It’s been two days since I last binged or purged! I’m so incredibly proud of myself for this accomplishment. It has also, coincidentally, been two days since Pippa my puppy last peed on the carpet!
I have come leaps and bounds over the last couple of days, with regards to my bulimia. And notice here the vocabulary used: my bulimia is getting better, but my EATING DISORDER is still hanging around. This is a distinction, as I’m starting to conceptualize, bulimia is not the eating disorder. Bulimia is a symptom of my eating disorder.
My eating disorder encompasses my narrow view of “good” eating. It is a judgement on myself and my eating, and it all ties back to my self-esteem; how worthy I feel I am of eating. And that’s all there is to it. I don’t deem myself to be worthy of eating, so I have constructed a particular viewpoint towards food that allows for bulimia to enter the scene.
So , as you may know, I have just recently started taking prozac, an antidepressant medication that is sometimes used in treating bulimia. I suspected a couple of day ago that it had started working. However, I am now totally convinced of its magical healing powers. I have no appetite! No cravings! No binges! No overeating even! I am able to look at food without being driven mad! It’s an amazing transformation. I feel so happy, so free.
Mu mother raised the point with me that perhaps the prozac was going to take me too far into the world of anorexia. To that I say, yes it may. But it’ll be infinitely easier to treat a straightforward, restrictive, anorexic type eating disorder without the bulimia getting in the way of things. Treatment now becomes a clearcut path towards “eating more” and “having a better relationship with food”. It doesn’t involve binges. It doesn’t involve the self-harming aspect that is purging.
It all feels more manageable today. I can do it.
My eating disorder is constantly shifting, changing. I can feel its slithering, scaly skin under my grip as it squirms. I can tell, that even now it has been so established, it changes. Never is it static, never lets me stagnate. Continuously I find glass ceilings to break; I never allow myself a moment of peace OR quiet.
I think that perhaps this change however, is a good one. I recently started taking Prozac, and I’m starting to think that my eating shift must be connected to this. My eating lately, over the past few days, has been much less horrible. I’ve had much more manageable levels of cravings, I haven’t binged and I’ve even eaten fairly restrained portions. My purging has decreased to around once a day, which is practically a miracle in and of itself. Today I started to binge, and then just stopped. This doesn’t happen, ever. When I begin a binge, I don’t stop until I’ve eaten everything available.
I am hopeful for a couple of things from this situation:
Firstly, I hope this connection between the Prozac and my eating is real. It’s possible that it’s a total coincidence, and that my eating isn’t actually improving. It’s probable that my eating won’t improve steadily, but I’m hopeful that it IS improving. It would be a major step forward to get my purging behaviors under control.
I was chatting with a counselor at the eating disorders clinic in Victoria, who had some interesting theories regarding my specific case of disordered eating. I used to think that I was originally struggling with Bulimia nervosa, and turned to Anorexia nervosa as a solution. Meaning that I had issues with bingeing and purging, so as a solution I stopped eating altogether. This counselor interpreted my eating disorder as being a disorder of restriction. With my overly restrictive eating patterns, I likely don’t get enough nutrients to fuel my body. This fuels my insatiable cravings, and gives me reason to binge and thus, purge. This would change my perspective about my eating disorder so much, and would explain a great deal of my struggles. It would explain why my strategies to get better and to stop purging have been failing; I’ve been trying to combat my eating disorder as if it were a classic bulimic story. But bulimia isn’t a usually restrictive diet. That must be the missing piece in my logic train: I am not a classic bulimic. I have an issue with being overly restrictive, the solution to which is bulimia nervosa. To treat the problem, I must focus on the overly restrictive perspective of food that I possess. I’ve therefore been going about my treatment all wrong! Trying to restrict more is just making my bulimia worse. To treat this disorder, I’ll have to treat the underlying anorexic mindset that I have in place.
This prospect excites me highly, because things are starting to make more sense now. I hope that the Prozac is working. I hope that it continues to work. I hope I hope.
I participate in many forms of treatment for my mental illnesses. There isn’t a single “cure” for any of them, therefore the treatment must be approached from many different sides. I take a combination of prescription drugs and natural remedies. I see two different therapists, who both have distinctly different approaches and views.
