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Body Dysmorphia Part 2: Mental illness and anorexia, my story

Katherine Maslowski, MD OBGYN

Trigger warning: This article is about mental illness and anorexia. This article is about my personal experience with both.

If you don’t have the mental space to read this today or this topic is too close to home for you please don’t keep reading xx

This is a follow up to the post on Body image body dysmorphia.

First things first

Everyone’s experience of mental illness is different, even if people have the “same” diagnosis. This is just my own experience but hopefully, if you have experienced mental illness and anorexia or something similar you will know you are not alone. And if you know someone who is struggling it might help you to understand.

 

How it all started

I was diagnosed with anorexia at the end of my first year at uni. I was 19 years old and had managed to pass it off as “stress” for almost 6 months. For context, I was trying to get into medical school, I had moved out of home for the first time, my parents’ marriage was falling apart, my grandad had just died and my boyfriend at the time was not being very supportive of all of the above. So it was easy to pass it off as stress. No one questioned my response of “I’m just really stressed” when they commented on my weight and asked if I was okay.

 

My eating disorder started with calorie counting.

My sister was trying to lose weight for her school ball and was using a calorie counting app. I was interested to see what it was and whether it worked or not. Previously, I had a pretty healthy relationship with my body and with food. I had never really “dieted” as such, I was an active child and teenager, I played sports, my mum cooked healthy food. Overall, I had a pretty balanced lifestyle. But then I was curious about calories and it all unravelled. I lost a few kilos with the calorie counting.

For context, I am a small person. My parents and sister are all small. I didn’t really have a lot of weight to lose before it became a problem.  I thought that maybe I should stop because I was lighter than I had been in a long time and I thought that probably wasn’t good. But then some switch seemed to flick in my brain and suddenly I couldn’t STOP eating. I starting binge eating and completely lost control of my eating habits. I put on the weight I had lost and then some in about 2 weeks.

This scared me, but mostly it was the lack of control I felt around food that scared me. When I couldn’t control the bingeing I started vomiting up my meals. It just got worse and worse until I was vomiting every meal except breakfast, even if I had only eaten a normal amount.

 

This meant that I was losing weight pretty quickly.

And people were noticing, and asking if I was okay. And I was telling them I was stressed.

Until my mum caught me vomiting when I was home from uni one weekend. She confronted me about it, and I admitted to what I had been doing. It scares me slightly to wonder what would have happened if she hadn’t noticed. After that I didn’t want to let her down so I didn’t want to make myself vomit anymore. So then things swung the other way. I suddenly had SO MUCH control over what I was eating and was trying so hard not to binge that I was hardly eating anything. So I kept losing weight. I was also exercising A LOT because I was so stressed at uni and exercise has always been a stress relief for me.

The way I remember it was that I was exercising to handle my stress (rather than to lose weight). BUT it had become obsessive and not a healthy way of exercising. I was taking my uni notes to the gym and reading them while I ran on the treadmill. I was restricting my food intake to keep the bingeing under control and the weight loss was sort of an accidental side effect of all this.

How I got help

After my exams finished for the year Mum took me to a psychologist who specialised in eating disorders. She weighed me and measured me and told me I had the BMI of someone with anorexia. AND I WAS SURPRISED! That probably gives you some insight into how warped my view of my own body was. And my eating and exercise habits. But she scared me enough to make me listen to her. She said I had to stop exercising immediately because she was worried my heart couldn’t take it.

Even though I hadn’t consciously been trying to lose weight, once someone told me I had to put on weight everything changed. I became obsessed with how my body looked, I felt fat all the time, if I ate “too much” (read: a normal amount) then I was convinced I could feel my thighs getting fatter. There are very few photos of myself during this time but the ones I do have show that I was very, VERY wrong about how I looked. I looked sick. I definitely didn’t look “fat”.

 

My recovery was slow. A lot slower than I would have admitted at the time. I worked with a psychologist and dietician for months but relapsed into my old habits several times. Unfortunately, I fundamentally disagreed with them about what my diagnosis was and what my goal weight should be. I think I also became depressed through the process of trying to recover and I missed the endorphins of exercising. In summary, it was a bad time in my life.

 

How I recovered

But eventually I got there. I credit my recovery to a course called the Lightning Process that I did with a woman in Auckland, New Zealand (she now teaches a similar course called the Switch). I don’t know where I would have ended up without that course. Definitely not where I am today anyway. Somehow she managed to make my situation my responsibility (and therefore something I could change) without making it my fault. It was all about changing the pathways in our brains and the thought patterns away from the unhelpful habits and towards new, positive ones. It is quite hard to explain or describe how much this course helped me and changed the direction of my life. But I think the key to recovery is professional help. It is so hard to do this on your own.

 

I was probably unwell for about 3 years in the end but now I have fully recovered. Every now and then I still think about it, but mostly it feels like it all happened to a different person. I am so lucky and so grateful for this. But I know that many people who struggle with eating disorders struggle for a lot longer than I did. And some never fully recover. Anorexia has the highest mortality (death rate) of any mental illness. I am so grateful to have survived it.

 

The shame I felt

For years and years, I was so ashamed of my illness that I hardly told anyone about it. I was also afraid that uni would find out and wouldn’t let me into medical school or would kick me out.

