Wednesday, April 30, 2014

Practicing What I Preach

I mentioned yesterday that I was having an uptick in pain. Predictably, this has yet again set off a cascade of panicky, devastating thoughts about omgit'sback. I can't really describe how awful and terrifying that is—as if the past six months have just been a nice dream and now we're back to the nightmare.

I just spent an hour in tears with Dr. P who pointed out that this level of catastrophizing is maybe not quite warranted for a couple reasons:
(1) I went through a similar experience almost exactly one month ago, suggesting that this is possibly the result of some cyclical hormonal fluctuation.
(2) I've been upping my exercise again after SWEARING to her and you guys and myself that I would wouldn't. And the pain seemed to pick up after two consecutive days of long bike rides.

Less than 24 hours ago, I was waxing poetic about how I choose health and all that, and I still do! But that's easier blogged than done. Oddly, these days the food piece is easier than the exercise piece. But I'm working on it.

Tuesday, April 29, 2014

The Weight Cure: Part Three

I wrote this post over a year ago and then this follow-up post last fall about how weight gain had done WONDERS for my crazy anorexic brain, and how maybe this whole not-being-a-skeleton thing wasn't so bad after all. Well, I figured it was time to take inventory again and see how things really stand for me, recovery-wise. Some of this may not be news to those of you who read regularly (WHICH I KNOW YOU ALL DO), but it still helps me to go over it so bear with me.

My body image is good. Not great, but good. Considering this is my highest lifetime weight, considering I weigh double-digits more now than I have for most of the past five years, having "good" body image is a small miracle. I don't LOVE my body, but I appreciate it and I respect it in ways I never have before.

The big obvious change since my last Weight Cure post is that the pelvic nerve pain, which they told me over and over again was chronic and incurable, has largely been alleviated (thank you, Dr. A and your magical fire cream). It's not completely gone, and I still have iffy days and weeks here and there, but the overall quality of life improvement has been dramatic. So, it's a lot easier to appreciate my body when it doesn't seem intent on making my life miserable. But what I've learned over the past several months is that my body doesn't want to hurt me; it wants to just BE. And by forcing it to run X miles every day on YYYY calories, or forcing it to wait Z hours between meals even when it's hungry, I am only making it harder on both of us.

The exercise piece is still a struggle. Remember my recent scare when the running started to get out of control? Well, as soon as I got a handle on THAT, I started biking too much. And had another uptick in pain. So I'm back on self-imposed exercise restriction this week, limiting myself in time and intensity, at least until my pain levels go back down to baseline. I told you guys I wouldn't get it perfectly the first time, and apparently not the second time either, but I am trying.

In terms of intake, I've bumped up my calories a tad over the past couple months. I am also working on redistributing them a bit better throughout the day, so that I eat more earlier on when I am actually hungry as opposed to saving up until the evening, when the thought of stuffing in enough food to meet my target is totally unappealing. This is still very much a work in progress. Variety is still so-so, which is as much a product of my complete and utter lack of interest/ability in the kitchen as it is residual ED-ness. That's not to say I am no longer rigid about food; I am. I still don't like restaurants. I still count my calories, and I still largely choose foods based on their caloric content. But the anxiety associated with all of the above is much reduced from six months or a year ago. I haven't weighed myself in over a month, and I don't miss it. Never thought I would be able to say that.

This has all been a gradual process - there was no Recovery switch flipping. It has been months of trying and messing up, and then trying a different way and messing up a different way. But each time, I've gotten back on my feet, dusted myself off, and found myself a little further ahead than I was before.

So here's the thing: I don't love my body, but I appreciate and respect it, and I am beginning to accept it. I never really understood what that meant before - to accept your body - but now I think I do. It means to have a baseline level of comfort with it; to know that if you treat it right, it will respond with health and energy. But that health and energy are not a given. That health is something to achieve and maintain, not something to ignore and throw away.

I am beginning to accept that I will never weigh double-digits again. I am beginning to accept that I cannot lose weight and be healthy. I am beginning to accept that the health consequences of losing weight are far more terrible and unbearable than facing the discomfort of weight gain. This used to be an impossible dilemma for me: that I could either be in pain, or be "fat." Now, this dilemma seems ridiculous. Now, I have accepted that I can be healthy or sick. And I choose health.

Saturday, April 26, 2014

Skin tips?

