Wasted: A Memoir of Anorexia and Bulimia by Marya Hornbacher is one of my favourite books. It’s probably my favourite memoir of all time. My eating disorder has never been that serious, but I can relate to the author eerily well. It was often as if I was reading about what was going on inside my own head, only expressed much more eloquently than I could hope to do so myself. I’m a good writer, not that it’s evident on this blog… but Marya Hornbacher is an amazing writer, and I am in awe of her. The book is an honest an insightful portrayal of illness, although I wish she had written about her actual recovery. Even more than that, I’ve often wished that someone would write a book about manic depression that was just like Wasted.

So I was pretty excited when I was reading the People article about “Britney’s mental illness” (no, I’m not even going to go there right now) and there was a sidebar about Hornbacher’s upcoming memoir, Madness: A Bipolar Life. There are some very annoying annoying things in the book description, but at least I know Hornbacher didn’t write the jacket copy herself:

At age twenty-four, Hornbacher was diagnosed with Type 1 rapid-cycle bipolar, the most severe form of bipolar disease there is.

Ugh. Yeah, I’m also rapid-cycling bipolar I, and so what? Do not brag about how your manic depression’s penis is bigger than other people’s, okay? This is not something where you can just whip out a tape measure and settle the matter once and for all, and even if you could, it would be pointless. There are sucktastic things about all flavours of bipolar disorder, and mental illness one-upmanship is really tacky and helps nobody.

Also, Hornbacher’s fiercely self-aware portrait of her own bipolar as early as age four will powerfully change the current debate on whether bipolar in children exists.

This is another one of those don’t-even-go-there things that is probably unfair of me to comment on until I’ve read the actual book.

I can’t say I like the title much, either, but I’m still dying to read the book. Probably there will be parts that will annoy me, and there will be parts that I love, like this passage from Wasted:

People who’ve Been to Hell and Back develop a certain sort of self-righteousness. There is a tendency to say: I have an addictive personality, I am terribly sensitive, I’m touched with fire, I have Scars. There is a self-perpetuating belief that one simply cannot help it, and this is very dangerous. It becomes an identity in and of itself. It becomes its own religion, and you wait for salvation, and you wait, and wait, and wait, and do not save yourself.

Or this part, where she falls down and is too weak from starvation to get up:

Halfway home I began to run, a faltering, stumbling run, eyelashes fluttering with snowflakes, face numb, hair falling into my face with the weight of wet snow. I slipped and fell and could not get up. I sat there in a heap in front of the vice president’s mansion. I, up-and-coming young journalist, A student, maniac, starving artist, invisible basket case, me. I cried with an impotent fury at my legs for refusing to stand when I told them to and thought of my cousin Brian as my hands, pure white, indiscernible in the white snow, scrabbled about trying to collect the contents of my bags which had spilled. I thought of my brilliant and wonderful cousin, dear friend and lifelong confidant, who’d been in a wheelchair since he was small. I thought of how he must feel every day, legs refusing to work, through no fault of his own, through some miserable joke of God, and I thought: This is your own fucking fault. Get up. GET UP. I hated myself with a pure and fierce energy and I wished myself dead.

I don’t hate myself anymore. It’s been a long time since I did. But that excerpt says everything you need to know about the way I felt back when I did hate myself.

I’m still rapid cycling. At first I was keeping things under control so well that no one could tell there was something wrong. Now I’m keeping things under control so well that only my boyfriend can tell there’s something wrong.

I don’t want to lose any more control than this. I don’t want friends or coworkers or random strangers to know that there’s anything wrong.

Last night, irritated as hell by everything, wanting to knock down pyramids of cans displayed at the grocery store, just because they were there, but not, of course, doing it. (I say “of course” as if it’s a given that I wouldn’t do such a thing, but I guess it’s not. Just because I haven’t before doesn’t mean I wouldn’t ever. Although I don’t think I would.) The night before that, crying and crying and crying and thinking that there was no point to anything.

Tonight? Happy and peppy. Tra la, tra la. Hey, maybe I’m finished with the rapid cycling for now. Maybe it’ll stay this way. Hey, maybe I’ll be happy for the rest of my life! Tee hee hee.

I am doing better with the eating thing, mainly because I seem to be getting some of my appetite back. So now I am eating food and feeling guilty about it, which I guess is progress from eating almost no food and still feeling guilty.

There were plenty of Important Topics that I would have liked to post about in the past few days, but I could never manage to unscramble my brain enough to actually do it. Now I can barely even remember what they were. Maybe tomorrow.

