Monday, March 29, 2010

Breaking the Cycle

We have all heard at some point 'along the way' that an eating disorder is not about food. Huh? it's really about emotional regulation, not knowing how to cope with intense feelings, and also pressures from both internal and external forces to be 'perfect', in control, etc.
It's a short jog from the point of emotional distress, to extreme dieting to be thin (isn't thin 'perfect'?), bingeing and purging in an effort to control weight, or any other numerous behaviors that ARE about eating, weight and FOOD.
Once your body and mind reach the point of starvation, both your behaviors and your thoughts become obsessively focused on food. The cycle begins...and it may present with slightly different characteristics, but for the most part it's centered around avoiding feelings by restricting or some other disordered behavior related to food, then penance and shame for that behavior, then the intense feelings again, and the cycle goes round and round. And my description is sadly simplistic.
Even though an eating disorder 'is not about food', it IS about food, because you cannot begin to truly focus on learning different coping tools until that eating disordered cycle (chaotic eating) is interrupted, or broken. So for a time, it has to be about normalizing food intake, weight, and stopping any dangerous behaviors that may be involved.
This 'cycle' feels and presents very much as an addictive, obsessive behavior, largely due to the affects of starvation on the body and brain. Breaking this cycle in order to move on to the process work required for full recovery must involve a knowledgable professional. I see no other way of stepping into that next phase...the cognitive processing.
Recovery is not quick, simple or easy. But it is completely possible. There are immense fears involved that may likely cause one to pull back and think that it's not worth the pain.
Freedom from an eating disorder is worth every bit of pain and hard work that is required. This is a life and death choice.
Breaking the cycle is the first step. Will you move on to experience life as it truly can be?
Don't ever give up!

Without apology....♥

Thursday, March 25, 2010

Eating Disorders and Suicide

This is not a pleasant subject, but one that deserves attention. I attended a presentation at the IAEDP Conference a couple of weeks ago about suicide. There were some interesting facts that I wanted to share.
In the United States alone, there are 790,000 suicide attempts made each year out of the general population, with 31,655 cases of completed suicides, as they are referred to. Approximately half of those who commit suicide met with a clinician in the weeks prior to taking their lives. What does this mean?
Often a person who is struggling with thoughts of suicide (suicidal ideation) will not reveal this to anyone, nor will they ask for help. Also, many times, the people who attempt suicide, have no intention of dying, but are truly expressing their distress about certain things in their lives, or their lives in general. Then there are those who talk about wanting to die, threaten, and may even make an attempt, but their intention is likely to gain attention, and they may not have knowledge or skills to get it in a positive way. Anyone who fits into any of these groups needs help, regardless of the level of real danger involved.
Surprisingly enough, suicide rates are higher for those with eating disorders or substance abuse issues than for those with Major Depressive Disorder. This is thought to be a result of closer monitoring for suicidal ideation among those with MDD than for patients who present with an ED or substance abuse issues. It was also noted that persons suffering from eating disorders are likely to use a much more violent method to take their life. This is thought to be related to the common element of low self-esteem, even self-hatred, experienced by many people with eating disorders.
A study conducted by Sullivan (1995) on mortality among eating disorder patients showed that out of 3006 patients, there were 178 deaths. 54% of those deaths were due to eating disorder complications, 27% were due to suicide, and 19% were from unknown/other causes.
One source, Pompili et al, refutes the belief that starvation is the primary cause of death among those suffering from anorexia, stating that in fact, suicide is the major cause of death.
There is no way that a treatment professional can predict that a person will choose to take their life, but an important tool for prevention is to perform a thorough suicide assessment on every psychiatric patient.
Many times, a patient with an eating disorder will present with a comorbid diagnosis.
With Anorexia nervosa (Restricting type), examples of comorbid conditions may include:
Personality Disorder-22%
For Anorexia nervosa (Binge Eating/Purging Type):
And with Bulimia nervosa:
-Dependent, Histrionic, Avoidant-20%
In summary, I will share my own experience of losing a very dear friend to suicide. In addition to suffering for many years from an eating disorder, she suffered greatly from deep depression that seemingly could not be controlled. Her suicide was a great shock to all those who knew her.
Please, no one, ever take a person's despair or threat to self-harm lightly. Listen, offer support, and always call necessary emergency personnel if you ever suspect anyone is in danger.
Eating disorders are treatable. Full recovery is absolutely possible. NEVER give up!!
Without apology....♥

Saturday, March 20, 2010

Imprisoned by Freedom?

