We all have our little vices.

With mental illness, it’s particularly important to work out which ones you’re going to have to sacrifice for your wellbeing.

After a big slump in January, I decided to have a bit of a clearout.  I made a number of lifestyle changes that helped me regain some motivation and stability, some of which have stuck and some haven’t.

Cutting out alcohol: check.  Apart from a handful of booze-ups this year, all of which have been planned for (including the aftermath), I am alcohol free and I feel a lot better for it.  I’m convinced it’s probably the major contributor to my 12kg weight loss this year, from 92kg to just on 80kg, which apparently is within my healthy BMI range.

Consistent sleep/wake times: yes and no.  I have slowly come to recognize that my body actually does need a certain amount of sleep each night, and in order for my body to find a natural sleep/wake rhythm, I need to at least give it a chance by giving it some consistency, not pulling a 3am sleep/7am wake one day and crashing at 5pm till 9am the next.

Fitness: yes and then no.  I started a running programme, as I talked about the other week, which has fallen by the wayside.  I am going to reinstate this, or at least some form of regular walking, now that the summer months are returning.

Cutting down caffeine: fail, but not for the want of trying.

In February, I chose a replacement beverage for caffeine and alcohol: green tea.  With drinking (and smoking), your body doesn’t just become used to the chemicals, it become used to the consistent action of imbibing.

Green tea seemed perfect as it was a hot drink that could be consumed slowly in a social setting, allowing me to match pace with my drinking fellows without filling myself full of sugary soft drinks.  During the day, the psychological need to have a cup of something to drink when I sat down at a new task was also met.

It didn’t last too long, and it’s not hard to understand why.  Caffeine is a psychoactive substance, and according to Medscape, it’s the world’s favourite.  Coffee is second only to petrol as the world’s most traded commodity.

Of course, alchohol and nicotine are pretty well consumed as well, along with sugary sweety things, but we know these are not good to stuff yourself with.

Is coffee good for you?

Apparently, yes – and if you’re a woman, it may even act as a potential shield against depression, says the results of a new study published recently in the Archives of Internal Medicine.  Brain Blogger reports:

The researchers followed more than 50,000 women with an average age of 63 years from May 1980 to April 2004 as part of the Nurses’ Health Study. At the beginning of the study, none of the women had a diagnosis of depression. Researchers collected and analyzed self-reported data regarding tea, coffee, soft drink, and chocolate consumption. Over a 10-year period, 2607 of the women developed depression, defined as physician-diagnosed depression or antidepressant use.

The risk of developing depression was 15% lower for women who consumed 2 to 3 cups of coffee per day, compared with women who consumed less than 1 cup a week. For women who consumed 4 or more cups of coffee daily, the risk was 20% lower.

Thing is, I don’t just love coffee.

I have an almost insatiable penchant for energy drinks, for which the evidence of goodness is decidedly lesser.  The study above found no association between reduced rates of depression and caffeine from sources other than a regular cup of coffee.

Consider this case study from a Medscape paper on caffeine-related psychiatric disorders:

Brenda had started college 6 months ago and was struggling to keep up. As her grades slipped, Brenda redoubled her efforts by studying more. Unfortunately, fatigue set in and made her less attentive…

While some students might turn to more potent and illicit drugs, Brenda chose caffeine instead. She carefully read labels and soon discovered an energy drink with the highest level of caffeine. The energy drink did the trick, at least for a brief period. Brenda soon found that 6 energy drinks in the evening kept her awake and relatively alert. The caffeine excess came at a cost though, measured in terms of persisting insomnia, nervousness, and mood fluctuations. Those symptoms actually worsened her test performance leading a friend to suggest she visit a doctor.

I know how Brenda feels.  I discovered the Brain Blogger entry about the caffeine study last week, and happily deluded myself for a few days as I continued to guzzle those ridiculously large 500ml cans of V (now in an inticing, sickly new blue flavor) that I was actually going to be fine.

But this is just another form of self-medicating.

I’m still feeling fragile about my recent three-week crash, and caffeine is acting as a crutch to keep me up even when I’m feeling fine.  It’s almost like I feel it’s an insurance policy for getting through the day.

The Medscape article recommends that “every individual entering the medical system should, at some point, receive a nutritional assessment.”  I have never had one – I’ve had conversations, but nothing so formal as an assessment:

Clinicians should attempt to quantify each beverage type consumed per day. To assist data collection, the person can be instructed to keep a daily log of all liquids consumed. This can be an instructive lesson for the individual, who might discover, for example, that all liquids consumed in an average day might be caffeinated sodas. This allows the clinician to stress the importance of varying the diet and, most importantly, of adding water in place of other beverages.

There’s no reason why you can’t do this yourself.  Keeping a diary of your liquid diet could help you see how you may be unwittingly adding to your mood swings.

I’ve found it’s a common reaction both for those with a mental illness and people in our orbit to blame problems that crop up on problems with medication or dosage, but these things don’t work in isolation.

I think it might be time to face up that while caffeine may help me achieve lift-off, everything that goes up comes down eventually, even if it shoots into orbit.

And Skylab didn’t look too flash after re-entry.