anxiety and my eating disorder

Again I scrutinize the mirror, willing it to answer.

My reflection stares back, frustrated and expectant.

Do I even know the question anymore?

I don’t like talking about my eating disorder. Or perhaps, let’s personify “my eating disorder does not like being talked about.” I am not one of the teenagers who had a bout of anorexia, went to treatment and was able to move on. Atypical anorexia has burdened me for over half my life. I don’t think it is cured for all of us. Rather, in some, it becomes an illness like substance abuse that one must work at to avoid relapse.

This is where I find myself. The question used to be “am I fat?” or some variation of that, but aging and some measure of recovery and wisdom now points to the question being something more ambiguous like “am I good enough?” which will never be answered in a mirror nor will be changed by any measure of activity, body weight, or food intake.

I’ve never known good enough, but that’s beside the point. The point is my anxiety wants me to believe that if I just [insert eating disorder behavior here] I will be good enough [not fat]. When I successfully laugh at my eating disorder’s irrational process I am still left with tummy-swirling, chest stomping anxiety. 11 years of therapy, a few medications, various self help tricks, advice, and the single most helpful technique aside from exercise (which can bring with it potential problems particularly if you’re in recovery from an eating disorder.. moderation) is distress tolerance.

Sitting with the distress. Tolerating the feelings and knowing they will in fact pass. It’s terrible, I know. I wish I had a cooler answer. There are lots of techniques to tolerate the distress and YMMV on which one(s) work the best for you, so try many, but yep, good job Marsha Linehan.

I Stopped Writing

I’ve done myself – and perhaps you – a disservice and I’m sorry.

I stopped writing. A quick jaunt through my previous posts and I smiled – I’m proud of the work I did; why did I stop?

Fear.

Right.

The truth is I did lose my mind a little. And as evidenced by literature, referrals I’m seeing in my inbox, the news, and my colleague burnout, I’m not the only one. Mine might have been a bit more intense than some, perhaps less than others. I needed care away from home to support me and that’s tough to acknowledge when you’re the professional.

I packed my bags, kissed my loved ones, and boarded that plane. Then I had to remember how to be the one cared for. The one encouraged to take up space in a group and not facilitate everyone else’s healing. The one trying a med change after 11 years because it was a safe setting to do so.

Being the patient. Being not in control of anything. And being ok with that.

He Would be 62 Today

With the exception of this blog, I have not mentioned my dad today. Which is unusual because today is his birthday. I always post a memory on Facebook about it but I avoid FB like the plague these days so I didn’t bother. Which means I also didn’t get the few supportive words I get from those anniversary posts. I had therapy today and didn’t bring him up. I chatted with my mom this morning and I did not mention him.

Recently I was confronted with a situation in my neighborhood that called up the painful memories of his life. He was a troubled man and his alcoholism and mood disorder often resulted in physical violence, of which I don’t cognitively remember but somatic memories still trigger trauma response and it’s been a trying few weeks.

So maybe I’m mad at him today. I was never mad that he died by suicide. But I was mad about his addiction. And I am mad today about his addiction, despite intimate personal awareness of living in addiction. I am mad that he never experienced sobriety and stability. That he didn’t “try harder.” I say this knowing the disease process of addiction, knowing what my family has seen me go through, knowing intimately the pain of mental illness and hopelessness. Both things are true. He was sick and fought a hard battle. He was also my dad who was forever inappropriate and unpredictable.

But I knew he loved me. I knew so young that he was limited in his access to expression of love. I “knew” that dads are absent and that any expression of love was always ready to be whisked away on the breeze. Thus I knew better than to place faith in the availability of that love. It was like the sunshine – warm when visible but cold when not. But I always knew that at some point, whenever I was in his presence, I felt loved.

So I think I’m mad because it’s hard to remember what feeling loved by my daddy is like.

Chasing the Next One?

I tend to develop an interest in something, learn as much as possible about it, how to be good at it, doggedly pursue it for a month or two and then fizzle. Currently it’s makeup and beauty. Over the summer it was Tik Tok. Previous years have included container gardening, essential oils, and bullet journaling. Within these hobbies always cycle Minecraft, the Sims, and Stardew Valley. It’s as if I’m addicted to new hobbies.

I just rid myself of about 25 bottles of essential oils that I never used (but were ABSOLUTELY NECESSARY for me to purchase at the time). Now I do have a few that I keep and do use and I do attempt gardening every summer and have managed to continue a very minimalist style of bullet journaling but like why do I go all in with a new hobby? I often wonder if it’s a low hum of hypomania. I’m always a gamer – that never leaves – but I get on these new hobbies and they become the most incredible thing I’ve ever done.