My medication journey is a long and tired road, commencing in September 2015 with a prescription for lithium to treat a misdiagnosis of bipolar one disorder. Ever since then, I’ve been experimenting with a variety of different combinations of psychiatric drugs: lithium, valproate, abilify, olanzapine, venlafaxine, prozac, cipralex, rispiridone, seroquel and ativan. I currently take abilify as a mood stabilizer, venlafaxine as an anti-anxiety and anti-depressant, and prozac as a treatment for bulimia. The first two work well for me, and the third (prozac) is new, so I have no information about its efficiencies. Taking prescription medication can be really hard. My issues stem from the thought that “I’m not good enough on my own”. It feels like a weakness, rather than an illness. I feel guilty for having to take these medications. Here is where one can use the cancer comparison. Say you had cancer. Would you feel guilty for doing chemotherapy? No? Then you, by the same logic, shouldn’t need to feel guilty for having a mental illness and for having to take medication to help your symptoms.
To treat some of my borderline symptoms, such as the feelings of emptiness that I experience, as well as much impulsivity, I use medicinal cannabis. This is a rather stigmatized thing, however, it helps my symptoms immensely. When I use cannabis, I take it orally, and I take only Indica strains. This is a strain that has more of a mellowing effect, and tends to relax rather than excite. I take anywhere from 17.5 mg THC to about 100 mg THC. The amount depends on the severity of my symptoms at the time. I turn to cannabis when I feel extremely impulsive, or when I feel unbearably empty. It can also help to break a bingeing and purging cycle.
My therapy is a double edged sword, with two different therapists playing a role. My private therapist is a DBT (dialectical behavioral therapy) specialist. DBT is the most often recommended treatment for BPD and chronic suicidality. It was developed in the 90’s by Marsha Linehan, who is my personal hero. She suffers from BPD as well, and she created a treatment to help her personal symptoms, and with her treatment of her own symptoms, she managed to create a whole treatment plan for an entire demographic of BPD sufferers. The therapy itself is of the approach of radical acceptance. This is the idea that it is possible to both be content and happy with something – accepting it – while simultaneously striving to do, or be, better. In this therapy, which I attend once a week, we do tons of behavioral analysis, meaning that my therapist and I deconstruct events in my life to identify triggers, and learn from mistakes made. DBT believes in the powers of both distraction and mindfulness, and thus draws on theories relating to these for treatment plans.There are many skills and strategies that come with DBT, including my self soothe kit (a bag full of things that calm me down or cheer me up), mindfulness strategies and distraction techniques.
My second counselor takes nearly the opposite approach, by trying to fit everything into a bigger picture to make sense of my symptoms. While my DBT therapist is extremely granular, my counselor is very abstract and theoretical. We do a lot of thinking, realizing and epiphanizing during these sessions, which I also attend once a week.
I see my psychiatrist regularly once a month, but more often if I happen to go to the hospital anytime in between.
I try many lifestyle treatments too. By adjusting my creative output and thinking, using mindfulness techniques such as meditation and reducing the stressors in my life, I am able to maintain a semblance of control over my life. I use this blog as a method of reflection, and it allows me to verbalize end express a lot of my emotions in an indirect method of communicating, which I find I am more comfortable with in general.
I also am training my dog Pippa to be (eventually) a PSD (psychiatric service dog). She will be trained to alert me to mood changes and remind me to calm down. She provides an acute anti-anxiety treatment, as an alternative to drugs such as ativan or seroquel.
My treatments are many-pronged, and varied. However, this strengthens the approach that I take towards my mental illnesses. From drugs to cannabis to dog therapy to lifestyle choices; the focus of my life at the moment is working on myself and healing my mental illness.
Seven months. Seven months that feels like a total lifetime. Seven months is how long I’ve been struggling with an active, head-rearing, rampant eating disorder.
My eating has been on the “disordered” side of the eating disorder spectrum, without being a fully fledged, diagnosable eating disorder, for a long time. It all started in September 2015, which is when I got my first mental health diagnosis of Bipolar 1 disorder. While, as you will know if you’ve been reading along, I do not actually HAVE this disorder, I was treated for it for the better part of a year. This treatment was mostly the introduction into my system of harsh mood stablizing, anti-anxiety, anti-depressants and anti-psychotic prescription medications. Lithium, Seroquel, Ativan, Cipralex, Olanzapine, Rispiridone, Venlafaxine, Abilify, Prozac, Valproate. This huge medicated cocktail of a body (note, I did not take all of these all at the same time, but many of them were taken together to create the aforementioned cocktail), was turned into practically a walking, talking side effect. I got tremors from the lithium, I got muscle stiffness from Rispiridone, I was drowsy from Ativan and Seroquel. And nearly every single one of these medications had a side effect of weight gain.
