Confidence as a Behavior

There are some things that we tend to think of as traits, things that you naturally are or aren’t. You can act outside of your natural tendency for a while but after a while it will be too exhausting or feel too uncomfortable. There are some things that psychology has found do tend to be like this: introversion/extroversion, neuroticism, and the other Big Five traits, but it seems to me that a lot of the things we view as traits are emotions plus behaviors. We can’t necessarily change our emotions but we can change our behaviors to gain some of the social benefits of traits we don’t have.

Here’s a thing:

I am not generally a confident, jump in and get stuff done kind of a person. I often seem lazy because if I don’t know that I’m supposed to do something I don’t do it. I wait for instructions, I need some coaching, and I need to know the “rules” of whatever situation I’m in before I feel comfortable making decisions and choosing my own actions. I’ve found that this need for comfort has really gotten in the way of my ability to be the kind of friend/housemate/employee/etc. that I want to be, and so I’ve decided that I want to change it.

Now I can’t just make myself feel confident. I will never be able to choose not to be worried. I will never naturally start doing things unless I really think about it and choose to do those things. But what I can do is mimic the behaviors of confident people. The other day I was playing basketball with some friends. I’m real bad at basketball. But I told myself that I was going to at least try to do things, even if I couldn’t do them well. That meant not pulling myself back if I was going to make contact with someone, running hard, and trying to notice what other people were doing to make myself try it too. I’ve been doing this in all areas of my life. “Are there things that could be done right now? I will do them.”

That behavior of simply going ahead and doing something whether you’ve been asked or not often gets read as confidence, or at least willingness to try (which is its own brand of confidence). I still don’t feel confident, but I’m getting read that way more often. I may not have looked super confident on the basketball court, but I made myself get up and try anyway, which looked much better than my first impulse (which was to hide behind my boyfriend).

It’s important to distinguish between behaviors that are helpful and emotions and traits that are valid. My shyness and nervousness are valid. However a lot of the time they aren’t helpful if I let them dictate my actions. What is helpful is recognizing that I need a few moments to assess a situation. Sometimes that’s even more helpful than having the first impulse to jump in, as I get a minute to figure out what’s going on and analyze things a bit before I start acting.

What I want to specify is that there’s nothing wrong with a lack of confidence when we’re talking about the emotional side. But there are behaviors that are separate from traits that we can notice and change. And each of us gets to decide for ourselves how far we’re willing to go in behaving in ways that don’t feel natural to us.

It might seem straightforward and obvious, but realizing that my emotions are separate from my actions is pretty exciting to me. I’m not required to continue acting within my comfort zone. Of course it takes more emotional energy, but if there’s something that’s frustrating to me about myself, I can do it differently.

Mindfulness has been incredibly helpful with this in letting me notice what’s going on around me so that I can be a little more intentional about what I do. Taking the time to notice what behaviors I find impressive or admirable in others is also helpful. Then I can start to notice the areas where I could do the same. I will never be confident as an internal trait. But I can make myself confident enough that I can do things I am afraid of. And my reflective nature was what helped me see that in the first place.


Into the Unknown

In about two weeks, I’ll be starting a very new chapter in my life. I’m quitting my full time job and moving to a part time gig doing communications, supplemented with freelance writing. Unlike my usual 9-5 gigs, this is a slightly more adventurous and less stable venture.

I’m excited. I’m so incredibly excited that I’m finally going to be doing the thing I’ve known I wanted to do since I was 10, that I’ll have time to work on my book, that I will get the freedom to set my own schedule and work at my own pace. Not to brag or anything, but this is basically the dream set up for me, so that’s cool.

But of course, because my brain is my brain and it does what it does, I’m also completely terrified. Thanks brain! And I suppose that’s the point of today’s post: even good things require coping skills. It’s not rare for a good decision to be one that requires change and growth. Oftentimes the best things mean you have to leave behind a safety net, a comfort level, because if you were already in the good place, why leave?

