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Depression Eating Disorders Living While Fat My Story

ARFID rears its ugly head

I have eating disorders. Two, mainly. ARFID and Binge Eating Disorder [BED] (with occasional visits from the Anorexia and Bulimia fairies). It took me many, many years to acknowledge that I had an eating disorder at all. I thought I just ate too much. I thought it was because I was weak willed or addicted or some other thing. Now I know that the reason I eat too much consistently over time is because of my deeply disordered eating. I’ve posted before (see links above) about what the DSM V has to say about eating disorders. Spoiler: It’s very simplistic and reductionist and not exactly body positive.

In any case, I have been diagnosed with BED for five years or so, although it hasn’t been nearly that long since I accepted the diagnosis. Having BED means I dissociate when I am eating and eat far too much at individual sittings, to the point of becoming sick. It means I prefer calorie dense foods. It means I need to feel full to feel safe and comfortable.

But it turns out, it’s not the point. The first term I heard the term “ARFID” was about a year ago, when I met my current nutritionist, who is an ED specialist. She did my intake interview, and asked if I had ever heard of ARFID. No, I hadn’t. What was it? ARFID–avoidant/restrictive food intake disorder–is a food/eating anxiety disorder. Food makes me anxious and it is hard for me to deal with preparing or eating complex or highly variable foods. I avoid fruits, vegetables, fatty meats, anything that might spoil or be mushy. I’m hypersensitive to the texture and smell of my food. And if a food turns me off once, it can take me a very, very long time to try it again. Classic ARFID anecdote: I once tried, in a diet context, to eat a piece of pineapple in front of a group of friends. I bit down, got one hint of the texture of the stuff, gagged, spit it out, and choke/cough/gagged for about five minutes. Needless to say, breakfast was over.

I am finding ARFID much harder to fight than BED. I believe now that ARFID is the root disorder–at some point in my early childhood I became deeply anxious about food–and that BED is actually a coping mechanism to keep me from starving to death. When I am dissociated I can eat, which, honestly, is a relief after the way the ARFID makes me feel. I eat so much partially because I subconsciously know that my ARFID is going to keep me from eating again until I am famished and I need to “stock up.”

It is probably no surprise that in this most anxious of times, the ARFID is in control again. Over the past 3-4 weeks, there has been incident after incident of me panicking over food, refusing to eat until I am in pain from hunger, and being unable to feed myself or, sometimes, even move until I am hand-fed by my husband. I wept over a bloody egg. I panicked over a bag of vegetables and shoved it in the fridge still in the supermarket bag. I went to bed hungry (a lot of times).

My nutritionist says that many of her ED patients are experience an exacerbated tendency to restrictive food behaviors right now. It’s the anxiety. It’s so hard to care for oneself in general, and when you have an ED (or more than one) it is already harder. I don’t actually know what to do. I’m becoming dependent on my husband, who is learning to spot the signs that I’ve gone into an ARFID state. I ate twice today. I can remember only one day in the past two weeks when I had more than three eating episodes, and most days are either two, or two plus a middle-of-the-night panicked kitchen run by hubby. I’m regressing and I don’t know what to do, how to get out. The feeling of not eating, the knowing that I am not gaining weight even in enforced idleness and surrounded by a food-filled kitchen–it’s enticing. I don’t know how to beat it or even start fighting it.

I will say this, though–if I see one more meme about people getting fat right now and grazing too much, I am going to punch a wall.

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Depression My Story

Setback

Last week was awful. And strange. I came home Sunday evening from the event I posted about here. I was extremely tired, but I slept a lot and got up and went to work on Monday. It was a normal, if sleepy, day.

Shutdown

Tuesday morning I woke up and my brain said “No.” I cancelled my early morning appointment and went back to bed.

An hour later, I dragged myself out of bed, did my morning routine, and drove to work. I parked my car. I didn’t get out. I thought about the day I had ahead at work and I just couldn’t do it. It was like there was a wall between myself and the world, and I could not get through. So I called my office and let them know I wasn’t coming and arranged for people to cover my few un-cancellable obligations that day.

I went back to bed. I had three naps and five large meals that day. I was exhausted and starving from the weekend. At first I thought I was having a binge eating relapse, but I quickly realized that I wasn’t actually eating much past satiety and that my hunger was genuine. So I kept eating. I’m proud of myself about that because the temptation to limit myself based on perceived “portion size”s or ideal meal frequencies was hard to resist.

Wednesday I woke up and I felt a little better so I did my morning routine and drove to work. I parked my car. I didn’t get out. I called my husband to ask what to do, and he convinced me to go in to work.

As soon as I got there I knew that it had been a mistake, but once I was in I couldn’t leave immediately. I spent about four hours there catching up on exigent work and making a plan to clear my desk for Thursday. By the time I got home I had a pounding headache and felt like death. I went to bed. I only had time for two naps that day but they were really good.

Thursday I woke up. More of the same. This time I did not even try to go to work. I spent the morning puttering around and answering emails in my pajamas.

I had, in my panic, made an extra appointment with my therapist in the afternoon. When the time came to get dressed and go I almost could not make myself do it. I knew she would help, but I get agoraphobic when I am depressed and getting dressed and going out was almost too much. But I went. We talked for the regulation 50 minutes. She said a lot of helpful stuff.

I left feeling superficially much the same as I had since Tuesday. I decided to get a late lunch on the way home because I was very tired of house food by then. I ate lunch. It was a normal lunch. As far as I know it contained no special psychoactive chemicals.

