As I've researched depression more and more, I've made a list of possible causes for my problems. I brought them to my doctor, and started going down the list, asking for tests to check if these were the root of my problem.
Right from the start, she made like she thought it was purely cognitive. I asked for testing the Thyroid, and it came up normal. PCOS was next on the list.
She looked at me and told me that since I didn't have abnormal body hair for a woman (And I do, just not a LOT like she expected) that she doubted I had it. But she asked for the tests and sent me in. Low and behold, I have cysts all over my ovaries. My hormonal levels are technically within the normal range, but that's in keeping with the minimal amount of excess body hair (for a woman with PCOS).
Lesson 1: It doesn't matter if the doctor doesn't like it. Do your research, and take your medical care into your own hands. They often won't suggest tests, but will not refuse to administer them for liability reasons.
Some of you may recall that I've been having weird dizzy spells since the fall, and had thought there might be something wrong with me. I kept on meaning to mention that I wanted to be tested to see if I was prediabetic, but forgot. So, when the doctor started going down the list of risk factors and treatment options, and she got to diabetes, I pushed. I said that I'd been suspecting I was prediabetic for a while and that I wanted to get tested, so she initiated the test for that. Again, she said she doubted I was suffering from prediabetes (which I believe is synonymous with insulin resistance), because I haven't had a sudden loss of weight. I'll hear back from them by Monday at the latest, probably. But I suspect this will be another application of
Lesson 1.
Other than that, she recommended I lose weight and either induce a period regularly or get on birth control. OK. I opted for the latter; I'll be back on alesse, which worked well for me previously, and bleeding four times a year. I'll come back to this in a moment.
Now, the somnolence (ie. sleepiness) symptoms from my medication, Paroxetine (the generic version of Paxil), have gotten out of control. I've been toying with the notion of going off of them, and it occurs to me at this point that, if my depression and anxiety are hormonally caused, then perhaps it isn't doing anything at all for me anyway! So I asked, and she said no.
SSRIs can help people with hormonal mood instabilities.But, I decided that I needed to be off Paxil, which is a problem since it is the one SSRI on the market with the WORST withdrawal symptoms. Weaning myself off of it will take at least a month. She suggested starting by going from 40 mgs to 20 mgs, then to 10, then alternating days, then longer and longer gaps between days. I'm a little dubious about that first leap, and I'm considering starting by going down to 30 mgs. Between that, dieting like mad, and starting birth control, I'll probably be an emotional mess for the next month. Yay! Er, boo!
I've been learning some fascinating things.
Lesson 2: If you are a woman with irregular periods who is overweight (especially if your weight tends to go to your abdomen), you have an 80-90% chance of having PCOS. Get checked. No really.
Lesson 3: Gee, weight gain is supposed to equal calories in-calories out. How could something make someone more likely to gain weight, and make it harder to lose weight?From a review on Amazon, this is a good starting point:
Most, not all, women with PCOS suffer from insulin resistance (this simply means that the body cells are resisting allowing insulin to deliver the blood sugar they need, while the fat cells are screaming "Hey! Just back that truckload of glucose in RIGHT here!").
Look at it this way (warning; based on preliminary understanding):
Step 1 - IR causes the woman to crave type of food A, which is high in glucose
Step 2 - In a perfect body, that food would be spent on fueling the body, and then anything that was left over would get stored as fat. In a body that is IR, a lower than normal percentage of glucose rich foods is used for fuel immediately, and a higher than normal percentage is stored as fat immediately. To adequately fuel the body, a woman would have to eat more of the food. More per serving goes to fat, and this woman is having more servings than normal!
Step 3 - The body sees this happening, and releases more insulin. But, because of the insulin resistance, most of it doesn't get used up, so the body adjusts to the higher insulin levels, and becomes even more insulin resistant! This is similar to the way we build muscles, except that its bad.
Step 4 - After steps 1-3 have repeated long enough, the woman goes over the edge into Type II diabetes land. Suck.
The trick, apparently, is to change the types of foods the woman is eating, and the frequency. Remove white bread, rice, pasta, and other similar carbs and have grainy whole wheat, brown rice, and whole wheat pasta instead. Minimize the consumption of sugars, especially processed sugars. Balance sweets and carbohydrates with proteins. So, toast with jam is out, but whole wheat toast with peanut butter, almond butter, etc.? That's right in.
I'm hoping that once I've lost a lot of weight I can go back to having sweets, when balanced with other things. In the meantime, I'll just have to be a good girl. With the threat of diabetes hanging over my head, I hope that this proves easier than it has in the past.