The thing that scares me, that scares people like me, the perfectionists and rule followers and “good girls”, is free falling. An open field without a path. Of course open spaces are entirely necessary for growth, but that doesn’t make them any less scary. I know that I’m not the only one in the Millennial crowd who’s dealing with stuff like this. There are more freelancers than ever, the traditional college/career path is becoming more and more rare, full time well-paying jobs are harder to come by, and part time or retail or other work is getting more common. I know people who are perfectly happy working a low wage retail job for now because they like it and they can get by on it. I know people who are struggling to find contract work or temp or freelance, people who are mashing together a variety of part time jobs.

Work looks different for people my age than it has in the past. The good part of this? More people have gotten ok with choosing a different kind of life path than their parents or the received wisdom. People are more ok with looking at what works for them and building a life based on their priorities and goals. That’s awesome. The less awesome part is that it’s a generation of people trying to figure things out in a very different way from what they were prepared for. Until this year I had never even considered that I might work a job that wasn’t a 9-5 office gig. Many of my friends are living lives very different from what their parents and teachers told them they would.

There’s some bravery there. There’s at least a little bit more emotional awareness in a generation that’s starting to learn that there isn’t one way to be happy. And there’s also some rebellion. My generation was groomed to be really good at working. We were supposed to get good grades and volunteer and do a lot of extracurriculars and get into Harvard or something. There’s a lot of Rory Gilmores around. Except it turns out none of these Rorys actually want to get that dream job, they’d rather work on their own terms and live a little more simply.

I suspect this is a big part of the fear and whining that you hear a lot from the Millennials. It might be why our parents and older generations think we can’t get a job or don’t work hard enough. We work differently and have different priorities, but it’s scary to try out those new things. It’s scary to realize that going through a lot of stress in a change might mean feeling a lot better over the long term. I don’t know entirely what my point is, except that I feel a lot of people around me feel as if they’re standing on the edge of a precipice. Perhaps some of us would have taken the normal path if it were more available to us, but thanks to crap tons of therapy most of us have learned that it might be a lot easier and feel safer to do things the “normal” way, doesn’t mean it’s actually a good fit.

I don’t have to tolerate things that feel crappy over the long term. There’s no benefit to it. I get to do things that look stupid because they make me happier. I get to take the less stable job because it’s what I enjoy. Woohoo!

Also I might be a bit muddled with all the change, so apologies if this is even less clear than my normal posts.

What Do I Mean When I Say Anxiety?

Yesterday, I made a Facebook post that included the word anxiety. When I made it, I was dealing with a fairly strong anxiety attack, and I mentioned my frustration at coping skills that weren’t working. A few people commented and joked or just treated it like I was talking about having too much energy. It wasn’t a big deal, but it did rub me the wrong way as I was trying to be open about something that was a fairly crappy experience for me and a lot of people completely misunderstood what I was saying.

A lot of the time, people don’t understand why mental illness advocates suggest that they don’t use words like “OCD”, “anorexia” or “depression” to mean things other than the actual diagnosable illnesses. This seems to me to be a good example. We have lots of words for things that aren’t clinical level anxiety: worry, fear, nervousness, a sense of impending doom. But we don’t really have any other words for the feeling of anxiety that comes with an anxiety disorder. So when I try to express that feeling, I have no way to say it except with a word that will inevitably be misunderstood by at least some of the people I’m speaking to.

That’s actually incredibly frustrating and can feel quite invalidating. If you had a broken leg and tried to tell someone, and their response was more along the lines of what you’d say to a stubbed toe, you’d be a little miffed. That’s what it feels like to try to talk about mental illness and get advice that applies to neurotypical brains. There’s fairly good evidence that invalidation is really bad for a person’s mental health, as it makes it hard for them to trust their own emotions. So while no one was intending to fuck with me last night, it certainly felt as though I was trying to ask for help or comfort or recognition, and instead got people completely ignoring what I was saying.

