THIS HUNGER IS SECRET is now available!

Click here to download the .pdf file!  You can download it RIGHT NOW!

This Hunger Is Secret: My Journeys Through Mental Illness and Wellness will be available in paperback form in about nine months.

The publisher is Chipmunkapublishing.  Their website is www.chipmunka.com

Something I just learned that’s in the DSM-IV regarding Bulimia

I got this off of medicinenet.com:

The actual criteria for bulimia nervosa are found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). There are five basic criteria in the diagnosis of bulimia:

  1. Recurrent episodes of binge eating. This is characterized by eating within a two-hour period an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
  2. A sense of lack of control over the eating during the episode, or a feeling that one cannot stop eating.
  3. In addition to the binge eating, there is an inappropriate compensatory behavior in order to prevent weight gain. These behaviors can include self-induced vomiting, misuse of laxatives, diuretics, enemas or other medications, fasting, or excessive exercise.
  4. Both the binge eating and the compensatory behaviors must occur at least two times per week for three months and must not occur exclusively during episodes of anorexia.
  5. Finally, there is dissatisfaction with body shape and/or weight.

The DSM-IV also identifies two subtypes of bulimia nervosa. The purging type regularly engages in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. The nonpurging type engages in other inappropriate compensatory behaviors, such as fasting or excessive exercise, rather than purging methods.

I was not aware of the non-purging type of bulimia.  What’s in the media and most books you read are descriptions of bulimics who typically binge and then vomit.

In 1981 I was diagnosed with bulimia because there was no such diagnosis as binge eating disorder.  According to the DSM-III, which was the definitive text then I believe, I did not fit the criteria for bulimia, not exactly, because I did not throw up.  Following every binge, though, I fasted for a long, long time.  If the DSM-IV had been around back then, the diagnosis would have been correct; I would have been categorized as bulimic.  Interesting.

In 1982 I attended a group for people with eating disorders.  It was like a pioneer group, because there were very few such opportunities around.  I was lucky to get in.  Most of the women in the group had at one point been anorexic, and were currently bulimic.  They all threw up.  Except me.  You know something?  I felt like I wasn’t a “good enough” bulimic, that I was inferior, that I didn’t deserve to be in the group even though the bingeing was devastating to me.  I never told anyone in the group that I felt this way.

Message to anorexics, bulimics, binge eaters, anyone with any kind of eating disorder: You cannot be “better” at your eating disorder.  Your eating disorder will get the better of you.  It will steal your life from you.  Do not go down its path.  Turn away now.

I am told that it is never too late to give it up.  I wonder what it’s like to just let it go the way one would release a captured snake into the forest, and watch it slink away between the trees.

You know, it takes a lot of effort to keep a wild snake alive.  I must be working pretty hard at it.  When I was a kid I captured a snake, and secretly kept it in a box, hidden from my parents.  I felt guilty,  but I felt like the snake was something special that was mine and mine only.

Was I sad when the snake died, or relieved that I didn’t have to keep a secret anymore?  I remember having a secret burial in the backyard, just me and the special snake.  It was hard making the hole.  I think I cried, grieved for the secret part of myself that had died and was now being sent to the earth.

I am told that when people truly give up their eating disorders, they grieve.  I felt some of this in June when they made me give up starvation (for a little while) and eat.  I ate a lot and cried.  I missed starvation, I craved it, wanted it back, and when I couldn’t stand the craving anymore, returned to it and embraced it.  Now, I am trapped, and I don’t know what to do.

I want to get back–to what?  I want to get back to me, but I don’t even know what me is anymore.  I can’t remember when the last time was that I was me.  I look back…I don’t know.  I don’t know anymore.  I really don’t.

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My wonderful new book, This Hunger Is Secret: My Journeys Through Mental Illness and Wellness is now available in e-book form from Chipmunkapublishing.  Click here to download the .pdf file.  To read excerpts at my home site, click here.  The book will be available in paperback form in May 2011.

