Within 10 years of treatment

I got up today and was shocked that I didn't gain weight over night.  It's still interesting to me how much a history of ED effects the way you think.  I didn't weigh myself for 2 days out of fear of what I'd see since I'm up north with the family.  We went to dinner before a baseball game Thursday night and to 'fit in' and not draw unwanted attention to myself I ate way more than I wanted but refused to give in and purge.  Funny thing about getting onto a semi normal eating schedule is that your body suddenly gets hungry again all the time (feels like it anyway).  So I ate breakfast yesterday, which I hardly ever do.  Skipped lunch because I actually didn't get up until like 11 but had a snack.  Then we had a pretty heavy dinner and I ate a dilly bar a little later before we went out.  Then I drank lots of beer (stupid empty calories) and we got food on the way home around 2.  No purges.  

Even as I write it all out it makes me feel bloated and confused at how I could weigh the same today as I did 2 days ago after eating all that food.  Then I started thinking that most people wouldn't be surprised or interested in that fact.  But then most people don't fixate on every single thing they ingest or weigh themselves at least once a day.  And there is a classic example of the disordered thinking that is listed as a complication of ED.  I think disorderly... ha.  It's not really that funny but sometimes you just have to laugh at the ridiculous.

I'm overdue to see Dr. M, I've already expressed how little I'm looking forward to that visit, which is why I've been thinking a lot about treatment again and where to go from here.  I'm torn again...  I feel like I want to go all in again (which is always easier to say this time of year) but I just don't know how realistic that is during the school year.  So I started off today researching a bit into ED and treatment and found an incredibly interesting article.

http://www.umm.edu/patiented/articles/what_eating_disorders_000049_1.htm

If you want a quick eating disorder education or a refresher there's your ED 101.  There were a couple parts that really got to me personally.  One, a lot of the lesser health effects (and by lesser I mean not death due to emaciation) are greater for those that have behaviors of both bulimia and anorexia.  That sucks.  I have to say that for one of the first times ever, I read the section on complications and really hope I haven't done any permanent damage that I don't know about.  I also thought about how much I don't want to ever be that bad.

And then right when I was getting all determined to research treatment approaches more I stumble upon the most depressing part in my opinion.  They were actually trying to put a bright spin on treatment because the statistics are pretty grim.  They were trying to not make treatment sound like a gamble I suppose (which is what it feels like most of the time) and stated that in long term studies 70% of bulimics and 27-50% of anoretics are ED free within 10 years of treatment... within 10 years?!

It shouldn't be shocking.  I've known it would be a long LONG process (which is probably why I rarely want to start) but to see it in black and white based on long term studies was depressing.  And that was just the part of patients able to recover at all...

We just want back the you that you used to be...

I hear this in one form or another all the time.  It's odd and confusing really.  One, I don't want the me I use to be.  There are parts of her I want and honestly that I don't believe ever left.  Maybe there have been times that they aren't seen as clearly but I don't believe that I have truly lost any good part of my personality and being.

No matter where I am on the long and winding path towards recovery, I don't believe that I've stopped being the person those that care about me know or 'knew' as is sometimes put.  I guess I should clear up here and now that this blog was created with the soul purpose of venting.  It was a way to get my true unguarded emotions out before I could shut them down or bottle them up.  And like all raw emotion, it can easily be misunderstood or generalized when it shouldn't be.  (Also note that I shared it on advice from a therapist who assured me it was a good idea.)

If I have a bad day, it doesn't mean that everyday is a bad day.  I get over stuff pretty fast.  So if you actually know me and got concerned over some past posts where I said I was okay with starving I hope you take that with a grain of salt.  I'm not okay with starving to death or to near death.  I don't feel that I'm starving ever really.  Raw emotions lead to exaggeration.  On the other side, I'll be honest.  Some times I post things about being ready for recovery and ending all my bad ways and that isn't always true for very long either.  All I can say is this, right now I'm a bundle of contradiction and really have been so for years.  It's just the first time ever that I've put it out there for others to read.

So if you are my friend and you do not wish to keep up with this blog for that reason, you will not hurt my feelings if you never read it again.  I understand.  If you do, please don't feel that you need to have an intervention because I have a bad day or few.  I'm okay.  I'm not great (that would be a total lie and I'm not going to lie on here).  But I'm stable and I'm healthy physically.  I have faith that I will get better and I need you to have faith in that too.  It took a very long time to get where I am today and I've been better and I've been worse.  It's going to take an equally long time (well I hope not quite equal) for me to ever be able to claim the label of recovered.  I'm always going to have to take meds for depression and there will always be rough days or weeks even on it.  I'm going to have some major work ahead of me to tackle the anxiety because I really do want to avoid medication for that.  And the eating stuff... it's so complex and wrapped up in other things that it is going to be quite a ride to get to where I want to be.  In the end, to my friends again I say, be patient with me.  Don't give up on me or assume the worse.  And have faith in the fact that I have lived with this for longer than I haven't and I have yet to be committed.  That has to count for something.  I'll be okay through the process on the good and bad days.  I'll expand and contract from time to time.  I have no working idea of how to just be one size.  Neither one is indicative of me losing my mind or giving up to the disorder.

Also, the fact is that I'm happy right now.  Maybe it isn't what you viewed as me happy in the past but I've also been miserable and dangerously self destructive since then.  I'm not either of those things now.  I'm okay with me and I'm liking my life in general and that's a pretty significant thing for me.

No one is the person they were 8 years ago and will never be again.  Neither am I.  Personally I'm looking forward to the me I'm heading towards eventually, bumps and all.  

Loss

In "Why did I stop eating part 2" I think it was pretty clear that I don't handle loss very well or at all.  All my other issues aside, how can you form and keep attachements to others when everytime you let someone in, really let them in, they leave you.  I've lost (one way or another) so many people I have loved and it makes me distant and want to pull back completely. 

I've been at my current school for 3 years total now and this summer at inservice was the first time I felt like I could start letting people in and maybe even form some real friendships.  Three years later... I've cut out two family members because outside of everything else, it's easier to be the one rejecting than to be rejected.  I can't even talk about loved ones that have passed.  Especially my one that seems like it happened yesterday and that I still haven't dealt with.  When people hear that I don't speak to my dad I always hear the same thing, "You have to take the time you have now, because who knows how long that is and you'll regret it when it's gone."  I'm becoming a firm believer that it will actually help it hurt less.  Less attachment, less pain. 

It's kind of like love.  Some people subscribe to the theory of "it is better to have loved and loss than to have never loved at all" and some people don't.  I for one would rather never love than have to feel the pains I've seen my friends and family members go through.  I'm not sold that it's anywhere near worth it. 

So I have a wall up and always have.  It's very hard to really get to know me.  I'm freinds to many MANY people, but only a small number know a lot about me because I keep most of my experiences private.  I remember a former roommate in college's response to me unloading a couple big ones on her, "I just don't know how you could keep that in!?"  I don't understand how you can't.  There are probably only two people on the planet that know everything about me and I'm not even 100% confident of that.  But if you know more than half of my life events, struggles, and issues then you are part of the very few people I have let in.  And I let that number get pretty big over the past years which makes me uncomfortable.  Much bigger odds on losing yet another important person in my life and dealing with the pain and abandonment. 

There's no worse feeling to me than that of being left or given up on.  It's very hard to bounce back from that.  Going to bed quite puffy eyed tonight.

Hypersentitive?

I have a tendency to only have two emotional responses to life; numb or hypersensitive.  When it comes to everyone else I am logical, empathetic, and compassionate.  Haven't quite gotten those things down for myself.  I don't ever really talk about this, but I spend most days in a constant state of doubt when it comes to other people.  Do people like me?  What do people think about me?  Did I make this person mad?  Did I dissappoint this person?  Did I talk too much and annoy them?  Did I get my point across the way I meant to or was I misunderstood?  It's never ending.  Most likely this comes from never feeling secure in my parent relationships as a child but it can be quite annoying and overwhelming. 

So whether I am being oversensitive or not, right now I'm feeling very conflicted about the idea of 'support'.  I don't feel all that supported right now.  I feel doubted.  I feel judged.  I feel as if people see me as broken and in need of fixing.  I feel as if I'm a burden.  I feel as if some don't care at all.  I feel that some people are distant.  I feel attacked.  I feel questioned.  I feel ignored.  I feel underestimated.  I feel misunderstood.