These are the kinds of small experiences that add up. If you have a mental illness you get them all the time, which means that you have to spend extra time and energy deciding how you want to explain yourself and your feelings to other people. It also means always feeling as if you have to convince other people of the seriousness of a given emotion or problem. When I say anxiety, I don’t mean I’m worried about something. I mean that my whole body feels like it’s going to rip apart, that I have so much energy I can’t keep still, that I alternately cry and do pushups, that my brain will not and cannot turn off, that I am desperate to escape whatever situation is bothering me. These differences are important. We need a word to talk about the intense anxiety. It’s hard enough to talk about it without having the language itself obscure your meaning.

For those who don’t have to learn how to express their emotions in a language separate from the one everyone else does, it might seem like no big deal. But if you’re trying to be honest and open with others and not seem overly dramatic, it’s really important to be able to use the accurate terms without them being misunderstood.

Recovery In a World of Triggers

It’s extremely common for people with eating disorders to relapse at least once after feeling as if they’re in recovery or on their way to recovery. Some stats put relapse rates as high as 80%, although with more research on good treatment and long term support for people with a history of eating disorders, it’s likely that the number will go down. But unlike lots of other mental health problems, eating disorders live in a place where the bad behaviors are often praised, and triggers are basically everywhere all the time.

It’s astounding to me that anyone manages to recover at all. I’ve been doing fairly well for about six months, but the longer I spend away from the eating disorder, the more I realize how many unhealthy messages there are all around me. I recently had a conversation in which someone who was well aware of my eating disordered history and who brands themself a skeptic and scientifically literature person suggested that a diet of 1200 calories was an appropriate form of weight loss. Almost every day I hear people talking about how unhealthy it is to eat sugar or carbs or gluten or really anything. No matter how many times I try to remind myself that what’s important is eating food that tastes good to me and eating enough food that I feel full, I am constantly and every day reminded that being hyper aware of diet seems to be synonymous with health.

And yes, there is good evidence that being at a mid range weight, not eating tons o sugar, and getting decent exercise are good for you. The problem is how to interpret that statement when your brain is built for all or nothing thinking and perfectionism, for guilt tripping you and punishing you. How do you find any sort of middle ground between “I am allowed to eat what I want” and “I should try to eat in a healthy manner”? This to me is what makes eating disorder recovery so hard. There is no cold turkey to eating disorders because food is always going to be part of your life, which means at least a few times a day you’ll be thinking about the thing that ruled your mind for so long.

In addition, there’s tons of conflicting information out there about what’s healthy. Even for someone who doesn’t have an eating disorder, sorting through the morass of studies and recommendations can be incredibly difficult, and reading about diet studies can be extremely triggering for someone with a history of an eating disorder. That means most of us just want someone to tell us what’s right, what’s ok. No one can and no one will, so instead we’re surrounded with a thousand different messages and left reeling about what is or isn’t appropriate food behavior.

The unknowing is almost more triggering than the obviously pro-skinniness, pro-dieting messages. The deep uncertainty about whether or not your weight is too high or too low, your diet is too unhealthy or too many calories or too few calories, or not enough veggies, that gets into your mind until you just want the clear rules again. Unlike nearly any other mental health problem, eating disorders circulate around something that’s considered completely acceptable to comment on publicly: food. And it’s a conversation that everyone wants to have, so no matter how you try to avoid it, you have a coworker who says “Oh I’ll be bad and have a cupcake” or a family member who says “I’m down 15 pounds!” in a tone of pride. Each time you try to retrain your mind to erase the disordered messages that say “skinnier is better”, someone else comes along and nonchalantly dismantles your hard work.

Perhaps worse is the fact that many people seem to believe that choosing a “this works for me” approach is unacceptable when it comes to eating. You must be doing what is the most healthy, backed up by evidence, best diet ever or you’re not healthy at all. That means that for someone who has an eating disorder and might have to take some shortcuts (like: if I feel hungry for x food I let myself eat x food so that I get enough calories), their (perfectly logical and healthy) choices are derided as illogical and unhealthy. Some of us know that we engage in unhealthy behaviors and have to accept that to get food in our bodies at all. Some of us need to ignore some of the research to convince ourselves that eating more than 1200 calories a day is necessary. Some of us need to be irrational in order to be healthy, and that’s ok.

