Friday, October 10, 2014

World Mental Health Day 2014

Hi, my name is Sam, and I'm a [recovering] anorectic.

Or so they tell me.

I still have a hard time believing it.

I've debated a loooooooooong time about writing this post. It has been over a year since the idea was first suggested to me, and I have been, mentally, sitting here with my hands over my ears yelling, "NOT LISTENING!" to the idea. Très mature of me, I know.

So what's this all about? To answer the question in a roundabout sort of way, let me tell you about the Minnesota Starvation Experiment. In WWII, faced with the necessity of dealing with millions of starving concentration camp victims, the US government asked for volunteers among conscientious objecting men. These volunteers had two simple tasks: 1) to be starved for several months and 2) to then be refed under supervision. These men were healthy young men in their 20s. None had any psychiatric illnesses or pathologies. They were just your average young men trying to do something to help their country.

The results were startling. Shocking, even. As the starvation experiment wound on, the men developed, essentially, characteristics of full-blown eating disorders. They became obsessed with food and recipes. Some started binging in secret. They developed intricate food "rituals," or habits around how they ate their meals. And, when it came time to re-feed the men, things got even odder. Remember, these men did not have body image issues when they started. And yet, many grew obsessed with the idea of gaining weight; some voluntarily continued restricting their calories. Others binged wildly. One even chopped off three of his own fingers in his distress at the refeeding process.

All of this strongly suggests that starvation itself, by itself, with no co-occurring mental illness (at least at the start of starvation) can induce all of the medical criteria for a full-blown eating disorder (ED).

This, my dear friends, is what happened to me. Or so I'm told. Many of you know that I was hospitalized for a number of weeks in 2013. Very, very few of you know the whole truth: I was hospitalized with Anorexia Nervosa (AN). It would appear that the starvation induced by my gastroparesis did to me exactly what the Minnesota Starvation Experiment did to the participating volunteers: it induced a genuine eating disorder. (This is, of course, a vast oversimplification. Eating disorders run in my family. But if genetics loaded the gun, gastroparesis pulled the trigger that sent AN spiraling directly into my brain). Imagine my surprise. And my denial. I spent the majority of the time I was in the hospital denying that I had any such problem. I'm told this is typical.

Fast forward a year and a few months. I am confidently assured by one of the country's leading specialists on eating disorders that I am, in fact, a recovering anorectic. Do I believe it? Most days, yes. There is now a devil that lives on my shoulder hissing at me anytime I choose to take care of myself. "You are such a pig...if you were really anorexic you wouldn't eat so much." In fact, that devil is part of why I haven't written about this before now. I've been able to maintain my weight in the healthy range since leaving treatment...barely, sometimes, but I'm not actually underweight. Below the weight the doctor suggested, certainly, but not underweight. Ergo, hisses the devil, I have no right, no right at all, to write about eating disorders. I should at least wait to see if I relapse hard enough to end up in hospital again. Then maybe I can write about it.

Bullshit. This, I realized, in a startling moment of clarity, is bloody stupid. I've been an inpatient in one of the country's highest ranked eating disorder clinics. I was told by a number of highly trained psychiatrists that I had a severe eating disorder that was potentially life-threatening. Maybe it's time I come out about it... I don't know that I have much that will help anyone else, but it behooves me to try. I will add that this is the scariest thing I have ever written about. It's one thing to talk publically about a physical disease (lupus). It's quite another to admit to the world, including potential future employers, that one is certifiably bat-shit crazy. But if I don't, who will? In honor of World Mental Health Day, I offer you my story in the hopes that one little voice can chip away at the stigma of mental illness.


  1. You are not bat-shit crazy. You did exactly what you needed to do to take care of yourself even in the face of your illness making it so very hard to do so. That is a sign of a woman stronger than anything illness can ever throw at you and I am proud of you.

  2. Most certainly not bat shit crazy. What you are doing is a sign of recovery. Hang in there. You got this!

  3. It seems like this is the opposite of Pavlov's dogs. You eat, it makes you sick, it really puts you off eating. However, you pretty much have to eat, so you can't just swear off it. You have to deal with it somehow. I'm really amazed at how you manage to keep holding a job, teaching classes, and writing coherent sentences with all of the garbage life keeps throwing at you. Keep it up!

  4. I'm also curious about your take on Ebola, as you have more training in the field of epidemiology than anyone I know of. It seems that so much of the transmission pathways are influence by individual choices of people with their own agendas, and there is a lot we don't know, so I can't get a handle on this myself.

