Depression, a heavy burden. A bit about depression and weight gain

both!

This is something I've been thinking about quite a bit lately.  I feel very strongly that psychiatric medications are necessary and life-saving for certain people and there is far too much stigma surrounding taking them.  That being said, there's no denying that they have undesirable side effects for many, weight gain being one of them.  This has definitely been the case for me and this reason I would like to be on the lowest dose that is sufficient to stabilise me. I've been fairly stable for a good few months now and recently went to my GP for a review to discuss reducing my dose.  I mentioned my weight gain and so the doctor asked me to get on the scales.  I happened to sneak a glance at their screen and saw that I've put on 11kg since being on the medication.  It's no real shock, I had definitely noticed it in myself and in the way my clothes fit (or don't fit!) me.  I can't completely shirk responsibility. I'm not sure how much of that 11kg is down to the medication and how much is just me eating too much but there has been research that has demonstrated a link between antidepressant use and weight gain.  With depression usually adversely affecting people's self-esteem, you can imagine that putting on weight isn't exactly helpful in most cases.

So what's the answer?

all too familiar!

I don't know. I wish I did. I have been going to the gym and eating healthily (without being overtly strict).  When you have recovered from a depressive episode and are just starting to enjoy life again you don't want to deprive yourself of one its main pleasures! (Food glorious food!) I do like healthy and nutritious food but I also like indulgent treats and alcohol! I've been incorporating exercise into my lifestyle also but I know that if I put myself under immense pressure to lose the weight, that will not be helpful for my mental health.  There have been times where I've really put myself down about the weight gain and binge eating. I've felt like I 'should' know better, having a degree in nutrition and I 'should' be using a dietary approach to help alleviate my depression.  There are some people who have managed to see significant improvements in depressive symptoms through changing their diet but each person is an individual and what works for one person won't necessarily work for another.   A severe depressive episode can feel a bit like a tornado and all you can do is seek shelter and refuge and wait for it to pass.  If your home town was hit by a natural disaster and your life was turned upside down, eating a healthy diet would probably not be your highest priority and you would seek solace in any way possible.  I'm not trying to deny that binge eating is unhealthy but when depression is severe, that momentary calm that overeating brings can help people get through the toughest of times.

Obviously not all people with depression binge eat and/or gain weight.  Some lose their appetite, hardly eat at all and end up losing weight.  Others have different coping mechanisms that affect them in different ways.  However, with so much focus on obesity in the media and in NHS campaigns, people who are classified as overweight or obese can feel a great deal of shame and I think it's something that needs to be talked about.

What's the lesser of 2 evils?

The decision of whether to take medication for depression or not can be very difficult and should not be taken lightly (and I don't think most people do!)  I get quite irritated when I hear people say things like 'antidepressants are way over-prescribed' and 'Doctors hand out antidepressants like candy'.  I have yet to see any evidence of this and I think it's just the case that depression is very common and there are a lot of people who do genuinely need it. I personally suffered (on and off) from depressive episodes for well over a decade before plucking up the courage to go to a GP about it and I think there are a lot of people out there suffering in silence. There are often undesirable side effects so it's just about weighing up whether the benefits of medication outweigh the disadvantages.  I have struggled with my weight a lot and so I don't exactly welcome the medication with open arms. But after trying therapy several times, exercise, reading goodness knows how many self-help/positive thinking books, eating a nutritious diet and ensuring I'm not deficient in anything with no lasting effect on suppressing depression, it's something I definitely felt was necessary for my well-being even if it does mean a bit of weight gain.  I'm not saying that therapy, exercise and a healthy lifestyle aren't important or helpful, of course they are, but in some cases it's insufficient to alleviate depression.

So what to do if medication makes you gain weight?

I can attempt to lose weight through diet and exercise but I think what's most important as I've said in my post about body image: http://samanthathesanevegan.blogspot.co.uk/2016/05/the-girl-in-mirror-2-all-about-that.html is to focus on building self-esteem.  Our society puts a lot of pressure on people to look a certain way or to weigh a certain amount in order to be considered healthy but there is so much more to a person than the number on the scales.  It's really not in my nature to say positive things about myself, it feels very unnatural to me but what I've done sometimes is ask people close to me what they think are my strengths or what they admire about me. There are so many people who might not fit society's typical health or beauty ideals but who are extremely talented or kind.  A person's weight does not and should not define their worth! 

