Medication question

[Uglyducklin]

Hi guys I'm sorry to post again but this is just a couple of medication questions. My depression and PTSD have got a lot worse and I'm really losing it. I'm just so fat and I feel like I'm trapped in my body and having violent thoughts in my head ( towards myself not others). When I saw the doctor on Friday they wanted me to try Quetiapine to manage my depression and anxiety. I'm scared as my weight always does strange things and I'm a fat freak that I will gain even more weight. I can't tolerate other antidepressants so they are ruled out. I tolerate benzodiazepines better but they are reluctant to prescribe them. I just wondered if it was common for professionals to be so reluctant? Apologies if I'm ignorant or for not making sense.

[talaiporia]

Hi Jess. I think it's worth trying the medications that they're willing to prescribe, because it's not common for medication to cause significant weight gain (and in any case, a lot of people think this might be connected to increased eating, rather than the medication effects itself).

[Epicene]

It is fairly common for professionals to be reluctant about prescribing benzodiazepines, yes. They have a high potential for addiction, which means that even if people don't misuse them (though some do), your brain will become tolerant to its effects and it will not continue being helpful. Essentially, they're trying to offer you something which will work better in the longer term.

I take quetiapine and find it very helpful, and it does have antidepressant properties which sounds helpful if you can't tolerate antidepressants. However, it sounds like it would be most helpful for you to talk to your doctor and ask them how they think it would benefit you and whether other options are available. I will be honest and say that I gained a lot of weight, BUT I am also emotionally better able to tolerate this because my mental health overall is so much better on it than off it.

[sherlock holmes]

I appreciate that it's difficult to think about taking medications due to the possible weight gain issues. I have gained weight before on medication, but I'm fairly sure it wasn't really the medication itself that caused the weight gain, but because I was so depressed and in hospital I ate to make myself feel better, and there was no opportunity to exercise.

Once I got out of hospital, and was feeling better, I was able to lose weight even though I was on the same medication.

If you try the quetiapine you should be able to minimise weight gain by sticking to a healthy balanced diet with reasonable amounts of exercise. All doctors are reluctant to prescribe benzos as they are highly addictive and only supposed to be used very short term (a few days to a few weeks). If they prescribed them for you, it would only be a few days worth after which you'd need to find a new medication to try, so it's worth going for the quetiapine.

[Uglyducklin]

Thanks all of you I'm just so terrified and one of my biggest issues is around my weight going up and doing unpredictable things. It causes so much shame as I'm supposed to be anorexic and this has prevented me from receiving is treatment as people assume I'm exaggerating or want to say unwell. My current team have a better understanding but I'm still ashamed and embarrassed. I'm having some thoughts but it just came out so clumsy when I tried to explain it to the doctor . Sorry I'm rambling x

[Epicene]

I can totally relate to that concern; I first entered adult services for anorexia and although Eating Disorder remains one of my diagnoses, I am actually pretty overweight as a result of medication. I also feel a lot of shame, but actually my team are still very aware of my eating issues and body image. It sounds like it might be similar for you as you have an understanding team. However, just because some people gain weight it doesn't mean that you will. There is no real harm in trying and seeing what happens, and how you feel.

[tiptoes]

I have a history of eating disorders and am on quetiapine I understand your fears about weight gain.

I've been on quetiapine twice and only gained a very small amount of weight which I subsequently lost without much effort and at one point I was taking alongside a second med that was notorious for weight gain. It is also the only thing that comes close to stabilising my mood.

[Uglyducklin]

Thanks everyone. I feel so low and fat and dirty and trapped. I can feel the disapproval of the professionals already. I just feel lost and broken my body has been messed with so much both as a result of medical reasons and abuse. I'm so scared.

[Pi.R^2]

Are you not able to take any anti-depressants at all? That's quite odd!

Quetiapine is a good medication though, so definitely worth trying.

I'm supposed to be anorexic
This stuck out to me for some reason. Who says you're 'supposed' to? Humans are categorically not 'supposed' to be anorexic; that is why the body freaks out so much when starved! Sorry if that's a bit of a tangent here, I was just wondering.

In what way do you feel the professionals are disapproving?

[Uglyducklin]

Hi Jenna no I'm not they made me really sick and put me to bed literally :( I'm emetaphobic so it's not an option. Sorry I'm scared they will disapprove of the fact I couldn't take them. I'm also scared of being judged for struggling and having suicidal thoughts. Professionals say that I'm articulate but what I say doesn't touch how I'm feeling. Sorry I didn't mean I'm meant to be anorexic as if it is a state that myself or others are meant to be in just that anorexia is my diagnosis so I meant to be well really thin. I'm not I'm fat and built like brick **** house from muscles and years of riding horses. I'm sorry I just feel so overwhelmed with hatred and being so low.

