How I Conquered Anorexia and Depression—and Learned to Love My Body (and Life)

It took years of hard work and the right treatment, but here's how I was able to recover from anorexia and depression.

Even though it was 17 years ago, I remember what life was like at my lowest weight—94 pounds—quite vividly. That’s because every 24-hour day felt about 124 hours. I was living (that’s actually a very generous way to put it; I was surviving) to make it to the pillow at night.

I’d wake up to my alarm to get ready for school, and would spend the next 14 hours shivering and snapping at others. From that moment on, it would almost be a challenge to see how long I could wait to eat breakfast and how little I could eat the rest of the day. Also, it became a challenge of how much I could sneak around and act “normal” so my uber-low-calorie diet and eating rituals wouldn’t be too “weird” for anyone else.

I was actually quite open publicly about the fact that I had been diagnosed with anorexia nervosa by my doctor at age 16. It’s not like I could easily hide the fact that I had faded away from 180 pounds to 94 in just 12 months.

(Related: How the Pandemic Finally Made Me Confront My Eating Disorder)

An innocent “health kick” turns unhealthy

My “health kick” started innocently and honestly at first. Five days a week, I’d hop on the elliptical for 30 minutes after school and for dinner, I’d choose grilled chicken and a baked potato instead of breaded chicken fingers and fries.

At some point, the competitive and Type A side (more competitive, highly organized, and more impatient) took the reins. The “you look so great!” comments when I reached 120 pounds spurred me on to believe that I might as well keep going. Keep shrinking. And eventually, I might as well keep starving.

Eating disorder and depression: Which came first?

Around the time my period went MIA, any hint of emotion seemed to disappear too. The best way to describe it is that I felt flat. I rarely cried and never felt suicidal, but I was essentially completely devoid of emotion.

I’d hear my mom crying in another room at home and know that I was the reason why. Yet, I couldn’t seem to feel all that sad about what I was doing to myself. I felt remorseful that I was putting her and my dad through this; watching their daughter slowly shrink away.

This is why I finally decided to take them up on their suggestion to begin meeting with a psychiatrist once per week. I’d been avoiding it, fearful of how much it would cost them or that seeing a mental health professional was something only people with “real” struggles should do.

In the eternal chicken-and-egg debate, it’s tough to say whether the depression may have contributed to the eating disorder or the eating disorder impacted my brain chemistry so much that it contributed to depression.

“Several studies suggest that in many, but not all cases, an anxiety disorder was present before the development of the eating disorder,” explains Andrea C. Castelhano, a licensed psychologist at Baltimore Therapy Group in Towson, Maryland, when I recently presented her with this exact conundrum.

“The psychiatric consequences of eating disorder behaviour, particularly restrictive eating, are well documented. When our bodies are consistently denied the nourishment and energy needed to thrive, what typically follows might be an increase in obsessive thoughts and behaviour, irritability, depression, concentration problems, brain fog, and social withdrawal,” she explains.

The connection between eating disorders and the brain

There are many factors that contribute to an eating disorder, says Linda Snell, a therapist at New Method Wellness in San Juan Capistrano, California. An individual may be genetically or biologically predisposed, and changes in one’s brain chemicals may also contribute.

“Psychological and emotional health can also be contributing factors. Low self-esteem, low self-worth, perfectionism, poor impulse control, interpersonal conflict, and trauma all can contribute to the development of an eating disorder,” Snell says. “The social environment can play a role as well, and an eating disorder can be a learned behaviour modeled during childhood,” she says.

Increases in cortisol (the body’s primary stress hormone) and hypoglycemia (low blood sugar) appear to be linked to emotional and cognitive functioning challenges among those who are battling eating disorders.

This applies to whether we’re referring to anorexia, bulimia, binge eating, and restricting or otherwise, Castelhano adds. As a result, the comorbidity rate of eating disorders and another diagnosed mental health condition—in my case, depression—is considerable.

Researchers believe somewhere between 56 and 94 percent of individuals with eating disorders also suffer from anxiety, depression, substance use disorder, or post-traumatic stress disorder.

According to Castelhano, “the good news is that most of the physical and psychiatric consequences of disordered eating and exercise behaviour are resolved when regular eating is resumed and maintained.”

(Related: What Are the Signs of an Eating Disorder?)

The healing begins

“There’s no one-size-fits-all treatment method for eating disorders,” says DeAnna J. Crosby, the clinical director at New Method Wellness in San Juan Capistrano, California.

My outpatient treatment team at the time included my family doctor, a dietitian, and my psychiatrist, who collaborated to put me on:

  • “Bed rest” so my low blood pressure wouldn’t lead to a heart attack
  • A calorie-rich diet (which, in full disclosure, I didn’t always follow in the first few months even though I knew it would be best for me)
  • Cognitive behavioural therapy (CBT) to help change how I think and behave to address my problems
  • A prescription to help me sleep, as my bony body would ache all night
  • A prescription selective serotonin reuptake inhibitor (SSRI), the most common class of antidepressant that results in more serotonin (a key happiness and mood-stabilizing hormone) coursing throughout the brain

The “gold standards” of eating disorder treatment depend on the particular diagnosis.

