One question I have been thinking about when thinking of eating disorders is, IS THERE FULL RECOVERY? What is considered full recovery? I mean, obviously if you have bulimia and stop purging, then you have reached recovery in that respect, but what about anorexia? If you are not restricting calories, not working out to extremes (or working out at all), not taking anything to intentionally make you lose weight, but it still takes you hours at the grocery store to pick out foods that constitute a meal that someone who had never had an eating disorder would consider a meal, you can still remember a whole list of the calorie and fat contents of foods and you are losing weight, is that recovered? At what point are you considered recovered?
Grab your blankets and beverage kids. Story time!!!! 🙂
I am so lucky that in 2004, when I finally decided to stop the bullshit efforts of college campus doctors that did nothing but give me some Zoloft (which was so harsh on my stomach I had constant nausea which made my eating disorder worse), I chose to get some real, serious help by a psychotherapist that specialized in eating disorders, but also treated bipolar disorder. I mean, at that point, I was now working full time in a career and for the first time ever had my own health insurance, so why not use it to get the help I needed since I obviously was doing a piss poor job of getting rid of it on my own. He treated me for my eating disorders and around 2006, when I believed I was finally approaching recovery, I ended up in the hospital and came out with a diagnosis of Bipolar II. Even more fortunate for me, my doctor had done rounds at that particular hospital and in their psych facility so they gave him the professional courtesy to treat me while I was in there. (Before they granted him that though, I had 2 other doctors that tried to treat me. One told me I just had an anger issue with my boss, the other kept trying to force me to take Welbutrin even though my doctor had told me that I was never to be on that medication again because of my eating disorder history. He had put me on it before for the period of a month as a scare tactic to get me to discontinue purging and with my scardey cat ass, it sure worked. I stopped purging and haven’t purged since! But, he also said that I should never be put on it again, just in case. I raised a stink because this doctor was putting me on it despite my protests and my continuing declarations of my eating disorder history and gave him my doctors business card with instructions to contact my current doctor to verify. They did one better and just brought HIM in to treat me.) So, my doctor has my full history with eating disorders and bipolar disorder and monitors both. Why do I think this is so great? Well, when someone tries to give you something that you aren’t supposed to give to people with a history of eating disorders, he sure knows not to give that to me! 🙂 Not just that though, but he knows that if certain medications for bipolar disorder are going to cause extreme weight gain, he won’t use those in my treatment. He knows to test my blood levels CONSTANTLY because I am on lithium and any changes in my thyroid, either hyper or hypo, could potentially send me back to old habits. But, he also knows that some of my life stressors can cause weight loss, regardless, and some medications that he starts me out on can cause weight loss at first, depending on the combination with other medications, but will be careful to monitor that and make sure that after being on the medication for some time, those old habits do NOT come back.
After my eating disorder seemed to be handled and recovery was within arms reach, my doctor sat down with me an agreement with him on certain #s for my weight etc. We looked at my height and then at a chart of what was considered healthy weight for someone of my height and body type and activity level. We also had been monitoring my weight and what numbers I PERSONALLY felt comfortable with and felt comfortable in. You know, weights where I wouldn’t care or hesitate if I ate a little too much for dinner that night and a weight that kept me in the same clothing size (give or take a tiny bit based on the store or designer of course…us girls know how all of that crap fluctuated. I mean, I am one size at Abercrombie, but another size at every other store and with different designers) so that I could gauge when I was out of my comfort zone. If my CLOTHES started to fit different in an uncomfortable way, THEN I could check my weight and think about doing a few more exercises or cutting back on the junk food a little. After a bit of that, we then settled on a comfortable weight range for me. If I fall below, then I need to schedule an appointment with him and we need to talk about my eating. If I go above and am unhappy and uncomfortable with it, I schedule an appt and we talk. If I go above, but I am ok with it, then its ok, but I am not to start freaking out about my weight UNLESS I go ABOVE that designated number the two of us settled on. I was originally given a 5lb weight range. That was back in 2004. I now have increased it myself to a 10lb range (an extra 5lbs on the high end) before I freak out and call him. I had to give myself a little bit of breathing room on the number because of the medicationsavailable for bipolar disorder. Some make you gain, some make you loose, so your weight can go up and down as fast as our moods do. Until our meds get stabilized and consistent, its hard to keep our weight consistent. Some of the biggest culprits are mood stabilizers like Lithium, Depakote, and Seroquel.
Right now, I have just started some new meds. I was previously on the same meds since my first hospitalization. My dosages changed and I had some Vyvanse (a stimulant which contains Adderall) added when I was diagnosed with PTSD in 2008, but otherwise, my body had gotten used to the same meds and my weight would fluctuated based on my dosage of Vyvanse and life stressors as well as work. The more stress and anxiety, the faster the weight came off. However, I was not intentionally restricting any calories, I was not working out to extremes (I wasn’t hitting the gym at all!). Life just handed me a plate of stress and anxiety and the pounds dropped off. Does that mean I am not recovered???? Even now, with this brand new med change, I eat my ass off, but I am about 3 lbs under the lowest set weight by my doctor and I. I have mentioned it to my doctor and he has said that until we let the meds work themselves through my system for at least a full month, and I am truly eating and not trying to lose weight or restricting, then we aren’t going to worry about my weight at this point. I admit that when someone asks me what I want to eat I am “that person” that always says “I don’t care.” Most times, (because once I focus on something, I lose all concept of time and everything), I don’t eat my first meal til after 5pm, unless I had breakfast with my meds, but its not because I am afraid to eat, its not because I DON’T WANT TO EAT, and its not because I don’t want gain weight. Does this mean that I am not in recovery?
Having bipolar disorder and eating disorders or a history of eating disorders, every little thing impacts our weight when you consider our medications, mood swings, if we are also diagnosed with an anxiety disorder or not (anxiety can make the metabolism move faster than a speeding bullet! lol), how much we work out, how much stress we are under, etc. Environmental factors play such a huge role as well. I found this one out all too well. If things at home are not well or if things at the office are not well, watch those pounds fall off. Even if you eat!!!!!!!
I believe that I AM in recovery. It was a process and I still have to be mindful of triggers and other behaviors creeping up. I have been on the lookout for them since 2004. I think I always will.
As someone who has a website who discusses mental illness, including eating disorders, and having personally experienced an eating disorder, I know that when we are suffering or are at our worst, we look to those who have recovered or who have stabilized and look to them for hope and inspiration that we too can achieve that. That is, given that recovery is possible and stability is possible. So, what constitutes recovery for an eating disorder? What constitutes stability for bipolar disorder?
Even though I consider myself in recovery, am I really???????