Or maybe you're just anorexic

I have been extra tired lately.  VERY extra-tired.  I go through spells of this and am always fairly convinced that there’s something wrong with me.  It’s not normal for someone to get eight hours of sleep and need one – two naps during the day.  I end up having conversations with my fiance like this:

grey: I think that I’m anemic.
fiance: oh?
grey: I have all the symptoms — fatigue, headache, difficulty concentrating, pale skin, leg cramps…
fiance: Funny, those sound like the same symptoms of anorexia.

Then, the next month…

grey: I think I have hypothyroidism.
fiance: You don’t say.
grey: No, really — I have all the symptoms.  fatigue, dry hair, pale skin, cold intolerance, muscle cramps, depression, abnormal menstrual cycles….
fiance: Kinda like anorexia.

And again….

grey: I think I have mono.
fiance: Let me guess — lack of energy, loss of appetite and chills.
grey: Exactly!
fiance: You don’t have mono, you have anorexia.
grey: I could have anorexia AND mono.
fiance: Do you have a severe sore throat?
grey: Well…. not YET….

Humph.  He is right — these could all be consequences of the eating disorder.  For the most part I know this, but whenever I feel overly tired of cold or crappy, I really feel like it must be something else.  My eating isn’t particularly worse that day — why should I feel worse?

I think that I forget that how I treat (or mistreat) my body compounds over time.  If my eating has been off-track for the past three ways, having a great day today isn’t going to guarantee that I feel okay.  And, even on a larger scale, I think that years of disorderedness has taken a toll on my body.  My eating disorder is nowhere near as severe as it was back in high school, but I still haven’t been 100% over the years.  Now I notice how prone to headaches I am (very prone), how I often have stomach aches, how dysfunctional I am on minimal sleep, etc.  I can’t get away with the things that I used to be able to.  Because my weight is higher and I’m eating more, this doesn’t make sense to me — clearly something ELSE must be wrong with me (like anemia or hypothyroidism or mono).  But… maybe all the years of the eating disorder has taken a toll on my body.  Beyond the bone density and menstrual issues, maybe I am just not as resilient as I once was.

However… I am still going to have labs done at some point to rule everything out.  You know, just in case…. (and in secret hopes of proving my fiance wrong!)

Or maybe you’re just anorexic

I have been extra tired lately.  VERY extra-tired.  I go through spells of this and am always fairly convinced that there’s something wrong with me.  It’s not normal for someone to get eight hours of sleep and need one – two naps during the day.  I end up having conversations with my fiance like this:

grey: I think that I’m anemic.
fiance: oh?
grey: I have all the symptoms — fatigue, headache, difficulty concentrating, pale skin, leg cramps…
fiance: Funny, those sound like the same symptoms of anorexia.

Then, the next month…

grey: I think I have hypothyroidism.
fiance: You don’t say.
grey: No, really — I have all the symptoms.  fatigue, dry hair, pale skin, cold intolerance, muscle cramps, depression, abnormal menstrual cycles….
fiance: Kinda like anorexia.

And again….

grey: I think I have mono.
fiance: Let me guess — lack of energy, loss of appetite and chills.
grey: Exactly!
fiance: You don’t have mono, you have anorexia.
grey: I could have anorexia AND mono.
fiance: Do you have a severe sore throat?
grey: Well…. not YET….

Humph.  He is right — these could all be consequences of the eating disorder.  For the most part I know this, but whenever I feel overly tired of cold or crappy, I really feel like it must be something else.  My eating isn’t particularly worse that day — why should I feel worse?

I think that I forget that how I treat (or mistreat) my body compounds over time.  If my eating has been off-track for the past three ways, having a great day today isn’t going to guarantee that I feel okay.  And, even on a larger scale, I think that years of disorderedness has taken a toll on my body.  My eating disorder is nowhere near as severe as it was back in high school, but I still haven’t been 100% over the years.  Now I notice how prone to headaches I am (very prone), how I often have stomach aches, how dysfunctional I am on minimal sleep, etc.  I can’t get away with the things that I used to be able to.  Because my weight is higher and I’m eating more, this doesn’t make sense to me — clearly something ELSE must be wrong with me (like anemia or hypothyroidism or mono).  But… maybe all the years of the eating disorder has taken a toll on my body.  Beyond the bone density and menstrual issues, maybe I am just not as resilient as I once was.

However… I am still going to have labs done at some point to rule everything out.  You know, just in case…. (and in secret hopes of proving my fiance wrong!)

