Small triumphs, shock, denial and a plan

I lost a little bit more weight over the weekend, though it did fluctuate a bit. I had lost a lot on Sunday morning, but I think it was through dehydration, as I’d gained most of that back by this morning. Unfortunately I didn’t manage to go a single day without purging and ended up purging several times on Sunday. The thoughts have abated a little bit today I think because I gave into them so much at the weekend. I’ve managed to break from routine today and add a small “skinny*” muffin to my lunch. It hasn’t even caused that much of an emotional backlash so I’m counting it as a victory. As long as I can keep having the occasionally small triumph against all this then I’ll still feel like I do have a modicum of control. Am I just fooling myself?

I have also been trying to do a lot of thinking about what I need to do. I think I have to face the fact that this isn’t just a temporary problem and this is a proper eating disorder relapse. And if it's a proper relapse I may have to face the fact that I can't get out of this by myself. I think I’m kind of in shock and denial still. Shock because it’s been nine or ten years since I’ve had problems like this. I did have a brief period in 2008, during a serious relationship break-up, where I had a minor relapse, but I didn’t purge at all that time, and I pulled myself out of it without needing any extra support from my doctor (or in fact making anyone else aware of it). The last time I had serious problems was in 2002 and then the depression really over shadowed the eating disorder and as I got treatment for the depression the problems with the eating disorder eased dramatically as well. So to be honest I was feeling pretty cocky about the fact that I was fine now and eating disorders weren’t something I needed to be worried about anymore – in fact before last November I was actually at a BMI that placed me as slightly overweight (damn side effects of antipsychotics) and not feeling overally bothered about it. How can I go from not minding being slightly overweight to caught up in an eating disorder with almost no warning?

I think the denial stems from two things. Firstly, I don’t want to believe it’s true and if I carry on then things will just sort themselves out (see above for “that isn’t me anymore, not after so long”). This is why I’m finding the idea of asking for help so very difficult – because if I’m getting medical help for an eating disorder then I do actually have an eating disorder and it’s not all in my mind (as opposed to blogging about it… which doesn’t make it real). Secondly, although I can logically comprehend the idea that if I lose much more weight I’ll be underweight and that might start to have health consequences; I can’t actually believe that I’ll actually be at any real risk. I’ve weighed a lot less than this before and been fine, right?

Anyway... I’ve made two deals with myself. At some point this month I have to make a GP appointment to get a refill for my medication. If I’m still purging more than once a week by then I will try and broach the subject with my GP. If I'm purging less than once a week I will maybe give myself a bit more time as that would be a sign I can get out of this myself. I know this isn’t the greatest commitment in the world. But it’s a start and it’s the only one I don’t feel terrified making right now. I’ve probably got about three weeks worth of medication left at home at the moment. So I’ve got three weeks to try and turn things around myself. Maybe the fact I’ve got a very real deadline a head of me will give me a bit of strength to actually fight the eating disorder thoughts.

Here’s hoping.

* Hmmm. I doubt it was that skinny, but hey, this is me trying new things!

# As fast as I pick it up # It runs away through my clutching hands #

I’ve been thinking a lot in the last 24 hours. I tried really hard last night. I ate a meal (a small victory) and didn’t purge (a second small victory). This morning I couldn’t stop myself from standing on the scales. The number was the same as yesterdays number. It swam in front on my eyes. It taunted me. But I’m trying not to care. I said to myself. I’m trying not to be like this anymore. But my brain didn’t listen. I went downstairs and my partner shouted “make sure you grab something for breakfast”. I grabbed something from the cupboard and shouted back. I got to the end of the street and threw it away. I’m only lying to myself.

On my commute this morning The Cure, For Elise, came on my iPod.

I thought this time I'd keep all of my promises
I thought you were the girl I always dreamed about
But I let the dream go
And the promises broke
And the make-believe ran out...

I’ve been caught up in the mess of an eating disorder before when I was a lot younger. And I don’t know how I’ve let myself fall back into this almost without even realising. After so long I really thought I was “cured”. Last weekend when I decided to start a blog, to help focus my mind, to figure out what I’m doing… I didn’t think it would be this difficult. I thought I’d look back on the week and see that things weren’t that bad.

And every time I try to pick it up
Like falling sand

As fast as I pick it up

It runs away through my clutching hands

Every time, this week, I’ve tried to challenge the eating disorder. When I’ve tried not to purge, tried not to restrict, tried to control the self hatred and the intrusive thoughts. Every time it (by “it”, I guess, I mean the facet of my personality, or the part of my mind, or the segment of my brain, that is the eating disorder. It is part of me, though it does feel like a separate entity) fights back. I’ll just keep trying. But I just don’t know how I can win this.

But there's nothing else I can really do
There's nothing else I can really do
There's nothing else
I can really do
At all...

Eep!

