Eating disorder

Theory behind an eating disorder

I’m torn.

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.

Anxiety · BPD · Eating disorder · Life

The many formed monster

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.

Life

Rational mind, Emotional mind and Wise mind

You may perhaps be wondering what the terms “rational mind”, “emotional mind” and “wise mind” mean, and how they relate to each other. These states of mind are all different types of thinking that can exist. We each use all of these thinking patterns (rational, emotional and wise thinking patterns) differently, and each one is characterized by differing ways of thinking:

Rational mind – This is the state in which logic rules. Where one is extremely factual and matter of fact about everything.

Emotional mind – This is the heart on the sleeve. In emotional mind, things can be quite impulsive and emotionally driven.

Wise mind – This is a combination of emotional and rational mind. If you imagine a venn diagram, wise mind would be in the center circle.

It is important to note that engaging the rational mind is the cure to an overwhelming emotional mind. The combination of the two mind states creates a strong wise mind.

I, personally, am nearly always in emotional mind, where impulsivity and frantic desperation live. So, sometimes to counter my emotionality, I can distract and redirect with facts. Doing math or genetics problems, homework, watching documentaries, thinking creatively (doing art, writing etc.), reading or thinking critically about anything really; all these are strategies that allow me to jump out of emotional mind. This aspect is what makes me such an exceptional student at school: When I engage my rational mind, I create a wise minded state, where I can function optimally. This state is so pleasant that I end up really enjoying schoolwork and the mindset it fosters in myself. This is also why I am so successful, generally, when I incorporate school, learning or other brain activities into my life. This summer, I plan to re-engage my rational mind more, by working through my genetics textbooks and keeping my brain creatively engaged, in art, especially in my writing exercises.

Feelings · Life

What’s going on?!

As has been previously demonstrated, I have a certain delusion regarding myself and my place in the world. I have a belief that I am simply not “good” enough. This story is one that originated in childhood. Somehow my underdeveloped brain decided that it was advantageous to think of myself as a lesser being, perhaps because it served as an excuse or a crutch to help me handle my intense feelings, and for when failure inevitably struck. Anyways, my thought process is thus: everything that happens is because I’m not “good” enough. Somehow I messed it all up.

I’m not good enough? Who defined “good”? What authority decides on “enough”? I allowed the media to help define these things, and the media is a harsh judge. It said that I wasn’t skinny enough to be “pretty”, wasn’t smart enough to be “clever”. And the worst of it? I believed all these false standards put in place, practically brainwashed into me, by the mainstream media.

So this is the current paradigm that I am trying to shift. Understanding that the people who defined “good” and “enough” know nothing of my life and thus cannot be the judge of me.

This is me, redefining good. Taking control over my own definition. From now on, I will be “good”. “Good” is whatever you make it out to be. From my unsightly scars to my bulging thighs: good. My quirky brain with its myriad of mental illnesses? Good. All that I am, is, in fact, good.

Goodness is totally subjective. I will evaluate good to be joyful, kind, compassionate, confident, truthful. Good is not perfect. There is no such thing as perfect anyways. I’m not buying into that bullcrap anymore. I’m not going to let a piddly little amount of self esteem spoil my fun in life any longer. As I let this go, I will make room for more of what truly matters to me, and what aligns with my values. No more of these superficial, judgmental, awful, unlivable and unattainable standards. Only peace and love is left.

(I think I might be turning buddhist guys).

Life

For those who don’t understand tattoos

My parents do not understand my obsession with tattoos. In their mind, it is a frivolous and reckless endeavor, which  overshadows any of the good aspects of tattoos. The way I see it, is as a deeply spiritual act. My tattoos all represent incredibly important values that I have, for example my earthworm tattoo represents my connection to the earth and to nature. My tattoos serve a purpose to me. My tattoos are all visual reminders of things I love, of values that I possess, of things that light a fire inside my heart. With my sensitive personality, I can be triggered into emotion fairly easily, and this includes good emotions too. I can glance at one of my tattoos, and the mere sight of it will fill my heart with warmth.

