Tag Archives: Binge Eating

In Between Mental Illness and Wellness

I have often talked about recovery on this blog. Particularly, I have talked about recovery from my disordered eating habits and to a lesser degree self-injury. I wanted to get rid of my binge eating and stop self-injuring. Today, as I gave this some more thought, I took recovery one step further. So what if I stop bingeing and self-injuring? Would that then mean I’d be cured of my mental illness?

Of course, strictly speaking it wouldn’t. However, what if it did? What if I were cured of my mental illnness? After all, I exhibit far fewer destructive and aggressive behaviors than I did years ago. If I were to check mysel finto a mental hospital just as I am now, with no history of acute mental illness, the registrar would laugh at me. I wonder even if I’d be sick enough for outpatient mental health care if I presented with jut the symptoms I’ve been having lately. My overeating may or may not meet the criteria for binge eating disorder or eating disorder NOS. My self-harm does meet the criteria for non-suicidal self-injury, but then again these crteria are quite vague. My mood does not meet the criteria for a disorder. Heck, even when I was suicidal in 2007 and was clearly in need of acute psychiatric care, the only diagnosis the psychiatrist could come up with was adjustment disorder. Adjustment disorder is no longer covered by health insurance. In other words, under DSM-IV, which doesn’t include binge eating or self-injury as diagnoses, I would hardly if at all qualify for psychiatric care.

Of course, I do have borderline personality disorder and Asperger’s Syndrome – I still meet the criteria for these. However, no general practitioner would come up with the idea that I’d have these if I asked them to refer me to mental health services, and the vague referral letter my GP wrote in 2007 would not be enough now. So if I’m not sick enough at first sight for mental health care, am I then recovered? I don’t think so.

Mental health care has in recent years been more and more reduced to mere crisis intervention or other interventions directed at averting people becoming a pain in the neck. Now I won’t say I can’t be a pain in the neck, but a GP writing my referral letter from scratch now would not know. If you aren’t a danger to yourself or others, you most likely won’t get mental health services paid for through insurance. As such, mental health treatment is focused on curing the symptoms of severe mental illness (which is in most cases impossible), whereas recovery is more than that. Recovery, after all, is getting your life back on track.

As a long-term institution patient, I struggle with this. I am relatively well mentally speaking – probably not as well as I describe in the above paragraphs, but still -, but I don’t have a life. When I was admitted to the mental hospital in 2007, I was a university freshman in a new city. Now I’m nearly 30 and have little that could fulfill my life. I have my blog, but that’s about it. It makes me depressed. Not suicidal-type depressed (or should I say “adjustment-disordered”), but it does definitely make me slightly depressed. If I am not sick enough for mental health services and not well enough to get my life back on track without help, then where do I find help in recovering my life?

I hope that outpatient mental health services aren’t really as bad as I now think they are. I can only hope the recovery model still hasn’t been killed by the push for budget cuts. It however makes me sad to read in memoirs of mental health consumers about the recovery model and using mental health services to get your life back on track. After all, I’m afraid you can’t get mental health care for that now even if you’re severely mentally ill like myself.

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Willpower

I am a member of a few general recovery groups on Facebook. Most of the members are addicts or alcoholics. I am not. I consider myself addicted to food in some ways, but it isn’t like I can just stop eating, like an addict can quit their substance of abuse. I’m not saying that’s easy either. That’s my point of this post.

Most recovery groups are based on some twelve-step model. As such, we see a lot of references to a higher power or God in the posts. One that I came across recently was that we have to redefine willpower. Willpower is the will to turn over the reigns of our life to God.

I like this statement. It doesn’t mean we don’t have to attempt abstinence (or in the case of an eating disorder, balance). We do still need to refrain from engaging in addictive behaviors. The difference is, God is guiding us on our journeys. If we turn over the reigns of our life to God, we are realizing that we need to follow His lead, not the road of addiction.

I am a person who often turns over the reigns of her life to other people. I allow others to make decisions for me and in some ways, I’d like them to make the decision that I can’t have binge food, too. Staff won’t do this, as I’m an adult and responsible for my own recovery. My husband sometimes gets me a small bag of candy when I’d intended on eating a far larger quantity. This may lessen the physical effects of a binge, but it still means I engage in compulsive eating.