I have to take my Zoloft with food. If I don’t have enough food with it, I get this horrible feeling in my throat, like choking to death, only I can breathe okay. I realize that this description makes no sense unless you’ve had the same feeling yourself, but that’s what it’s like. It’s not exactly pain, but it’s extreme discomfort. This particular discomfort feels a lot worse than some things that cause actual pain, and when I experience it, it’s all I can think about until it goes away, which usually takes about two or three hours.

The first time this happened to me, which was over eight years ago, I didn’t know what was going on and I was terrified that I was going to stop breathing and die. Luckily, when it happened again the next night, I quickly figured out that I should probably eat more food when I take my Zoloft. This was a completely random guess, a shot in the dark, but it turned out to be correct.

Occasionally, the amount of food that is generally enough to prevent the choking feeling will not work, and I will still be in extreme discomfort, despite having eaten the same amount that I usually do before I take my Zoloft. Tonight, I ate more than I usually eat before taking my Zoloft. I ate more today than I’ve eaten on any other day in the past two months, without throwing any of it up, and I was all proud of myself for my progress with the eating disorder thing. I ate lunch. I ate supper. I ate a good-sized snack and then took my Zoloft and Epival. And I still feel kind of like I’m choking. It’s not as bad as it usually is when it happens, thank goodness. Moderate discomfort as opposed to extreme discomfort — if it was the extreme choking feeling, there is no way I would be able to type this right now.

When I have a really bad night with the choking feeling, then I really don’t want to take my meds the next day. Or any time in the near future, really. There’s all this trepidation and uncertainty. Usually, I eat something and take my Zoloft and I feel fine, but other times, I eat something and take my Zoloft and feel like there’s a giant hand closing around my throat.

Does this happen to anybody else? I once had a doctor tell me that this side effect that I was experiencing did not exist. If he traded esophagi with me and took some Zoloft without food, he would never say that again.

I have an appointment with a new psychiatrist tomorrow. I’m nervous about this. The last time I saw a psychiatrist was about eight months ago. He was a complete asshole who pronounced me borderline, histrionic, and narcissistic after watching through a two-way mirror as a medical student interviewed me for about forty minutes and only speaking briefly with me himself. (By the way, the last mental health professionals who had dealt with me, who saw me nearly every day for seven weeks, had said that I definitely do not have any personality disorders.)

When I asked him why he thought I probably had these three personality disorders, he said it was because I showed no emotion whatsoever and denied the fact that I even had emotions. This is patently untrue, as I am pretty much the exact opposite. (And although I also don’t have histrionic personality disorder, I’d still like to point out that “shows no emotions” certainly doesn’t describe a histrionic, either.) He said that he could tell I had personality disorders because I didn’t talk about my feelings, just about things like the dates that certain things happened to me, and about every medications I had ever taken and at what dosages. Um, the reason I was talking about those things was that I was answering the questions the med student asked me. I thought a lot of them were tedious myself and I would have preferred to talk about other things, so why the hell was he basing my diagnosis on his dislike of the student’s interviewing style?

He didn’t have access to my previous files, in which my diagnosis of bipolar disorder is confirmed by multiple doctors, but I’m sure it would have made no difference to him if he had.

He also said some other bizarre things, like that I should tell my mother that I hate her. I don’t hate her, so I don’t know what purpose that would serve, but when I asked him why I should tell her I hate her, all he would say was that I should tell her I hate her and he wouldn’t give me any actual reason. He said that it wouldn’t kill her or anything if I told her I hated her, and I said, “Yeah, I know that. I’ve gotten angry at my mother plenty of times and it didn’t kill her, but I don’t see why I should tell her I hate her when I don’t.”

Who died and made him Freud?

He said that the best thing for me would be “fairness focused therapy” or something like that. I don’t remember the exact term, but it involved the words “fairness” and “therapy.” I haven’t really done extensive searching on the topic, but I have tried doing some Google searches and some journal searches, and as of yet, I have seen nothing that would indicate that this particular type of therapy even exists, let alone that it would be the best treatment for me. He told me I should go to some “fairness” program at the hospital three times a week, and when I asked if it were possible for a person to attend that program and still hold down a job, he seemed to think this was a completely unimportant consideration, despite the fact that I was stable at the time and there was nothing else that would prevent me from working.

So I figured he could fuck off and die. I didn’t say that to him, though. I was polite and decided never to go back to that hospital again because whatever crazy shit he must have written about me in my chart would totally bias anybody there against me.

I am seeing a shrink elsewhere tomorrow, not at the hospital, but you can see why I’m nervous. At least I think I’m seeing a shrink. My GP referred me to a shrink and I’ve got an appointment at a mental health centre, but I don’t know if I actually get to see the shrink tomorrow or if I see a social worker first or what.