For someone who's feelings typically consist of various levels of 'fine' I guess it's progress or a good sign at least that I can articulate any of those feelings.  I don't even know how many of my friends that I've shared this blog with actually still read it (and after this post maybe less is better...) and I'm by no means feeling all those things about any one person in my life.  It doesn't even apply at all to some.  But I'm becoming quite cynical of the term 'support'. 

I'm not sure what I think it should look or feel like, but I know that I don't really like the way it looks and feels right now.  My feelings on the topic are why I chose to write an elegy as if Support were a person.  I sort of feel like it died. 

Right now, if I could, I would take it all back.  I would have never told a single person that I struggled with depression or ED.  I haven't really gotten anything positive out of sharing. 

Elegy

Support was always my tower of strength,
Until the day I realized she hid her true face.
Her acceptance was always at arm's length,
Dissaproval made up her cold embrace.

Game Plan?

This is hard to articulate and put out there but here goes...

I've been doing a lot of reflecting about where I am right now in all of this.  I quit therapy due to finances and not feeling like I was getting my money's worth.  I think I've figured out why.  Maybe if I get it all out on here and process then I can explain it all to Dr. M when I see her next.  It's coming up and I'm not looking forward to it because she is not going to be happy to hear that I quit the rest of the team.

I was going to get a new psychiatrist too (for a fresh start), but in the end she's just so intelligent.  I don't mean to be snobby about this factor, but I am.  I meet too many dumb people and it's hard to handle them ever, but especially when you're suppose to be in their care.  Sure, we disagree (a lot) and she frustrates me almost every time I see her.  But in the end its all because she challenges me and can hold her own against my ability to make things sound logical (even if they aren't).  So she stays, but I'm going to have to set a few things straight next time I see her.

Issue one:  I'm not bulimic and she'll have to switch her focus away from gauging how I'm doing based on those behaviors.

Issue two:  I'm not anorexic.  I am not below a healthy weight nor will I be when I lose the last 5 pounds.  95 sounds ridiculous to a lot of people but most people aren't 5 foot.  I'm tiny no matter what and tiny things tend to weigh less.  I'm medically overweight at 125.  Yes my goal puts me at the lowest point of the healthy range, but its in the healthy range.  If I weighed 90 I'd be underweight but nowhere near critically underweight (or anorexic) and would only be giving myself the same health risks that slightly overweight people do.  But that's not even my goal.  My goal weight is healthy.  And being at that weight is a nonnegotiable.

Issue three:  I'm not nor have I ever been an alcoholic.  She asks me about alcohol intake every time and makes me feel like I have a problem if I drink at all.  I started lying and just saying I hadn't drank at all.  I get that when I first started seeing her I binge drank a lot.  I was also not on meds for my depression and mildly crazy.  I was also 24 and just living a normal life for a girl with a social life.  I rarely drink anymore and when I do, yes, I get drunk.  Seriously, I'm 5 foot and weight 100 pounds, I'm legally drunk after two.  But I don't get wasted often and not on purpose like I did when I was younger.  So those questions have got to go.

Issue four:  I will not see a dietician again.  Ever.  It's a complete waste of money and time.  I took nutrition in school, I can read, I can research, I am capable of creating a meal plan for myself that has the suggested amount of calories and food groups.  I choose not to.  I tried and I can't do it right now.  So it's paying someone almost 200 bucks a month just to tell them I failed.

Issue five:  I need a new psychologist with a new focus.  I need them to be female, incredibly smart, and a specialist in anxiety not ED.

This is what I've realized as I've looked back over the past year when I honest to goodness tried very hard to do all the things everyone wanted me to do.  My team tried to do too much with me too soon and focused on too many things at once.  I felt way too much pressure to just get better, be better right away.

I know I'm not good right now.  I'm a driven person.  When I want something, I get it.  When I set a goal, I reach it.  I don't allow myself not too and I never have.  Oh those perfectionistic qualities that rule my life... And the things and goals never end because to me I will never be good enough because I expect perfection and it doesn't exist.  But, when I am reaching a goal I'm not one to take the slow and steady path to get there.  I set a goal of staying under 100 and a target of 95 when I weighed 114.  I could eat slightly less, exercise more, be patient, and give it time like I should but that's not me.  I want 95 as soon as I can get it and I have no problem starving to do it.  This isn't about being at the bottom of an addiction, it's about me being a workaholic with unrealistically high standards for herself and believing the ends justify the means.

I know this is an issue that eventually needs to be dealt with, but not now.  Every time I've quit therapy, no matter what reasons I came up with (all valid though) there is one common factor.  I started having a very hard time handling my life when therapy started getting real or 'working'.  It's not that therapy got too hard, it's that when therapy got easier life got harder.  Anxiety, which I'm finding completely controls my life, started seriously negatively effecting my daily life when therapy started going well.  Specifically my career which is probably the absolute most important thing to me.

In my many years of obsession with reading, researching, and learning about psychology I've never really given much attention or care to anxiety as a disorder.  You think I would have too since my mother has severe general anxiety disorder and has been on medication for it since I was 13.  I don't think I've ever taken it that seriously though, much like how most people don't take depression seriously if they have never experienced it.

It took me a while to take depression seriously and come to terms with mine.  My depression has been debilitating for most of my life (though I like to deny this fact).  I hid it well but I've spent the majority of my life in a deep self hatred, not understanding why I was put here just to live in such a state of misery, and obsessed with the idea of my own death.  When I was younger I would fantasize about ways I could die prematurely while most people hope to die old, happy, and asleep in their bed.  Not me.  Every time I drove on a tall bridge or highway loop I'd imagine driving off it.  I'd obsessively come up with ideas on how to kill myself.  I also created various scenarios in which a tragic event would send me from this world so that I wouldn't have to cause the pain suicide causes the ones you leave behind.  I was a pretty messed up kid and teen, so it's kind of comforting to know its a chemical imbalance now.  I never wanted anyone to see it, but I came to terms with the fact that I had a psychological disorder by senior year in high school.  I could have gone on drugs then, but my pride made me think that I'd made it to 18 without them so I could continue without them too.

Ten years later and I have now realized that I could go on living without antidepressants but I prefer life with them.  I don't feel like I did my whole life pre 24.  I feel good and happy and can just be.  Might sound boring and common to some people but before I started my meds I had never genuinely felt like that.

When you're suicidal that's really all anyone focuses on, even you.  And who cares about an eating disorder if you're not dying from it but you are wishing and considering killing yourself.  It's so distracting in fact that  I and everyone who worked with me (before psychologist S) totally missed the other just as serious disorder which is my general anxiety disorder that I can probably thank my mother for.  Why wasn't it obvious?  Because I found an incredibly effective way to medicate it long before any professional started working with me.  My eating habits.  As soon as I started restricting I became a significantly less anxious child.  Makes sense because I felt in control of something.  Textbook case really.  I avoided feeling, therefore anxiety, by starving and restricting and losing weight.  Weight goes down, anxiety goes down.  The more anxiety I experience, the more weight I lose.  Sometimes correlation does equal causation.

I think this is the most complicated part of treatment for my eating issues.  They are more than just an addiction and issues with self image, while they are both of those things.  Mostly they have let me live a relatively anxiety free life for the past 16 years.  I'm high strung for sure, especially in certain aspects of my life, but as I found over the last year, nothing compared to how it could be.  I have my mini panic attacks over a million different things all the time, but I get past them quickly by restricting and purging.  It's like the two medications I had for migraines.  I had one for acute attacks and one as a preventative.  Purging is my acute reaction to sudden intense anxiety and restricting is my preventative of that anxiety in the first place.  So just as taking away those meds causes an immediate return of numerous migraine headaches, taking away my purging and restriction causes an immediate return of intense anxiety.