The first step of Overeaters Anonymous is to say we’re powerless over food. (The same statement is used in Alcoholics Anonymous and Narcotics Anonymous, with “alcohol” or “drugs” instead of “food”.) Therefore, we need to find a power greater than ourselves to help us recover from our addiction. Note that this higher power doesn’t necessarily have to be God: for atheists and agnostics, it can be the OA group they participate in. This signifies that, while no-one is taking responsibility for another’s choices, it is the guidance of our higher power, be it God or the group, that leads us into recovery. Even as believers, we believe that we have free will, but we can still turn the reigns of our life over to God. If we do this, we learn to rely on Him for paving the way for us into recovery. It isn’t that we are no longer ourselves in recovery or not, but we rely on God for facilitating our process of recovery.

I am nowhere near recovering, as regular readers of this blog know. My last binge was last Friday, and I was tempted to give in again today. I didn’t, which is a small win, and my thoughts on willpower contributed to that. I realized that God doesn’t want me to binge, and He gives me the means to resist the urge. Today, I was led to write this post instead of binge. It may sound like I don’t practise what I preach, as someone who’s still pretty deep in her eating disorder, but it personally helps me to preach recovery.

Disordered Eating: A Cry for Help

One day when I was probably in seventh grade, I read an audio magazine for blind teens. It was really a mixture of its own content with content from other teen magazines read aloud. One of the articles from another magazine was about an eating disorders unit. I just remembered this as I read a passage in J.J. Johnson’s Believarexic, in which Jennifer remembers learning about anorexia for the first time in fifth grade and wondering how the celebrity who died of it, got as skinny as she did. Later on, Jennifer learns about people being hospitalized for eating disorders. She envies them because of their size but also because of the attention they get.

This hit home with me. Back in seventh grade, I had already firmly embarked on the binge eating boat, but since I was at a healthy weight for my age and height, I didn’t notice my eating had spiraled out of control already. I remember once, probably in the same year, being confronted by my classmates about getting five candy bars out of the vending machine and eating them all in one sitting. However, I just got annoyed and didn’t realize that my classmates may have wanted to protect me from unhealthful choices.

We didn’t learn about binge eating disorder or compulsive overeating in health class. All we learned about eating disorders was about anorexia and bulimia. I even did one of my gifted program projects on these eating disorders. I didn’t tell anyone that, as I was writing the paper, I was trying to figure out how I could become anorexic.

No, I didn’t “want” anorexia, like some teens say they do. No-one consciously decides to develop an eating disorder. But I did want the perseverance that I perceived anorexics had. So I began keeping food diaries. This was before I had access to the Internet and I couldn’t read packaging, so I couldn’t check calories. In truth, as I look back at my food diaries of the time, they show a pretty typical overeater’s pattern. But I wanted to have some control over my food intake by keeping these diaries. Not that it worked, of course. Over the years, my binge eating got worse.

Back to the article about the eating disorders unit. For some reason, I felt compelled to be like these patients. I don’t know whether it was pure attention-seeking. I mean, I got plenty of attention from my parents and teachers. What I might’ve been missing was someone who saw how much I was struggling. Maybe, if I became anorexic, they’d see how miserable I was.

The other day, I had a meeting with my psychologist. She wa spushing me to take steps towards independence in preparation for my move in with my husband. I can’t remember whether she said so, but she gave me the impression that she felt I was doing better because I had much fewer meltdowns and emotional outbursts. In truth, I may be a little better, but I still have a pretty miserable life and feel pretty crap. Instead of becoming self-destructive or aggressive, I lie in bed or resort to overeating. A fair quality of life is not just not being a pain in the neck, but also being able to experience pleasure every once in a while. It isn’t that I never do, but it’s quite rare that I do things that bring me any sort of satisfaction. For example, I don’t craft nearly as much as I used to, because I can’t handle the noise and crowdedness at day activities.

I was also telling my psychologist that I’m completely dependent on my treatment team. What I meant was close to the exact opposite: I have no control over what goals are set for me, but it is my sole responsibility to reach them.

