Abilify, Not I : Adventures in Antipsychotics

Lately, I have written a series of posts over the last two months describing certain troublesome symptoms I associated with the worsening of Bipolar Disorder, or the potential for comorbid disorders.

In my last post, When Medications Go Wrong, I briefly wrote about my recent discontiuation of the pharmocological treatment using Abilify as part of my medication regimen:

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

I went on to describe some of the awful side effects I was experiencing as a result.  However, the list was truncated for the sake of keeping word count down.  The description is rather limited in terms of accurately depicting exactly what I was subject to.

  • Cognition Disturbances and Memory Fragmenting.  Originally, I wrongfully blamed Lamictal in Vitamin L : Medication Adventures for my aphasia-like symptoms.  The disturbances felt like aphasia.  At first, it was almost indescernable.  I started word dropping again, meaning I would be reaching for a word, but was unable to grasp it.  Instead, I would be able to get to every synonym around it, however, those words did not fit the exact context.  Eventually, it became a more severe form of word dropping, and I found myself dropping sentences entirely at the loss of any word or synonyms around it.  It progressed into entirely dropping conversations at the loss of a sentence.  Then, I found myself

    I started forgetting things again.  These were simple things, like losing my purse or shoes in the house.  It seemed like just a simple case of forgetfulness, maybe stress related.

  • Emotional Blunting and Partial Flattening.  I had never had too much trouble with emotional blunting in the past.  While I’ve found myself in times where it was difficult to express my emotions, this didn’t indicate a lack of emotional response.  I describe it as a partial emotional flattening, because it wasn’t an entire lack of reactivity.  It felt like my spectrum of emotions had been significantly reduced, although not completely removed.  There was a certain inaccessibility to certain strong emotions.  Rather than completely removing extreme emotions, it threw a wet blanket on top of them, leaving them to bubble under the surface.  So, the emotions still existed, but were muted and unable to be adequately expressed.

    At it’s worst, I began to lose most feeling entirely, with the exception of irritation and the sensation of boredom and fatigue.  I began to lose love and my attachments to meaningful people and my relationships with them.

  • Dissociation I touched on a summary of the dissociative symptoms that Abilify had brought on.  I have been writing articles on the experience throughout the last few months on the subject, describing the feeling in great detail, but remained unable to exactly identify is appropriately.  The dissociation probably occurred as a response to the prior bullet points.

    The dissociation cited was experienced as a removal of self and removal from my own life.  I had felt as if I had been separated from myself and my world.  It was a feeling of something being stolen from me, or something fundamentally inaccessible.  Like, I was being locked out of my own life, or becoming transparent and just fading away.

  • Worsening of Depressive States.   This is probably a direct result of the first three bullet points.  I started to disengage from my life.  I lost interest in just about everything.  Most things were considered to be either boring or tedious.  Important things started to lose meaning.  This was experienced as a part of the emotional flattening, but it caused a concerning and distressful reaction.
  • Exacerbation of Social Anxiety Since I had lost the ability to carry on a conversation and found myself completely disinterested in socialization, my social anxiety went through the roof.  I simply didn’t care about anything anymore, especially trivial things I used to find interest in.  Therefore, I found it difficult to carry on a conversation.  This caused extreme distress in social situations, and encouraged further isolation.
  • Disturbed Sugar Levels.  While I have no concrete proof in terms of tests, certain symptoms have come to my attention.  They are notated below in the next two bullet points as thirst and weight gain.
  • Loss of Sensation of Bodily Hunger, Thirst, and Fullness.  Within the last few years, I started to become more in tune with my body.  I was able to feel the sensations of hunger through my sugar level, which probably caused the loss of bodily hunger.  The disturbed sugar levels probably also caused an extreme thirst that could not be quenched.  At first, I craved water.  Eventually, I started to put the soda back down, which probably caused part of the weight gain mentioned below.  And I felt an extreme pressure in my stomach, which was also exacerbated by the influx of so much fluid.
  • Extreme Weight GainTruthfully, I don’t dare get on a scale at the moment, so I am unable to notate at this time exactly how much weight I’ve gained.  By the fit of my clothing, I will estimate that I have gained somewhere between ten and fifteen pounds in the last three months.  That is a substantial gain for me, especially since I was losing weight prior to the start of this medication.
  • Exacerbation of Eating Related Problems.  By all definitions, it’s completely possible that I am living with an undiagnosed eating disorder.  However, I am not entirely convinced, since it isn’t an ongoing and prevalent problem.  Therefore, I define it as eating related problems and difficulties.

