Thursday, 8 November 2012

It certainly has been awhile...

So, I’m not going to lie. I am not proud of the time left in between my last post and this one. No excuses, I know, but I will give you the down ‘lo on just why I’ve been so absent lately (it actually corresponds with this week’s topic!).

These past ten to fourteen days have been quite… Interesting. I’ve down and backed to New Brunswick a couple of times, have been poked with more needles (not just blood work needles this time!), have had my blood stolen from me (yes, stolen. Blood work people are vampires, I just know it), have had to go to several appointments and weigh-ins (which are stressful, unpleasant, and happen on a weekly basis), and have spent much time on the phone with various support systems trying to get even more into motion for my recovery. I was also finishing up my application for my Masters of Arts in Sociology. That was sent in and supporting documents were mailed a few days ago… I am a very happy (and tired) camper!

Yes, all very eventful…But I said that the past ten to fourteen days have been interesting. 
I should have said “interesting”.

My body is proving to be the most stubborn mother fucker on the face of the planet. Now, today is not one of those “having Anorexia Nervosa sucks, so come hug my poor frail body” sort of days. It’s more like a “what the fuck are you doing to me, asshole!? I am trying to get better here!” kind of situation. Fists and blunt objects are thrown, feelings are hurt, I am left imagining a Spartan battle to the death between myself and my eating disorder (I will have you know, ED does not look as good in period Spartan war gear as I do). Over the past 48 hours especially I have experienced the shakes, the sweats (which is sort of a nice change from freezing all the time, I will admit… Though It does get annoying), nausea, A LOT of pain in my muscles, joints, chest, kidneys, etc (well, there is always pain, just more than usual), and some other not so pleasant experiences I will not share here, for I value decency (psh) and not driving you away on account of my body’s rebelliousness. All of this bullshit, however, is being brought on by my own actions… 

And lucky me, it’s going to be like this for a while.

You see, my last appointment with the good doctor gave me a good kick in the arse. I was given an ultimatum, gain weight or die. Now, I really don’t feel like dying, so, I guess I only really have one other option. This option, to gain weight… It’s the scariest motherfucking thing anyone could ever say to me or have me do. First of all, I have spent the greater majority of my life trying to reduce my size. All of a sudden I’m being told I need to increase it. See how fucked up that is? It’s really confusing, but I understand that what I’ve got going for me is unhealthy and most definitely unsexy (though that doesn’t make it unscary). I’ve had some positive news recently – my bloodwork (thanks to my taking a plethora of nasty-ass supplements every morning) is just about tip top. This means that I can concentrate on this whole weight gain journey thing without having to worry about “my levels” too much. So, don’t for one second think that natural health supplements don’t work. 

Anyway. I had a point. I might as well get back to it.

So, my body is being a motherfucker – yes, we have established this. This is all well and good. What is interesting about it, however, is the reason why my body is being a motherfucker. To be completely honest, my body’s reaction to my weight gain plan has been the most interesting part of my anorexia (I’ll let you know how I’m planning to achieve gaining weight in a healthy way a little later on). To see the human body work at the absolute base level has been a journey (and it’s only day 5) and an eye opener not only to how resilient we are at a mechanical level, but at how absolutely important it is to finally aknowledge the biology of this disorder. I have been concentrating on culture lately, culture and society. Now, I am not all of a sudden saying that blaming society isn’t the way to go. For the record, I never throught blaming society was the way to go. Recall that I believe that culture has fueled the prevalence of eaing disorders, not caused them. Looking at raw statistic shows us that the prevalence of eating disorders corresponds with changing ideals surrounding the body as well as outside pressure to achieve these ideals above all else. I mentioned briefly the medical and psychological roots of this disorder, and I would very much like to go back to that. The bottom line here is that the triggers of disordered eating are changing, but the base cause? That, my friends, has not changed. 

Friends, readers, I give to you, chapter four of A Love Affair…
Built on biology.
So, to put this at the most basic level, I am essentially a drug addict. There are these lovely little things that float around our brains called endorphins. They make us feel good. These little bits of fairy dust are released within the brain when we do things like eat, get sleep, smile, listen to a song we really like – that sort of thing. Now, endorphins are an important part of evolution as well. They are released when we are in pain in order to counter the effects of pain. Think about working out. You are tearing muscles with every movement you make, and that shit hurts. Your body releases endorphins to mask the pain so you can keep going. That’s why you hurt more the next day – the endorphins aren’t bouncing around your brain like jumping beans. The same thing basically happens when you starve. Think about it – if your body gave into the side effects of starvation and did not mask them somehow, how would you continue to migrate across the dessert in the middle of Africa? Now, endorphins make us feel realllllllllllly good (really good). That’s sort of the downside. Your body craves them, so we partake in things that give us access to these endorphins. When it comes to starving, the only way to reach that level of feeling good is to refrain from eating or eat very little. Your body goes into starvation mode and the neural pathway is open again. It’s kind of like taking a hit of a drug. You become addicted to the endorphin rush and bam, you end up with anorexia, or something similar.