It’s gotta be hypomania because it does meet the criteria of goal directed activities, does often come with a slight uptick in spending (albeit very thrifty – I’m a bargain gal), definitely involves flight of creativity and energy and confidence in my newfound skill (perhaps unfounded confidence?) but it doesn’t disrupt my functioning. Yep that is textbook hypomania.

The existentialist in me finds this fascinating as that means there are facets to me that are not always present or even accessible and I apparently have no choice in the matter. The anxious self worries every time a new hobby starts that it’ll end up just another collection in the corner. To both, the pragmatist will declare “at least you are continuing to learn new skills.”

Turn On All the Lights

It is as if the corners of my mouth are fatigued. My cheeks have atrophied. The dreary gray of October has drained the life out of my face, like Winifred drains the souls of the children.

I am not quite sad, but less interested. The contrast of colors are muted, blurring one into the next; their vividness passing through the doorway of dull.

Monotony.

Anxiety in the dismal is worse than the frenetic angst. It calls forth demons of the past without warning. Does the smell not exist when the sun is warm or does the sun provide hope and reassurance, its absence known in the bleak fall?

Turn on all the lights.

The Funhouse Mirror

I referenced the mirror in a previous poem and it is with regret I admit I continue to be harassed by it. Certainly progress has been made, but I still suffer the endless committee meeting in my head discussing all the things wrong with my body.

Strangely (or perhaps not) aging while bringing its own difficulties has lessened the battle somewhat. I am nearing 40 and I have 2 teenagers. I workout 5 days a week and walk my 10000 steps everyday. I eat generally whole, clean foods with mostly balanced macros for my activity level. There’s really nothing more I can do that does not fall into eating disorder land. It is easier to accept my imperfections as I’m not supposed to look 20 anymore – not without plastic surgery anyway. So, acceptance is the answer to my problems today. Courage to accept what I cannot change.

The mental battle is fatiguing though, I will admit. I do slip into old patterns particularly when I’m very stressed but very quickly my cognitive functioning is impacted and it makes working difficult. As a therapist, I cannot be mentally tuned out during session. It’s very interesting indeed how important nutrition is to cognitive functioning. Consider that the next time you skip breakfast ☺️

September is but one month

As I looked upon her in her final hours, something began nagging at me. This same, strong woman, this same month 11 years ago suffered a hemorrhagic stroke. The same week of that year my then 3 y/o daughter was hospitalized. And not for the first time, I began losing my mind.

Looking back, it’s really not surprising I developed post traumatic grief when my dad killed himself 3 months later. I was already well entrenched in complex post traumatic stress from years of various forms of abuse and his death – no how he left – zapped my rather tenuous remaining grip on reality.

I didn’t actually lose my mind though certain people in my life at the time would say otherwise in attempts to cover up their own antisocial behavior. It is but an act of God I was an assistant in my university’s counseling department at the time of his death. Days after that New Year’s Eve 2009 I made a call to see a counselor. The journey out of abuse and untreated Bipolar Disorder would commence.

As I sit at her bedside, I begin to realize why September has been a source of somatic cues insisting dissociation and depersonalization is required for survival. My body has been trying to protect me from feeling the magnitude of fall 2009. I hold the recognized traumaversary trifecta in the present. I am able for the first time to be fully embodied in the present year of September, no longer held hostage by the past. Over a decade of therapy later, my cognitive self and my physical being are in sync. I am safe. The monster is no longer under the bed.

That, my friends, is the power of psychotherapy within the confines of a well established, structured therapeutic relationship.

I am grateful

I often forget the general population isn’t well versed in mental wellness, never mind mental illness. I am well versed on either end of the spectrum, both professionally and personally. In fact, during college and graduate school where many of my cohort were learning things for the first time, my response was more along the lines of “oh that has a name?!”

In medical school as well as training to be a therapist, there is the tendency to diagnose oneself with every disorder learned. I had already had a moderate handful of diagnoses before studying them academically so I skipped right into imposter syndrome by my second semester of graduate school. The critical voices in my head had a new sneer, “how can you help others when you’re a mess yourself?”

Indeed, in my third semester of grad school I found myself reluctantly agreeing with my therapist to enter treatment for my eating disorder following a collapse in dance class. I felt ashamed but also incredibly grateful to my dance professor who required clearance from treatment before she would allow me to dance again. Bless her everyday for setting that boundary.

So I forget that the whole world isn’t constantly engaged in coping with and studying mental illness. When my instinct with friends or family discussing their bad day is to use words like processing, stabilizing, grounding and phrases like “ask yourself if” or “what are you aware of in your body right now?” And they look at me as if I have a grown a second head. Granted they know I’m a therapist so maybe they chalk it up to “psychobabble” but I hate that term because it implies lack of sincerity on my part and I can assure you, I couldn’t be more genuine.

I wouldn’t know how to be any other way at this point. It is my job but it is also why I have a job and a family and a home.