    The concern for weight gain and the sensation of fullness caused a very terrible reaction of binging and purging.  I was unable to control my eating, as notated above, therefore the sensation of extreme fullness would cause me to perceive the overeating as worse than it actually was.  Unfortunately, this led to a very vicious cycle and encouraged further weight gain.

  • Disturbed REM Sleep.  I was waking up tired, and noticed that it felt like I had stopped dreaming.  This caused my mental state to take a considerable dive.  It caused extreme fatigue and excessive, unproductive sleeping.

While I am cleared of most dissociative symptoms, emotional flattening, and my depressive state is lifting a little, some side effects have remained.

  • Cognitive Disturbances.   The aphasia-like symptoms remain, but to a lesser degree.  I am back to just being a little forgetful, and have some minor word dropping.
  • Memory Fragmenting.   Some of my memories remain dull, but seem to be returning.  However, most of the last three months remains inaccessible.  It may never become accessible, due to the disruption in the formation of short-term memory.
  • Disturbed Sugar Levels.   I am still thirsty, but I am no longer engaging in carbohydrate seeking consumption behavior.  I figure it will take awhile before my sugar is regulated properly again.
  • Weight.   Thankfully, my weight does seem to be coming down.  I have only been completely off of the medication for less than a week, and my clothes are already fitting better.  I’m going to assume that in addition to the weight gain, I was retaining water and constipation.  My regularity has come back, and I don’t feel as puffy as I did

Unfortunately, I am experiencing a return of some of my milder psychotic symptoms.  In Imaginary Enemies, I described a cognitive disturbance I described as “The Voice”“The Voice” can be characterized as a singular persona, as I wrote about in Conscious, Subconscious, and Extraconscious, where I described a theory of a third consciousness that exists between the subconscious and the conscious mind.

The Extraconscious is postulated as where the persona(s) reside, laying in semi-dormant waiting, perfectly aware of the current reality that is being experienced.  “The Voice”, in more severe psychotic states, can be experienced as a separate entity entirely, detached from the consciousness.  That is the defining line between a cognitive distortion and an auditory hallucination, when a persona detaches itself from the extraconscious as an external sensation.

As an extraconscious persona, “The Voice” can best be defined as a quasipersona, lying somewhere between Dissociative Identity Disorder and psychosis.  It is experienced as a semi-active part of the conscious mind, as the dominant persona is well aware of it’s existence and there is a certain interaction that occurs between the dominant persona and “The Voice”.

That is the best theory I can offer as to the existence and function of the quasipersona, known to me as “The Voice”.

The mild auditory hallucinations and visual hallucinations have returned, probably defined better as a sensory disturbance, rather than a symptom of psychosis.  When experiencing a sensory disturbance, it’s not full on hallucinations as described in the definition of psychosis.  There are not entities separate from the body.  They are recognized as a disturbance in the current reality, distorting shapes, colors, and contrast in the vision.  In the hearing, it is experienced as a distortion in sound, causing sounds to be sharper, duller, muffled, or louder than they actually are.  It can only be sensed by a sudden shift in perception.

So, instead of hearing things at a normal sound level, the sound volume may increase to deafening levels or may become muted and difficult to discern from nonexistent static that occurs in the mind.  My visual disturbances may be perceived as viewing the world in high contrast, extremely bright colors, and / or extra high definition resolution.  Or, they may be seen as duller than usual, muting colors, distorting shapes, and / or clouding the vision with that appearance of a veil or foggy goggles.

Intrusive thoughts have returned, but not with the same extreme nature as experienced several months ago.  In truth, they were never completely removed by the Abilify, and at some points were made worse by the drug.  Instead of experiencing them as a truth in reality, I am now able to separate them using logic.  I can talk myself off of the ledge and separate them from the reality of a situation using DBT techniques of mindfulness and distress tolerance.  Prior to the cessation of Abilify, I was unable to utilize those techniques.

I don’t mean to put anybody off of treatment with psychiatric medications, but I felt this was important to document and have as a resource on the internet for anyone who is thinking about taking the drug.  Some of these side effects aren’t listed in the pamphlet, as they are probably isolated to a condition.  But, I feel they are still a distinct possibility for anyone who is being treated for similar conditions.  It is vital that this information be notated and readily available for medication education purposes.  This information probably should not be generalized to all psychiatric medications, especially in the class of antipsychotics.