Aretha's voice is a lot more important
than what she weighs! 

Tearing down (negative) labels

On my way to the seaside yesterday I was reading something in Psychologies magazines about removing labels that you or other people might have about yourself and that have negative connotations for you. This is definitely something that affects me and that I think about a lot. In my previous blog: https://samanthathesanevegan.blogspot.co.uk/2018/05/what-is-sane-or-normal.html I've talked about whether those who are highly sensitive and therefore experience stronger highs and lows emotionally should be labelled as 'insane' because statistically we are in the minority. (If you don't get a chance to read it, my answer was, of course, no!) I proudly wear the highly sensitive person label and I'm not ashamed to say I have a mental illness.  There's a few personality traits or characteristics that I or other people associate with me and that do nothing for my sense of self-worth.  So I decided to do the exercise about removing negative labels whilst on the beach (whilst listening to Bob Marley!)

So what are the labels that I don't like being associated with myself?

'Too quiet, Introverted, Shy'

My unhelpful labels.
I should've put 'too quiet'!

I don't think any of these are necessarily negative qualities but I don't like it when people associate them with me.  I think this is because it was always what people said about me in school growing up (it was definitely true at the time!). So when people still continue to say this about me I feel that they are disregarding all the great progress I have made since then with regard to confidence. 

It depends on where I am mentally (whether I'm in a depressive episode or not) but I can be quite outgoing and sociable.  I like going to meet-ups to meet more like-minded people and try new experiences and it doesn't really phase me if there won't be anyone I know there (the younger me wouldn't dream of doing this!).  I have a hedonistic side and I like socialising and dancing.  What is definitely true of me, however, is that I find endless conversation (especially small talk!) exhausting and I DEFINITELY need a lot of 'me' time and headspace otherwise I go crazy.  None of the words 'quiet, shy or introvert' are insults but I think I have negative connotations with them ('social recluse' 'antisocial' 'hermit') because of what people said about me at school.  Despite those things not being insults, if a label is unhelpful to me, I will disassociate it from myself!

 

'Fat, Overweight'

I put on quite a lot of weight last year, partly due to the binge eating that accompanies my depression and partly the medication I take and so now I'm the heaviest I've ever been and my BMI is almost in the obese category.  I often find myself calling myself fat in a jokey/self-deprecating way, to distract myself from how upset I really am, which I really don't think is helpful.  I do struggle a lot because I love indulgent food and alcohol but I do also like healthy food, I exercise as much as I can and I put a lot of consideration into what I eat. 

I don't know why I am letting the fact that my weight in kg divided by my height squared is higher than 25 have so much power over me when really I know there are much more important things in life! This is definitely a label that serves no positive purpose and that I want to rid myself any association with. 

'Boring', 'Geek'

From my proudly intellectual
Psychologies magazine!

These are also words that people associated with me in school because I wasn't loud and boisterous and got (mostly!) good grades (I was in a school where that wasn't considered a good thing at the time but something that got you bullied or made fun of!).  I feel like people really got me all wrong.  I don't think there is anything wrong with the kind of person that people would consider a 'geek', somebody intellectual who is a real bookworm and doesn't enjoy parties or sports.  It just wasn't really me! In school there were a couple of subjects I had a bit of a head-start on because my mum was a teacher (Maths and French) but I was no genius and I wasn't particularly studious either! I can't remember what I used to do in my spare time as a teenager but I seem to remember spending a lot of time sleeping and resting and constantly leaving my homework until the last minute! In school I was used to not doing a lot of work and still getting relatively good grades so university came as a total shock to me! I wasn't brilliant at sport but not awful either and I have enjoyed dancing and enjoying upbeat music from as long as I can remember. I haven't been to school for about 16 years so I don't know why people's incorrect perception should still bother me. 

I won a potato race aged 10,
wasn't that bad at sports!

 

When I have the mental energy, I now love to learn new things as an adult.  I had to work extremely hard to do that nutrition diploma, with science never having been one of my strong points and it's one of my proudest achievements.  It's so wrong that in certain academic institutions those who do well are ridiculed and people use derogatory words like 'geek' to describe them.  It's also a word that serves no positive purpose.

my new labels! 

How to remove negative or unhelpful labels and create new ones!