Anyone else have the weird post-anorexia skin issues? My skin was essentially perfect for about 10 years until last spring/summer, when I was eating well, had gained weight and gotten my period back, and randomly started breaking out like a pre-teen. It was never AWFUL acne, but enough to make me super self-conscious. My skin cleared up a bunch in the winter, but now that it's getting warmer and more humid, it seems like my skin is getting angry again. I've always been prone to oily skin, but now it's SUPER oily (although also dry in some places, oddly enough) and I'm not sure what I can do to keep from breaking out again like last year. I assume it's just a question of hormones rebalancing after years of turmoil, but I would like them to hurry up and rebalance please! I'm 23, not 13!

This is such a dumb little thing, but a total self-esteem buster. Help!

Tuesday, April 22, 2014

Easter Weekend

I had an absolutely lovely Easter weekend with my aunt, uncle, and cousins up in Big Northern City. (For those of who may recall, I made the same trip last year.) I drove up Saturday morning and got in around 1pm. My cousins (E—age 22 and G—age 19) and I went out for lunch and then came back home to decorate Easter eggs, make chocolate-covered strawberries, and hang around the house while my aunt cooked. Then E and I went out for sandwiches before seeing Transcendence at one of those ridiculous new theaters with recliner seats. I think the movie was good, but can't actually give you a valid review because it required a lot of thinking and I was dozing off after the early morning and long day. (The recliners didn't help.) But Johnny Depp always kills me.

those eyes
On Sunday, I slept until 8:30 (ALERT THE MEDIA) which is like unheard of for me, as I'm usually up and bouncing around by 6 or 7. We got breakfast and coffee, then helped my aunt with some cooking and errands and such. My cousin and I went for a walk (meaning, I made her take me for a walk) because it was gorgeous and warm outside, and then we came back and ate our big main meal around 1pm. Afterwards we did an Easter egg hunt. Yes, that would be me, age 23; E, age 22; G, age 19; and G's friend, age 19 hunting for the eggs that my aunt and uncle hid. I learned last year that Aunt H and Uncle L take the whole Easter thing extremely seriously. YOLO, right?

E and I hit the road later that afternoon and got back to College City around 9. I dropped her off at her apartment, and then floored it the 15ish minutes to my place because by that point, I was SO sick of driving. But I had an amazing time, loved pretty much every minute of it, and reminded myself how incredible it is to have such welcoming, loving family within driving distance, especially when my own parents are so far away.

Regarding the food situation, which was insanely hard and stressful last year: I was way less stressed, and did way better. I still struggled a little with the drive on Saturday, and had made myself get up early to run beforehand. That may have been a stupid and ED-fueled decision, but say what you want. I have a really hard time sitting still for that long. So I got in my run, ate breakfast, and was on the road by 8am. By the time I got to my aunt and uncle's house between 1 and 2pm, I was starving and light-headed. I usually only let myself go 3 or 4 hours between breakfast and lunch, so it was a big gap. I made up for it a little with my lunch, and then made up more by eating a bigger dinner than usual, and even getting a giant cookie to go with it. Later that night I ate one of the snacks I'd brought, so my daily total was a tad low but not horrible. I expected Sunday to be harder with the lack of exercise and huge meal planned, but actually experienced very little anxiety or stress about it. The walk with my cousin before lunch helped a lot, and reminded me that exercise can be low-impact, light, and relaxing instead of an all-out sprint that leaves me drenched in sweat and gasping for air. Plus, I am convinced sunshine has magical mood-improving properties.

source

I didn't think about schoolwork once all weekend. Which was a little stressful when I got back Sunday night, but totally worth it. I had brought my laptop, but didn't even take it out of my backpack the whole time I was there. So freeing and relaxing. Hope everyone had an equally nice time and is getting back into the swing of things!

Friday, April 18, 2014

Pre-Easter Pondering on Anxiety Management

Happy Friday! I am currently procrastinating although I have a MILLION things to do. I'm getting up bright and early tomorrow morning to hop on the road and drive six hours to Big Northern City for a whirlwind Easter weekend with my aunt, uncle, and two cousins. By "whirlwind," I mean I'll be driving up Saturday morning, spending 24 hours with them, and driving back with my cousin in tow Sunday night (she also lives in College City, but got a ride up to her parents' house earlier this week). Obviously I do NOT have a weekend to spare in terms of schoolwork, but I'll bring my books and my computer and get some work done Saturday night and Sunday morning, hopefully. Otherwise I'm just going to take off my Anal Retentive hat and chill out and have a good time and worry about the schoolwork when I get back.

