Roadblocks to Recovery: Virtual Valium

I have massive anxiety issues. It was never overtly obvious when I was younger--my anxiety appeared more as irritability (my parents referred to me as "Grumpy Bear" from the Care Bears) and a nasty temper than out-and-out anxiety. Even through high school (and the appearance of a clinical anxiety disorder), I always thought I was more crotchety than anxious. It turns out that my irritability directly reflects my anxiety--when I'm super anxious, the world just grates at me and every little thing ticks me off.

I'm getting better at understanding just how much anxiety pervades my life. That's a start. But what I still struggle with is actually coping with the anxiety. Which brings me to my next roadblock to recovery:

Anorexia as an anxiety lessener

When I was in college and my AN just emerging (no one, least of all me, had a clue what was going on), I was also struggling with a resurgence of OCD and other assorted anxiety issues. By this time, I was seeing a therapist for depression/anxiety, and had recently started an SSRI. However, I still had plenty of freak-outs and moments of complete panic. So my MD gave me a small prescription of Xanax (a benzodiazapine) to help with these moments. There was a problem, however. The pills worked and help calm me down enough to be rational, but they also zonked me out, which left me no more functional than I was before.

Not surprisingly, as the AN kicked in to higher and higher levels, I found that not eating did a rather fine job of taking the edge off the anxiety. It didn't leave me quasi-comatose, and I got to feel like I was "accomplishing" something (ie, losing weight, eating "right," exercising, etc).

Even during my last relapse, I was aware that I should probably start eating more, that eventually my return to AN wasn't going to end well for me. I found myself frozen for a number of reasons, not the least of it was fear of weight gain and fear of change. But one of the biggest reasons I didn't want to start eating again was that I knew the anxiety kickback was going to be awful, and I just couldn't face it. With the ED, I didn't have to agonize over what to eat, or what to say or do (as long as it involved not eating and enough time to exercise, I was just fine). The added fact was that anorexia served as my trump card, which dulled the anxiety about everything else. Because even if everything else went to pot, at least I could be anorexic, right?

Recovering from anorexia meant giving up all that. It meant giving up my "virtual valium" and my go-to anxiety coping skill. Recovery hasn't, alas, diminished my anxiety any. I'm still just as bad as I ever was, only now it seems worse because I know the feeling is anxiety and not just me being, well, me. I have probably tried everything imaginable to help with the anxiety, from yoga to meditation to stress balls. I need an arsenal because not all coping skills are appropriate for all situations--I would look pretty stupid doing downward dog in the middle of the bakery. Ditto for crocheting a scarf. But I can use deep breathing techniques and I can remind myself that I have good problem solving skills. I can stash a stress ball or some Silly Putty in my purse or pocket. And I think learning to accept the inevitable anxiety will help me go a long way in decreasing the distress it causes me. At this point in my life, my anxiety isn't going anywhere. My mind tends to come up with ridiculous alternatives, and I'm not all that good at shutting down my brain. That's just the way it is, and I can accept that in a "Boy aren't I screwed" sort of way, or I can accept it in a "Anxiety hasn't killed me yet, so I can manage" sort of way.

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Cathy (UK) said...

I'm so sorry you struggle with all this too Carrie... I nearly always identify with your posts, but this one... Well, I could have written it myself...

I've had people ask me why I stuck in anorexia nervosa (AN) for nearly 30 yrs and the best answer I can give is that AN was the best tranquiliser I knew of. It was tranquilising because:

1. My anorexic rituals directed my day - providing a routine.

2. When starved my whole world narrowed so that all I thought about was food and exercise. There was probably some starvation-induced metabolic/neurophysiological CNS/brain effect in operation as well.

3. I was so thin that I felt 'invisible' and protected from 'scary people'.

Like you Carrie I have OCD - and had it from being a small child. I also had eating difficulties which worsened when I started school as a 4-year old. According to my mother I was hyper-anxious as a baby in a way that my (older) brother never was. As a baby I chewed my fingers and scratched my face. I had motor tics. When my AN started at age 11 it just seemed like an extension of all my childhood anxiety, obsessions and compulsions.

Overcoming/managing my AN has been the most difficult thing I have ever done - because of the unbearable anxiety associated with behavioural change. Sad as it sounds, I have learnt to recognise that I can only control my AN by making big lifestyle modifications that control my anxiety. My life is limited relative to many other people's lives but if that's what I need to remain well then so be it.

Finding Melissa said...

Gosh - a lot of this resonates here too, especially around OCD, which I didn't notice much as a child, but went into overdrive when I started to make behavioural changes to my eating disorder. The "scary people" idea is also something that I'm trying to work through at the moment, and I recognise from far back. My eating disorder gave me a bit of a defence wall, then an excuse to hide and finally a comfort when it all seemed too much.

I guess I'm learning that neither I - nor the world - will fundamentally change; and that the eating disorder solution almost affirmed my fears (yes, the world is bad and you do need me) rather than really making them better....which is something looking at them head on will hopefully acheive.

