La Vie en Remeron, Part 1

meowser-48.jpg posted by meowser

(TRIGGER WARNING is in effect for this post for those who are triggered by stories about suicide or suicidal impulses.)

Alabama doesn’t want my kind.

As no doubt you know already if you’ve been reading other fatblogs, the state of Alabama has decided that they’re giving fatasses with BMIs greater than 35, along with people with high cholesterol, high blood pressure, and high blood sugar of all weights, until the year 2010 to get their numbers into what they consider an “acceptable range” or be charged $25 a month for their insurance. They’re already charging tobacco users that surcharge. (I have to assume, though, that all these charges apply only to rank-and-file employees and not to top-ranked government officials; I can’t see Bob Riley, for example, getting hit by a random nicotine check to see if he enjoyed a Cohiba the night before.)

The usual blah-blah about “higher health care costs for teh fatties” is being used as justification for this beeyess. But I’ve four (4) predictions:

1) Doing this will save Alabama’s government not one red cent. Ever heard of higher health care costs because of crash dieting, eating disorders, and emotional stressors related to discrimination, guys? And making people go on multiple medications for blood pressure, cholesterol, etc., not to mention many of those people having to go on additional medications and miss work time because of side effects, isn’t exactly inexpensive either. And medications require doctor visits and lab checks, y’know. Early and often. You can’t buy Lipitor and Lopressor and Glucophage over the counter, capisce?

2) They won’t give a damn about that and will just keep doing it anyway, because it’s worth the extra tax dollars to punish people for having any external stigmata of allowing themselves pleasure and relaxation, or even just having a life. Not to mention that it’s a great way to sneak racism, ablism, classism, and agism through the back door. Last acceptable prejudice, my economy-sized turkeywattle — it’s code.

3) (and perhaps most germanely) Every other fucking state in the union will soon follow suit.

4) And good luck trying to find a private employer that doesn’t, either. They will have to need your skill set reaaaaallly badly in order not to subject you to Random Bacon-Spotting Whiz In This Cup Tests. (Evidently Alabama thinks any interchangeable simian with a college degree will do for most of its positions, even one that had only half a can of dry tuna and two brownish apple slices for lunch.)

And that’s where I come in. Or don’t. You see, not only do my lipid panels show an LDL screaming for multiple statins, in spite of the fact that studies show that those drugs do approximately bupkis for preventing heart disease in women, but I’ve lately discovered through costly trial-and-error that the only way I can keep my BMI under the magic number of 35 is not to take antidepressants.

Know what happens when I don’t take antidepressants? For the first couple of couple of months I’m emotionally fine, for the most part. My weight starts dropping. I start thinking I can do without the damn pills that make me sleep like a hibernating bear and make me gain, gain, gain, gain, gain, without my having to take so much as an extra mouthful of anything — in fact, even eating somewhat less than I did pre-medication. I keep reading all these stories that make BMI 35 the OMG Instant Fatty Death Explosion Cutoff — countries whose health plans require you have your BMI under the 35 mark to get health care no matter what it takes, not to private insurers that won’t pay doctors that don’t recommend WLS to anyone with BMI > 35 with “comorbidities” (including depression! like it isn’t a wonder that any fat person could go through life without a case of the black bile the way we get treated!) — and I freak.

Mandatory weight loss surgery. That’s all you have to say to me, and I want to stay far, far away from the Evil Zombie Psychoactive Drugs of Doom.

But over time, even with tens of thousands of dollars’ worth of therapy and fistfuls of vitamins and amino acids and light boxes and exercises and affirmations and all those other good things that probably do a world of good for people whose depression doesn’t get as bad as mine does, I start to slide. And that bottom is low. Very low. Suicidally low.

Hey, at least Alabama wouldn’t have to pay for my health coverage if I bit it, right? (Yeah, I can actually make bad jokes about it now. Believe it or not, that’s progress.)

Here’s the pattern. I start having suicidal feelings first once a month. Then multiple times a month. Then multiple times a week. Because I’m aspie, I don’t have a neurotypical pattern of depression, more like a constant low-volume background hum of “I suck I suck I suck” that eventually turns, under times of meltdown, into a full-throated roar. A roar that could kill me. Ninety-five percent of the time I don’t feel like killing myself. But that five percent is what’s really fucking dangerous. And it would probably have taken my life, had I not gotten my still-fat-but-just-barely-under-BMI-35 ass to the doctor and gotten myself back on the meds.