I enjoyed doing this exercise  from Psychologies magazine in the picture above. I established what the inaccurate and/or unhelpful labels were and wrote my new ones.  Instead of 'quiet' I put 'selectively talkative!' I talk when I feel like it and I do truly believe not every gap has to be filled with crap! 'Geek' I replaced with 'Intellectual and sporty!', boring I replaced with 'Interesting and fun-loving' and 'Fat' I replaced with 'Voluptuous, muscular and healthy'.  And the unhelpful labels? I stuck them onto stones and threw them into the sea, to symbolise ridding myself of my association with them. It felt good! (other than the slight guilt for polluting the sea with 4 mini post-it notes) It might take a while for me to fully stop linking myself with any of those labels but I am going to try and focus on my new more positive and accurate labels.  Don't let anyone give you a label you don't like or that is not helpful to you!

What is 'sane' or 'normal'?

if you're struggling mentally,
it's completely understandable

Who gets to decide what is sane or not? I remember once seeing an event advertised on facebook for a talk entitled 'Are normal people sane?' and thinking it sounded really interesting but I didn't get the chance to go.  It is something I do wonder about sometimes though.  My brother came up with the name for this blog 'Samantha, the sane vegan' to differentiate myself from the tiny minority of vegans who are overtly puritanical and judgemental. So it's ironic that a lot of my blogs have ended up being about me not being sane! I suppose I do consider myself classified as having a mental illness because I do experience periods of clinical depression interspersed with periods of temporary sanity and sometimes low-level mania (hypomania).  I have always felt a bit different and never really felt like I was one who fitted in with the crowds in school.  Reading up about the prevalence of HSPs (highly sensitive people) and meeting more in real life and in online forums (finding my tribe!) has helped me to understand myself better but it still doesn't make being in a minority in society easy.

In what ways do I feel different and how does it affect my life?

yep, that's me!

Socially! In school everyone (teachers and classmates!) always commented that I was too quiet and didn't talk much and it's something people continue to say to me as an adult. I never really know how to respond when people say this.  I only tend to talk when I've got something interesting to say and sometimes I don't (that just doesn't seem to stop a lot of people!) I've never felt the need to be continuously talking and I find endless conversation, small talk and people who won't let you get a word in edgeways mentally exhausting and stressful. (Partly why I like blogging, no one can interrupt me haha!).  I also think as a HSP I need more headspace than others and I go a bit crazy if I don't get enough 'me' time to decompress.

some people have likened me
 to Lisa Simpson! lol

Morally! I can remember when asking my siblings to describe me the first things they said were 'moral, caring and ethical'.  I've always thought a lot about how our actions impact on the world around us.  Some people find it odd that I buy most of my clothes from charity shops but I do it because of ethical and environmental concerns about factory-made clothes.  If I have a glass bottle or can on me I'll hang onto it until I can find a recycling bin.  I was always uncomfortable with the idea of eating animals for as long as I can remember and put a lot of thought into what I purchase and everything I do.  There are some people who go much further than me with regard to this and have achieved a lot more than me in terms of making a difference in the world at a younger age than me.  I'm no Martin Luther King or Harriet Tubman. I've just observed that I care about a lot of things more than most people do.  I've read part of a book called 'The Moral Molecule' that suggests that it might be linked with having higher levels of a hormone called oxytocin (it's a lot more complicated than that obviously!).

Emotional sensitivity-wise

ok that sounds ever so slightly arrogant
but I see where he's coming from!

I've always been quite sensitive and get really badly affected by watching violent, bloodthirsty or emotionally difficult films or series.  Horror films, films with torture and series like Game of Thrones with gratuitous violence are extremely popular these days and I've been in situations where I feel like the odd one out with regards to this.  But I think the fact that most people seem to be desensitised to this is very worrying and it should be normal to be horrified by it! I often can't cope with watching the news as it upsets me too much.  I've had people say to me that we need to know about what's happening in the world and I need a reality check.  It's not like I want to just bury my head in the sand or that I go by the motto 'ignorance is bliss' but sometimes I reach a limit and I have to step back from it all in order to protect my mental health.

Does being in the minority make me in the wrong?

Am I 'insane' or weird because I don't fit in with the majority of people? I think in society we tend to get our ideas about what is normal and acceptable from what we see around us.  But I think questioning what we are brought up to believe in and having the confidence to be different  is positive and a sign of intelligence.  Minority influence is often the way a lot of  revolutionary changes start.  Life isn't always easy when you feel different and unusual but I've found that as I get older I learn to embrace who I am more and meet more like-minded people. I'm happy to be different!

they do indeed!

