do not metaphor me

The most common side effect of antipsychotics is weight gain.  This happens for several reasons.  One of the main reasons is that antipsychotics change how your brain controls appetite and stores energy.  It does this by blocking specific chemical receptors that regulate eating behaviors in the brain.  It blocks Histamine H1 receptors causing constant hunger and strong cravings for sweet, starchy, or fatty foods. It stops the brain from telling a person they are full by blocking Serotonin 5-HT2C receptors.  It can also change your dopamine levels which can cause overeating for comfort.

And as if that weren’t enough reasons there are also hormonal and metabolic changes that antipsychotics cause.  A person can develop leptin resistance.  Causing their brain to think they are starving.  One of the metabolic changes is your body changes the way it processes sugar that turns extra calories into body fat.  The other metabolic change is antipsychotics may also slow a person’s metabolism.  With all of these changes happening inside and outside of the brain it is no wonder why weight gain is the number one side effect of antipsychotics.  Anyone who is on an antipsychotic for any reason (be it schizophrenia, bipolar disorder, insomnia, dementia…) can expect some to a lot of weight gain. 

Even if a person who is bipolar isn’t on antipsychotics, the same is true for mood stabilizers and antidepressants.

It’s like when they formulated the medicine, they didn’t even try to find a combination that would not cause weight gain.  I mean, I guess, since they aren’t the ones gaining twenty to a hundred pounds why should they care.  It’s not their self-esteem on the line.

I have not handled the weight I have gained because of my medication well.  I don’t look full straight on into mirrors anymore because of my size.  I’ll look at my face, just to see where my shirt hits my legs, my hair, but I never look at the whole of me.  And if I accidentally do see the whole of me in the mirror, I am filled with so much shame and disgust thoughts of self-harm rapid fire through my brain.  But I dig down deep and push them out.  (I usually fixate on a song and sing it over and over in my mind.  Swap one obsessive thought for a healthier one.)  I also don’t even try to dress cute.  What’s the point? There is no style of clothes that can change the size I am.  And my history of anorexia and bulimia does not help matters at all.

Maybe I shouldn’t complain.  After all, there is some part of me that doesn’t regret the weight gain at all.  The exchange has been worth it for me.  That is until I look dead straight on in the mirror.  Then I live with a lot of regret until I’m able to forget what I look like again.