Specifically, he put me on Remeron. Here’s what the Crazy Meds site has to say about Remeron:

At any dosage it will make you crave doughnuts. Seriously. You will want to invest in Krispy Kreme stock (or maybe something along similar lines that isn’t tanking); as Remeron’s antagonism of the H1 receptor and stimulation of your serotonin production gives you the munchies for carbohydrates and sugars like you were 16 and smoking the best pot ever in the parking lot of a strip mall with a 24-hour doughnut shop beckoning you with glazed and jelly-filled ecstasy. People dipping spoons into a bag of sugar and eating it as is – not unheard of when on Remeron. This stuff is nothing more than legal marijuana, and if I knew crap about biochemistry I could probably prove that crazy statement…When it works it makes people feel really good. I mean really good. Remeron is the closest thing to a happy pill on the market. Until you get all bummed out about how much weight you’ve put on and how little you do because you’re sleeping all the time.

No, I haven’t been eating sugar out of the bag or boxes of doughnuts or anything like that. And although I did feel monumentally dopey for about the first week, that’s mostly gone now. But he’s not kidding about the sleeping part. There’s days I spend more time asleep than awake, although I’m told that — along with the other side effects — will diminish as the dose is titrated up. (For what it’s worth, I was a total all-day zombiewoman on 7.5 mg but I could actually spell my name again once I went up to 15.)

I haven’t felt suicidal since I started taking the stuff. Two weeks, now. And even the superego background you’re-a-failure assblattering is starting to recede. (All the therapy I’ve had for the last 10 months is finally starting to get through, whoot.) But even though I don’t weigh myself, I can feel the spare tire, can feel my fat cells filling up, can feel myself start to gain weight again.

If I cave in to the Obesity Epi-Panic, I could lose everything.

More thoughts tomorrow.

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19 Responses to “La Vie en Remeron, Part 1”

  1. Tiana Says:

    It’s completely ridiculous, isn’t it? I wish there was some kind of huge public forum where I could put up a note that says “If you gain weight due to medication, you’re not ruining your freaking health. You’re saving it is more like it!”

    Sometimes I wonder if the people who say that medication X makes you more hungry aren’t actually just fooled into believing that by seeing the weight gain and figuring that they must be eating more. Or maybe the possible threat of weight gain makes them restrict their intake a little, which is what then causes real cravings.

    Of course I could be completely wrong, I’m basing this on nothing more than observation of two people who incidentally took the same pills. Heh. Both gained weight, but only one of them tried to battle this. The one who didn’t thinks that he’s still eating the same as before, whereas the other guy was freaking out about how hungry he was after only a few weeks. One day he complained about this to the other one, who just looked at him funny and shrugged.

  2. Nancy Lebovitz Says:

    Thank you very much for writing this.

    One more thing for point one: exercise injuries.

    I’m very interested in anything you want to say about aspie vs. neurotypical depression. I think I’ve got some aspie tendencies, and my depression (not nearly as serious as yours) has a lot of background self-hatred.

    If you’ll excuse some advice, sometimes I find it helps me to focus on the idea that I’m not going to do the people who might hate me’s work for them. If they attack, they attack, but I don’t have to attack myself.

  3. Piffle Says:

    My thoughts when I heard about this association of fat with medical expenses was precisely about what if these expensive medical conditions are causing fat? Childbirth raises expenses and causes weight gain (yes, even a gain in the fat stores!). Diabetes is expensive and the medication to treat it causes weight gain. Depression is expensive and the meds cause weight gain. And those are just the ones I know off the top of my head, I’m sure there are more.

    It’s just a scheme to get more money, not based on health. At least they aren’t restricting what treatments people can get while fat, like Britain’s NHS is doing.

  4. occhiblusf Says:

    I think Kate Harding’s mentioned this in the past, but I’d be *really* interested to see how increased medication usage in this country correlates with the “obesity crisis booga booga.” I just finished a psychopharmacology class, and I think every drug we looked at, with the exception of Topomax, caused weight gain. I can’t believe it’s all that much different for medications for physical illnesses.

