Tuesday, March 17, 2009
The situation has changed and not entirely for the good.
The good news is that the diet seemed to work. Here is an update on the weight situation
09/2005 96 Kg (= 211 pounds or 15 stone 1 pound)
12/2005 89 Kg (= 196 pounds or 14 stone exactly)
02/2006 86 Kg (= 189 pounds or 13 and a half stone)
06/2007 84 Kg (= 185 pounds or 13 stone 3 pounds)
06/2008 79 Kg (= 174 pounds or 12 stone 6 pounds)
03/2009 85 Kg (= 187 pounds or 12 stone 5 pounds)
So in effect my steady weight loss continued right through until the summer of last year, but then started to rise. Somewhat spectacularly. And that spectacular rise has been associated with just about the worse depression I have ever had. Its certainly the longest lasting. I first noticed that my concentration levels were dropping alarmingly. As I was driving for a living at the time, and carrying passengers, this was potentially very dangerous. I therefore had to stop driving. The depression has just got worse and worse. My concentration levels are low, I have very little energy to do anything and the old patterns have returned. I have a bulbous belly, I find it hard to sleep at night, and I just seem to be dead in the head until about 10 pm when I become alive. The sleep pattern is such that I am awake most of the night and even if I do manage to get to sleep, I wake up often so the sleep is very light. I can sleep in the mornings.. Typically 4 or 5 hours from about 6 or 7 am until 11 am. Then I am either awake the rest of the day, or as with today (having forced myself to do few miles walking) I flopped on the bed at about 7pm dead tired and woke up at about 11pm fairly wide awake.
All the time my weight has been falling I have been fairly OK. I even managed to start a new relationship this last year which has been very nice. But the dreaded weight gain that has come on since is clearly associated with depressed mood.
The interesting question again is why? Did the weight gain CAUSE the depression? I don't think so. Or does the depression CAUSE the weight gain? Again I don't think so. I am now clearly of the view that the weight gain and the depression are both symptomatic of something else that is going on. As I have hinted in previous posts I think that this other factor is the key to understanding depression.
I strongly suspect that it is a powerful genetic and environmental interaction associated with stress. In my case, stress triggers a powerful change in my metabolic rate. The process which go on in our bodies and enable us to be active and burn energy, are forced to slow down. As a result, I am no longer able to spend energy in the way that I used to. Food that I would normally eat, which gets converted to energy in metabolic processes instead gets stored as fat. This process of slowing down happens due to stress. I believe that the survival of genes that cause a reaction to stress which slows down metabolic process during the day (but speeds them up at night) is because this helped my genetic ancestors survive the sharp winters. In winter, food could have become scarce and winter nights are cold. Winter time brought on particular stresses for our ancestors. What better strategy for surviving winter than to gain weight but speed up metabolism at night (to generate internal heating) and prevent sleep (which could lead to fires going out and death through hypothermia). So I believe I have these genes. They were a blessing for my ancestors, but they are a curse for me. The good thing is this. Now that I know the reason for this is natural, it does make it a bit easier to deal with. There is no point blaming oneself for gaining weight and becoming depressed in winter time. Its natural. Just should look at in the same way as sleep. Its just a natural process. Yes it would be nice to have better control of it, and one day I suspect we shall be able to switch off the gene that causes this to happen. But until that happens, I am not going to beat myself up over it.
Now I think that this "stress reaction" can become associated with winter, and that is certainly a pattern in my depression. But it is also associated with stress. (And as I say, in the past, winter time was stressful, so there may be some automatic linkage between stress and this genetic process). In my case I have had down periods in the winter, but in the last few years these have been short lived. A month or so is normal for me, and these depressions can be fairly mild. For instance in December/January of 2007/8 U was training as bus driver and the depression was relatively mild and did not affect my ability to get up early in the mornings or go out driving. But looking back over the last year I have faced some quite unusual stresses. I had started a new job as a bus driver in March 2008 I found myself almost immediately in conflict with my boss. Two specific matters were at the root of that, one of which was work related and the other personal. We seemed to get those sorted by the summer but later on the year there came a dispute over unpaid working hours. Due to a change in working times imposed by the employer (not specifically by my boss - he was just following orders) I found myself having to work extra time every day. Other drivers were affected by this too. When I added up the extra hours I was working it was quite shocking to discover that, over an average two week working period, I was being paid for 10 days work, but I was actually working unpaid hours equivalent to 11 days. On top of that, the shifts I was working were sometimes unreasonably long and therefore not only stressful, potentially dangerous to me and the passengers on the bus. I tried to get these hours paid, but no luck. And for reasons which I won't go into, it was not practical proposition to go to court to try to get the money owned to me paid back. The company has, I hear, been in trouble before over the payment of salaries. I hear that in the last year the company employed over 90 different permanent employees (a statistic that is needed for the company accounts). However, the average number of drivers at any one time is between 50 and 60, so the driver turnover is an incredible 50% per annum. I think staff turnover in other industries is normally of the order of about 5 per cent per annum. So I am not the only one. But I probably react to this kind of situation more badly than other people.
I have tried to stay faithful to my strictly low carbohydrate diet, but because I am in a new relationship, it is much harder to control my diet because it is unfair for me to impose my diet restrictions on my new partner. So it has been less strict, but not so very different. Well spring time is coming and I am hopeful that the depression will lift soon. But it has not done so yet. I have been depressed now since last October, thus making this at least as bad as the worst of the depressions I have previously suffered from - maybe even the worst.
Wednesday, September 19, 2007
Here are some factors to consider. If you answer YES to 5 of the following statments matches you, read on for more help.