On Stinking Properties

Sometimes, when Puzzle and I go out for walks, we encounter these odors.  I don’t know the source, but I don’t think it’s dog poop, and I don’t think it’s dripping from trash trucks.  I think it goes deeper than that.  Maybe it’s in the soil or the ground water.  The stink seems intrinsic to the environment.  It seems to be just in certain places, and it doesn’t move around; that is, it’s located right in front of particular homes or businesses–permanently.

You’d think that the stench, this horrible smell, this garbage-shit odor that seems to be peppered all over Watertown– the quiet suburb of Watertown, MA, where you’d never suspect this would occur–would surely lower property values where it occurred, wouldn’t you?  I mean, surely, when real estate agents sold these homes, they probably lied to the buyers about the odor:  “Yeah, there’s something in the air tonight, occasionally somebody puts down fertilizer,” or, “Someone must have spilled their garbage.”  Yeah, sure.  Little does the unsuspecting buyer know that the odor is permanent….

Then, they find out.  It’s too late.  They’ve bought the home.  They live with the stench, day in, day out.  They smell it when they rise in the morning and when the retire at night.  They smell it when they leave for work and when they return.  They smell it at mealtimes, three times a day.  Their children smell it.  They have to apologize to guests.  And when they finally decide to sell the fucking house, it won’t sell.

I often feel like I am like this home.  I have this permanent stink.  I am damaged goods that nobody wants.   And if you come near me, my stink might rub off on you, and you might stink, too.

It started when I first got sick.  It started when I first started worrying about my weight, when I started obsessing over it.  It started when I started my first diet in 1980.  It started when I stopped being me. When me got replaced by my eating disorder, and me generally didn’t peek its head back to the surface.  And the stink that started in 1980–trust me–has been with me ever since.

Can anything be done?  Perhaps.  It would take a zillion dollars on the part of the town to rid the soil of its odor.  Maybe it would have to be sifted or replaced or rinsed–heck, I wouldn’t know.  But obviously, the town would come to the conclusion that any town would come to, and besides, the money isn’t there–in Watertown, or in any town, no matter how rich.

The property, they would say, ain’t worth it anyway.

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My wonderful new book, This Hunger Is Secret: My Journeys Through Mental Illness and Wellness is now available in e-book form from Chipmunkapublishing.  Click here to download the .pdf file.  To read excerpts at my home site, click here.  The book will be available in paperback form in May 2011.

On Family

I just read this article about a woman who battled anorexia for 20 years and finally died.  I burst into tears when I read the article.  I choose not to share it with you.  Instead, I e-mailed the link to myself for future reference.

I have been struggling with this for 30 years.  Like Emily, I’ve sought many different types of treatment for my eating disorder–not ED treatment, though, because either I was misdiagnosed or the ED was ignored or there was simply no treatment available.  But I don’t want to suggest to you that I am going down the same path that Emily took.

But I don’t want to talk about that today.  I want to talk about family.  I found the article about Emily while searching for a quote about how family is typically the last to acknowledge that anything is wrong with the eating disordered family member.  As you can see, I got side-tracked.  But it’s true: families are often in denial.  They don’t want to believe it’s true.  The eating disordered person can be deteriorating right before their eyes, and family won’t see it.

Such is the case with my family.  My mother has no clue that I have an eating disorder.  Sure, she’s been in family therapy with me and knows I had an eating disorder.  She sees how skinny I am and has even commented–once–on my “tiny waistline.”  (How rude to comment on a body part!)  She thinks it’s good to be skinny.  She has no clue that I have anorexia.  No clue whatsoever.

It is ironic that I have asked my brother and my sister-in-law to come in to a meeting with my therapist as a last resort.  It seems that this should have happened long ago.  They live a mere hour away.  But I see them only twice a year when they do their “duty” to see our mother (who lives near me) and come up for Hanukkah and Passover.  Twice a year if they don’t cancel.

So I called my brother Tuesday.  He called me back–finally–today, Sunday, saying he’s been busy.  He said he couldn’t come to a session.  He has to work.  My sister-in-law, too, has to work.  No, they can’t take time off.  No, he can’t leave work early, not even a couple of hours early, for a 45-minute session.  Not even for me.  His sister.  Period.