Does that sound unlike me? Well, shut up. I'm trying to be less of a freak! Ever since my psychiatrist Dr. L and I talked about tapering off my meds (which I am not planning to do this very second, but will be considering in the future), I've been thinking a lot about strategies to keep myself happy and centered and anxiety-free. My therapist Dr. P gave me a list of YouTube links to mindfulness exercises and really, I tried a couple, and I just can't do it. I know it works miracles for some people, and I know it's like supported by evidence and whatnot to reduce anxiety, but seriously. I just can't not chortle my way through those things. I'M SORRY. They just make me laugh. My old therapist Dr. R once made me do deep breathing exercises in his office and it was a disaster. An absolute DISASTER, I tell you.

Anyway. Alternatives: I think I committed to this once before and then promptly failed at it, but I've been trying to write in my journal semi-regularly about the things I'm thankful for—my friends, my parents, my apartment, whatever happens to strike me at that particular moment. I just think it puts me in a positive, grateful, grounded state of mind. I've also been making a real concerted effort to spend time with people who make me happy: a few of my closest friends in my grad program, a couple other close friends from undergrad still in College City, my cousin, my advisor, my tutoring students, etc. Life is too short to spend so much time alone, you know? And after isolating myself so much the last couple years, I finally feel myself coming out of my shell again and actually enjoying time out with people. And finally, I am limiting my exercise, listening to my body, and doing my best to treat myself more kindly. Living workout-to-workout, meal-to-meal...it's stressful and it's not healthy. It puts my brain in a weird place, and it makes everything else feel secondary.

Still not weighing myself, still feeling good about it. Still little-to-no pelvic pain, few-to-no eye problems, and still able to appreciate the miracle of good health.

Much love and Happy Easter to all.

Thursday, April 17, 2014

Related Reading

Well, this was timely. Not sure I agree with everything she says, but it's an interesting read:

The Antidepressant Generation.










Thoughts?

Wednesday, April 16, 2014

Med Thoughts

I'm in a very post-y mood this week. YOU'RE WELCOME. Maybe it's because I don't have too much work, or maybe because the weight/exercise stuff has been on my mind a lot and I don't really have another outlet for that (other than my T), or maybe I'm just feeling wordy! I saw Dr. P this morning and we talked about the Celexa situation; she basically gave me two scenarios:

1) Taper off. If I feel like I need some sort of confirmation that the med is necessary, I could taper off and see what happens. If I'm fine, I'm fine! If I have a nervous breakdown, then I'll know I still need the drug after all.

2) Stay on my current dose. Maybe I still need the med, maybe I don't. But things seem to be going well for now, so why mess with a good thing?

It's weird because I used to be SO OPPOSED to taking any medication, and then my anxiety spiraled out of control and I very quickly lost all sanity and dignity. After years of flat-out refusing to take anything, I was practically begging my psych to prescribe something. So she did, and I took it, and the anxiety very quickly quieted. Depression, not so much. But like I said before, I am a miserable but perfectly functional Depressed Person. I am not a functional Anxious Person.

So, I am inclined to leave things as they are for now. Things are going relatively well, and anxiety scares the crap out of me. A lot has changed in terms of my life circumstances since that last terrible breakdown in May 2012 when I was first prescribed Celexa, but things aren't perfect and I don't yet trust my brain to stay this okay without a safety net.

Update on the non-weighing thing: still going strong. Still not super interested in knowing the number. Still eating better, exercising less, and overall feeling pretty solid.

EDIT: This is kind of awkward and not related, but someone found my blog by searching "disproportionately big feet." HA! I hope you found what you were looking for, Big-Footed Stranger!

Tuesday, April 15, 2014

Weightless

Well my period finally came, thank goodness, but sheesh this whole womanly thing is messing with my appetite. I am usually STARVING for breakfast and even more STARVING for lunch (hmm maybe my breakfast needs to be bigger?) but not today, because I am bloated and crampy and have NO appetite whatsoever. My uterus feels like weighs about 60 pounds. If this what pregnancy is like? Minus the period and plus a fetus, obviously?

It has been TWO weeks since I last weighed myself. Progress, right?? It's driving me nuts not to know, and I still have to physically restrain myself each morning from reaching into my cabinet under the bathroom sink for my scale (should probably move that) but overall it has been very freeing. It's really more that I'm scared to know than any grand recovery-minded breakthroughs, but still. Feels better. SOme of the obsessing in my head has quieted down a bit, now that I don't have a constant number in my head. Obviously I'm freaked out that my weight has gone up, but I'll deal. And I just feel lighter—mentally, I mean. My jeans still fit, even with all this period bloat, so that's a good sign.