That’s sort of the basic explanation. There’s a lot more to it, obviously, like the involvement of the hypothalamus and pituitary gland – but I didn’t want you getting into this shit without a bit of a background. 

I almost feel as if I should apologize in advance. The research to put this post together was quite heavy and brought me back to my biological psychology days (days I don’t really want to remember, but hey, I’ll take one for the team). The necessity to explore these disorders inside and out is just another part in understanding the sociology of it all. By looking at things like psychology, biology, evolution, medicine, history, and exploring cultural aspects, changing ideals, prevalence rates, co-morbid issues/problems and looking to the future and trying to predict where we as a society are headed we can better understand exactly what disorders like Anorexia, Bulimia, EDNOS, Binge Eating Disorder, etc are actually made up of. They didn’t appear, they have always been there. They are multi-layered and multi-leveled, and their triggers change and shape with the society around them. Understanding (or at least discussing) the constants within this curse (e.g.: what’s going on in the brains of people suffering from disordered eating patterns) makes us better sociologists and overall more knowledgeable about a VERY big issue in society today that spans cultures, races, ages, religions that just doesn’t get the air time it deserves… which is airtime that should be devoted to education and putting a stop to this, not the slander that makes up the information the majority of modern society has access to. 

So, what’s “caused” eating disorders have been the hot topic within research for a bajillion years. It makes me feel as if people are more pre-occupied with where this shit comes from rather than focusing on help (yes, I know that in order to help, we need to know the root causes, just let me have my moment). Anyway, there were these psychiatrists in 1987 who wrote a very compelling paper about the biological aspects of Ana and Mia. Their research is pretty close to the basics still in circulation today, and I liked the way they presented their information, so a peer reviewed source from the 80’s is what you’re gonna get (I am shaking my fist threateningly at all of you as I type this, just so you know). Now, Kaplan and Woodside (1987) did a pretty in depth study on the biology behind the “big two” including medical complications associated with the disorders as well as the cognitive consequences and what they figured would be good potential treatment routes and tied it up into a nice little package published in the the Journal of Consulting and Clinical Psychology. For a while, people though hormonal changes were the base causes of eating disorcers. Yes, hormones had something to do with it, but they aren’t the be all end all. 

I mentioned the hypothalamus earlier. Now, this teensy little brain part is in charge of nearly everything food. Essentially, as it’s understood today, this is where the base root of the brain issues start. Because the hypothalamus is being a bit of a flake(as it’s been affected by all of those lovely endorphins) its ability to sense hunger, decide what is appropriate for eating and what is enough goes all to shit (hence why some people may restrict while others eat uncontrollably). This, in effect, screws with the pituitary gland, which is the boss man of the hormonal releasing and stimulating factors within our heads. This is where hormones come in. Essentially, because of the starvation (in the case of anorexia), we end up with loads of screw-ups in hormone production and release. This causes a lot of crankiness and snappiness from the individuals affected, lack of sex drive (severe lack of sex drive…), leads to lack of menstruation, and lowers reproductive ability through severe reduction in testosterone and estrogen for both men and women. And those are just some of the biological complications, you wait until I get into the physiological shit! 

In the end, the stimulation of the opioid release in your brain and the havoc endorphin release is wreaking on your pituitary tips us on to the fact that the reaction is simply the body’s defense mechanism to starvation. Endorphins, as I’ve mentioned, are key in pain control (but also addictive behaviors) and as well in the control of eating! Now, starvation has been known to increase the release of these opioids and you – the addict – can’t get enough of it (hence why I’m sitting here at 119 pounds having eaten less than 1000 calories today and am feeling no pain. In fact, I feel great, and that’s where the problem lies, because I feel the opposite when I eat… those are the opiate withdrawal symptoms– and that’s fucking scary). All of this stuff affects your metabolism. Essentially, with the way I eat at the present moment, I should be dropping weight at an alarming rate. I, however, am losing weight quite slowly… Now why is that? 