Tattoos also help lift my low self-esteem. If you’ve been following my story, you’ll be aware that my perception of myself is very different than my perception of other people: I see myself as being rather inferior to others. A big aspect of this is the physical; I have trouble finding anything good, that I like, about my body. Tattoos are permanent changes to your body – for the better. I love my tattoos, and I love the way that they look on my body. My tattoos make me more compassionate towards my own body, and more self-love is then cultivated.

I have plans for about a million more tattoos, I don’t think I’ll ever tire of them. My next one will be a quote somewhere on my left forearm/hand: “I have loved the stars too fondly to be fearful of the night”, along with a few speckled stars around the words. Along with this, on my right middle finger, will be the words “bowl of stars” (a line from my favorite song, “Mrs Potter’s lullaby) with each word taking up the space of a finger-segment. The finishing touch will be the word “star” on the fingers of my left hand, accompanying some more stars – the kind that look hand-drawn.

The others that I’m planning on getting are:

  • The little prince on his planet, which will be on my right thigh (this one is going to be bigger, so it will cost more, hence the absence of its existence currently
  • An Alice in wonderland/ballad of reading gaol inspired tattoo on the right side all up my back (again another larger piece) The ballad of reading gaol quote is the first three lines of the poem :”He did not wear his scarlet coat/for blood and wine are red/and blood and wine were on his hands”. The Alice in Wonderland element is that of a white rose being painted red by two playing card men. These elements will be very stylized and spindly (think Tim Burton-esque).
  • A series of affirmations along my right forearm, the first being “I choose to/be proud of/myself”, each affirmation being separated by a prominent semi colon.
  • The words “I am, I am, I am”, a quote from the Bell jar, with the words floating randomly around my right ear.

So, all of my tattoos and tattoo ideas are all very meaningful to me. They aren’t just pretty pictures, they have a heart and soul too. Covering your body with something that you love is a pretty special and spiritual decision to be able to make – it is a privilege to me to be able to get tattoos. It’s like sharing a piece of my own soul via symbolism, which is a very personal way of communicating my story with others. These tattoos are a part of me, whether they are complete, or simply ideas; they will always be there, no matter if they are visible or not.

BPD · Life

Psychiatric service dog training

As many of you will be familiar with by now, I am training a Psychiatric Service Dog (PSD) for my own treatment.

The first point of confusion is this: there are three classifications of dogs that provide support for humans. The first of these is called an ESA, or emotional support animal. These are dogs (or any type of animal) that have no formal training, and simply provide companionship and love to their owners. They usually help to alleviate loneliness and similar emotional states. They need no certification, besides a letter from your psychiatrist of physician stating your need for an ESA. The second classification is a Therapy dog. A therapy dog is one who visits institutions such as elder care facilities or hospitals. They provide joy and novelty to patients suffering from every sort of ailment. Special training is required to become a therapy dog. A Psychiatric Service Dogs are those who required for the owner’s wellbeing and independence. They are a subset of the classification of service dogs, who provide physical support for their owners, such as guide dogs. They are trained to perform tasks that help alleviate the symptoms of a psychiatric illness or disorder. They, as you will soon learn, require lots of training and are regulated and certified by the government.

My little puppy came to me at the ripe old age of 11 weeks. This is slightly older than the usual age that puppies join their new families, which is around 8 weeks. I found an ad on kijiji.com and in a whirlwind of emails, I bought her and brought her home. She is three quarters lemon beagle and one quarter king Charles cavalier spaniel. Its a lovely mix of breeds, and she is one of my favorite things in the world.

The treatment of BPD with a psychiatric service dog is quite novel. PSDs are fairly common for conditions such as anxiety or PTSD. But borderline? What can a dog do for borderline?

A dog can do a lot for a borderline. First and foremost, because of my BPD, I feel a combination of unloved, abandoned, impulsive and empty. Just the mere presence of a dog, such as an ESA, can aid in mitigating some of these symptoms, especially the persistent feelings of emptiness. Personally, this manifests in the following way: when the emptiness strikes, Pippa helps keep me grounded (literally prevents dissociation, which is something I experience often and permits a more impulsive mindset – it’s easy to sit back and let bad things continue if you aren’t even inhabiting your body anyways). When I feel myself “floating” ie. dissociating, I go through a ritual with Pippa. I stroke her fur, and focus on her breathing. She will sit on my lap, as if to physically block my spirit from floating up and away.

