Broadening My Treatment

You can’t say I’m not trying to get better. Therapy, medication, cranio-sacral massage, yoga, meditation, group, blogging… E has told me, “If how you felt were directly related to effort, you’d be feeling great. Unfortunately, I know it isn’t that straightforward.”

(But at least I get an “A” for effort. I was always very motivated to get good grades, after all.)

Lately I’ve added another layer to my treatment: nutrition.

I don’t think I’ve written about it very much, but I first started working some with a nutritionist in December of 2017, on the recommendation of Tabitha, my psychiatric nurse. Linda, the nutritionist, has a very deep knowledge of chemistry and the gut-brain connection. When we first started working together, she conducted a lengthy intake and then had me start by cutting carbs, especially bread, white rice, and pasta. She told me how to make chicken bone broth and encouraged me to eat whole foods and cook a lot at home. I like that way of eating anyway and didn’t find it hard to make a few changes to accommodate it. I lost maybe 10 pounds over a couple of months.

But then I started to shift away from eating like that. Partly it was because I didn’t feel well when I started weaning off the Effexor, and with less energy, it was harder to feel like cooking. Also, we went on a Mediterranean vacation in the fall, and I decided not to deny myself and went back to eating bread. Then, as you know, things got a lot worse this winter after I took a bigger drop in my Effexor dose. Tortilla chips became a quick and easy way to satisfy my hunger without any food preparation.

Those 10 pounds cam back, plus a couple more. And whatever healthy benefit I might have had from my eating changes had entirely evaporated. I also hadn’t talked to Linda for about seven months.

So, time to start over again. This time, I agreed to do a blood test, for possible food sensitivities, and a stool test (gross), to look at my microbiome. (Naturally, these aren’t covered by insurance, so there’s another $500 flying out the window.)

You’ve probably read or heard about the growing body of research that connects the state of the microbiome in our gut–an enormous collection of different types of bacteria, that together can weigh something like four pounds–to our mental health. The idea is that having the right balance of “good” bacteria relative to “bad” bacteria, and not having too much yeast, sets you up for a greater mental and emotional balance. In contrast, an imbalance causes a chronic inflammation that can lead to depression, as well as metabolic problems like diabetes.

Linda wanted us to look at my gut bacteria, see if anything needs balancing, and give me a diet that would help re-establish a healthy combination of bacteria. But she said that it’s also possible that I have some food intolerance(s) I don’t know about. If we don’t also attend to those, then I could be wasting the effort to change my microbiome, because some other things might also be leading to inflammation. I’ve read mixed opinions about whether food insensitivity tests are very accurate or not, but I decided that if I was going to try Linda’s approach, I’d go with it all the way.

I appreciated that she said, “A food intolerance isn’t necessarily permanent. It tends to be the result of not being well. Once you are better, you can often start eating the food again. There is nothing inherently bad about gluten or many other things people have intolerance to, but sometimes your body isn’t in a state where it can handle that food.” Since I’ve never been a person to bar foods* from my diet, this stance seemed like something I could live with.

(*Note: I have an allergy to peanuts and tree nuts. An intolerance is about an inability to digest effectively. An allergy causes rashes, trouble breathing, and anaphalactic shock. I have always had to avoid nuts, and this isn’t going to change. Also, nuts are a big part of the ketogenic diet, which makes finding good recipes a little more challenging.)

So, we get on the phone together when my results comes back. I don’t have a yeast problem, that’s good. My microbiome isn’t well balanced, but isn’t terrible either. There’s definitely some indication of underlying inflammation, however. Linda prescribes a “basically ketogenic-style” diet with some modifications to accommodate the food intolerances I apparently have. It’s an odd list of things I would never have imagined being a problem for me: chicken, turkey, pork (but not bacon?!?), salmon, snapper, egg yolks, gluten, corn, vanilla, garlic, ginger, zucchini (really?!?) along with some particular food additives and coloring.

I’m skeptical when I hear this, but I’m willing to try. So for the past three weeks, I’ve been eating pretty much a vegetable and egg white omelette for breakfast, sometimes with a slice of bacon, a big salad for lunch, and soup or beef something or a shrimp stir fry for dinner. A friend gave me a keto cookbook, and I’ve tried a few recipes, but I tend to fall back on the same old familiar and easy things because I don’t want to make every meal take a really long time to prepare.

