Anorexics Don’t Exist.

Anorexics Don’t Exist.

Nor, for that matter, do bulimics, or alcoholics, or schizophrenics.

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There is no such thing as “the mentally ill,” just people with mental illnesses.

In short, PEOPLE ARE NOT DEFINED BY THEIR CONDITIONS.

There are people with anorexia, yes. But anorexics? Never met one.

There’s an unfortunate tendency in society to label people. We like to categorize things. Our kitchens and closets and inboxes are all neatly organized by content, color and origin, and we try to do the same with people, as though they were folders we can just slap labels on before filing away in a box somewhere.

But here’s the thing: People are not folders, and we do not belong in boxes.

People are complicated, multi-dimensional, and undefinable. We’re always changing and we are so much more than any one label, or multiple labels, for that matter, could ever begin to describe.

But what’s the harm in labeling people? Can’t it help us to talk about things in a more organized way? Can’t it help us to put like things together in order to better study them? Yes, it can. But we can do that without turning people into just one of their many characteristics. One of the problems with labels is that they promote stereotypes. They encourage us to view all the people with that label as the same, which couldn’t be further from the truth. Take anorexia for example. I’ve met many, many people struggling with anorexia in my lifetime. So many I’d have trouble naming them all. But I wouldn’t hesitate to tell you that they were all unique. Some were overly concerned with their appearances, yes, but many more were not. Some were perfectionists, some were not. Some had a distorted body image, while others didn’t. Some were artists, others had dreams of becoming doctors. You get where I’m going with this, right?

It’s the same with everything else.

Another problem with labels is that they separate us. They put up walls between us where none should exist. So while there are black people and there are white people, there are not “blacks” and “whites.” See how using the terms that way automatically erects a barrier?

The point is this: Language has power. So let’s be more careful how we use it to describe ourselves and our fellow travelers. Let’s stop putting one another in boxes and assuming that we can know everything there is to know about a person simply because we know one thing about them. Let’s look past society’s name tags and get to know the real person behind them. Because I guarantee you that behind every label is a living, breathing human being with thoughts and feelings, hopes and dreams, and worries and fears very similar to your own.

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R E S P E C T (just a little bit)

Part of the reason I started this blog was to help people understand what it’s like to live with something like an eating disorder. (Or anxiety, or depression, or any other type of mental illness.) There is so much misunderstanding out there about mental illness that I hoped to serve as a beacon of light in the overwhelming darkness. Somehow I thought my words could help paint a clearer picture of what we, the survivors of mental illness, face on a daily basis. Hopefully, I’ve done that to some degree, but I’m also beginning to see that perhaps understanding is too much to expect. I mean, heck — even I, someone who has struggled with anxiety, depression and anorexia for a good chunk of her life, don’t fully understand the issue. So how can I expect people with no experience whatsoever to “get it” just after reading a few blog posts? It’s simply not realistic. It may not even be possible.

But you know what? That’s okay. They don’t have to understand. YOU don’t have to understand. I’m okay with that.

What I’m NOT okay with is people making broad generalizations or assumptions about a whole community of people simply because they don’t understand. It happens every day. And not just with mental illness, but with all sorts of differences, from skin color to religion, to political affiliation. You know what I’m talking about — people with depression need to “cheer up.” People with eating disorders are vain, selfish and should “just eat.” Muslims are extremists and not to be trusted.

ALL LIES.

But that’s what people do when they don’t understand. Not content to just accept that they don’t understand, they seek to explain things in the only way they know how, in a way that makes sense to them. Or they decide that if they can’t understand it, something is obviously messed up about it.

ALSO A LIE.

You get where I’m going with this. I guess what I’m trying to say is, perhaps my goal to help everyone understand was a little misguided, and admittedly borne from a place deep inside ME that yearns to be understood. But the older I get and the more I try to explain my issues to people, the more I’m beginning to see that not everyone will understand. And that’s okay. Even those of us struggling with the same issues don’t experience those issues in exactly the same way. My experience with anorexia is not the same as everyone else’s. That’s okay too. Have I fully understood the issues of everyone I’ve encountered on my recovery journey? No way. And I actually tried. But that’s also okay. People do not have to understand everyone else’s experience. My journey does not have to make sense to you.

But what we DO need to understand, is that a lack of understanding does not warrant a lack of respect. We can respect one another without understanding one another.

I may not be able to wrap my head around why my best friend cuts herself when she’s hurting inside. I may even think it’s the stupidest thing I’ve ever heard of. But I can still love her, and support her, and respect her.

You may not understand why a loved one who is obviously underweight has such a hard time eating a decent meal — it may seem like the craziest thing in the world to you — but you can give her a hug, tell her you care and respect her.

Because the truth is, EVERYONE deserves respect. I don’t care who they are or what they’ve done, they are a HUMAN BEING with feelings and a beating heart. You don’t know what kind of life they’ve had, or what factors have shaped them into the person you see, or what inner demons they’re battling. We all have a hard enough road to travel without encountering disrespect from our fellow travelers along the way.

