to start fresh again, and I hope I don’t blow it.