Starting out, I was on Lithium, Rispiridone and Seroquel. Here, Seroquel is the biggest weight gain-inducer out of the bunch – naturally I hate this medication. To this day, I have an aversion to it, along with most of my other medications. So, in order to try to prevent this imminent and seemingly inevitable weight gain, I went on a diet. It seemed the sensible thing to do. I started slowly, by eating less dessert, eating smaller portions and small things like this. Slowly, very slowly, it started to take over my life. I began counting calories. Then I started to restrict my calories. Then I banned certain foods altogether. I would get undeniable cravings – I would stuff myself full of food, until I reached my calorie limit (which at one point was as low as 1200 kcals a day, but usually averaged around 1450 kcals a day). I would eat my entire days worth of calories in a 30 minute binge, then continue to not eat anything for the rest of the day. The worst part of this situation? I actually thought I was being healthy, and making good decisions for my bodily wellbeing. While I obsessed over my weight, and over calorie content and over food, I actually ended up losing weight while on this diet/medication combination. Not a lot of weight, but around 5-7 pounds were shed during this phase of my life.
When this combination of medications didn’t seem to be doing the trick, and the side effects were outperforming the functionality of the medications, I switched from everything I was on to a singular force: Olanzapine. Also known as Zyprexa, this is an interesting medication for me. I have an absolute burning hatred for this medication, and for what it did to me. Unfortunately, this is at complete odds with the fact that it actually seemed to keep me stable. I functioned pretty optimally, if not slightly drowsy constantly, while taking Olanzapine. Of course this would be the case.
While on Olanzapine, my anxiety started to worsen, and with that, the food cravings followed. I would binge regularly. Inevitably, with the extreme medication and the extreme food related behaviors, I started to gain weight. I stopped counting calories, and started eating my feelings. I didn’t stop eating, not until I had gained 30 pounds in under 3 months.
Finally, come December, the last straw was accounted for, and my eating disorder came into being. It was not all at once, but rather piece by piece. I began taking laxatives purchased in secret from the pharmacy, occasionally at first, then transitioning to a regular occurrence; perhaps even daily. Then, Christmas day, I became a member of the full-blown eating disorders club, when I purged (vomited after eating) all of my giant turkey dinner.
So that was how it all began. It would continue to grow, transform and mutate over the next seven months. My new year started with me stopping my Olanzapine and starting on a newer drug called Abilify. It was supposed to have no weight related side effects, and it proves correct. This is the mood stabilizer/anti-psychotic/anti-depressant/amazing, calming medication that I am currently taking.
In addition to stopping my intake of Olanzapine, I stopped eating almost altogether for a month. I was restrictive to the extreme. During a whole day, I’d consume a singular rice cake, plain. This amounts to a whopping 50 calories per day. I lost 10 pounds in 2 weeks.
It progressed from there into utter bulimia. This means cycles of bingeing and purging, eating and vomiting. Flash forward to present day, and you will find me in a desperate situation: with intense cravings and compulsions to eat. These get so bad that sometimes while at work, I will even eat soil from the plants, paper from the receipt printer.
Food is such a multifaceted concept for me now. I both love it, am a slave to it, worship it; and hate it, despise it with all of my being. I am obsessed with it, constantly craving, always wanting. I feel so much guilt. Plagued by this guilt, I eat to comfort myself, then I purge away the guilt. The cycle continues, feeding into itself and fanning the flames.
I am now at a completely normal weight, having lost all the weight that I had previously gained while on Olanzapine. However, my bulimia persists.
But, I too, persist. I fight, every single day. Battles against urges and compulsions and cravings; wars are waged inside my body on a daily basis. I feel sick if I eat, I feel sick if I don’t vomit. My body has no clue as to what to do with the foreign concept that is food. But still, I eat. Still I try. I wake up every day with mountains to climb. My eating disorder clings to my heels as I hike, but on good days, it falls behind and loses momentum – in other words, I emerge from the rubble victorious.
Will I ever recover? I must believe this. Will I ever be able to go back to “normal” eating? I think not. I will always be wary of chocolate cake and bacon. I will always consider the calorie content of food. I will always be cautious of going to the toilet after eating. But I have faith in myself, that I will learn to appreciate the art of food once more, that I will return to a place of functionality in my eating. This is my dream. I will, eventually, eat and be happy.