Lamictal side effect: Bulimia ????

Hi Karen-
My DBT coach did call back. It was a little bad timing b/c my partner was home. But I was folding laundry upstairs and had some privacy. And since she answered the phone and knew who it was, she didn't ask what we spoke about.

Ironically, one of the things my DBT coach wanted to talk about was that she feels I need to tell my partner. She suggested I at least start thinking about "wanting" to want to tell her.

I saw my pscyhiatrist yesterday- she also pushes me to tell her.

It just isn't going to happen. I'm a million miles away from telling her. I'm hoping and praying I get a handle on this and she never, ever knows a thing.

A big part of me regrets telling anyone (in real life- not meaning here.) It sounds strange, but now I feel a different kind of pressure. Before I was just coasting along, making my eating/purging decisions by my own whims. Now my decisions all feel tethered down by this awareness of being "watched." Last month, my psychiatrist asked for me to get an electrolytes test and I got out of it. But this time she said she's sent an order to the lab for me to get it done anytime next week. I can't just NOT go, b/c I don't want to be a contrary patient. But I also don't WANT to go for fear of the lab results. The time between then and now weighs heavily on me - and actually makes me feel MORE stressed. Like everything I do between now and then will be read in that lab result in some way or another.

Now that my DBT coach knows, she seems keen on bringing it up of her own accord, which throws me off. I preferred the notion of being able to talk about it when I felt like it. Now it all feels so unpredictable and out of my hands.

Today mood is okay, but didn't escape purging. Yesterday I was good, though- no binge/purge. Day before, not so good. The binge urge is making me insane. I HATE it.

Tomorrow is Thanksgiving- a day of feasting. We're hosting a dinner for some friends. I'm excited about seeing everyone- and about cooking (I actually LOVE to cook!) but terrified of how I'm going to deal with the food! What am I going to eat- what will "Edie" ALLOW me to eat? Will I eat too much? How will I manage it if I do? If I restrict, will I be discreet enough to avoid comments? Holidays! Feh!

I have the feeling you know just what I'm feeling! How do you handle Holiday feasts?

Hi Stella

I am glad your DBT coach called you, although I am sorry you noe feel pressured by her and your psychiatrist.

Ultimately, the decision whether or not to tell your partner is entirely up to you. I can understand both sides of this. The professionals obviously would like you to have some more support, but you are worried about someone else knowing and how knowing this information might affect your partner. It is a dilemma.

For my part, I would say you don't need to do anything unless or until you feel ready. I can only say I've always felt I have received more help and support from close friends than I have from professionals. But no one can force you to tell your partner anything if you choose not to.

I suppose all the time she doesn't know, there is no one at home preventing you from purging or restricting, and I wonder if this is part of the reason you are reluctant to confide in her. I apologise if I am wrong, but for my own part I am usually desperate for help to stop bingeing, but I don't actually want anyone to prevent me doing the 'behaviours' that help me feel better, ie purging any food I have eaten and restricting food. It seems the bingeing is a little better for you right now, so I can understand you not wanting to risk being under more scrutiny at home.

As far as the monitoring from your psychiatrist and the blood tests, I am afraid this is standard procedure when they know someone is purging and/or restricting. You know the health consequences and they will do everything to prevent you causing yourself damage. However, at the same time I know I always resented it and now I am at the point where I have disengaged with all professionals because of trust issues and because I am fed up of having my life controlled by others. I am sorry you feel you made the wrong decision to confide in any of these people. It would be more helpful if they offered you real help and support to work towards recovery from the illness.

Tomorrow is Thanksgiving- a day of feasting. We're hosting a dinner for some friends. I'm excited about seeing everyone- and about cooking (I actually LOVE to cook!) but terrified of how I'm going to deal with the food! What am I going to eat- what will "Edie" ALLOW me to eat? Will I eat too much? How will I manage it if I do? If I restrict, will I be discreet enough to avoid comments? Holidays! Feh!

Yes, I know exactly how you feel. It is common for people with an eating disorder to enjoy seeing others eat, or feeding them and cooking for them, but the thought of eating anything ourselves fills us with terror. I also find I eat less in front of other people so it is always an excuse for me to restrict.

How do you handle Holiday feasts?

That's a tough question because to be honest I don't cope with holidays at all. I dread Christmas and Easter and any other occasion associated with food. I suppose all you can do is take it one day at a time and remember that whatever you eat is probably far less than anyone else would, and also that it is normal to have times at holiday feasts to eat more than others. I doubt that really helps how you feel though. Sorry, I am not a lot of help.