When I really did start working in therapy this last go around and even went as far as seeing dietician CA and making plans to start going to a support group I had no idea what I was in for.  I always assumed the anxiety treatment brought was over fear of gaining weight or losing control and I'm sure part of it is... at first.  But what happened this time was a feeling that I was losing it completely.  I can't put into words what my daily life was like there for a while.  I was on edge and felt like I could explode or breakdown at any moment.  I was constantly walking on a tightrope with no net below trying desperately not to fall.  It took nothing to make me cry.  The smallest most insignificant things could send me into a state of intense panic that I've never experienced before.  I was afraid everyone was mad at me or disappointed all the time.  One misinterpreted comment or look and I would be sure I'd ruined a relationship with someone.  I didn't want to talk to anyone or go anywhere because it stressed me out too much.  I basically stopped talking to people on the phone completely.  I couldn't go to sleep because my mind was racing and once I did fall asleep I woke up constantly to stressmares.  I felt like I couldn't and wasn't doing my job, that I was failing my kids.

I couldn't and can't live my life like that.  My heart is racing just thinking about that period of time.  I was recently incredibly disappointed in my end of year testing scores.  There are many factors that contributed to my failure this year, but I know that treatment and my instability this year was the number one reason I didn't perform well.  And now I feel incredibly guilty and selfish for doing it at all because my problem became my students' problem.  I won't let that happen again.

This next time around I'm going a different route.  I know I need to get into consistent treatment because I do realize that there is a chance that I may not want to stop losing at 95 and I have a lot of baggage to deal with before I can live a 'healthy/normal' life (though I don't want too normal).  But I can't try again until I already have a bag full of tools to handle my anxiety.  I can't let go of my ED while also learning how to deal with feelings, issues, and anxiety.  Someday I hope I will be able to really work at recovery but I won't jeopardize everything else for it.  I'm okay with my habits if they are what keep me sane and happy.

And there's another problem, I'm happier now than I have been in a long time.  I'm not even taking the work thing as badly as I would have a year or two ago.  Part of it is because I do feel that I know why, I won't let it happen again, and I'm keeping the same kids next year so I get to fix it.  The other reason is that I just plain feel good.  I don't hate the image I see in the mirror nearly as much as I normally do.  I feel great.  I'm not stressed and on edge.  And if a non life threatening version of an eating disorder is the reason, then I'm okay with that until there's another option.  My last round of therapy wasn't able to give me anything that worked in it's place.  I'm not willing to go back to how I felt and functioned then and I'll just have to hope to find a psychologist who can accept and work with that.  

Poem number 2

I Could Be Just Fine If You'd Let Me

(Style of Tanka)

Judging eyes pierce me.

Unspoken words stifle me.

It's my choice not yours!

Shrinking brings pain that rivals not

The grief your doubt in me breeds.

I'm Okay

I really am okay.  I know I have my moments of venting and to most people my logic sounds false and that I lie to myself to justify living the way I want to live.  I get that.  But I am fine.  I'm not hurting myself.  You, my doctor, my psychologist, psychiatrist, nutritionist, and neurologist could not tell me that anything was physically wrong with me.  I have self destructive behaviors that can lead to health issues and complications later, but I'll work on those.  But right now I'm fine.

I don't even fit into the diagnostic criteria for having an ED.  I restrict more than many and have a bit of an unrealistic view of myself and goal for weight.  All of which falls in a completely healthy range even though the lower part.  I'm fine.  I eat, enough.  I avoid situations in which I will purge.  I've cut down those instances a lot.

Just please don't worry about me.  Several people have made comments about me getting really thin and the fact is that I'm not that thin.  I'm 107 thanks to the trip to I and it is mainly all on my hips and butt.  I hide those so you don't see them, but trust me I have the ten pounds to lose there.

And I will lose them by any means necessary.  End of story.  Ten more pounds and then I'll be good (relatively speaking of course.)  Ten more pounds and I can focus on something other than work and weight for a while.  Have a social life even.  :)

Point is, I'm okay!  

My first peom in the style Terza rima :)

Returning Hollow Back

She sits numb with head turned and lips sealed tightly,

Lamenting eyes guilt the fork to do its work, 

Bites untasted and swallowed with agony.  

Explosion of feelings as the void is gone,

Intense emotions send sanity to her knees

Fiercely all is purged returning hollow back.

All is well again... until the day it"s not...

MM 5/10/11

The world revolves around food...

Showers, happy hours, birthday parties, regular parties, work celebrations (rewards/treats), holidays, get togethers, reunions... what do they all have in common?  Food is always the focus.  Why is it that when people get together they always need to eat?  And it's rarely ever anything that isn't horrible for you.  Or if the food's okay, you still have the dessert to deal with (normally several that you 'have just got try').  

It's like putting an alcoholic in a bar.  Nothing will ever be a bigger trigger for purging.  The best option is to eat on my own and not eat at functions but it's like a major taboo to not eat when food is provided and everyone else is eating.  

General social situations are okay.  I'm getting pretty good at just knowing my limits and not letting people who have no idea the war in my head guilt me into eating things that I know I can't handle.  Family though... that's a whole other issue entirely.  

American culture fixates on food, but my family is over the top.  Food has always been the center of family time (extended especially).  Christmas is almost a solid week of constant food being made and kept out on the table.  If we're hanging out, then we're eating.  We go out to dinner, our tab is ridiculous. I have a tendency to stick out up north with all those guys.  I'm significantly thinner than the rest of my family and I can't eat the way they do and keep my head out of the toilet.  

I love LOVE spending time with my extended fam on my dad's side.  I'm going up this weekend and am really excited.  But unfortunately that happiness and excitement will always be paired with intense anxiety over the food battles and never ending war.  

Sometimes I wonder if my parents had stayed up north after college and I had grown up there, would I be 'normal' about food?  How much did growing up in the south and in two big cities (known for pretty blondes and cheerleaders) effect who I am?  Always comes down to nature vs nurture.  One of my favorite authors made an interesting point about why she became ED and said that no doubt it was about self destruction, but she had many different options and means and for some reason she chose ED.  Obviously she didn't have the answer to why, no one does.  I find it very interesting though.  How different would things have turned out if there had been slightly different circumstances.  And think about how worse it could have been!  Starving is numbing and in large doses induces varying degrees of mania.  Purging offers releif from anxiety and crisis mode.  I could get all this from a variety of uppers and downers (legal and not).  I could have been strung out on a plethora of dangerous substances by my teens.  Still could.  I've never not had access to these things.  So looking at it that way I'm glad I have some eating issues over substance ones.  

Why did I stop eating? Part 2

Having a lot of trouble sleeping lately so time to write.  Let's see, last I left off I was 13 and in Houston...

Half way through 7th grade my mom decided that she wanted for sure to move us up to Dallas.  I can't even begin to explain the anxiety, depression, and hatred towards my mother that developed with this decision.  In my head at the time, she had always sucked as a mom and my dad had never actually had to be a dad.  And now she was moving me away from all the adults who took care of me and the friends that were like siblings that I'd had all my life.  Plus I'm not by nature any good at change, especially forced change.

The end of 7th grade and she had for sure taken a job and we moved into a rich suburban town that was the absolute opposite of the neighborhood I came from.  Well opposite might be misleading.  I was from a neighborhood that had been build the year I was born.  My parents along with tons of other parents with kids my age moved in that same year.  It was affordable starter homes for young parents.  It was very 'real' and not snobby and laid back.  My new home... full of 6 figure millionaires.  Tons of snobs and people who spent a lot of time and money on appearing well off whether they were or not.

I went from acceptance for who you were to a middle school that defined you by what you wore, where you lived, what your parents drove, and of course what you looked like.  Well surprise surprise that depression, anxiety, hatred of parents, shallow and judgemental environment, and no control over ones life would feed into ED.  In truth I don't remember much of the year 13.  I was so deeply sad all the time that what I remember is hazy.  I remember getting my period for the first time, La Femme Nikita, discovering AOL chat, and trying very hard not to make friends because I already had wonderful friends that didn't need to be replaced.  I remember being very miserable and making it a mission to make my mother just as miserable.  World War III had erupted.

I often feel guilt for my sister because she also doesn't remember this time well but I think more out of the fact that it traumatized her.  Life under our roof was not fun or healthy for anybody.  I don't remember eating much at all and since I can recall exact instances of eating foods since about age 5 that says to me that I just plain wasn't eating much.  I don't even think it was conscious.  I was just simply too depressed to do anything but sleep, watch Nikita, listen to music, and wish I was dead.

