Information & Various Musings on Chronic Anorexia Nervosa

The Media does NOT cause Eating Disorders

2008-04-03T06:06:00.000-07:00

Repeat after me: THE MEDIA DOES NOT CAUSE EATING DISORDERS!

Phew ok that feels better, honestly it is so frustrating to see what is essentially proving to be a Neurobiologically based illness being associated with nothing more than a media influenced strive for thinness. Anorexia Nervosa was first officially identified in 1689 by Richard Morton, and there are unofficial case histories of the illness dating back to ancient Greek and Roman times, so tell me where was the media back then? Anorexia Nervosa has existed throughout history regardless of the existence of mass media and irrespective of body cultures of the time. So how is it that the media of today is suddenly to blame? Quite simply it isn't!

It's been a while...

2008-04-02T11:01:00.000-07:00

It has been quite sometime since I lasted posted on here. Like many things I suppose sometimes we start off with a flurry of activity and promise but then things like life and other distractions take over and get in the way.

The initial impressions of my new Therapist are promising. I have only had 2 sessions with her but so far I like her approach, it is far more action orientated rather than the traditional "navel gazing" tell me about your childhood experiences which I have found to be unhelpful in the past. She has encouraged me to keep a record of my negative thoughts and emotions and the circumstances in which they arise, by doing this I am hoping to be able to firstly identify triggers and to then begin to learn and put into practice a healthier response to them. Nutrionally and Weight wise at the moment I am stable, albeit a few kilos below my personal healthy setpoint, although the Anorexia would prefer that this was different (I am ignoring what it wants, it can go to hell with what it wants as far as I'm concerned!). I have been managing at least 2 meals a day plus a couple of snacks on most days and meeting my calorie requirements most days, there is definitely room for improvement but I'm getting there.

Apart from Eating Disorder related matters, my husband and I have just bought our first home. A lovely little semi detached 3 bedroom house with polished floorboards and a brand new Kitchen for me to cook all manner of healthy nutritious Anorexia fighting meals in. I love the place, my husband loves the place, our cat loves the place...we are all very happy here :)

Despite my continuing battle with Anorexia progress is gradually being made and life is moving in a positive direction.

It's all your fault Mum....or is it?

2008-01-24T12:59:00.000-08:00

Growing up with an Eating Disorder in the 1980s most of us were lead to believe, by the conventional wisdom at the time, that Anorexia Nervosa and other Eating Disorders were the by product of some sort of dire Family Dysfunction. You developed an Eating Disorder because somewhere, somehow you're Parents had done something wrong and the Eating Disorder was a conscious or unconscious (depending on your point of view) way of dealing with that fact.

I held to this (now) outdated belief for many years. After all it was what I had been "taught" to believe, any book written on the subject at the time always seemed to emphasise the role of the family (and of the Mother in particular). I believed that all I had to do was to work out exactly what went wrong, accept it, deal with it and in time all would be well. There would be an almost "light bulb" moment of realisation where the veil was drawn back and suddenly everything would be clear, things could be worked through and all would be right with the world once again. I am not going to speak for anyone elses situation, but for me personally I no longer believe any of the above to be the case....and trust me if anyone has a reason to blame their Parents for their Eating Disorder I would be a pretty good candidate, seeing as a description of my family reads like a Hilde Bruch Case Study.

So what changed my mind? a number of things. First of all the fact that plenty of other people are raised in similar or even worse situations and don't go on to develop an Eating Disorder...Second of all the fact that there is now (in my opinion) overwhelming evidence of a Neurobiological component to Anorexia Nervosa (in particular) and Third (and most of all) the fact that I have spent countless hours over many years, both in Therapy and through my own personal soul searching, understanding all the nuances of my Family history, interaction, problems et al, what if any effects that has had on my emotional development/development and continuation of my Eating Disorder and for the most part have dealt with/come to an understanding of it. And none of it, not one shred of this knowledge or understanding has made one iota bit of difference to whether I continue to suffer from Anorexia or not.

So what do I now believe to be the most likely cause of Anorexia Nervosa within me? Quite simply I believe my Anorexia is a Biological Anomaly which has become a Maladaptive Coping Mechanism. Unlike the vast majority of people on this planet starvation for me is exceedingly pleasant, it produces a real feeling of calm and stability within me which goes beyond just the psychological aspects into the realms of an actual physical feeling of tranquility and centredness. It is not unlike the effects that someone else may experience upon taking an Anxiolytic (anti-anxiety) type medication. Over many years it has been easy for me to respond to stress, anxiety and other stressful emotions or issues with starvation because, quite simply, I know it's going to work to relieve those feelings, and thus overtime it has become almost like a learned behaviour for me, a maladaptive coping mechanism in response to any and all negative stresses et al because it is what I know will provide relief.