On top of all of that, you carry your biggest trigger around with you every day: your body. The changes that happen in your body, even if they’re completely natural, are extremely noticeable to a brain that’s used to nitpicking every ounce of fat. The weirdest things will set you off. I found yesterday that I couldn’t fit into a pair of shoes that had been in my closet since last fall, and that my ring size appears to have changed. These are tiny little reminders that I’m moving into uncharted territory, things to be feared.

All of this is to say that I understand why the relapse rates of eating disorders are so high. I hate blaming diet culture for eating disorders, since a mental illness is not just a diet, but it is true that all the conflicting and horrible information about healthy eating has serious impacts on people trying to bring their eating back to a reasonable middle ground. The good news is that there are people who have managed to recover and stay healthy. The good news is that we’re allowed to set boundaries, remove ourselves from conversations filled with diet talk, block the hell out of triggering websites and ads. The good news is that we’re entitled to our own health and well being, no matter what anyone else says about the appropriate way to eat.

When Learning Things Is Triggering

I wrote last week about something called building mastery, and how it can be a struggle to recognize that you’re making progress when your body and mind are worn out from a mental illness. I’d like to expand on that a little further today by talking about what it’s like to have to learn new things, especially skill based things like how to do your job (huzzah!).

One of the things that many people who have bad depression, anxiety, or many other mental illnesses don’t do a whole lot is push themselves far out of their comfort zones. Don’t get me wrong, sometimes just getting out the door is like taking a flying leap out of the places that you feel comfortable, but people in the midst of serious depressive episodes aren’t known for trying out new things or meeting lots of new people. So during the recovery process, it’s pretty common to be working from zero on some new skills, whether that’s starting a new job or learning how to set boundaries for the first time.

If it’s been a while since you’ve been in a space of learning, it’s easy to forget that everyone sucks at things when they first try them. Facts: when you try something for the first time, you’ll probably get it wrong. You’ll probably need help. You might need things reiterated a few times, or you might make a mistake and have to go back and fix it. None of these facts means that you’re really bad at whatever it is you’re doing or that you’re a slow learner or unintelligent, they mostly just mean that it’s the first time you’ve tried something and you need a little bit of time to learn.

So if you have forgotten that these are completely normal and that the first failures you have when doing something new are really just the first steps to not sucking at that thing, it’s really easy to think that there’s something wrong with you or get discouraged. Add on to that a predisposition towards anxiety, depression, or another mental illness, and learning new things during recovery can become a fraught process. The very process of learning and building mastery over new skills and meeting new people that will eventually lead to a strong identity and support network can be triggering.

When you’ve already spent a lot of your time thinking that you’re bad at things, it really sucks to try new things. Because you will be bad at them. It’s just that being bad at new things isn’t some sort of horrible failing. It’s normal and ok, and you’ll get past it. The problem for people who are so used to feeling that way is that it’s hard to remember that it will pass. Negative feelings about oneself seem endless when depressed or anxious, so situations that induce those feelings are things to be avoided at all costs.

This puts people who are trying to recover in a bit of a catch 22 situation in which they’re encouraged to try new things or meet new people, but those experiences leave them feeling overwhelmed and panicked, inducing the kinds of feelings that they were just trying to get away from without the clear memory that this is a normal thing. Like many things that come with recovery from depression or anxiety, it seems that the only way to get through it is to accept that the negative feeling is there and not try to get rid of it. It will probably go away on its own sooner or later. Trusting that it will is possibly the hardest part of recovering though.

So in the meantime, while you’re trying to survive feeling like a failure while you learn how to cross stitch or swing dance, it’s good to be reminded that learning is hard. It might be triggering. But that doesn’t mean it’s wrong.


1. I bought new clothes last year. In my head I called them my fat clothes, and settled deep into the knowledge that there would always be a gap of two fingers between my waist and the band of my jeans. I felt powerful when I threw away the skirt that had never fit, but somewhere in my nooks and crannies there is a question remaining: did I just give myself permission to give up? I tried to pull on jeans yesterday, and couldn’t get the zipper closed.