1. Is your body mass index over 25? You can calculate you BMI at http://www.nhlbisupport.com/bmi/bmi-m.htm
2. Do you find that sometimes you become more alert at night time and sleep is the hardest thing to do then?
3. Is it 3/4/5 in the morning before you can get to sleep?
4. Is 10.30-11.00 in the morning your body's preferred waking time almost irrespective of when you get to sleep at night?
5. Do you find that you sometimes get sleepy or even fall asleep soon after eating during the day time?
6. Is night time snacking something that you do because you crave it or because you know or believe it will help you fall aleep?
7. Have you sometimes wondered if you have at least one of the following conditions
* Delayed Sleep Phase Syndrome (DSPS)?
* Thryoid malfunction (especially hypothryroidism - low thyroid) but your doctor says its normal or low, but not abnormally so?
* Insulin resistance
8. You have been diagnosed with depression, but antidepressants (SSRIs) don't really make you feel wonderful again?
9. Do you get "brain-fog" and decision making becomes very hard or you make the most unbelievably silly mistakes if you do make decisions?
10. Is your blood sugar higher than it should be but you are not yet officually diabetic?
11. You no longer seem to dream as much as you once did.
Here's what I think the problem is......
Our bodies are designed to store fat as an insurance policy against food shortages.
This happens especially as the fall/autumn draws into winter.
Its a natural process that has happened for millennia and is genetically programmed in.
As we gain fat, our bodies become insulin resistant.
Insulin resistance blocks the rate of energy take up by the cells in your body. This is why you feel that you have little energy to do anything... you actually don't!
Its also why you get "brain-fog"... your brain is just a collection if cells too! If your brain is starved of energy, it won't work properly either.
Because you are not "burning" energy, your blood sugar is likely to be higher than normal because the cells are not using it up. It's danagerous. Some doctors call this "pre-diabetic". If it carries on you can end up with full blown diabetes.
One result of this is that more sugar is left around to be converted to body fat. Hence you gain weight.
The more weight you gain, the more resistant to insulin you become. Yep, its a vicious circle!
There is a strong tendency for this to happen either as winter approaches OR if you have been through some very stressful event in the last 12 months or so. By the time you are in the dead of winter comes or 3 months after you first started to feel at bit low, you could be feeling at rock bottom.
Your sleep pattern is completely shot through. You want to be awake all night and even when you wake up, often late in the morning, it does not feel like you had a good night's sleep.
I think I know know why dreaming stops in people with this condition, but would only be interested in sharing this with genuine sleep researchers. I think this is a "real" lack of REM sleep not a "less likely to remember" issue. This genuine lack of REM sleep probably worsens the "brain-fog".
Here's what I did.
1. In the last 2 years I have shed 17Kg (37 pounds) by following VERY STRICTLY the Atkins diet and exercising regularly. Sure, the exercise was hard work, but it has paid off. I used Ketostix to monitor progress.
2. In those 2 years, I have had periods where I relaxed the diet slightly and allowed some carbs, BUT... only those that are VERY VERY slow releasing. I would for example eat spinach, shredded cabbage, lettuce, onion, 100% rye crackers, rye porrage. ABSOLUTELY NO potatoes, rice, pasta, anything with flour (wheatflour or corn starch) ... so no bread either. And absolutely nothing with sugar or its derivatives. It took me 3 months on a strict plan to lose the first 7kg (15 pounds), 3 months to lose the next 3 Kg (7 pounds), 6 months to lose the next 3 Kg (albeit on a more gentle version of the diet, and a whopping 9 months to lose the next 3Kg. But I am just about on the brink of my target range. I'd like to lose another 3 or 4 Kg and may do the diet strictly again. This is because winter is approaching and the natural thing to do at this time of the year is to EAT CARBS by the bucketload, so I figure that doing the absolute opposite will make it clear to my body that we are not ready to play that game this winter!! And I intend to intensify the exercise regime just to rub it home.
3. Drink plenty of fluid (tap water is great! ..no additives). Avoid alcohol. I did allow the occational diet drink.
4. Don't buy anything you cannot eat.
(That's gonna be hard for anyone with families 'cos surely you don't want to deprive them of sugary food like chocolate and ice-cream, cookies, colas, and salty/oily food like potato snacks. Hmm .. well maybe you should! Its stuff like that which is causing so much diabetes and overwight in our society. Its OKAY for a while, but longer term you are building a problem. Best not to have it in the house then you can't be tempted. Better for them to eat fruit and raw vegetables like carrots. (By the way, most fruit is off your diet until you get into the normal BMI zone (18-25 or so).
5. Make a rule. DO NOT EAT LATER THAN 8 PM IN THE EVENING... 6 or 7 PM is even better.
This is REALLY important. Breakfast is not called "break fast" for nothing. The ancestors that called it that new a thing or two. As is the wise old saying "eat like a king for breakfast, a prince for lunch, and as a pauper at supper-time". It will promote good and effective sleep.
6. Drink plenty of fluid, and use powdered psyllium (ispaghula) husk as a dietry suppliment to keep your bowel movements going and your stools soft. This because the strict Atkins diet can switch off your bowel movements, and your exess need for fluid to metabolise body fat as fuel can make the stools reallt hard and hard to pass.
Sound hard? Can't do it? Hmm... wanna live to a ripe old age? Wanna feel NORMAL again? Wanna get back into those old jeans at the back of the closet?