Why not help one another along?

 

The Diagnostic and Statistical Manual: Friend or Foe?

I made a note to myself to write this post a long time ago, because as both a long-time diagnos-ee (what, I can’t make words up?) as well as a once upon a time would-be diagnos-er (yeah, I used to think I wanted to be a social worker…), the DSM is something I’ve become relatively familiar with. And I have mixed feelings about it. I think it’s those complicated feelings, not to mention the complexity of the topic (I mean, does anyone really know what they’re talking about when they try to discuss the 500 pound gospel of mental health?), that have kept me from attempting it until now. After an interesting conversation with my psychiatrist yesterday, however, I think perhaps it’s time to take it on. But first, a disclaimer: I am not an expert. I am not AT ALL an expert. I could make this post all heavy on research and facts, but that would be hard. And I don’t feel like doing any research. So I’m going to focus on what I know from first hand experience — what I’ve witnessed as the pluses and minuses of having a tome like the DSM. (side note: I did at least google around a little bit before writing this, and apparently there’s A LOT of discussion out there about the DSM and its downfalls. And it does seem to have quite a few downfalls. Case in point: I also discovered that homosexuality was recognized as a mental illness until 1973…)

To set the stage, a little background: At the age of 12, I was diagnosed with anorexia nervosa. Back then, the doctors I was seeing were using the DSM-IV (it’s recently been ‘upgraded’ to the DSM-V), so on every receipt I received for mental health services, I saw the code 307.1. That number and its accompanying diagnosis came to define me, and as I’m just now realizing, has played a significant role in how I’ve viewed myself for much of my life. So imagine my surprise when about a year ago, a doctor somewhat casually mentioned that I may not actually have anorexia after all. We didn’t really get into it, though, and I got my scrip for Prozac and left. I pondered it a bit afterward, but the more I did, the more I didn’t really give a shit. They could call it whatever the hell they wanted — It was ruining my life no matter what number you wanted to slap on it, and that’s all I cared about. So I didn’t really think any more of it.

Until yesterday.

Once again, this doctor brings up the fact that anorexia may not be the correct diagnosis for what I’ve been struggling with. Apparently the fact that I do not have a distorted body image or fear of gaining weight makes me “ineligible” for that label. (Funny that no one has ever told me that before….) According to this doctor, my symptoms may in fact be a result of untreated anxiety and depression, with perhaps a dab of OCD mixed in, which would in fact be much easier to treat. Now that got my attention. I’m all about easy to treat. So at my next appointment, we’re going to do some more investigating, maybe some über fun psychological testing, and figure this shit out.

My reaction to this new development has surprised me for several reason, one being that I was convinced I was over the whole label thing. I thought I didn’t care what I “had” as long as I could kick its ass. But all of a sudden I feel relieved. Like maybe I don’t have a death sentence hanging over my head after all. Maybe I will, after years and years of struggling, finally achieve full recovery. It’s strange to notice thoughts like these moving through my head because I didn’t realize I’d given up hope. To be fair, I’m still not so sure that I had, but two decades of fighting an illness that lives in both your brain and your body is tiring. It’s worn me down and after this long of a struggle without much to show for it, I guess I shouldn’t be so surprised that my hope got chipped away a little bit. So yes, this new development has reignited that old spark. This is something new. It’s not the same old, same old I’ve been getting from doctors for twenty years. That’s refreshing.

But anyway, enough about me. Let’s talk about that bitch of a book’s whole role in this. First, the glaring fact that out of the many, many, MANY doctors I have seen over the years, this is the first one to point out that I don’t meet one of the key criteria for the diagnosis of anorexia nervosa. In the past when I’ve told doctors (and therapists) that I don’t have a distorted body image, they’ve either A. thought I was lying, or B. thought I was unaware of it. I think the DSM is partly to blame for this, because when you walk into an office with a particular diagnosis, the treating professional (and I use that term loosely here) makes all sorts of assumptions about you. They assume you’re like every other person with that diagnosis and they forget to look at you as an INDIVIDUAL. They neglect to listen to anything you have to say that goes against what they’ve learned about said diagnosis. To be fair, I’m sure not every doctor, therapist, psychiatrist, what have you is this way, but in my experience, a hell of a lot of them are. So that’s my main beef with the book, and with labels in general, for that matter. If it were treated as a loose guide that would be one thing, but in my experience it’s not.

Another thing I witnessed while in inpatient treatment is the way insurance companies often require an official diagnosis before they agree to provide coverage. Many of the young men and women I encountered were turned away from getting the care they needed just because they didn’t meet one or two criteria defined by the DSM. Or they were discharged after just a few days (um, not enough time to recover from an eating disorder..)  Not only does this serve to deny people the treatment their lives quite literally depend on, but in many cases, it also reinforces in their minds that “they’re not sick after all” or they’re “not sick enough.” They may even use it as fuel to dive deeper into their disorders because after all, the pros say they don’t even have a problem. On the flip side, sometimes being given a diagnosis can make people feel helpless. They’re no longer individuals in charge of their own lives but pawns of a ‘disorder’ they can’t control.

