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Food and sleep diary * maybe, mentions of items of food*


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I have a new tdoc. I didn't like her at first, but I think she is growing on me. Which is good news. She is still fixated on my sleep, but she says once that's at a good standard then we can move on, because she thinks you need to be 'well rested' to tackle other things. Probably a bit of a stretch, but I'll stick it out. I had to fill in this activity diary, with caffeine, wake time, work, eating, time in bed and gross hours slept type thing. I filled it out properly, on most of the days I ate once, and on some of them I didn't. So she gave me another diary with spaces for food intake. I don't think it matters because I'm doing okay. I feel a little light headed, but I like it and I'm not going to faint. I am aware that my intake is not at the recommended level (ie. not eating my bmr, still freaking out about the set point thing) , most days I might have a piece of toast, or soy milk or fruit or something. I don't want to fill it out, it's not something I need to talk about, it's impacting my life. What do I do?

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She's probably just concerned of how not eating a substantial amount of food is affecting you. If you don't want to fill it out, then don't. You need a good source of vegetarian/vegan protein in your day, even if you eat once, you still need a good amount of protein which you aren't getting. With the exception of thyroid issues, and even than it is possible, if you eat less than your BMR you will lose weight. You'd be surprised just how much food IS impacting your life. Proper nutrition is vital for a healthy body and mind. I hope with your under-eating you are taking a good multivitamin (with iron and b12). Weight loss fads come and go, but eating right, exercising, are really the only way to stay fit. I understand your concern with vanity, I'm around your age, and realize that you must have an enormous pressure to stay thin or be in shape, it is like that between my friends as well. 

 

Keeping a food journal may just help you realize what you are eating and just how much. It is just a tool to make you more conscious. 

 

If worst comes to worst you don't have to share, just explain to your therapist that you don't think it is necessary. However your therapist seems to be hitting the nail on the head with trying to analyze your sleep. Most people with Bipolar Disorder have erratic sleep schedules and this exacerbate their issues. 

Edited by Forbidden91
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 Weight loss fads come and go, but eating right, exercising, are really the only way to stay fit. I understand your concern with vanity, I'm around your age, and realize that you must have an enormous pressure to stay thin or be in shape, it is like that between my friends as well. 

 

Keeping a food journal may just help you realize what you are eating and just how much. It is just a tool to make you more conscious. 

 

If worst comes to worst you don't have to share, just explain to your therapist that you don't think it is necessary. However your therapist seems to be hitting the nail on the head with trying to analyze your sleep. Most people with Bipolar Disorder have erratic sleep schedules and this exacerbate their issues. 

Not to be picky or something but this isn't a weight loss fad thing, it's in the eating disorder forum. It's not about being in shape.

 

I haven't considered the option of refusing to do it, because I'm a pretty good patient and I usually complain. Yes that is her rational bipolar stuff does not do well with crappy sleep, she thinks food is directly related to sleep but I don't really see it.

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Food intake is actually related to sleep. The majority of restrictors are insomniac, and actively restriction fuels the insomnia.

The body knows when it is starving, and it has a very instinctual response, which is to find food. It will pull energy from your brain (we need that) and heart (also crucial) in order to fuel finding food. It will do that before sleeping, or rest, for fear that were it to do so it won't wake up again. Restriction, even if you're not skeletal yet, can be fatal.

I know that it's very hard to track intake (I find it immensely triggering) so I'm sort of of two minds about it. I do think that your tdoc needs to know, but I'm not sure if this will do it.

Please take care of yourself.

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This is a tough one.  Honestly, if you are restricting your intake to the point of feeling light headed, then it is going to start impacting your life at some point.  Your body needs more than some fruit and toast to function.  I know that you know this, but I also know how sneaky disordered eating can be.  I hear you.

 

I would explain to your tdoc your reservations about keeping a food journal while also trying to remain open to talking about your eating periodically.  Even if you don't think your eating is a big issue right now, keeping tabs on it will help you and your tdoc notice if you are slipping further.  I truly don't think it is something you should ignore altogether.

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I have actually suffered from an eating disorder, you just stating that you didn't feel that monitoring what you ate and discussing set point I just assumed you were dieting. Of course I don't know the level of your restricting but I can potentially share what helped me. And I just didn't want blatantly assume you had an eating disorder as it was also not listed in your signature. Of course I shouldn't assume, and I am assuming you didn't realize that I had an eating disorder as well (because being a male it is much more well hidden, and being a gay it drastically increases my likelihood of actually possessing one). 