Today has not been a great day. I met my friend last night and managed to have a good evening chatting and catching up. In fact for a while the intrusive thoughts abated and I thought I’d be ok. When I got home though the thoughts were awful and I tried to eat something that I thought would be safe but I couldn’t stop myself from purging afterwards. I weighed myself this morning and had lost another pound which I hoped would make today easier. In fact I even managed to break with routine and eat some fruit for breakfast. But then I remembered I was meeting a friend on my lunch break and knew I’d be expected to have lunch with her. This messes with my normal routine (timing/location/contents/preparation all make lunch feel safe for me) but I knew I had to go to “keep up appearance”. I tried really hard to be ok but purged almost immediately on returning to the office. I’m hoping the fact I’ve already given into the urges once today will mean tonight is easier.

In all honesty I’m feeling a bit desperate about all of this. I started this blog as I thought it would help me get my thoughts straight and maybe be a start of getting myself out of this. And it’s making me realise how bad things actually are and how little control I have over my eating. I suppose it’s good that it’s making me realise that, if I can use that realisation in order to aid recovery, or push me into asking for help.

But it’s just not a particularly great feeling to realise maybe how screwed up things have become.

One day at a time

I did actually manage to go last night without purging. I think I managed it because I went for items that I consider to be safe foods and I only ate about half of the food on my plate. The pets were slyly fed the rest. I still felt pretty bad afterwards, but I distracted myself by going for a walk and putting on a movie when I got back - though I did end up buying alcohol and getting a bit drunk as well. The alcohol has made me hate myself today as I know exactly how many calories the drinks contained. I weighed myself this morning and my weight hasn’t gone down any further. Which since I’m trying to not be like this I should be pleased about… but I’ll be honest, I’m really really not. (My weight hadn't gone up either so I'm trying not to freak out too much).

Even so I would still like to think of yesterday as a success, but I don’t know what the chances of replicating it today are. I’ve managed my normal routine so far for the day, with a couple of extra walks round the building (and up and down lots of stairs) to appease some of the worst moments. There is no way, however, that I’m going to be able to eat tonight without purging. I’m not even sure if I’m going to be able to eat at all to be honest. I’m meeting a friend in town later and if I say I ate in town then no one will notice if I don’t eat at home. And I imagine my friend will want to go to a couple of bars which means alcohol again.

The thoughts/self hate are quite literally off the scale in intensity. Ever since I was a teenager I’ve dealt with intrusive thoughts. When I’m not ill I’d say I have a background level of negative/self destructive thoughts continuing for about 5 to 10% of the time. And it’s not great but I'm used to it, they don't control me and I can function at a level I’m content with. Since these problems started again I think the thoughts have been taking up about 50% of my time. When they’re this frequent I find it really hard to resist them (like purging, or self harm), but can still do it most of the time, and I can still get other stuff (like my job done) but maybe not to the best standard. Today I think that maybe 80-90% of the day so far has been nothing but intrusive thoughts. And I’m not really getting any work done. And I’m struggling to have conversations with people at work as it’s all very distracting. Mostly the thoughts are related to food/focussed on disliking my body, with a few self-harm thoughts thrown in there. And when they’re this frequent they’re so very hard to not act on. The weird thing is I don’t actually think I’m depressed at the moment. I think the current medication I'm on is working in that respect. I don’t have any of the normal symptoms I get when I’m depressed. My mind feels really active. I’m not tearful or tired. And bizarrely, given my thought content, I feel sad. If anything I'd say I actually feel good - except for some reason there's this constant barrage of intrusive thoughts.

I’m pretty certain the increase in intrusive thoughts and the anxiety results from taking in more calories than I’m ok with and resisting the urge to purge yesterday. I think I really need to strike a balance between fighting this and doing myself more damage in the long run because of fall out from when I do resist the urges. Or maybe the fall out will get less each time and this will get easier. 

I will keep trying tonight.

Purging

Last night I purged twice. I really tried not to; but in the end the thoughts were just too damn strong. My daily routine (on a work day) is a bowl of noodles or soup during the day along with green tea, peppermint tea and water. At home I will usually cook a meal with my partner and currently I’m purging that meal most days. Weekends are more complex because I’m with partner for 90% of the time. I have to lie more at the weekends. I’ll often walk into the room carrying the last bite of something I supposedly in the process of eating (having thrown the rest away) so when he asks what we’re having for lunch I can say “oh I just had some XXXX, I’m not hungry, but I can make you something if you want”. I’m normally a terrible liar and it’s scary how adept I am when it comes to covering up my lack of eating.  I hate lying to my partner.