In a sense, maybe this whole disordered eating thing is a way of showing peope I need help. It sounds so pathetic though: someone who’s nearly thirty-years-old needing to be taken care of like a little child. IN truth though, often I feel that vulnerable.

Fighting My Disordered Eating

“Fight” is one of the writing prompts from Mama’s Losin’ It for this week. The first thing that came to mind as I reflect on this word is my fight against my eating disorder tendencies. This fight has been on my mind a lot lately.

Last week, had a bad binge and then in the evening, a fellow patient gave us cake. A nurse was joking about all the calories in the cake, poking my tummy as she asked: “Do you want whipped cream on your cake?” This was extremely triggering to me. At first, I thought “screw you” and decided to indeed get whipped cream on my cake. As time went by and I ruminated on what had happened, the nurse’s words and actions took on a life of their own, causing me to doubt my will to recover from binge eating. Not that I didn’t want to lose weight, but my initial instinct was to move back in the direction of bulimia by starting to purge again.

I later told the nurse that what had happened had been immensely triggering and she assured me that she’d just been fooling around a bit. Usually, this nurse has quite good ideas for helping me recovr from my disordered eating tendencies, so I took no further offense.

This doesn’t mean the doubts about how to fight my obesity have gone. In fact, the only thing holding me back from starting to purge again is my chronic heartburn, for which I’m getting an upper GI endoscopy done to see what might be wrong. I don’t have that long of a history of purging, but that doesn’t mean that the purging I did do can’t have caused damage. It certainly won’t get better if I resort back to purging now.

However, eating disorders are not just about preserving one’s health. After all, they often do the exact opposite. There is this hierarchy in eating disorders where restrictive anorexics rank as most perseverant and stubborn, followed by binge/purge anorexics, bulimics depending on their weight and the biggest losers (no pun intended) are the compulsive overeaters. In other words, as someone who suffers from binge eating only, I’m a total failure of an eating disorder sufferer. Yet I am not just an eating disorder sufferer, I am a person who happens to have disordered eating tendencies and who wants to fight these tendencies.

This hierarchy of the eating disordered is, however, also reflected in how seriously I take myself and am taken by other people with regard to my disordered eating tendencies. When I still purged, my GP put in my file that I had bulimia. I didn’t – bulimia has very strict criteria that I didn’t meet -, but it was in my records nonetheless. Now that I probably do meet the criteria of binge eating disorder, I’m commonly seen as just a little overweight at best and as an unmotivated, lazy fatass at worst. It’s probably crazy that I’d rather be seen as sick than lazy.

Mama’s Losin’ It

A Letter to My Body

Dear body,

I am sorry. I have not been taking good care of you lately. I have not been exercising regularly, have been binge eating a lot and have slept at all the wrong moments and been awake at night.

Of course, I could blame my eating disorder and see it as something entirely separate from myself. I could blame the holiday season. I could blame the winter blues (or general blues, since I’m not sure if it’s seasonal at all) for my laziness regarding exercise, my increase in binge eating and my poor sleeping habits. Then again, that’d be avoiding my responsibility.

Sometimes, I feel as though you don’t deserve to be taken care of. I feel you’re ugly, fat and unheathy anyway. You’re fat, but at least my husband doesn’t consider you ugly and you could be a lot less healthy than you are.

Besides, right now I don’t have as poor an image of you as I had before. I like my skin feeling softer when I apply shower cream, then scrub it, then apply body butter. I particularly even like my belly, which is the part you seem to be storing most of your fat.

I want you to know there’s nothing you did to deserve me stuffing you with binge food and depriving you of the exercise and sleep you need. I’m stressed, but you didn’t cause me to be stressed. I’m slightly depressed, but you didn’t cause me to be depressed.

So I want to thank you for being relatively healthy while I don’t take as good care of you as I should. All your major functions (except for vision of course) are intact. You keep your vitamin and mineral levels okay. You haven’t developed diseases like diabetes or heart disease in spite of your obesity, caused by my lack of proper care. You are okay.