 

Protein is probably one of the most important macronutrient in dealing with satiation and hunger regulation, and from past information that you have shared, I made that recommendation out of caring for you and even specified vegan or vegetarian as I clearly remember you saying you had it. 

 

Referencing: 

 

A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations: http://ajcn.nutrition.org/content/82/1/41.full  

 

Restricting makes me feel in control especially when everything around me is going haywire. When I was in high school I started having issues with anorexia, which eventually led me to bulimia. I did purge occasionally, but mostly it was excessive exercise, and abuse of laxatives. I have stopped doing this. I still restrict, and work out like a mad man, but I have a much healthier take on what I eat. I probably fall in the EDNOS category and more often the term orthorexia fits. I am obsessed with what I see as clean food, and see other foods as evil or revolting. when I became obsessive, I would do almost anything to feel "clean" again from abusing syrup of ipecac to purge, to fasting for 14 days at a time. 

 

I honestly didn't mean to offend you, I just didn't realize you were suffering from an eating disorder. I should have used my better judgement. I know the sense of control and ramification of eating disorders. Ana and Mia became friends, and cardio and lifting were the only way I could feel good about myself. Judging your self-worth on a number on a scale is a sad way to live, and I know this first hand. Of course if you saw me, you would never know this, and I am a male which probably throws you off. Everyone has a different reasoning on why they do what they do, you just wake up one day. 

 

So to explain, I just didn't have all the details, and didn't realize the extent of what you were experiencing. It was late at night, and I definitely didn't mean to minimize your issues. I have friends who promote disordered eating, for the sake of vanity, and tried to convey that I understood where you were coming from. I mostly don't explain to people that I have an eating disorder and still do. I monitor how people perceive me, and take criticism very personally. 

 

Of course I often still have restriction issues, and sometimes wish I could see my ribs again. Again I am suggesting you take the opportunity to discuss this with your therapist, as food and mood have direct regulations. And the vitamin suggestion wasn't in bad taste yet truly worrying about you. 

 

As a vegetarian/vegan and someone who suffers from eating disorder the chance you have vitamin or mineral deficiency is high, and the effects can be extreme in severe cases:

 

Vitamin B12 Deficiency Manifested as Psychosis Without Anemia: http://ajp.psychiatryonline.org/article.aspx?articleID=174091
Vitamin B12 Deficiency Manifested as Mania: A Case Report: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1911186/
Vitamin D deficiency and depression in adults: systematic review and meta-analysis. http://www.ncbi.nlm.nih.gov/pubmed/23377209
 
Relationship between depressive symptoms, anemia, and iron status in older residents from a national survey population. http://www.ncbi.nlm.nih.gov/pubmed/22286844

 

Again suggesting the vitamins and mineral a good multivitamin at least was only to aid you.

 

 

Diet affects your sleep, and sleep deprivation definitely affects your diet: 

 

Poor sleeping habits can lead to overeating, but can unhealthy diets keep you up at night?: http://healthland.time.com/2013/02/07/does-your-diet-influence-how-well-you-sleep/#ixzz2aGvvDwWR

 

 

Of course I realize that eating disorder aren't rational. I hope I've been able to help, and again I apologize for the misunderstanding. I received warning points for my post, and felt that I needed to explain my self. 

Edited by Forbidden91
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I wish my brain absorbed logic right now. Maybe I'll partially fill it out or something. You guys gave me some good ideas. I don't want to 'track' it as she wants but it will have to do. I don't know if it's worth calling to explain why I won't do it as instructed or to wait until my next appointment. I feel that if I don't do it right and I turn up with nothing much to work on them it will seem like a waste of time for not doing 'homework'. She does read email which is new to me, will read it and call you back not email.

I didn't know that Rosie, you are so knowedgeable. I'm sleeping okayish but I guess enough sleep meds would over ride that so I don't notice it.

I'm sorry that you've suffered with this forbidden. I wasn't upset I was just clarifying, I would only post in a forum in which

I did not have an rx without a special cause. Im glad you werent discussing dieting in this forum

Because we both know thats not appropriate. t's not in my signature because I'm mostly okay but lately things have been slipping I think. I might amend it for future clarity. I'm on my phone but I'll check out the links when I'm on my laptop.

Thank you all for responding so kindly, I know that the answer and solution should be obvious to me.

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