 

Advertisements

When Medications Go Wrong

For years, I’ve pretty much been medicating myself.  I take my scripts home and medicate how I see fit for my situation.  I realize that makes me medication non-compliant.  The trouble I come to is my trust in doctors.  I have been burned so badly before that I find I have a lack of faith in them to know how they are really treating me.

When I was in my teens, and being treated for Major Depressive Disorder (misdiagnosis – strike one), I was put on high doses over a slew of medications for years with little result (overmedication – strike two).  I suffered extreme side effects, with little done to relieve them.  I took Zoloft in increasing doses over a three year period.  I continued to complain of extreme fatigue, anxiety, motion sickness, and periods of flu-like symptoms.

The doctor’s answer?  More medication.  It came to a head when I found that if I sat still for too long, I would drift off to sleep.  Sitting in school became impossible, and I was sleeping fourteen to sixteen hours a day.  Eventually, I was put on 300 mg of Zoloft with Provigil to combat narcoleptic symptoms.

It was at the doctor’s suggestion that I continue to exceed maximum dose and go to 350 mg that my mother finally put her foot down.  “Put her on something else.  We’ve put three years into this, and it clearly isn’t working.”  And much to my doctor’s chagrin, I was switched to Lexapro.

Wrong answer.

Immediately, I started to have dissociative symptoms.  I recall laying in my room, laying on the floor, and staring at my ceiling in the dark.  My mother stood in my doorway, just observing me.

“What are you doing?” she asked.

“Nothing,” I answered blankly.

Yes, I was finally awake.  But, every moment was torturous.  I lost my sense of self, and started to drift away.  My memory began to fragment, and I sunk into a deep, desperate depression.  I was frantic and crazed, while feeling numb and blank at the same time.  I became paranoid, and started to assert that everyone was doing things against me.  They were intending to harm me, and I started to give meaning to harmless comments and phrases.

I attempted suicide several times in the first month.  The cutting became so bad that I was doing it in rather public places.  I was caught one time at my boyfriend’s house, and I had a dull exacto set ripped off of me and immediately chucked into the local creek.

We were unaware of all of the side effects at the time, because all of the medications I was placed on were brand new.  When a pharmaceutical representative left her office prior to my visit one day, it became clear that I had become an experiment to brand new medications.  I was taking expensive, largely untested medications for her financial benefit.  Strike three.

I had gained thirty-five pounds over a six month period.  I was 4’11” and 165lbs.  That put me at a BMI of 33.3, and in the obese range.  And despite all of my best, and even worst, and unhealthy efforts, I still couldn’t manage to get my weight below 145lbs.  I was starving myself on 900 calories a day, and I still hovered around obesity.

I couldn’t afford my medication once I was kicked off of my parent’s insurance, and I just decided that since it failed to ease my symptoms, I would stop taking the medication entirely.  They failed to mention that if I attempted to stop the medication cold, then I would be stricken with the worst withdrawal I had ever known.  It was a good thing my parents had been through this before with my father, because they knew how to ween me off.

It took me years to get the rest of that weight off.  But, by then, the medication had already done long lasting damage far worse than just weight.  I had begun to develop a drinking problem.  I had engaged in risky sexual behavior due to hypomania.  And it sent me walking with bad eating habits.

After that, I distrusted doctors and medication entirely.  I had lost faith in mental health treatment.  I was left with a feeling that I didn’t have a disorder at all, and instead, it was just me.  I was convinced that I wasn’t treatable.

It took a lot to make me realize that I was in desperate need of treatment.  I had taken psychology courses and was suggested by several psychologists in my college to have bipolar disorder.  I knew my behavior wasn’t “normal”, just as I had always suspected.  It took the my marriage, my depleting mental health of my husband, and the birth of my son to encourage me to start treatment again.

Three years, four doctors, and a another slew of medications later, and here I am, again the victim of overmedication and bad medication choices.

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

Suddenly, I was able to think again.  I started to feel more like myself.  I became more aware of what I was thinking and feeling, and I finally started actually living in the world around me.  It actually felt like living again.  And that’s when I noticed the weight I had put on.  I had fell victim to Abilify’s weight gain, among other things.