    (As an interesting side tangent, because they test these drugs mostly on men, side effects like “weight gain” can also be totally unpredictable, (1) because men may be less likely to report gaining weight as an unacceptable side effect and (2) hormone variations might make the side effect greater in women. So there are also tons of drugs that tend to cause weight gain, but doctors somehow don’t believe that they do, because it’s not listed in the pharmaceutical literature. I can’t believe how many times I’ve argued with (male) doctors about weight gain being a common side effect of birth control pills.)

  5. Sara Anderson Says:

    Thanks for linking to crazymeds – I’d never seen it before, and my pharmaceutical adventures have led me to use a lot of different drugs on that site. It appears to be a general neurophermaceutical thing rather than mostly related to mental health and psychological issues.

    So, a good resource for me!

  6. kate217 Says:

    ((((((((((((Meowzer))))))))))))

    I so get you. I have that constant “you’re not good enough and no one will ever love you” chant in my head 24/7 even when I’m taking the meds that make me able to get out of bed and get to work.

  7. meowser Says:

    Nancy Lebovitz: Damn, yes, you’re so right about the exercise/sports injuries. I mean, sports are great and everything, but other than professional or Olympic-level athletes who people actually pay to entertain them, does anyone really participate in athletics for anyone but themselves? And if not, why is becoming injured that way any more “virtuous” than indulging in a bag of donuts? And yeah, I like “I’m not going to do the people who might hate me’s work for them” too. Thanks!

    Piffle: Yeah, good point! I do think we really do not know everything there is to know about the chicken-egg relationship between insulin resistance and fat, and it’s probably at least as likely that insulin resistance leads to easy weight gain as the other way around. And I think there’s an external-stressor component to diabetes and hypertension also, and that making people freak excessively about their “numbers” is NOT going to help.

    Kate217: You ARE good enough, and *I* love you, for whatever that’s worth. Thanks for your support.

  8. LN Says:

    “Why is becoming injured that way any more ‘virtuous’ than indulging in a bag of donuts?”

    I came on this blog by way of a random livejournal link, but I have to say there’s a huge difference between the physical risk of playing sports and the physical risk of living a sedentary life “indulging” in doughnuts. Playing sports not only provides the healthy exercise that *everyone* needs–burning unneccessary fat, building muscle, training your heart–it teaches valuable skills about socializing and cooperation. You learn how to work in a team and how to support others where they’re weakest while allowing them to support you where you’re weak. And you learn to work for the good of the group; sometimes I didn’t want to run those miles but knowing that it made me stronger and that it made my team stronger made it worthwhile. Additionally, this kind of exercise also makes you very aware that food is fuel and that if you don’t need the fuel, you don’t need the food–that is, doughnuts shouldn’t be a variable at all. I have issues carrying excess weight, which means that I just don’t do processed sugars. Hey, and there’s another sports lesson–make what sacrifices you need to reach your goal, whether that’s scoring points or losing weight in a healthy way.

    As for injuries, this is a much smaller part of sports than you would think–in eight years of playing hardcore varsity tennis and lacrosse, I have had one injury that’s seen the inside of a hospital. Playing sports teaches you to respect your body and to build it back stronger after you injure it. All my practices when I was injured were spent working as much as I could in the pool. So what does this metaphorical BMI-challenged person who has just indulged in a bag of doughnuts do after they’ve harmed their body? Surely they don’t turn around and try to heal it and make it stronger by hitting the gym?

  9. Nancy Lebovitz Says:

    Also, I believe exercise and sports injuries are more likely if a person is focused on an external goal like losing weight, if they’re punishing themselves for not being good enough, and/or if they’re proving their virtue by how much pain they’re enduring.

  10. kate217 Says:

    Thanks, Meowzer. Knowing something intellectually and convincing the fecking chanty demons in your head are two entirely differently things. I love you, too, and to me, that’s worth a LOT.

  11. April Says:

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    Thanks.

  12. Kat Says:

    Hope you’re doing ok Meowser. I get the chant sometimes too. I’ve tried going off my meds two or three times…not a good idea. I still get the chant sometimes even on meds, but I’m for sure a goner without them.

    Glad you got yourself to the doc. Please fight this. Ever thought about leaving Alabama?

  13. Meowser Says:

    Kat: I don’t live in Alabama. I’m just saying that if I did…

    LN: Re this:

    I came on this blog by way of a random livejournal link, but I have to say there’s a huge difference between the physical risk of playing sports and the physical risk of living a sedentary life “indulging” in doughnuts.

