This is a hard post to write.
The topics I’ve been reading about this week, and the terms I’ve been learning, paint a picture of where this post is going. Eating disorders. Orthorexia. Subjective binge eating. Social anxiety. Comorbidity.
It is fairly easy for me to discuss social anxiety openly. I feel no real shame or need to keep it a secret (futile as that effort would be) that I am just a little bit shy and inhibited in social situations, current or anticipated.
I’ve even mentioned other things I struggle with at a “diagnosable” level:
- depression (specifically persistent depressive disorder with low self-esteem, but also provisional major depressive disorder). I don’t talk about this one directly because my psychiatrist and I decided to tackle the social anxiety first and then see how much of an issue depression still is. It may be that the stress and struggles of social anxiety are what drive or underlie the depressive cycles. And, if I’m honest, there’s a part of me that isn’t ready to stare depression directly in the eye. There’s a part of me that resists that diagnosis and that “label.” I can confront whatever is going on there once I’ve untangled some more acute stuff first.
- perfectionism. This one is easy to share. It’s so prevalent that there isn’t really any kind of shame or stigma attached to it. If anything, we need to work on de-glorifying perfectionism and see it for the destructive and insidious little beast it is.
- generalized anxiety disorder. I do struggle with GAD, but its intensity has gone down significantly since starting therapy. Again, for me there’s no shame in self-disclosing any kind of anxiety.
- body-focused repetitive behaviours (skin picking, cuticle destruction). Alright, this one is more embarrassing and frustrating because it leaves physical evidence of what feels to me like a complete lack of self-restraint. I don’t talk about it much, but there isn’t a whole lot of shame or denial here. It’s a thing that I do, and I hope it will get better as I address the underlying issues.
I feel reasonably comfortable sharing my experience with the conditions or “struggles” above. The biggest thing that holds me back from going into depth on more than one topic on this blog is a fear that people will think I’m some sort of hysterical hypochondriac who enjoys trying on mental health disorders to see how they look in the mirror (this is a classic example of a mind-reading distortion). Obviously, I am able to push that fear aside most of the time, or I wouldn’t be writing this blog in the first place.
Okay. I’ve delayed getting into the meat of this post long enough.
There is one area that I have struggled with my entire life since very early adolescence, possibly even earlier. There is one struggle that I feel shame disclosing, especially as an addition to what I normally talk about here. I flirted with the topic in my Worth My Weight post recently, but here it is, unfiltered:
The brain bully shouts, “They won’t believe you! How could YOU have an eating disorder? You are a healthy weight. You don’t purge or use laxatives. You eat regularly. Everyone has some body-consciousness struggles. You don’t have an eating disorder, you crazy person.”
And yet. This week I attended a long-awaited orientation and screening at the eating disorders clinic on the same floor of the hospital where I attend my anxiety therapy sessions.
My whole life, I have “flown under the radar” of eating disorder related screenings, because, as my brain bully so helpfully points out, I’m a healthy weight and I don’t fit any of the “big” categories.
But there’s this thing called comorbidity, and it refers to the presence of more than one disorder simultaneously. There is a very high rate of comorbidity between social anxiety and eating disorders (I only just learned this). This is why, I assume, my psychiatrist referred me to a dietitian when I mentioned a certain level of distress surrounding eating.
On our second meeting, months ago now, the dietitian asked the question that finally broke through my veneer of self-control regarding food and eating: “Do you feel ashamed of how you’ve eaten this week?” That question was like a switch. Or a hammer. I broke down crying.
Yes. I feel great shame. Every interaction I have with food is laced with shame, guilt, self-condemnation, and self-judgment. I feel controlled by food. Food has power over me, over how I feel about myself. Deeper than that, there is a profound rejection of my own body. This body that gave us two beautiful, healthy children. This body that is not objectively ugly. This body that is actually a healthy weight (even though it doesn’t feel that way), and strong, and capable of running 4k (and counting).
This dietitian finally saw the red flags that had flown under the radar for so long. She started the referral process (with my relieved consent) for the eating disorders clinic.
Body image is all I really thought I would need help with. But I was wrong.
The orientation and screening, a four-hour process, finally happened this week. After learning about the programs, I met with a psychologist and a nurse who both specialize in eating disorders.
I shared my emotional turmoil and my toxic relationship with food. I shared some of my history with food restriction, yo-yo dieting, pills and supplements, good foods and bad foods, self-harm, the restrict-binge pendulum, “failed” attempts at purging and “failed” attempts at fasting.
At the beginning, I opened with, “I’m not sure if I’m in the right place.”
At the end, I asked… “Do you think there might be… something to all this?”
The reply I got was, “Yes, absolutely, without question. We can help you. We want you to be free from this.” The feeling evoked by these words can only be described as “shattered with relief and validation.”
They told me about subjective binge eating. It’s different from objective binge eating in the sense that the amount of food consumed during a “binge” is not actually that high, but all the emotional and psychological symptoms and distress are the same. (Learn more here.)
They told me about orthorexia. An obsession with health or healthy ingredients. (Learn more here.)
I don’t know if these are official categories of eating disorders. I don’t even have an official diagnosis of an eating disorder yet. I’ve been “accepted” into the program for a full assessment, which will take another day and a half sometime soon, and it seems very likely I will be given a spot in a 25-week eating disorder group in the winter (once a week as an outpatient, just like the social anxiety group).
Beyond that, I am feeling very unsure, a little lost, and reeling. Half of me is screaming, “You don’t have an eating disorder, this is just your anxiety talking.” The other half is whispering, “You have always known this, deep down.”
Is my social anxiety driving my disordered eating? Is it the other way around? Are they separate issues? Right now my focus is on social anxiety, but in the winter I’ll have to choose between continuing therapy for social anxiety or beginning therapy for eating disorders and body image.
I am still processing all this. I feel like something inside me, this strangled little voice that has been there for decades, is sobbing, “Finally, finally, finally.”
I am embarrassed to share this. Terrified to hit Publish. But I must. I must because I promised myself that I would share this journey openly on behalf of the lost little girl still trapped inside me. If another lost little girl, or tormented adult, or suffering mom, or anyone, really, can benefit from this level of transparency and openness, it will be worth it.
We NEED to bring invisible illnesses into the light of day. We need to stop doubting ourselves and discrediting others by not “buying” their disorder or telling them to just “stop being anxious/stop overeating/stop being so sad.” We need to empower each other to help ourselves.
If you are struggling, please consider reaching out to someone. If you need someone to share your story with, I can listen. I am not a professional but I will believe you.