Spring and Summer were such a carefree and fun time for the first ten years of my life. I can almost feel the excitement on that last day of school in May when I knew I was FREE for three months before school began again...not a worry in the world!!
What a contrast to the dread I developed within only a few years, of the warmer months when so much was 'expected' of me. You see, by the time I was 15 years old, anorexia had taken over my body, mind and life, so very little, if any of the things I did were truly chosen by the true 'me'.
The beautiful warm weather of Spring and Summer brought only more rules to my daily regimen. I could not enjoy the blue skies or the sunshine, for worrying that I had to be active and take advantage of every moment that I could be outside.
By age 18, I had been married for several months, and I was a slave to the eating disorder and to the exercise and activity expectations that I put on myself. Winter to me, was a bit of a reprieve. Life was bit slower, but when I had no 'excuse' to not be out biking or walking, etc., I constantly questioned if I was doing enough or being active enough.
I felt pressured when I would see someone jogging. If a friend or family member would comment on being involved in an activity, I felt guilty if I were not also 'working' or exercising. I planned my exercise and activity around what I saw others doing, because I had no clear idea of what I wanted or who I was at that time.
My life was a quest for an identity that I could not find.
I remember when my sons were growing up and very involved in summer sports. By that time, my body was so depleted and I was pushing myself to the point that I had no energy to enjoy life at all. Every day was a chore to live. I can recall the sheer dread and wishing time away in an effort to avoid having to struggle to find the energy to get through the day.
From March through October I was on my own personal merry-go-round, literally hating the clear, warm days that left me compelled to push myself to the very end of my energy. Even taking my sons to swim at my parents' house was torture. Faced with a pool, I had rules about swimming laps, so everywhere I turned, life held more demands for me.
I realize now that these were self-imposed, but at the time, I truly resented other people for causing me to have to measure up, for not allowing me to relax, for not allowing me to make the choice about how I spent those warmer months of the year. Because of this, I lived with bitterness and oftentimes, a kind of death wish. A wish for it to all just stop...or for something to take me out of 'life'.
I have been reminded of these things in recent days as the weather has warmed, and thoughts of the warm months ahead come to mind. I hear others who are still trapped by this compulsion to always be moving, doing, exercising, and I recall the horror of that prison. That prison leaves no room for personal choice.
I am grateful beyond words that I am now free. I do not have to compete with others or with my own internal 'rules'. I love that I live my life daily with openness and an excitement for any and every experience. I no longer feel compelled to DO. I now focus on who I choose to BE.
It's only March, but I am looking forward to sharing leisurely bike rides with my husband as the weather warms, but only as I choose, and our time allows. I will plant some flowers because I want to, not because it is expected of me. And when I see others running or walking, I know I will not feel compelled to match their activity because I know no other choice.
The freedom I enjoy today is based on MY choices and desires, and the experiences that life puts in my daily path.
I will be ruled no longer by the distortions and desperate attempts to be accepted that imprisoned me for so many years of my life.
Without apology.....

Friday, March 19, 2010

Medical Complications

Any specific eating disorder can result in any number or combination of medical complications, or even death. The human body was not designed to be starved, or 'abused' by the types of behaviors that present with an eating disorder. Everyone is affected differently and to different degrees, and it is impossible to predict what type of damage or harm may ensue, but there is no doubt that the body suffers.I would like to point out just a very few medical complications that a person may experience if they have either anorexia or bulimia.Within the overall eating disorder population, there is a 5.6 times risk of death over the general population, one-third of those deaths resulting from cardiac complications.The increased risk for edema (fluid retention) is caused by the decreased fulid intake with anorexia, and/or the depletion of fluids in one who is bingeing/purging, or using other compensatory behaviors, such as laxatives, diuretics, etc. The kidneys and the adrenal glands work together to help rid the body of waste, and when there is significant fluid volume depletion, this combination becomes imbalanced at the least, and may shut down in some more serious instances. For lack of better description, this system 'forgets' temporarily how to function at it's optimum level.Therefore, any slight change in fluid or food intake, can confuse what is already out of balance, and will ilkely result in the kidneys attempting to 'hold onto' every molecule of water and salt that is available...hence, resulting in fluid retention as a survival tactic. It's important to remember that in most cases, this will normalize again, but for some who have restricted their fluids/food intake, or who have engaged in long-term fluid depletion by some means, permanent kidney damage may result. The importance of getting help cannot be emphasized enough. It's also important that the process of restoring 'normal' eating be closely monitored for those who may be experiencing these things, so that the body is not overwhelmed, and so that certain hormone/electrolyte levels can be monitored for safety reasons.Another possible complication which may result from long term laxative abuse is called cathartic colon syndrome, which in layman's terms, means that the digestive process can be retarded and slowed significantly, and a type of paralysis called gastroparesis can result which is sometimes irreversible. This is due to the destruction of nerve cells in the stomach and colon, and may result in bloating, increased gas and pain after eating. This is not unlike the swollen bellies that you may see in pictures of children who are literally starving in impoverished countries.This swelling is similar to how a person's weight may settle temporarily around their middle when they are in the process of restoring their weight. THIS is temporary if monitored carefully. This is related to cortisol levels, which likely will normalize over a period time if the person does not once again slip into the symptoms of the eating disorder.This is a very simplified picture of an amazingly complex problem.Most of all, I'd like to emphasize that during recovery, most importantly, one must be monitored by a professional, for medical and psychological issues, AND, that it takes time for the body to restore normal function after being 'turned off' for sometimes a very long time.
Without apology...♥