CG said...

Carrie, one thing that I have always had trouble understanding, and I'm hoping you might be able to expand on, is how you (and quite a few other anorexia sufferers online) adamantly state that for you, the addiction was not about looking a certain way or weighing a certain amount, and that you would probably have developed it anyway even if thinness were not glorified and plastered everywhere in our society... yet you frequently mention "the fear of weight gain." Why this fear, then? Surely the 'high' and anxiety reduction associated with starvation would have been attainable at any body weight, and (in the mindset you described) no need to have feared its disappearance from a higher weight alone?
Just curious! Love, CG

James Clayton said...

As ever, this resonates so much right now. Anxiety about anxiety is crippling. Faced with nerves, irritability, lack of self-esteem and feelings of not being safe, etreat into the comfort and familiarity of anorexia or OCD seems to make sense.

Following on from everyone elses' thoughts, it exemplifies how eating disorders aren't just a superficial 'fad'-like thing. The anxiety goes beyond food, weight and body-imaged - it's a complex mix of issues that need treating together.

As Melissa says, it's all about affirming that the eating disorders only support your fears. Here;s to confronting them head on without 'virtual valium'...

Cathy (UK) said...

CG (comment above:)

I know that your comment was addressed (primarily) to Carrie, but I'm keen to answer your question from my personal perspective - because I get very weary of anorexia nervosa (AN) being attributed to the media.

(Carrie/others' answers may be different to mine..).

My AN was never about looking a certain way, or weighing a certain amount, and on many occasions my weight fell to as low as 80 pounds (my height is 5ft 6in). At that weight I was scared of gaining weight.

I never planned to reach such a low weight - and in fact I never planned to lose a lot of weight at any point in my life. My weight dropped or remained low because I had created exercise and diet 'rules/rituals' for myself that I felt compelled to abide to.

I felt I 'had' to do 'X' minutes of exercise at certain times of the day and eat (restrict) in a certain way. If I didn't adhere to my 'rules/rituals' I felt out of control (of my anxiety), and also quite impulsive (I had the urge to harm myself by cutting etc.).

I was scared of gaining weight because in order to gain weight I had to break my rules - and therefore face the accompanying anxiety.

Another issue for many people is that AN causes body image disturbance (not vice versa). Although I could see that I was thin when I was emaciated, I seemed to be able to justify, within my mind, that I was not too thin. I didn't see a 'fat' person in the mirror though.

So, in summary, the fear of weight gain related to the fear of the emotions I would feel if I changed my behaviours (and hence broke my 'rules/rituals').

As I say, others may give different reasons for fear of weight gain in AN...

Cammy said...

This is interesting, because my experience falls onto two different sides of the anxiety issue. Over time, I've found that I'm generally much more balanced, calm, and able to handle disruptions now that I'm healthier. At one point even a 5 minute deviation from my normal schedule could send me into a full-fledged panic attack. And as I've made progress and broken down barriers, life is just less stressful in general.

BUT I totally get the anorexia as anxiety relief thing. I have a hard time understanding when I hear about people agonizing over sticking to their diets, because for me the restrictions of eating choices just made it so easy. Follow the script, measure the portion, do the required workout, and everything is good. Formula and structure mean you don't have to make a choice, you just do it.

I LOVE this series of Recovery Roadblocks, Carrie! Hang in there with the anxiety, remember that the only way to overcome certain issues that stress you out is to take them on and show them who's boss! You're awesome.

Kim said...

I second Cammy -- I LOVE this series!

Anorexia was very numbing for me. It's like all the buzzing of the world around me stopped and I was like a horse with blinders on -- just focused on controlling my food. It was a very simple existence. I know I'm an anxious person. Medication has helped with that, but it's probably always something I'll deal with. I really think anorexia is primarily an anxiety disorder.

CG said...

Cathy - that's interesting, thanks. So would it be correct to say that for you, the fear was not of weighing a higher amount and looking differently (not actually a fear of weight gain), but instead, a fear of eating and exercise reduction, which heightened anxiety (and which only consequently would lead to weight gain)?

Cathy (UK) said...

CG, yes, that is correct. I feared changing my behaviours, although it was difficult to know why. I am a very ritual-bound person anyway, even after weight gain - and I've always had compulsive behaviours - even pre-AN.

I felt I wouldn't be able to cope without the rituals of my AN. But those rituals were also a personal test of my perceived self worth. I liked myself when I adhered to them and hated myself when I didn't. Logically it doesn't make sense, but emotionally it 'felt right'...

Anyway, I am conscious that I am writing all over Carrie's blog so I'd better shut up now...

anne said...

What about cognitive-behavioral therapy? Have any of you tried this? If so, what do you think about it? Has it helped?

B squared said...
This comment has been removed by the author.
Carrie Arnold said...


My current therapist is helping me using a CBT-based approach. Right now I'm working on some mindfulness techniques to help bring down the baseline level of anxiety.

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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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