Here’s a hint: metabolism has just about everything to do with it. Metabolism is controlled by yout thyroid mostly, which is driven by hormones from the pituitary gland which are triggered by signals within the hypothalamus! Such a perfect connection, and all it takes is one little fuck up to screw everything else in the body straight to hell. Luckily, this is all reversible. Most of the shit I discuss begins to regulate itself upon getting the proper nutrients. This is a relief to me, because I really don’t want to be like this for life.

Anyway, metabolism. 

So, I’m not losing weight like at a crazy fast pace because these starvation signals my body is giving… My brain realizes that I’m not giving into the endorphin rushes I get when I restrict and starve, so it’s fighting back in the only way it can. It has consumed my fat, it’s eating my muscles (including my heart, the fat around my organs and the fatty myelin surrounding my brain), and it really wants to do this as little as possible. Remember, your body just wants to keep you alive (how nice of it)… Essentially what happens is that the metabolism slows in order to conserve energy. Systems that aren’t necessarily “needed” at the time are silenced (e.g.: hormone production and release, sex drive, having a period). This is why I tire easily and I want to sleep all the time. My body just wants to conserve every little ounce of energy, because I don’t give it enough through food.

How mean of me...

So I’ve dabbled in the side effects of all this shit. They were mostly internal. This includes the screwed up hormone and nutrient levels, the heart problems and chest pain, the pain felt while eating/digesting… All of that. Other more visible side effects of this include hair loss (which is the sole reason I cut all of mine off), possible visible emaciation (remember, some people with eating disorders hold very suitable weights for their body types), stumbling or dizziness, jaundice, being cold ALL the time (very visible in the summer time when you’re like me – going to the beach in August wearing pants and a sweater in 30 degree heat), extreme irritability, developing habits such as smoking or chewing multiple packs of gum per day (guilty as charged), lack of sexual interest, increased obsessive behaviors… The list goes on and on. It isn’t pleasant, but it’s a reality, and it all begins in our amazing (albeit scary complicated) brain parts. 

You know, I had mentioned earlier that there was a newer theory that had immerged regarding this whole “why the fuck do people get eating disorders” issue. Evolution. To me, it makes sense. As stated by Guisinger (2003) it’s 

“psychological and societal factors [that] account for the decision to diet but not for the phenomenology of the disorder…[there is] evidence that AN’s distinctive symptoms of restricting food, denial of starvation, and hyperactivity are likely to be evolved adaptive mechanisms that facilitated ancestral nomadic foragers leaving depleted environments”

The above simply means that as an anorexic, I am the way I am because of some sort of evolutionary mechanism within me that was triggered by my starvation and it relates to my African ancestors who had to move and migrate with the food, potentially risking weeks of starvation! How else would they go on without this evolutionary mechanism? It’s pretty interesting once you think about it.

Disclaimer: Guisinger does, of course, acknowledge the fact that disordered eating is not simply caused by evolutionary factors, but is a combination of psychopathology and societal influences that effect people with certain biological vulnerability. They just prefer to concentrate on the idea that there could be an evolutionary link, which is totally cool.

Throughout this report, many interesting points are raised. Some of the highlights of this research include psychoanalytic theories that discuss the struggles food triggers within an anorexic’s mind and how it connects to autonomy and control or lack there of), the fact that to many this refusal may appear to be an act of sheer will but is more of a “morbid fear” of fatness, or the food itself. There is paranoia surrounding the person’s self-image and the finding that despite what many people may think, many people with anorexia really do want to get better – desperately. It has been reported that people in this condition feel something within them controlling their conscious decisions – even if they want to eat, they cannot (which is very true in my situation).

Social theories are also discussed such as anorexia symbolizing the restraint on women’s desires, praise surrounding thinness, the importance of a thin body to fashion and entertainment industries, distorted standards of beauty… essentially some stuff that’s already been covered by yours truly. 

That’s when we get into the biomedical side of things – some anorexic symptomology as an adaptive mechanism to migration. They go on to discuss the reasoning behind how some people with anorexia still have the amazing ability to be physically active (as slowing the metabolism would be necessary to conserve the energy needed when a food source was actually present). Essentially, in order to adequately migrate, our bodies needed to shut off certain triggers that are caused by starving such as immediate depression and lethargy (that comes later, promise). Instead, those lovely endorphins are relaeased, and we all know what that leads to! This couples with the evolutionary mechanism that denies the fact that the body may be starving, which in modern day leads us into distorted body-image and a slippery slope into avoiding eating even when food is readily available. What ends up happening is an obsession with food, but a fear attached with indulging as if it is a shameful act (keeping the cycle going). That’s where all of this evolutionary, biology, psychological, media shit gets into a head on collision. You don’t know what to do when presented with food, you don’t know how to plan your day, and when you actually do plan meals and make them, you’ve often thought about it so much you don’t want it any more. Trust me, your body comes up with all kinds of tricks that act as ways to distract you from eating. There are so many factors at play with all this that it’s hard to know what to make of it anymore. I do know, however, that the adrenaline that kicks in in order to keep you going to a few more hours (also mentioned in the article) is a blessing and a curse. You’re tired, but you don’t sleep, but then again, if you fell asleep, you’d probably never get up and just give in to the fatigue caused by starving. It’s as if what the author is talking about is that this little evolutionary mechanism is supposed to be temporary, but then it takes over, and a whole ‘nother can of worms is opened. This leads to all sorts of other issues. It’s like a domino effect, and it sucks. 

