I need some advice here.
I have been entertaining thoughts of abusing wellbutrin for weight loss. I used the word abuse because I found out accidentally recently that taken in overdoses, it caused me to lose appetite and it was not the original reason why the medication was prescribed. I was given the medication because of depressive episodes as a result of bipolar disorder since late last year. I have very bad weight issues (BMI of 40++) and is on followup with a dietitian in a hospital separate from where I see my psychiatrist and psychologist. I also thought of using appetite suppressants because I want to lose weight and the yet the hunger pushes me to eat.
The only reason why I did not take both the appetite suppressant and the antidepressant (in overdose) is because I have gone off all my meds and have done so for quite some time because I can't make myself take medications after being on them for years. My psychologist is aware of my non-compliance with medications, and so is my psychiatrist.
The more I try to diet (without the aid of medications, overdose or in normal doses), the more I eat and the angrier I feel. Now I am supposedly on meal replacement - OptiFast but I still keep eating and it makes me angry with myself so much so that I entertain thoughts of punishing myself. I don't want to gain weight because I am fat, being more than a hundred kg.
I am also well aware that all this is NOT right but I can't get an earlier appointment to see my psychiatrist and psychologist. I still have to wait for two weeks because they are fully booked - I tried calling the hospital for earlier appointment but to no avail. My dietitian has kindly offered me support but I have only seen her once and she is unaware of my psychiatric history of self harm, apparently so does my psychiatrist because she will only be my doctor for this year till my own regular doc returns next year.
Current psychiatrist don't care about my weight issues, and wants my psychologist to work with me on it but the latter has no time to work with me on it because we are currently working on other areas (I was recently discharged from hospital just last week due to wellbutrin overdose). When I saw her the day after discharge, I was slightly hypomanic and fast and thus felt very good about myself and so she thought I was ok despite being aware that I may be hypomanic. But my mood swung down within 3 or 4 days and now I am sliding down badly - perhaps aggravated due to not taking the mood stabilizer, lamictal which I was on. Anyway, I had to re-titrate the lamictal I was taking because of non-compliance and its truly sickening to me.
I find it useless to talk to my psychiatrist anyway because she will only suggest I get admitted to IMH which will disrupt my life more than it is now. I feel even angrier when she said that and she knows I hate admission of any sorts.
I used to hate dieting. Now I am on one but I hate myself for not being able to stay on it. I don't know if I should tell the weight management team (the physiotherapist and dietitian) that I can't do dieting because I hate being a failure. I hate exercising too because I feel like a piece of blubber and that's why I always refused to listen to advice telling me to exercise.
I am twenty, at the prime of my life but I feel so unhappy. In light of this, who should I turn to for help and how can I better handle this myself?
Dear “Psychiatric issues, medications and weight loss”
No wonder you are angry, frustrated & unhappy. It’s tough, at any age, for anyone to be told that they have mental illness & it’s much tougher for a teenager. In addition to that, there were self-harm & weight management issues. & making the situation worse are the pieces of advice from health professionals whom you feel don’t have the full picture & don’t seem to support you in the way that you would like.
While we may not have a satisfactory answer for you, we wish to highlight certain things. & before we go on, we would ask that you, just for a moment, set aside all your emotions & issues. Just look at some of your decisions & actions re:
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non-medication compliance,
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re-titrate medication;
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abusing wellbutrin;
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on-off diet;
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keeping quiet about pertinent info
You appear pretty intelligent & knowledgeable about medical matters. So what are the consequences of any of these actions? Are they sustainable without lasting harm? Can they help someone feel at the prime of his/her life? Sure, you are angry. So how useful is it when anger & hatred are allowed to be in charge of the decision-making process? Who gets affected by the consequences? It seems you were already punishing yourself.
So what have you learned from these decisions & actions? & as you hate, what do you hate most? Mood swings, 100+kg, diet, exercise, poor illness & weight management? Yes, it’s extremely dreary & weary to take the meds or make tiny lifestyle improvements every day for don’t know how long. & the consequences of continuing emotion-driven decisions are not? Only you can decide when you want to start doing things to better handle this yourself. Our suggestion: request for a multi-disciplinary team, if possible, to collaborate with you on the management of your psychiatric, medical, emotional & physical concerns.
Regards,
Depnet