This was the first time that I planned suicide.  I had thought about dying and killing myself for as long as I can remember.  It's not much more unique to my personality than being dramatic or athletic.  I was sad and wished I wasn't around.  13 though was the year I almost slit my wrists in the bath.  So cliche I know.  Part of the reason I stopped after the first cut.  The others were as follows, I decided my mother wouldn't win (because she might as well have been the anitchrist), I didn't want my 8 year old sister to find me in a tub full of my own blood, and I wasn't crazy about EMS strangers dragging my naked dead body away.  Later I would add the fact that if you try and fail then you're labeled crazy and decrease your chances of getting away with it in the future.

I did make friends despite my wall, however.  Two of them best friends of mine to this day.  By my freshman year (14) I actually had a core group of friends and started adjusting to the fact that no matter how miserable I might make my mother, we were not moving back and 18 was a long ways away.  Freshman year I started restricting again.  Probably the only year you might have been able to classify me as anorexic if you ignored that fact that I never was rid of my period.  In an effort to make peace, my mom started sending me to H town to visit.  Keeping an open connection to my roots made me more inspired to make a life in the big D so that I had updates and an image to share when I got back.  Reenter the fantasy of dropping 30 punds by the next visit to finish the transformation.  I remember almost thinking I was thin enough that year.  That and platform shoes.  Man did I love platform shoes.

Spring Break was awesome that year.  I didn't know then how important that long weekend in Galveston would be to my memories.  I remember every detail.  The clothes I bought for the trip or chose to pack to show off the new me I was suppose to be.  The solo walk in both airports and pulling up to the G's house and surprising CG who didn't know I was coming.  The alone bonding time with F upon arrival since she had an off period.  All the preparations for our quick trip into Galveston to the beach condo.  Driving with the girls and listening to Sublime and hanging out at the pool and beach. And the severe relapse in depression when I got home.

I don't think I must have gotten over it by the end of the year because I don't have many memories outside of that fateful graduation weekend.  It was a weekend with my dad and we had told everyone that we would meet the extended fam in KC for the weekend.  Then we decided not to go but my dad being eternally irresponsible didn't tell anyone.  He didn't want to hear it from his family so he didn't answer their calls and since he didn't ever want to hear from my mom he didn't answer hers either... until call 50ish.

I knew a battle was coming so I retreated into my room the second I heard my mom on the other line screaming at him that everyone had been looking for us and that she had even called highway patrol to search for wreckage.  I remember aside from his initial yelled response about over reacting that he never rose his voice again and yet hadn't hung up on her and that he stayed on the line and didn't come into my room for about twenty minutes.  Then he came in, sat down next to me not meeting my eyes.  I've never felt the level of dread and internal knowledge that something horrible had happened like I did right then (and to this day if my mom calls me several times in a row I assume the worst).

He simply said this, "Well... it's never easy to hear this type of news.  F died this morning in a car accident coming back into Houston from Galveston for P's graduation."  I sat for 30 seconds, stood up, walked into my bathroom, shut/locked the door, turned on the sink, climbed into the tub and sat there for who knows how long.  I'm not sure I even cried.  The only person close to me who had died was my dad's mom and it was sudden and she died young at 58.  I know I felt cheated and abandoned and I know that I shut out the whole thing.  I have no memories of that time and I was almost 9.

The day F died though, I shut off.  I didn't want to talk to anyone and I wasn't interested in being close to anyone emotionally.  We went to the funeral (it was horribly southern babtist) and all about celebrating her life and not mourning her loss and in my head I thought "F you, all of you.  She was 16."  I didn't talk about it to anyone and I never dealt with it.  The first time I cried outside of the funeral (cuz who can't cry at a SB funeral?) was when seventh heaven aired their episode where Lucy finds out her friend's sister has died on her way to pick her up against parent permission.  It took seeing familiar pain for me to express mine and then that was over within an hour.

I guess it's definitely a peice of why food and weight obsession intensified during this time.  I retreated from the world more each day and into the mirror.  I didn't want anyone to bug me about anything (then I'd maybe have to deal) so I became a very good liar and actress in the year that followed.  It was also the building blocks of many other self destructive behaviors I would have love affairs with both short and long term through out the next decade plus.  

Why did I stop eating? Part 1

First of all, wow was my last post all over the place and incoherent at times.  I have gone through and edited it and reorganized and what not so that it actually makes sense and is an accurate glimpse into my mind (minus the new drugs that I was still getting use to).  If you read the last one, please go back and reread it now that it is fixed.  So embarrassed but what was done was done and luckily is now fixed.

So I had started on a tangent at the end about the origin of my eating issues and I figure I'll continue where I left off.  Actually I'm going to repost what I cut from the last one since it was way off topic.  The inspiration for a few of my latest thoughts and posts are the last few episodes of Make it or Break it.  I know, I'm lame because I'm almost 28 and watch shows designed for teens but what can I say but I love gymnastics and drama.  Recently they have made one of their main characters develop anorexia.  I found this initially frustrating because her character went from fine to crisis and treatment center mode within a few episodes.  I know, I know it's just TV but the model she meets at treatment is what pissed me off.  They end up having her be the one that teaches her all the tricks to get out and then when they are both out the model goes to catch her flight to Milan and dies of heart failure.  The character they portrayed would never have been an anorexic who would randomly die of heart failure.  I know it struck a nerve because I didn't few her character as bad medically, as I don't view myself, and then she died which would suggest that you could be 'not that bad' and still randomly die.  I get the psych crap of all that, but logically the odds are against both situations ever happening.

That spurred the venting post about the fact that I don't really feel that I have an Eating Disorder.  Then they played the next episode where the main character is dealing with the fact that she does in fact have a problem and she starts exploring where it came from.  Her therapists on the show asks her "Why did you stop eating?"  Of course she thinks the simple answer is she had to beat another gymnast and she didn't stand a change without dropping some weight to be able to do a competitive routine.  Then she has a heart to heart with a song writer (I'll spare you anymore of the play by play) and she realizes that the reasons for her eventual actions came from things long before that one moment.

This really got me to thinking about my own history and causes.  It was such a simple question "Why did you stop eating?"  None of my therapists have ever asked me that.  They have always been so focuses on whether I still binge drink, how many times I've purged, what I was feeling when I purged, and whether I'm feeling like offing myself.  All valid things, but I think they've all been missing the biggest key to me ever making lasting change in my life.

So, why did I stop eating (or become so obsessed with restriction to the point that I don't think twice about shoving my fingers down my throat when I do eat)?  I don't really know.  It's hard to even pin point when it all started.  So until I find a new therapist I think I'll just explore this topic a while.

From 11-15 I undeniably started my restriction behaviors.  I didn't count calories like I do now.  I ate as little as possible every day just because less eating meant less weight gain and more weight loss if I was lucky.  I went on my first diet at 11.  The gummy bear diet.  I loved it.  I ate gummy bears all the time, whenever I was hungry.  No fat.  I thought it was great.  I didn't understand calories or how food really worked but I had an intense fear of weight gain and I always felt that as soon as I loss weight (this unrealistic amount of weight, one that I could never have actually accomplished) that I would just become this different and MUCH better person.  As soon as I lost ALL this weight everything would be alright.  I guess the everything should be a big focus since I don't really know what everything was or what alright would have looked like.  I just KNEW that it would be, when I lost weight.  I lived, and still do to a large extent, in this fantasy world where I could all of a sudden drop 30 pounds and be this new and much better me.  At the time of course I felt the weight loss would immediately make me pretty with a better personality.  Girls would want to be me and my friend and guys would want me (though in truth until 16 I really wasn't sure I wanted them- just wanted them to want me).  To say the least I had acceptance issues.  

Well everything was not alright because of course this dream world was not a reality.  I never loss this drastic amount of weight.  I never all of a sudden became this 'new' me.  And I hate the me I was.  I spent every day of year 11-12 feeling like I didn't fit in my skin.  I still lived in Houston and still had the extended family (of neighbor parents and my best friends since kinder) to stabilize my life.  I just felt so fat and so not good enough.  CG was my best friend and my total opposite.  She was a tomboy and good at all physical stuff and so comfortable with herself and confident.  F was her older sister, so by definition of how close we and our families were, mine too.  She was amazing.  Beautiful, bubbly, confident, not afraid to say what she thought or to be a strong woman.  She didn't care what people thought and she didn't need to since everyone loved her.  I was nothing like CG and F and I so desperately wanted to be.  I don't know why I thought that weight loss would get me there.  They never focused on their weight.  I'm not sure they owned a scale or ever once mentioned anything about their size.  I just remember those first few teen years feeling miserable because I didn't fit in with their world (more the popular crowd- thought they totally accepted me despite this) or 'mine' which was the gifted, academically high, and musically inclined crowd.  