I am fighting the urges to purge. Currently I've found the following tactics are helpful:

• Bargaining: I bargain with myself about what will be an acceptable content/amount to eat. If I keep to very healthy; or small amounts of food; or food that comes in very specific portions so I know its exact content, then it’s allowed. I think this is why I’m always ok with the noodles/soup at lunch – they both come in sealed packets so I know exactly how much is in them. I still get the urge to get rid of the food, but it’s really easy to resist and I very rarely act on it. Bargaining doesn’t always work because sometimes I might think I’ve agreed with myself and once I’ve finished the food my thoughts will kick in with vengeance and I won’t be able to focus upon anything put purging.
• Rituals: This is similar to the first step, but if I follow very specific rituals while I’m preparing the food, or eating the food, then it makes it ok and I don’t have such a hard time resisting the thoughts. Rituals like chewing a certain number of times; or cutting the food into certain size bites; or using a particular saucepan on a particular hob; or making sure the foods are all a similar colour. All these things do help. The fact at work that I always use the same bowl/brand of noodles/fork and spoon/microwave/usually eat at the same time – all these things make lunch easier. And again, evening, are harder, because of the amount of variation that is possible.
• Distractions: If I watch a movie while I’m eating then it helps distract me from the thoughts. Also I find it harder to make excuses to leave the room half way through a movie. Partner will say “can’t you just wait until the end of movie” as pausing it ruins the flow. The longer I manage to distract myself the less likely I am to actually purge. If I can get passed an hour I’m usually safe. Distraction was something I use a lot to deal with self harm urges as well (a self harm is something I pretty much never do anymore).
• Waiting: I will say to myself “ok, if I wait 10 minutes and still feel like this then I’ll let myself purge”. And then after 10 minutes “come on, I lasted 10 minutes, I’ll wait another 10 minutes and then let myself if I still need to”. Telling the thoughts that I will follow then in 10 minutes helps them temporarily abate, until it has been too long to really purge effectively or the urges actually do subside. Again this method also works well for self harm urges.
• Making it difficult: This sounds grim but some things just seem physically harder for me to purge. I rarely eat these foods for this very reason but sometimes if I’m especially determined I will force myself. Though sometimes this backfires as I’ll still try and I always end up feeling like I’ve actually done some damage to stomach/oesophagus afterwards.
• Substituting Exercise: Ok, so I would still be getting rid of calories, but I don’t think I ever manage to lose all of them through exercise. And this must be better for me than purging. Right?

Anyway – I’m going to try and get through tonight without purging, which would be the first time in over a week that I’ve not done it at least once. Fingers and toes crossed.

This is not real life

I can’t really talk about any of this in my “real” life. My partner, family and friends either wouldn’t understand or I’d just be too embarrassed to explain any of this. I don’t want to disappoint them. I don’t feel I can talk to my doctor (my GP or my psychiatrist) because I don’t want to acknowledge that this is a genuine problem, it’s not real if I don’t say it out loud and I don’t want yet another psychiatric label. I already feel unsure/unhappy about the ones that I already seem to have. My colleagues are lovely, but I strongly feel that work boundaries need to be maintained for me to survive professionally – my immediate line manager knows that I see my doctor fairly regularly and take medication, and one particularly close colleague knows that I had fairly serious mental health issues “when I was younger”. But I’ve always referred to my problems using the ubiquitous term stress and I try very very hard to limit any impact on my workplace functioning. I’d like to think I mostly succeed.

Also - and probably more significantly - admitting to any of the above people what I’m doing would mean that I wouldn’t be able to continue unobserved. The idea that someone would be actually watching out for my behaviours and monitoring my weight terrifies me. I’d actually have to actively try and stop what I’m doing and change these behaviours or get a lot better at hiding them. I feel very ambivalent about all of this. I don’t want an eating disorder; but I don’t want to stop this either. I guess that’s part of the craziness. Starting this blog is hopefully my first step to actually challenging the behaviours and maybe stopping this. I want to think I have the strength to get myself out of this; but if not I need to build up the courage to open up to someone. The anonymity of a blog makes me feel ok about opening up here anyway, and I guess that is a start.

Now realistically, even if I don’t talk to someone, I know that I won’t be able to continue unseen indefinitely. Since the start of November, when I started restricting my food, I’ve lost 30lbs. This has taken me from the higher end of healthy weight to the lower end. I’ve had a lot of complements and congratulations on my sudden and dramatic change. Though I have also now had one or two comments about how I shouldn’t lose any more weight. Warnings: to be careful. I’m sure that my partner will at some point soon tell me I'm too thin, or will eventually notice one of the many tricks I’m using to avoid food and will stop being supportive of my “healthy diet”. If I can’t get control of this myself I’d like to at least have control about when people find out and I’m hoping writing here will help me do that. So I can ask for help before someone notices and tries to help without my asking.

I’m hoping that putting my jumbled thoughts into words, into sentences, into paragraphs, and so on, will help me order my mind and find a way out of this. I want to see the wood through the trees. I want to be able to reread what is written and see my situation from an external point of view. If I can remove myself from my mind quagmire I’m hoping things will start to make more sense.

"For now we see through a glass, darkly"