The worst parts of eating disorders

The National Council for Community Behavioral Healthcare and AstraZeneca conducted a really interesting survey on the impact of bipolar depression on people’s lives.  There were a couple of points in the study that really caught my attention:

• The greatest concerns among people living with bipolar disorder are that their symptoms will have an impact on daily life, such as family, relationships, or job (73%), and that they will have long periods of depressive episodes (63%).
• Ninety percent of people living with bipolar disorder said that they have difficulty managing or completing day-to-day tasks due to their bipolar depression symptoms.
• When asked how they felt most of the time, only 27 percent of people living with bipolar disorder said they felt well-balanced and just 23 percent felt their depression was well-controlled.
• The majority of people living with bipolar disorder agreed that bipolar depression causes difficulty in their ability to manage housework (73%), run errands (59%), groom themselves (53%), and pay bills (49%).
• Sixty-one percent of people with bipolar disorder said their depressive episodes last longer than their manic episodes
• Fifty-three percent of people living with bipolar disorder agreed that they would rather feel “less than perfect” than go through another medication switch.

These findings got me thinking — what are/were the most disturbing effects of the eating disorder on my life?  I would have to say….

• Constant preoccupation with food that took away from my ability to concentrate on school / work.
• Low blood sugar and tiredness that further inhibited my school / work efforts.
• Heightened depression, anxiety, and panic attacks.
• Tension among family members due to their frustration/concern and my irritability.
• Avoidance of most social situations in fear of the event involving food.
• Isolation from friends.
• Lack of interest in all hobbies and many relationships, and. the inability to motivate myself to care about the things I once cared about.

I could probably make a list three-pages long, but these are probably some of the most upsetting elements of the eating disorder.  It would be interesting to see a similar survey to the Bipolar Depression Treatment Dynamic conducted for EDs.

It's Your Reality

“You get to define which experiences are traumatic for you, whether or not it would impact others in the same manner.  It’s not the objective facts that determine whether an event is traumatic,  but your own emotional experience of the event.”

— Dr. Kathleen Young

This is just a quick post, but I read this on a trauma blog tonight and thought it was so well-put.  This is something that i struggle with a lot — whether or not something “counts” as significant.  Maybe I am making it up.  Maybe it was no big deal and I should have been fine.  Maybe I am fine and am just crying wolf.

I’m not even limiting this to trauma — of course I can extend it to eating disorders, too (because I have to somehow relate everything to eating disorders, or so it seems).  There’s always that fear that maybe I’m not sick enough to actually need help.  It’s not that I want to be sicker; I’m just afraid of asking for help that isn’t justified.  What if someone else in my position wouldn’t need help?  What if I’m actually okay-enough?

It is such a good reminder for me that my “own emotional experience” is my reality — and in the end, that’s what is important.  Regardless of whether or not it should “count” as significant, it affects me, my sense of self, my relationships, and my future.

It’s Your Reality

“You get to define which experiences are traumatic for you, whether or not it would impact others in the same manner.  It’s not the objective facts that determine whether an event is traumatic,  but your own emotional experience of the event.”

— Dr. Kathleen Young

This is just a quick post, but I read this on a trauma blog tonight and thought it was so well-put.  This is something that i struggle with a lot — whether or not something “counts” as significant.  Maybe I am making it up.  Maybe it was no big deal and I should have been fine.  Maybe I am fine and am just crying wolf.

I’m not even limiting this to trauma — of course I can extend it to eating disorders, too (because I have to somehow relate everything to eating disorders, or so it seems).  There’s always that fear that maybe I’m not sick enough to actually need help.  It’s not that I want to be sicker; I’m just afraid of asking for help that isn’t justified.  What if someone else in my position wouldn’t need help?  What if I’m actually okay-enough?

It is such a good reminder for me that my “own emotional experience” is my reality — and in the end, that’s what is important.  Regardless of whether or not it should “count” as significant, it affects me, my sense of self, my relationships, and my future.

Economists and bulimia

I can’t remember the last time I saw “economist” and “bulimia” in the same headline — I usually don’t put the two together.  However, this article (Eating-Disorders Experts Challenge Economists’ Conclusions About Bulimia) made some pretty interesting statements:

1. Bulimia Nervosa (BN) is an addiction rather than an eating disorder
2. Black females are 50% more likely to be bulimic than white females
3. “Bulimic behavior” is less likely among wealthier, better-educated families.

