What Do People With Anorexia Eat?

Over a year ago I wrote a post about how people with eating disorders were misrepresented in the media via their use of skeletal pictures when interviewing or discussing someone with the disorders, yet lately I have noticed there is another stereotypical image being promoted that drives me equally round the bend, that being the idea that people with anorexia do not eat anything at all, and it is this myth I really want to tackle in this post as it is simply not true and is unhelpful to everyone.

You see when you come across articles in the paper interviewing someone with an eating disorder, they always make it sound as if the person has gone years without ever letting a morsel of food pass their lips. 

I am often reading pieces stating that someone lived on half a cornflake for three years or something ridiculous, a statement that is physically impossible and that must be taken with a pinch of salt as everyone knows journalists will often exaggerate or make things sound worse by picking and choosing details from an interview to make a good story. If an article makes it sounds like someone interviewed supposedly hasn’t eaten more than half a cornflake for three years, it is most definitely false and cannot be taken as a fact in general or by which other sufferers can be measured. 

Admittedly, people with anorexia frequently do not eat enough, it is after all one of the symptoms, the classic restricting of calories to lose or prevent weight gain. Indeed people with anorexia often eat very little, nowhere near as much as they need to keep themselves alive, but that still doesn’t mean they don’t eat anything at all and spend years living on air. In addition to those in relapse  who still eat at least something (regardless as to whether it be enough or not), when people are in recovery and on a weight gain meal plan they may actually eat more than some “normal” people. I know I have certainly followed meal plans that exceed the “government guidelines” irrelevant calorie limit, which have been prescribed to me both in and out of hospital. People in relapse and recovery are still considered as having “anorexia” if their mental state dictates that diagnosis, no matter how much they eat, and they should all be counted and taken seriously as a voice for people with eating disorders without being discriminated against for (brace yourselves)…having breakfast. What about the people who have severe anorexia but eat to keep their families off their back or to maintain a job? The ones who eat purely to stay out of hospital or the ones who are trying their best to eat to get better yet are still in as much mental pain as anyone else and hating every second? The ones who want to scream and shout every time they eat but force themselves on anyway because they don’t want their kids to see them worrying about food in fear that they may also pick up on the anxiety? That image, of people with anorexia eating, is never represented in the media, as equally valid or not it isn’t a dramatic image that would sell a story in a magazine. After all, headlines of “anorexic eats an appropriate number of calories, not because they are better but because they don’t want to scare the children” are never going to sell or create as much drama as “anorexic eats nothing and only licks a blade of grass once a month for 10 years”.

I am pretty sure that every member of my family is aware that I have anorexia and in a way I find this helpful. With them knowing, it means I don’t have to lie all the time, if I disappear for a few months to go into hospital it isn’t a big secret and I don’t have to pretend I have been off travelling, climbing Kilimanjaro or building schools for orphaned penguins in the Arctic, but in a way it actually makes things harder because I feel there is an expectation of the way I should behave at family gatherings. I am currently unable to eat outside of my house or with family anyway, but even if I were able to I would find attempting it incredibly intimidating as I imagine if I were to eat anything, people would be confused. If a person without an eating disorder goes out for a meal and eats, nobody raises an eyebrow, but if someone who is known to have an eating disorder goes out for a meal, when they eat people start to question whether there is anything actually wrong with that person in the first place. If you hear someone has to go into hospital for a new leg and then you see them prior to admission dancing the tango pretty happily using their old one, you might wonder why on earth the new leg is needed as clearly there is no problem. The issue is of course that though someone may appear to be eating happily on the surface, they could still be going through mental torture inside and may be just trying not to make a fuss and embarrass themselves or draw attention.

The dangers of this misconception that “anorexics don’t eat” are very similar to the ones created by the idea that people with anorexia are underweight. Again, family members or professionals may not be concerned about someone they suspected may have an eating disorder because the person often sits down for a family meal. Sufferers also might find themselves in situations where they don’t eat, not because of their disorder in particular, but because they feel they can’t incase people suspect that they are faking the whole thing. Much like images of skeletal bodies, people hearing the myth that people with anorexia don’t eat can cause people to think that they are not “that bad”, “not ill enough to warrant help” or even worse it can trigger them to restrict their intake further because they think there is some “anorexic standard” they have to live up to. You cannot compare the severity of a person’s illness with that of someone else’s just by looking at what they look like or how much they eat without having any idea of what is going on inside their heads. 