Based on this realisation/knowledge, in future both my own personal and therapeutic work towards (one day hopefully) overcoming this illness will be twofold. 1), restoring my weight and nutritional health back to a level which is normal and healthy for my individual circumstances (age, metabolism, build etc) and 2) discovering, learning and putting into practice healthier ways of coping with stress, anxiety et al until the compulsion to starve in response to negative emotions etc is no longer my default choice of coping.

How did it come to this? The history/story of my Eating Disorder thus far.

2008-01-20T06:06:00.000-08:00

The first stirrings of something being amiss began when I was around 6 years old. I suffered from a childhood Anxiety Disorder and this, coupled with other issues such as family problems and bullying (NB I do not believe my family is in anyway shape or form the cause of my Anorexia, I will explain what I feel is the cause of my Eating Disorder in a later post) lead to my feeling very overwhelmed, "large" and conspicuous in the face of it all. I began to feel as if I just wanted to shrink away, to make myself very tiny so that the anxiety and all the other bad things wouldn't be able to find me (how innocent and childish it all sounds now).

The behaviours began 2 years later at the age of 8. Initially they were not in response to any body image issues, mainly because at that age most children do not have the cognitive awareness to always realise that I desire outcome A therefore if I do behaviour B it will lead to that outcome. Indeed up until the age of around 10 the eating behaviours and the feelings of being too large ("fat") and wanting to shrink to be smaller ("lose weight") were two completely separate issues. The behaviours themselves actually started out as a child's talisman game of sorts, the type of game where "if I make it to the corner before the lights change, so and so will be nice to me at school today" except for me it was "if I eat 3 bites of this, 2 bites of that and don't eat something else at all then I will be "safe"" . Within a very short period of time I realised that food restriction has/had a rather interesting and paradoxical effect on me. Instead of it being something that was unpleasant and to be avoided at all costs, I found that restricting food actually had an exceedingly pleasant effect on me, it made me feel very calm and grounded. As you can imagine for someone who already suffered from frequent bouts of anxiety at the time this seemed like an "answer" to all my problems. To my child's brain it was simple really if you're stressed and/or anxious then restrict food and you will feel better. Very rapidly food restriction became my standard response to any and all stress and anxiety in my life, but soon it also began to take on a life of it's own. What was initially something which happened as a response to stress, became more and more compulsive. I began to feel as if I "couldn't" eat normally and if I dared to disobey then I had to suffer the consequences. Playtime instead of being fun and carefree became endless rounds of compensatory exercise and if I ate over a certain amount of food in a day then I had to be punished in someway, for example with even harsher food restrictions for the next few days or not allowing myself to do something I enjoyed.

At the age of 10 the body image issues (feeling too large, as if I took up too much space, wanting to shrink, lose weight, be thinner/smaller) and the behaviours came together and from that time onwards the disorder took on the added dimension of active weight control and a means to achieving a certain desired - albeit unhealthy - outcome (ie to become smaller/shrink myself down). Prior to this age, most likely due to as I mentioned my cognitive development at the time, if anyone had asked me "why aren't you eating properly" they would not have received a response such as "because I feel fat" or "because I want to lose weight and be smaller", instead they would've heard something along the lines of "because it makes me feel safe" or "because I feel calm when I don't eat". This is actually something that people should be aware of when dealing with childhood onset of Anorexia Nervosa, below a certain threshold of age it does not usually present as the typical case where the sufferer claims to feel "too fat" and voices a distinct desire to control their food intake in order to affect weight loss.

Fast forward to age 16. The preceding years had been taken up with an ever increasing obsession regarding food, dieting, exercise and anything on Anorexia Nervosa I could get my hands on at that time. Anorexia was a subject that fascinated me and I felt a real sense of kinship, of kindred spirit, with sufferers of the illness not realising, or rather not being willing to accept, that I was a sufferer myself. By age 16 the restrictive form of the illness had given way to the purging subtype and for the first time I began to accept that maybe I really did have a problem that I needed to address. I had had thoughts that perhaps something was quite right prior to this, from about the age of 12, but denial was a strong point in my illness and I always ended up "talking" myself out of any notions of there being a problem...."I don't have a problem I'm just on a health kick", "I don't have a problem, I'm just watching my weight", "I don't have a problem I'm just not a big eater" and so on and so forth. Finally though my wall of denial was broken for long enough that I accepted that yes I did have a problem and yes I needed help with it. So I made an appointment with a General Practitioner and set about trying to get some help for myself (bear in mind that by this stage I had already had 8 years of an active Eating Disorder...more than 7 years is considered a chronic form of the illness).