I met my first ED prone friend in 6th grade.  We developed the gummy bear diet together and talked about weight and how we might lose it all the time.  We both had divorcing parents with little supervision and no one to notice our oddly developing eating habits.  We were in short horribly bad for one another (CT).  I guess you could say CT made me feel like my concerns and goals were normal.  No one else that over heard us (when we let that happen) ever said anything or thought we were weird for it.  All girls talk about weight and want to lose it, right?  CT wound up anorexic for life and died a few years ago from heart failure.  Haven't ever told anyone about this (unless I did so under alcohol or ambien influence in which case I obviously don't remember).  Want to know what my first thought was when I found out?  She won.  She was successful where I was not.  She was what we both unknowingly at the time were after, the golden title of being anorexic.  I have spent my life trying and failing.  I should have been mourning her loss (thought we lost touch over ten years ago) and reflecting on the way I life my life and feeling fortunate that I never got that bad.  Instead I was feeling self hatred for being so weak that I ate that day.  

But I moved on from that.  I did get sad and I am grateful I'm not that bad or dead.  Maybe that's why I have a condition not a disorder. ;)  But that was definitely not a promising start to adolescence.  Not sure it really gets down to the why, but it's a start to the how and what I suppose.  

I'm exhausted and sick and off to bed.  Just needed to fix my horrible last post and gets some of this off my mind.  I'm finally taking a sick day tomorrow to really get some good sleep and regain some much needed energy and uplift of mood.  

Lies I tell myself?

I don't really know where to start.  I guess first is about my stop in treatment as far as psych/nutr.  Yes, I did run out of my medical money.  Yes, I'm still getting that large chunk of used money taken from each paycheck until Sept.  Yes, it makes it quite tight to try to pay out of pocket on top of that.  Could it be done, yes.  I'd have to sacrifice all dinners with friends and shopping at all, but yes for the next three months I could swing it.

Truth, I don't want to.  I can't explain it well.  It's not that I want to just stop because I am 'fine', though most of the time I do feel fine.  It's more I think that this particular psychologist (S) and dietician (CA) are not for me.  I've made excuses for them.  I like S because she is smart and to the point.  I like CA (thought I hate her by definition because she tells me what to eat), because she is the nicest person you will ever meet.  But in the end they are both very religious, though S hides it better, and I am not.  I don't believe in 'God".  I'm not sure what I believe in, but it's not the 'Christian God'.  I don't believe in organized religion at all and I think it does more damage in the grand scheme of things in humanity than good at this point in our history.  I hold true to Bill Maher's idea that we need to be rid of it in order to evolve to a peaceful, logical, and truly caring species.  But I'm also a die hard socialist which is all that more ironic (as I think of all the Christians that flinch at the mention of the S word) since if Jesus walked the Earth today, he would vote democratic in the US and be socialist leaning in general because he in fact preached and lived a life of putting the greater good and good for anyone he came across in front of his own.  Jesus would have never ignored the poor or less fortunate because it might cost him a few hundred dollars more a year in taxes (not to piss anyone off but don't tell me you're truly Christian if you think a few extra hundred dollars in your pocket is more important than the welfare of others- period.)  He would have supported and dare I say expected his followers with much to share with those with little.  But I totally digress and you get my point.  How can I subscribe to any religion here in the states when they are all so hypocritical.  And that doesn't even bring Science and Historical fact into it.  So in the end these two wonderful and experience women are not for me.  I just can't connect with a team that truly believes that church and religious support groups are the key to my health. That stuff works great with those that have that kind of faith, but I do not.

So obviously these two clinicians (S and CA) are just not for me.  But I lie to my psychiatrist too.  She has been totally off my case since she knew I was seeing them so I just happened to not mention that I haven't seen them in over a month when I saw her this week.  Thing is, I research, experience, read, and talk to enough people like me or similar in some way to me to have a very good idea of what meds I should be on.  I don't take advantage.  I could have anything I want, but only suggest things I think are minimally needed.  I don't like drugs in general and am never happy to add to my list.  It's a pride thing.  Anxiety, however, has been disabling lately for me so I did fib a bit (told her I'd been on it in the past) and lead Dr. M to prescribe me Klonopin.  I'm just not ready for Xanax yet.  It works wonders for several dear friends but I think this is a good start.  I take it at night to help with the stressmares, and against doctors orders (or rather not with them) I take them during the day when I feel the need.  So far it has made daily life so much more manageable.  So as I told Dr. M, if I have to choose between my pride and my sanity then I guess I'll go with my sanity.  

I do need to find a new therapist and I realize this.  I don't think I'm ready for a dietician yet.  It was just so hard.  I'd need at least Klonopin and Xanax if not Lithium too to really make it through days with the the big D.  It was way too much for me.  I was truly a basket case.  But this whole thing is more than just being uncomfortable.  It's easy to say, oh she couldn't hack it and ran away as always.  Trust me I don't need anyone to tell me that.  I am, always have been, and always will be my hardest and most unfair critic. I just can't put into words the anxiety finding new therapists causes me.  I hate everything about the process.  But I have come to realize a few key points.  I'm not bulimic.  I have to stop telling the intake receptionist or nurse that I am out of convenience and simplicity.  As I said in my last post I'm simply not nor will I ever be bulimic.  

I have to stop saying I am, or rather allow myself to be pigeon holed into the diagnosis every time.  It gives me an easy out.  It's very easy for me to manipulate sessions and avoid the real issues when bulimia is their working assumption.  When you are bulimic there are certain techniques and focuses that all of the team works on.  I think the idea of getting someone to stop binging and purging is more concrete and easier to develop a plan for.  Since I don't binge, in general these plans of attack are not affective on me.  I live my life as an anoretic 'at heart' and though I have never been successful of 'earning' the title due to weight (which feeds right into the failure complex), it is the way my brain works.  It been better, it's been worse.  It's up in the air which time in my life was better psychologically.

Revisions to DSM... Disorder or Condition?

I would never argue that I am normal about eating.  I will argue that very few women are, but not that I am.  But I have never been comfortable with the label bulimic.  It's been the go to diagnosis because if you throw up then you must be bulimic.  It's very hard to take therapy seriously when everyone is treating you for a disorder you don't have.  I don't binge, period.  The only time I come close is after a very long period of restriction (auto pilot as I think of it) and even then calling it a binge is more my perception than diagnosable.

Under the DSM IV I'm not anorexic either.  I don't meet diagnosis (even purging type) because I have never been and am not underweight.  In fact they say 85% or less of minimal weight for size and age.  I'd have to weigh 85 or less to be diagnosable.  I also would have to stop having my period (which would be perk).

So I've always technically been EDNOS which most people don't know much about and is the catch all 'I think you have a problem and need help' diagnosis.  It's like there are these two exclusive clubs and you're not accepted into either.

DSM IV

It stands to reason that if my behavior is not medically and psychiatrically significant enough to get a real name and a real set of criteria, then how bad is it?  I mean realistically I'm not even at the bottom of my weight range, I function fine physically and mentally, have completely normal blood work every time, and my blood pressure is better now than it's ever been.  So I've got some maladaptive self destructive behaviors, but who doesn't.  Show me one completely normal person and I'll show you a liar or someone really good at hiding their quirks.  Mine just happen to be about food.

I'm not saying that restricting oneself to 800-1000 calories a day and purging anything over that is okay.  I definitely needs to work on some new ways to deal with the stress of life.  I'm just wondering if it's worth thousands of dollars a year in therapy and treatment and people treating you like your broken.

I have been keeping track of the revisions they have been considering for ED in the DSM-V due to hit your local psychiatrist in 2013.  It not that I thought there would be a disorder that was the perfect fit (like the elusive pair of perfect jeans), but I did think I'd fit in somewhere since I keep getting told 'it's a big deal' and 'beating this is going to be the hardest thing you do in your life'.