Overall I guess the message of this post is that when it comes to the portrayal of people with eating disorders in the media, take all the pictures and interviews as pieces of journalism to sell a paper with the nuggets of truth inside partially skewed or not representative of eating disorder patients as a whole. Making judgements based on accounts that are for the purpose of selling papers rather than truly giving a voice to people with no ulterior motive is never going to provide an unbiased piece that one can make conclusions from. Basically what I want to say is do not trust the media at all, instead you should trust strangers on the internet like me…actually don’t trust strangers on the internet…that isn’t the message I want to promote at all…. just don’t think that people with anorexia don’t eat. 

Take care everyone x

Sandwich

Why Boundaries Are Important When Living With Mental Health Problems

A few weeks ago when I was talking about the fact that I am getting discharged from an inpatient setting on the 20th of February/tomorrow if you are reading this on the day of upload, (handy link to that blog post here: The Pressure To “Get Better” When You Are Struggling With Mental Health Problems), I mentioned that there were going to be a lot of rules and boundaries in place regarding my mental illness that I would have to follow back home.
Seeing as these boundaries were set by my parents you might think I live in a particularly strict household with rules and regulations more often seen in a school rather than a home setting, but actually, I am starting to think that when you are living with mental health problems, it is vital for everyone to set some boundaries.

Thing is, when you have a mental illness bobbing along with you through life, you can guarantee that it is going to do all it can to interfere with any plans you had prepared. Thought you were going out for a night with friends? Surprise! Depression has crossed that out of the calendar and scheduled you in for a good old evening of crying into a pillow and thinking about what a terrible person you are. Decided to spend several hours working on that novel and actually being productive with your life? Nope! Instead OCD would like you to waste those hours antibacterialising various objects in the house that were already clean to begin with. No matter what illness you have, it is obviously going to impact your daily routine, and if left with total freedom, it is likely that it will impact your daily routine more and more as time goes on until you find yourself looking back and wondering how on earth things managed to get so out of control. Now when you are in an inpatient setting this aspect of mental health problems is managed somewhat by the rigid structure of your day to day life on the ward, but on the outside it is a hell of a lot easier to get carried away with your own rigid routines.

The reason for this is that I have started to realise that mental illnesses are much like dinosaurs, and living with them is analogous to being that professor that Richard Attenborough plays in Jurassic Park and it is that analogy (to be fair it has been a while since we settled in for a good old traditional Born without Marbles analogy) that I want to talk about today.

Maybe some of you out there haven’t actually seen Jurassic Park (and if you haven’t you really should, it is fabulous), but basically in Jurassic Park there is this guy called Professor Hammond (that’s the person with mental health problems in this analogy), and he owns this safari park of dinosaurs he created out of some blood that has been hiding inside of a mosquito for several thousand years (in the analogy the park is your brain and the dinosaurs are your mental illnesses, except obviously in the mental health version you did not create your dinosaurs/illnesses, rather they appeared one day and as a result you found yourself as keeper of this prehistoric zoo of insanity).

Having the dinosaurs there is obviously dangerous, so Professor Hammond does all he can to keep that danger to a minimum. In order to keep the visitors safe, he has a whole team of keepers helping him to keep an eye on his dinosaurs (aka psychologists and other mental health professionals), and there are physical boundaries/electrified fences set up all over the island around the dinosaurs to keep them in check. They are still dangerous dinosaurs, but when confined by their boundaries, their level of threat is somewhat controlled.

However in the film, before long, this idiotic man with absolutely no common sense turns off all the electric fences and cages that were housing the dinosaurs, and utter chaos ensues.
Without the fences, the dinosaurs do not remain in their neat little pens, they run amok and cause a hell of a lot of destruction and noise when doing so. That image (aka that of dinosaurs running madly all over the place eating people and crashing into everything), pretty much illustrates the importance of boundaries when living with mental health problems and why I have so many regulations in coming home.

For example, whilst I have been in hospital at my local eating disorder unit, there have been very definite rules set out to govern my behaviour. These rules are numerous and I cannot list them all for fear of boring you all to floods of uncontrollable tears, but as an example they have been things like the fact that if I do not eat my meal, there will be a replacement issued which if not completed will lead to consequences in ward round, or the rule that meal times take place at set points throughout the day with no option to delay that peanut butter sandwich for another five minutes. Meal times are meal times, you eat your meals in meal times, end of discussion.

