Anorexia Nervosa

I’m fat. I admit it. I haven’t been fat all my life, so this came as something of a surprise to me, but I’m dealing with it. I don’t know whether it’s my eating habits or my medication or some genetic thing that has caused me to gain weight, but there you have it. It could be any or all of those.

I’m not trying extreme diets or grueling workouts, though I admit that some exercise would be good for my mental condition as well as my body. I’m living with and acknowledging the fact that I am fat.

The thing is, when I think about myself, I don’t think of myself as fat. Perhaps I’m in denial about it. But I do know how much I weigh and that it’s over what I should, according to all the height vs. weight and BMI Index charts. And I don’t think of myself as thin. I just feel as though I’m still in my 30s and weigh what I weighed then, despite my body’s very clear rejection of those notions. I know I’m really in my 60s and have trouble getting up off the floor if I fall, in part because of what I weigh.

I’ve heard that everyone gets stuck in their head at a certain age and always remains that same age in their mind. It’s not quite like having an inner child of four or ten (or in my case, more like 15). I used to think I didn’t have an inner child until I remembered how much I still love chocolate milk, plush animals, and naps. And I do have that inner teen that wants to make up for all the things I missed when I was a depressed teen, like mad crushes and experimenting with fingernail polish and fake nails. But having an inner weight is different somehow. It’s like my brain and my body are clashing in some way.

At least I don’t have Body Dysmorphic Disorder. That’s when you see tiny, imperceptible flaws in yourself and magnify them until you think that’s all people see when they look at you. Technically, it’s not the same as anorexia because, in anorexia, you focus only on your weight even if you are thin. Anorexia is an eating disorder that you have as a reaction to your flawed perception of your body size. Dysmorphic Disorder is more about smaller perceived flaws such as balding or the size of your nose. (The Mayo Clinic does say that Body Dysmorphic Disorder can cause or be associated with eating disorders, low self-esteem, mood disorders, obsessive-compulsive disorder, and substance abuse. The DSM-5 does not classify Body Dysmorphia as an eating disorder. It’s confusing.)

One of the dangers of Body Dysmorphic Disorder is overuse of plastic surgery, which can be somewhat of an addiction in itself. Just watch a few episodes of the TV series Botched and you’ll see what I mean. There are always horror stories like the one in which a young man wanted to look like Michael Jackson and as a result of repeated surgery suffered the same health problems and conditions that the singer did.

Read the full story here: https://bipolarme.blog/2022/09/25/body-and-brain-self-image/

Up to 53.8% of patients with BPD also meet criteria for an eating disorder. Borderline personality has been shown to be present in about 25 percent of those with anorexia nervosa and 28 percent of those with bulimia nervosa.

Everyone feels self-conscious about their body from time to time. However, if you hate something about your body and these feelings are interfering with your everyday life, you may have body dysmorphic disorder.

BDD appears to be relatively common. Studies have reported a point prevalence of 0.7% to 2.4% in the general population. These studies suggest that BDD is more common than disorders such as schizophrenia or anorexia nervosa.

People with BDD may seek reassurance about the way they look. But try not to get drawn into debates about your appearance and encourage others not to do the same. #BPD #BDD #Anorexia

Part 1 of 2 I have been a fourteen to seventeen old anorexic. I remember having too much pain in the present to think much about any future, a confident despair that told me nothing but distraction would break the grip of physical weakness and fear, and that only for a few hours. I did not believe in any suggested motivations to recover. Now, in my mid-fifties, I have relapsed. My underlying health is broken and hope is much harder to come by. I don’t know what recovery might bring. The rewards will likely be less and the journey no easier.

My going forth into #EatingDisorders recovery in my late teens was a very different journey than the release Isaiah describes. It began not in joy and peace, but from shame and grief when I could not donate blood platelets a close friend needed to prolong her life. Cognitive behavioral therapy with a sensible psychologist laid the groundwork and helped me make recovery a reality.

Recovery itself challenged my body and spirit. Judging from the reactions of my parents, it was a stress on my family as well. When I was weak from malnutrition and running interference for my eating disorder, much of my energy went toward distracting and pacifying parents. I spent hours drilling myself into good grades and scores on standardized tests. My room was neat, I wore clothes my parents liked, and prioritized family events. When I did act out, the underlying need could be dismissed as part of my illness. In recovery, suppressed emotions burst out sometimes from a direct cause and sometimes randomly after being ignored too long. I even had tantrums until the worst rebound was over. I had the energy for a full social life with peers. I was no longer convenient and predictable.