When is it ok not to exercise?

sometimes if that's all
 you can manage
that's ok!

I have an interesting relationship with exercise.  I've always been quite an active person.  I don't drive so I walk a lot when the weather's decent. I currently go to the gym fairly regularly and do a mixture of cardio and weights but I've previously done ice-skating lessons and I have roller blades and I occasionally go for a run.  I can get very restless if I don't exercise and one of the reasons I'm not more of a reader is that I don't generally like sitting still! In episodes of depression, however, I find it difficult, exhausting and unpleasant and I struggle to do what might be considered a healthy amount of exercise.

On my nutrition course I learned about the devastating impact of sedentary lifestyles on our health.  I have seen it being described as on a par with smoking in terms of the damage it does. I currently work as a receptionist so spend a large proportion of my working day sitting on my bum and I think it has definitely taken its toll on my physical and mental health.  But whilst it's my job there's not an awful lot I can do other than getting up and moving occasionally and ensuring I have the correct posture and a lot of people are in a similar situation.  It's apparently impossible to counteract the negative effect of being sedentary by doing a few sessions at the gym, but nonetheless, it's still a good idea to find ways of being active where possible.

Exercise and mood

if somebody feels like
this, telling them
to exercise isn't
helpful

Although exercise can certainly help people with their mood, I often tire of people referring to exercise as an antidepressant, because that is misleading and incorrect.  As I said in one of my previous blogs, it shames people who have reached a point where they are unable to exercise and those who have physical disabilities that make exercise very difficult or impossible.  Some people with mild to moderate or maybe even occasionally severe depression might find exercise to be beneficial to their mood and an aid to recovery but it should not be assumed that this is the case for everyone.  A major depressive episode can feel like being hit by a tornado and sometimes the best thing to do is find shelter (metaphorically!).

I personally don't always find exercise to immediately boost my mood or give me a 'buzz' (unless I'm hypomanic!) but when for example, I had ice-skating lessons, learning a new skill and getting better at it at a steady pace was great for my self-esteem and that in turn can boost ones mood.

Are there instances when exercise can be doing more harm than good?

There are times when we're well but we can just feel a bit apathetic towards exercise because of bad weather, temporary bad moods or work issues but with a bit of a kick up the bum we can make ourselves exercise and reap the benefits.  Earlier this year the weather was absolutely miserable, I didn't want to leave my warm comfortable house to venture outside and I can't really exercise much at home due to lack of space.  But I knew I needed to lose some of the weight I put on over last year and burn off the excess calories from the comfort foods I didn't want to exclude! I managed to push myself to go to the gym 2-3 times per week and now I'm slowly achieving a healthier body composition and losing a few pounds.

just admit you don't like running
 and find something else!

On the other hand, there are many different reasons why we might be exhausted and our body just needs to recover.  Severe depression, anaemia, Chronic fatigue (ME), fibromyalgia, arthritis and Multiple Sclerosis are just a few examples of  chronic conditions that can cause exhaustion and/or pain and seriously hinder our ability to exercise.  Common colds, flu viruses and bugs can also seriously zap our energy.

me before one of my
3 runs of the year!

In some cases gentle exercises may be possible and it's definitely worth giving it a try if you're able to.  Other times it's better to preserve what little energy you have and allow your body to heal by taking some rest.  I've made my feelings about those 'what's your excuse' posts quite clear!  It is so important that we look after our physical and mental health and sometimes that means taking it easy. In other cases with a bit of a push or with gentle encouragement we can enhance our health, wellbeing and quality of life by incorporating exercise into our lifestyle.

The Privilege of Sanity and the Cost of High Sensitivity

I wrote the blog about sanity being over-rated :http://samanthathesanevegan.blogspot.co.
uk/2015/08/im-not-sane-but-sanity-is-over-rated.html to help try to reduce the stigma of mental illness whilst at the same time not trying to romanticise it.  It's an area where you really have to tread carefully. Many people attribute their creativity to their mental health issue.  Others feel that the experience of having a mental health issue can be a good teacher and allow them to help others. 

now that's my kind of inspiration! RIP

The reality is, however, that mental illnesses can make life difficult and can add further obstacles to achieving what we want to in life.  I'm just the kind of person who tries to look for the silver lining, this is why I try to embrace my lack of sanity and also why I love Alice in Wonderland! I feel that sometimes sane (or 'neurotypical' to be PC!) people fail to acknowledge the extent to which mental illnesses can impact on a person's life and trivialise their feelings, accusing them of being lazy or not trying hard enough.