When I finished the lunch I felt absolutely fine. Completely normal, happy, restored energy level, the same me that had been walking the earth the week before. Depression gone. No trace.

Went to work somewhat hesitantly on Friday, worried that work would be a trigger, but there was no problem. Worked a full day and even went out with friends afterwards.

Depression

I have been struggling with depression for decades. I explicitly remember being suicidal in middle school but I can’t say for sure that it didn’t start before then. So at least 30 years. High school, college, grad school, my first five or six years of grown-up-ness. All misery. I cut myself; I fantasized about killing myself; I lay in bed in a semi-catatonic state. I hated myself and wanted to die.

For the past 8 or 9 years I have been working my ass off to beat it. It was a slow crawl at first, because it’s hard to find the right providers and the right meds. There were setbacks, bad weeks, months, and years. Depression was my constant friend, my familiar companion, my home place.

Gradually, that began to change. Zoloft works. Cognitive Behavioral Therapy works. I stabilized. I wasn’t happy, but I wasn’t a danger to myself and I could do my job and live my life.

Then I found my current therapist, and we have actually been working through things for four or five years at a deeper level. I found out that people like me, and that I am naturally sociable and outgoing. I found hobbies. I got promoted at work and developed more confidence in that sphere. I found out that I didn’t actually give a shit about people who thought I wasn’t that good at some parts of my job. I found out that I could be myself and do what I wanted to do. I found out that I am a good person who is doing her best in the world, and I found out that that actually is enough.

I got better. Most of the changes were under the surface. There were still bad patches, but they were more like days or weeks instead of months or years. Energy was up. Resilience was up. I actually worked through some of my issues with my family.

The final ingredient was my introduction to body liberation and radical self love earlier this year. One day, after seeing my new nutritionist for a month or two, talking with her over those ideas but maintaining reserve and skepticism, something snapped inside. It was like “Fuck you, I’m awesome and I’m not afraid to feel it and say it.” Since then, things have been dancing. Lots of changes, above and below the surface. Lots of happiness and lots of love. My therapist actually said my depression was asymptomatic at this point and my psychiatrist reduced my meds. Victory.

Relapse

What happened on Tuesday felt like I had woken up in a horrible flashback nightmare. I was 28 again and couldn’t deal; a wall had come up between myself and all my work and all of my recovery. In every detail it was a perfect mirror of the old me. The near catatonia and inability to talk or communicate. The light sensitivity. The desire to cut myself (although I successfully resisted). The extreme pleasure I used to take from sleeping, especially naps. The excessive REM sleep. Even the starting hints of some suicidal ideation.

I was shocked. I felt confused and helpless. And terror, because I didn’t know if it was back for good. Intellectually, I knew that somewhere inside I had a whole bunch of tools that would eventually lead me back to myself. But every time I tried to pull a thread in the knot, it would snap or lead nowhere. I didn’t know what to do.

Recovery

I still don’t know what I did. All of sudden I was just fine again. It was like a broken bone that had been set, or a train being set back on the rails. It didn’t feel gradual and organic, like my work at recovery had paid off. It was just…fixed…gone…better.

Not that I’m not grateful. I’m incredibly grateful. I thought I was going to have to take a leave of absence from my job and start again at the beginning of the recovery. But I’m still terrified because if it happened once it can happen again. I suppose that’s why you can never not have chronic depression once you have had it–you just go into remission.

I wish I knew what precautions to take, what tools to prepare. My husband says I must have been a boy scout in a former life because I always over-prepare. And I want to over-prepare for the next relapse. But I don’t know how. I think I understand the weird combination of triggers that set me off this time, but I can’t guarantee that they, or others, will never catch me again. And I don’t know how to be ready if they do.

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My Story

When Life is “Under Control” and When it is Not

Work was insanely busy last week. I got so behind that I simply shut down, stopped answering emails and started blindly staring at my computer in the rare quiet moments in my office. By Friday I was in full collapse. Luckily I had no plans for the weekend so I simply hibernated for two days.

Unfortunately I think this is the new normal–the next few months look to be pretty bad. Time at my desk actually getting shit done will be very limited (something like 7-10 hours a week), contact hours of meetings and appointments will be way up.

This is partially my own decision, a result of actually prioritizing self-care. I now get to work around 10 each day, with morning appointments for therapy, nutrition, group, and training. So you’d think, ok, well work shut down but luckily I was set up with some boss self-care so I weathered it pretty well. Right? Right?

Not so much. It turns out that no matter how much self-care I have set up and how much I tell myself that I am focusing on self-care right now and will be content to merely do my job well, failure to stay 100% on top of my job leads to breakdown. Breakdown leads to failure to meditate, journal, exercise, get out of bed, put on clothes, shower, etc etc etc. So much for focusing on self-care.

Breakdown also leads to huge amounts of emotional food drama. I didn’t have a full binge but I had a LOT of food thoughts, food self-argumentation, food eating when not entirely hungry, food not stopping when definitely pretty full, food choices that didn’t feel like what my body really wanted.

I’m pretty sure a huge amount of the breakdown was just simple exhaustion. I am the world’s most sociable introvert, and when I’ve over-extended on the social scale (which happens a lot in my line of work), I just collapse. I also need more sleep than I get (who doesn’t?). I’m working on the self-compassion to know that I was over-stressed and that I am not now a failure because of the breakdown.

I’m also working to get back on my feet. Today was a fairly quiet day and a lot of that missed work got done. My work to-do list only has about 20 things on it. Bracing for impact tomorrow. Wish me luck!