Then there was the matter of eating and weight gain. I began gaining weight on Christmas cookies and well-buttered bread. One family member, annoyed that I was having all this treat food after causing such trouble, told me plain bread and salads was a better plan. Carnation instant breakfast in milk was a good weight gain strategy not because I liked it (I didn’t) but because as I gained weight thought I could change to skim milk.

In college, freedom to eat without censure, a physical need for enough reserves to convince my body it was safe to use energy on repairs, and a lower nutrient to calorie ratio than home cooking led to more weight gain. The year I began menstruating again a family member advised smoking to keep from gaining too much weight. Under pressure to restrict at home on breaks I did, and my weight fluctuated annually between the upper and lower limits of a healthy range. In the summer, dessert was off-limits except for family-defined special occasions, and even then how much I ate was subject to scrutiny and commentary. A packed lunch of two packaged toast pieces, ten raw peanuts, and three dried apricot pieces brought the comment that I was losing college weight, “without doing anything crazy”.

Recovery was physically difficult as well. Weight came on unevenly; for the first half-year maternity clothes would have been a good idea. Dresses were easiest, jeans essential but difficult, and skirts impossible. My feet and legs were no longer used to energetic movement and carrying a normal-weight body; I had foot pain so severe I could only walk in padded boots. I had to rediscover bras that fit. When menstruation resumed, it was heavy and unpredictable enough that I could not always manage it gracefully. Going forth from anorexia did bring joy, but at the cost of peace.

Please, you who are in the cold peace of suppressed emotions and a dying body, do not let this make you afraid. Recovery side-effects pass. During recovery I did manage to stay in school and earn diploma. I went on to a joyful career in teaching, marriage, volunteering, and mothering two children. I hiked, visited cities and museums, enjoyed books and music, and eating, as well as other activities, with friends. I studied a martial art.

Recovery does not mean the end to all problems, even physical ones. I developed celiac disease and irritable bowl syndrome, making some measure of restriction in eating necessary and pushing my weight to the lower limit for physical health. Osteoporosis and arthritis do run in my family, but I have a more severe case of the first than my mother and grandmothers did. I have healed from a fractured pelvis and fractured hip, but still need to do daily exercises to preserve mobility. My liver function is not good and I have low blood sugar. Two bouts of pneumonia meant an interruption of eating and I never did resume anything close to sufficient calorie intake, so I am again underweight enough to directly cause physical and emotional problems.

At this point, recovery seems much more of a gamble,

Part 2 of 2 even a waste of time and strength. I have no confidence that the damage time and years of physical abuse is fixable by any diet. All I know for sure is that it will hurt, and the very people who most want me to recover may not appreciate all aspects of my full recovery. I, and the recovery process, will be inconvenient in ways even I cannot fully predict.

So again, I beg you who are younger and I hope less damaged, do the work now. Don’t let anyone tell you you’re not sick enough, or look fine. The sooner you recover, the longer you will be able to enjoy it.

Part 1 of 2 Trigger Warning – mentions of #EatingDisorders behaviours, possible trigger for Emetophobia.

Irony. It’s a fickle thing, and (ironically) it only seems to show up in our lives at the most inconvenient of times.

I have battled an eating disorder actively since I was 11. I’m now 24. I’ve been diagnosed at various stages with #BulimiaNervosa , #AnorexiaNervosa  and Eating Disorder Not Otherwise Specified – in short, I have displayed a mishmash of every eating disorder trick and behaviour there is. Seriously – you name it, I’ve done it in an effort to numb myself, hurt myself, lose weight, and altogether disappear. 13 years of restricting, binging, purging,

laxatives, diuretics, exercising, fasting, eating super “healthy”, dehydrating, over-hydrating, eating nothing but chocolate, ordering my salads with dressing on the side or spending hours in the food court cycling between restaurants and the bathrooms. My bank account has taken massive hits, my weight has fluctuated wildly, I’ve legitimately lost count of the number of hospital admissions I’ve had. My health though? That’s been destroyed.