I can blame the dissociative symptoms on Abilify.  It had created an emotional flattening, and I started to dissociate from myself and my world.  It had robbed me of my ability to write and care for my family appropriately.  I wasn’t feeling, so I wasn’t caring.

The anxiety?  Well, I recently started to run out of a supply of Wellbutrin I can’t really afford right now.  I started to cut back to make ends meet, and I discovered that was starting to subside.  Other than rebound depressive symptoms, I was feeling better.  It didn’t matter to me anyway.  I was still going through crying jags, whether I was taking the Wellbutrin or not.  The difference was between whether they were loaded with distressful urgency to cut or not.  I decided that I would prefer to keep my near streak of four months without cutting.

I don’t blame my doctor.  He’s an old school doctor who works off of the biological model and treats symptoms.  I have declined therapy several times, though my requests to be seen since have not been honored.  All of my symptoms point to mild psychosis in general, aggravated by extreme life stressors.

I blame myself for not listening to myself and taking action sooner.  Treatment happens on both ends, and I have not been holding up my end of the bargain.  I have not been mood charting, and I have not been notating subtle symptoms.  It has become abundantly clear to me since my extreme meltdown and psychotic break during the summer that I had been probably Bipolar 1.5 all along.

Though I don’t experience full on mania, I do experience mild psychosis, practically all of the time.  I have not been pressing the issue about invasive thoughts, paranoia, “The Voice”, or any of the mild hallucinations that I experience.  Only when I had my break did I bring it to my doctor’s full attention.  And I was met with extreme medication.

Personally, I’m at a loss as to what to do.  I’m damned if I do, and I’m damned if I don’t.  I noticed last night that “The Voice” has returned, even if it’s benign (right now).  I don’t want to be overmedicated, and I can’t risk gaining anymore weight.  The weight is worse for my mental health than anything else.

And it completely screws up my bodily function.  Now, I’m experiencing weight related problems again.  My knees and back hurt.  I have acid reflux near to the point of anorexia again.  Sexual dysfunction is destroying my sex life, my self-esteem, and hurting my marriage.  And I’m back to full on social anxiety, because I’m too self-conscious to function.

But, at the same time, I’m aware that I need some kind of medication.  While, for now, I’m better off without it, the day will come where I am asked to step up, and perform at a higher function.  My family, including Finn, has been very great about my general lower function and picking up a lot of the slack for me.  However, this won’t last forever.

Autumnal Affects

Plunged back into the frigid clutches of winter.

I’ve written something like this before called “The Grey Season” back on “As the Pendulum Swings”.  It was a post describing my current view of an abysmal autumn in Pittsburgh and the terrible affects it has on the mood.

In years past, I have always been partial to the autumn season.  The air becomes cooler, and I find that I begin to breathe without a struggle or medical interventions.  It was quite liberating.  The sun eases, emitting softer rays on my delicate pink skin.  And there is a certain crisp freshness of the air with gorgeous foliage in various shades of reds, oranges, and yellows to behold.

The beauty and majesty of autumn.

Everything about autumn is enticing.  There was a return to school and the return of direction in my life.  New challenges awaited me with a wealth of new opportunity.  Cozy blankets in all colors existed to wrap around me in a warm, snug embrace.  I could bundle up in flattering autumn attire, covering all of the bulges and rolls that were uncomfortably exposed in the summer months.  A cool refreshing breeze picked up, and whistled in my ears, taking away all of the static polluting my mind.

It was always a beautiful time in my life.  But, somewhere along the way, the season was morphed into something sinister and foreboding.

The Grey Season

November rains were something I used to look forward to.  I would lay in bed in a room cast in shadows, just listening to the soothing sound of rain on my tin rooftop.  But, at one point, I described them as:

I have felt grey over the past few days.  I can’t feel for a better word.  Something like, my flame isn’t burning as brightly. It’s a dampening effect, casting a shadow over me everywhere I go.  The vibrant colors of the world filter and leave only the grey inside of me.

Some would consider a Seasonal Affect.  But, that could not be father from the actual truth.  I have been symptomatic since my early teens, when I would enjoy this season better than all of joys of the other seasons combined.  Winter was the season that meant imprisonment and cumbersome living.  Not autumn in the slightest.

The mysterious loss of adoration for this season plagued me.  I obsessively mulled over it for quite awhile, trying to find the exact point in time where my affections changed into something loathsome.  Sure, these November rains are the precursor to the awful, miserable blankets of snow.  The shifting winds bring the lake effect chill from Lake Erie in the north.  The whole world is changing around me, threatening to bring some kind of desperate gloominess.  But, why?

