Letters to my eating disorder

My therapist asked me to write two letters to my eating disorder. One letter addressing the disorder as my friend, the other addressing it as my enemy.

I don’t really know what I expected myself to write, but reading them I was quite taken aback. I don’t think I realised what the ‘friend’ letter would be like, well really I had no idea what either letter would consist of. I tried to write them at times where I felt 'ok', so I wasn't biased towards the disorder being more of a friend, or more of an enemy. 

I think the comparison of these letters is probably one of the best ways to explain what having an eating disorder is like, to somebody who knows nothing about them. The two sides, contrasting feelings that tear the sufferer down the middle.

Dear ED, my friend,

I do not really remember my life before you. I do vaguely, but it doesn’t seem real to think that there was a time you were not a part of me. It would be a lie to say that everything you’ve done for me has been pleasant, but through the worst times you have been there to offer me control and to give words of encouragement. Through the hundreds of sleepless nights, the daily physical struggles of crippling stomach pains, the loss of energy and muscle mass, and through the worst times where my hair has fallen out and my bodily systems have been taken far out of my control, you have been there. You have encouraged me that these struggles are worth it. You have always been there to remind me that these struggles will lead to the ultimate goal: to be thin, as thin as possible.

I named you Beelzebub, after Binsfeld’s classification of demons, named the seven princes of Hell.  This name suits you because you are powerful and, like Beelzebub, you make mere mortals worship you. Beelzebub is also one of the seven deadly sins, it is gluttony; which felt very fitting.

You have made me feel powerful, so powerful; by showing me I am not weak. You taught me how to have the will power to starve myself for days on end if I want to, or how to live on a single piece of fruit a day. If I have that power, then nobody can call me weak. I am more powerful than other people, because you taught me I do not need to eat like they do. I have no need for three meals a day.

I was raised as a Christian and have always believed in God, so for me to insinuate that you are God-like would be wrong, but just as I know God cares for mankind, I know you care for me. It is hard to not liken you to a God. Your powerful is extraordinary. You can sustain me in a way that food cannot.

I have missed many social occasions because of you, but I know, although I miss my friends and family, you are showing me the way to my ultimate goal and sacrifices must be made. 

Through our relationship, I have become less emotional and I often feel numb or empty. But I am never empty because I have you. Some people may think the deadening of my emotions is a negative thing, but they’re wrong. Thanks to you I realise that most day to day things are meaningless. I know that achieving our goal will be a constant fight, so I do not need to waste my emotions on irrelevant issues.

It could be argued that you, Beelzebub, have taken my life away from me. I’m sure many people would view it that way. Actually, you have given me more control over my life than anything else ever has. You are my greatest and most faithful companion.

With love,

Your Catharine. X

Dear ED, my enemy,

It’s hard for me to remember what my life was like before you were here. It feels an extremely long time ago. I suppose that’s because it is a long time ago. It has been over seven years since I first met you, and being twenty five that is a considerable chunk of my life. I can vaguely remember what it was like to go out with friends or family, to go out for meals and not feel sheer panic, physical sickness, anxiety and absolute dread. All I have are distant memories of my life before I met you.

I wish I had never met you. Since you, my life has fallen apart bit by bit. I have lost friendships and a relationship because you turned me into a shell of who I was. You made me into an anxious, terrified, pathetic mess whose life revolves completely around you. You have rendered me incapable of socialising properly, made me believe I am unworthy of friends, unworthy of anything nice.

You have complete power and control over me; you have ensured that the only thing I truly long for is the ultimate goal of being as thin as possible. Sometimes I feel very small parts of who I used to be coming through, trying to fight their way in. In these moments I’m more likely to eat something, I’m more likely to have energy and motivation, but these moments last such a short time. You stamp the old parts of me down, until they shrink into nothingness again.

I can never escape from you, you’re there when I go to sleep and there when I wake up. You’re everywhere I go because you have made a home inside my soul.

But my soul was not yours to take.

I lied earlier, there is another thing I truly long for and that is to be rid of you.

Regretfully yours,

Catharine. 

Where I am may be lost

I can't remember the last time I wasn't in pain. 

Not only mental pain but physical too. I get huge discomfort if I eat more than a salad or half a sandwich a day. 

Every day, at one time or another, I'll be in pain from laxative use. This ranges from hours of stabbing pain that can wake me up in the night or stop me from sleeping, to just an hours pain when I first wake up. 