So, there you have it. Just a little bit of a peek into something other than ranting and raving about Twiggy and society and beauty ideals. I didn’t want you to forget that these disorders are based within biology and start in the brain. That’s why you see cases of anorexia and bulimia hundreds of years ago when there weren’t many outside societal influences that pressured women to be twig ladies. Just the rise in the prevalence of disordered eating over the past 50 years ago alone shows us the influence culture has over this sort of thing. What I wanted to explore here was the fact that there had to be something in place first, something that gets triggered by those cultural and societal influences. This sort of explains why some are more apt to develop eating disorders over others. Predispositions to many disorders exist, it just depends on which disorder hidden away in your brain has the smallest tipping point and the environment around you that provides those triggers. 

Of course, it’s the discrepancies between the triggers and causes and the combinations of issues that go along with developing eating disorders that are more often than not misconstrued and misunderstood because of A) lack of education regarding the topic and B) the fact that much media portrayal upholds myths and stereotypes regarding eating disorders that can tend to be a little far fetched. That’s a whole other chapter, however… The next chapter, actually! Myths and misconceptions surrounding eating disorders, how fun! I am actually quite excited for this one, because it means I get closer and closer to writing my fat blog post!

Just a couple of things before I leave you

  1. I know I sometimes use the term “anorexics” when talking about people with anorexia. I don’t really like doing that, but for the sake of ease I will throw it in there every so often. It just makes me feel as if you are defining a person by their disorder. 
  2. I have been trying to gain weight this week and have failed miserably, but I’m determined! I had a lot of bad days this past while. By a lot I mean most days were horrid. The depression was really fucking bad, the pain that came with refeeding and introducing new foods really beat me down. I was tempted to stop, but really where is that going to get me? I just can’t figure out how to get past my own fear. Gaining weight does not mean becoming fat, it means life… Wow, that’s so much easier to type than it is to adopt. Fuck.
a.       Speaking of gaining weight, my diet plan is consisting of eating as much protein and starch as possible. By starch I don’t mean a lot of bread or pasta, in fact, I’m avoiding a lot of this stuff. The plan is to gain weight using healthy vegetable starch, lean protein and whole grains. You see, a lot of starchy food has a lot of added shit in it that act as appetite stimulants. Now, hunger is scary enough. These appetite stimulants put me at risk for binge eating, developing bulimia on top of my anorexia, or developing binge eating disorder. That’s just not something I want to deal with. So, I will be limiting anything white flour, fake, or deep fried (which is something I already do religiously). Whole grains, proteins and starch are the way to go. I’m getting there… I mean, I’ve encorporated oatmeal and egg whites as well as squash into the safe zone. I even had shrimp last week! So… It’s coming… And it’s going to be one slow fucking process. My weight is going to zigzag drastically as my body is going to be concerned with holding water weight in order to repair my innards. I’m going to gain organ weight too, which is sort of interesting. Either way, I dunno if I’m ready for this, but I haven’t much of a choice.
               3.    Halloween was last week. I was a skeleton. I thought the irony was appropriate.
               4.      I GOT MY RECOVERY TATTOO
  I have written far too much here for any of this to be interesting anymore. So, I’m going to wrap this the fuck up. Thank you for reading, thank you for being there. I don’t know where I’d be without the support I’ve received (well… I have some idea, but I’m not going to think about it).

So, stay tuned for chapter 5. I’m pretty stoked with where this blog is going. I’m glad you’re all along for the ride. Until next time, keep your chin up, keep on truckin’, and burn all of your Cosmopolitan magazines =). 

Guisinger, S. (2003). Adapted to flee famine: Adding an evolutionary perspective on anorexia nervosa. Psychological Review, 110, 745-761.

Kaplan, A.S., & Woodside, D.B. (1987). Biological aspects of anorexia nervosa and bulimia nervosa. Journal of Consulting and Clinical Psychology, 35, 645-653.

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