Suddenly, it occurred to me.  In my time with Avi, I spent a great deal of time escaping him on my own balcony.  Summer meant liberation from the imprisonment in our singular room where we were imprisoned in an icy hell together.  Autumn was the time when the chill rolled in.  It wasn’t enough to warrant the use of our kerosine heater, our only source of warmth.  However, the days and nights were cool enough to make life absolutely miserable, together, alone in our cage.

The shiver rattles my bones when I recall the whole wretched situation.  Our shack of a home trapped us together.  I remember how my hands would freeze up so badly that I could hardly type any longer.  I remember the intense loneliness, because I didn’t dare invite guests into such a disgusting situation.  The trash would pile up, because Avi was an absolute pig.  The walls closed in, and the stiff, threatening air was suffocating.  Bottles of liquor, my only escape from such an awful life, littered the floor as a testament to my misery.  And all I could do was put on another layer of heavy, useless clothing and pray for an early spring.

I recall that detestable house.  Even after Xan had managed to save me from another burden of winter, the drafts were enough to render the electric heat useless on days that went below freezing.  There were times where we had to abandon the house when temperatures dropped to subfreezing.  The furnace ran incessantly, driving us into abject poverty while we doled our precious funds out to the electricity company.  I fought shut off notice after shut off notice in constant anxiety.

Autumn began to translate into fear.  Fear of isolation.  Fear of exposure.  Fear for myself and my family.  And the worst of all, the fear of losing my sanity entirely.

The dim rays of cloud covered skies filter into my windows, casting dismal shadows in every corner of the every room.  The grey bleeds in and threatens my very being.  I look into the now barren woods with dread.  Apprehension wells up inside of me each time I approach the thermostat.  Everything becomes filled with trepidation, each movement, each decision.  And the chill, the unforgiving, merciless chill invades my very soul.

I spent one last day yesterday on the patio.  I didn’t long for the crazy summer with people hanging from the rafters, and my brain short circuiting.  I breathed deeply, taking in the essence of autumns long forgotten.  I let the beautiful autumnal winds blow against my bare skin.  I recalled fond moments from years past.  The birth of my son happened in an October rain, right on the first fall rain.  Xan and I were eagerly planning our marriage during this time, five years ago. We both took our first steps into our careers during the days of November rains.  We laid together in empty rooms of a house we were fixing, the house where we first lived together as a couple, just listening to the rain on the wooden roof.

The sound of the remaining leaves filled my mind, and the sparrows chirped to one another.  And for a moment, just one moment in time, I was at peace with this season.

Treasure

Today, my son taught me an important lesson on value and how we place it.

My son is a really special little guy. He has Pervasive Development Disorder – Not Otherwise Specified on the Autism Spectrum.  So, a lot of little things that would be be considered typical in other children are really significant for him.  I can’t tell you how many times I’ve heard a parent tell their four year old to shut up because the chatter became overbearingly annoying.  I always feel that twinge of sadness, fearing that my son may never speak enough for me to become aggravated at all.  Those moments are significant for me, too.

But, then there are those moments that are significant in an enlightening way.

I was sitting at the dining room table this morning with my wallet and what we call “The petty cash box”.  I was mindlessly dumping change into it when my son approached me.  When he speaks, I listen with all of my might to make out what he is saying.  It might be the only thing I ever put my full attention into.  He said, “Mommy, money!”  I was thrilled that he took an interest in what I was doing, and I allowed him to put the money in the box while supervised.

He happily put the money in, and presented me with a quarter saying, “Mommy, want quarter?”  I was delighted that he could identify it.  Suddenly, he grabbed the box and started to walk away.  I was about to chase him down just when he put it on the end table. He turned to me excitedly and shouted, “Look, Mommy! Treasure!”

He started to prattle on about being a pirate when my heart just melted. It was a brilliant observation. The little box kind of resembled a treasure chest, brimming with different colored coins. And that’s when it hit me. It wasn’t just about the likeness. It was about the whole interaction. And the whole thing had taken on an entirely different value.

I started to think about the things that I value. What do I cherish?

The realization hit me. Lately, I’ve been dwelling on the things that I want, but don’t have. My focus had been shifted onto the seemingly hopeless pursuit of these things. And I realized that those things are intangible idealizations that may never even have the possibility of becoming a reality. Those things had gained all of the value over the things I truly cherished and clouded my mind.