2. I moved into a room full of mirrors last year. Mirrors on the closet doors, mirrors on the bathroom door, mirrors across the walls and everywhere I looked. It took me six months to snap. I set out my tools, an assortment of screwdrivers and hammers, and tried to pry the mirrors off the closet, only to find that it was mirrors all the way down. I left glass shards on my floor and trickles of blood on my fingers, but my closet doesn’t have doors anymore.

3. Some people describe their eating disorder as a voice or a worm or another version of themselves. My eating disorder is a rock. It lives at the bottom of my stomach, and on the days when I think that I’m about to slip away into the air because I’m just not solid enough to be real, it holds me down and tells me who I am. It’s extra, and so to contain it I need to empty myself out and scrape away a space inside of me that it fits. My new jeans aren’t big enough to hold all of me and the stone inside, the unbreakable certainty that tells me who and where I am. Choices must be made.

4. Bodies are adaptable, amazingly so. Bellies swell or fade, but underneath organs are churning to function on the smallest slivers of energy. These days when I miss a meal my hands go clammy and my muscles shake. Insides rebel with nausea, in a desperate bid to be heard. The rock inside me doesn’t provide a source of motion. I sit as still as possible and feel it holding me down. The pulling feeling fills me with a faux hunger, and when I find food, I fill every inch of myself, stretching and growing in a matter of seconds. I see myself expand, and the rock pins me down.

5. They told me that recovery would mean more energy. Last night I slept for 11 hours and woke up yawning. Rocks never get tired, and my body is heavier than it used to be. There are still runes scrawled across my body that tell me I should run further or swim faster, but my muscles go limp in a moment. Despite my weight, I feel empty. I remember the lightness of a truly empty self, and it hurts.

6. When I laugh, I forget that there are rocks inside me instead of insides. I laugh a lot now.

A New Sexual Spectrum

One of the issues that comes across my radar quite often is incompatible sex drives in relationships. I frequent many asexual communities and websites, talk a lot about consent, and generally am interested in making sure that people who don’t want to have sex aren’t forced into having sex.

However it has been brought to my attention that sometimes people do want to have sex, and sometimes those people are in relationships with people who have low sex drives. This causes Unhappiness on the part of every party, and is sometimes used as an excuse for cheating, a reason to open the relationship, a reason to break up, or as some kind of horrible leverage to pressure one partner into having sex with the other. Sometimes it just results in sad resentment simmering while no one has sex.

I also hear that sometimes relationships require compromise, and that since sex is part of a relationship, both parties need to learn how to compromise and have sex sometimes when they’re not that interested or learn how to take a no from their partner. There are lots of advice books and articles out there about these kinds of compromises (some of them that drive me completely bonkers like the ones that say a wife always has to be sexually available to her husband or he will cheat). On the positive side of the advice giving I see people who promote talking to your partner, working out which sex acts feel better and worse to them, figuring out what gets them in the mood, and coming to conclusions about what’s reasonable in your relationship to ask for (some people might be real annoyed if you asked for a blowjob after they’d turned you down for sex, whereas others might see it as a way they can be giving and kind without feeling discomfort).

There’s one element of this that sometimes gets waved at but not really discussed, and that’s the role that sex plays in a relationship. Many articles (especially super sexist ones) like to talk about how sex is incredibly important for men to be able to express and feel intimacy, so women need to be willing to give it up more often. We’re going to ignore that crappy advice, and instead talk about the fact that in long term relationships sex can have different meaning for different people, a fact which is too often overlooked, or when it is recognized is often used to shame people who don’t have the “right” meaning for sex.

But sex is a great and varied thing, and people get different things out of it. For some people it’s just a nice, pleasurable experience like eating cookies. For other people, it’s incredibly intimate and one of the ways that they express and feel close to a partner. For other people, it’s contingent on feeling close to a partner, and only really happens as an extension of emotional closeness. Some people don’t see sex as an integral part of a relationship and could do without it, others feel as if it cements emotional bonds.