 

Recently there has been an improvement in the way society views people with mental illness, but we still have a long way to go. I think often mental illness (especially things like eating disorders, depression or anxiety) is seen as something that people are inflicting on themselves. The attitude often seems to be “why doesn’t she just eat?” Or “why can’t they just be happy?” Or “why does he worry so much?” People with a mental illness would not have a mental illness if it was a choice. It is debilitating and painful and scary and sometimes fatal. It is not a choice. But I think that can sometimes be hard to understand.

 

What I have learned from my mental illness and anorexia

I do not presume to know everything there is to know about mental health. I can only speak from my own experiences. But based on my own experience, I have decided that the world can roughly be divided into two groups of people: those who understand mental illness and those who don’t. That’s not a judgment on anyone and, for the people who don’t understand, it’s often not for lack of trying. Some people just have no frame of reference to understand how it feels when you and your brain are not on the same team. I don’t think it matters what team your brain is on, whether it’s depression or anxiety or OCD or schizophrenia or whatever. The point is it’s not the same team as you.

 

At some point during my first year at university my Dad noticed that I started referring to myself and my brain as separate entities. I think that is how it feels. If this seems like a strange concept, a good analogy seems to be irrational fears or phobias. I have one of those as well so can confirm it feels similar.

If you are afraid of balloons or marshmallows or something equally objectively harmless then my description will probably sound familiar. Intellectually, you know that a marshmallow is not going to hurt you, but your stomach still tightens and your heart starts racing and you feel like something awful is about to happen. You can’t control that response, regardless of how sure you are that the marshmallow will not hurt you. It’s like part of your brain is reasonable and logical, and the other part is terrified and there’s nothing you can do to get them to talk to each other.

 

This is really hard for people to understand.

Especially if they haven’t ever experienced anything like this. If someone you love is struggling with mental illness is can be hard to understand what’s happening and support them the way they need you to. For example, my boyfriend at the time all this was happening just could not understand that it was not a choice. What he saw was me refusing to eat something or crying because I thought I had eaten too much. What he didn’t see was an internal spiral like the one I described before every time someone expected me to eat something. He couldn’t see the internal battle so to him it didn’t exist.

 

In the end, we had to agree to disagree about whether it was a choice or not. We stayed together for 4 years after that and it just became a taboo topic.

 

Recovering from this eating disorder is the biggest achievement of my life. And it was something I was not allowed to talk about with the person I was closest to. It made me feel like there was something inherently wrong with who I was. This shame makes recovery so difficult. I read a quote once that said “one of the hardest things was learning that I was worth recovering”. It’s very easy to feel that your mental illness, whatever it may be, is the entirety of who you are. It takes over and it becomes difficult to see anything past it.

 

If you are experiencing something similar

I do not presume to understand what you are going through but I’m sorry that this is happening to you. I have no doubt that it is awful and consumes so much of your time and energy.  You do not deserve it. No one does. IT IS NOT YOUR FAULT. Yes, I put that in bold AND in capitals. And I will say it again. This is not your fault. You deserve to recover, and you can get better. There is hope. You are not alone.

 

If you know someone who is struggling with mental illnesses and anorexia

They are not doing this on purpose. It might seem like they are being difficult or hard to reason with or frustrating or infuriating but they are fighting a battle with their own mind. They don’t have the energy to do battle with you too.

You cannot “fix” them. But you can support them to get help.

Everyone is different so I don’t have a “one size fits all” instruction manual for how to help them. But please make sure they know you love them. And that you know it is not their fault. And you are there if they need support.

 

Things that help me now

I’m not a psychologist or psychotherapist and professionals are the best people to help you if you are struggling. Please get help, you deserve it!

But these are some things that I do that help me when things start to get a bit worse (which still happens from time to time).

  • Yoga
  • Meditation
  • Moving my body
    • But being careful not to get obsessive about it
    • Dancing is good for this
  • Surrounding myself with friends and loved ones
  • NEVER checking my weight
  • Therapy (even now that I feel I’ve fully recovered)
    • I think there is always more to learn about yourself and more to heal with the help of a therapist
  • Remembering that my brain does not have to control me
    • There is a fantastic podcast that talks about this if you are interested. It is season 4, episode 4 of How to Fail with Elizabeth Day where she interviews Mo Gawdat (if you can’t access podcasts on Spotify)
  • Giving myself permission to struggle
    • We don’t have to have everything together all the time
  • Being kind to myself
    • This is the one I struggle with the most
    • But it is SO important

Mental health resources

If you are struggling with mental illness and anorexia these resources might be helpful:

UK:

Mind.org
Mental health UK
NHS
Centre for Mental Health
Support line
Samaritans

NZ:

Mental Health Org NZ
Health Gov
Life line

 

Disclaimer: This website does not provide medical advice
The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

  • June 11, 2021
  • Personal stories
Katherine Maslowski, MD OBGYN

Katherine Maslowski, MD OBGYN

Katherine is a junior doctor from New Zealand who has experience working in Obstetrics and Gynaecology and is currently studying an MSc in Women’s Health. She is passionate about women’s health and empowering women to learn about their bodies and understand how they work. She is particularly interested in sexual and reproductive health and helping women to make educated, informed choices about their health and wellbeing.

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