So in what ways can having a mental illness impact on a person's life?

This is something I've really felt compelled to write about.  Practically everyone I encounter in my life: family, friends, colleagues, acquaintances, (with the exception of a few friends who have experienced depression themselves) comments on the fact that I have a low status job for my level of intelligence.  Somebody (who I don't know that well) recently actually asked me if I was 'mad' and said that I had gotten too lazy and comfortable. 

When I talk about the difficulties I have with job hunting and interviews as a person with low self-confidence and recurrent depression I'm met with 'Oh but everyone hates job hunting' and 'Just act confident'. People cannot differentiate between the normal mild anxiety people feel when going for interviews and that of somebody with an actual mental disorder.  It is an actual fact that having a serious mental illness dramatically lowers one's chances of getting a job.  

As this article states 'Only about 20% of people with severe mental health problems are employed, compared to 65% of people with physical health problems and 75% for the whole adult population. Even for people with more common types of mental illness, such as depression, only about half are competitively employed.'
https://www.theguardian.com/society/2007/nov/14/mentalhealth2

'Oh, but what about this 'inspirational' celebrity who had depression or bipolar disorder and was still successful?'

Ugh, 'Inspiration Porn'

brilliantly put

There might be 'inspirational' stories of people with mental illnesses who still achieved great things and this might make some people think that all people with a mental illness have just as much opportunity as others, they just need determination or to 'change their attitude'.  It's akin to saying, for example, that the existence of successful black female jazz singers like Ella Fitzgerald or Nina Simone in the 1950s in America proves that black women were not a marginalised group and had the same opportunities as everyone else.  Race, gender and mental illness are of course separate and different issues but they are all factors that can impact on a person's life opportunities.  It needs to be acknowledged that those without a mental illness have an advantage over those who do.  There is nothing I loathe more than those 'What's your excuse?' or 'The only disability in life is a bad attitude' posts!

Sensitivity - Blessing or curse?

overwhelm is a horrible feeling

I've written before about being a HSP (highly sensitive person) in my blog: http://samanthathesanevegan.blogspot.co.uk/2015/05/depression-part-2-food-mood-and.html. There are 15-20% of the population who are believed to have a higher than average level of sensitivity and empathy (and I definitely fall into this category!) Whilst psychopaths are often highly successful in terms of climbing up the career ladder and earning large sums of money, highly sensitive people are more easily overwhelmed and tend to have lower self-confidence.  It's been found that about 1 in 5 CEOs are psychopaths.  Many people in positions of power such as politicians fit the typical profile of a psychopath whereas the tendency to feel overwhelmed in highly sensitive people may sometimes result in lower status (and lower paid!) jobs for highly sensitive people.  There are some world figures and politicians who fit the profile of a HSP (Martin Luther King, Nelson Mandela, Jo Cox (a British MP)) who managed to accomplish wonderful things and fight for justice (tragic that so many of them seem to end up being murdered!) Others might feel debilitated by their sensitivity and suffer from quite serious depression that prevents them from being able to function normally in life, let alone further their career. There is such a thing as 'Compassion Fatigue', a sort of exhaustion/burnout that some people experience from caring too much.  Self-care and taking some time for oneself where possible is key in these cases. 

Redefining Success

What does success look like for you? It is a shame that society seems to define success in life as a sort of 'grocery list' of achievements or milestones and Heath Ledger has really hit the nail on the head in this quote. If I thought of success in those terms like I used to, I would make myself miserable.  Do I have any of the things society might expect a woman in her early thirties to have? Nope!  But am I currently happy and do I experience pleasure and joy in my daily life? Yes!  That to me is success.  

I really wish that on social occasions, rather than asking what you do for a living or whether you've met that special someone yet or gotten pregnant etc, people would seek to find out how your life is going and genuinely want to offer support and care if the answer was not so great.  This would definitely take away a lot of pressure and the feeling of dread many people get when socialising at a lower point in their life.