Yes you can do it! You may experience hunger for the first few days. When it happens, eat eggs, bacon, meat, fish...but absolutely no carbs. It will speed you into benign ketosis and when that few days is over, you will not feel hunger again. SO LONG AS YOU KEEP STRICTLY TO THE DIET. One ice cream, a soda pop, a small choclate bar or a potato, and you will within seconds undo all the hard work you did in those few days AND IT WILL TAKE ANOTHER FEW DAYS BEFORE YOU CAN UNDO THE DAMAGE DONE IN THAT MOMENT OF MADNESS.
And here is the good news! When you are losing weight on the Atkins diet, your body is fuelling not on sugar but a modified form of the excess fat you have been storing. And this process is NOT insulin dependent. So you will start to have more energy, your body will actually become a little warmer as your cells start functioning properly again. You may even get a little sweaty, but be content that this means you are losing that excess weight even faster. You find that you can sleep normally again, and at the proper time. Your brain fog will lift, and you can lead a normal sort of life, except your diet is anything but normal.
But the aim of this is to get your BMI down into the normal range and prevent the insulin resistance that cause your DSPS like symptoms.
When you get into the normal BMI range, your diet can become more varied. But you will probably be best advised not to go back to eating chocolate and ice cream and sticky buns or chips or cookies on a regular basis. Have them as treats, maybe once a week, and never have them stocked in your kitchen. And never shop when you are hungry!!!!
When you are off the Atkins diet (either as a temporary break in the weight loss program or when you reach your target BMI) eat only foods that have a low glycemic index such as home made soups contain lentils, a bowl of chilli con carne, and use finely shredded cabbage, lightly steamed as replacement for rice. Keep your portion size low, and drink plenty of fluids and psyllium in sugar free fruit squash will add variety and fill yourself up.
Its important to stay active so try to keep to some fitness regime. I go swimming regulary and do Nordic Pole Walking. And I go to the gym too if I can once or twice a week. Use the stairs and not the elevator. Take a bike to make short journeys instead of the car. It all helps.
I now sleep better than I did before and the alarm call is now not dreaded. I think better. I look better. I'm still a little outside my target BMI but it has gone from just over 30 (obese... oh shame!!!) to a fraction over 25 (just outside the top end of the normal range). Getting the next 5Kg (11 pounds) off is going to be hard work. But I will get there because I know I can do it. I weigh myself religiously. And if the needle goes the wrong way, alarm bells start ringing and I modify my behaviour accordingly. Both what and when I eat, how much, and how much exercise I do. Quick corrective action really does get you back again.
Well, that's my advice to you.
Good luck if you can do it and I hope it helps you as much as it seems to have helped me.
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Tuesday, February 07, 2006
I mentioned in my last post that I was doing the low carbohydrate Atkins Diet, the reason being that (a) I have been overweight for some time and it had been getting worse (b) the doctor had detected high blood sugar levels and was making warning noises about diabetes and losing weight, and (c) I recalled that the last time I lost a significant amount of weight using Atkins my so-called depression vanished. So I am kind of wondering if by losing weight again I can shed myself of the depression and sleep-disorder problem again. If it works I will aim to keep my weight and blood sugar levels under control.
Well I started this diet in September at which time I tipped the scales at about 96 kilos (211 pounds for my North American readers or just over 15 stone if you are from the British Isles). As a male of 5ft 10ins my NORMAL weight range according to the Met Life tables should be between 158 and 180 pounds. If I take somewhere in the mid-point as my target, I should be aiming for about 172 pounds / 78 Kilos / or about 12 stone 4 lb. I believe that in 2001 when I had my wonder year (no problems and very good mental fitness, my weight had dropped to within a few pounds of this target. So now I am really keen to get back to this level again.
Just before Christmas I stopped the Atkins diet for a couple of weeks because I just new that I would not enjoy Christmas without all my favourite foods. That cost me 2 weeks off the diet and another 2 weeks to get back into ketosis., so about 4 weeks in total.. but I think it was worth it. I needed to have some dietary variety again.
Here is the result
09/2005 96 Kg (= 211 pounds or 15 stone 1 pound)
12/2005 89 Kg (= 196 pounds or 14 stone exactly)
02/2006 86 Kg (= 189 pounds or 13 and a half stone)
Lost so far 10 Kg (= 22 pounds)
still to lose 8 Kg (= 17 pounds)
which I am really pleased about because I am more than half-way there. What is more, this winter I have mostly avoided the deep depression that I fell into last winter (which lasted about a month). I have noticed that my skin condition stayed mostly good (although the yeast infection on my eyebrows returned during the Christmas period when I stopped the diet). But all in all, it has gone very well. I am already out of the ´gigantic sizes of jeans that I had to buy a couple of years back and am into some better fitting ones. I will even have to buy some new belts soon because the old ones are now too big.
I did get my body-clock completely screwed up after sitting up until almost 6am with friends on Christmas Day. That was a really stupid thing to do because I knew that getting the right sleep rhythm back was going to be dificult.
The worst thing is that when I get home from my course I usually eat at about 4 or 5 pm. Within an hour or two the food has gone from my gut and is starting to hit my bloodstream. I know this because I get really sleepy, and if I am not careful, I will sleep for a good 1 or 2 hours. When I wake up I feel a surge running through my veins which I take to be a hormone of some kind kicking in (Adrenalin? Cortisone?). Its a weird feeling...like a tingling sensation and I can feel it travel through my body from top to bottom. After this surge I get me mental peak. Anyhow, I realize now that my body realizes that it is running on a low energy input right now and it takes an instant decision what to do with the energy that I have just consumed. It is trying to save it and so sends me to sleep, perhaps for just as long as to tuck away that energy somehow. I figure that saving energy requires you not to be spending it. To counter this, I now try to do some moderate exercise after eating. A brisk walk is enough, or a gentle swim and sauna session will get the heart pumping.