DSM-V ED thus far

First of all, they want to change the section to be titled Feeding and Eating Disorders.  Really?  We are now going to go from ED to FED?  Was that some psychiatric humor?  Not only in 2013 will I become FED, but I get to switch from the subtitle of EDNOS (eating disorder not otherwise specified) to Feeding and Eating Disorders Not Otherwise Classified or FEDNOC.  If you really wanted a new verb you might as well have gone with something like tagged so it could be FEDNOT.  At least it would have had some matching humor.  Next I get to go to all the subtypes in FEDNOC and get cross listed as Atypical Anorexia Nervosa and Purging Disorder.  More bang for my buck I guess... two for one special.  Oh except that these aren't actually classified as disorders, they are conditions.  But it says that only one condition should be assigned to patients so I guess I'll have to pick one.

I do think they are suggesting sound and needed changes.  I'm just beginning to think that if the diagnostic world doesn't think I have a disorder then I shouldn't either.  I have a condition.  Sounds much better than I am ED, EDNOS, or bulimic.  Some people eat too much salt, red meat, sugar, fried and processed foods.  The average american woman weighs about 30 lbs more than a 'healthy' range which means to me there are a LOT of over weight women out there.  A lot of women that eat too much and many that don't watch what they eat at all.  They don't have a 'condition' for that.  No one goes to their friend that is 30 or more pounds too big (very much putting them at more risk across the board medically) and tells them they think they have a problem.  When they eat when their not hungry or are never not hungry no one freaks out.  In fact no one really even bats an eye until someone is grossly overweight and well past simply obese.

So it's a double standard really.  I'm not hungry as often as many and sometimes I don't eat even if I am.  I watch what I eat very closely and when I feel that I need or want to drop a few pounds, I eat less.  I have a purging disorder (but classified as a condition) and I am working on it.  It's not surprising that it hasn't been an issue of late since I'm not stuffing myself on someone else's meal plan and idea of how much I should consume.  You can argue that I'm increasing my health risks (what doesn't), but I've had everything checked routinely over the past few years and I am 100% healthy.  I can continue to work on better stress management and continue the treatment that has my depression in check without treating a disorder that I don't have.  Now if I drop to 85 pounds, start losing my hair, and put myself in serious danger of heart failure then I'm just in denial now (and the past 14 years?) and you can tell me you told me so (and I'd qualify for treatment under my insurance for once).

"thin"

You can never be too rich or too thin.  My dad was far from the only person who quoted this during my childhood, adolescence, and young adulthood.  I hear it all the time still.  Sometimes by people who know that I'm ED.  Not that I think poorly about them for it, they just weren't thinking when they said it.  But that's because it's one of those sayings that people don't think about.  They are said in passing and the fact is that most people believe it to a certain extent.  Which is frustrating when you're like me and being told continuously by numerous people that you have an unrealistic idea of thin enough.  I don't think I'm the core problem.  I could never argue that my bulimic behaviors aren't totally out there and dangerous and let's face it disgusting.  But I've wanted those behaviors gone since they started.  But people are so sensitive to my restrictive behaviors and it all can feel pretty hypocritical.  I mean where is the line between dieting/weight loss and "we think you have a problem again."  Will I ever be allowed to be like every other female out there who decides that she needs to get a little thinner?  I understand the uncomfortable feeling, the wondering "but will she stop before she's too thin?"

What is too thin?  I am 5 ft nothing.  I could be picky and say 5 ft and 1/2 in because I know I'm slightly taller than my mother and she is exactly 5 foot.  I have a tiny frame, little bones.  Doctors say my ideal weight range is 90-130.  I wouldn't be 'too thin' medically until I was in the 80s.  Most medical doctors, though you know how I feel about them, wouldn't even be concerned until closer to the 70's.  I'm not saying I want to weight 70 pound, because I don't.  I'd like to live a normal life and not be committed into a hospital.  I would like to be around the low 90's.  I was there at 16/17 (well after I had stopped growing and maturing) and again for a 6 month section a couple years ago at 25ish.  I don't think I was too thin.  I don't think anyone who wasn't a friend who knew my struggles with ED would have thought I was too thin.  Very thin, yes, but not too thin.  

I guess I just worry that for the rest of my life, if I lose weight (even when I actually do need too) everyone will be worried and start talking about being too thin.  Too thin is in the 80's or less.  Too thin is having heart problems, unstable blood pressure, low body temperature, and your labs coming back all fucked up.  Well I weight 105 and I would like to get down to at least 95.  My blood pressure is stable, no heart issues, normal body temp and my labs all came back within normal ranges.  So I'm not too thin now and when I lose the 10 pounds I want gone, I still will not be too thin.  

If I had an extra 30 grand laying around...

I can't afford treatment anymore.  Not until September when my flex plan starts again.  I never dreamed when I made my elections and signed up for a huge chunk of my check to go to my medical account that it would be drained by April.  I tried to make it work.  I even decided to not refill my ungodly expensive migraine preventative so I could at least keep up with S.  I'm going to have to go get it though.  The headaches are back and worse than ever.  Maybe they seem so bad because I had so long with out them.  Either way it's becoming increasingly harder to function each day.  I have less patience with the kids and I'm very noise sensitive.  Last night I had to take more than normal to get to sleep and tonight my head feels like it's going to explode.  I'm really regretting my decision to pass up my prescription for the pain meds because those were at least cheap and effective if only a quick fix.  At the time I really didn't need them and wouldn't now if the other weren't so expensive.  


Headaches are a common complaint among people with ED.  The statistical correlation of the disorders with treatment for migraines is very high.  I'm fully aware that my own behaviors could be to blame for my condition.  If I could change my life just like that then I wouldn't have the high medical bills, but that's not the way it works.  My ex neurologist would have me believe that it is a disorder of itself and one that I will have for the rest of my life.  How much can you trust an opinion from a guy that only makes money off you if he makes you believe that?  Side effect, disorder, or both it doesn't really matter.  I'm miserable.  I can't concentrate on getting better and be in this severe state of constant pain.


I shouldn't have to choose between the two, but that's how the 'wonderful' American health care system works.  People who argue things like universal health care only help the 'poor' are ignorant.  It's people like me, who pay my fair share of taxes and uphold my place in our society, that get screwed the way things are.  People like me have to make choices between which medical issues to seek help for and which I can try to do without so that I can pay bills and live life.  But then again it's just my mental health... I should just 'get over it'.  It's just 'all in my head'.  Or to take the advice of the wonderful doctor I saw recently, just take up rock climbing.  

Another Road Block

I haven't been doing well with my diet plan.  I guess it started two weeks before Spring Break.  I had an intense fear of gaining weight over my trip with cousin K.  It's our thing to road trip all over and one of the highlights is always eating all the amazing food each city has to offer.  This is a nightmare for me though trying to get into recovery.  But I also refuse to ruin our annual trips because of my eating and food issues.  Which means I restricted as much as I could the two weeks before to lose as much weight as I could in case I gained any while gone.  Then I spent the week eating whatever we wanted and was grateful for every public toilet I found with privacy for purging.  I purged 2-3 times a day the 6 days we were traveling about.  Sad thing is that she thought I was doing well.  K just hasn't been around me enough since she found out to not be blinded by my song and dance of being ok.

What I hate the most is that I will always look back on these trips with my most distinct memories being what we ate and how long it was before I could purge and every bathroom I found to purge in.  It's just so sad that the most exciting moments for me during the whole trip was walking into a public bathroom to find it empty and knowing that I could keep my secret.

Since I've been back I decided that I would have to really restrict to make up for the week of bingeing.  It wound up being horrible.  I would eat my greek yogurt and maybe something small at work but then come home and eat what I wanted.  I don't eat anything I want that doesn't make me feel that I must purge it.  So... I purged every night last week.  I didn't eat anything all day Saturday until on my way home from friends late I stopped as Whataburger for a number 9 (My fav).  I went home and ate it almost without tasting it and then purged.  I then ate nothing today until the evening when I ate the rest of the things in the house that I didn't want to tempt me anymore.  So I ate one, purged, ate the second, purged, and then ate the last and purged.  I don't get dizzy, lightheaded, and weak when I purge but I did today.  I don't feel good at all right now.  But it's all gone now so there's nothing to tempt me and I'm not going shopping this week.  An empty fridge is safer.