I don’t know what to think.  They are both salaried, and have been at their positions a long time.  I’m sure they both leave work early all the time when it’s for a good reason.  Am I not a good enough reason?

I have a fatal disease, for godsakes!

It’s not like I’m going to die right away and they have to see me and say goodbye.  It’s not like they have to see to my affairs or make end-of-life decisions.  No, not that, thankfully.

But maybe, just maybe…they can help me.  Maybe they have some answers for me.  Maybe they can at least see me more often, provide companionship, comfort, humor, closeness, and sharing.  Maybe they can be what family are supposed to be.  Helpful.  Supportive.  Loving.

It seems like all the avenues of recovery for me are blocked off or dead ends.  I have been denied treatment or treatment doesn’t work.  Friends say goodbye.  Now, my own family will not come to my side.  What will I lose next?

Somehow, something has to give.

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My wonderful new book, This Hunger Is Secret: My Journeys Through Mental Illness and Wellness is now available in e-book form from Chipmunkapublishing.  Click here to download the .pdf file.  To read excerpts at my home site, click here.  The book will be available in paperback form in May 2011.

Day in the Life: A Trip to the Supermarket

I decide to go to the supermarket to buy food I will barely eat.  It is a 20-minute walk via the “shortcut,” a walk on the footbridge over the Charles River.  I have done this route many times.  Today, I am taking my rolling backpack and a pack I will carry on my back as well.  I plan to buy, among other things, a fair amount of canned food and dairy, including eggs, and a glass baking pan to make a turkey-lentil-rice dish I’ve been dreaming up.

It is a warm and windy afternoon.  I have eaten a meal today and taken vitamins.  I rarely take vitamins anymore, because they are only effective if you take them with a meal, and I don’t eat meals anymore, but today something got into me and I ate an entire meal, or at least the equivalent of one.  So I knew I had enough energy and strength to make this trip without Gatorade as a backup.

The supermarket is in the same shopping center as my gym.  I keep wondering if someone who goes to my gym shops at the same supermarket and sees me there.  When I work out, I cannot hide my body very easily, even in loose clothing.  Sometimes, I wear long sleeves and wind pants.  Other times, I just don’t bother covering myself.  It’s obvious something’s not right.

The last time I went to the gym I was working out three or four times a week between mid-June and the end of July.  Very few people knew this, even my closest friends.  While many of my friends who were trying to lose weight were having trouble getting up the motivation to exercise, I had  motivation to spare.  I wasn’t doing it specifically to burn calories, but to do something with all the energy I had from eating all the food they were making me eat.

Bullshit.  The truth is, as soon as I saw the scale go up, as soon as I saw the flesh on my body, I panicked, and would do whatever it took to get rid of it.

I worked out vigorously.  Where I was originally using 15-pound resistance, I worked my way up to 45 pounds.   Forty pounds became 70.  I increased my walking speed from 3.5 miles per hour to 4.1.  I taught myself new exercises, and incorporated some of my old routines into the current routine I was doing.  I developed solid muscles all over my body.  And on a skinny person, muscles are very, very noticeable.  I had to hide my new biceps from my therapist because I was afraid she’d ask questions.  So I wore long sleeves.

This didn’t last long.  When the starvation returned at the end of July, I knew I was too malnourished to support a vigorous workout, so I stopped going to the gym.  When you don’t eat enough, your body takes nutrients from itself–from fat stores, from hair, from bones, from all the organs including muscles.  So I lost muscle mass.  A lot of muscle mass to the point that I can now roll up my sleeves and I no longer have to worry about my T seeing enlarged biceps.  Really.

I arrive at the supermarket and grab a carriage.  I place my rolling backpack on the underneath thingy and wheel the carriage into the supermarket.  This time, I’m less self-conscious about what I’m buying and who is seeing me than I usually am.  Relieved, I turn up my MP3 player and head into the dairy department.

Yogurt.  Nonfat.  Plain.  Uh-oh, someone’s there.  Who is this skinny girl buying yogurt, anyway?  What right does she have to buy nonfat?  And plain?  Why the heck doesn’t she buy vanilla like a normal person?