I reckon the remaining weight will take another 6 months to lose. It is bound to be harder to lose as I get close to target. I will try and do some more gym work. Before Christmas I was regularly swimming 1000 metres evey other day and I think that helped a lot. I also bought some Nordic walking poles which are also really good for exercise and are immensely popular here in Finland.
If as I lose the remaining weight I notice my metabolism and mental condition improving I think I will find that to be convincing evidence that my over-weight condition and the depression/SAD are somehow linked. And if not, well losing that spare tyre (or what seemed more like an air-bag!) under my shirt cannot be a bad thing. And if I am right, I will be kicking myself that I did not solve my weight problem much sooner.
Friday, November 18, 2005
* My SAD is worst in the mornings and I am almost brain dead until about mid-day and then slowly start to function. My peak mental state usually comes between 10 pm and 2 am, and hardly surprising, it is at this time that I can actually get on and do all the things that have eluded me all day.
* When I wake up on the morning, I have distinct bright red patches around my nose and following my nose up towards and partly around my eyes. As the day goes by and my mental state improves, these red patches disappear. I have come (I think) to realise the reason and significance for this. More on this later in this posting.
* My diagnosis earlier this year of persistent higher than it should be blood sugar (an indicator of adult on-set diabetes) has set me thinking. Is there a connection between this and SAD, or at least the worst aspects of it. I have a reason for thinking this and again this will be explained later in this posting.
OK lets start with the SAD symptoms. I start this discussion with the pre-conception that these symptoms and associated behaviours relate to a genetically inherited trait that favours winter survival.
I have often felt that I am hibernating, so to speak, in winter. I refuse to go outside unless I absolutely have to. This is an "instinctive" behaviour, not driven by any fears at a psychological level, but probably related to an inherited genetic ancestry of behaviours that tended to favour survival in the harsh winters. I can go out, and often when I have done so, I feel much better for having done so. But the logic of going out making me feel better is not powerful enough to overcome the instinctive behavioral pressure NOT to go out. I really do think that this is, in some way, an instinctive "energy saving" and "keep out of risk" strategy on the part of my brain. If you have enough food and it is warm and comfortable inside, it is better strategy for surviving the winter than going out Sit at home and do put yourself at risk of losing your energy stores that will keep you going through the winter season, or succumbing to hyperthermia (an almost negligible risk today, but not so to our genetic ancestors not so many years ago).
The other issue that set me thinking was the curious matter of what happens to me when my depression comes on and when it lifts. When it comes on there is a distinct phase when my body temperature appears to drop. I say appears to drop because this is a perceptive thing that I have not measured with a thermometer. Needless to say, it usually happens around September/October at which time I have to ask people if THEY feel cold. It is a funny thing because I do not feel that my environment is cold... I kind of know that it is ME that is cold, but I need to get people to verify this by confirming that they don't feel the same way. This tends to come on bad during the middle of the day when I am at work and may last for a couple of hours before wearing off. And the symptoms may recurr every few days before stopping. I now suspect that this is the first perceptive signal that things are going to be different, but until last year I did not cognitively make this connection. I suspect that Mother Nature is sending me a signal to prepare for the winter. Keep warm, get eating and build some fat reserves for the winter!!!! So starts the food cravings, and the periods of long inactivity and the desire to stay home at all costs.
Another related observation came at Christmas time a few years back. I was going out with my son and he was amazed at how lightly I dressed to go out. He said it was freezing cold out there.. but to me it was just mildly chilly. Now some might say that this is the result of the layers of fat around my body that tend to come on over winter. But I think not. For this reason. When spring comes, there is usually day or a few days that come when again I feel absolutely freezing cold. But this is completely different from the Autumn chill I go through. This time i KNOW that it is MY ENVIRONMENT that has become cold (or seemingly so). My reaction to this is to want to get moving and generate some internal heat. What's more, when this happens, suddenly all the energy that I lacked in the winter is gone and I can be wonderfully active and "normal" again. I know for a fact that this is a PERCEPTUAL experience because my thermometers at home confirm that the interenal and external temperatures have actually NOT changed. The upshot of all this is that IN WINTER, I DO NOT FEEL THE COLD AS MUCH AS I SHOULD. Somehow mother nature has blessed me with a coldness perception blocker, but she has also landed me with a set of "behaviours" and "conditions" that protect me from getting exposed to the cold. These "behaviours" are in fact my depression. When spring comes, it's as though that cold protection mechanism in my head that stops me feeling cold has been turned off.
Now what about the red nose and eyes that I seem to have when I wake up in winter? This is actually one of the best indicators of my mental mood! The redder the patches, the more zombified I feel. This year, I have been fortunate enough to be unemployed and have time to watch these things a little more closely. I now realize that in fact, the blood supply to my facial skin changes. The patches seem really red, and I have been inclined to think my skin there is inflamed. But having paid more close attention to these things I now realise that in fact I really have white skin that is drained of blood around most of my face and in effect, the skin around my eyes and nose are really is more or less as it should be!!!! As the day goes by, the colour of the skin in the other areas of my face reddens up and so the so called patches around my nose and eyes seem to disappear or blend in. So I conclude that the blood supply to my skin is severly restricted in the mornings. What I think is happening is that when I go to sleep at night, as heat saving measure, the external blood capilliaries around my skin close up. For all I know, it may be happening in my brain too, which may explain the zombie like feeling I have at that time of day. I have now noticed that at night time, the skin all over my body tends to redden up. I think what is happening is that my body's internal furnace is being turned up, probably to counteract that historic genetic expectation that I will experience winter's cold and need some protection from it. This "opening up of the furnace" is really just the increased activation of all the cells in my body. It is why I feel alert at night and dead during the day when the furnace is turned down.