I'm still on the fence about switching up my medication. After my appointment on Saturday, my psych e-mailed me with a more detailed tapering plan "should I decide to discontinue Celexa," which makes me feel like I should. The drug didn't seem to put much dent in my depression last year, but did wonders for my anxiety. And while the depression certainly made me miserable, but it was the anxiety that made me nonfunctional. Then again, a lot has changed in the two years since I started Celexa, so part of me is feeling kind of cocky about quitting. Plus, there's a teeny tiny part of me that has always wondered if the drug contributed to my weight gain. So wouldn't it be nice to get off it and maybepossiblyhopefully shed a few pounds.

Other stuff: registered for my summer and fall classes. I am SO excited for fall semester; it should be fantastic. And only three weeks left of this semester! Can't wait until summer—meaning, summer weather—is finally here.

Sunday, April 13, 2014

Uterus Confusion, Pills, and Insomnia

My reproductive system is really baffling the heck out of me lately. Last month, my period was five days early; this month it's late,although I've been having cramps for almost two weeks. I feel bloated and fat. I've also been having a lot of trouble sleeping, which may be a PMS thing or maybe also due to the weather changes we've been having. Plus MY BOOBS REALLY HURT. However,I'm not that moody or weepy or emotional like last month, which is weird but a-okay with me.

yes, there is such a thing
as "menstruation clipart"

Speaking of mood issues, I saw my psychiatrist Dr. L yesterday for a six-month follow-up. I always forget how much I like her. And I like her even more now that she offers Saturday appointments! We talked about me possible weaning off my antidepressant (Celexa) over the next several months, which appeals to me but also scares me. Still thinkin about it. I don't want to get cocky just because I've been doing relatively well recently, but I also hate hate HATE drugs and don't want to be on it anymore.

drugz

Anyway, I'm having a great weekend despite all the uterus issues. A friend and I got dinner at a great restaurant and then saw a show on Friday night. Yesterday I went for a long beautiful bike ride, spent some time at a coffee shop, and got tons of work done. Then I did some hardcore cleaning so now my apartment is sparkling. I didn't sleep well again last night so I'm feeling pretty sluggish today, but I guess that just means more coffee is in order.

Much love and have a great Sunday, everyone.

Wednesday, April 9, 2014

"What Suffering Does"

I love this.

"First, suffering drags you deeper into yourself. The theologian Paul Tillich wrote that people who endure suffering are taken beneath the routines of life and find they are not who they believed themselves to be. The agony involved in, say, composing a great piece of music or the grief of having lost a loved one smashes through what they thought was the bottom floor of their personality, revealing an area below, and then it smashes through that floor revealing another area.

"Then, suffering gives people a more accurate sense of their own limitations, what they can control and cannot control. When people are thrust down into these deeper zones, they are forced to confront the fact they can’t determine what goes on there. Try as they might, they just can’t tell themselves to stop feeling pain, or to stop missing the one who has died or gone. And even when tranquillity begins to come back, or in those moments when grief eases, it is not clear where the relief comes from. The healing process, too, feels as though it’s part of some natural or divine process beyond individual control."

From "What Suffering Does" by David Brooks
New York Times Opinion Pages, April 7, 2014

Monday, April 7, 2014

Monday Check-In

Argh. Monday again. Why is it always Monday? Also it's raining. However, I am psyched because my bike got here over the weekend, (shipped from Mom and Dad's house) and I'm excited for the new set of wheels to ride around College City. Although, again, it's raining.

Anyway sorry to be so up-and-down these days, but I am feeling a LOT better since my last post. I think I may have finally accepted that weighing myself does more harm than good, and I need to just STOP.

I had a tricky day Friday food-wise, because I went out with a friend from college right after work. This friend comes from a very overweight family who eats totally differently than the way I grew up (and obviously differently than the way I ate when I was, you know, not eating) and we have completely different tastes, so it is always kind of stressful to go out with her. The original plan had been happy hour and then dinner, which turned into happy hour, appetizers, and THEN dinner, but not until like 10pm. Did I mention that I had skipped my snack earlier that afternoon because I had back-to-back patients at clinic? So by the time I met up with her around 6 and realized that we were just drinking, not eating yet, I probably should have pulled out my snack and eaten it then. Instead, I got drunk on Long Island Iced Teas and pretended to nibble on mozzarella sticks. By the time we got dinner (Chinese food—NOT my choice and NOT an easy cuisine for me) several hours later, I was starving and stressed. I ended up eating an okay dinner, although apparently it wasn't enough because later that night at home, I realized I was hungry again and had to eat a snack around 1 in the morning. So...poor planning on that one.

source

But I still accepted another happy hour/dinner invite the next night, mixed up the exercise by working out with a friend during the day, and had a fantastic time at both. Sounds like progress, right? My body image is still ehhh okay-not-great, but I'm not too hung up on it right now. Stopping the weighing seems to have helped. I think I may have to keep that up.