Fuck off, fat lady.  I grab two quart tubs and move on.

Other groceries are easier.  I dodge more fat people in the aisles.  I bump into a guy.  He gives me a look: You’re so skinny–you had plenty of room to get by. I apologize.  He obviously isn’t accepting my apology.  Well, fuck you.

I turn up Indigo Girls even louder.  What brand of tuna is the best?  Who knows.

Finally, I get to the register.  I empty my cart.  I easily slip between the cart and the candy display.  I remember a time that I barely fit between the cash registers, for godsakes.  Okay, that’s an exaggeration.  But I was once fat.  Once.

I pay for my groceries.  This is complicated.  Store card, food stamps card, debit card, coupon, receipt.  Meanwhile, the bagger has bagged my groceries in plastic.  I did not want bags.

Why the heck did he bag them without even asking me if I wanted bags, or even if I wanted “paper or plastic”?  Why did he just assume I wanted plastic bags?  I am pissed.

“I didn’t want–”  I stopped myself.  “Okay, okay, you’ve already bagged them.  I’ll take the plastic.  Fine.”  I went on and dealt with the plastic, that will pollute our earth and never go away.

I pack my groceries into my rolling backpack, most of them.  Most of them I keep in the plastic, just for the heck of it.  I place the glass baking dish and eggs in the backpack I am carrying on my back.  I return my carriage and off I go.

I know I am carrying one hell of a lot of stuff.  The canned goods are heavy, and yes–I have soda on me, too.  Diet, of course.  I ask myself if I would be able to carry the rolling backpack up the stairs after I get off the footbridge.  With my weakened arms?  Probably not. Added to that is my general state of body weakness.  I could easily lose my balance, fall, and injure myself.  Going up the stairs, unless I have help from some stranger, would definitely be unwise.  And what were the chances of running into a stranger who could–and would–offer to help?  So, reluctantly, I go around the long way.  This is adding about 15 minutes to my trip, especially considering I’m slow with the heavy load.  I curse my eating disorder the entire way home as Indigo Girls sing and strum mightily.

I arrive home to Puzzle.  Home now.  But this isn’t the end of the story.  So keep reading.

I let Puzzle out of her crate, and turn the AC up to 80 degrees.  I have to keep it on for her allergies, otherwise I’d shut if off entirely.  I switch off Indigo Girls.  Take the wallets out of my pockets.  They slide out so easily now that my jeans are so loose.  Only one pair fits now.  Then I empty my groceries.  The dairy goes into the refrigerator, canned onto the counter.  The non-refrigerated stuff I can deal with later.

Then, I place the knapsack I carried on my back onto the counter.  I remove the eggs, carefully unwrap them from the canvas bag I used to protect them, and inspect them for breakage.  Suddenly, whoom!  The knapsack falls.

The glass baking dish shatters into a million pieces.

And no, the glass doesn’t end up all over the floor, to cut into Puzzle’s little paws and unsuspecting bare feet.  No, the shattered glass pieces don’t end up under the refrigerator.  The entire glass baking dish, shattered to bits, is protected, carefully wrapped, against my wishes, in a plastic bag.

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My wonderful new book, This Hunger Is Secret: My Journeys Through Mental Illness and Wellness is now available in e-book form from Chipmunkapublishing.  Click here to download the .pdf file.  To read excerpts at my home site, click here.  The book will be available in paperback form in May 2011.

A Purchase: Some Thoughts

I went out to buy diet soda–again.  This time, as last time, I chose not to go to Tedeschi’s, as they know me, but to CVS, where I can be more anonymous.  There is another convenience store closer by, but they charge $2 a bottle, and CVS has diet soda on sale for $1.25 right now.  That plus at the other convenience store, which is family owned, they are always giving me looks.  I think they give everyone looks.  Maybe not, though.

So I went to CVS, a longer walk to save 70 cents.  As I approached the soda aisle, I saw some kids with their parent blocking the corner.  Annoyed, I walked around an entire aisle to avoid them, then came up the next aisle, and all the way around to the soda.  I don’t want to be seen.

