Got Ants in My Pants and I Need to Dance!

Recently, my doctor and I decided to up the dosage of my antipsychotic. Unfortunately, this has caused a major problem for me: akathisia.

What is akathisia? According to Wikipedia:

Akathisia is a movement disorder characterized by a feeling of inner restlessness and a compelling need to be in constant motion, as well as by actions such as rocking while standing or sitting, lifting the feet as if marching on the spot, and crossing and uncrossing the legs while sitting. People with akathisia are unable to sit or keep still, complain of restlessness, fidget, rock from foot to foot, and pace.

One of the major causes of this is drug withdrawal, although antipsychotics have this as a common side effect. In terms of side effects, this one is miserable. You’re down, you’re up, you’re side to side. Your legs are moving, your arms jittery, unable to sit or lie down. Every muscle is on fire. Just go, just go. Your legs run on the floor, miles in minutes, without you going anywhere.

There are a few different ways to treat this, one being medication. Keep in mind that you should always talk to your doctor before making med changes though. Beta blockers and lorazepam are shown to help minimize the side effect. In addition, you can talk to your doctor about lowering the dosage of the medication that causes it or find a new medication. There has also been some data that show that Benedryl can be effective in treating akathisia as well.

But what to do in the meantime? Well, I’ve found that funneling movements helps. For example, I have a fidget toy with me to keep my hands busy, and I have bouncy hemispheres that keep my legs busy. If I have to concentrate on something, I usually pace in order to eliminate the amount of energy that goes into stopping the movements.

If I have time on my hands and the akathisia is particularly bad, I try to channel it into various workouts. You can find some basic fitness moves online or on an app. Use this miserable side effect for the better.

When I have akathisia, I try to drink more than I usually would, since my body is expending more energy. Try keeping a water bottle with you, especially if it’s warm out.

So, what do you guys do for akathisia?

Secured Snacks

Here it is in all its glory

Here it is in all its glory

– TRIGGER WARNING –

I’ve been putting off writing about this hack for awhile. This one is difficult to admit. Food, weight, and control are some of my biggest triggers, and here they are in one embarrassing life hack.

Let me start at the beginning: I’m on a number of medications, including antipsychotics. I take them at night, but there’s this twilight hour (sometimes longer) between the time the meds kick in and the time I fall asleep that is hell. All I think about is food, and my self-control disappears. If that twilight zone lasts too long, it goes into a cycle of binging and purging. I eat tons of stuff that I don’t even really like, and then Ctrl + z my stomach by puking. Again, and again, and again until I fall asleep.

To make matters worse, I eat in my sleep. There have been times when I wake up with half-eaten food in my bed and I have no idea how it got there. Chips, crackers, tortillas… even frozen (!) lobster ravioli. When the sun comes up, it shines on crumbs, shame, guilt, and one hell of a stomach ache.

I’ve tried everything to stop. Brushing my teeth, chewing gum, chewing wax, whitening my teeth, drinking water, drinking Diet Coke, taking my pills later, taking my pills earlier, mints, low-calorie snacks, trying to just say no, self-injury, eating more during the day, eating less during the day, “thinspiration,” positive thinking, negative thinking, eating acidic foods so it hurts to purge, journaling, art… this is only a portion of the list. And you know what it did?

Jack shit.

When I lived at college, I just didn’t keep any food in the room, but when I moved back in with my parents, I couldn’t control the pantry. However, when I moved into a new space with my boyfriend, I decided to accept the side effect and admit that I needed a stronger barrier than what my tired mind could provide.

And that’s where the bicycle lock comes in. I’ve designated one cabinet as a secure snack space. I put all of the foods I’m most likely to binge on or sleep-eat. It’s mostly dark chocolate (I have a small piece every night before I go to bed), high-carb food, desserts, and salty snacks. If it doesn’t fit in the cabinet, I only buy small portions. During the day, I leave the cabinet open. I only binge after I’ve taken my meds. Before I go to bed, I lock the cabinet and hand the key to my boyfriend P, who hides it somewhere around the house. Sleep-me can’t find the key, and awake-me often settles for a low-cal snack or just gives up. There’s something about removing temptation that sets me free and relieves stress. I don’t have to put so much effort into self-control if binging isn’t even an option. When P wakes up, he unlocks the cabinet or tells me where the key is.

The process started out as humiliating:

“I’m so pathetic that I have to lock my food up?”

“What does P think? I’m so embarrassed.”

“I’m a failure.”

But somewhere along the way, I realized that it’s not really me who’s binging. That’s Seroquel-me, not regular me. It’s not something I could really control even if I tried. There have been so many studies about gaining weight on antipsychotics and other psychiatric medications. If this is something I have to do to counteract Seroquel-me, I shouldn’t be embarrassed.

There are a few problems with this system. You can’t live alone (who would hide the key?). If you live with a lot of other people, they might not be happy about locking food up. It’s harder to lock fridges and freezers. Your roommate could forget where they hid the key. If you have guests, it could be embarrassing for them to see locks on the cabinets (I use a bicycle lock to prevent this- I take it off and no one is any the wiser). But who knows? It might work for you.

Easy Eats

Time to prep a midnight snack.

Time to prep a midnight snack.

Let’s face it- a big part of what we choose to eat is what we see in front of us. Think about it. It’s late at night and a hour after you took your Seroquel. You get that nagging need to eat, so you raid your fridge and pantry looking for something to nom on.

What do you eat? Well, what’s there? Ice cream? Chips?

