Depression / self-image spiral

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Depression / self-image spiral

Post by nearly_takuan on Wed Jun 06, 2018 9:27 pm

My wife has been diagnosed with a form of depression for many years, and tried (with a psychiatrist) many prescribed medications to try to deal with it. The least-bad solution that's been found so far, which worked well enough to continue using for years, has been Zoloft; it doesn't make all the symptoms go away, but reduces the severity enough that what remains is manageable.

One of the side-effects, however, is weight gain.

My wife has a physically-demanding job that keeps her active, albeit during the evening and night; she also accompanies me to the gym occasionally. She occasionally indulges in candy, bread, etc. but otherwise mostly eats the same stuff I do, which mostly is decently healthy grocery-store food.

The effects are small but cumulative, and we are starting to approach a point where the weight gain (and inability to lose weight) is making her feel extremely sad.

We are planning to check with doctors soonish, to see if there's anything further she can do to try to lose the weight in a healthy way, but neither of us is especially optimistic; it certainly seems to be the case that even non-depressed people often have difficulty making their bodies be a shape they're satisfied with.

I am posting this here partly because I'd be interested in hearing about what this is like from someone who may have been in her situation. We've talked about this between each other as much as we could within our respective comfort levels, plus a little bit past that. I have first-hand experience with depression, of course, but it's a fundamentally different type of depression; and the only body-issues I've ever had have been pretty much the opposite in every way. So I don't have a great sense of what she needs from me, and it doesn't seem like she does either.

At this point I feel like any time she brings the subject up, failure is the only option. If she asks if I think she's gained weight and I say no, then I'm a lying liar who is just saying what I think will make her feel better, and I have to answer increasingly rigorous questions about why I think she's lost weight / hasn't gained weight, and then it turns out the bathroom scale doesn't agree with what I said anyway and now everything is terrible. If I say yes, just a little bit, but there's nothing wrong with that / it might be water-weight / it might be muscle / whatever, then there's some other reason that this doesn't make enough sense and now everything is terrible. I don't think it's being intentionally set up as a trap, but it still feels like a trap for both of us. (Pointing out that this is a trap will probably be interpreted as avoiding the question, and implicitly giving the worst possible answer along with it, and accusing her of something, so I've been ruling this out under the assumption that it's definitely the wrong move.)

She is aware that I find her very attractive as-is, so this is not really the issue. However, there are two ways in which I am still indirectly responsible for some of the badfeels:

1. We're anticipating lots of interactions with her family in the near-to-mid future. Many of them haven't seen her face-to-face in years, and she is anticipating overt judgement coming from several of her less-tactful relatives. I can't do anything about this.
2. I have basically the opposite body type, naturally-skinny, and after a few years of exercising -- ironically started at first partly in an effort to attract a mate -- I'm in OK shape. (Trainers at the gym still ask if I've ever been to a gym before and if I need some help learning the ropes, but people at my office ask about my regimen.)
2a. We're married and live together, so we share meals pretty often. My maintenance-level caloric intake is almost double what hers is, so if we eat the same amounts of the same stuff, then either I lose "good" weight or she gains "bad" weight or there's a little of both. Of course right now the best trade-off is for me to be a little hungry and lose a little "progress" in exchange for her mental and physical well-enough-being, but this isn't super sustainable in the long run.
2b. Of course she compares our bodies and has feelings about that.


1. What should I say when she wants to talk about this? Is there a way I might try to phrase or frame that conversation that might help, or at least not let her use it as an excuse to feel even worse?
2. Is there anything I could do in the background, either to help support her weight goals, or to help her feel better about her body?

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Re: Depression / self-image spiral

Post by Enail on Thu Jun 07, 2018 1:30 pm

That sounds tough, Nearly. It sounds like the loaded questions are the biggest problem here, or at least the biggest one that shouldn't have to be. Is it something you could talk to her about directly when she's not already started on the question? Like, just say directly "when you ask me about your weight, I feel like you're using me as a tool to obsess and make yourself feel worse, and I don't think there's any answer I could give, no matter how true and/or how kind, that would make you feel better. So I'm not going to answer anymore, and I think you should try and stop roping me into this obsess about your weight game." If she seems open to having that conversation in the abstract without it setting off any spirals, you might ask what kind of responses she'd find supportive that don't ask you to play that game.

If you don't think it'd be wise to bring it up when it's not already started, then you could do something similar when she starts asking. I think the key is that once you've explained it, once, just be really boring and repetitive about it.

"Do you think I've gained weight?"
"I'm not going to get into this question game again. I think you're attractive, if that's what you're trying to ask. "
"But what about X, Y and Z."
"I've told you I'm not going to help you obsess about your weight."
"But the scale says X"
"So you're saying you think I'm fat and awful in every possible way?"
"I'm saying that I don't want to talk about your weight. But I do want you to know I think you're attractive."

One other thing: You say if you eat the same amounts of the same stuff, one of you is not getting the ideal amount... Why on earth do you have to eat the same amounts of the same stuff?!?!  Of course you share meals, but you don't have to eat the same size portions of those meals?? eShe can change how much she eats without it having any effect on you, and vice versa (other than different amounts of leftovers). If she wants to eat less, I think it's on her to decide and I wouldn't normally suggest that you suggest it, but it sounds like you've talked about the fact that you share meals and jointly determined that the only way for her to eat the amount she feels is ideal for her is for you to also eat that amount and thus go hungry, so unless there's something I'm missing here, I think you might revisit that and say "no, we can each serve ourselves the amount that's right for us of the shared meal."

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Re: Depression / self-image spiral

Post by KMR on Thu Jun 07, 2018 4:28 pm

It can be really tough to adjust to a changing body type, to not seeing yourself in the way you're used to, and coupled with the societal pressures and body shaming that people (and especially women) are constantly bombarded with, it becomes even more difficult. I used to be underweight, have gained 15 pounds over the past several years that are definitely to my benefit, and I still look objectively skinny, yet I occasionally feel uncomfortable with my body in a way that I never had before or thought I'd ever have to deal with. In large part because our society is so harsh about every little aspect of a woman's appearance, that the fact that my stomach sticks out slightly more than it used to FEELS wrong, and I'm compelled to wonder if I should take measures to prevent further weight gain, even though intellectually, I know that I could probably still stand to gain a few pounds. So yeah, body image is a... complicated thing at best.

For me at least, it helps to be aware of just how much of self-image is related to external factors, like media representations and other people's judginess, and to separate concerns about what others think from my own personal discomfort about my body. A way to combat the external concerns is to continually remind oneself how problematic societal standards of beauty are, which means it's also problematic to apply those standards. It may help to remind oneself that weight and health are not necessarily correlated; it sounds like your wife has fairly healthy eating and fitness habits, which is the more important factor in the long-run.

If she brings up the topic of her weight, I wonder if you could sort of redirect the question away from objective measures and instead use it as an opportunity to discuss her feelings and provide support. So if she asks, "Do you think I've gained weight?" maybe say, "I'm not sure/I can't really tell. Do you feel like you have?" Then if she says yes, you can sympathize with her concerns, provide reassurance, tell her you're here to help in whatever way you can, etc. Might be a way of at least avoiding the blame game.

It also might be better for her to not fall into a habit of weighing herself too often, because that could make her overly fixated on the numbers in a way that is unproductive. It could be that she feels a little better about her body at certain points, then the scale tells her she has gained weight (or hasn't lost it) and it makes her feel bad about herself again. Or if she already feels like she might be gaining weight, the scale could just further reinforce the bad mood. Since weight tends to fluctuate anyway in the short-term, it's not really helpful to keep checking it.

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Re: Depression / self-image spiral

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