The mind and body connection is really quite marked. I recently bought a skipping rope to lose some weight. I find that if I use it when my skin is pale, I tend to trip up more easily in the rope and can only skips about 10-12 times before starting to feel tired. When I feel mentally alert, I have noticed the skin on my face as well as elsewhere (such as the backs of my hands) is quite "pink" and I can skip hundred or so times and perhaps make just one or two trips in the rope. I think this blood circulation issue is the reason why I can't run for the train in the winter and why the heart rate monitor at the gym behaves as it does. Because I have poor circulation, my poor heart is pumping like mad to push blood round contricted capilliaries, and not succeeding! Which is why I get so ****** tired and why my brain is not working as it should!!! But why are the eyes and nose not deprived of their blood supply? Well, if you take an evoltionary biology view of this issue, I think that is clear why Mother Nature has not deprived me of all my senses!
Well at least I now think I know what is going on. Of course, it will be for others to find out why.
One last thing. A few years back I started the Atkins diet and lost an amazing amount of weight. I think I went from over 195 lbs (14 stone or 89 kilos) to 175 llbs (12.5 stone or less than 80 Kg), which is still slightly higher than the recommended weight for my height. This was the only winter I can recall when I did not get a severe winter depression. And my activity levels went up and I was a regular caller at the gym. That year I felt incredibly "smart". My technical job as a computer systems analyst suddenly seemed easy. I could do in a few hours what would normally take me a day and half to do. I could read my newspaper on the 30 minute journey train journey to work. I would know that I had skim read all the key articles of the day that interested me, read in depth all the articles that I wanted to read deeply, and knowingly scanned and declined to read all the articles that I did not want to read. If that is how you read a newspaper then I think you may think me mad for mentioning this. But because of my depression, I no longer function like this most days. In winter time I have barely finished reading pages 1 and 2 of the paper before my journey's end. Not even in summer, though it is nowhere near as bad as in the winter. I felt like I had emerged from a nightmare into a wonderful world of colour and interest. I started a University Course. But as I neared my target weight, I started adding back the carbohydrates to my diet. And at this point I noticeable started to slow down mentally. This was around August /September 2000. At this time I had not even recognised the seasonal nature of my depressions thought I had been having them for at least 5 or 6 years. In fact, with a high pressure job, a busy family commitment and a university course to do it all became too much. I gave up the course and lost a lot of money as a result. Soon after, other external things made life even more complicated and I lost focus on my own health for a couple of years. By the time I did so, I realized that my weight problem was ever worse than before. Although in the description above the slowing down could be attibutable to season or carbohydrate addition to diet, I did not actually make the connection at the time.
The interesting thing about the carbohydrate factor was my recent diagnoses of adult on-set (type 2) diabetes. I read that in this condition, the body produces insulin to mobilse sugar, but die to factors unknown, people like me do not seem to get the energy into the cells. We tend therefore to put on weight and have high blood sugar. Under instructions from my doctor to lose weight and knowing whatI now suspect about carbohydrates, I re-started the Atkins diet. I did this knowing that it surely must get my blood sugar down if I stopped taking sugars/carbs in my diet. Again I quicky lost weight. I started about 8 weeks ago and have lost a steady 2 lbs or almost a kilo each week. And here is an amazing observation. My skin in the mornings was no longer blotchy. My skin colour was remarkably red.. I sometimes look as though I have been in the sun, even though this is Finland in Wínter and the snow has already come! I have been able to swim 1000m most days or go on long walks and not get tired. My body is largely fuelling itself on body fat, and at the beginning of November no sign of the winter blues. Then, as an experiment, this week, I started adding back a few carbohydrates to the diet. The ketone urine strips have stopped turning red and so my body is now out of ketosis. And guess what?!! The red eyes and nose are back, the problems focussing during the day are back, and its impossible to get to sleep before 3 am. I am tired and starting to crave carbs again. Back to the old routine. Well, as you can guess, I will be putting myself back on the Atkins diet soon, even though I have to go through that hunger pain barrier again. But I think it will be worth it. I have not yet reached the peak of mental alertness I experienced back in 2000 and I am only now at the weight I was then when I STARTED my 1999/2000 diet. But at least there is hope.
Friday, January 21, 2005
- I get tired,
- when I actually sleep,
- when I wake,
- and whether, when I wake I am dreaming.
I have also been tracking my mood, by which I mean how active I wish to be intellectually.
When I am good,
- I feel bright, and
- want to be physically and mentally active.
When I am bad,
I feel as though my body is awake but my thinking brain is asleep...
I cannot think clearly, my memory is shot through, and I just want to sit and do nothing (these are the times when bliss is to sit and wash the washing going round and round in the washing machine. Anything more taxing than this is impossible).
Then there is a medium feeling between these extremes when
- it is hard to motivate oneself, but not impossible,
- though the effort to da anything is ridiculously taxing physically and mentally.
The upshot of keeping this diary is it confirms that
- my go-to-sleep-time is shifting forwards by about 30 mins on average a day
- I can only dream (or recall any dreams) when I have been asleep for at least 6 hours
- I feel better if I have been dreaming
- It is much better to go to bed in the early evening and wake when it is still dark than to go to bed late and wake up when it is light.. (this confirms my suspicion that the light coming up is like a wake up call (probably histaminic)
- If I get insufficient sleep at night, I can sleep in the afternoon, but this sleep does not culminate in dreaming..its as though my lower brain has completed its sleep cycle but did not trigger any useful sleep activitiy for my higher brain.