Oh, and I also gave up Diet Coke at the same time. I have been addicted to that stuff for maybe 20 years. I think this is at least the fourth time I’ve given it up.

Here’s what it’s like for me, three weeks into eating this way:

  • I’m down about five pounds. I didn’t lose anything the first two weeks, which was aggravating. But this week, I’ve seen the scale move some.
  • I really like egg white omelettes, to my surprise.
  • I’m good at making delicious salads. I don’t feel deprived eating them, though I sometimes do get hungry before dinner.
  • I haven’t had any alcohol. It’s been tempting, especially on Friday evenings, when I usually celebrate the arrival of the weekend by drinking wine with my husband, but it hasn’t been that hard to say, “no, for now I won’t.”
  • I have not been longing for Diet Coke, to my surprise.
  • I drink only black tea and water.  A LOT of water, often sparkling water (good use of the Soda Stream).
  • This is easier overall than I would have imagined.
  • I’ve cheated a little on the no sugar part. Two nights I took a little dark chocolate, and not the totally unsweetened kind.
  • I feel pretty good, most days.
  • I went out to eat only once, Thursday night, with a friend I hadn’t seen in ages. I think there was some gluten and maybe some garlic in the food I ordered (a beef brisket), and the next day, I had a headache all day and no energy. Today, the day after that, both the headache and lethargy are gone. Coincidence? I can’t say.

I have a lot of questions for my next appointment with Linda, in a week. Am I supposed to be as low carb as some of the keto diets recommend? Because I haven’t gone that low. I’m not entirely sure what “basically ketogenic-style” really means, so I realize now that I may have to make this stricter than I’ve been. For example, I’ve allowed myself an occasional banana, and one night I had half a cup of brown rice, way too many carbs for a true ketogenic dieter.

I also have a lot of questions for myself. Am I just feeling better these days because I bumped up my Wellbutrin, and now I’m attributing it to the food? Am I just wishing for one miracle cure after another? I was so hopeful when I first went on meds, or when I started meditating, or when I started working with my body in therapy. This is what will help me shake off the persistent depression, I thought. Maybe I’m just doing the same thing now with food, thinking there is some magical cure waiting for me.

On the other hand, say it is actually helpful. Will I be able to keep it up? I will  want to drink wine with friends, or have a cold beer in the middle of summer, I know it. I will not be able to give up all sugary foods. I have never stayed off the Diet Coke for more than maybe six months; what will make this different?

Then I take a breath and let those thoughts go. Who knows what will happen. For now, I’m content with eating this way. Maybe it’s helping, maybe it’s not, but I’m fine and willing to keep it up for a while longer.

CREDIT: Photo by Anna Pelzer on Unsplash


    • Thank you, dear TS. I’m not sure I buy the keto diet stuff, either. I think it’s helped that my nutritionist seems to know a ton of chemistry. Unfortunately, I don’t really know enough to do more than nod and be impressed when she’s explaining things. But I don’t think I’m doing any harm by trying it (I hope). I will check out the website tonight. xxoo

      Liked by 1 person

  1. I can so relate to hoping that each new thing I try will be what finally fixes me, and being rather disappointed when I only get a partial or temporary improvement. I find that things do work, but the overall effect of each one is relatively small and the pace of improvement way slower than I would like – but better than nothing.

    Liked by 1 person

    • I know, there’s probably no magic bullet. It seems like it’s really a combination of things: eating well (whether it’s keto or something else I haven’t yet done), getting enough sleep (not always something I can control), getting exercise (if I have enough energy), keeping the stress down (mostly I’m doing that, unless my son has a crisis), staying socially connected (goes up and down), practicing mindfulness (goes up and down) and taking the right level of the right medication (which is a complete guessing game). When I lay it out that way, so many pieces and only a few that I truly understand and have full control over, no wonder stability and health can feel elusive.

      Still, I’m earning that A for effort! 🙂

      Liked by 3 people

  2. I applaud your effort. I’ve found that my diet is the thing I have most difficulty getting under control. While I don’t think I’d ever go completely keto or cut out the junk food altogether, I know that the moderation and planning and consistency helps. I’m glad that it hasn’t been such a difficult experience and you’re seeing some gains. Hope it continues on as such.

    Liked by 1 person

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