Signed Up For Aquafitness

I’m not a “sporty” person, quite the opposite: about 50 pounds overweight – not morbidly obese (anymore), but in the area where my weight will most likely lead to health problems down the road. The last big check-up was five years ago when I applied for the clinical study. Back then I was physically healthy, but I am aware that it doesn’t take much to change that.

Since November 2014, I lost 8 kg/ 18 lbs. Not through dieting, because going on a diet flips some kind of switch in my brain which causes me to think about nothing but food all day long. Instead, I practice moderation, and thanks to the escitalopram, I am a little more active than I used to be. It’s a slow process, just a pound lost per month on average, but it’s trending towards the right direction.

My all-time maximum weight I had in 2003, when I was 17 kg / 37 lbs heavier than today. It was mostly due to the untreated hypothyroidism that I gained that much, but if I thought taking the appropriate medication would melt the fat away, I was mistaken. Even during my most active times, I would shed the pounds very slowly only.

A few weeks ago, I decided to sign up for an aquafit course – one especially for overweight and/or unfit people. Even though I loved the Tae Bo class, it was so physically demanding that I don’t think I’d be able to do it anymore, and even at the best of times it made me very self-conscious about my body, because the rest of the people were really toned… That definitely shouldn’t be a problem anymore.

Even though I talked a lot about weight, losing it is not my main motivation: I want to be healthy. At almost 36 years old, it is for the first time ever that I feel like my body might fail me if I do not take care of it. I don’t want to get rid of the physical symptoms of depression just to suffer from the side-effects of ill health. Thanks to Facebook I know that somebody I went to school with suffered two heart attacks last year, and even though his lifestyle was a lot unhealthier than mine, I don’t want to be next in line.

Apart from the physical benefits, I also hope for a positive effect on my mental health. I do not believe that an active lifestyle can prevent depression – it was from my most active period ever that I crashed into one of the bleakest phases of my life, and there are too many amateur and professional athletes suffering from it – but that it can help prevent a rebound. Especially since the biggest anxiety factor (being the only fat person among a group of slim people) is being eliminated.

Class starts the first week of April; just an hour once a week. Not a massive programme, but it’s one hour less of sitting on my butt.

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Looking Back

The first week is finally over. Those were difficult days, but compared to my last attempts (yes, the plural is correct) at studying over the past few years, I have been doing better. I have not skipped classes because I was afraid, I have gone to lectures where attendance was not mandatory, and I have managed this week on my own, without talking to my therapist about it. I’m going to see him next week for a regular session (the intervals between them are three weeks now), but I don’t want to become someone who depends on the therapist for every decision – my therapy goal is to become more independent… I’d lie if I claimed I didn’t think about what I’d tell him, but I’m glad things didn’t become so bad that I had to contact him.

Something I learned from this week is how relative success really is. For the majority of my fellow freshmen, this simply is another step in their education. They go to university, sit their exams and eventually graduate, and to them it means a lot of hard work and adapting to a new way of life and new working methods. To most of them, the biggest challenge will be an intellectual one: a certain class or project they’re going to find difficult. Other than that, they don’t struggle with being a student.
If (when) I graduate, however, the real triumph will not be in reaching a certain level of education, it will be the fact that I actually beat my anxiety and stayed in university long enough to reach graduation day.

Prior to Monday, I hadn’t attended a class in a year and a half… Exactly two years ago, in October 2009, I started my last attempt at finishing my old degree in prehistoric archaeology and got assigned a rather demanding project – holding a lecture called “A Diachronic Comparison Of Small Houses On Mineral Soil”, presenting settlement patterns and building structures throughout prehistoric times with a special focus on how those patterns might reflect socio-economic structures. It was a demanding project, both intellectually and in terms of energy invested, cost me most of the Christmas holidays and saw me working 16 hours a day on it towards the end.
I hadn’t been depression free since the age of 12, but around Christmas 2009 one of the better phases – which had allowed me going back to university in the first place – came to an end and I started slipping into depression rapidly. I still managed my presentation at the end of January (which I got the best grade for), but when I was told I had to hand in a written version of it before receiving my credits, it was too much. Every day I told myself I’d start typing it, but there was so little energy in me left and the depression got worse so quickly – I just could not do it. February 2010 was the last time I attended a class. I was depleted, burned out, empty.
It had been the last audible cough of a dying beast, but the deadly wound had been inflicted years before. In spring 2002, my aunt died from leukaemia after a short ailment and an even shorter but nonetheless dramatic decline, leaving behind two children aged 10 and 16. It was a rather sad time for the whole family, naturally, and this sadness somehow morphed into depression as the months went by, because I was also hypothyroid back then. I had no energy for studying and my job caused me social anxiety, all augmented by my malfunctioning thyroid. Even as the thyroid medication was well-adjusted, I never managed going back to university for more than a couple of weeks and a few hours per week at a time despite the best intentions.
Despite some anxiety and some tears this week, it has already been a success, because I haven’t attended so many classes in almost ten years.