What do I value then?

Little, daily victories for my son. A few engaged words here and snippets of hopeful conversation there. His new discoveries and interests. And each beautiful little smile and giggle. All of those shining moments that give me hope for his development through Autism Spectrum Disorder.

But even more for him, I value him. Him, as he is. My 4 foot tall, 55lb, brown haired, green eyed little Beast.

I value my husband’s caresses. This morning, he unexpectedly turned over and actually spooned me. It was more than welcome. It was soothing, comforting, and all spontaneous. It was one of those rare, intuitive moments he had. I cherish those.

But, I value even more than those fleeting moments. It is bigger than that. I see what I have missed all along. Every action is an intuitive, invested action. Whether I know it or not, he’s taking care of my needs that I don’t even think about anymore. I was overlooking what was right there in front of me because I was too involved with what I considered to be neglected needs.

Finally, my eyes started to open up.

When I really thought about it, I found value in myself today. I have been so fixated on what I am not, and the things I thought I had lost, I lost sight of who I am and all of the things I have gained. I am a mother. I am a wife. I have been those things for longer than I have been anything else. I am those things above all else. And I don’t know how I came to value anything else.

I lack certain qualities, but that does not make me devoid of myself. There is plenty of me. I am not stable, but I am spirited. I am not entirely well right now, but I cannot expect to be well all of the time. I have Bipolar Disorder. I am not Bipolar. I am more than my illness and more than my symptoms.

Today, I connected with my husband without trying or wanting. I connected with a son I thought I was losing to Autism Spectrum Disorder. But more so, he connected with me. He reached out and connected me with the world again. And that was what made all of the difference.

A new dawn, a new day.

The Friday Confessional : Baby Weight


TRIGGER WARNING : This post contains material that may be a potential trigger for some.  It’s contents include talk of eating disorders and self-injury.  If you are sensitive to this material, please use your discretion before reading.

I am by no means a thin woman.  As a matter of fact, according to my BMI, I am actually slightly in the overweight range.  It’s not really unusual for a person who lives in the good ol’ US-of-A.  Obesity is considered an epidemic in this region of the world.

I have bad body image.  This started as a very young child when the other kids would pick on me for being overweight.  At that point, it wasn’t my fault.  I wasn’t responsible for my diet, and my family had terrible eating habits.  In fact, as I started to notice while my parents were watching my child, they encouraged recreational eating for lack of other engaging activities.  As a result, I ended up a fat, miserable kid.

I remember I stopped eating my lunch at one point.  A lunch aid came over and asked what was wrong.  I recall telling her, “I’m on a diet.”  She looked shocked and appalled.  Now that I’m an adult, it’s completely understandable.  I was eight, and I was confessing that I was unhappy because of my weight.  To her credit, she attempted to explain to me that I had a lot of years to grow into the weight, and it was unhealthy to deprive myself of food.

Essentially, she was trying to talk me out of developing an eating disorder.  Unfortunately, talk is too cheap when you’re eight.

Eventually, people close to me stopped mentioning my weight.  And I continued to grow.  By the time I was in the fifth grade, I was obese.  I was eleven, 4’8”, and weighed approximately what a fourteen year-old 5’1” teenager should have weight in a healthy weight range.  My clothes continued to shrink rapidly, and the only excuse my mother could come up with was that I was just “having a growth spurt”.

It wasn’t lost on my peers or teachers, though.  While I had the brains, I didn’t have the body.  And the outside was all that mattered.  Summer break came, and I was about to enter middle school.  It was at that time that I decided that I would shed my “baby weight”, as people were so eager to call it, and become a slender woman.

That was the summer where it all began.

The real secret is something I’ve hinted at throughout the last year, but could never bring myself to actually come out and say.  Even now, I find myself typing and retyping the sentence that will start to change everything.  It will change how people think of me, and how people treat me.  It will have people worry and watch me like a hawk.  And those are all things that I’ve tried to avoid over the years.

I have undiagnosed disordered eating.

As a child, it developed from recreational eating into comfort eating.  I would gorge myself far beyond bursting, to the point of where it felt like the contents of my stomach were backing up into my throat.  The act of eating was comforting and satisfying.  The sensation of fullness seemed to fill this hole inside of me.  It took away the emptiness that I had tried so hard to fill with accomplishment.  Even for a moment, I was full.  I was whole.