Pippa will (eventually 🙂 ) be trained to be in tune with my personal emotions. She will alert me in some manner, either a bark or a lick, to my shifting moods and emotions. Personally, I suffer from a hypersensitivity to my environment and to triggers, and I have a slow return to my emotional baseline, meaning that triggers can build upon eachother to create an extreme emotionality on my part. Pippas job will be to provide an external cue for my triggers, and will remind me to regularly use my coping, distraction and self-soothing strategies to help mitigate the cumulative effects of various environmental triggers. She will notice when my stress levels rise, and remind me to calm down. This is an extremely useful tactic, as I have difficulty assessing and reacting to my emotions. Often, a situation will needlessly worsen for me, simply because I do not have the emotional insight or development to be able to see the train screaming down the tracks in front of me.

Pippa has a long way to go before her training is complete. To become an accredited service dog, she must be able to pass completely (100% score) a public safety test, composed of various behavioral assessments. Obedience in cars, in new locations, with distractions and exposure to food are all skills that will be tested. She must learn skills such as loose leash walking amidst distractions, calmness around people (including a non-soliciatory attitude towards strangers), sitting on command and many other obedience behaviors.

Having a PSD is an interesting situation. I have an invisible disability, but Pippas presence suddenly makes it conspicuous. I cannot hide it while Pippa works. That’s a scary prospect. But if Pippa helps, and she does, then everything will have been worth it.

 

Life

Quitting my job in favor of mental sanity

Revelations once again. I shall elaborate presently:

I quit my job.

Yes, I am now unemployed. And I feel so completely good about my decision. For a couple of weeks now, my job has been like a cloud looming over my head, blocking the rays of sun from reaching my aching skin. Why was work such a dreaded activity? Why couldn’t I handle the simple shifts of plant maintenance?

It can be described accurately by saying that “work is composed of a million little triggers”. It is an atmosphere in which one must perform, and if one doesn’t perform adequately, it is made apparent to everyone via the state of the plants. I underwatered, then promptly overwatered in compensation. This job actually requires a ton of skillful patience and care. These are attributes which I can, under the right circumstances, display, however, under the pressure of wanting to perform perfectly, I created an atmosphere of stress that made it impossible to do so. Needless to say, the very mindset that I had created towards work was toxic and triggering in and of itself. So, without the ability to properly complete my job on a daily basis, I simply put, did a bad job of watering the plants. This allowed for room for criticism, lo and behold, another trigger.

in addition to this vicious cycle of stress and plant watering, there were the usual triggers that one encounters in everyday living. Things such as being asked questions about plants that I couldn’t answer, having to admit I didn’t know where we kept a certain product etc. etc. There were even triggers of sometimes feeling lost, and like I had nothing to do and was simply wasting away my time at work.

Work was, very evidently, taking over my life. I could not compartmentalize my life, with work staying at work. Instead, it bled into my everything. With my choice to quit, I am able to confidently reprioritize my life, with therapy and recovery being at the very top of my priorities, rather than being captivated by work.

Now, don’t get me wrong. I actually loved my job. It’s the kind of job that is actually perfect for me. Just not now. In the future, when I have less going on in my brain, I will be able to dedicate myself to a job and throw myself fully into a career even! But that time is not now. Now is the time to develop my coping skills, to work on my dialectical behavioral therapy, to calm myself, to learn how to live comfortably with myself. I am in a position where I don’t know how to be alone and live a life, which is one of the reasons I always fall back on my undercurrent of suicidality : I don’t know how to live.

So, for the remainder of the summer, I shall read. I shall practice DBT. I shall garden. I shall spend time with friends. I shall go to therapy. I shall train Pippa. All these things that I will be able to focus on without any pressure, and all because of my decision to quit my job. In this moment, I feel incredibly strong, empowered even, by my decisions.