Almost Anorexic: A Book Review and a Personal Revelation

Almost Anorexic is a book published by the Harvard Medical School’s The Almost Effect series, which discusses the grey area of medical conditions that aren’t necessarily a diagnosable condition but are still definitely not in the “healthy” range. Eating disorders and other medical conditions exist on a spectrum. This book is about falling on the spectrum between healthy and full blown eating disorder, in the grey area with subthreshold conditions that don’t get the attention diagnosable conditions receive. It was a collaboration written by Dr. Jennifer J. Thomas, an assistant professor at Harvard Medical School, and Jenni Schaefer, author of the book “Life Without Ed”, who has recovered from anorexia nervosa, and is chair of the Ambassadors Council of the National Eating Disorders Association. I discovered Almost Anorexic while searching for books that would actually address my personal experiences with disordered eating. This book was the key to helping me to unlock and unearth what was probably my dirtiest not-so-secret secret. I call it this because it is not something that I am proud of and I have a great deal of shame and guilt surrounding the subject and while a few people know, I have never blatantly verbalized or acknowledged it publicly, so perhaps this is a revelation of sorts as well as a review on this helpful book.

People look to the DSM (Diagnostic and Statistical Manual of Mental Disorders) to know if they have a true problem, but while helpful, it also can be one of the biggest impediments to their actual healing if they can’t find themselves in the book. How do you properly treat your illness if you don’t feel you have a legit problem or it isn’t even recognized as one by professionals, family, or friends? This is one of the things that Almost Anorexic addresses. A lot of the reason people think that they don’t have a problem is because of the diagnostic criteria. Sadly, this can keep them from getting the help they really do need. If someone doesn't meet all the criteria for a disorder, they are typically diagnosed as EDNOS (Eating disorders not otherwise specified) or OSFED (Other specified feeding and eating disorders), which aren't even considered officially recognized eating disorders. I would have been in this group dubbed by some clinicians as “diagnostic orphans”. The point is all subclinical eating disorders are worthy of help.

I never became underweight which is required for an anorexia nervosa diagnosis but, like many other diagnostic orphans, I exhibited all of the same behaviors as someone diagnosed with anorexia nervosa. Had I taken the EAT-26 (Eating Attitudes) test back then, I'm sure it would have indicated I had a real problem. I also lost 35% of my body weight which actually WOULD get an anorexia nervosa diagnosis according to earlier versions of the DSM, which called for a weight loss of at least 25%. The DSM has changed since then a couple of times and is now on its 5^th edition. In the newest edition I would be diagnosed as OSFED, atypical anorexia nervosa. Even though I gained all of the weight that I lost back after I stopped restricting on top of my intense exercise regime, I still carried many of these behaviors with me into my 30’s; I still struggle with the Binge/Purge pattern even in other areas of my life. Ed is still in my head and still has a big say in my daily life, whether I am fully aware of it or not. Awareness is half the battle. Eating disorders are behavioral disorders, and let’s face it...behaviors don’t just magically go away because you refuse to acknowledge them or time passes. There is still a residue. And while I am not currently dealing with full blown disordered eating anymore, I am still dealing with a lot of behavioral residue from the days when I was. I believe you need to acknowledge and change behaviors or you will unconsciously relive them repeatedly. You can’t change what you don’t acknowledge.

There is a drastic difference between healthy weight loss and an eating disorder. What I did in high school was not healthy and I know now that I most likely lost my gall bladder at the age of 16 because of how fast I lost the majority of the weight. I also know now that intense restriction is not a sustainable way to achieve weight loss...period. Restriction wasn't my only problem, though, as I also developed an obsessive relationship with exercise. Exercise is one of the best things you can do for your body, but not when you force your body to do it as a punishment when you haven't fed it anything for a week. I starved and abused my body, I desecrated my temple. My body didn't trust me anymore after this ordeal, and I am still working on regaining it's trust 20 years after the fact.

I was amazed by how much I found myself in this book, maybe not so much my current Self, but pieces of my Self, and especially that younger aspect of my Self. She was there in all of those pages. The book uses many case studies and personal anecdotes that I definitely found relatable. Almost Anorexic deals with the subclinical end of the eating disorder, while using stories from Jenni’s personal recovery to explain the obsessive relationship people can develop with food and exercise. It not only covers food related problems like binge eating and restricting, but also discusses compensatory behaviors and the highly important subject of body image. Dr. Thomas and Jenni discuss the physiological and psychological changes that occur in “almost eating disorder” syndromes. The second half of the book gives solutions and suggestions for recovery, and also includes helpful activities for you to do on your own, including identifying your social support network, and creating a personalized relapse prevention plan. An interesting exercise from Chapter 6 has you write two letters to your eating disorder, one as if it were a friend, and one as if it were a foe.