And this is just the tip of the iceberg, limited as it is to my own personal experience. As I mentioned earlier, run a quick google search if you’re hungry for more. Granted, the DSM no doubt has its value. I’m certainly not suggesting it be banned or that we all host huge bonfire parties. I’m merely suggesting that it be used with care and urging professionals to maintain an open mind at all times. While a diagnosis can certainly help guide treatment, the DSM is a double edged sword and should be wielded with caution.

So, in summation:

Pros:

1. Diagnoses can help patients receive insurance coverage for treatment more easily.

2. Much like medical diagnoses, mental health diagnoses can help doctors and other helping professionals determine the best line of treatment

3. Having an illness recognized by the DSM can help to legitimize it as a real problem.

4. Yeah. Sorry. I can’t think of any more..

Cons:

1. NOT having a diagnosis can make it more difficult to receive insurance coverage for treatment.

2. Having a diagnosis can put you in a box. Just because your illness been given a particular label, professionals seem to assume you’re like every other person they’ve seen or read about with that label.

3. If your illness doesn’t fit the criteria defined by the DSM, your problems may not be treated as seriously. (see number 3 above; flip it around)

4. On the other hand, having a diagnosed mental illness can make you feel doomed or helpless.

5. I’m sure there are tons more.

I’d love to hear what others think. What have your experiences been, either as a patient or as a caregiver? Do you love the DSM or hate it? Have you ever been misdiagnosed and how did that affect you? Leave your opinion in the comments.

The Media and Eating Disorders: It’s not what you think

The National Eating Disorder Association supplies this infographic to educate people about the media’s role in contributing to the dangerous level of body dissatisfaction in our society:  Media Literacyinfographic2_13

Among other things, it points out that the more young people are exposed to media messages, the more likely they are to be concerned about their appearance. I don’t doubt it. I know that on some level, seeing perfectly portrayed people on television and in magazines all the time certainly makes me feel more than a little insecure about my plain Jane appearance. I like to think I’m immune to media influence, but it’s hard not to worry about what you look like in a culture where one’s level of attractiveness seems to determine his or her worth as a person. So while I don’t dispute the media’s impact in that capacity, I think something that goes largely unnoticed is the way the media discusses the very problem it perpetuates. Specifically, I’m disturbed by the way the media portrays eating disorders.

I realize some people think there’s a glamorization of eating disorders going on in our society, but I’ve noticed quite the opposite. One need look no further than the recent hot topic of whether or not the latest winner of “The Biggest Loser” has an eating disorder to see it at play. Hundreds of news outlets are speculating on the status of this woman’s mental health, and somehow I doubt it’s out of concern. Now, I can’t comment on the specifics as I’ve never once watched the show, but that’s beside the point. This woman is merely the latest person to be caught up in the media’s obsession with “do they or don’t they.” It’s a ridiculous game that in my mind benefits absolutely no one. We all know there are myriad celebrities who have struggled or still struggle with some type of eating disorder. Some are open about it, but a larger number aren’t. And who can blame them when the media goes after them as though conducting some sort of witch hunt? Magazine covers accuse people of having an eating disorder as though it were some sort of wretched condition they should be ashamed of. I don’t know about you, but sensationalist headlines along the lines of “Is Renee Zellweger anorexic? Actress addresses rumors…” and “Biggest loser winner denies eating disorder accusations” just rub me the wrong way. Accusations? Rumors? When did this all become a criminal trial?

Maybe they do, maybe they don’t. This obsession with an individual’s weight — no matter their size — needs to stop. I don’t see anyone writing flashy headlines about people suffering from physical illnesses. I mean, have you ever seen  “Actor denies allegations of being diabetic,” or “Does so and so have a heart murmur?” splashed across any front pages lately?  What’s more, in their eagerness to make clear that eating disorders are not healthy, sometimes even well meaning people end up making those of us who are still struggling with one feel pretty shitty. Criticizing anyone‘s appearance is hurtful, regardless of the intention. In case you’ve overlooked the title I chose for this blog, let’s just say I’m of the belief that negativity in any form tends to do more harm than good.  So when eating disorders are characterized as “gross,” “ugly” and “disgusting,” I fear it may only serve to drive more people who are struggling with one to keep silent. Granted, I’ll also be the first to tell you that although I’m actively working to recover from my eating disorder, I’m still (at least in my eyes) noticeably thin, so perhaps I’m just being sensitive, but I think there’s more to it. Body shaming in any form is wrong, plain and simple. You just don’t do it. Tell people eating disorders are deadly, tell them how they’re hurting their bones, their hearts, their muscles, but don’t tell them they’re ugly. I’ve found that no matter how different someone looks on the outside, we’re all incredibly alike on the inside. And no one likes to be criticized.