Managing Depression and Triathlon

This post appeared originally on September 19th, 2012 on basetrifit.blogspot.com

Today’s blog is about depression. This is a very personal topic but I feel it applies to a lot of friends and athletes out there and that is why I am posting.  I am very open about my experience with depression because what’s the point of going through something hard if you can’t help others?  If you know me, I’m pretty much an open book so please add any questions to the comment section below and I will be happy to expand on anything I’ve posted on the topic.
I am not a medical professional or mental health professional, this is about my story and my treatment and not meant to diagnose or treat anyone.

The College Years
I was a moody person as long as I can remember.  I’ve had ups and downs and all over the places, but I would say the biggest change happened in college.  I was diagnosed with Major Depression when I was 21 years old.  I was in college in Chicagoland had several events that I would consider ‘significant’ as far as stress goes.  At first my ‘illness’ manifested itself through disordered eating where I would monitor my caloric intake so much that I would have major anxiety attacks if I ate more than 150 calories at any one sitting.  Restricting my calories then morphed into me binging on candy or sweets whenever I went out and had a few drinks.  One friend noticed this but never said anything to me.  Remember this, I’ll come back to it.
After a while I got so bad that one morning, I could not get out of bed. I called my mom to say “I need you to come help me”. She was on her way that day.
I spent the next year working with a team of professionals (my primary care physician, psychologist, psychiatrist, and nutritionist).  I was put on medication for depression and started to do a lot of work on myself. I have always been an open minded person and have my own belief system when it comes to the universe, but I think it is fair to say I did a lot of significant soul searching during this time.

Out of Order: Broken Person Ahead
It was very difficult for me to hear a diagnosis like ‘depression’. I felt like I had a label across my chest that said BROKEN. It was also frustrating to have to take medicine because I felt as if I should be able to fix my problems myself.  Depression is a disorder of the brain.[1]  I needed medicine to assist me as I learned how to handle stress in a positive way. The medicine also helped me know what it felt like to be happy and steady again.  It was amazing at how conditioned I was to think that sadness was normal and that apathy toward life was acceptable.
Some people might say that taking medicine shows weakness.  I think it takes a lot of strength to ask for help and take the initiative in your own treatment.  Many of us are very quick to judge others but have a difficult time evaluating our own issues. Had I not had medicine (in combination with therapy), who knows where I would be today.

There’s a Light at the End of the Tunnel
As my treatment progressed, I learned more about myself, my depression, and my disordered relationship with food.  The nutritionist I worked with asked me if I knew when I was hungry and when I was full.  The answer was astoundingly “no”.  I had never thought of that before.  Our focus for a long time was just to listen to my body and really hear when it told me I was hungry or full.  It took a long time, but I remember one day being out to lunch with a friend and eating half of my sandwich. When I looked at my plate and I thought “holy c#@%! I’M FULL”.  It was a good day.
I was making progress. I looked at the positive versus the negative.  I put more focused energy back into things like schoolwork and work.  I created new friendships that were positive and reinforced good behaviors.  I also helped others who suffered from depression and openly talked about my struggles in the hopes that it would help others open up.

Here We Go Again
After about a year of treatment I can say I had made progress to the point where we started evaluating the need for medication.  I did get to a point where I no longer needed medication.  I still continued to see my psychologist and kept my primary care doctor up to speed on my mental health.
In the time between then and the fall of 2010, I graduated, moved to Columbus,Ohio, graduated with my Masters degree, fell in love, got married, and completed several Ironman competitions.  I managed any stress or anxiety with hypnosis and had great results. (I think hypnosis has helped me significantly in my treatment and would recommend it to supplement anyone’s treatment)
In 2010, one of my doctors wanted to start me on birth control to manage painful cramps (sorry guys bear with me).  I had previously been on bc that had NOT agreed with me (I had basically tried everything).  I was very wary starting a medication a month before my Ironman Florida race but she felt strongly it would help.  I agreed to take the medication.
After about 3 weeks I was a mess. I felt all the work I had done climbing out of this hole of depression had been a waste.  I experienced major depressive symptoms again and felt like I had no control over my emotions. I called my doctor who told me to stop taking it immediately.  If you read the DNF post this is what I was referring to when I said I’d post more information about it later.
After a conversation with my primary care physician here in Columbus, I started anti-depressants again, picked up therapy again, and got back in touch with my good friend Sherri DeRhodes to do some hypnotherapy.  I have all the while continued to train and focus on improving myself as a person and an athlete.
I am still on medication, but I am in a positive place again.  My husband is very supportive of me, my goals and my management of this illness.  I may get to a point where I no longer need medication, but I’m not worried about that at the moment.  I want to enjoy my life with my family, enjoy my sport, and live a good positive life.  It is my responsibility to keep myself as level and grounded as I can.

