EDs are mental illnesses

It seems odd that I, of all people, would have to remind myself of this. I can (and frequently do) go on hour-long diatribes about the real nature of eating disorders to anyone and everyone in earshot. It makes perfect sense that EDs in other people are mental illnesses because I can see the distortions. I understand how a nibble of a Saltine can seem like "too much food" or how running a marathon can be "too little exercise." I understand it and yet I can see that it's not exactly reality.

My problem is that when I'm thinking these things, they seem perfectly rational. If I had vowed not to eat lunch, and then had a nibble of a cracker, I would have griped about how much I ate. Because a nibble is more than nothing, I clearly ate too much. It doesn't seem distorted in the least. It seems normal and (dare I say it?) sensible.

This is where I have problems. I have a hard time understanding that MY distorted thoughts are symptoms of a mental illness.

I can compare my ED experiences with those I've had with depression and anxiety. I became inured to the mild depression and anxiety that characterized my life, to the point where I kind of stopped noticing it. But when I get really depressed or really anxious, I don't feel like me. I've never been high-energy, but when I don't even want to get out of bed, that doesn't seem like me. It's not pleasant. Taking a shower and going back to bed might be the actual best I can manage, but it's still not pleasant. When I first developed OCD in high school, I thought I was going crazy. I knew that my touch probably wouldn't cause someone to die of AIDS but I was so terrified it might that I washed my hands and tried not to leave the house if I could avoid it. I didn't know that this was , in fact, a mental illness called obsessive-compulsive disorder, but I was able to recognize that something was wrong. More than that, I was aware that other people knew that this was very bizarre behavior.

The anorexia was very, very different. Basically night and day different. Eating less and exercising more seemed very normal and rational and common. I got compliments about how "good" I was being. No one complimented my freakishly clean hands (thanks, Clorox and Ajax!) even though they were freshly scrubbed. No one complimented my ability to stay in bed all day or scream and cry and throw things at the drop of a hat. I had excuses for all of my odd ED behaviors. I had excuses for all of my other odd behaviors, too, but with the ED, I actually believed my own bullshit.

I seriously began to believe that a sip of water would make me fat, that I just "didn't like eating," that I worked better on an empty stomach, that I simply adored the treadmill. There were definitely OCD moments when I believed I was a death- and disease-spreading machine, but these moments also passed. The AN delusions didn't.

Although I continued to lose weight, I wasn't able to see it in the mirror. The number on the scale was different, my clothes were looser, but I still looked the same. Ergo, I must actually look the same. I could tell when other people had cut their hair or lost weight, so the same must be true for me, right? So if my mom is telling me I'm way too thin, I'm emaciated, I'm dying, and I can't see it, it must not be true. I mean, I know what I look like...don't I? I will eat, I told myself, when I see that I'm too thin. Oddly, this is the same trap I fell into on this latest relapse- I couldn't see a difference in how I looked in the mirror despite my almost hourly trips to the bathroom scale.

When I am really depressed or really OCD/anxious, I can tell a difference between those states and my "normal" state. When I am into the ED, it's much harder. I feel almost more like myself--more intense, more driven, more on top of things, in a sense, I feel like a better version of myself--when I slide back into the AN. I can't point to a difference. My mom can. My boss probably could. But if I feel the same and look the same and am just freaking fine, dammit then how in the HELL could I be sick?

How? Because the illness I have, this pernicious eating disorder of mine, makes it very very hard to understand that I am sick. It's one of the symptoms of the illness, this inability to understand that you are ill. Laura Collins introduced me to the term anosognosia and I love that word. Can't pronounce it, but I love using it. The depression and OCD aren't anosognostic- I knew damn well that something was up even if I didn't have a name for it and didn't know that it was a mental illness that could be treated. Anorexia is very anosognostic and it will probably be my Achilles' heel. Not so much the illness itself, but the difficulties in recognizing it.

However untalented I may be at recognizing my own eating disorder even when the evidence is literally staring me in the face, it doesn't change the fact that EDs are mental illnesses. Including my own.

6 comments:

Kim said...

I completely relate to this. Logically, I know I have an "illness," but part of that illness is disbelieving, in my heart, that it's really there. Some days, I'm more logic-based than others. But, other days, I get stuck in the emotion of, "mental illness? What mental illness?" Like you, I have to remind myself pretty frequently that I have a disease and I have to stay on top of it. I would love for it to be the passing fad that the media thinks it is. Too bad!

Wrapped up in Life said...

I especially appreciated your point about the fact that others so readily acknowledge and noticed the 'side effects' of your ed, but not the OD- - inspired spotless hands.

Great observation.

Niika said...

I totally relate to this as well... when I'm restricting, it feels like I'm doing this wonderful thing for myself, to improve myself, and I obviously look fat to myself, so how can it possibly be wrong? It becomes VERY hard to see all the lies that ED wraps my brain in. Eventually, though, you can learn to see it.

KristineM said...

Carrie, thanks for your articulate description of how you feel normal, even better than normal, inside when in reality your body is starving. I wonder if that is some kind of evolutionary survival technique that our bodies have that allows us to carry on during times of little food. Then, for non-ED people, when food becomes plentiful again, they eat lots of it and get healthy again. ED people, of course, do not. You got me thinking!

My D was a restricting anorexic for years as a child and adolescent. Her health care professionals and H & I made sure that she wasn't in physical danger most of the time, but her weight was never high enough to allow for proper adolescent growth and development. She tells me that during her emaciated times in the beginning and during 2 relapses that she always knew that she was too thin, emaciated even. But her ED frame of mind insisted that that was what she wanted. Even though she couldn't hide the effects of her illness from herself, she felt compelled to continue it.

hungry for hunger said...

I actually think you're sort of asking the wrong question. I'd pose to you: Is the distinction between illness and mental illness worth preserving? I say no. I say science has led us to see that you can't cleanly say one pile of diseases are mental and one pile are physical and, that the further science gets, the more and more such distinctions will seem arbitrary.

The blurring of taxonomy only increases as we learn more and more about the genetic causes of ED's or addictions (or many other illnesses thought of us mental illnesses). At what point, do we say ED's have crossed the imaginary line and have as strong a biological component as a traditionally non-mental illness with an occasional mental health presentation, something like Lyme Disease or Syphillis? Where is that line to be crossed?

I don't think it's a worthwhile distinction to make anymore. It's imprecise in the scientific sense, as in you're using a yardstick to measure grams.

And it's actually why I disagree with the premise of mental health parity. Mental Health parity is separate but equal, but I think it's all the same and no provider or insurance company should be making arbitrary distinctions either.

Special K said...

Isn't it so strange how we can continue to lie and distrust the very core of who we are? Now, as you challenge that voice in your head and rediscover your true desires, I wish you grace...and like I said this morning
TRUST YOURSELF!
I challenge you to participate! http://thespecialktreatment.wordpress.com/
Just comment if you do with your story!

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote



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