All of these different approaches to sex mean that people will feel comfortable with sex in different circumstances. If sex is something you do to feel nice, you might not want to do it when you’re stressed out or thinking about other things. If sex is something you do to feel close, you’ll probably want it more if you’re feeling your partner is distant. But if you see sex as an offshoot of emotional closeness, the last thing you’d want to do when your partner feels distant is have sex.

Ok so what does this have to do with compromises around differing sex drives? If one person has a lower sex drive than another, or is not feeling like having sex, or just isn’t wanting it, it might be a good time to start talking about what sex means to both partners. Especially if sex is something that is deeply connected to emotions in some way, that’s important for both partners to know. And while it’s on both people to figure out a way to make their sex life work, this kind of information can make it easier for higher sex drive person to make things comfortable and conducive for lower sex drive person to get in the mood.

Example: I don’t really feel sexually attracted to someone unless I’m feeling emotionally close to them. Not just that I like them, but emotionally intimate. Have a philosophical discussion with me or tell me your deepest, darkest secrets and I’m way more likely to get physically into you. Some partners like to only express their intimacy with their bodies and through physicality. If we’re feeling disconnected, they might try to initiate sex while the last thing that I’d want is sex. The solution? Talking about it so that they know having emotional discussions or building our relationship in other ways will make me more comfortable and interested in sex.

This might not be a straight line of emotional—>non emotional sex, but perhaps more of a crazy explosion of different attitudes and needs. Many people are proponents of communication around sex, so I’d imagine incorporating discussions of what you get from sex and how else you might be able to fulfill some of those needs would be an important part of having a good sex life. It can also help when you’re having a mismatch of needs to understand what it is that you feel like you’re missing.

You Can Rely on Meds

I’m angry. Honestly, deeply, really angry. And worse than that, I’m angry about something that I wanted to like and support.

The New York Times is currently running a series in their Opinionator column about one women’s experiences choosing to go off her meds (with the help and support of her doctor). The first few pieces of the series I enjoyed a great deal. I understood her reasons for going off meds (they had some side effects she wasn’t too happy with, and she felt that her mood was stable enough without them), but in the most recent piece she doesn’t really describe the process of going off meds, what she describes is just having depression. Seriously, full on episode, cannot leave the house for days at a time depression.

Now don’t get me wrong, I am in support of pieces that describe what it’s like to live with depression. Too often the disease is misunderstood or swept under the table and I want to cheer when people openly speak about what it means to be depressed. But where this piece makes me angry is that the point of it is to talk about what it’s like to be at a stage of recovery that you feel you can go without meds. Now the author is describing what appears to be a relapse, and based on the information available to the reader, no one is helping her, she is not seeing a therapist or her doctor again, and she is not considering bumping her dose up a small amount until she has better skills available to her.

New York Times, that is irresponsible. In the first article, the author says that she isn’t in therapy and doesn’t want to go to therapy. That means that all the improvement she was seeing was at the hands of her meds. I cannot believe that the New York Times thought it was appropriate to watch one of their authors make this incredibly personal choice with little to no support from either a family and friends network or a therapist, and asked her to write about it. I can’t believe that no one has jumped in to say that if you don’t have the skills and techniques to handle serious anxiety and depression, then maybe you still need your meds. And I especially can’t believe that no one, anywhere, has said that it’s ok if you need to stay on meds for the rest of your life.

I don’t want to condemn this individual for making a choice based on what was important to them in their life. Everyone has the right to choose to either take or not take meds, go to therapy or not go to therapy. Meds have all kinds of side effects and can seriously impact your life (in good and bad ways), although I would also throw out that meds for many chronic illnesses have side effects but if it keeps you alive and functioning it’s still considered a good choice to take them indefinitely.