- My depressions are more a result of insufficient continuous sleep than anything else. Failure to regulate my go to bed time is probably the biggest cause
In the last few days, my get to sleep time was getting so late again I was beginning to miss classes at the university. So I have again gone a whole night without sleep in order to move my go to bed time to the early evening. It seems to have worked, as yesterday I was able to go to bed at 8pm, be asleep by 8.30 and woke up dreaming. But I was than able to get up and do the homework that had been staring me in the face for the previous 12 hours without gaining a glance from me (because of my poor mood). So some good success!!!
This time I need to find some strategies for stopping the body clock drifting forward. I will try being more firm about my go to bed time. If that works I will not resort to using the light box (because I have had mixed results in the past with this). Sadly, going to bed at 8pm is not very good for my social life, as I would like nothing better to go to the bar and socialize with my friends. However, if I can stop the body clock drift with regular hours I would be more willing to go out a bit later. But my health is most important to me right now and I must put that first. Speaking of which, last week I got some blood test results last week. The important things were that
- My TSH was 3.5 (which my finnish doctor thinks is OK, but I know is bad because I always feel better when it is below 2 and better still when it is at 0.5)
- My Creatine levels were above normal range (this is probably familial because my Dad had a similar problem). I'm not sure what this could mean. Doctor did not seem over concerned, but I should have told her about my brother's kidney cancer, because Creatine is a sign of kidney malfunction.
- My Cholesterol leves are also high. Last time they were tested they were also above normal. The advise was to cut down on animal fats (unsurprisingly). I am also trying Benecol.. a Finnish product I should add.
- And to make matters worse, my blood sugar levels were also considered to be too high. But no advice from the GP other than I need to lose weight (which I know anyway, but its hard to exercise when I feel low).
Next week I start my start my work placement as part of my university course. I am looking forward to this, but with a little bit of trepidation. Still, we shall see soon enough how it goes.
Thursday, December 30, 2004
In the last post I reported a single sleep block ending in a refreshing dream state sleep. I also felt more active and inclined to get on and do things after this and so there was some success, although I was now waking up 12 hours later than I should be.
Now, knowing that the human body has a natural tendency to a 25 hour unregulated diurnal cycle and that shifting the clock back is harder than shifting it forward, the plan from then on has been aimed at moving the wake up time forward an hour or two per day, starting from 26 December.
The aim was to peg my wake up time and determine my target go-to-sleep time. Having woken up on Christmas Day at 1700 and reckoning on needing 7 or 8 hours sleep my aim was to go to bed at about 1000 on the first day, and then day by day push this forward an hour or two until I was going to bed at a more normal time. I reckoned this might be possible in about 10-12 days.
I have had some unexpected fortune on the first day because I could not get to sleep until 1400 and ended up sleeping for another 9 hours instead of 7 (which was an excellent start really because I leapt forward 8 hours on the plan instead of 2 hours). So I woke up at 2300 which meant that my wake up time just needed to be forwarded by another 8 hours.
The next day I slept another 10 hours but this was split across two periods, one starting much earlier than planned (asleep 1300 awake refreshed at 1900) and the other 0300 to 0700 . Now this is the time I should be waking up!!! So in 2 days I was already on target. Could it be sustained?
Across the last 48 hours I have again slept in two periods. A 2 hour period in the late afternoon (my twighlight doze) and a 7 or 8 hour period, the first of which left me waking up at 0700 again but the last leaving me awake at 0330. This happened because yesterday I responded to a feeling of sleepiness at 2000 and decided to go to bed instead of going out as planned. I am beginning to think that my problems begin when I ignore a sleep signal in the early evenings.
I also now think that 7 hours sleep is fine in summer but in winter I should be aiming for 9 hours per night, to some extent mirroring the lengthening nights of winter. I was curious to learn from Coturnix that 2 periods of sleep per night is a normal pre-electric light sleep pattern, with the first sleep happening at sundown. Maybe I should not worry that I am currently getting my 9 hours sleep over 2 periods.
And here is another interesting observation which I have not mentioned before but which is interesting to note. Last Christmas when I was living in England I went out for a brisk walk with my son who complained bitterly at how cold it was outside. I was wearing fewer layers of clothes than he yet did not feel the cold at all. Months later, on March 1st in fact, I woke up at 0700 and felt frozen to the bone. I immediately leapt into the shower, got dressed and then was amazingly active. I then realised that my depression had lifted but only later called into question whether that morning was any colder than any other morning. My central heating system was working so the thermostat should make the temperature inside the same as yesterday. A call to a friend confirmed that my coldness was purely experiential to me as the outside temperature had certainly not changed. Conclusion? Well I believe that in winter I become cold tolerant. I therefore think that mother nature prevents me from experiencing the cold in winter time and takes steps to ensure that I do not become accidentally cold exposed. So I am awake at night and I am encouraged not to go out in the day*. (*Another feature of my so called depression is that I never seem to want to venture out unless I am forced to... a behavioural trait that is certainly a winter-time one and led by instinct rather than logic).
The interesting thing this morning was that 0630, soon after getting up I suddenly felt terribly cold. Frozen to the bone in fact! Now again this was experiential because I was not cold at 0530 and the temperature inside is well regulated. Am I coming out of the depression? An hour later the feeling had gone.