When I was 19 I was diagnosed with POTS – postural orthostatic tachycardia syndrome – which makes me dizzy, my heart beats too fast when I stand, my blood pressure is too low, I often faint. This chronic illness which affects millions of people worldwide was the first real and permanent hit my health took as a result of my eating disorder. The cardiologist who diagnosed me said “you know, if you hadn’t put so much strain on your heart by vomiting so much, this never would have happened.” I don’t know if it’s entirely true, but considering the time I spent on the cardiac wards in children’s and adult’s hospitals, I know I’ve done permanent damage to my heart. POTS forced me to take a semester off university after the fifth time I fainted trying to tackle the hills on campus. I now live in a state of constant awareness – don’t stand up too quickly, don’t crouch for too long, eat lots of salt, take medication to slow your heart rate, when that looming blackness of a faint comes, get to safety, try to look at your watch before and after you faint so you can see how long you were out for, call the hospital if you hit your head. I am fatigued from my heart constantly thinking I’m running a marathon when I’m sitting at my desk at work, but I’m used to it. I can cope with it.

When I was 23 I had cameras stuck up both ends of me (tell me, during an endoscopy-colonoscopy, do the cameras meet in the middle and say hello?) to try to figure out why my intestinal tract was failing me. I was told I have IBS, we tested for many intolerances and allergies… I had none. And this time I was told I just had to cope with the symptoms of debilitating bloating and diarrhoea every day. Nothing could be done, between starving and purging and abusing laxatives I had, as my doctor so eloquently put it, “fucked my guts”.

But over the next 6 months, something magical happened. I began to wholeheartedly recover from my eating disorder. After 13 years of hell, I was finally eating freely, rarely binging or purging and I genuinely wanted to eat.

By January of 2022, I was better than I had been since my ED began. My weight had finally stabilised and my exhausted body was craving food it wanted and needed in appropriate and health-promoting amounts. It was glorious. Going out to eat wasn’t scary, the scales no longer ruled my every waking moment and (as per my previous article) I was working full time, living on my own, and finally making headway in therapy. It turns out, when your mind isn’t clouded by malnutrition and disordered thinking, you can really tackle your trauma and depression, and get to the roots of why you feel compelled to use maladaptive behaviours like eating disorders or self harm or substance abuse.

Unfortunately, my euphoria at my recovery was short-lived. By the end of January, I was (unintentionally) throwing up almost every solid food I ate, living with endless nausea and stomach pain and was beginning to lose weight rapidly. During February I ended up in hospital twice, desperately dehydrated from days of not being able to keep down food or water or any of my life-giving medication. My kidneys were failing and my inflammation markers and liver enzymes were off the charts because my body had become deficient in everything. I was diagnosed with #Gastroparesis , and not long after my depression had consumed me again, so badly I was admitted to a psychiatric hospital for yet another round of electro-convulsive therapy.

So h

Part 2 of 2 ere is the cruel irony – I finally wanted to eat freely and abundantly… and my body refused to let me. Gastroparesis means my stomach empties much more slowly than is normal. Food will sit in a ball (an aching, agonising ball) in my stomach for hours on end, not moving through, not nourishing me, just sitting there until eventually it’s rejected and vomited back up.

With the help of the hospital dietician, and my own private one, I was started on naso-gastric feeding (a slow drip of liquid nutrition into my stomach that is gradually digested over many hours). It saved my life. My weight loss slowed and my blood test results improved. My fatigue lessened, as did my depression. I learnt a horrible lesson – the starvation that used to make me feel high on adrenaline when it was self-induced, now just made me sick, tired, depressed, anxious… my memories of self-imposed starvation were of euphoria and control. My knowledge of uncontrollable starvation is of pain. So much pain. And I feel for my past disordered self, knowing how much pain she was masking behind a guise of “purity” and “self-control”. That sad, sick girl

fooled herself into thinking starvation was a happy thing. Knowing what I know now, I could never go back.

I am now eating some of my food gradually over the course of the day, the rest I’m still receiving through a feeding tube overnight. But I’m well enough to be back at work and living my life (around endless appointments for medical monitoring and planning, psychology, psychiatry… it goes on and on). I’m even in a relationship again! I never dreamed someone could find this body attractive, let alone this body with a tube taped to its face. But, as usual, my disordered brain was wrong. But every day as I lift meagre portions of bland food to my lips, or hunch over the toilet regretting a more “normal” meal, I come face to face with irony in all her glory. I once strived for a life of restrictions, would have been gleeful for an excuse to throw up, would have been joyous at the thought of tiny portions and rapid weight loss. Now that these things are no longer of interest to me, my life is overcome by them.