But tomorrow's a new start.  No more dinner drama.  I'll have my coffees, greek yogurt for lunch, maybe a small snack, and then a cup of cottage cheese so that I'm keeping my protein up.  But I'm done with dinner right now.  It's too complicated and I really need to lose 8 pounds to feel okay right now.  Once I get there CA and I can figure out how to handle dinner in a way that isn't going to make me purge or get fat.  Because I'm NOT going to gain weight.  Not an option.

My vitals are good, all my blood work and tests came back good.  My hair looks healthy and great according to my stylist.  Everything is fine right now.  I'm fine right now.  I'm being honest and for now that's all I have.  I see S on Thursday and I think we're going to need to reevaluate our sessions because what we've been doing isn't working.

This is why I avoid doctors...

I have never been a fan of going to the doctor.  Call it avoidance of medical issues or attention (it probably was) but I've never liked the feel of the doctor's office, the demeanor of the nurses, the indifference of the doctors or how much more about getting money it is over patient care.  I avoid going to a general practitioner because it is never a good experience.  The first thing you do is step on a scale, fully clothed, and have to look at a number that is always larger than the one I see the three times a day I step on my scale.  And even though I know that the larger number is due to the clothing and other variables, it's still a bigger number and that just starts the visit with heightened anxiety.  Next you go through the nurse intake questions.  This is always the awkward part.  I never know how much of my history they read.  Do they know I'm ED?  If not should I tell them or just the doc?  If they do are they judging me?  Next comes the doctor who I only request as female.  No matter what I'm there for I will historically down play symptoms. I'm always convinced I'm not that sick and often feel guilty for taking their time.  And I'm closed off in general so if they don't ask the right question, they won't get the right answer.  Then there is always their quick jump to and willingness to prescribe me any psychiatric med I could want without really understanding the specific details of my disorders or a background in these medications.  Today's visit, however, was this bad plus oh so much more.

Today I had to take an appointment with a different doctor so that I could get in later and sooner.  I went for the chronic cough I've had that makes me sound like I'm about to die but doesn't make me feel bad physically any other way.  I had to take an appointment with a male doctor.  I never see male doctors because it is my opinion and experience that they suck.  Today was an excellent example of why I feel that way.  Picture me as a brand new patient to a 40 something year old, recently married to a younger woman, with a couple young kids who is a practicing doctor but also gives speeches about his theory on wellness and health, has a radio show, and is writing a book (all of which we spent most of our session talking about... or he did the talking at any rate).

The nurse brings me back and weighs me facing the scale so that I saw the weight 111 which is an issue in itself because my scale is off 4 pounds and that sent me into huge anxiety.  But this is still about 20 pounds less than what I weighed last April which calmed me some but also make me mad that I let myself gain all that weight.  She takes my BP and it was really good (sign lower than last time, but its better numbers now so I don't think that's a concern).  She leaves.

In comes Doc.  I've name him this because he presented himself as someone who would go by Doc.  So Doc comes in all casual and confident and he pulls up my charts on the computer.  I just waited as I always do for them to read the ED.  He sees it listed as Bulimia (use to be easier just to say that's what I have).  He then looks at me in a confused/analytical manner and says "You have bulimia?"  His tone and questioning look was everything I fear in these situations.  Basically thoughts like but you seem so normal, your way not fat, you don't look anorexic.  The later thought always gets me the most since I would in fact like to be truly anorexic and be thin enough to warrant the label.  I'm actively getting help so that that isn't what I want anymore, but it is what it is now, but thanks Doc for bringing it up.  Then when I corrected him that I have EDNOS, he says he doesn't know what that is.  I clarify Eating Disorder Not Otherwise Specified and got a blank look and "I've never heard of that one."  That one!?  It's only the most talked about ED recently and I hear up for much debate when the next DM comes out. I mean I know you're just a medical doctor, but I would expect as a general practitioner who works with women that you would have some basic medical and treatment knowledge on a disorder that effects a huge amount of women of all ages.  Just sayin.

Next thing he says in response or maybe to fill the awkward silence was "I dated a model once when I was younger.  She was bulimic.  She was hot as hell though."  Ok, really?  How do you not know that that's not okay and inappropriate.  She had a potentially deadly disease... but she was hot?!  Thanks ass.

Next up anxiety discussion where he was more than willing to write me some scripts for that without knowing an in depth background on my treatment and medical and psychiatric history.  It's just wrong and dangerous that so many doctors do this.  He not trained or specialized in psychiatric disorders (by his own admission) and therefore has no moral right to prescribe medication for disorders he doesn't understand.  Oh and he thinks he understands anxiety.  He's over come his from his past.  Well mine come from a lot of different things, but the current height is due to the ED behaviors and me trying to decrease their occurrence.

Then I got to listen all about his theories on medicine and wellness.  Not that he didn't have some interesting theories and thoughts, but this visit was about me, the patient, not you the guy trying to presale his book.  Blah!  And in explaining his theory on predicting where you will be health wise in a year or more by looking at the average experiences of the past year was just so uplifting.  I mean hello dumbass, I'm on meds for depression, anxiety, sleep, and migrains and I see a psychiatrist, psychologist, neurologist (though thankfully no more if Dr M. keeps prescribing for me), and a dietician.  Pretty sure I've had a pretty shitty past year.  Thanks for sharing that your theory is that in a year from now I'm not going to be much better than I am right now.  Even though it made since in his long explanation, what jerk tells that to someone trying for the first time to really do treatment and work on this for real?

And he doesn't feel my treatment team will resolve my anxiety.  His other theory is all about taking us back to primal instincts and fears.  He wants me to start rock climbing, rope courses, kickboxing, and running (not jogging but sprinting).  His theory made since, but anyone who knows me knows these are a far cry from anything you'd catch me doing on my Saturdays.  May have left with a better taste in my mouth if he hadn't said while pushing the rock climbing thing again "you need to get your skinny butt out there."  On my way home I repeated ass, but I'm really hoping that was me putting it in the memory because I hear the phrase skinny ass more.  I'm really hoping that he didn't actually say ass, though maybe.  Either way, really?!  It's just so male!  I don't know how to talk to an ED girl so I'll make comments about how skinny she is.

So not helpful when your treatment team thinks you're still losing weight and they don't want you to and when you yourself take every complement you hear as validation for your self starvation.  I don't stand a chance of eating over 400 cal in a day if someone has complimented my weight/size that day.

He actually ordered a lot of labs I needed done anyway and wants to have another meeting to go over them even if they are all normal so that we can talk about making them even better.  I'll see him that time and then no more.  Another note though, when discussing why I should come back in a week to discuss the results he made the comment "I'm sure your boringly healthy but..."  Who says that to someone in intense treatment for an eating disorder?  Sure, my labs might be fine they normally are.  Yes, I look fine.  But it has been my treatment team's job to warn me and educate me on all the bad I'm doing to my body and it's possible we're going to find some not so good stuff.  But even if I am 'boringly health' I'm going down a road that if I don't get in check and better, I will be far from healthy and that's where my head's got to be at.  As my doctor he should know that, shouldn't he?

So no more male doctors... ever!  I am now searching for a good general practitioner who has experience  with ED patients and good references from former/current ED patients.  Not sure how to go about finding that.  I guess I'll ask CA when I see her.  

I said that I'd stopped.

"I had not stopped.  My eating disorder had taken a sharp turn for the worse.  I lay in bed each night and stared at my body with a hate that even now brings bile to my tongue.  My hatred of bulimia steadily grew. That hatred became, with a little time, an absolute commitment to becoming an anorectic.  Bulimia is hard to see because it doesn't necessarily change your body size. It is also more immediately dangerous." - Marya Hornbacher

I'm not being completely honest with my treatment team.  I know I should be but it's hard.  I met with S after 4 weeks since I canceled our last one.  I really felt like quitting again.  I really almost did.  I don't think either of them would be surprised.  But once again I can't quit.  I don't quit anything of importance.  The hardest part was the honest emotions being felt and shared.  I had decided to quit seeing Dietician CA but after my good session with S I felt like I haven't given her enough time to figure me out and make progress.  So I go see her thursday.

I've now cried at the end of a session twice with these woman.  I hate crying in public so much.  They get me every time when they talk about how proud they are of me for what doesn't seem like much to me.  I mean I'm miserable following the meal plan and I just feel like I could be doing so much better.  I guess it's that whole need for perfection.

