Stuck, Unhealthy.. and Middle-Aged

Around the time I was diagnosed with Borderline Personality Disorder, and Complex Post-Traumatic Stress Disorder, I discovered The Ketogenic Diet. I had been prescribed Lamotrigine as a mood stabiliser, and whilst researching exactly what I was putting in my body, after many unsuccessful years of a variety of Selective Serotonin Re-uptake Inhibitors (SSRI - Anti-Depressants), I came across this diet via the fact that Lamotrigine (Lamictal) had been a long available medication for Epilepsy. Digging deeper I came across Ketosis, in simple terms the state the body achieves when switching to fat burning from the 'quick hit' of using carbohydrates (sugars) as fuel. When glucose supplies are exhausted, fat tissue releases fatty acids into the blood which then travels to the liver which in turn creates ketone bodies that become the primary energy source. Still here? Good.

Okay, so the 'Keto Diet', which probably didn't have such a media friendly name at the time, was developed by a chap called Dr. Russell Wilder in 1921 upon discovering a significant impact on seizures and cognitive processes, due to reduced inflammation in the brain after prolonged starvation, or what we refer to less terrifyingly as 'fasting'. Wilder hit a sweet spot by dividing up food sources into a high fat, moderate protein, and low-to-no carbohydrates. This ratio would encourage the body to switch to fat burning by 'kind of' imitating a fasted state.

Obviously, burning fat as a primary source of fuel would have an effect on the actual amount of fat available to the body, I mean, if you burn wood in your lovely home fire or stove you will notice a significant decrease in the amount of wood you have in your shed. I don't even think this even qualifies as science, it's just a thing right?

So, the double-whammy of fat loss and perhaps a potential cure, or at least an improvement on my constant brain fog and utterly off the scale mood swings was a big draw. I'd been in a much worse state than ever after the long period of isolation during peak COVID Pandemic (that we may, or may not still be in), which to my mind didn't make sense, being forced to interact and take part in social interaction seemed like a blessing to me. I felt I had nothing to lose other than the beer and pizza that had made me 'blossom' into a rather impressive 160 Kilograms (353 pounds).

It took a further two years to realise that this period of pandemic had exacerbated the at this point, undiagnosed, Attention Deficit Hyper-activity Disorder and Autism that I had been battered with my entire life, which then in turn, exacerbated any mental illness I suffered from (I have it all going on eh?).

I put myself on this diet with a little 'popular science' assistance from the late Dr. Michael Mosley via his Channel 4 show 'Lose a Stone in 21 Days with Michael Mosley'. It seemed like a less weird, and less brutally scientific thing to do to myself at the time. You don't really become aware of this at first but the first few kilos you shed are due to water loss, a great deal more peeing, water being critical to the fat burning, and waste extraction process thereof. Ketosis alone is not the golden pill for weight loss, significant calorie deficit, either on a daily basis, or via Intermittent Fasting is an important part, after all if you keep buying logs your woodshed will remain full. So after three weeks of removing my beloved carbohydrates, especially those extra tasty ultra-processed ones that are so difficult to digest thoroughly, I managed to lose more than ten kilos, and over the period of about a year as much as forty-five kilos, obviously the fat loss slows down as severely restricting calorie intake becomes unsustainable, and we throw in a few more eggs here, and another couple of organic grass fed beefburgers there.

So, I managed to keep this weight off for nearly two years, and also to the astonishment of one or two medical professionals, I completely reversed Type II Diabetes, with only a brief period of 'bad' cholesterol, which actually pretty much just sorted itself out.

Then I had my ADD/ASD diagnosis, and was subsequently prescribed a starter dose of 30 mg of Lisdexamfetamine (Elvanse, or Vyvanse to any readers I might have from the USA), which is a stimulant medication for Attention Deficit Hyperactivity Disorder, which sounds a bit counter-productive, but actually calms, with like any medication, some exceptions, ADHD brains, much in the way you hear about us drinking a gallon of strong black coffee and taking a nap, which is now one of those 'Internet Memes' that I'm not sure I approve of, this stuff just isn't fun or entertaining really (this might be another post for another time). Things were great for a couple of months as my dosage was gradually increased, I was back to swimming every day, walking the dog, cooking for my partner, and our collective (grown up) children. I was, as one might say, quite perky, and more to the point, functioning, albeit in my always preferred, restricted company. However, as my brain settled into its daily dose of amphetamines, things got a little strange, I still had the mental clarity on a level I had never experienced in my life, ever, I could concentrate on tasks I had set myself and more often than not see them through to completion. My sleep, although still not what I would call brilliant, was consistent and actually getting there, by comparison, was a great deal easier. But, I forgot how to do stuff, I refused to make decisions, or go outside. I started eating more or less the exact same meal for days, even weeks on end, because it was safe, predictable and reliable. We see the term AuDHD a lot these days, it's pretty much a social media thing really, a way to say I have Autism and ADHD all in one go. Unfortunately, the reality is quite different, because rather than 'and', we're looking at Autism versus ADHD. These aren't variations of the same thing, they are opposing, or conflicting conditions that sadly do not cancel each other out, or in any way co-operate. One craves structure, the other thrives on chaos, and so on. Medicating ADHD had allowed Autism to flourish, and really have its day in the sun, and all those coping strategies that I had adopted through life to make like I'm just like everyone else were gone, the rules had changed.

I put on weight, not the entire forty-five kilos that I had lost but three or four, I hadn't gone back to drinking beer, eating pizza, chips (fries), chocolate or sandwiches. I just sort of stopped moving. My Lamotrigine had been discontinued by my psychiatrist, he'd been a little overconfident that all my problems stemmed from ADHD, an ill advised move it would seem as my mood plummeted, this has since been reinstated but things are definitely not how they were. I imagine this is often the sort of thing that might happen quite frequently when a local mental health unit is pretty much surviving on a rotating cast of locum consultant psychiatrists who never really have the full story and are also overloaded with patients, I feel a little wobbly thinking about the times I've received outpatient reports and wondered if they were actually mine.

I couldn't go out without the dog, or my partner, not due to any noticeable anxiety or paranoia, I just couldn't, as if I had simply forgotten how to be. Several months down the line I am still like this, I'm driving myself crazy about not swimming, or going to the gym, and only walking with my partner and/or the dog, and never getting any real pace going or working my heart and muscles. I doom-scroll, play video games, re-watch television programmes I've watched over and over again, and sometimes I just sit, for hours. I feel well and truly stuck, and I am really hoping this will pass. I've 'just' started to manage doing some weights and stretching in the spare room but it's only ten minutes or so at a time, which, I suppose, is better than nothing. If ever there was a need for psychotherapy, it's now. I've been promised help from the ever over-strained National Health Service but it could still be another year, or even more, there is no way to tell. Money is tight, so private therapy would be tricky, and although I have a shared care agreement with my doctor for my Elvanse I still need very expensive treatment reviews with the private ADHD clinic.

Essentially I am in a position where I will be constantly waiting for something, whether that be therapy or just some kind of switch clicking in my head that will allow me to at least know, and decide what to do.