    1. Well, the good news is that it isn't spread by air. The bad news is that it is spread by bodily fluids, of which there are an awful lot when the body crashes from the virus. I don't think we will have a major outbreak here in the states, but Africa is in serious trouble.

      The best explanation I've heard for why it is such a big outbreak this time is that it hit Western Africa, instead of Eastern Africa. Western Africa has malaria, and for the first bit of the outbreak patients were assumed to have malaria and sent home with antimalarials. This allowed the virus to spread to the big cities, and from there, to the airports. Since most of those countries don't have anywhere near our level of expertise at isolating dangerous patients, it's raging out of control. We are pretty good at it, though-- you'll notice that there hasn't been a major outbreak in Spain or Texas, despite patients being found in both places.

  5. Sam--

    Thanks for taking the risk and speaking out. It takes a lot of courage to admit and treat, much less publicly disclose, mental health problems and treatment.

    I'm the adult daughter of two people with mental health and addiction diseases who have never acknowledged, much less gotten treatment, of their illnesses. I believe their true selves would be appalled by the people their sicknesses have turned them into.
    Speaking out is shining a light on places people don't want to look. I believe more visibility can help to minimize the shame of having such illnesses and hopefully lead to more recognition and treatment.
    Thanks for having the courage to not only seek help and/or accept treatment, but being brave enough to speak out.

    I wish you well,


    1. Lisa--
      Thank you for your kind words. Mental illness is super-scary to disclose...I didn't even tell my family that I was in the loony bin. Or about my diagnosis. But I've seen too many friends forced to hide their diagnoses, and I don't like it. If I am open about my history of cancer, why the hell wouldn't I be open about an eating disorder? Logically it's inconsistent to talk about one and hide the other, no? And I figure that, as a ridiculously over-educated PhD with a stable government job, if I can't talk about it, who can? But it was still the scariest thing I've ever written.
      I wish you the best of luck with your parents. I know what it's like to watch helplessly as people refuse to acknowledge mental makes you want to take a 2x4 to their head and yell "Go. Get. Help!"


  6. Sam-

    Love the concept of taking a 2X4 to their heads and sending them for help. That's about the only thing I didn't try in nearly 40 years of watching family disappear down the chute of addiction and mental illness. Without acknowledgement and help, the illness doesn't change except to get worse. And it gets worse. And worse. I eventually accepted that I couldn't change/cure/control the addictions or mental illness(es). I walked away, toward help for myself, and didn't go back. That's why I am so convinced that speaking out and no longer hiding from the truth are so important. I appreciate your encouragement and willingness to be open. Covering up the truth only allowed my family to become sicker and sicker. Opening up to the truth is painful, but is the way back to a better life.

    Keep fighting. There's good ahead.


  7. Sam, I'm going to ask what may be a really rude question. If so, just tell me that. But someone at church mentioned that her daughter had been hospitalized for anorexia nervosa. Because I had recently read this post, I started wondering how AN feels. I'm wondering if there is the sense of "I'm hungry, but I can't let myself eat, because I've already eaten too much." Or is it more like "I can't eat because I'm not hungry and it doesn't taste good." As we were preparing to move to San Jose years ago, I was so stressed out that I found eating really hard. I had kids to feed, so I made myself eat a reasonable amount, but it was tough. I lost all of the baby weight from kid #5. However, I have since gone the opposite way, and now I deal with stress by eating. Oh well. Sometimes when my husband cooks and serves the food from the stove, he gives me as much as he wants to eat, eating can really be a chore. Does it feel like that?

    I hope this isn't rude or too personal, but you are one person who has the training and medical background to put this sort of thing into words.

    1. Sorry, didn't see this comment earlier. It's not too personal...but it's not easy to answer. For some patients it's "I am not personally allowed to eat," or "I don't deserve to eat." For others eating is a sign of a loss of self-control. And frankly, although healthy people never get this, there is a "high" that you get when you're starving that gets addictive. That high can be particularly addictive if you're going through stressful times, because it blocks anxiety. That's why eating disorders are sometimes referred to as maladaptive coping mechanism. I definitely experienced that last one in spades...I started starving because of the gastroparesis, and then got hooked on the high because I was going through a ton of stress. And now I have to watch it when I get stressed because it's so easy to slip back into bad habits...once you get past a certain point you get sucked in fast and start free-falling and then it's bad.