That led to another problem.  Childhood obesity.  And the lack of friends I had resulting from my obesity and the intimidation of my perfectionism and accomplishment created an even bigger hole.  What started out as a small snag in the woven fabric of my life started to unravel into a gaping hole, threatening to tear seam to seam.  Comfort eating turned into binge eating and created a cycle that continually fed into itself.

The summer before middle school, I decided to start dieting.  How absurd – an eleven year old on a diet.  I restricted my food intake to half of what I was eating.  I refused to eat between meals.  I started both biking and running once a day for at least an hour.  When my clothes started to become loose, it only served to encourage all of these behaviors.

I was a child on a mission.  I started only eating half of what I was eating, leaving me eating meals off of saucers.  I added running stairs onto my exercise regimen.  I would spend a half an hour each day running the basement stairs, as to not bother my parents.  My clothes became so loose that I became reduced to wearing my 90lb mother’s clothes.

I had done it.  In fact, I had done so well that most of my peers didn’t recognize me anymore.  Many people started referring to me as “the new girl”, as I didn’t have any friends to correct them.  And much to my surprise, those shallow little girls I had come to despise welcomed me to their clicks with open arms.  I was no longer intimidating or disgusting.

Throughout the years, my weight bounced up and down.  I would binge and then go on an exercise craze.  In my mid-teens, I discovered those ephedra pills that could be found at any gas station.  Friends and I would take handfuls of them and stay up, bouncing off of the walls, for 72 hours at a time.  I remember lying in bed just vibrating, desperately mentally exhausted, but completely wired.

My relationship with my first love, my high school sweetheart, started going south around the time that I was seventeen.  And the binging started once again.  I hated myself for it, and I watched myself grow out of my clothes once again.  I knew he had to have found me repulsive, and I knew he was eyeing other women.  But, it only served to make it worse.

I will never forget this.  I had my eighteenth birthday at my boyfriend’s place.  I was surrounded by many of my friends, and we ordered several pizzas that I paid for.  I watched all of the girls daintily eat one or two slices of pizza, when I realized that I had gorged myself on four.  I looked at their slender bodies with envy.  What a disgusting pig I am!  I thought.  No wonder I’m so fat!

I went to the bathroom and locked the door.  I leaned over and stared into the bowl.  I was about to do something that we all had accused and ridiculed thin cheerleaders for.  It was this, or being doomed to a life of obesity and loneliness.  I extended my index finger and pressed down on the back of my tongue.

The vomit came pouring out like a fountain into the bowl.  The taste was awful, like orange juice mixed with something foul.  But, the sensation was incredible.  I could feel the load lightening, and my stomach shrinking.  I did it again, this time making myself gag harder, almost to the point where I made an audible noise.  It felt like all of the awful feelings were just pouring out from inside of me.  It was almost like cutting, but without any noticeable tell-tale scars.

I purged until there was nothing left but stomach acid.  I sat against the door, breathing heavily and relishing in the hollow feeling in my belly.  There was something so beautiful about feeling that emptiness.  It ached, along with my raw throat, and the bitter aftertaste of vomit in my mouth.

This doesn’t happen regularly.  It only happens when I have a severely awful body image.  My clothes start to get tight, and automatically, my stomach starts to churn, as if it knows what’s about to come.  If I’ve eaten just before a fight with someone, I find myself getting queasy and running for a bathroom.  If I am rejected, I automatically assume it’s because I’m not attractive.  I find myself hell bent on getting back a body I once had.

But even worse is when I do it as a form of self-injury and control.  I binge, feeling the sensation of my belly swelling with all of the emotion I can’t experience.  The contents rise into my throat, without a place left to go.  I excuse myself and wrap myself in an awful embrace with that cold, unforgiving porcelain.  For a moment, just a brief shining moment, I stare into the bowl, trying to talk myself out of it.  There’s no other way.  I lean in, and the deed is done.

And each time, the whooshing of the flush brings shame to my already teary eyes.  I stare at the bloodshot eyes, ringed with raccoon eyes.  My face is red and looks exhausted.  All I can do is take to cleaning up the mess I created.

Just Snap Out of It

Society has developed some seriously bad attitudes toward mental illness.  It’s no surprise.  We see it attached to the stigma of it.  We’re treated like lepers, as if this were a terribly contagious thing.