Having a mental illness and being highly sensitive is part of me and something I've come to terms with, I don't want to sound like I see myself as a victim. I recognise that I have a number of great privileges in life and I am grateful: being born into a first-world country, being able-bodied, absence of any physical health problems, being a native English speaker, having 2 parents and a stable upbringing with good moral guidance. I just wish for a bit more understanding of the challenges people with mental illnesses and/or high sensitivity face and a shift away from the 'grocery list' view of success! 

Are some health problems our own doing?

There is no doubt that our diet
has a vast impact on our health but
it can't cure everything.

Constantly through the media and government health advice we are exposed to statements like '40% of cancers could be prevented by changes in diet and lifestyle' suggesting that the cause of illnesses can be simply divided into two categories: those that are either down to bad luck, unknown causes and genetics, and those are the result of sloth, overindulgence and poor lifestyle choices (smoking, recreational drug use, binge-drinking).  

Illnesses such as congenital heart disease or type 1 (insulin dependent) diabetes and some kinds of cancer are unrelated to lifestyle and more associated with genetics.  In recent years, research is emerging into altering gene expression (we cannot change our genes but it is possible to manipulate which genes are expressed) with nutrition.  It is a fairly new field and it will be a very long time before it becomes mainstream but might provide a means of lowering risk of such illnesses in the future. 

erm, even if that was true
we can't really do
anything about that can we?

Heart disease, hypertension and type 2 diabetes are sometimes referred to as 'diseases of affluence.' Gout is associated with consumption of rich foods. Breast cancer is often linked with high alcohol consumption and being overweight. I often see in the media articles or posts about how many incidences of depression could be avoided if only people took more exercise, spent more time in nature, ate more omega-3 rich food etc (As someone who has depressive episodes despite doing all those things, this seriously irritates me!). Whilst I don't dispute the idea that our lifestyle impacts on our health, it certainly does, I think this is over-simplistic and can appear quite accusatory and judgemental.

Those who have had or have witnessed somebody close to them having a serious illness might feel that saying it could have been prevented is suggesting that the illness is a punishment for not having been healthy enough.  When you or the person with the serious illness are someone who makes a great deal of effort to live a healthy lifestyle or sees other people who live a far less healthy lifestyle without getting ill it can feel seriously unjust.  

My view is that: a) whilst some illnesses might be more associated with genetics and others with lifestyle, all are multi-factorial, do not have one sole cause and can affect anyone and b) the belief that a health problem is one's fault is extremely unhelpful and detrimental.

Are 'diseases of affluence' our fault?

There are instances when people try very hard to main a healthy lifestyle but still end up with these illnesses.  We can only control what happens to us to a certain extent but avoiding over-eating, binge-drinking, smoking, recreational drug use and being sedentary can dramatically help reduce disease risk. What is important as well as highlighting these factors is examining the reasons why people do these things and what the barriers are to stopping.

How lovely it would be if it were as simple as that
What about people who have physical disabilities
as well as mental health issues and can't
exercise or have difficulty exercising?

With regard to the lifestyle factors, there might be a number of reasons why people overeat or abuse drugs and/or alcohol, but what these behaviours all have in common is that they're all methods (albeit unhealthy ones!) of coping with stress.  Most people experience stress in our lives in some form whether it's due to work, studying, family and relationship issues or financial troubles. I believe stress has a vast impact on our health and even those who don't binge eat, smoke or drink aren't immune to its effects. There are of course healthy ways of dealing with stress i.e. exercise, therapy, spending time in nature, taking a holiday.  The trouble is, access to all of these can be limited by our life circumstances.

What are the barriers to coping with stress healthily?

Disablities

I'm very much in favour of people being active but physical and mental disabilities can restrict the range of exercises a person can do.  

dance or exercises classes can
often be intimidating

I have family members who have disabilities such as MS and arthritis who can't simply go for a walk or run in order to boost their mood.  Additionally, people (particularly those with mental health issues) can feel very self-conscious about their weight, physical appearance and level of energy and fitness and exercise can feel like their idea of hell.  During bouts of severe depression, I've tried going to the gym and it doesn't make me feel better at all. The health benefits of exercise are constantly communicated to us through the NHS and media.  You'd have to be living under a rock not to be aware that exercise benefits our health.

Constantly shaming people for not exercising or for needing medication to reach a place where they're able to exercise is seriously unhelpful.