To say that the appointment didn't go well would be the absolute epitome of the word understatement. I sat in front of this man, at 5'7 weighing 42 kilos, and poured my heart out, I told him how terrified I was of eating, how not eating made me feel safe and calm, how I still felt fat despite my low weight, that indeed I desperately wanted to lose more weight. I laid all my cards on the table and was greeted with (paraphrased) "I wouldn't worry about it too much, all teenage girls go through a phase like this, you're not that thin and you haven't lost your period (NB I have never ceased menstruating in 27 years of illness and that includes at weights well into the emaciated range) so I think you're fine". Needless to say I did not try and seek help again for quite sometime after this first initial disastrous attempt to reach out. Indeed it wasn't until my illness had quite literally become life threatening (due to sever electrolyte imbalances from laxative abuse causing cardiac arrhythmia) that once again I reached out for help.

Around the age of 18 I entered into an outpatient treatment program and began attending a local support group for sufferers of Anorexia and other Eating Disorders. With the help of the support program and the limited sessions as an outpatient that I attended I managed to cease the binging and purging behaviour, although the restrictive behaviours remained a problem for me. Of course my response to this, as was my tendency, was to fall back into the seemingly safe and happy land of denial. I stopped treatment and stopped attending the support group because in my mind I firmly believed that once I "grew up", once I had my own place and my own adult responsibilities to worry about this Anorexia nonsense would somehow just miraculously go away. Obviously I was very wrong on that point and obviously it didn't.

By my early 20's I continued to struggle with the compulsion to restrict food along with the other Anorexic obsessions such as weight and the "desire/urge" to be ever thinner. Then I began using various chemical substances, Ecstasy, Acid, Speed, Pills, anything and everything I could find that would alter my consciousness in some way. I used and abused drugs for several years, culminating in an addiction to Heroin that I battled for 2 years to overcome. During this entire time I (wrongly) believed myself to be recovered from my Eating Disorder. Let's see just how recovered I really was...I still could not deal with being a normal weight or indeed being above a certain threshold of weight, I still struggled with the ability to eat normal regular meals and the drugs themselves had partly become just another method in my weight control repertoire. All the drugs managed to was to cover up the issues and push them sufficiently enough from the forefront of my mind that it allowed me to slip almost imperceptibly once more into a state of denial. The fact that during my battle with Heroin addiction a 2 kilo weight gain had me immediately reaching for a syringe full of the stuff to immediately shoot into my veins with the knowledge that it would make me violently ill and therefore hopefully register a loss of weight on the scale (and that indeed if I was honest with myself at the time, my use of Heroin was in part simply an alternative method of purging) probably should have given me some idea that perhaps I wasn't quite as "recovered" as I imagined myself to be, but denial is a funny and powerful thing sometimes. By the age of 30 I had managed to overcome my drug problem and win the battle against addiction. And forthwith, as if within a vacuum that had been left behind after the battle with drugs was over, promptly and completely "relapsed" straight back into full blown (restrictive subtype) Anorexia Nervosa.

This brings us to the present day. At the age of 31 with the help, support and encouragement of my ever patient and most loving Husband and an online support group for sufferers of Eating Disorders that I am a member of (whose name/URL will remain anonymous out of respect for the privacy of fellow members), after many years spent struggling with this illness and more years than I care to remember spent living in a world of denial, I finally began to walk along the road called Recovery. It has not been easy, there has been many a slip up, detour and even a couple of relapses along the way, but I continue to plod along, placing one foot in front of the other, taking it one day, one meal at a time and trying to remain focused on the path ahead. Currently I am partly weight restored, still technically underweight but at a safe (although obviously not desirable) level and managing (on most days) to maintain a reasonable level of nutrition. Statistically speaking, having developed my Eating Disorder during the childhood years and having a chronic form of the illness for more than 25 years, the chances of my actually making a full recovery are not that good, but the battle continues....as a very wise friend of mine once quoted to me "shoot for the moon, even if you miss you'll still land amongst the stars".

A Welcome and an Introduction.

2008-01-20T05:43:00.000-08:00

I was inspired to start this blog by Laura of eatingwithyouranorexic.blogspot, whose excellent blog is helping to dispel many of the myths and secrecy surrounding the illness of Anorexia Nervosa and whose advocacy is helping to build better understanding of and better/more effective treatment options for those who are unfortunate enough to be afflicted with this illness.

I am a 35 year old woman who has been "living" with Anorexia Nervosa (in varying degrees of severity) for the past 27 years. I first developed the disease in childhood (age 8), at a time when Anorexia Nervosa was not well recognised in children, hence the illness went unrecognised and untreated for many years.

The purpose of this blog is to share information on Anorexia Nervosa and hopefully to try and dispell some of the myths and misinformation that still abounds and to also allow you an insight into what it is like to "live" with Chronic Anorexia Nervosa.

I look forward to your company as I share my journey and the knowledge I have gained over the years.