As I said, I could look at your negative attributes: your not being as fit as I’d like you to be, your causing me acid reflux, irritable bowel syndrome and random pains and aches. Then again, whether it’s you causing me these problems or me causing you these problems, could be debated. The thing is, I can’t change your functions without taking better care of you first.

As dialectical behavior therapy also teaches, I can’t change you witout accepting you as you are first. You are okay as you are. Now I can work on improving you.

Yours,
Astrid

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Mom's Small Victories

What My Mental Illness Feels Like #Write31Days

31 Days of Mental Health

Welcome to day 29 in the #Write31Days challenge on mental health. Phew, we’re almost done. I truly find it a challenge and unfortunately don’t find it particularly rewarding.

Today, I’ll give you a glimpse into my unquiet mind by describing what it feels like tohave my mental illness. I have been diagnosed with borderline personality disorder, which is characterized by self-regulation difficulties. It also overlaps with other disorders.

Once, years before I had been diagnosed with any mental illness at all, I read a description on a Dutch site of the “borderline feeling”. It described a starting point at which you are feeling fine, or at least appearing as though you are fine. Then, a minor annoyance occurs. You start feeling frustrated, angry, infuriated. Then you feel sad, depressed, depserate. Fear and then panic also comes in. Finally, all feelings tumble over each other and create a big emotional whirlwind. That’s what the experience of BPD is like.

I can illustrate this with an example. This afternoon, I was feeling slightly on edge because it was time to make afternoon coffee and no-one was available to assist me. Then, when I noticed the nurses were flipping through some seemingly unrelated photos at the nurse’s station, I completely lost it. They had told me they were busy and now they were just chattering! I can’t even remember how the situation progressed, but within minutes I was banging my head, screaming and then ran off. When I came back to the unit (I had the sense of rationality to find my way back myself), I accused the nurses of faking being busy and ignoring me. They had truly ignored me (or been oblivious to me at least) when i stood at the nurse’s station and I still cannot be sure what thing was keeping them so busy. That being said, I couldn’t politely ask them whether they truly didn’t have time to help me make coffee.

We had a group discussion, in which I was again relatively calm. Then we had dinner, after which I went on the computer for a bit. I still was feeling slightly on edge but not over the edge. I wanted to talk to the nurse, so made use of my daily talk time to discuss my tension. However, I couldn’t get it out clearly what I was feeling and why. At that point, all emotions started coming together and I became angry and depressed and fearful at the same time. I went outside, accompanied by the nurse, to blow off some steam.

Usually, this feeling I had in the evining for me is triggered by some flashbacks or relivings of past “trauma”. I put that between scare quotes because the events I am reliving can be relatively minor. However, they can cause distress nonetheless.

During such episodes I also often feel dissociated. I used to completely regress into a child mode, but now I just feel as though I’m small and start speaking or babbling incoherently but don’t fully act like a child.

When an episode is severe, I may resort to self-destructive behaviors such as binge eating or self-injury. Usually, these behaviors temporarily relieve the tension but obviously they aren’t the solution. I often relapse soon after I engaged in destructive behaviors. With PRN tranquilizers, especially benzodiazepines, the same used to be true: they temporarily calmed me down, but when they wore off, I was increasingly agitated. Research shows that borderlines often become more agitated and may become aggressive when given benzodiazepines, because benzodiazepines reduce their anxiety and thereby their impulse inhibition. I do not personally experience this.

Mental Health Goal: Move In with My Husband #Write31Days

31 Days of Mental Health

Welcome to day 26 in the #Write31Days challenge on mental health. Today, my husband and I accepted the house to the right side of Arnhem we were offered on Thursday. I am therefore cheating a bit with the 30-day mental illness awareness challenge and choosing the question from day 29. Actually, it isn’t cheating at all since I never followed the challenge to a T. Anyway, for day 29, the question is about some of your goals with regard to your mental health.

My main goal that I’ve been working on for the past nine months now is to eventually be able to move in with my husband. Since we’re moving to the right side of Arnhem in probably less than a month, you may think there’ll be a bit of a delay in finding me care, but things never went that fast anyway. I hadn’t had an intake interview with supported housing on this side yet. Neither had a definite decision about allocated care hours been made. Remember, we’ve been working on this goal for nine months. Things go that slowly.

