Excess Baggage

I've been sleeping during the daytime and thinking about food when I wake.

The chemical pathways that are acted upon by antidepressants to alter our moods are somewhat crudely tweaked. So sleep, appetite, aggression, and sex drive are all tweaked too, inadvertently, by antidepressants. I remember how my appetite crept up when taking mirtazapine until one day I couldn't walk past food without tucking in. I looked and felt awful. The hunger drive is a powerful one and I satisfied it, whether I needed the calories or not. The weight gain was rapid and, because the behaviour didn't show any signs of subsiding, it continued rising indefinitely.

Quetiapine has a similar action on appetite and, given my dose is expected to increase steadily from 50mg to perhaps 300mg, this battle with my weight is set to be a long one. Sadly, some patients refuse to take Quetiapine because they fear the weight gain. It might seem strange that someone with a mood disorder would leave it untreated to preserve their appearance. However, low self esteem is a common foundation stone in cases of recurrent depression, as it is with me. Low self esteem ... that's looking in the mirror metaphorically and literally, and finding all sorts of reasons to dislike what you see. It isn't a good context for binge eating and weight gain. The mystery is why pharmaceutical companies consider antidepressants that cause weight gain a success.

One blogger taking Quetiapine recounted how he awoke each morning to find food on his mouth and open wrappers beside the bed. He had been sleep eating! Another told of how she now set five different alarms to wake her - but still found she couldn't make it to work on time! In her sedated state she had turned each alarm off in turn and smothered her iPhone under her sleeping chest.

I can appreciate the feelings in each of these stories. My brain's focus on food is akin to what you would experience had you fasted for 24 hours, only I am eating and I've yet to feel full. My sleep has been a dreamless void into which I disappear indefinitely without means to reach me.

I want to avoid the weight gain and the excessive sleep. I'm well past the vanity of attending to my appearance ... I just want to be fit enough to do the things that fathers do. So even now, as the Quetiapine makes its first claims on my appetite, I'm fighting back... albeit with apples and water! There, I've said it now, so you can hold me to it.