Similarly there are rules to govern my OCD such as time limits for showers because without this kind of rule, my OCD tends to grab hold of all control over how long I take to shower and run with it a lot faster than I can chase after it (I was never one for athletics in school.)
When I have a time limit however, I have something to aim for, and though my OCD will still be present in my behaviours for the duration of the shower, it is my attempt at controlling it as best I can. If in hospital I weren’t to shower within the allocated time, I would be removed from the shower, so I sort of had to reason with my little OCD dinosaur to get through it. My dinosaur wanted to spend the next three years washing yet the rules meant this was impossible, so we had to work together and compromise. I would shower and do all the rituals I was told to, but only for a certain length of time. Having a time limit obviously didn’t always work and there are times where I still couldn’t stick to it, but like I said, it gave something to aim for and consequently I will still have that shower time limit now that I am heading back home again. Again it is unlikely that I will always be able to keep myself in check, but I know that without any rules in the shower things would be a lot worse than they often are and if I didn’t have a boundary set in place, then I doubt I would ever be able to get out of the shower at all.
I can of course tell my OCD that I have finished washing but OCD will always come back with “just another five minutes”, a request that, when given into, will be repeated every five minutes leaving me stuck in a ritual with no way out. With my rule, I at least have an argument against that. In the shower the OCD still dictates behaviours, but when it is time to leave the shower, I at least have the statement of “time is up and we must leave now to avoid consequences” to come back at any “five more minute” suggestions that should arise.

If you are living with mental health problems then, it is important to have your own rules in place to try and keep track of the interference it causes. You can’t control whether or not you have a disorder, but there are some things you do have control of that can help lessen the impact. Say you have an eating disorder and, as I will be attempting when I get home, you are trying to give yourself enough nutrition.
If you say to your eating disorder “I am going to eat better today”, then it is unlikely that you will achieve much, as “better” is a negotiable, subjective term that you will find yourself debating. Instead, hard and fast rules like “I am going to eat three meals and three snacks today” are more likely to merit results. They won’t necessarily mean you achieve what you want, yet again, like the shower time limit, it gives you something to aim for rather than a wishy washy “I will eat something” or “I will shower quicker” which without specifics don’t really mean anything and give too much control to your illness. I know that especially with eating disorders, giving into little things are a sure fire way of letting them spiral completely.
Whenever I have a bowl of cereal for example, I weigh out exactly the same number of grams each day without question. This is disordered of course, and one day I would like to pour cereal with all the gay abandon of a cereal pouring professional, but I know that if I don’t have a weight from my dietician to stick to, aka a boundary, then my portions will just get smaller and smaller. My eating disorder won’t ask for anything dramatic at first, just little requests like “just one flake less today” or “one gram less”, which doesn’t sound much but if you keep listening to that you will end up a few weeks down the line staring at a solitary rice crispy in the bottom of a bowl wondering where all the others went (and possibly hearing a very quiet pitiful sobbing from the rice crispy as they are very social creatures who, when portioned out individually, often get rather lonely. Rice has feelings too kids.)

You don’t have to make loads of rules and they can be small rules to start off, but no matter what the size it is vital that the rules are there. If you have depression, that sucks and you cannot control the effect depression will have on your mood. What you can control however, is things like taking any medication you have been prescribed or attending any appointments to try and keep it in check. If you have an eating disorder and a meal plan you have been told to stick to, make that meal plan your rule, your boundary that cannot be negotiated. Ok the eating disorder will still be there screaming and it may interfere with your behaviours, but having that meal plan there is a non negotiable that is not up for debate. With OCD rituals put time limits on how long they can take so that a quick five minute tidy doesn’t descend into a five hour mass organisation mission or at least put a limit in place as to how many times you are allowed to do something simply to give you something to aim for.
Like I said, this is not going to cure you of any mental health problems nor is it going to stop them interfering/being dangerous beasts much like the dinosaurs in Jurassic Park. In or out of a cage, a T-rex is a T-rex (unless it is a bunny in disguise), and you cannot control the existence of that T-rex or its nature/behaviour as a stomping, roaring, chomping scaly thing. What you can do however, is put boundaries in place to try and limit the destruction that dinosaur can cause, to do the best you can to take control of something that otherwise will take lack of rules as a chance to run amok to see what it can get away with, and that is why, as I go home tomorrow, I go with a set of rules and boundaries in place.