One factor in this slow-going process was the fact that my treatment team and I were waiting for the consultation with the autism center we didn’t have till the middle of May. Looking back, there’s not a single thing this center has been helpful with. Another factor, however, was the fact that my husband and I had been planning on moving for months. Even though my psychologist said she’d make arrangements as if we weren’t going to move, I at least have a bit of hope (or illusion) that now that the elephant is out of the room, we can actually start making arrangements for my care.

Apart from preparing for living with my husband, I don’t have any real goals for my mental health treatment right now. However, living with my husband requires a greater level of emotional self-control than living in an institution with 24-hour care. My husband works irregular hours and may be working long days. I won’t have support available when I need it right then during my husband’s work hours. If a support worker will be able to come out to the tiny village on call at all, it’ll take at least fifteen minutes if they can leave right away. Fortunately, I am relatively good now at spending time without care if I know at what times I’ll be abe to enlist a support worker or my husband will be home. I still need to work on improving this ability, because my husband cannot always tell when he’ll be home.

When I do live with my husband, additional goals for my mental health will have to do with other aspects of emotion regulation. I want to finally learn to kick the binge eating beast, for example. There are undoubteldy other negative coping skills I need to learn to replace, but I can’t think of them right now. In short, I hope to eventually be able to participate in day activities and live with my husband without too much emotional turmoil or behavioral outbursts.

Those First Five Pounds

As regular readers of this blog will know, I am quite overweight. In fact, I need to lose about 30lbs to be at a healthy BMI. Thankfully, I haven’t gained any weight in the past eighteen months, but I haven’t lost any either.

One of this week’s prompts over at Mama’s Losin’ It asks me what is sabotaging my plans of losing five pounds. Though five pounds isn’t even enough to get my BMI under 30, every journey of a thousand miles starts with a single step. So what’s keeping me from losing those first few pounds?

Let me for once not go into the details of my disordered eating habits. I have written many times abut my tendency towards emotional eating and bingeing, but this does not seem to be the only factor keeping me from dropping those first five pounds. Of course, weihgt loss requires self-control, and this is exactly what I lack during a bingeing episode. However, doesn’t everyone have times when they lose control over themselves? Also, I’ve not binged in a few weeks and yet haven’t lost any weight. Could it not be the simple habit of eating too much over an extended period of time and not getting my butt off the chair that is truly keeping me from losing any weight?

I don’t check food labels when I get something to eat. I don’t count calories. Now I’m not advocating obsessing over calories, but some awareness is essential for weight loss. I habitually think that foods are less calorie-rich than they actually are. This doesn’t just go for binge foods like candy, where I can easily exceed 2000 calories in one binge. I was shocked one day when my husband and I went to McDonald’s for lunch and I had downed 1000 calories with what I considered a small meal. Like, a burger, small serving of fries and a small milkshake. Yes, I do know milkshakes are not healthy, but I seriously didn’t know they were that high on calories. My husband warned me that I shouldn’t eat 1000 extra calories everyday or I’d gain over 100lbs in a year. The truth is, I probably exceed the number of calories I burn by at least 500 almost everyday.

I also don’t exercise nearly enough. I get fitness-focused physical therapy once a week and go to the gym once a week for 45 minutes. That’s not enough. In addition, I should be going on the elliptical or stationary bike at least twice during the week. I did this faithfully for a while, but have been too lazy to do this lately. I do go for walks, but not as often as most people do.

Now that I review this post, it’s a miracle I am not over 200lbs already. I went to the gym this morning, so I’m not sure it’s healthy to go on the elliptical now. Then again, I didn’t disclose how much I ate today and am not going to go into detail on it either (hint: 720 calories for lunch). It’s too bad writing about weight loss won’t get me to drop those extra pounds.

Mama’s Losin’ It

Prayer and Reflection: Jesus Helps Me Through My Eating Disorder

I have had quite the urge to engage in eating disorder behaviors today. It’s raining, so I can’t go out to the town store to get some candy. Besides, it’d not be right in the long run. After all, I’d not be caring for myself well by indulging in the urge to binge.