Happy Monday everyone. If you're anywhere near College City, stay dry!

Thursday, April 3, 2014

Icky Body Image

Things are so-so. The not running has been hard. I just feel kind of icky, especially on the days that I don't get much walking in. It's been raining nonstop the past two days here, so I've pretty much been stuck inside on my butt and it's driving me NUTS. And I made the mistake of weighing myself this morning. Did I mention that was a mistake?

I am having a hard time trusting my body these days. After several months of stability, my weight has started inching up again and it scares me. I guess a lot has changed in terms of my exercise (from no running to lots of running back to no running, semi-consistent strength-training, very little walking to lots of walking, etc) and my period has become slightly irregular again over the past couple months after over a year of a metronomic 30-day cycle, so maybe these changes are a sign of something hormonally again? I hate that I've started obsessing about it again SO much. I can't tell how much of this is in my head, but my clothes feel tight and my gut feels bloated and I always seem to feel sluggish and gross. Mentally, it feels like I'm going backwards.

I am trying so hard to have a little faith. Not like God-faith, but faith that I'm doing the best I can, that I am by no means eating too much or too little, that my exercise level is just fine, and that my weight cannot go up forever. That maybe this is still post-ED recovery after so many years of restriction - sometimes hardcore, sometimes subclinical. I need a little faith that my body has already recovered from two major, baffling conditions and thus is obviously super resilient, and that a little more weight is always better than a little less. Right guys? Right? Right?!!?

What I hate most is that otherwise, things are going great. I love my research, I'm excited about my work, and (most of) my classes are awesome. So, I really don't want to let stupid ED stuff get me down.

Tuesday, April 1, 2014

Following Through

I've been working with this patient at clinic. She is in her fifties and has a number of health problems along with pretty severe anxiety and depression. I also suspect her husband is beating her, but I have no proof - just a gut feeling. She calls my office about twice a week to vent and cry. I am trying to get her set up with some temporary medical coverage and HOPEFULLY (fingers and toes crossed) disability benefits. Unfortunately College State is ultra-conservative and thus pretty stingy with anything that might, like, benefit the populace, but that is a post for a different day. Anyway, I spoke to this particular patient last Thursday about a few questions she had regarding Medicaid and SSI and such but didn't have the answers readily available, so I promised to do some digging and follow up with her the following day. Fast-forward to Friday evening, nearly 6pm, I'm tired and cranky and ready to head home...when I remember that I had forgotten to call her back. I waffle for a few minutes on whether or not she would care or notice, decide that she probably would, and call her back.

After we talked a bit about some specific next steps, she thanked me and said something along the lines of: "It means a lot that you called. Whenever you say you're going to do something, you do it." 

And with other people, I generally do. I do not flake out. I never ask for extensions. I always show up. I am Reliable.

But with myself? It's different. I procrastinate like crazy. I drop the ball. I toss out plans all the time. This is why I never make time for the dentist. This is why I never do PT like I'm supposed to. This is why I still bite my nails, after probably 15 consecutive New Year's Resolutions to quit.

This is why it has taken me so many years to start finally getting over my eating disorder - because all those times I promised to put my health first, I flaked out. Or I didn't even try.

I make commitments to others all the time, and I always follow through. But I probably break more promises to myself than I keep.

I am trying so hard to make this time different. And so far, I'm doing well. I haven't run in over a week, and I haven't cut my intake at all. So, in essence, I have an extra XXX calories to work with each day that I am no longer burning off before breakfast. Yes it's hard and I'm going a little nuts, but it's also kind of liberating. Things are more okay than I expected. I feel kind of icky, but I'll survive. And most importantly, I feel like I'm finally making a commitment and sticking to it because it is the right thing for me and the best thing for  my health. Obviously running X miles a day and limiting my calories doesn't work in any sense of the word, so I'm willing to trust my body for a while, to believe that the amount I'm eating won't make anyone fat, and that my body hasn't had a chance to fully recover in all these years of halfhearted attempts. Time to stand up and follow through.