Monday, March 15, 2010

Metaphorically: How can YOU relate?

This is a true story.

If you read the first page of the San Francisco Chronicle on Thursday, Dec. 14, 2005,
you would have read about a female humpback whale who had become entangled in a spider web of crab traps and lines. She was weighted down by hundreds of pounds
of traps that caused her to struggle to stay afloat.
She also had hundreds of yards of line rope wrapped around her body-her tail,
her torso, a line tugging in her mouth.
A fisherman spotted her just east of the Farralone Islands (outside of the Golden Gate)
and radioed an environmental group for help.
Within hours, the rescue team arrived and determined that she was
so bad off, the only way to save her was to dive in and
untangle her-a very dangerous proposition.
One slap of the tail could kill a rescuer.
They worked for hours with curved knives and eventually freed her.
When she was free, the divers say she swam in what seemed like joyous circles.
She then came back to each and every diver, one at a time, and nudged them,
pushed them gently around-she thanked them.
Some said it was the most incredibly beautiful experience of their lives.
The guy who cut the rope out of her mouth says her eye
was following him the whole time, and he will never be the same.
May you, and all those you love, be so blessed and fortunate—to be surrounded
by people who will help you get untangled from the things that are binding you.
And, may you always know the joy of giving and receiving gratitude.
Even as I typed this out, I had goose bumps on my arms and legs, as I imagined the miracle of this experience.
How does this story relate to YOUR experiences with having an eating disorder, or life in general? Or does it?
For myself, I was first struck by the whale's heavy prison of tangled lines, and how first, she had in no way caused herself to become entangled, and also, how this prison could lead to her death. So pertinent to how an eating disorder kidnaps us, and can be truly deadly.
In order to rescue her, someone could be hurt badly in the process. How many of us (you) hesitate or simply don't involve those close to you for fear of hurting THEM?

Freeing this whale was a slow, labor-intensive process, not by just one person, but a team of professionals. Recovery is not easy or quick, nor can it be done without professional help.

The eye contact mentioned by the one diver, reminds me that the true 'heart' of who we are can only be communicated by the honesty in our eyes. AND, both (or all) parties may be deeply affected.
Do you have people in your life who want to help you be free from those traps and lines that you are entangled in?
Do we offer our gratitude and thanks to those in our lives who ARE there for us?

Have YOU ever received the 'gift' of giving? Do you allow others to receive that 'gift' from you, by allowing them in to help?
Without apology...♥

Monday, March 8, 2010

How Does Smaller FEEL Bigger?

How can a person who is literally starving, 'feel' so BIG, so FULL and desperately miserable? When you are caught in the throes of an eating disorder, your perceptions about YOUR own size are not accurate. Anyone who has suffered probably realizes that.
But knowing that does not give you the sudden ability to process what you see in the mirror accurately.
Even though at various times while I was struggling with anorexia, my weight was steadily decreasing, there was never a point where I truly 'felt' thin enough, empty enough, or just simply 'OK'.
For many many years all I could see in the mirror was someone who still wasn't acceptable, and the only method I had control over to change myself was with food, to restrict, to take more laxatives, to exercise, almost ANYTHING, in an attempt to 'shape' myself into a person who would finally meet the expectations of those around me.
I realize now, that it was for the most part, all about that. I had no clue what would please ME, b/c I had never been shown or told that I should consider that.
The attempt to find that 'perfect' acceptable weight is not about what you weigh at all. It goes much deeper than the size of your body .
The smaller I became, the more obsessed I was about my weight, and the more internal pressure I felt to eat less and lose more weight. I truly 'felt' bigger in my own skin as my body became smaller. It made no sense, but because my brain was so starved, I could not rationalize between fact and fear.
These distortions have both biological and psychological foundations. The 'starvation syndrome' overrides a person's cognitive ability to reason, and the literal fact that you are starving, leads to the driving obsession about food, weight, exercise, etc. If you went without sleep for several days, what do you think you would be obsessed about?? SLEEPING!!
I believe that while actually 'being' smaller, the actions that have led to this...avoiding or stuffing any emotions, focusing on our body and weight, are the reasons that we actually FEEL larger. Inside, there is so much confusion and conflicting emotions that need to be expressed and released that we are like a balloon about to burst.
Losing weight and controlling my life in a very ritualistic and lonely way only took a major part of my life from me.
Less became more in terms of turmoil, confusion and illness.
More has now become less in terms of fears and isolation.
My days are now focused on actually living my life.