Family, Friends, Triathlon
Depression is really hard to explain if you’ve never had it.  I guess I would personally liken it to when you have a really bad day, it’s cloudy outside, and you can’t seem to find the positive in anything.  I was very lucky to have a strong, loving family who helped me when I needed support the most.
My mom drove down the day I called her to help me.  She dropped everything to come and help me ‘figure it out’.  She did research with me to figure out who to go see, what I needed to do, and how we were going to do it.  Could I have done it on my own, yes. Was it helpful to know I had someone backing me up, absolutely.  Ever since that day, she and I have been incredibly close and I can’t ever thank her enough for being there for me.
Many of you are probably asking “okay, so why is she posting this on a blog about triathlon?”  I have always been active and I always worked out in some way or another.  In college it was no exception.  I worked out a lot, especially during the depression episode.  Exercise was one of the things that made me feel better.
I got involved in the triathlon training group at DePaul.  We had such a close group of athletes working toward a positive goal that it gave me something to focus on that was fun.  It was my ‘release’ to train.  I got to take any frustration, sadness, fear, whatever and put it into a swim, bike, run, or lift.  I found solace and peace in what I considered a ‘moving meditation’.  It also provided me with an instant social connection when I moved to Columbus. Getting involved in COTT helped me transition from Chi town to Cbus.
Some may say that I traded one ‘obsession’ (restricting calories) for another (triathlon training) (Google female athlete triad for more info). I had this conversation with my psychologist and she proposed that athletics can raise self confidence and feelings of accomplishment.  I agree with her that in my instance, triathlon has been therapeutic.  There is research that goes both ways on this topic—so I say to each their own on this one.

Focus and Accountability
Triathlon has given me 2 things that I think are very hard to find when you suffer from depression; focus and accountability.  I had a goal that I felt was outside of my head.  By competing in a race I didn’t need to ‘think’ about anything – I just had to DO.  I also had a coach and a plan that kept me accountable. I had to get out of bed on days I didn’t want to. I had to get stuff done when I didn’t want to otherwise I wouldn’t be able to race the way I wanted to.  I will forever be grateful I found this sport because it gave me a way ‘out’ when I couldn’t focus on anything other than how sad and low I felt.

So Why the Post?
Depression affects so many people. I’ve listed some facts below for you to check out.  If you or someone you love seems to be down and sad—it is okay to reach out to them.  Let them know you are there and you care.  The person may or may not open up to you and hey, they may even DENY they are sad or have a problem.  That is OK.  Remember I mentioned a friend who noticed a problem but didn’t say anything to me.  When I found out she realized something was wrong but never offered to help or even asked about it I was hurt.  As a friend she saw I was in pain but ignored it.  Ignoring the problem in a friend or in you will NOT help the situation.
As a friend you can only let the person know you are there.  Don’t take responsibility for their depression or sadness but do be patient and loving. It can be very hard to do this when someone with depression seems ‘cold’ and ‘withdrawn’.  If you can, get the person outside in nature—perhaps on a walk.  The energy of nature is very powerful and can help ease pain and heal.

What Causes Depression:
According to the National Institute of Mental Health “Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depressive illnesses are disorders of the brain. Longstanding theories about depression suggest that important neurotransmitters—chemicals that brain cells use to communicate—are out of balance in depression. But it has been difficult to prove this. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression. Some types of depression tend to run in families. However, depression can occur in people without family histories of depression too. Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors. In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Other depressive episodes may occur with or without an obvious trigger.”

Some facts about Depression:
  • Major Depressive Disorder affects 6.7% of the U.S adult population
  • 30% of those cases are classified as severe.[2]
  • Women are 72% more likely to experience depression throughout their lifetime[3]
  • The average age of onset is 32 years old[4]

Signs and Symptoms of Depression:
  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.[5]

Need Help?
  • If you are thinking of harming yourself or know someone who is, tell someone who can help right away.
  • Do not leave the person alone – or isolate yourself.
  • Call your doctor, 911 or go to an emergency room.
  • If you can’t do this alone, call a friend or family member. Call me if you can’t find anyone else!
  •  Call the National Suicide Prevention Lifeline @ 1-800-273-TALK.
Please share this with anyone you know who has or does suffer from depression.  If you suffer from depression it is okay! Life gets better, things turn around, and you will know what it is like to smile again. Please be responsible in your treatment and follow through with your doctors prescription. Also, do not take yourself off of your medication without first discussing how to taper off of the medicine with your doctor.  Many people start to feel better and stop taking their medicine.  You CAN get off of medication but do it in the smartest way possible.
Thank you for reading today’s entry as it is close to my heart and I hope it sheds some light on depression.  There are some good threads on slowtwitch.com as well about triathlon and depression if you want to see if what you are feeling is ‘normal’.

[2] Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 2005 Jun;62(6):617-27.
[3] Kessler RC, Berglund PA, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2005 Jun;62(6):593-602.
[4] Kessler RC, Berglund PA, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun;62(6):593-602.