Coincidentally, that is also why mental health problems are like dinosaurs and why it is vital to have boundaries when living with them in your head/prehistoric safari park. Rules may be broken, but having certain rules in place at home does often help me to manage typically unmanageable situations a little better. If you have been in hospital, take hospital rules back home when you are discharged so that the illness doesn’t have the total freedom to reinvade, and if you haven’t been in hospital then maybe come up with some rules with friends and family who are willing to support you in your battle for sanity. Remember, a dinosaur is always going to be a wild destructive interference, but with boundaries, that destruction can at least be controlled as much as possible…I hope…

Take care everyone x

BoundariesDinosaur

The Mental Health “Spot The Good Things” Challenge

This week, when I sat down to write my blog post, I was determined to try and make it about something positive. Over the past few weeks I have gone on about drowning kidneys, an exploding appendix and suicide, and there is nothing fun to read about there. Admittedly, this is a blog about mental health so things aren’t going to be all fun and games (except for on Wednesdays when we play snakes and ladders…I say we…it is just me…talking to the green snake on the board…nobody else ever wants to play…not that I mind…*Sobs in a corner whilst rolling dice pathetically*).
Still, I have lovely people reading my blog, and as much as I want to talk about all that deep important stuff, I would like to think that people enjoy reading it a little bit, and enjoyment is seldom found when one is talking about exploding organs.

Therefore, determined to write a chirpier post, I sat down today, opened my laptop, placed my fingers upon the keyboard…and wrote nothing. I so desperately wanted to say something happy, but when you have depression that is quite the challenge, and suddenly, as the word challenge arose in my marbleless brain, I became even more determined to succeed. If there is one thing I love nearly as much as penguins and Helena Bonham Carter, it is a challenge (as long as I win of course), and so it was that an idea came to me for a challenge that I would like to invite you all to join me in today (it is a team challenge so we can all win don’t worry.)

I think one of the most frustrating things about living with depression isn’t just the suffocating sadness and inability to feel positive emotions, it is the fact that those things feel so infinite and you cannot imagine an alternative.
If we knew our suffering was temporary, depression would be an easier ride, get through the storm to reach the nice happy place kind of thing, but depression doesn’t let you think that, it tells you that it is here forever and that because you cannot feel or appreciate good things, those good things do not exist. This, as recently proved by an intense and vigorous lie detector test on the embodiment of depression itself, is a lie.
Just because you have no apples left in the fruit bowl, it does not mean that all the apple trees in the world have perished, and even if those apples are incredibly difficult to find and maybe you can’t even taste them when you find them, they are growing somewhere.

In Harry Potter, the Dementors that guard Azkaban/suck people’s souls out/generally float around in shapeless black sheets that Gok Wan would surely improve by accessorising with a nice belt, make you feel like you will never be happy again, much like depression, and the only way to get them to go away is to whip your wand out and throw animals at them made of good things (J.K.Rowling explains it better but that is the gist). It was this that gave me the idea for this challenge, the challenge being to write a list every day of at least three good things to look at as a reminder that good things do exist when depression is sucking the life out of you.

Now you may be thinking “Katie, this is not an original idea, I have seen people make lists of things that they are grateful for or things that make them happy and it doesn’t work.” Well no, in my opinion those lists often don’t work, but this is not one of those lists.

I myself used to keep a list of three things I was grateful for every day and it has been an activity suggested to me many times over the years in my battle with depression. However, as great as it is to feel grateful about things (and believe me when I say I really am), I found that writing those things down sometimes made me feel worse. For example if you are having a really bad day and then you write that you are grateful to live in a house with running water, you can be pleased about that yet then become frustrated and angry at yourself for being so lucky as to live in such conditions yet STILL not be happy. It is like when people say things like “I know you are sad but just be grateful that you don’t live in North Korea”, and of course I am grateful that I don’t live in North Korea (I hear the weather is terrible), but reminding someone of another person’s pain doesn’t take their pain away and is more likely to make their pain worse by making them feel guilty about complaining.