Without apology...♥

Saturday, March 6, 2010

'Body Conscious' vs. 'Feeling Fat'

This past week I was faced with a situation which evoked a complex emotional response within me, plus a very unexpected couple of days of some very strong 'body consciousness'.
I have not felt any discomfort within my body, in terms of being hyper-aware of my body's presence, for a very long least a couple of years.
When I was ill with anorexia, the body discomfort and consciousness was a constant 'feeling'. As I progessed through recovery, I discovered that those 'feelings' and the discomfort with my body, which were a large part of what triggered my eating disorder behaviors, were directly related to the build up of emotions I had inside.
So I began to use those moments of 'body awareness' to do some serious thinking about what was truly going on..what was I feeling, and why was it upsetting me? I learned to deal with what I was feeling, allow myself to feel it, and then move on...without allowing the body discomfort to take me back to my eating disorder.
This is one of the most important tools that I have discovered and learned to use in my life. Being able to separate my emotions from how I deal with food, or how I interpret my physical appearance has been critical.
This week? Those couple of days were important for me to realize that I'm pretty normal. How many women NEVER feel uncomfortable in their bodies? Probably none.
This experience was a reminder to me of the tools I have developed and have stored in my recovery 'toolbox'. My discomfort led me to identify those intense feelings, interpret them in a rational way, and eventually move on with a peaceful feeling.
The best part? I continued to feed my body with the proper food and amounts without hesitation.
Without apology.....♥

Wednesday, March 3, 2010

Self Harm --> Self Care

When I was miserable as a child, and at age 13 began dieting in an attempt to be accepted and 'pretty', I had no idea that this would result in an eating disorder that held me captive for over 35 years.
Until only recently (the last few years) have I realized that the behaviors that I engaged in as an attempt to SURVIVE, were actually self-harming behaviors. I was literally hurting myself in an attempt to survive the pain that I could not handle. Trading pain for pain?
I have never 'cut' myself, but I can now see that the 'pain' of starvation, and the mindset of deprivation and ignoring my needs truly fit together with the forum of harming myself.
I felt anger, resentment, anxiety and great fear, but I did not know how to express those feelings at all, nor did I even recognize them at the time. The 'harm' and pain I was inflicting on myself was, I believe, not consciously aimed at ME, but at the people around me. In my twisted, ill-equipped psyche, I can see now that I was attempting to hurt them by hurting myself.
Kind of an 'I'll show them' attitude, but very passive/aggressive.
Yes, the people in my life were hurt by seeing me hurt, but I was obviously not solving anything with that approach. Again, none of this was evident to me during the time it was happening.
I now believe that an eating disorder does fall into the spectrum of self-harm, and like cutting, burning oneself or any other direct injurious behavior, this becomes cyclical, ebbing and flowing over time.
Another important aspect to self-harm is the lack of concern for one's health or safety. While in the midst of it, the severity is not recognized or even believed. It is a coping tool that seems to work in the moment, bringing about a pseudo relief. But the truth is, the boomerang effect is much more painful and long lasting. Solving nothing, it truly adds to a person's shame and lack of respect for themself.
Recognizing that this is what is happening is the first step to changing. Talking to someone, and/or seeking professional help is critical to moving beyond self-harm to self-care.
The key to changing is developing new and safer ways to deal with pain, shame and low self-esteem. One of the necessary steps is learning that you can control how you express or react to your emotions, instead of automatically allowing them to control you.
Increased awareness, over time, will help you to protect yourself from situations that may trigger feelings or beliefs that have played part in the harmful behaviors in the past.
As you are able to replace the old behaviors with those that do not harm, but that truly do help, your belief in your own power will increase and prepare you to move forward.
Self-acceptance and embracing who I am, 'without apology' has been THE most healing viewpoint for me in my recovery.
My words here show only a very small picture of this issue.
Life is precious. We are here on this planet together for some reason.
Why would I choose to hurt myself?
Without apology....♥