Interview with Ms. Alvarez

Ms. Alvarez is a 66 year-old female with severe depression, severe obesity, post traumatic stress disorder, anxiety, and diabetes.

What made you decide to see a doctor specializing in psychiatry at the age of 66?

Before beginning this lifestyle journey, Ms. Alvarez describes herself as significantly “depressed and verbally [aggressive] towards [her] daughter.” She cared much for her daughter but constantly found herself unable to refrain from being agitated and easily “annoyed when she spoke,” and she had no reason why. Her daughter was always concerned about her health and safety, frequently searching for ways she could help her beloved mother feel happy. Ms. Alvarez’s daughter got  her a cane to help her walk or take her to various doctors who provided medication treatments for her ailments. She suffered from anxiety, trauma, depression and severe obesity and diabetes. Her daughter was intrigued by the ketogenic diet and its possible treatment effects for her anxiety, depression, weight and diabetes In a desperate attempt to help her mother, her  daughter looked for a metabolic psychiatrist and found Dr Sethi Dalai on Youtube, eventually finding a local doctor who provides this treatment. She proposed this idea to Ms. Alvarez and they both decided to visit Dr. Sethi Dalai’s clinic.  


What were your goals before you began?

Ms. Alvarez describes how she hoped to “maintain a healthy weight” and wanted to “get rid of diabetes…[as well as the] pain [in her] knees and joints.” She wanted a result that would allow her more energy and improved mood so she could create a better relationship with her daughter. 


You have been through a lot of trauma, how do you think that affected you before versus now?

Beforehand, Ms. Alvarez found herself experiencing “deep self-confidence issues.” She had “long periods of depression” and “soothed [her] sorrows [by] eating whatever [she] wanted.” Her depression was clinically diagnosed with a resulting PHQ-9 intake of 26—a sign of severe depression. Her scores on the PCL-5 trauma survey when she initially presented were also concerningly high.


How did your sleep schedule change throughout the process, how soon did these changes help you?

Initially, Ms. Alvarez faced “only 3 hours [of sleep] per night.” Her sleep schedule had been completely erratic due to her recent retirement following an intensive career as a neonatal nurse in New York. She was frequently called at any time of night and for the past 30 years, she has never experienced a proper or “stable sleep schedule.” After the lifestyle changes she made with structure, movement, and nutrition, she claims, “I now sleep 8 hours per night. It occurred soon after starting the program.” 

Could you just talk to me about your journey? Specific changes you would see yourself going through?

Ms. Alvarez always had trouble confronting her own issues, but when she began this journey, she started to really feel herself smiling and laughing with her daughter: “I finally began walking without the... cane my daughter had gotten me—To where she was surprised [saying] ‘did you really walk all the way home without your cane?’” She noticed significant changes from no longer “running out of breath... having serious mood swings…[experiencing fatigue]...or fighting with [her] daughter.” She befriended her neighbor, talking with her for hours. Ms. Alvarez states, “I used to be a lion in the I am a nice sweet woman.”


Was there a comfort person that you talked to everyday? Was there anyone who showed you support in this effort that you could identify?

Ms. Alvarez identifies her daughter’s incredible support and dedication to her throughout this experience, doing everything in her power to get her mother the help she needed. From traveling to various doctors and physicians, testing all kinds of medication, and eventually finding the ketogenic diet, Ms. Alvarez cites her daughter’s incredibly important support throughout the program. Ms. Alvarez mentions that she is so grateful to have her daughter helping her through her trauma and “appreciate[s] her [daughter’s] efforts...every step [of the way].”


Were there things that you did routinely that made you feel good? Did you give yourself rewards after losing weight etc.?

Ms. Alvarez mentions, while laughing, that she is always reminded of her daughter taking her to the clothing store after a session with Dr. Sethi Dalai and making her try on new outfits, as Ms. Alvarez describes, “like a fashion show.” It was very uplifting and forged an even stronger bond with her daughter, increasing her self confidence. 


What set you off? What were the trouble issues that caused panic? What was in the dialogue with your daughter that made you stressed?

Ms. Alvarez is a very organized person, and prefers that  everything have  a place. Although she doesn't understand why, she always seemed to “get angry when she entered the kitchen and [her] daughter did not put away the dishes or [left] them dirty.” She never understood that some of her symptoms were from a root problem that arose from past traumas, until she began receiving help or whether her metabolic problems were contributing to her irritability. 


How were your mood swings before starting on the ketogenic diet and how could you feel yourself changing?

Ms. Alvarez vividly remembers how significant her mood swings were before beginning the ketogenic diet. She describes her days of uncertainty: “Sometimes I have a lot of energy to clean… and keep everything organized, and … [on] other days I don’t want to do anything.” Frequently feeling as though she was “slow and stupid,” she even called upon the priest at her local Parish who managed to calm her about her “overwhelming feelings of angst.” Her thoughts about suicide, which she explains as moments where she “feel[s] tired of living”, had been communicated to her daughter during their arguments. 


What do you think caused these mood swings?

Ms. Alvarez always blamed her mood swings solely on her unstable sleep schedule as described above, but even though she knew this affected her temper and disposition, she never sought direct help with sleep treatment. Her trauma history and PTSD in her adolescence and well into her adulthood may have also contributed to her anxiety and mood swings. 


What progress have you made with your diet?-mentally, emotionally, physically, routine-wise?

Ms. Alvarez describes how, now around seven months in, she can see “so much improvement” in her mood swing frequency, sleep, movement ability, her blood sugar, and weight. She is no longer considered depressed, anxious, or even obese by her doctor. Her PHQ-9, PCL5 and GAD-7 scales are low/subthreshold in contrast to her initial visit. This experience taught her the importance of keeping a routine schedule and focusing on the quality of her food. Particularly,  decreasing artificial and highly processed foods allowed her to create and develop a new, calmer relationship with her daughter. 


Did you ever journal? How did/do you keep your routine?

Ms. Alvarez mentions that she journals frequently. It helps her keep track of a specific schedule which, in and of itself, allowed her to develop a foundational routine for her nutrition plan. The more she kept track of her journal entries, the more dedicated she became in recognizing her healthier lifestyle. 


What advice would you give to others starting this journey or having trouble deciding on if they should start this type of change?

Ms. Alvarez recommends others to start this journey. The biggest advice she has is to “always keep track of everything and journal.” Ms. Alvarez hopes that her story will “[encourage] and inspire others with a similar condition” to embark on this journey themselves. 

* Alias name used for confidentiality 

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