Depression is no exception.  Today, a lot of people have been discussing the topic of the “Just Snap Out of It” phenomenon that occurs out there.  Honestly, there is a saying out there about how if a person hasn’t experienced it, then they can never truly know.  A person who hasn’t experienced clinical depression, either in the form of MDD or BP depression can never truly know it’s depth and breadth.  It is an all encompassing monster that claims every last bit of life and any possible joy that can come from it.

Having Bipolar Disorder, I am a person who naturally experiences some sometimes pretty obvious mood swings.  And the attitudes toward it are so completely off.  I have never had a person treat me poorly while I was in a manic episode.  Not one.  Not even when the plainly awful behaviors were showing.  Each person seemed to find it charming, amusing, or interesting.  Even when there were moments where I was so out of control that I was scared out of my wits, not a single person around me seemed to notice that there was something absolutely wrong with it.

No, my energy and spirits were high.  I would act impulsively, and people would take it as spontaneity.  I’d be overly, annoyingly chatty, and rudely interrupting others, but they took it as being outgoing.  Everyone seemed to think that was a sign that I wasn’t depressed anymore.  They seemed to think that it was some kind of miraculous recovery from “being like that”.

People only seem to take notice when I am depressed or mixed, like it’s some kind of disease that I choose to be afflicted with.  And the comments are absolutely endless, because everyone seems to have their own opinion about it.  It’s as if they consider themselves to be the authority on depression, anxiety and sadness in general. I will constantly hear phrases like, “Get over it” and “Get a grip” as if just snapping out of it were an option for me.

Meanwhile, people without mental health diagnoses start flinging clinical terms around, like they had some true application to their fleeting, shallow emotion.  For instance, “Oh, I’m so *bipolar* today”, instead of just saying that they are moody, or women arbitrarily making a comparison between PMS and Bipolar Disorder.   Or “I’ve just been so depressed lately”, to reference a little bit of discontent or sadness.

It’s not cute. It’s not funny. No one with those diagnoses thinks that it’s witty that someone is taking a serious clinical term with so much guilt and stigma that it could bring down a religion, and applying it to their BS, frivolous emotions!

It does everything it can to minimize those conditions.  It puts it in a light that we have some kind of real control over it.  As if it were something that a person can just “snap out of”.  It implies that a person chooses to be disordered.  It also puts a shameful connotation of attention seeking behavior.

Yeah, it’s the life, let me tell you. If I were doing anything for attention, it wouldn’t be this. It would probably be something more hilarious, like plastering myself with an obscenely worded banner and rollerblading through Downtown. Depression isn’t newsworthy, but that sure is.  Or maybe I’d be doing something a little more productive or noteworthy, like finding a cure for cancer.  But no, my depression is just that interesting that I would choose to gain that much needed attention from people I don’t even know or care about.

I have to wonder if the general public has to be so naive that they would actually be jealous over it.  So much emphasis is put on the “just get over it” ideals, as if that were possible. If I could will myself out of this state, don’t you think I would do it already? It would be more logical to think that I want to reclaim my life and be a productive person.  But no, according to others who are ignorant enough of mental illness, I am perfectly content to have disordered behaviors.   Sure, who doesn’t love ignoring their kid because the voices just got too loud? Personally, I love gripping my ears and screaming, “SHUT UP! SHUT UP! SHUT UP!!!!”

And as a result of this blatant ignorance, I am really starting to believe that some are just plain jealous.  Because, they seem to think that those with disorder aren’t being responsible for their emotions and behaviors that result.  I certainly have quarrels with wanting to thrust a sense of selfishness and entitlement out there, because it’s what I have to do to take care of myself and my own in this world.  It’s those same people that shove themselves and their ideals down other people’s throats, only to make them feel bad. Misery loves company, and we’re perfect targets, right?

The point is this.  If a person is out there reading this and getting offended, it’s time to take a step back and think hard.  Is it so fair to be so judgmental?  Isn’t it about time to take a look from another perspective?  Does a person with a congenital disorder choose to be symptomatic?  It would be an entirely different story if I were refusing treatment, but like anyone else, I am keeping my appointments and taking my medication according to doctors orders.  We don’t blame someone for their symptoms when they have a seizure.  Why should this be any different?

Let me assure everyone.  If could have snapped out of this disorder and been a “normal” person, I may have done it, instead of living this ongoing nightmare.