[Pi.R^2]

But have you tried every different anti-depressant in every class (SSRIs, tetracyclics etc), because they're all very different so if one made you sick, it doesn't mean the others will.

When a professional diagnoses someone with anorexia it means that person is too thin and needs to gain weight so being anorexic actually means you are meant to gain weight! So if you were to gain weight you would be living up to the expectations of that diagnosis. I know it's a pedantic point, but it's a different way of looking at it.

[sherlock holmes]

I personally believe that anorexia is rooted in the mind, and that actually body weight is one of many symptoms that may or not be present.

I know in the diagnostic criteria they still go by weight and BMI but I think it's ridiculous. Someone can be very rooted in anorexic behaviours and thinking and be normal weight or overweight.

I'm wondering though if being anorexic is part of your identity? You were concerned that if you're supposed to be anorexic then that means you need to be underweight. Is this because it's quite a visible thing and you want or need other people to be able to recognise you're ill in that way?

I guess at the end of the day your mental health team, family etc will know you have an eating disorder regardless of your physical appearance or weight and they will still be able to help you.

[Uglyducklin]

I know what you mean and I do understand the diagnosis. It is part of my identity but not in an attention seeking way. I also have trouble I believe I don't deserve help and when I'm at a lower weight I feel I can allow myself to accept help? I'm just so ashamed of my body as it is now. I'm trying hard to talk and use the support I'm being offered and I'm under pressure to get it right this is my last chance. Sorry to ramble x

[talaiporia]

I think it's very ingrained, especially in terms of the trauma you suffered.
I think that your image of yourself is inconsistent with how others see you.

[Uglyducklin]

I don't know how I change these thoughts or how I untangle this mess . I feel I'm screwing everything up but if I gain anymore weight I will be buying new clothes at this rate and financially I can't afford that not to mention the self loathing getting worse. I don't know the thoughts are so violent. I'm sorry I'm making no sense.

[KelcieLe]

"Just finished reading the discussion and I noticed how much negative thoughts you have in your mind Uglyducklin. Believe in yourself and all the problems will subside eventually.

P.S. Don't blame your weight for everything.

[Uglyducklin]

Thanks Kelciele so sick of the fat and the sense of failure. The fear and sadness that sits in my chest. I lost it in my gps on Friday I'm usually so numb and so cut off like I recognise my emotions but they float somewhere I can't touch or really feel. I'm ashamed to say I cried for the whole appointment. I hate myself even more for my inaction. Sorry I'm rambling.

[talaiporia]

Fat is a feeling, for you, rather than a physical state. You aren't being fat, you are feeling fat. What happened at your GPs?

[Uglyducklin]

Hi Sophia nothing really she just listened which helped in itself. There is no real way forward yet. I can't take it the thoughts and violence in. My head I just need to destroy my fat body. They assume that because my weight isn't dropping that I cope but it's not true. I'm not I wake up and wish I was dead and my life feels like ground hog day. I'm scared to admit this as there is so much going on and I don't want to add to things for my mum. I just feel in bits. I'm sorry I don't know.

[Uglyducklin]

I'm sorry to bump this. Im just in pieces I've felt so desperate and ashamed I went to see a nutritionist about my weight and she said there was nothing she could do and it was unethical because of my eating disorder. I don't know what to do I keep bargaining and buying time but I don't know how much longer I can keep this up? I'm such a fat failure. Im scared if I say how low I am people won't believe me. Sorry I'm waffling. I don't deserve to post.

[tiptoes]

It's been a few days since you posted this, how are you getting on? Sorry no one has replied earlier.

[Miyobi]

I hope you're doing okay Ducklin, has there been any progression on the medication front? If not I believe it would be beneficial to have another appointment with your GP. I have not tried the medication he is willing to prescribe, so I have no personal knowledge of it but I think if you can tolerate it then maybe it's worth giving it a go.

Try not to let your weight be the reason you don't take these meds, there are various side effects to medication but in the end isn't it better to be able to cope with how you feel you look but have the energy and positive outlook to change it?

<3

[Uglyducklin]

Thanks both of you. The doctor is supporting me to investigate possible cause of the weight gain as the overall consensus is that it should not be happening. I feel terrified and like a fat freak. I feel so vulnerable and I'm scared if I gain more weight I won't have the strength to bargain? I'm sorry I'm making no sense.

[Miyobi]

Thankfully the doctor is supporting you and helping you find the cause. It's okay to say how you feel, even if it makes no sense to yourself I get the general gist of what you mean but I don't want to put words in your mouth.

There's no need to say sorry, you're in a very scary place right now, don't apologise for your feelings, you have every right to feel how you do, and you will gain the strength to over come it.

<3