There it was.  Still on sale.  Four for five dollars.  I grabbed a bottle.  Diet Wild Cherry Pepsi.  I checked ten times to make sure it was “diet.”  I snuck around the back way to the registers.  No wait.  Good.  I approached the cashier, a gentleman, maybe 60.  Never seen him before.  Sweet.  I used my debit card, so that I could get a $10 bill for the cab to my primary care doctor’s on Tuesday for weigh-in (I take a cab there and bus home as it is a complicated commute).  He handed me $30.

“Huh?”

“That’s what it said.  Thirty.”

“Okay.”  I looked at the sales slip.  Looked again.  “Nope.  I put in ten, and it says ten on here.  You just owe me ten.”

“Well, thanks for your honesty.”

I hand him back the $20 bill.

It isn’t until I eft the store that I realized that he never asked me for my CVS card, and I didn’t get the 75 cent discount.  They are supposed to ask for the card so customers can get the discount.  Was I supposed to remember the card myself?  Probably.  But I didn’t.  I expected the discount without it.

Was the guy new?  Probably not.  That particular CVS isn’t doing well enough to be hiring new people, as far as I know.  Maybe he isn’t accustomed to working the registers.  Maybe he normally works “out back.”  I can only speculate.  Maybe he just didn’t know the complexities of cash register work.

What I know he didn’t know was that I, his customer, was going to go home and fill up on diet soda so that I would feel full enough so that I wouldn’t eat anything, because I hadn’t eaten dinner.  What he didn’t know was that I starve myself.  What he didn’t know is that I am a lot skinnier than I appeared to him in the store tonight.

Or maybe I didn’t fool him.  Maybe he knew. Maybe he has a daughter, a niece, a friend, a wife, a lover, a son, who is anorexic.  Maybe he himself has an eating disorder.  Maybe he is going to leave work, stop at Tedeschi’s, buy a couple of cheesecakes and three bags of chips,  go home, gorge himself, and then puke his guts out.

We don’t know.  Eating disorders are for the most part invisible.  There are an incredible amount of people out there with eating disorders who are doing ED behaviors in secret.  Even people who are unusually heavy or thin can hide their eating disorders–or the severity of their disorders–from everyone, professionals included.

When I first developed anorexia in 1980, no one suspected–not even me!  I had never heard of anorexia, and I’ll bet half of the people around me hadn’t heard of it, either.  Some noticed that I had lost weight, others did not.  One person–one–remarked that I may have lost a bit too much weight, and showed concern on her face.  This was someone on the music faculty at my college.

I’d like to talk to her now.  I’d like to tell her that I wish I’d spoken up.  I’d like to tell her that I wish I’d cried out for help just then, and told her about the obsession, the restricting, the fact that I ate so little, and wanted to lose more and more, and how deeply unhappy I was.  I wish I’d asked her what my problem was called.  Maybe she would have told me it was called “Anorexia Nervosa.”  Maybe she would have told me there was such thing as eating disorders, and that I was not alone.  Maybe she would have known where I could have gone to get help for it.

Actually, I don’t really know for certain that she knew. I can only guess.  But chances are, she did.

But the subject was dropped.  We went our separate ways.  Nothing more was said of the subject.  When we saw each other again, we talked about music.

Music.  I swear everyone else at the college was clueless.  Totally.  Myself included.

Maybe I still am.

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My wonderful new book, This Hunger Is Secret: My Journeys Through Mental Illness and Wellness is now available in e-book form from Chipmunkapublishing.  Click here to download the .pdf file.  To read excerpts at my home site, click here.  The book will be available in paperback form in May 2011.

My visit to Dr. P

…which was yesterday.

Dr. P and my primary care physician, Dr. K, are in agreement.  I need a “higher level of care” than what I have now.  Dr. P suggested the ED hospital, and I refused to go, saying that the ED hospital constituted “inhumane treatment.” She replied, “It is not inhumane.”

“Dr. P,” I wanted to reply, “you have not been there.”  But I didn’t.