In my therapy, I have recently started to dive into this aspect of my story. I thought it would be helpful to "tell someone" as this book instructs. This secret casts a dark shadow on me and I am now working on bringing everything into the light. “For good and for real.” This book is a wonderful read for anyone who has had, has, thought they had, or may have an eating disorder. It is filled with an extensive amount of resources for help. I encourage anyone that thinks that they may have a problem with food and body image to read this book. I also encourage anyone who thinks that their loved one may have a problem with food to think about reading this book. I spent the majority of my life in a state of limbo, somewhere stranded in the middle of the spectrum. Almost recovered isn’t the same as fully recovered and while I’m almost there, I’m not going to settle for almost recovered anymore.

For Good and For Real,

Missie Sue

SOURCES:

Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem?

Thomas, Jennifer J. and Jenni Schaefer

Center City, Minnesota:  Harvard University/Hazeldon, 2013. Print.

Reflecting the Stigma of Depression

Robin Williams’ recent passing has everyone sad, a bit confused and even some ranting up on their social soapboxes.  Facebook blew up last night with the news and everyone was chiming in on the subject, even those who probably should not have been.  I saw many comments and statuses from people asking why, some even stating that celebrities and others just can’t deal.  It is in comments like this that we see how many people simply do not understand how depression works or even what it is, for that matter.  Many people believe that depression is just being sad.  Often times the word is used interchangeably for the state of temporary sadness we all experience from time to time.  People seem to think that Robin Williams should have been able to snap out of it or just think positive and change his mood.  For those of us suffering from depression, we know the dark truth.  Depression is a demon that surrounds you no matter where you go or what you do, and as this tragic event shows us, no matter who you are.  Depression does not discriminate.  All walks of life are afflicted and anyone can be sucked into this black hole, even the brightest of us, even the most talented...especially the most talented. 

In retrospect, as soon as I heard the news I wondered how I or others didn’t recognize this about Robin.  Looking into his face, I think you could see his inner pain.  His manic style of stream of consciousness comedy was so intense and unmatched, but Newton’s law tells us that what goes up...ultimately and inevitably must come down.  Ain’t it the truth?  In my readings I saw people mention that most comedians suffer from this type of manic expression of their darkness.  It is in my opinion that a good majority of artists in general are plagued by this same darkness, for no light that bright can exist without its corresponding shadow.  And it makes for great art, don’t get me wrong, but the creation of that art can be one of the most difficult graces to grab onto.  The hardest thing for us to do is to let that inner light shine through that murky cesspool of despair that shrouds our souls, and it can be quite the struggle.   People do battle with depression and often they do this most of their lives.  There are ups and downs, major episodes, minor episodes and then the mania, which can seem like a relief from the pain, but in all actuality, it is one of the biggest energy suckers of all.  Once you go up that high, you go down even harder.  It’s difficult pretending that everything is fine or that you are “normal”.  Robin Williams never pretended to be “normal”, per se, but he did hide his pain behind the mask of comedy.  I don’t believe that I’ve ever pretended to be normal or faked it, but I certainly wear my own mask to cover the many faces that I have.

I vividly remember the day that I carried my diagnostic sheet up to the front desk after seeing the doctor and was given the referral to my therapist and the prescription for my medication.  Looking down at that diagnosis of “Depression” staring up at me like some label, like a mocking label, was hard to handle at the time but it was certainly easier than everything else I have had to deal with since.  Admitting I had a problem was just the first step in this long journey of recovery that I have been on.  I suffered in silence for almost 20 years before getting any help.  I feel guilty that the Robin Williams situation makes me feel better in a way, but it does.  It also makes me feel incredibly worse, because it is terrifying.  This situation is terrifying in that the demon that took his life is the same shadow that lives inside of me, however different.  I haven’t had suicidal thoughts since college, but you never forget that feeling even if you do heal.  It’s like a scar on your soul.  Even though I don’t believe suicide is ever the right choice to make in this situation, I don’t judge his decision because I have had that same demon whisper into my ear.  Today I am taking a look at my own scar and it has been making me sob off and on all day, especially when looking into his face in all of the pictures people are sharing.  It is proof that this illness is serious and real and that I should be proud of the progress I have made because many of us are not so fortunate.  It is also a reminder that I am not alone in this.  None of us are alone in this. 