Irony is fucking cruel.

Part 1 of 2 There certainly are a lot of mental health campaigns going on. There’s one or more in every month. Most of these are “awareness” days, which is a little bit confusing. People who already have the assorted disorders are already aware of them, as are probably their families and perhaps their friends.

When it comes to awareness, though, most non-affected people (or people who don’t realize they are affected) find out about them through TV commercials – during Men’s Health Month, in ads for medications, or from organizations like the Wounded Warriors Project. There may be local events, too, but I haven’t seen any in my area. I don’t even see much of anything on my Facebook timeline, even though my friends list contains a lot of people with mental health concerns. I note that there isn’t a Women’s Mental Health Month, even though most people who receive treatment for mental illnesses are women. (There are many, many special days not related to mental health that I knew nothing of until I started to research this post, such as World Animal Road Accident Awareness Day, Insect Repellent Awareness Day, and even Spider-Man Day.)

Here’s what I did find.

January

Mental Wellness Month

February

Children’s Mental Health Week

International Boost Self-Esteem Month

National School Counseling Week

National Eating Disorders Week

March

Self-Harm Awareness Month

Brain Injury Awareness Month

World Bipolar Day (which I had never heard of, despite being bipolar myself)

April

National Stress Awareness Month

National Counseling Awareness Month

May

Mental Health Awareness Month

National Maternal Depression Month

National Borderline Personality Disorder Awareness Month

Tourette Awareness Month (May into June)

Children’s Mental Health Awareness Week

June

PTSD Awareness Month

Men’s Mental Health Month

July

International Self-Care Day

BIPOC (or Minority) Mental Health Month

August

National Grief Awareness Day

September

World Suicide Prevention Day (and National Week and Month)

October

World Mental Health Day

National Depression and Mental Health Screening Month

ADHD Awareness Week

OCD Awareness Week

November

National Family Caregivers Month

International Stress Awareness Week

International Survivors of Suicide Day

December

International Day of Persons With Disabilities

National Stress-Free Family Holidays Month

So, how are people made aware of most of these various disorders? By people wearing different colors of ribbons that correspond to them. The idea, I guess, is to prompt people to ask, “What is that silver ribbon for?” and to be told, “It’s for Borderline Personality Disorder Awareness.” If the person inquires further, it’s a chance to educate them, but most people don’t ask at all or ask only what the color means.

There are only a couple of colored ribbons that everyone knows the meaning of – yellow and pink. The yellow ribbon campaign was started in 1979 to show support for persons held hostage in Iran, but now means support for the Armed Forces. The pink ribbon for the Breast Cancer Awareness campaign started in 1991 and is probably the most successful ribbon awareness symbol there is.

Here are the colors of various ribbons and what #MentalHealth concerns they are intended to promote awareness of.

Peach – Invisible Illness

Yellow – Suicide Prevention

Periwinkle blue – Anorexia Nervosa

Teal – Agoraphobia, Anxiety Disorders, Dissociative Identity Disorder, OCD, Tourette Syndrome, Stress Disorders, Social Anxiety Disorder, PTSD, Panic Disorder

Green – Mental Health, Bipolar Disorder, Major Depressive Disorder

Lime green – Mood Disorders, Psychosis, Depression, Mental Illness, Postpartum Depression, Childhood Depression, Maternal Mental Health

Purple – Binge Eating Disorder, Bulimia Nervosa, Eating Disorders, Caregiver Appreciation

Purple and Teal – Suicide, Survivors of Suicide, Family Members of Suicide

Gray – Personality Disorders

Orange – ADHD, ADD, Self-Harm

Silver – Borderline Personality Disorder

So now you know what color ribbon to wear and what month to wear it in. I hope that if you do, people will ask about it and allow you to expand on what it means. I don’t expect that, however. Almost no one has ever asked me about my semicolon tattoo for Suicide Prevention and Awareness. (I occasionally get to explain it if I point it out to them.)

Probably the most effective reminders are t-shirts that ident