So I paged through Journaling in Eating Disorder Recovery. The book is explicitly Christian. Since I am a Jesus follower too, I have felt very much touched by the questions and suggestions in the book. At several points, the author encourages the reader to find Bible verses or other inspirational material that will help them through their recovery journey. So I looked online for some Bible verses that help me strengthen my willpower to overcome this urge, at least for now.

“For this reason he had to be made like them, fully human in every way, in order that he might become a merciful and faithful high priest in service to God, and that he might make atonement for the
sins of the people. Because he himself suffered when he was tempted, he is able to help those who are being tempted.” (Hebrews 2:17-18 NIV)

This is so powerful. Jesus was human himself, suffering all the usual temptations us humans face on a daily basis. Jesus did not have an eating disorder, but He was undoubtedly tempted to indulge overeating every once in a while. After all, everyone is tempted ot overeat at times. Yet Jesus overcame this temptation. We could say He did so because he is God, too. That would be disempowering ourselves, because we are saying: “I coud never resist temptation like Jesus did, because I’m not God.”

What this Bible verse says, however, is that Jesus is able to empathize with us and thereby help us. We may not have the Godly powers Jesus has, but we can lean on Him, and He will care. After all He knows what it is like to be fully human. He cannot just sympathize, but truly empathize.

As a mental health sufferer, I tend to look to people who have a lot in common with me for guidance and support. I look to people who have had the same experiences and struggles I face. I look to people who cannot just sympathize, but empathize.

How wonderful is it that God HImself, through His son Jesus Christ, can empathize with all of us! He knows what it is like to be tempted, so He is willing and able to help us through.

God, help me through the urge to binge for just one day. Help me face the reality that, in the long run, bingeing will be bad for my body, and I need to take good care of my body. Help me realize that, through your son Jesus Christ, who suffered human temptation, I am able to overcome this same temptation. Amen.

After Recovery

This week, the One Word blog linkup has “after” or “pretend” as the choices of words. I could write a post inspired by both of these words, but I need to choose one. When I found out about this week’s words, immediately an idea popped up in my mind, inspired also by my eating disorder recovery journaling project. What would my long-term goals for recovery be, and what would my life look like after I fully recover?

The answer to this question of course depends on the question: recover from what? Just my eating disorder or mental illness in general. In the latter case, I need to note that recovery is not the same as cure. Recovery means living beyond the illness, not necessarily without it. In Dutch, the word for “beyond” is “voorbij”, which in most cases connotes the thing we go beyond has passed. In English, the word “beyond” does not have such a connotation.

First, let’s pretend (ha, the other word sneaked in!)j that I can be fully cured of my eating disorder. This is in fact not just pretend, as people do live past their eating disorders. What would this look like?


  • I would be able to snack without losing control.

  • I would not feel guilty (most of the time) after eating.

  • I would no longer compensate for (over)eating in an unhealthy way, such as by purging.

  • I would feel okay about my body. This does not necessarily mean I’m at a healthy weight, as weight loss is a completely different journey from eating disorder recovery even if your main behavior is bingeing. It would simply mean I’d no longer hate my body.

  • I would have and use healthy ways of coping with stress.

This is where recovery form mental illness in general, in my case borderline personality disorder, comes in. After all, one of my primary goals in recovery is to develop healthy coping mechanisms.

Suppose I developed those healthy coping mechanisms. What else would I want to have accomplished after recovery? First, I’d like to feel mostly stable. I’d still have down days and up days, would still get angry at times, because that is human. I would, however, no longer experience those intense states of hopelessness which usually lead to destructive coping mechanisms or feel chronically empty.

Another way of looking at recovery, however, is to look at what I want my life to be like beyond my illness. In other words, what would I like to achieve in life in spite of my mental health problems. Here goes:


  • Live with my husband.

  • Be able to do a volunteer job>

  • Be able to spend enough time on my hobbies not to get bored, but not so much that I get overwhelmed.

  • Be grateful for the smaller and larger joys of life without immediately second-guessing myself.


Lastly, this is somewhat unrelated to recovery. It is more a general life goal. I’d love to write my autobiography.