In addition to being mega-nervous about this appointment in general, I’m also worried about my recent eating-disordered behaviour. To the best of my knowledge, I’ve never been officially diagnosed with an eating disorder. This is mainly because I am — okay, I want to say “a big fat liar,” but that is so not appropriate here. Let’s just say that I’m a liar, okay? And a really good, sneaky, convincing one, as far as eating disorders are concerned. The other reason is that whenever I do come clean about my eating-disordered behaviour, it’s always about things I’ve done in the past and never anything I’m currently doing.

“Officially” diagnosed or not, however, in the past I have met full criteria for anorexia nervosa. This would have been in 2001, when I lost over 20% of my body weight, had a BMI of 15.2, and still managed to convince most people that I wasn’t doing it on purpose. I didn’t fool my mom, but I fooled everyone else. I started losing weight when I was in the hospital in December 2000, following my suicide attempt, because I was physically weak after the overdose and hospital food sucked, and after that I just kept losing weight on purpose, because starving yourself is a more socially acceptable form of self-injury than cutting, I was manic so it was easy to lose weight, and I think I had developed a weird addiction to it.

I’ve never been overweight. I’ve always been thin. I have the extreme good luck to not even gain any weight when on anticonvulsants and atypical antipsychotics. I do not think my appearance would be improved if I lost weight. I know it actually makes me look worse. Eating-disordered behaviour is purely a form of self-injury for me. Well, eating disorders have all sorts of complex causes, but I can assure you, mine has nothing to do with me wanting to look pretty. (I know a lot of other people’s don’t, either, but I know it is a factor in some people’s EDs.)

Anyway, I’ve been restricting my food intake way too much lately (and since I’m naturally thin, any time that I restrict my food intake at all instead of eating whatever I damn well please is a sign of disordered eating for me) and worrying about my weight. For about the past two months, I hadn’t been feeling as hungry as usual… so a few weeks ago, I just sort of took that fact and ran with it. The less I ate, the less I decided I should eat. Now I’m purposely restricting instead of just eating less because I haven’t been hungry. I know I’ve lost a bit of weight. I’ve been eating one meal a day, but now I’ve even started worrying about exactly what that one meal contains, counting calories and all of that.

It was in 2002 that I may have met full criteria for bulimia nervosa. Maybe not, though. I’m not sure I binged enough for that, but I sure as hell threw up a lot. Binged and threw up, ate normally and threw up, restricted and threw up. Most of the weight that I had lost previously, I gained back in late 2001, and then lost it again in 2002. Purged once or twice a day, got nosebleeds from throwing up so much. If your eating disorder is mainly a means of self-injury, then you love the immediacy of bulimia. Binge right now, then purge a few minutes later! Relief right now, or self-torture right now, or both, whichever you want, but right now! No waiting like there is when you’re starving yourself, instant results! It’s mercurial and intense and appeals to short attention spans.

I’m managing to stay away from it now, though. It might have even been years since I’ve purged. I’m tempted lately, but I’m not vomiting and I’m not taking laxatives (yeah, I did that, too, although mostly back in 1999). Maybe my self-control has gotten better. Heck, maybe it’s gotten a little bit too good, what with the restricting.

I have had food issues, mostly in an ED-NOS sort of way, on and off for at least eight years, probably longer. It never lasts very long. Never more than six months at a really serious level, anyway. It always goes away, but then it always comes back. Socially sanctioned self-destruction. Eating-disordered behaviour is always the last card I have up my sleeve when everything else is gone, and I keep playing it again and again and again.

And I’m getting fucking sick of it. I’d thought I was better, because it had been away for so long this time. I thought it wasn’t coming back. I thought it could just go away on its own without me working to fix it, because I thought it wasn’t really serious, you know, not like eating disorders that other people have. That other people have real problems and deserve real help and I don’t.

This time, I would kind of like to tell somebody about it so I can start working on this for the first time in my life and make some real progress on it. But I’m scared that people will think I’m just making a big deal out of nothing. So I’ve been on an unnecessary diet for a few weeks, so what? Haven’t most people been at one time or another? Don’t I have enough real issues to deal with, without getting all bent out of shape over this? I really am scared that no one will take me seriously if I ask for help with this.

Also, at the same time, I kind of don’t want to get better.

Just out of curiosity, I recently looked up information online about the nearest eating disorders clinic. It’s not really near at all and I know my problem isn’t severe enough that I’d need the programme there, but having been in a partial hospitalization programme last year, I just had an idle curiosity about such things. I noticed when I read the referral criteria that even if I wanted to participate in the programme, I couldn’t, because my current BMI is lower than the minimum allowed (they want participants to be at a healthy weight before they work on their psychological issues). This pleased me.

I am seriously sick in the head.