It’s usually when I’m in this pain that I think I simply can’t carry on like this. 

I get a right feeling in my chest and heart palpitations from excessive amounts of diet tablets. I get headaches due to lack of food and drink. 

Yes I’m alive, breathing and I have many, many thing to be grateful for, but what quality of life is it to be ruled by an eating disorder? To plan every day around the needs of the disorder? To put the needs above the disorder above everything else? 

I ask myself over and over why I do this to myself, as if I have any choice or control. 

Mental illnesses take control of people and make us lose touch with who we really are.

So many people who suffer with eating disorders hide it, I hid my problem for years. I pray one day the society we live in will be more open and people will not have to hide the truth. 

'I am not lost for I know where I am. However where I am may be lost' - A.A Milne 

Reflect on your blessings

The last few months have been the worst months of my life. The darkness has been unbearable at times. In the recent week or two I have tried so hard to eat a little more than I was, but it's difficult and I'm still not putting on weight. My laxative use renders me half paralysed at times and makes it impossible to sleep properly at night. My blood tests show my immune system struggling. My hair is starting to die and falling out due to lack of nutrients, and I feel weak almost all the time. 

Due to how dark things feel, I decided to try and think about things I am grateful for.

I don't mean the big things in life that we are all grateful for, like my family, friends, my cat. 

All very important things but I wanted to think about the little things that I probably don't even realise I'm grateful for. 

-The fact my flat has a private garden, my garden is definitely my 'calm place'.

-The fact supermarkets sell low fat iced coffees.

-Tracksuit bottoms and slippers.

-The elderly couple who live a few flats away from me, whom I've never actually spoken to, but who wave whenever they see me.

-Johnson's baby bedtime bath soak, it smells amazing.

-My recent weekend stay in Somerset, I love that place and staying there reminded me how much I want to qualify so I can go and work there. 

-One of my close friends just gave birth to a beautiful baby girl. Looking at this gorgeous baby reminds me I have to get better otherwise I won't ever be able to have a baby of my own. 

On top of these things, I am blessed with a loving family and such caring friends. I know in that aspect I am extremely lucky. 

Out of each week, I probably only have a day, or maybe two days, where I can see the good in life and the things I am grateful for. I also know if I carry on the way I am, my body will continue to shut down and eventually that will be the end. I know the fight is far from won but the things I am grateful for push me on. 

'Reflect upon your present blessings' - Charles Dickens 

Nine circles of hell

Being diagnosed with anything, physical or mental, can be a long and trying process. 

It can take time for professionals to be able to diagnosis or professionals may not always agree with each other. 

A diagnosis is not the be all and end all, but for some people it can be comforting to put a label or a name on the feelings they have. 

The diagnosis for my eating disorder is atypical anorexia nervosa. 

The 'atypical' part means that someone meets the majority of the criteria for anorexia nervosa, but not all of it. There is also atypical bulimia nervosa, and the 'atypical' disorders are often categorised as the 'eating disorders not otherwise specified' (EDNOS). 

In my case, I meet the criteria for anorexia, all apart from the fact that most months I still have my periods. In many ways this makes me feel invalid. 

As time goes on and I see more of my care coordinator and more of my psychiatric consultant, I am repeatedly told that I'm not a low enough weight to get any NHS help for my eating disorder.

I have said time and time again to professionals that I don't want physical help, as in being helped to put on weight. 

I want therapy to help my relationship with food and to help stop me seeing food as an enemy. 

I'm so sick of being told I still weigh too much to be helped. I'm sent for weekly blood tests and the slip I am given each time states 'anorexia nervosa' across the top, yet I'm still too heavy to be given help. 

Obviously there is private help, which I am looking into but I lack motivation to follow these things up or to make effort to contact anyone. Mainly, because I have little hope of this getting better. 

After hours upon hours with professionals, discussing every part of my life, the only statement that is left ringing in my ears, is that I am still too heavy. 

Dante wrote about nine circles of Hell, I am certain I am within one of them. 

Where is summer?

Days seem endless, full of assessments, visiting different hospitals to hear about a range of treatment programmes. 

I know almost everybody wants to help but nobody knows what to do. 

Nobody can diminish the darkness. 

I desperately don't want to go into a hospital, but my other options seem bleak. 

I'm tired of being tired, of being exhausted. I'm tired of feeling so mentally drained.

I long for someone to discover a medication that can stabilise this disorder, that can silence the voice of this disorder. 