Physical Side-Effects of Depression

In the therapy sessions, we usually concentrate on the emotional and behavioural aspects of depression, since this is the area where we can work on change. The physical side-effects of depression, which used to even eclipse the emotional pain quite often, will go away too when the depression vanishes.
For a long time, however, I wasn’t aware that these two aspects – mental/emotional well-being and physical pain – were so closely related. I blamed my thyroid and the Hashimoto’s disease for feeling fatigued and for the memory problems I was experiencing, even if the lab results showed that my medication was perfectly adjusted. For all the other complaints, I saw three doctors in total who all diagnosed me with a variety of conditions which usually matched the most recent physical manifestations, but always ignored the full picture. Nobody suspected depression before I started having panic attacks, and even though I personally suspected a mental health problem earlier, all the symptom lists for depression I checked mentioned weight loss and sleeplessness, while I was (am) clearly overweight and slept much more than the average person: I always dismissed the self-diagnosis again on these grounds. Only at the hospital I learned that in chronic depression, weight gain and hypersomnia can occur too, as well as many other symptoms.

Today, I wanted to take inventory of the physical side-effects which one would not necessarily relate to depression and which I experienced over the course of the years.

Permanent or frequent complaints:

• Muscle pain in the limbs: I’m not entirely sure when this started, but by spring 2009, I very often had severe pains in the muscles and nerves of my arms and legs. Sometimes it would feel like a “tennis arm”, sometimes like the kind of muscle cramps you get when over-exercising. I combatted the pain with ibuprofen, paracetamol or aspirin, which brought relief for a few hours.
  My second general physician diagnosed me with multiple sclerosis because of it.
  When I was put on an antidepressant in summer 2011, the pain went away after only four days. It returned after I discontinued citalopram; my therapist was the first person who told me that it was stress-related and caused by an inability to relax. Ever since, I lie down and try to consciously relax all of my body whenever I feel the pain. With the progress in therapy, the days when my limbs hurt become fewer and fewer.

• Inflammation of the eyeballs: This symptom first occurred in spring 2009 too, when my eyes became red, dry and sensitive to light. In the beginning, the intensity would be sometimes less, sometimes worse, but last year, it was permanent.
  My first general practitioner diagnosed it as hay fever – never mind that weather or seasonal changes had no influence on it at all. My sister and niece both have hay fever, so I am rather familiar with its symptoms, and I was very certain that the inflammation of my eyes was not allergy-related. The next doctor saw it as a symptom of MS, together with the muscle pain.
  As with the muscle pain, the inflammation vanished when I started to take citalopram and returned afterwards. Recently, the inflammation had come back, but as I try to counteract the stress, it gets a little better every day.

• Headaches: I used to have headaches very frequently; up to four or five times a week during the most intense periods. The most common form was a consistent, one-sided pain directly behind the eye, as if someone was relentlessly poking me into the eyeball from behind. In 70% of all cases, the left side was concerned. Rarely (once every couple of years), I will also have a case of migraines, when I can’t tolerate light and sound and have to lie down in a dark, quiet room with a wet cloth on my face.
  The headaches started very early, during my teenage years already, and currently occur on about two or three days per month.

• Digestive problems: Another group of symptoms that I had since adolescence – stomach aches / cramps, diarrhoea, a couple of episodes when I couldn’t eat anything but apples and plain rice, one episode of histamine intolerance that vanished after two weeks. Now I experience those problems about 2 – 3 times per month, but during the worst of it, that would be 4 – 5 times per week, for months on end.

• Backaches: For about twenty years, I used to have “typical” complaints like tense muscles around the shoulder and back of my neck, but in recent years, there have also been intense phases of lower back pain. The latter first occured early in 2008, about two weeks after I had started a new job that pushed me to the limit in regards to social anxiety. I didn’t make the connection back then, but in retrospect, it seems very clear that the job and the new type of backaches were related.

Infrequent or singular complaints:

• Vertigo: One morning in 2007, I woke up with such a heavy case of vertigo that I literally couldn’t get out of bed. Lifting my head alone brought such waves of nausea that I had to vomit. It took three days until I could leave the house and see a doctor for it, who was clueless and referred me to a specialist. I had my ears and head checked, especially the sense of equilibrium, but everything was fine. They sent me home, “If it happens again, come back.” So far, there has been no second episode of unexplainable vertigo.

• Chest cramps: This is a strange one. The first experience was the night after I celebrated my 18^th birthday with a party; I woke up in the wee hours of the morning with a feeling as if my stomach was starting to petrify. Since then, I have spells when it happens a couple of days in a row, just to stop again just as suddenly for about half a year.
  Very often, the cramps come at night and I wake up from the pain, but sometimes they can also occur during the day: the muscles around my stomach become hard and cramp; a very intense ache that I feel under the sternum and in the middle of my back. Sometimes, I can sense the muscles there going tense a few hours before the actual cramping, but usually it happens within minutes only.
  Heat helps as it relaxes the muscles. At my most desperate, I had hot water bottles on both chest and back and was drinking hot water to relax the muscles from inside as well, because the pain can get so intense that I can hardly stand upright anymore and feel like opening my chest with a knife just so I can reach under the sternum and massage the muscle.
  Some people have suggested that it might be heartburn, but it feels completely different and is not inside the oesophagus or stomach, but very clearly outside of it.
  It appears that the chest cramps have become less intense and more infrequent, but is too early for making a definite call still: I had episodes of up to nine months without them and experienced some chest cramps this spring, so it will need at the very least a year without them before I consider them gone.