I certainly hope so! But I must be careful here. In England my depressions normally come on bad in December and lift in early March. Here in Finland it came on bad in November. If controlled by the hours of daylight (which I am inclined to believe with the science community that it is) then I ought to expect it to run through to until March or even April. But I have been using my light box recently (and at some odd and un-recommended times but with the aim of aiding the shift in sleep times). I wonder if that has had an impact?
In the summer time, my sleep-wake pattern is fairly normal. I guess it runs something like this
23.00 - 04.00 5 hours deep sleep
04.00 - 06.00 2 hours rem sleep (assuming it is the normal 2 hours)
06.00 - 15.00 9 hours wakefulness
15.00 - 16.00 1 hour afternooon dip (I leave the office for some fresh air and to wake up)
16.00 - 23.00 7 hours wakefulness ... gently tailing off before sleep
In the dead of winter, my natural pattern is shifted thus...
05.00 - 11.00 6 hours deep sleep. Wake unrefreshed. Never dreaming. Histamine flush?
11.00 - 16.00 5 hours awake but inefficient memory and cognition
16.00 - 18.00 2 hours Extreme sleepiness often with REM (cos I dream & wake refreshed)
18.00 - 22.00 4 hours moderate wakefulness
22.00 - 05.00 7 hours Wakefulness. I transit from wake to sleep without feeling sleepy
So in the winter I am getting two periods of sleep. My feeling is that sleep is delayed (for reasons unknown) so sleep starts about 5 or 6 hours later than normal. I have a feeling that I am woken by a chemical flush of histamines (because of the red flashes that appear on my face at this time). Whereas in the summer my bed clothes are often on the floor when I wake up, in winter they are as neat and tidy as when I went to bed. I concude that my sleep is active in the summer and that I dream and move about. I almost never wake dreaming on those winter mornings and I conclude that I am not getting my REM sleep. When sleep researchers wake people before they go into REM phase, the effect is to lower the cognitive ability of the individual. This is exactly how I feel.
My winter afternoon sleeps are brought on by the sunset and though short, they are refreshing and are often dream state sleeps if allowed to run their course. Thus, it seems to me that my normal summer time morning REM sleep is shifted to the afternoon with the consequence that I am then up all night.
OK. My effort just before Christmas did not enable me to delay sleep and move the sleep start time to midnight. I still was awake at midnight on 24 December. However, When I did get to sleep eventually at 5am I did sleep (not surprisingly perhaps) for 12 hours waking up at 5pm on Christmas Day. The great thing was that I had a long sleep and woke up dreaming, and feeling like I had had a good night's sleep. I had managed to join up the early morning and late afternoon sleeps into a single sleep period starting with a deep sleep and ending ina REM sleep. The only problem was that this sleep was ending about 12 hours later than it should!
Friday, December 24, 2004
I have been succeeding in not sleeping in the day and utterly failing to sleep at night. You would think that the sleep deprivation would enable the catch-up mechanism to fall into place so that night sleep can take place. In my case at least, it does not.
I found an interesting link about sleep and the circadian rhythm
It includes some research by a Dr. Wozniak (whose work I will try and follow up on) and a recommendation for people with DSPS which is not unlike the others I have read. Maybe I should re-attempt using my light box to shift my sleep pattern bit by bit instead. But I get the impression that I need to freewheel first and get some proper sleep. Free-wheeling (sleeping as and when I needed it) was what I was doing after my rhythm broke down this year. Although it did not fit well with my university studies and I was not fully functional, at least I did not feel like I feel now... totally shattered!!
Then about a year ago I learned of a condition that actually described my problem quite well. Delayed Sleep Phase Syndrome, or DSPS. In DSPS, people seem to have the onset of sleep delayed until 3 or 4 in the morning. A period of sleep then follows, which in my case is usually about 7 hours, so I typically might wake at about 11. But this sleep is not refreshing at all and it might take another hour before I can really get out of bed and get moving. When I visit the bathroom I am met in the mirror with a red, blotchy face, especially around the nose and eyes. I now suspect that this is caused by histamine, a hormone that plays a role in promoting wakefulness.
In normal people, in the last 2 hours of sleep, cortisol levels rise markedly and this period is also associated with REM sleep and dreaming, functions that are thought to promote organization of knowledge and memories and thoughts... i.e. higher brain functions. People deprived of REM sleep eventually become disorganized and dis-oriented, so REM sleep is considered to be very important. In most people, a 7 or 8 hour sleep period is followed by a period of activity during the day, with a progressive slowing down towards the end of the day, followed of course by the start of the next sleep period.
In people with DSPS, the period of intense wakefulness happens at night and the sleep period is not followed immediately by a period of intense activity.
This describes me quite well. In fact I am physically awake at 11 am, but mentally still asleep. At about 4pm (say) as daylight begins to fade, I can get very tired and sleepy, but of course sleep is not always possible, especially if at work. Rest is about as much as you can do. If I do get the opportunity to sleep it is usually a short sleep of perhaps one or 2 hours, but is incredibly refreshing. I wake up and finally have the energy and motivation to do things that I have been lacking all day. Unfortunately the energy boost is short lived so by midnight, physical exhaustion is back, but mental activity remains high until 4 or 5 in the morning.
What is going on here? Well, I have not been able to get a proper diagnosis or help but here is what I think is happening.
My feeling is that, when I am in this DSPS condition, I am not getting the 2 hours of REM sleep and my cortisol levels are low in the morning instead of being high. This means I have a depressed mental ability for most of the day. So although my lower brain is working and controlling my limbs and my physical being and I am walking around with the rest of the world, my higher brain is in fact only just about ticking over. It might just as well be fully asleep sometimes, because in the nadir of this condition I am mentally capable of nothing in the mornings or afternoons. In the late evening my lower brain is winding down my physical body, but my higher brain is only just waking up. Hence I am the main with two brains, each running on a different bio-rhythm. It is no wonder that I feel like I am only half my normal self at this time!