What I do want to question is the narratives that get published, especially in places that are respected and widely read like the New York Times. Because more often than not, those narratives include medication as a temporary measure, with no consideration of the fact that it is entirely ok and for some people great to rely on meds for life, as well as little recognition of the importance of an integrated approach to treatment that includes therapy, meds, and sometimes even a primary care physician checking out any physical health issues that might be contributing. What I want to question is the inevitability of going off meds, the necessity of going off meds, and the requirement that one go all the way off meds if the withdrawal process is going poorly.

That is literally the exact reason why you shouldn’t go off your meds without the supervision of a doctor, because sometimes it has unexpected side effects and it’s a really good idea to have someone around who can coach you through whether or not you might need to plateau or try a different drug instead or get in to see a therapist. It’s also a really, really good idea not to take away the main thing that you’re relying on to cope with a mental illness without adding anything else to replace it.

Certainly the articles aren’t painting a rosy picture. In the first article, the author says “But at this point, I care less about my anxiety and depression worsening, and more about getting back to being me,” finishing up with “I’ve got this, my body is telling me lately. Let me show you I’ve got this.” For an individual person, these are choices that you get to make without criticism. But to publish these as insights in a major newspaper sends the message that what’s important isn’t dealing with a horrific illness, it’s being true to yourself. And that plays right into all the stereotypes about the evils of medications and how depression and anxiety aren’t that big of a deal.

That makes me angry. It makes me angry that a newspaper is publishing this woman’s real time descent into a depressive episode. It makes me angry that no one has said “stop, this isn’t healthy for you, please go talk to your doctor/therapist/anyone again.” It’s ok to need medication. It’s ok to be a different person when you’re treating your mental illness than you are when you’re not. It’s ok to never go off your medication or leave your therapist. Depression and anxiety are chronic diseases, and they need to be treated like it. They don’t need to be portrayed as little experiments in a kind of sadness porn that makes the NYT a lot of money off of one woman’s pain.

Memory Loss and Recovery

There are lots of side effects to extreme calorie restriction, widely documented among people with eating disorders. They include memory loss, fatigue, loss of concentration, emotional dysregulation, heart problems, and many others. One of the symptoms that I experienced most acutely while I was in the midst of my eating disorder was memory loss. In my freshman year of college, I was trying to study for a Latin final. I spent hours looking over the same passages, trying to remember exactly what they meant, but when the test came I only scraped out a B (which was not normal for me).

The incompetent feeling that comes with not being able to remember anything doesn’t help when it comes to treating yourself better and feeling worthy. Unfortunately, not all of these side effects disappear the moment that you start to increase your caloric intake again. Even if your body starts to look and feel healthier again, there are some lasting impacts, most particularly fatigue (does it ever go away? Please say it goes away) and difficulties with focus and memory.

One of the skills that lots of therapists and therapy techniques promote is building mastery. The idea is that if you learn how to do something relatively well, you start to feel more confident of yourself. That radiates across lots of different aspects of your life, and especially if you work to become better at things on a regular basis, your mood will probably improve across the board. From my personal experience, I’ve found it a very helpful skill, especially when I can take the time to recognize that I’ve become good or competent at something. The feeling of realizing I know how to do something without any help or instruction is basically the best, and it’s a big part of what keeps me going on a daily basis. I start to know who I am a little more, I start to understand that I don’t need someone else to tell me if I’m doing alright, but that I know myself because I can see that I am capable.

The problem is that my brain is hazy and my body is tired. I was learning a new process for work today, but no matter how hard I tried to concentrate, my eyes kept slipping in and out of focus, and I would miss sentences, jumping back into the explanation and desperately trying to backfill the information I had missed. I felt like a failure. I wrote a blog post last week in which I completely forgot to add citations, the whole thing sliding out of my fingers in a blur without any real realization of what I was doing. And then there are the days that I fight with myself about exercise and movement, trying to get my body up and out the door to go to the climbing gym or for a run. I know I won’t get better if I don’t do it, but my eyes can barely stay open. It seems as if I can’t learn anything, I can’t remember anything. I swear I did this before, but what did I do?

