issue 91 (our 8th year)
issue 91 (our 8th year)
Definitely. As with most things it is best to start early. Most of weight increase is usually at the start of treatment and can last for around 4 months, it then appears to plateau. Seeing a Dietitian for strategies to prevent or at least minimise any weight increase at the beginning of treatment works well.
Of course it is never too late to see a Dietitian to get some strategies to lose any weight gained and to prevent further weight increase.
Water is a great start. Ensuring you are having plenty of water during the day (8 glasses of water or herbal or green tea) will help. Then looking at high fibre foods such as wholegrains, vegetables and legumes. Adding a protein to a snack or meal can also help you to feel full. An example of a snack might be 2 wholegrain crackers (e.g. vita weat 9 grains) topped with tin tuna, tomato and cucumber or a small number of nuts (20g) and a piece of fruit. For a main meal making sure at least half the plate is vegetables or salad or your sandwich is wholegrain bread with wholemeal base and packed with a rainbow of salad and a small amount of lean meat.
Getting rid of that taste in your mouth can be tricky. Chewing sugar free gum/lollies or rinsing with mouth wash can help. Lollipop/lollies or similar is an option however they are not good for your teeth and will add to extra kilojoules which can lead to weight increase. Just beware of excess amount of any sugar free lollies/gums as they can cause stomach upsets for some people. So not going over board is good (maximum 2 or 3 pieces of gum or lollies over a day).
Another option is the wonderful range of herbal teas that are around now. Flavours such as liquorice or peppermint are strong enough to dull the metallic taste. A key thing for herbal teas is not to make them too strong. Don’t seep it like you might normal black tea, 30seconds or just a few ‘dunks’ will give you a milder flavour and is easier to get used to.
Emotional eating is very common. A good dietitian can help with this. Working out ‘Why’ you are eating is possible, then strategies can be personalised to help. I had one client that purchased a book called ‘Wreck this journal’. Every page had an activity to do like ‘fill the page with one word’. The picture she created with the word ocean with different colour pens was just amazing. This is just one idea. Distractions, nurturing ideas and riding the wave of a craving are all things that are considered useful to replace emotional eating.
This is a great question. Any health professional worth their salt will only ever give you strategies and goals that you can achieve. Even if you have a list of changes after the session, the dietitian will help you to prioritise and set small achievable goals. Overtime they should make your life easier not more complicated.
Any of the above. You can self-refer or be referred by your GP or other health worker.
If you have visits available under a mental health or other GP care plan this will give you a subsidised visit to a private dietitian ($52.95 off the price). This is helpful as appointments can range from $75 to $120 depending on what is available in the area. The Cost at the community health service I work for is bulk billed if you are on a Health Care Card or $75 if you are not.
Currently in Victoria there is also the Community Health Service option. And I say currently as there are lots of changes so funding is not guaranteed for the long term. This means at least for the next 12 months if you are on a Health Care Card or a Pension you can access the community health service for $10 – $20. At the community health service I work for (Inspiro) the cost is $10
Choosing wholemeal bread or wrap even better.
Article written specifically for the Bipolar Life newsletter by Tracey Higgins APD, Accredited Practicing Dietitian
1 piece or 1 cup of Fresh Fruit (the more variety the better)
20-30g of almonds (15 – 20) or other mixed nuts & seeds
Low fat hummus or Tzatziki dip and 2-3 wholemeal biscuits or sticks of celery, carrot or other vegetables
1 cup of plain popcorn
Roasted chick peas or broad beans
Celery stick with 100% nut paste or cottage cheese or dip
2 Whole Grain biscuits topped with vegemite or tinned salmon/tuna or sliced boiled egg or thin slice of cheese and tomato
2 Multigrain Corn thins with vegemite & 5% cream cheese
100ml-200ml of low fat yoghurt (less than 10g sugar per 100ml, 15g if added fruit)
250ml skinny milk coffee or hot chocolate
Small tin of flavoured or plain tuna or salmon
A boiled egg
Cup of home-made vegetable soup
With plenty of water and/or Herbal tea infusions
2 cranberry, raspberry and strawberry tea bags (or other herbal tea bags)
Also works well with Lemon and Ginger herbal tea
8 cups of water
(Makes approximately 2L of ice tea)
`1. Pour the water into an appropriate pitcher or empty bottle.