Karen

Dear Stella and Briary,

I've been reading your posts for several days and you have both touched my heart. I actually came across this site because I have recently weaned myself off Lamictal (down to 25 mg from 200), and have been incredibly hungry. I was searching to see if going off Lamictal caused this to happen.

I have taken great interest in your stories as I was anorexic and bulimic for about 10 years from about age 13-23 or so. I am now 44. I somehow stopped these behaviors on my own, and they have not reappeared. However, the behavior pattern of wanting to control my appearance and becoming obsessed about myself in other ways still manifests.

I am writing to offer some help, if I can. This year I have been dealing with an obsession about my skin which I have realized stems from the anorexic/bulimic pattern. The anxiety surrounding this issue has been intense. Without getting into the details, I have spent many hours a day and cried many tears over this behavior which I couldn't understand. I became more and more depressed and thought there wasn't a way out. I totally empathize with obsessive behavior as you both have mentioned as it begins to rule your life. Slowly the time devoted to it increases until it overshadows nearly everything. You wonder if you'll ever be able to live a "normal" life.

Through this experience, I discovered that my main issue has not been depression (I have been on medication since 1995), but anxiety. Generally they both go hand in hand. My anxiety fuels my depression. I have always been resentful of having to be on medication, as I strongly believe in holistic healing. I have always denied that I have some kind of incurable biochemical imbalance although my husband and family had always insisted that I did.

Early in the Summer my depression and anxiety increased, no matter what I did. For the first time I decided to consider that perhaps I was wrong and that everyone was right. I decided to up my Lexapro by 5 mg. to see if that would help. The following day I started to feel better. I knew it wasn't because of the Lexapro, it was too soon, so I went over what I did that day. For lunch I had a lot of soup, which caused me to be thirsty throughout the day, and I drank a lot of water. Thinking about this something clicked. I went online and searched for "depression and dehydration." Several sites came up and I learned that every drop of water one drinks first goes to the brain. Over time, the brain's chemicals get unbalanced and depleted, which causes not only depression, but anxiety and obsessive/compulsive behavior. As soon as I read this I realized that all I needed to do is to start drinking more water. At that time, I probably only drank about 8 oz. of liquids a day, including milk, water, etc.

I realized that I had been severely dehydrated for many years, most-likely since I was a child. In 2007 I was admitted to psychiatric hospitals 3 times, for a combined stay of over 6 weeks, where at that time I did not eat or drink. I am sure my brain chemistry suffered greatly.

When I learned the information about the benefit of water (our brain is 85% water, so if it is depleted, one cannot think clearly), I decided to not take the extra Lexapro, and drink water instead. I increased my daily intake dramatically, and within a week or less I felt like a totally different person. I was much calmer, happier, and my obsessive/compulsive behavior had greatly lessened. I felt like a cloud had been lifted. I had self control. I could breathe. It was a miracle. To test this, I gave it a month, and I still felt great. I saw my psychiatrist who was amazed that I was so happy. I have been feeling so good for the last 4-5 months that, as I mentioned, I have recently weaned off the Lamictal, and plan to eventually go off the 10 mg of Lexapro I currently take.

Here's a bit of information:

"Psychiatric illnesses ... are a sign of lifetime dehydration. Every sip of water is first dedicated to hydrating the brain and cranial fluids then to the rest of the body. When we fail to drink enough water over a lifetime, toxins begin to interfere with the brain's delicate neuro chemical balance. Once a single chemical reaction in the brain is significantly altered, the resulting ripple effect will be felt throughout the brain. The accumulation of these events can lead to brain diseases and imbalances of all kinds, including clinical depression, schizophrenia, bipolar disorder, Lewy Body disease and other dementia-related diseases... "

"Chronic dehydration is recognized as contributing to a wide range of debilitating conditions. With respect to depression there may also be a link. The important amino acid tryptophan is required by the brain to produce the neurotransmitter serotonin. When more serotonin is present, nerves in the brain function more normally. Dehydration can prevent the needed amount of water being available to transport tryptophan to the brain, causing less serotonin to be produced. As you probably know, serotonin plays an important part in the regulation of mood."

"Pathology that is seen to be associated with 'social stresses' -- fear, anxiety, insecurity, persistent emotional and matrimonial problems -- and the establishment of depression are the results of water deficiency to the point that the water requirement of brain tissue is affected. The brain uses electrical energy that is generated by the water drive of the energy-generating pumps. With dehydration, the level of energy generation in the brain is decreased. Many functions of the brain that depend on this type of energy become inefficient. We recognize this inadequacy of function, and call it depression."