Because I get the boost in energy levels in the early evening, I believe that I am getting my circadian boost of cortisol from about 7pm, reaching a peak at about midnight. I very often am physically exhausted at this time, being incapable of any physical activity, yet totally unable to sleep. The mind is too active. And I believe that it is primarily the action of histamine that is waking me up in the mornings, judging by the bright red blotches on my face that will go away as the day progresses.
Now there is a family connection here. My mother, in her later life, stopped working and would often be asleep until late morning and describer herself as feeling pretty useless. Yet my father, who used to work at nights, would come home to discover that she had been sitting up all night, intensely listening to the radio. She also had other problems which fortunately I do not have, but I do think that there is an inherited characteristic here. Which leads to an interesting question. Debilitating as this condition is to the suffer, why has it survived? Does it confer a biological advantage? And is the reason that this tends to come on the winter somehow significant? I believe it is, and here is why.
The life we lead today is nothing like the life our ancestors led. It is their lifestyle needs that shaped their biology and in particular, gene characteristics that conferred a biological advantage. So what can possibly be so biologically advantageous about DSPS? Well actually, I think it is quite obvious.
One of the most important problems for our ancestors that migrated over millennia out of Africa to the northern and southern hemispheres would have been how to survive those long winter nights. Hypothermia is a killer even today. It would have been a major killer too for our ancestors. At night, when we are asleep and our body temperature drops and we lose consciousness during sleep. If we get too cold, we could easily die. So being awake and keeping that body temperature up, whether by keeping a fire going or just by being awake and being active, might be the difference between life and death. As hunter gathers, the human population in winter time has no need to be particularly active. Hunting is difficult and energy consuming. Better to live on those starchy foods put aside for the winter (is this sounding familiar?) and conserve energy by being relatively inactive. No need for much cunning in the wintertime (a higher brain function). And what better time to sleep than as the sun is coming up and temperatures will again be rising and not falling. So I am living out in this modern world, a pattern of behaviour that kept my ancestors alive but makes my life as IT Manager quite hellish in winter.
It is interesting to ponder why "depression" is so closely related to "stress". Why on earth did such a situation arise, and what possible benefit could it be to the species. My condition almost certainly arose after a very stressful life event, as indeed was the case with my mother. Perhaps the evolutionary story above is the clue. The stress of winter survival would certainly be a real stress for our ancestors and its onset could have triggered this potentially life saving condition. Its just that our bodies are driving by chemical signals and there is not much to distinguish psychological stressors from physical ones.
In due course, we may evolve out of this situation... but that is little comfort for me today.
Wednesday, December 22, 2004
Welcome to my blogg. Thanks to R for getting me started on this. We shall see whether I can keep the thing going and have enough to say that doesn't make my reader want to fall asleep in seconds flat.
This week has been perhaps both the least yet in some ways the most productive of my time here in Finland.
On the downside I have stopped struggling with this stupid bio-rhythm disorder of mine. This keeps me wide awake all night until about 0500. Then I fall fast asleep from 0500 until about 1300 (after which I wake up feeling as though I have not in fact slept at all). I always wake with bright red blotches on my face which I think is a sign that a histamine shower has woken me. But then I am physically awake from 1300 but mentally half asleep until I wake up properly at about 1900, sometimes (but not always) with a productive 1 hour nap anytime between 4pm and 7pm. This sllep-wake pattern kicked in when my classes had stopped for 4 weeks. When classes resumed I tried keeping to normal time for about 4 or 5 days days during which time I managed with just about 11 hours sleep in total. Of course this was unsustainable and I collapsed in total exhaustion on the Friday afternoon. So there will be no more formal classes in the university for me until I can get back into a more sustainable rhythm.
On the upside, I have been doing some private study with some good outcome. But more to the point I have just about doubled the number of new friends I have made here in this little Finnish town where I live. I have already made some good friends here and elsewhere in Finland, and these new people I think I will become good friends because we share so much in common. The similarities are very strange.. almost spooky. Unfortunately two of these new friends are having a torrid time right now in their personal lives. Both are experiencing or have experienced recently the stress of divorce and family disharmony. I am especially worried about P who was in tears this evening. She is trying to cope and clearly manages to put on a brave face when she needs to (as I saw with one of her sons tonight) but...when he was gone she almost collapsed from the strain of it all. On top of everything she has lost her voice so everything is communicated in writing. We hardly "spoke" at all this evening because she was so engrossed in family matters, and they are clearly wearing her down.
I know hardly anything of her problems and I must rely on E. (who has problems of his own) to take care of P... but she needs him right now and I hope that he can provide her with the support she needs. He is a wise soul and I am sure she is right to trust him. I know she knows that I would like to help, but right now it would not help for her to even try to explain to me what is going on. I know she is not sleeping, and it shows. I fear for her terribly. I think this woman will be in hospital from sheer exhaustion before too long. I hope she is strong enough to cope the future whether or not that happens.
So I ought to be feeling elated about these new friendships but in fact I am rather fearful for them. And as for my other friend R, I know he is having problems of his own right now and I worry a little too about him. But he assures me that all is going to be OK and that he can at least share his troubles with a friend who understands.
As you who follow this bogg will come to realise, I am a born worrier! I worry about anything and everything. But it means that I care.
I hope you will find my observations about life in two different european cultures to be of interest.