She then suggested various treatment programs.  I did not play the “wild card” that I mentioned in my previous post.  I just quietly refused.

All the emphasis was on weight.  Weight weight weight.  A number.  “You are not gaining weight on you own.  Therefore, you need to go to some ‘higher level of care’ so that you will be forced to gain weight.”  That was the gist of it.  And, “You obviously aren’t eating on your own, therefore, you must have supervision in a program.”

I argued what I have stated here, that “treatment” isn’t the answer.

“Well, what is the answer, then?”

“I don’t know.  But ‘treatment’ isn’t working.  It’s got to be something else.”

“What?”

At this point, we were talking in circles.  I said, “I am trying desperately to figure this out.”

Meanwhile, she was typing out everything I said into her computer.  Word for word.  I hate that.  She does that sometimes, so that she can argue with me more effectively.

“You know, people in the waiting room have remarked on your weight loss, how extremely thin you are.”

“Many people comment on my weight.  It is rude of them to do so.”

“That is a lame comeback, Julie.  People wouldn’t comment if your weight was normal.”

I wanted to tell Dr. P that her remark about people in the waiting room was kind of rude, crossing boundaries, I think.

Wait, let me back up.  I came in there with a list.  I had written it on a 4×6 piece of note paper that I had neatly folded and put in my wallet.  I read the list to her at the beginning of the session.  Actually, I read the list real fast because she tends to interrupt, and since we only have 20 minutes, if she interrupts, I won’t get through the entire list.  I’ve had sessions where I’ve only gotten to the first item, and have neglected to mention all the others.   So I zoomed through the list.

I won’t tell you all the things right here right now, except to say that much of what I mentioned was positive.  Less depression.  No mood swings.  My meds are working.  The latest increases and decreases seem to have been good decisions.   I did, however, say that I felt extremely hopeless.  And I mentioned that I had lost a huge chunk of my friends.

Eating wasn’t on the list. Nothing whatsoever about it at all.   Of course, this was deliberate.

It’s all a game, Dr. P, all a game.

Manuscript sent to Chipmunkapublishing

Hi everyone, I sent off the final version of my manuscript just now.  It is like letting go of a helium balloon and letting it go wherever it wants to go.  Or at least that’s how it feels right now.

I’m kinda scared.  But relieved, too.  Now I don’t have the pressure of getting it done, of worrying that the publisher might get impatient with me, feeling that I can’t get on with any other projects (except writing to you, of course).

Now, I pretty much answer whatever questions they might have, and sit back and wait and see what happens.  And hope there are no snags.

Snags…my whole life has been a one big snag since I turned 22.

I dealt with it.  I do have two degrees after all.  I have a book on the way.  I met a wonderful man, fell in love with him, and dated him for many years.  I survived his sudden passing.  I have a wonderful dog.  Doesn’t that count for something?

This Hunger Is Secret: My Journeys Through Mental Illness and Wellness is about what happens when you find out you have a mental illness.  It’s about living with mental illness.  It’s about dealing with it.  It’s about surviving it.

You know, this is weird: Proofreading the book, I can’t help but weep when I read some of the chapters.  It surprises me which ones make me cry.  Some of them make me tear up every time I read through them.  I can’t help it.  I think these chapters are happy–and sad–and I don’t know why.  Some of them are about me being skinny, or at least I’m skinny when the events take place, and these chapters are hard to take.  Some of them I can’t imagine reading aloud.  Not now.  Not now, maybe not ever.

So I’ve let it go.  If I can touch one person, if one person reads it and can relate, or if one person reads it and and is moved in some way, then I’ve done my job.

Proofreading of This Hunger Is Secret is Finished

I have finished proofreading This Hunger Is Secret: My Journeys Through Mental Illness and Wellness. Finally.

What should have taken about two weeks took about three months, because I have been in a state of starvation.

Every time I go through certain points in the manuscript, I change something minuscule, then I go over it again, and change it back, just for the sake of changing something.  It’s time to let it go.  I plan to send it in to the publisher first thing tomorrow, or maybe later tonight if I get some food into me.  It takes a bit of energy to click on SEND.