Trying to build your life and identity into something that feels like self after an eating disorder is hard enough. It becomes even harder when your mind and body don’t cooperate to let you learn and grow, establish your abilities, and feel able of taking on the world. Failure is one of the fastest ways to set off depression, anxiety, or perfectionistic tendencies, all of which are quick ways to trigger a relapse into eating disordered behaviors. All of that means that the disorder itself is set up to keep you from getting better: you’re less competent after you’ve starved yourself, so you convince yourself that you’re incompetent, a failure, a loser, you don’t deserve food, and so you refuse to eat further. It’s vicious, and even when you start to get out of the cycle it takes time for your brain and body to catch up in the recovery process.

I suppose this all should serve as a reminder that certain skills need to be used with care until you reach a more stable state. Relying on external successes might not be the most important factor in building up an identity and self confidence at the beginning of recovery. It’s also a reminder that mastering a skill has to come in the context of where we’re starting and the resources we have available. For me right now, running 3 miles is a success. For lots of other people, or if I were healthier, that might be almost nothing. But at this moment, it is building a skill that I didn’t have before, and that still counts as growing and learning.

All of it still counts, no matter how much harder it is now.

You Can’t Turn Off An Eating Disordered Brain

Massive trigger warning for eating disorders

For about the past nine months I’ve been feeling pretty good when it comes to my body and my food intake. I still have a few hangups, mostly surrounding times when I should eat, but overall I was getting a decent number of calories and feeling fairly energized. I had stopped thinking about what my body looked like every day, and I had even stopped adding up the totals of what I had eaten each day to try to decide if I was allowed another item (or if I needed to go work out).

It was a massive relief to not have those scripts playing in my head anymore. But recently, somewhat out of nowhere, they’ve started to play again.

I have a lot more tools available to me now. I have more friends to ask for help, a better idea of what I want out of my life and why an eating disorder isn’t compatible with that, a fuzzy kitten to distract me, and a variety of strategies about what makes me feel good in the moment, but none of these things have managed to turn off the voices or the accompanying anxiety. They are enormously helpful when I need to choose a better behavior than restriction, purging, or overexercise, but no matter how often I try to ignore the bad suggestions my brain keeps giving me, it comes back louder.

This is what a lot of people refer to when they say that you never really recover from an eating disorder. The disordered brain will linger on and on and on. And while outsiders might suggest distracting yourself or challenging the thoughts, what they don’t understand is how incessant it is. When you wake up in the morning you wonder about what you’ll eat that day and think about whether yesterday was a “good” day (ran a calorie deficit). You go to put on clothes and are left with the quandary of what fits and what doesn’t, what you can convince your brain is acceptable. You go outside and now it’s the comparison game, who’s smaller than you are, who will see you as acceptable, does everyone see how big you are or do they care?

It goes on endlessly. You cannot turn it off (or at least no one has figured out the magic switch yet except constantly choosing a different behavior and working to focus on something else).

What no one tells you about jerkbrains, whether they’re eating disordered or OCD or depressed or anxious is that they will exhaust you. They don’t tell you that the worst part isn’t the full on meltdowns, but the normal days where you thought you were ok but instead have to spend half of your energy fighting with yourself.

It’s discouraging. While it is realistic to know that someone with a disorder that is highly linked to genetics will probably always have to be on the lookout against a recurrence of symptoms, it makes life feel like a neverending Sisyphean endeavor, even moreso than it might for someone who just has to get out of bed and drag themselves to the office each morning.

Even writing this feels like a repeat of things that I’ve said far too many times. It certainly puts more importance into the question of whether genetics are destiny. But pushing against all of the woe and angst and “determinism means it just doesn’t matter!” is the fact that I know I have changed. The eating disordered brain remains, but there is something in there or in me that can adjust. I make different choices, and the lows come further and further apart. I hate inspiration porn, especially when it comes to mental health, so I have to admit that I have no idea if there’s a relapse in my future or what it means for the quality of my life that self hatred is an essential ingredient of every day. But I am also done with wallowing in the unhappiness, so I also have to say that I have hope. There is the possibility of joy.