I met with my therapist yesterday and had a very good conversation. I have been seeing this guy off and on for over 10 years, and I usually investing in half dozen sessions each year as kind of a “tune-up” to keep me on track. With my recent flare up – a combination of anxiety, not-quite-depression funk, and overall sky-must-be-falling-soon gloominess, I find these occasions with him to be exactly what I need when I’m in an arm-flapping crisis of faith.
Previously I had mentioned that I had taken up blogging, and I was a combination of surprised, flattered, and mildly embarrassed to find he had sought out and read several of my posts. I mean, really, do I want my shrink (hi doc!) knowing how truly vacuous I am some of the time? Of course, he probably already knows, possibly better than even M realizes.
I bring it up because (1) I’m sort of embarrassed, and (2) because he found a constructive way to thread it through our conversation and use it for my benefit. He, like so many others in my life, is a runner. In fact, he was intrigued by a training group my son coaches for the California International Marathon, as he is considering upping from the 5K and 10K races he usually participates in to a full marathon. But he noted that I sound disappointed with my diet and exercise routines and express my frustration for making so little progress. Is that a perception or a science-based reality in that I am not losing weight, inches, or seeing a positive trend in my blood glucose testing?
Thinking about it then and now, I believe it is a little of both. I am not seeing the positive results because lately for every minute I spend rowing or walking or just moving with intent to improve my overall health I make a silly, stupid, ridiculous food choice that negates that positive movement. In fact, I would go so far as to say negates by a factor of 2, sometimes 3. Because I am not just making piss poor food choices, I am making them unconsciously (comfort food or stress eating) and I am consuming A LOT more than recommended portion sizes. I have not gotten on the scale this week (that’s Monday), but I do know some of my summer clothes that were fitting fine a couple of months ago are now snug to unwearably tight.
The doc and I discussed this and ways to make myself be more conscious of my actions and their consequences. My stressors are somewhat beyond my control (I cannot send my full-time bosses away forever, although they are currently both on vacation and out of my hair), but my responses are certainly controllable. I am dubious and doubtful about my ability to stay more conscious and in-the-moment when it comes to diet and exercise, because frankly there are no immediate impacts or consequences I can actualize and feel. I am always completely honest with him during these sessions, to be otherwise seems so pointless, right? I mean, he is well compensated by me and my insurance company and these hours do not come cheap, so I should do the work to reap the benefit of his training and expertise. Besides, I am a terrible liar and he knows how to deal directly with my bullshit when I try. It is at its worst a character flaw, but more likely just lack of discipline. Feels like the recurring theme of my life and its shortcomings.
Anyway, we were coming to the end of our hour and he reached for his prescription pad, which dismayed me. I hate taking medications, and the idea of being judged as so bad off that he’s going to give me drugs for depression and/or anxiety was upsetting. He told me he was prescribing “a few” different things and to pursue it consistently per his instructions until our next session, which is in 3 weeks because of vacation. He folded it in half and saw me out, handing me the paper as I was walking out the door. I was so distracted by the idea of drugs again that I did not even notice that he was not more specific about what he was prescribing.
I drove home without looking at it, because I can rarely read his handwriting anyway. I was upset about having new meds. Once I got home and actually looked at it to tell M what I was adding to my drug cache? My doc has prescribed 3 yoga classes per week, strength training 3 times per week, and cardio with a heart rate to 85% of max for 30 minutes 5 days per week.
Seriously – my psychiatrist wrote me a prescription for increasing my level of exercise.
It makes me laugh, yet in my heart I realize he is correct. I do sort of skate along moving, but not working especially hard at it. Yoga makes me sweat, but Bikram practice is always in a room heated to some extraordinary level for 60 to 90 minutes. Yes, I work hard, because I am restarting and extraordinarily inflexible, but my goal of 2 classes per week is a bare minimum. Since I have an unlimited membership that does not expire until August 31, 2016, I could conceivable go to 2 classes per day and have it not cost me any additional money. The strength training requires more commitment and I am in progress toward this goal with appointments with the trainer, but I will definitely have to step up my efforts. But the cardio … the cardio is so spot-on. I row every morning for 20 to 40 minutes, but anymore it’s not at a high-level of difficulty or particularly strenuous. I do it because it does make me feel good, refreshed, but it does not make me tired or sleep better the way working harder to elevate my heart rate affects me.
Since I tend to be a rule-obeying citizen, the prescription is like permission to take better care of myself. Except I do not need permission; I need someone (other than M) to kick me in the ass and hold me accountable. If I go back in 3 weeks and say I ignored his instructions, the unspoken disappointment will weigh upon my mind and make me feel guilty. A law-breaking rebel I am not.
What’s funny to me is that I have this same conversation about increasing my exercise every time I start feeling down or negative about myself. But because I tend to hate exercise, feel like I am not good at it or improving with consistent practice, it is the easiest thing in the world to procrastinate and put off. No more, I suppose. I was at a 8 a.m. yoga class this morning (along with 5 other “early” Saturday risers) and am plotting a nice afternoon of floating in the pool and working on my tan after I finish the laundry and housekeeping (and this blog post). Tonight I’ll hit the rower or the arc trainer in a more robust fashion, then maybe swim some more after dark.
It just goes to show that the first line of advice from every doctor I have is diet and exercise. But I am okay with that, because in this case it probably will make a world of difference.