    Even if true, you’re still doing it for the same reason, though: Your own gratification. Which is fine. But I could live without the holier-than-thou garbage that too often accompanies it. Not everyone can be athletic, nor does everyone need to be.

    And Kate217: I’m so glad!

    (And yeah, I know I’m way late with part 2 of this. It’s coming!)

  14. raven Says:

    I think it’s great that you brought this issue up. I had been wondering for a long time if the so-called “epidemic” of obesity could be partially a result of drug side effects. So many drugs cause people to gain weight, especially antidepressants and antipsychotics, as well as birth control pills. I find it hard to believe that M.D.’s would disagree; I saw friends gain a lot in college just from getting on the pill.

    I’ve suffered serious bouts of depression myself, so I know the agony of that. A few years ago a therapist was trying to get me to take antidepressants, but of course back then when I was still eating disordered and fat-phobic, I didn’t want to take them for fear of gaining weight. My search for an alternative led me to a book called Potatoes Not Prozac and from it I learned that part of my depression could be the result of my self-inflicted malnutrition. Eventually I changed my eating habits, finally making the decision to go on a diet to gain weight. That was 6 years ago. I have gone from a neurotic size 6 to a much happier and healthier (though still a little bit neurotic) size 12.

  15. Sniper Says:

    But I could live without the holier-than-thou garbage that too often accompanies it.

    I could live a lot happier if the holier-than-thou garbage disappeared from the face of the earth. Fat doesn’t make my life difficult. Fucking people make my life difficult.

  16. sannanina Says:

    Great post! As a fellow fat woman who struggles with depression I am particularly intrigued by this whole bullshit argument that being fat is a risk factor for depression. Until someone actually finds some kind of biochemical link between a compound produced by fat cells and the parts of brain metabolism that are affected in depression I think that the explanation that being bullied and discriminated because of being fat increases your risk for depression is the much more likely explanation.

    But over time, even with fistfuls of vitamins and amino acids and light boxes and exercises and affirmations and all those other good things that probably do a world of good for people whose depression doesn’t get as bad as mine does, I start to slide.

    I had a minor quibble with that one. You don’t mention therapy – you only talk about affirmations. But your statemtent sounds a bit like “therapy would not work for someone with depression as severe as mine”. From the articles that I have read (and I read a lot of them lately, since I am in the process of writing a paper on how non-pathological personality differences might influence responses to therapy for depression) both, medication and therapy work for about the same percentage of people – and I haven’t read that their effectiveness is dependent on severity of depression. Therapy does have the added advantage that it often keeps working even after people stop seeing their therapist while medication stops working once you don’t take it anymore.

    Of course therapy and medication might not work equally well for any individual person – in fact, I am sure they don’t. Additionally, different kinds of therapy and different kinds of medication don’t work equally well for an individual either. But it is not that medication is generally more potent – and your remark sounded a bit like that. (This point is important for me because the current medical system favors treatment with antidepressants although there is no evidence that they are truly the more effective choice for most people – probably because it is cheaper in the short term or because the pharma industry has quite some lobbying power.)

  17. La Vie en Remeron, Part 2: Backwards Day « fat fu Says:

    […] Comments Sniper on La Vie en Remeron, Part 1Meowser on La Vie en Remeron, Part 1Kat on La Vie en Remeron, […]

  18. Taylor Says:

    I’m bipolar, not aspie, so I can’t fully “get” that. But yeah, I did Remeron once, before I’d been diagnosed bipolar (the shrink thought I was “just” depressed and so did I). I don’t remember eating like crazy, but I did go manic, or at least very, very happy.

    And I am currently on Depakote and Zyprexa, and I suspect I would weigh less (170-something on a 5’8″ frame) if I quit. But I have been suicidal too and I would rather weigh more and not get that down. I’ve also done Topamax and that was scary. I had *no* appetite–I was drinking generic Ensure and nibbling cashews and bananas to get *some* calories in me.

    I hope your meds keep you reasonably stable and the weight gain doesn’t get to a life-threatening point or anything like that.

  19. meowser Says:

    Sannanina: Oh, I had therapy too, since I was 14. I’m having it now. I’ve edited the post to reflect that.


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