Similarly, I have struggled with the “three things that made me happy today lists” because when you have depression, a lot of the time you simply CANNOT feel happy, even if you know you should. Someone can give you a hug and you can mentally register that that person is a lovely person who is showing you kindness and that it should make you happy, but the logical identification of “this is good” never reaches the emotional sensors that are being held captive by depression, so you never FEEL that good. You could watch a film that you know is your favourite and feel totally numb, hear a joke that is funny yet be unable to laugh, and writing down things you should feel happy about but don’t is yet another miserable and fairly disheartening activity.

This list involved in this challenge however, is not a list of things that you should be grateful for or that you should feel happy or any other emotion about. It is not subjective or about feelings at all, so you can do it even when you are as numb as an anaesthetised turnip, because you are writing down the things that are objectively good, not to make you feel better, but just to remind you that they can exist.

After my post about suicide, I received such lovely comments reaching out to me with hope and kindness, and though it didn’t cure my depression, it served as a reassuring and helpful reminder that that hope and kindness is there. People told me how they or friends and family had been in similar situations but had made it through and though I may not be able to see or believe that possibility for myself right now, it shows that that possibility DOES exist, and for me, that was a very good thing. When I went to sleep that night I still had no apples in my tummy, but I knew that somewhere there was an apple tree growing, and right now, knowing that is enough.

Now, as someone who has been doing this challenge for a week now, I will admit that it is incredibly hard (hence the word challenge) because depression is so good at the whole black and white worldview that “EVERYTHING IS TERRIBLE”, and finding good things on some days has taken me hours. Some days I have even written my list and thought screw it I don’t even care about those good things, and a lot of the time you won’t, but again it doesn’t matter if you care or not or even if you hate all those good things, this is not a list about how you feel, this is simply a reminder to the objective factual part of you devoid of any emotions.

Things on this list don’t have to be big at all, you don’t have to win the lottery or suddenly gain the ability to fly, it can be ANYTHING that is objectively good even if it doesn’t affect you.
For example one day I was out shopping and saw that a popular shower gel was half price. I do not buy that shower gel so the half price offer was going to have no impact on my life, but I knew that objectively that offer was good for someone and I liked to think that someone who used that shower gel would come into the shop later, appreciate that good thing and maybe even make more good things by spending the money they saved on a hot chocolate to take home.

Maybe you were so depressed that you weren’t able to leave the house that day, or week or month, maybe you couldn’t even leave your bed, but still the key is to force yourself to think of something good even if you have to kind of make it up or get really creative. Even if you were under a duvet and didn’t see the outside world, you can be pretty sure that the sun rose that day and objectively that is good because somewhere a nice hedgerow enjoyed an afternoon of photosynthesis (unless it rained and was cloudy…which is also good because then the hedge had a drink…).

One day, one of my positives was the fact that after taking one of my medications that is absolutely vile, I only wretched uncontrollably over a bowl four times. Why is that good? Because the previous day I had wretched at least five times, and today I already know that one of my positives is that I did a big sneeze (I flipping love sneezing).
Admittedly a lot of the time during this challenge you are going to feel like you are sieving for gold and only finding dirt which you are then painting to fool yourself is gold and maybe that is true, but I still think it is important because even little bits of dirt painted like gold are somewhat of an argument and challenge to the overriding emotion that EVERYTHING is dirt.

So that is my challenge to you if you struggle with depression or indeed if you are reading this blog at all. If you can think of three things that actually made you feel happy then do that, but if that is a bit of a stretch right now as it is for me, just write three things that are scientifically objectively good, even if you feel absolutely nothing positive about them whatsoever. Then at the end of the week when you are feeling useless and like you have just wasted another seven days staring into the abyss, you will have 21 tiny examples that things DO exist outside of that abyss. It doesn’t matter if you don’t believe them now, the main thing is that you see them, acknowledge them and simply know that they are out there. Seeing good things isn’t as good as feeling them, but if seeing is believing, then my dears, we are at least a step along the way.

Thank you so much to everyone who has been sending me endless and wonderful support at this really rough time. You are all of my good things and I hope that this week, this hopefully less morbid post/challenge can partly repay you for all of that kindness and be a little support and help for you too.

Take care everyone x

GoodThings