Someone once said to me that it can snow as late as May but summer will always come in the end. That phrase has always stuck in my mind and all I can do now is to hope that somewhere along the way, summer comes and the darkness ends. 

Stigma/my diagnosis

The stigma that mental health illnesses carry are like dead weights. 

I can only write about things I have experienced myself, things I have heard people say or stuff I've read about. From my experience one of disorders that carries one of the heaviest and most detrimental stigmas is personality disorder. 

The name 'personality disorder' covers a range from avoidant to schizoid to narcissistic to emotionally unstable or borderline. 

Perhaps the most commonly heard of personality disorder is emotionally unstable/borderline. 

Borderline is the name given in DSM-IV and unemotionally unstable in ICD-10, but the criteria for borderline and emotionally unstable are almost identical. 

DSM-IV and ICD-10 both list the features of this disorder, and a person does not have to meet every single feature to be given the diagnosis. 

EUPD, unfortunately, holds a stigma with it that people with this disorder are manipulative, attention seeking and 'badly behaved'. That when/if they self harm or attempt suicide it's always only for attention. They purposely cause arguments and often make false allegations, they can't be trusted and a common phrase I hear about patients with EUPD is that they 'love being in hospital'. 

In actual fact, EUPD means the person has problems regulating their emotions, often leading to self harm. They may have unpredictable mood swings and/or not know why they feel certain ways. They often have identity issues and insecurities, making 

EUPD very common in people with eating disorders. 

But, it seems some healthcare professionals do not deem personality disorder as a 'real' mental illness, and do not view it in the same way they see bipolar or schizophrenia.

Patients with EUPD can be hugely challenging, as can patients with any other illness, but is this a reason to tarnish the name of personality disorder so new patients are almost written off before even being met, simply because of their diagnosis.

My official diagnosis is an atypical eating disorder, co-morbid with depressive disorder and traits of emotionally unstable personality disorder.

I wasn't surprised when I was given this diagnosis and it didn't upset me, but it does make me hope I am not seen as a manipulative or attention seeking patient. Even though it isn't a 'full' EUPD diagnosis, people are still quick to stigmatise. I knew I would be told I had EUPD traits due to my self harm, suicidal ideation and identity issues. 

Luckily, I knew myself for twenty five years before this diagnosis and I know I am not what any stereotype says. However, some people are not as fortunate as me and they get almost consumed by the stigma of disorders. 

Surely the best way to erase stigma is to remember that every illness is a valid illness and to try and see past the difficulties that mental disorders presents. 

The addicting outlet

(Trigger warning; post about self harm)

I first self harmed when I was fifteen years old. Looking back now I don't remember the reason why I made those first cuts.

My care coordinator questions me around this, she's looking for some sort of trauma that hit me at that age to start it off. 

But for me it wasn't a trauma or a life event that made me start self harming, it was just something I did. I wasn't terribly happy at the time but again, for no specific reason. Looking back I know I was a teenager and I probably felt emotions and didn't know how to deal with them, so cutting was my outlet. 

The problem with self harm, in whatever form it takes, is that it is hugely addictive.

I've heard many healthcare professionals say that they cannot understand what would take someone to the point of wanting to mutilate their own body. I think to myself good for you that you can't understand, that means you've never had that level of mental torment. Or, maybe, you could argue they handle their emotions in a more positive way, who knows. 

For me, self harm takes the form of cutting and burning, and the addiction is real. 

I think the pain is quite nice, physical pain can momentarily relieve the mental pain.

But it is about more than just the pain, it's something I can't even put into words. 

Having been addicted in the past to tablets containing speed, I would like self harm almost to the hold drugs can have over a person. 

You can have every good intention, every will in the world, but when push comes to shove self harm is like a familiar friend, a warm invitation that you recognise and know. Something incredibly hard to break away from. 

My care coordinator recently asked me if I feel ashamed or embarrassed about the scars I have. She asked this gesturing to the burns on my hands and scars on the inside of my arms. 

I think she wanted me to say yes I would be humiliated if someone saw them. - if I had said this, maybe she would have used this as a reason for me to stop.

But I said no, and that's the truth. I'm not ashamed of any scars or burn marks I have. 

I wish I could have got this far in my life without self harming but I don't believe that was possible so I have these marks on me, but I'm also still here. So no, I'm not ashamed. 

Nobody should be ashamed of self harm because it is natural to need to find ways to cope, and not all ways are deemed 'healthy', but at least you're still here.