2. Add the two tea bags.
3. Let steep for at least two hours or overnight in the fridge.
Add frozen berries, lemons or mint for an extra special twist
For a fresh summer treat serve chilled with crushed ice
Recipe adapted from http://www.food.com/recipe/simple-herbal-iced-tea-sugar-free-176209
4-6 sheets of thin pita bread cut into squares or triangles
3 tbsp. olive oil
2tsp fresh chopped herbs of your choice
1 clove garlic, crushed
1 ripe avocado
½ lemon, juiced
½ small Spanish onion, finely diced
1 tomato, finely diced
½ tsp Tabasco sauce or to taste
1 cup low fat Greek yoghurt
1 clove garlic, crushed
½ cucumber, finely diced
squeeze of lemon juice
salt and pepper
Adapted from www.mountainbread.com.au
(Joy is actually my middle name which is funny since joy is something I have not felt much of over the past few years.)
For the first time since being diagnosed with Bipolar Disorder I am starting to feel some hope. Hope that I may in fact be able to experience some joy in my future despite having one of the main disorders I never, ever wanted to have. I honestly would have chosen all manner of disorders over this one. I hate it. I hate that it robs me of my right to be me. I hate that it can cause me to behave in a way I would never behave when I was well.
I was 43 when I had my first symptoms of Bipolar Disorder. I was under a massive amount of stress trying to help my family. (I won’t go into details). I started being unable to sleep but kept going to work everyday despite that. Then I started doing everything quickly, including speaking. Now I know I was hypo-manic but at the time I had no idea what was going on. I just kept pushing myself to work and help others. The next thing that happened was I became completely manic with severe psychosis. I had to be physically removed from my home and was locked up in a psychiatric ward in hospital as an involuntary patient. There is a lot about that time I can’t remember but I do know I did a lot of singing and dancing whilst I was there. I was put on Olanzapine and eventually came home. I tried to return to work but unfortunately I became allergic to Olanzapine and had some nasty side effects including going Parkinsonian and being unable to sit still because I was completely agitated. The CAT team became involved and changed my medication to a medication for schizophrenia. (I don’t have schizophrenia though.) It was called Solian but I call it the Zombie drug because that’s what it made me like. I refused to take it after about a week of being completely wiped out by it. Then I went on Lithium and that is when I really started to improve. I still had sleep issues and found Melatonin very helpful if I took it the same time every night. Of course, I had valium often when sleep would not come any other way. I would say that the hardest part of this disorder for me so far has been the social and emotional costs. I had many awful things said to me by friends who could not understand. I was told that I was a trouble maker and “what you have isn’t an illness”, “you should’ve prayed to God and then this wouldn’t have happened” and that if I wanted to get better I “need to pray to God” (not take medication). One friend said “I’ve decided to forgive you (for what I did when manic) but “ I’ll know what you are by what you do in the future”. My niece cut contact with me because it was “too hard” and she’s “got children now”. Oh, the amount of pain such comments have caused me as I’ve struggled through the worst trauma of my life. I do have to say though that when I went to the Bipolar Life support group nobody I met had been told similar things so hopefully the stigma is getting less. My work, some friends and most of my family have been very supportive and understanding. I am so grateful to all those who supported me. The best thing I did for me was get myself pets once I got out of hospital. The words repeating around in my head were “I wish I had died. I want to be dead…….except for my dogs.” I was in mild depression for at least a year after the manic episode and couldn’t feel much joy but when I saw my dogs play together their joy infected me and I couldn’t help but smile. They have also been the best way to get known in my community. I didn’t know people in my area (being new to the area) but once I got the dogs so many neighbours and shop keepers started chatting to me. The dogs get me exercising too.
One thing that really helped me was understanding more about the disorder. After being told I was not sick but just being evil/anti-God it was a relief to me to learn that Bipolar Disorder is genetic and that it affects the limbic system (particularly the amygdyla) and pre-frontal cortex of the brain. I am a health professional so for me this was so important to know. It allowed me to understand and forgive myself for my behaviour when I was manic. It allowed me to understand this disorder is not my fault. So here I am now feeling like I am heading in the right direction. It is taking a lot of work but here’s a list of what is helping me:
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