It has been raining all day today, offering a deep cleansing for our collective soul.  I think why this is so sad for me and others is because we can relate to it so well.  I understand what it is like to mask the darkness inside of you and carry on excitedly and happily for the benefit of others, or simply for survival.  I understand what it is like to go to that manic place only to fall to the bottom once again.  It is incredibly draining and life sucking.  I think a lot of us can relate to Robin Williams; I think humanity has taken a deep collective sigh at his passing.  Nothing seems right about this but nothing is wrong in talking about it and perhaps his death can serve to help others take this condition more seriously and treat it with compassion.  Depression is a real problem but suicide is never the answer; that is something that depression tells you when you are vulnerable.  But people should not shame others for having suicidal thoughts, either.  It just goes with the territory.  Robin Williams struggled for years with his depression, and ultimately it won the battle, but nobody should judge him as weak for this and throwing words like coward around at suicide victims and the depressed does nothing to extend the compassion that these situations and people so desperately need and deserve.  He fought the good fight for years and he did one hell of a job at that and anyone that deals with depression will agree that is one of the bravest things that you can do.  Perhaps he was just tired of fighting that demon or simply succumbed to a moment of weakness and lapse in judgement, but we don’t REALLY know, do we?  You can never truly know the heart of another.  May his beautiful soul finally rest in peace.  Na-no na-no.  

Staring Into the Rising Sun

This picture has been my Facebook profile picture for over a year now.  I took this picture last June while on vacation with my family in Rodanthe, North Carolina.  I had never been to the Outer Banks before and I had also never seen a sunrise over the ocean.  I have kept this as my profile picture for so long because it just seems so fitting for this time in my life, for after all of the darkness, I am finally watching the sunrise. 

There's something about nature I have always loved;  I have always found God there.  Solitary moments in nature have always been when I receive my best advice.  They say God whispers.  Well, what better time to listen than when alone with the trees, the streams, or the critters that It has created.  I just happened upon this rising sun that morning at the beach, even though watching one was on my list of things for the week.  I had woken up to use the bathroom and afterward noted the time and realized that the sun would be coming up in less than a half an hour, so I left my husband and daughter sleeping in bed and slipped out onto the balcony outside our room to have an intimate moment with The Universe.

The sky had already started to turn a rosy pink at the horizon as the light of day prepared to peak over the Atlantic Ocean.  I sat in anticipation with my camera taking a handful of videos and pictures of the incredibly slow and unfolding process.  Isn't that what recovery could be called?  That sun was me.  I was that rising sun!  Slowly the sky grew in color, and every second you thought for sure that golden ball would pop up, but no...not yet.  Wait for it.  

Shade by shade the sky changed and there was such an expansive sense of Greatness...and persistence.  Everyday the Sun does this!  Every single day!  Regardless of what or who is watching, every single day the sun will rise and shine, like clockwork.  It gets the job done.  It sheds light on the shadows of Earth.  Every.single.day.  No days off for the sun.  On this day, I was watching.  I was listening, I was feeling.  I was believing.  I was in a different place.  I had just started therapy and meds at the beginning of that year.  I knew that I had a long journey ahead of me but still couldn't fathom the turns I would be making.

So there I was...waiting for it...on the balcony at the beach.  A million things flew through my mind as I waited eagerly.  Metaphorically speaking, in my mental progress I was waiting too...I was waiting for the sun, patiently watching for but unable yet to see solid proof of progress.  Tom Petty, musical guru that he is, was right when he said that this is the hardest part!  Phase one--The Waiting.  Waiting can seem like a delay of progress, but it is actually a quite necessary part of it.  My mind was full of thoughts until I was moved to mental silence by the first sliver of Light to break across the horizon.  

I was in awe as I watched the Sun cut into the pink sky it had been warming up this entire time.  There is something romantic about this moment in time, this fleeting moment of transition when the sun moves across the horizon and onto its vast palette of sky.  It goes so fast but also seems to be happening in slow motion.  Phase two--The Rising, had begun.  That's where I am now.  I was moved to tears in that intimate moment with the rising sun.  It was as if I was witnessing a birth as that shining head of Sun tore through the great Yoni of Life.  It slowly slipped out from behind the horizon and then was delivered into the Sky!  The birth of the day!!  It was a beautiful thing.

I am still experiencing the labor of my Light and feeling the pains of my awakening.  I'm doing my work.  I have been diligent and I finally have started to see positive results...but I have yet to shine.  After coming this far I fully understand now why some people choose to never do their work and move across the fire.  Some never face the sun, because it IS work.  If you do it right, it's uncomfortable for awhile.  It'll definitely make you squirm.  You leave your comfort zone of unconscious living in order to shine as bright as you can.  Well, I'm dying to shine.  Phase three is The Shining, and I'm on my way.  You Wait...You Rise...You Shine.