I hope you don't mind my rather long story, but when I read both of yours I thought that both of you are probably very dehydrated, and this increases the depression and desire to eat and purge. It seems really simple, probably too simple, but it may be the solution for you to drink more water. From what I read, you need to drink half your body weight in ounces a day. So if you weigh 120 lbs., then you would drink 60 oz. of water daily. And it must be water, not soda or juice as they don't have the same benefit. This may not cure the bulimia, but it may reduce your urges, calm your mind, and help you feel more in control.

Again, it may seem a bit odd, but it has been scientifically proven. I strongly believe that if more people up their intake of water, that their depression/anxiety/compulsions will go away. My psychiatrist, who is very well known and respected, had never heard of these studies, which really surprised me. I am sure most of the psychiatric community haven't as well. My doctor was so impressed that he said he is going to suggest the water idea to his other patients.

I am so much more balanced. And I think that is the key. If your body is out of balance, so is your mind.

Another thing that has really helped is to take a walk each day. I also take a lot of vitamins. B vitamins help with mood. Also, if you are experiencing any hair loss, which I have faced in the last 2 years from anxiety, I suggest that you take 5-10 mg of Biotin a day, 1000 mg of Alta Horsetail herb a day, and 1000 mg of MSM a day. I lost at least 1/2 of my hair. I started on this vitamin routine in April, and within a month my hair was stronger and has grown incredibly. To say I am amazed is an understatement. Worrying about my hair caused intense fear and depression, and now that is gone.

I sincerely hope that I have helped a bit. If I could, I'd give both of you great big hugs. You are courageous women. Stella, you are an incredibly gifted artist. Not until one walks in your shoes does one know the struggle. I do understand and I'd be more than happy to correspond with both of you if you need support. Feel free to email me at any time. I'd also be happy to be of support if you'd like to talk on the phone. Just send me an email and we can exchange contact information. I live in Pennsylvania.

Not to be trite but there is hope and light at the end of the tunnel. You are not alone. If I can help in any way, just let me know.

Blessings,
Debbi

Hey Karen- I've been having trouble logging onto the Uncommon Forum the past couple of days. Have you?

I recently read an article about the addiction to the binge/purge cycle in that there are endorphins released- and one actually becomes unwittinginly addicted to the endorphin rush. Have you heard of this? I have to say, I do feel very cheerful and maybe even a little "high" after purging. It was another angle to consider.

You're absolutely right that a big reason I can't tell my partner is b/c we live together. It's not that I don't want her to know- it's that I don't want her knowing dictating how/when I deal with food. I already have so much pressure- that would just push me to the edge.

I'll be curious to see what your opinion is of Debbi's water theory.

Hi Debbi! Thanks so much for joining in on my thread and sharing your experience! I find I get the most out of hearing what other's experiences have been. Your story is very sobering.

I totally agree that dehydration is a big deal in so many ways. I was chronically ill with an unknown food intolerance some ten years ago. the result was diarrhea 24/7- no matter what I ate or drank, b/c at that point the scillia in my intestines were so damaged, nothing could absorb. It was horrid. There were SO many things wrong with me after a couple of years of this- my period stopped, I constantly caught colds, I could barely get out of bed, I had vertigo so bad I'd fall over, I had the worst rages- just complete out-of-the-blue outbursts that made no sense whatsoever. I was a mess! And I truly owe it to the nutritient deficiency and dehydration. Once I got the food intolerance figured out, and the diarrhea ended, I was reborn into a totally different human being!

I'm certain the purging has caused me dehydration. So much fluid comes out of me- it seems even more than I initially put in. So that fluid is being drawn out of my gut. I know that's bad bad bad. I do try to drink a ton of water after a purge. But I know this can also throw electrolytes out of whack. I guess it's a moot point trying to do bulimia in a "healthy" manner.

I want you to know that I've heard your message- and I'll make a point to drink way more water. We have extremely good water, too- it's a dug well and has been tested. There are not chemicals or impurities in our water at all- just pure underground spring water. (Our friends even bring bottles to take some home with them!) So I have no excuses for not drinking lots of water!

I am losing my hair- and it's VERY frightening. Luckily I have lots of hair- but I want the hair loss to stop. I'm considering taking my pdoc up on her offer of Rogaine. I do take lots of supplements- including the Biotin you mention. But this doesn't seem to help.

May I ask if you've tried any therapy regarding your OCD issues? Did you find anything worked better than another?

PS You compliment on my art was so touching. Gave me a good warm feeling inside. Thanks!

Hi Stella,

Thanks so much for your reply.