Financial issues
Some people are fortunate enough to have disposable income that can be spent on healthy ways of dealing with stress (exercise classes, private therapy, massage, a short break). Others unfortunately struggle to pay their bills and cover the essentials and this can limit access to these. Whilst some exercises

all of these are good ideas but
not always possible. 
It's -1 degrees right now so getting outside
wouldn't reduce stress! 😆😆😆

are free or inexpensive (running, walking, gardening) others cost money, not just for the classes but for the sportswear or dancing/running shoes people might need for them.  Some exercises can be done at home but many people (me included!) live in quite cramped housing where there is hardly any space.

With regards to therapy for mental health, some is available free on the NHS, there are some self-help books that can be borrowed free from some libraries and some non-profit organisations such as MIND offer counselling.  The problem is, with mental health issues being as common as they are, there are often very long waiting lists and in some cases if people waited until therapy was available before getting any sort of treatment they would take their own lives.  From personal experience I can definitely say that reading, eating well and exercising is not always sufficient to help someone with depression.  There might not be any perfect medication with no side effects but it is sometimes necessary.

I've written about the costs of eating healthily in my blog: 
http://samanthathesanevegan.blogspot.co.uk
/2016/09/is-eating-healthily-expensive.html

Time Poverty! 

Getting adequate rest and sleep is definitely important in reducing stress and increasing our well-being. There are some people who make their lives busier than necessary  due to competitiveness or a 'workaholic' personality. On the other hand, many people are in a position where taking a break is not an option.  Parents and those who have caring responsibilities can often find it almost impossible to find a time when they can take a break.  Many people are having to work long hours or several different jobs in order to pay their rent/mortgage and bills. It's no wonder that people often resort to quick and more affordable fixes to relieve stress.

don't judge, support one another! 

Perhaps there are some people who are just a bit careless and overindulgent but I think a lot of the time people are just engaging in not-so-healthy habits as a response to daily life pressures.  Which is not people's fault!


I'm certainly not suggesting that people should continue to depend on junk food, cigarettes and alcohol forever in order to relieve stress, just that it's understandable when you look into the reasons why. I wholeheartedly admire the NHS and truly believe that people should try as hard as their circumstances allow them to maintain good health in order to reduce strain on its services.  I just believe a little bit more support and a bit less judgement would go a long way! 

x

'Where do you get your protein?' is not a stupid question!

Not suggesting all meat eaters look like that,
just saying that sometimes people should be more
worried about their own health!

I often see vegans complaining of being sick of being constantly asked where they get their protein as if it's a stupid question and people are ignorant for thinking it's not possible to get enough on a vegan diet.  Whilst it is incredibly annoying to be criticised for being vegan as if you're being irresponsible by people who smoke and/or binge drink and are really unhealthy themselves, I actually think it's a pertinent question and it is an important issue to address.  Most people (including me!) have been raised thinking of animal products as the main source of protein and so naturally excluding them from the diet can seem to be cause for concern.  Do I think it's possible to get enough protein on a vegan diet? Yes.  Do I think it's easy, convenient and affordable for all?  No

What's protein for?.........

When people hear protein they probably immediately think of building and repairing muscle but it has several other crucial functions.  Protein is broken down into amino acids that serve functions including liver detoxification and neurotransmitter (hormone-like chemical messengers of the nervous system) synthesis.  It also produces enzymes that speed up chemical reactions in the body.  Eating sufficient protein with carbohydrates helps to slow their release and provide more sustained energy and more stable blood sugar levels.

Whilst serious protein deficiency (known as kwashiorkor) is rare in developed countries, inadequate protein intake can contribute to low energy, sluggishness, depression and weight gain (all very common health complaints!).  It's a good idea to ensure your intake is sufficient (usually around 0.8g-1g per kg body weight for the average person) to maintain good health.

What are the vegan sources of protein?

Beans, lentils, split peas and chickpeas, peanuts, nuts,seeds and their butters, tofu and tempeh, meat substitutes, soya yoghurts, vegan protein bars and protein powders (rice, pea, hemp).  You can now buy pastas made from red lentils or chickpeas also.  I often see green vegetables such as broccoli and spinach described as a source of protein.  Whilst they're certainly an important and nutritious part of any diet it's worth bearing in mind that their calorie content is so low the amount of protein they provide is unlikely to contribute a significant amount of one's intake. Grains such as quinoa and buckwheat also provide some protein in addition to complex carbohydrates.

