ED Reflections, no. 10

Hello from Pareeee!!! I'm probably eating butter and cheese as you read this...haha...how ironic!

Alright, let's wrap this up, shall we? When I left off last time I was describing how I'd started bingeing and purging again after two years of anorexia. While my bulimia behaviors at this time were seemingly the same as they had been before, during, and after college, something had changed. The difference was that I really, really, really began to need to binge and purge. I started becoming more and more rigid in those routines because they allowed me to stop feeling, to go numb, to disengage from all the things in my life and about me that I couldn't deal with.

Ultimately, it was this that made me reach out for help. I knew that as badly as I wanted to binge and purge on any given night that it was only going to get more difficult to resist it in the future. Put simply, I had begun to experience a kind of panicked withdrawal when I was unable to binge and purge, and this really scared me.

So, I called my student health center and asked to see a therapist as well as a nutritionist. After just a few appointments, the nutritionist referred me to a medical doctor who specialized in ED patients. It's important to note that I was still in full denial at this point. Remember, I hadn't decided to get help for anorexia; I was in the doctor's office because I was scared of losing myself in an abyss of bingeing and purging. I didn't think there was anything wrong with my weight, and thus I was not receptive to the entreaties that the nutritionist and the MD made for me to eat more and exercise less.

Obviously my doctor didn't appreciate this, and she quickly assessed my symptoms and ran some baseline tests to determine how much damage I was doing to myself. In addition to having lost my period, I was severely anemic and clinically depressed. (Starvation literally shuts down your brain in a number of ways.) What worried my doctor most, however, was my heart rate, which was thirty seven beats per minute. Heh. I was pretty proud of that number, since I knew my pulse was slow and I was convinced that it meant I was in great shape. My doctor didn't see it that way, and immediately ordered more tests for my heart. She told me that my heart rate was so low that she was considering immediate hospitalization. Despite being proud of my heart rate, the idea of hospitalization scared me. (That seemed serious---duh!!!)

She didn't hospitalize me that day, but she did urge me to try an anti-depressant and she also set up non-negotiable appointments for me with her, with the nutritionist, and with an ED psychologist. I refused the Prozac and started what would be a long series of appointments with my medical doctor and my therapist. (I never quite clicked with the nutritionist, so after awhile I stopped seeing her.)

I saw my therapist, whom we will call Leslie, for over two years. I saw my medical doctor every few weeks for about a year as well, though it was Leslie who really got me through the worst of it. She listened to me. She offered me helpful strategies for coping with stress and anger. She got me into a therapy group that focused on altering my ED thoughts and behaviors. And most importantly she became the sane sounding board that I used to determine which thoughts in my head were worth encouraging and which ones were a function of the eating disorder. I can't remember the number of times she kind of "clued me in" to the subtle and harmful ways that I'd learned to talk to myself and think about food, body image, and weight.

I gained weight very slowly. I was adamant that I could recover without gaining much weight, and in particular I was adamant that I would not be that recovered anorexic girl who got better only to end up overeating and maybe even overweight. Even more difficult than gaining weight was the struggle that I undertook to get my period back. My doctor had my hormone levels tested when I first came in, and these tests revealed that the hormones responsible for menstruation were far too low for me to have a cycle. These numbers became my enemy, since getting my period back became a symbol of recovery (and something that would get my team of drs off my back) and these numbers kept standing in my way. Even with prescription hormones that were supposed to induce a cycle, I was still, for nearly three years, unable to have a period. During this time my doctor also hassled me to have a bone density scan to check for bone thinning, but I resisted this and kept my focus on getting my period back. I stopped running as much. At first I just ran for 55 minutes instead of one hour. Then I dropped it to 50 minutes. And I kept testing my hormone levels. I remember one particular day when I was confident that my levels were better and yet my doctor called to tell me that they were still too low and I wasn't improving fast enough. She urged the bone density scan again, as well as hormone replacement therapy to prevent any further bone loss. I balked at the thought of taking hormone replacement therapy. I mean, I was 28--I couldn't be taking the same menopausal medicine that my mother was taking! So I cried. And I cried. And I got into my car and drove about forty minutes to Lyons, Colorado where I just parked my car and cried some more.

David was invaluable at this time. He listened every time I called and cried or complained or worried, and he really became my partner in all of this: suggesting ways to overcome my bad habits, encouraging me to take on new good habits, and just generally supporting me in all the ways I needed to be supported during recovery. Finally, it happened. I had my hormone levels tested and they finally came back within the "normal" range. And approximately two or three months after that, I got a "visit" from an "old friend" that I hadn't seen in some time. In part as a celebratory gift David got me a new road bike, which we affectionately named "Flo."

Therapy, and recovery, are ridiculously difficult. Every single improvement I made came along with anxiety and additional issues that I would have to confront. For example, I had to learn that not everyone could support my recovery in a way that was healthy and helpful for me. At the beginning of my recovery, when I told a friend that I was going to gain five pounds, he advised against it, saying that I looked "great" already. Sigh.

The only recovery advice I have is to keep trying and to keep trying to move forward. I still struggle with old and new eating disorder thoughts and behaviors, and trying is all I can do. I was going to write more uplifting stuff to finish off this post, but I don't want to give off the impression that I'm fine and completely "cured" now. I'm not. I'm pretty confident that I never will be. But, I am a lot better.

*I've wrapped all this up somewhat abruptly--is there anything I've left out that you're still curious about?