I have briefly been to CBT and counseling, but they never really helped. I think this is because I have a strong mistrust of people. The best therapy I've found is going for a long walk. It enables me alleviate my stress, and makes me get out and do something instead of sitting in the house obsessing. I make a point of trying to walk between 1.5- 3 miles a day just to clear my head. It is amazing how good I feel when I come back.

Another thing that has helped is meditation.

Do you have any techniques that you use when you feel the urge to BP? Do you still believe it's the Lamictal that has triggered this?

One thing I realized is that I have been addicted to having a "problem" to obsess over. I'm not happy unless there is something wrong that I have to solve, and by solving, I feel a sense of accomplishment. This causes me to create problems just to solve them. It's very twisted, and somewhat masochistic, but after going over my life, I have recognized this pattern. Having compulsive disorders has been comfortable for me. I feel odd if everything is seemingly OK. When things do calm down, my impulse (unconscious) is to create havoc regarding something about my appearance. It's a habit. Do you find this applies to you as well?

Now that I have become conscious of this pattern, I have been working to stop it. It gave me a good excuse to be miserable and withdrawn and to avoid responsibility. However, it's not healthy. Years have gone by and I have not grown up, in a sense. Weird to say at my age.

Regarding hair growth, I highly recommend Alta Silica (horsetail herb), 1000-1500 mg a day, as in my previous post. My hair has stopped falling out and has never been healthier. I used to dread showering because I'd end up with a drain full of hair, but not anymore.

I hope you are doing well. I also hope Karen is as she hasn't posted in a while.

Debbi

angel_lotus wrote:t;] The best therapy I've found is going for a long walk. It enables me alleviate my stress, and makes me get out and do something instead of sitting in the house obsessing. I make a point of trying to walk between 1.5- 3 miles a day just to clear my head. It is amazing how good I feel when I come back.

I totally agree with you. My partner and I have horses. Nothing has been so therapeutic as taking "the girls" out on the trail. We live in a very rural area with miles and miles of trails. It's so good for me- Being out there in the natural world, the emotional connection with my horse, having quality time with my partner, the physical exercise (you wouldn't think there's much exertion riding a horse, but when I don't ride for a week my sore muscles remind me!) When I'm depressed, I really have to force myself to get out and ride- and sometimes it's just too much and I just can't - but the times I do, it's always worth the effort.

Another thing that has helped is meditation. Do you have any techniques that you use when you feel the urge to BP? Do you still believe it's the Lamictal that has triggered this?

I have some disorders that make conventional meditation (clearing the mind of all thoughts) impossible. I'm in Dialectical Behavior Therapy at this time. It's a 2 hour group session and 1 hour individual session per week. It's focus is on learning new coping skills to replace the dysfunctional ones. And many of the skills go along the lines of meditation. They're called "mindfulness" skills. One type is Breath Awareness. This is when you narrow your conscious focus on breathing. I like a yoga type exercise called "Square Breathing." It follows a cyclical sequence of breathing that helps me clear my mind, but keeps my mind just busy enough to block out intrusive, OCD thoughts.

As for the Lamictal- yes, I definitely think the increase in impulsivity was a side effect. And this was just the thing needed to push me into the binge/purge trap. I've always had an underlying eating disorder- but mostly in the form of restricting and fasting. The Lamictal just brought everything to the fore.

One thing I realized is that I have been addicted to having a "problem" to obsess over. I'm not happy unless there is something wrong that I have to solve, and by solving, I feel a sense of accomplishment. This causes me to create problems just to solve them.... It gave me a good excuse to be miserable and withdrawn and to avoid responsibility. However, it's not healthy. Years have gone by and I have not grown up, in a sense. Weird to say at my age.

Yes, I can kind of relate to this. Having "problems" allows you to ignore the real issues, right? I think the eating disorder is this, for me. Just a huge distraction from the real stuff. I'm 36, so don't feel like your alone with emotional crap coming to a head later in life. I've always thought of eating disorders as being a teen issue. It turns out none of these problems are isolated to early life.

Regarding hair growth, I highly recommend Alta Silica (horsetail herb), 1000-1500 mg a day, as in my previous post.

I'll definitely look this up. I've never heard of it! Thanks!

I hope you are doing well. I also hope Karen is as she hasn't posted in a while.

Debbi

Yes, you too. I'm worried about Karen. She's really going through a rough time.

Today's the first day in a while I haven't purged. I'm trying to take advantage of an upswing in my mood to do something proactive. I'm having a REALLY hard time at the moment, though. I had pizza for dinner and I feel awful - I really want to purge. I actually feel sick- can feel the food pushing up. Why did I eat???