So given the broad range of protein sources what are the barriers to getting enough and how do we get around them?

this kind of approach really doesn't
work for vegans!

The different macronutrient composition of vegan protein foods
The 3 macronutrients are carbohydrates, protein and fat.  When given dietary advice we're sometimes told to aim for X number grams of protein, carbs or fat or to fill a quarter or a third of our plate with protein and the rest with carbohydrates and vegetables.  Pulses (beans, lentils, chickpeas) actually contain more carbohydrates than protein and nuts and seeds contain more fat than protein so it can be more difficult to calculate the right balance of macronutrients.  Tofu and tempeh (made from soya) and seitan (wheat gluten) are high in protein and low in carbohydrates and fat but shouldn't be consumed too frequently and they are to be avoided by those with intolerances to gluten or soya.

I love these bars!

I find that as a vegan you're not always getting a big 'chunk' of protein but more little bits all that add up throughout the day.  For example, my breakfast today was porridge made with 50g oats (6g protein), 200ml soya milk (7g protein), a tablespoon of ground almonds (3-4g protein) a tablespoon of chia seeds (3-4 protein) and some blueberries (not a source of protein but nutritious in other ways!), equalling around 20g protein altogether.  Sometimes I'll have a protein smoothie using pea or rice protein or toast with nut butter.

If I'm having one of the more carb-heavy protein sources for lunch or dinner I'll have a smaller portion of rice or noodles than I would if I was having tofu and increase the proportion of non-starchy vegetables.  I generally have nuts and seeds more as a snack or something to sprinkle on top of things rather than a main protein source. Throughout the day if I get hungry between meals I try to snack on protein bars with not too many artificial ingredients or syrups. I also like Graze's veggie protein power and punchy protein nuts.

Allergies and intolerances 

I'm fortunate not to have any allergies or intolerances but many meat substitutes and vegan protein foods are based on soya and/or wheat gluten which are foods that some people are intolerant to.  Tree nuts and peanuts are also common allergens so that source of protein is cut out for some.  Fortunately there are protein powders based on less allergenic foods such as hemp, brown rice and split peas that can be used in smoothies and home-made protein bars/energy balls.  I wouldn't say it's impossible to eat a vegan diet with allergies but it's certainly challenging and it would be advisable to seek advice from a dietitian or nutritionist to ensure you're not lacking in anything.  This website has some very helpful information:
 http://veganhealth.org/

Foods are sometimes a taste substitute but not a nutritional substitute. 
There has been a great expansion in the range of vegan cheeses, yoghurts and milk alternatives available in supermarkets.  Whilst soya milk and yoghurts contain similar amounts of protein to that of dairy milk and yoghurts, those based on nuts, coconuts or rice are much lower in protein.  If you're someone who avoids soya due to allergies or health concerns just bear the lower protein content in mind and compensate for it with other protein sources.  Vegan cheeses made from soya, coconut or nuts are also low in protein compared with dairy cheese. I've often seen jackfruit advertised as a meat substitute because its texture resembles that of pulled pork but I've never seen it mentioned that it's not a protein source! I'm not saying people should never eat these things, it's natural to want to still enjoy the same kinds of meals you're used to, but it's important to be mindful of your protein intake.

this is delicious but low in protein!

Expense and convenience
I live in London where in the centre there are chains like itsu and Pret that have balanced vegan options available.  I find when I pop into central London it's not generally too hard to get something balanced and with a decent amount of protein.  However, I live on the outskirts where there are far more kebab and chicken shops and newsagents than places with healthy vegan options!  The answer is obviously to prepare well, plan meals and bring healthy food with you where possible.  I'm not always the most organised person and at times when I've not got any food on me I've ended up getting things like chips, crisps and flapjacks.  Really not ideal! It might seem like a pain having to plan ahead all the time but your body really will thank you.

healthy vegan options at pret

In addition to the convenience issue, expense is also a factor.  Protein foods generally are far more expensive than carbohydrate foods.  Beans, lentils and chickpeas are  quite cheap but nuts, protein bars, protein powders and tofu can all be very pricey.  I find I do spend a fair amount on food and I don't begrudge this but I do understand for those who are feeding a whole family on a budget it could be difficult.

So to conclude, whilst it is possible to get enough protein on a vegan diet, it's not always that straightforward and might be challenging for some.  Don't be afraid to seek out help if you're not sure if you're getting it right 😊