Road Block

I canceled my last psychologist session with S and didn't show up to my appointment with CA last Thursday.  I have actively not been following my meal plan for the past 2 weeks.  I am having a lot of thoughts about not going back.  I know they are all excuses, but I got so overwhelmed the last few weeks.  It's a huge time commitment to go to an appointment every Thursday and I'm so drained after each one, whether due to getting emotional or the effort to stay unemotional.  S's appointment I missed because I had last minute obligations and unexpected work stress.  Her appointments aren't until 6 which means I'm not home until almost 8 and that's just a very long day.  I need to talk to her this week about trying to find an earlier time.  While I skipped CA's last week to help with a thing at work and in order to support coworkers at an award ceremony, I must admit it was an easy decision.  I'll have to talk to S about this whole dietician thing.  I just don't like going.

This whole process is unbelievably uncomfortable.  This is probably the worst time of the year for me to have decided to 'get real' about treatment.  I have been plagued with stressmares.  I've always had insomnia and have been treating it medically for 8 years.  My issue has always been how long it takes me to fall asleep versus when I have to be awake.  With my dose of ambien (and my sensitivity to drugs in general) falling asleep isn't the issue anymore.  I may have a bad night here are there, but most nights I get my 7-8 hours in if I'm responsible.  Since this whole 'real' treatment thing started, however, I have been waking up on average 2-3 times a night from dreams so stressful that I am rigid and stiff with anxiety, every muscle hurts, and I spend the next 5 minutes or so calming myself down and assuring myself that it was just a dream.  These dreams are everyday social, family, and job related (students and staff situations) events and yet they always turn ugly as far as anxiety over one issue or another.  It wouldn't even be so bad if it weren't so hard to tell them apart from reality.  Sometime I catch myself thinking I've had conversation with people I really haven't.  I'm normally so worked up after waking to a stressmare that I don't go fully back to sleep and often have a few more stressmares before it's time to get up.  From mid January to a few weeks ago, I was averaging about 4 hours of real sleep a night.

Since I blew off my last two appointments and threw my meal plan to the wind, I've slept much better.  Shocker.  I guess that will be the next road block to treatment.  How do I do all the things I'm suppose to do and not allow it to affect my personal and professional life?  I can't walk around at work ready to burst into tears at the slightest thing (which is how I've been feeling) and I can't function well in general if I'm only getting 4 hours of sleep a night.  This was a big part of why I started thinking I'd need to check into some place this summer.  Well that was a nice idea until I found out that one place I found near by charges almost a grand a day for a min of 60 days.  There's no way I can afford it even with my insurance.  So what I'm doing now, while draining me financially as well, is about my only option that I know of.

S and I are going to have to have a very serious discussion this week about how this can all work.  Because it just isn't right now.  I know I'm the biggest obstacle, but I feel between S and CA they've got to be able to come up with a better plan to help me through this part.

Sia - Breathe Me

A diet means, medically, the overall eating habits of person...

I can't do this.  I'm trying so hard but I just don't think I can.  Last week I did okay.  The weekend was no good as always.  I think those will be the hardest and last areas I fix.  But I tried again on Monday and felt beyond disgusting.  Which then led to me not following my plan well today because I am so bloated that I am nauseous and uncomfortable.  It makes me not want to leave the house...  And then because I have to be able to put on a happy face and get to work doing my job well I'm left feeling strained and exhausted each day and slowly creeping back to the normal behaviors I know will make we feel better.  


How am I suppose to 'get better' and work a high pressure job that I am passionate about and stay as social as I am and want to be?  I don't ever have time to sit down and just process how hard this is all for me.  Because it is soooo very hard.  Not even just the eating stuff (though that sucks in a giant way) but all the emotions and reactions to things that are bubbling up.  I don't know how to deal with them and still function normally.


For instance I cried the other day while handing my partner papers I didn't get passed out that she would then need to pass out.  She was just giving me a hard time and teasing as we both always do, but that day I was so on edge I started crying.  She felt so bad she almost sent me flowers.  I just don't have the control I have always had on my emotions and it's really scary for me.  


I'm starting to see the benefits of inpatient treatment.  To be able to take a break from the world for 2 months and just work on me without the distractions and without being able to avoid the things I've spent my whole life avoiding.  


Hospitalization has always terrified me, but this would be a step above that.  And let's face it, if this thing doesn't work and I go off the deep end (And I've been feeling close for quite a while) I don't have 40 pounds to lose this time.  If I fall like last time I could very well end up hospitalized against my wishes. Surrendering yourself to a treatment center has got to be better.  I need to look up more information and talk with the insurance company about costs....

To be continued....

Living One Day at a Time

"Eating disorders, then, are really not about food.  They are about how you feel about yourself; they are about low self esteem, a tremendous need to feel in control of yourself and your surroundings, unrelenting perfectionism, and an alienation of the mind from the body.  They are also about a brain gone awry, frayed wires sparking and igniting as the brain is unable to process messages about food and anxiety normally.  While an eating disorder usually begins as a deliberate act by the sufferer to lose weight in order to feel better, the eating disorder soon takes control of everything.  As a person's problems become worse, the deeper one falls into the eating disorder.  It's like living on a sinking ship, continually bailing out water, refusing to leave even as help arrives and the water level continues to rise.  You still think you can saver your leaky boat- you do not trust the help, you cannot see the shore that beckons, and you fear the life raft that is being thrown to you won't keep you from drowning.  I can't guarantee you that you will make it to shore if you abandon your leaky boat.  But I can guarantee that you will surely drown if you do not let go."
-From Next to Nothing-Adolescent Mental Health Initiative


Session 3 with CA was today.  I went in feeling very anxious.  I barely got through the work day because all I could think about was how badly I had followed my meal plan.  And even though I knew she wouldn't be mad or disappointed, that was my natural worry.  


I tried really hard last Monday to follow the plan.  But then the snow days hit and I just slipped back into familiar time off from work behaviors of eating little outside of beers and snacks with friends at bars.  This week I started off good.  I followed my plan exactly Monday and made it all the way to dinner on Tuesday on track.  But then it just hit me... I felt so horribly full, bloated, fat.  I couldn't handle it and I purged part of dinner.  At least it wasn't a violent purge.  We were off school again for weather Wednesday so I ate out with friends and had some beers and purged as usual.  


Today I got back on track.  Had my greek yogurt in the morning, sandwich at lunch, and a snack on the way to my session with CA.  I felt disgusting and on edge all day.  I feel like I'm gaining weight and I'm not sure I can handle it.  


We talked about it and she explained the typical weight fluctuations in a normal young woman.  Then she took me through what happens to women like me when they go into 2 month hospitalization for treatment.  Here they have no choice but to follow their meal plan everyday and in doing so they tend to at first gain weight for a while.  Since the body is still naturally in starvation mode, it will cling to anything coming in and that person will therefor become bloated from that and liquids.  It doesn't last too long before it adjusts to the fact that it is not being starved anymore and most bulimics leave treatment thinner than they came in, but eating and keeping down more food than they ever had before treatment.  


It all makes sense and really it wasn't anything I didn't already know...  But this is me getting bloated and feeling almost nauseously full, and my scale going up.  I have a lot of anxiety over how I'm going to handle that and if I'll be able to handle it at all.  I'm already 5 pounds more than I want and to gain even more all on the faith that it will go back down soon.  How soon?  


I'm not sleeping through the nights anymore.  I'm hoping its just due to a lingering cough, but CA is concerned it may be from my heightened anxiety during this part of treatment.  I guess if it happens again tonight (which would make 5 nights of waking up starting at 3 or 4 with some nights not being able to sleep again and others able to have a few cat naps until the real time to get up) then I guess I'll have to call Dr. M.  Only anxiety meds I'm willing to take are one at night.  I don't want to be all drugged out during the day.  I don't know how anyone can function that way.    


I'm suppose to start finding inspirational books/quotes to help me through the rough patches.  This feels like one of those times and I find it slightly funny that the first quote to catch my heart is the one that is used so frequently among the types of support groups I really don't want to join.  Oh well, the prayer itself is just a classic and calms me tonight.  


"Grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference. Living one day at a time; Enjoying one moment at a time; Accepting hardship as a pathway to peace."  -Serenity Prayer