You should definitely read the article, but I have a couple of things to add to these points:

1. BN is an addiction
I always compare eating disorders and addictions — but I still wouldn’t put BN and alcoholism in the same category.  There are several key differences:

1. Lack of an addictive substance: Addictions require you to be, well, addicted to something — alcohol, opiates, cocaine, etc.  With bulimia, there’s no addictive substance.  I don’t think you can even argue “food” as the addictive substance.
2. No healthy use for symptoms: Occasional purging is not okay or normal.  I’d argue that anyone who purges has an eating disorder (at least on some level).  However, there are appropriate uses for alcohol, opiates, and even cocaine.
3. Goals of treatment: With addictions, the goal is to abstain from the addictive substance.  However, you can’t abstain from food (maybe from purging, but again, that’s only half of it).
4. Psychopathology: “Addict thinking” is not really the same as “eating disorder thinking.”  Similar — but not the same.

2. BN more common in black females
I don’t have much to say about this one, except that I’m skeptical.  I don’t think EDs are limited to certain races, but I think that if you looked at the cultural make-up of treatment centers, you’d find this claim to be false.  Yes, this is measuring those in treatment vs. BN prevalence — and there is likely a difference — but not a 30%+ difference!

3. Bulimia less common in upper-class families
Similarly, I don’t think that BN has socioeconomic limitations…

If for no other reason, the article at least challenges the many ED stereotypes.  It’s curious to me that a) there is no reference to males with eating disorders and b) the study is unique to bulimia.  I’d be interested to see if authors found similar results with anorexia.

Due next week: Therapy homework

Once in awhile, my therapist assigns me homework — usually for one of several reasons:

1. We only had time to touch on a subject in therapy and she wants me to keep thinking about it to flesh it out.
2. She wants to keep better track of my symptoms and I’m not very good at bringing up bad days (not because I’m manipulative and want to hide it from her, but because I never feel it’s “bad enough” to bring to her attention).
3. There’s something that I’m not able to say in person, and can much better articulate in writing.

I’m not anti-therapy homework, because it really is easier for me to write than to talk.  We started to talk about this in the comments of my last post, but I feel less uncomfortable and/or vulnerable when writing about issues than when talking about them.  Also, it’s helpful for me to be able to write and re-write my thoughts — I can spend 3 hours on that homework assignment if I want.  I can go back to old journals and do “research” (only I would come up with research for therapy homework!).  And…. I don’t have to necessarily be there when my therapist reads it, which means I don’t have to deal with the heavy emotions.

At the same time, though, I think a major problem with therapy homework is that it IS done at home.  Sometimes, if it’s a tough assignment, I end up really upsetting myself.  It’ll be 11:00pm and I’ll be sitting in my bedroom with old journals and reading things that I really should just burn.  My therapist isn’t there.  It could be a week until I see my therapist again.  Sometimes I’m still upset the next day, and it does affect my eating or mood.

Maybe I should put off any assignments until a couple of hours before therapy….

In tune with each other

I’ve been reading Dr. Drew’s book, “Cracked: Life on the Edge in a Rehab Clinic.” There are a million things that I could talk about concerning this book, so don’t be surprised if it’s referenced several times in future posts. Tonight, the following quote really caught my attention:

“Most believe [addicts] connect around a common experience of pain and powerlessness without the fear of exploitation. Their pain is so raw and tender that getting them to start the process requires them to be convinced that their pain will be understood. They’re all people with extreme trust issues, and the only people they’ve ever trusted are other addicts. They understand each other. (Interestingly, doctors have discovered that survivors of torture have similar reactions to treatment. They don’t open up unless they’re around others who’ve been through similar horrors, as though the pain of being misunderstood would be too great of a risk.)”

If you’ve ever been in ED treatment (or addiction / trauma treatment, I assume), you know that there’s something very different about the relationships that you form with other ED patients. You know all about their relationship issues and what they are / aren’t eating — but don’t know their last name. They might be thirty years older (or younger) than yourself or living a totally different lifestyle. Maybe they are completely opposite of the type of people that you usually hang out with, and if you met them in any other context you probably wouldn’t hit if off. But… despite all these differences, just their having an eating disorder makes it easier to talk with them than non-ED friends that you’ve had for years.

I have good friends, but the closest friends that I have are all people that I met in treatment. I just can’t open-up to other people in the same way that I can with them. Some of it is their ability to understand me — that definitely is a large part. My non-ED friends cannot relate to my frustration over food rituals. But I think it’s more than just their ability to empathize. Because they have an eating disorder (and were in treatment), it means they are the kind of person who you CAN talk to about this stuff. They have issues, too. I don’t know how some of my “regular” friends will respond to the stuff that I tell them… however, I do know that these ED friends are not going to invalidate my struggles. They aren’t going to think that I am ridiculous, and I don’t have to feel so ashamed. Dr. Drew explains it so well — “the pain of being misunderstood would be too great a risk.”