In general, it’s easier to find unhealthy snacks. They’re shelf stable, easy to package, and all the cooking is done for you. Fruits and vegetables, on the other hand, are hard. You have to wash them and cut them. Avocados go bad, like, five minutes after you buy them. If you’re not feeling that great or if it’s late at night, your train of thought won’t be, “Oh wow! So happy I grabbed that zucchini! Let’s wash, peel, and slice that sucker. Maybe I’ll pan-fry that bitch in some Himalayan sea salt and olive oil.” Or, if that is your train of thought, I envy you, because mine is: “Are those chips? Are they more than crumbs? How stale are they?” Although, I’d still eat them even if they tasted like cardboard and I had to use a spoon.

So what do you do? Make it easier to eat the healthy option. If you buy fresh vegetables, wash and cut them all at once and toss them in the fridge. I love fresh berries. When I get some, I dump them in my Sistema colander/storage container, wash them with a veggie wash, and stick them in the fridge. You can also find pre-cut and washed apples, carrots, etc in the produce department of your grocery store. Yogurt is a great choice, especially those nifty Siggi’s tubes. And there’s also my old stand-by of hard boiled eggs.

If you need something shelf-stable, try almonds or applesauce. Besides the salt, turkey jerky can be a good choice for protein. Bananas and peanut butter are a good choice.

Once you have a selection of good snacks, make the unhealthy snacks harder to get. You can avoid buying them, have a friend hide them from you, put them in the basement, or keep them in your car. Worst case? Get one of these kitchen timed safes. Make yourself work a little for it.

Just a Taste

Photo Apr 30, 10 14 47 AMI’ve developed a coping mechanism that I like to call the “Just a Taste” process. It began when I gained about 60 lbs during the first year of taking an anti-psychotic. I started to watch my weight obsessively, making sure I didn’t gain more, making sure than I didn’t eat one calorie more than I needed.

I don’t think I need to tell you how much that failed. If I’m craving a particular food, I can’t stop obsessing about it. I build it up in my brain to be something it’s not, not a food, yet another limitation I have from being sick. However, if I always give in, I immediately gain weight and sink further into a depression. This cycle haunts me and has been responsible for some of my deepest regrets.

So what do I do about it now? I give in, but just a little bit. For example, today I stopped at Dunkin’ Donuts (a chain of fast food coffee shops) and was really craving a doughnut. I can’t even tell you why, but today I just needed to have one. Instead of denying myself a doughnut and becoming depressed, I instead ordered a Munchkin. It’s like a doughnut, but smaller. It gives me the satisfaction of a doughnut without the guilt. I got “just a taste.”

You can do this with most food items. Do you really want a Snickers? Grab a fun size version. Want a Coke? Grab one of those mini cans. Once you have a taste of the thing you’re craving, it loses its power. I got my doughnut, and I can move on.

Getting Started with Healthy Eating

Beginning to eat healthy can be a very difficult to start. If it’s something in which you’re interested, check out this downloadable “Quick Start” guide made by Whole Foods. It’s pretty easy to understand, accessible, and gives some great tips on building smoothies and breakfast bowls, along with a few recipes and a shopping list. You can find the ingredients at most supermarkets.

 

Download Guide

Timing is Everything

Experiment with your medication time frames. [NOTE: Please consult with your doctor first to make sure this is ok.] For example, I’m on two doses of a stimulant that decreases my appetite, so I try to time lunch between them. I take my sedating night medications (such as antidepressants and antipsychotics) at night, generally around 10:30pm. I’m in bed by 11:00pm, and hopefully asleep around 11:30-11:45. If I take them earlier, I notice that I’m more likely to want to eat. If I take them too late, I’ll be groggy the next morning. For me, a 15 minute bracket of time can make all the difference. Now that I’ve established times that work for me, I set reminders on my Fitbit to make sure I fit in that 15 minute window.

Eating with Chopsticks

Another thing that helps is to deliberately slow down how you eat. If you want a snack, grab some shelled pistachios. Try eating with chopsticks. Let candy dissolve on your tongue rather than chew it. Separate large bags of food into smaller bags of food and put them far away so if you want more, you have to get up. When you slow it down by adding challenges, you’ll naturally eat less.

Healthy Exchange

Try to find snacks that are close to the foods you enjoy and crave, but are a little healthier. When I first started to revamp my diet, I tried to replace my favorite foods with  vegetables. If I craved Cheetos, I’d grab some carrots. However, it was really disappointing and frustrating to crave Cheetos and munch on carrots. After too many rounds of this, I’d get so pissed that I’d just buy Cheetos and ditch the carrots all-together. As you can imagine, this didn’t help at all- if anything, it made me more depressed. While I still keep carrots in the house, I also have a variety of healthy junk food exchanges. My “healthier” versions have to meet one or both of my two criteria: They either have to taste roughly equivalent to my unhealthy versions but made with better ingredients or they are similar in both taste and nutritional value, but take longer to eat. i’ve yet to find a food that really excels in both categories, but it’s not impossible. It might take some time to find the exchanges that work best for you, but once you know what to look for, it does get easier. One of my favorite exchanges is to replace Cheetos with Original Tings by Robert’s American Gourmet Food.

Cheetos Comparison-01

The easiest way to determine a good exchange is to compare the nutrition facts and the ingredients list. The two biggest differences between these two are the fat content and the sodium. In addition, check out how many ingredients are in the Cheetos versus the Tings. By replacing one food with another, you can minimize the terrible weight gain associated with psychotropic medications.

You can find more of these exchanges in the Eat This, Not That series of books by David Zinczenko and Matt Goulding. Some of the commentary in the books is a little harsh; however, if you ignore the words, you can glean quite a few good tips. They tell you a few of the most unhealthy options and suggest other items that are similar, but healthier.

Night Eating

One of the side effects I experience is night eating. I found that the best way to combat this is to have a snack before I go to bed to raise my blood sugar. I like to have a banana with a little peanut butter on top. That way, my snacking is defined, and I’m less likely to wake up in the middle of the night.

When this doesn’t work, I use my bicycle lock.