“There is strong support for CBT and family-based treatment (FBT) for anorexia nervosa; CBT, FBT, and interpersonal psychotherapy (IPT) for the treatment of bulimia nervosa; and CBT and IPT for the treatment of binge eating disorder,” Castelhano explains. “Nutritional intervention is crucial for many in eating disorder recovery. Finally, certain psychiatric medications also appear to be effective in managing symptoms,” she says.

Treatment for eating disorders is most successful when other mental health problems that one might be suffering from are treated simultaneously, says Sherry Benton, the Golden, Colorado-based founder and chief science officer of the online therapy resource TAO Connect.

“This is beneficial to ensure that someone achieves full recovery and is able to establish a happy and satisfying life,” Benton says.

Food and feelings return

It was a slow and winding process. I’d bawl my way through a “homework” challenge from my psychiatrist to eat a donut one day, then eat a bowl of ice cream the next with little stress.

Turns out, I’m not alone in lacking a linear recovery path.

“Rome wasn’t built in a day and neither is recovery. Most of the time, recovery is two steps forward and one step back. When my patients make mistakes regarding their eating disorder behaviours, I always encourage them to let them go quickly and move forward,” Crosby says.

Eventually, I began to notice “good” days of eating slightly more and feeling a bit brighter than the day prior became more common. My weight rebounded to 100, then 110, and while it took more than a decade for my period to return to normal, each passing year I’d feel a bit more at home in my body.

About three years later, my psychiatrist eased me off antidepressants, and I slowly scaled back on therapy appointments as I made my way through college.

Finding happiness in my body

After graduating from college and completing a 10-year shift in the corporate world, I decided to become an “entrepreneur” of sorts, and am a full-time freelance writer.

Now, at age 33, I find myself jumping out of the bed each morning excited to learn something new from the experts I interview, the studies I comb through for additional context, and the food I devour—yes, really—in my work as a food writer to support local businesses.

One of the key elements to regaining my emotions and finding peace and joy in my bones was finding passions and pursuits outside of myself. First, I found joy from contributing to the world. Later, I found joy by being myself within it.

“Long-term follow-up studies indicate that about 50 percent of those diagnosed with anorexia nervosa and over half of those diagnosed with bulimia nervosa will make a full recovery,” Castelhano says. “There is a lack of consensus on the definition of recovery, but in this research, ‘full recovery’ means the absence of behavioural, emotional, and cognitive symptoms and absence of difficulty or interference when it comes to personal, work, and social life. Negative body image thoughts are not unusual—in recovery and in general. The difference is really that those experiences no longer cause internal distress, nor do they lead to changes in behaviour.”

(Related: Meet 7 Canadian Body-Acceptance Influencers to Follow Now)

The ongoing work of recovery

I’ll readily admit that every so often, moments of self-doubt or body criticism do pop up in the back of my mind. For me, I think I’ll be in a continual state of recovery, but what differs now is that I’m so happy with who I’ve become and how I show up in the world that I don’t want to go back. I can flag them as vestiges of my eating disorder and call them out as such, so I don’t allow those thoughts to control my actions.

I’m well aware that there will likely be days ahead during which I’ll feel a little down or a little puffy, but now I think to myself in these moments, “Goodness, I sure am lucky to be alive. I have so much to live for, be grateful for, and be joyful about. And goodness, food sure tastes delicious.”

Self-esteem is associated with decreased symptoms of anxiety and depression and greater happiness and life satisfaction, and there’s a strong correlation between self-esteem and self-compassion, Snell says. Self-compassion involves accepting oneself, flaws and all, which results in a happiness boost.

(Related: Why Women in their 40s are Falling Through the Cracks When it Comes to Eating Disorders)

Practicing self-compassion

“Self-compassion also fosters resilience, moderating an individual’s response to negative events and increasing tolerance for experiencing negative emotions. A person’s ability to exhibit self-love, acceptance, and self-compassion is crucial to recovery and sustained happiness levels,” she says.

There will be great days, and there will be bad. But experiencing my eating disorder and being open about the challenges along the way has taught me that many more of us are working on overcoming mental and emotional challenges of our own, either publicly or privately. So when in doubt, I try to give myself and others grace, imagining there might be more going on under the surface than I’m aware of.

“Having the ability to be mindful of others’ suffering and struggles and being able to respond to those individuals with kindness, possessing compassion in our hearts and expressing that suffering is crucial,” Snell says. She adds, “If we realize it’s something we all share as part of the human condition, then we are better equipped to manage life’s adversity with more ease.”

If you or a loved one is struggling with obsessive thoughts around food or your body, contact the National Eating Disorder Information Centre. And If you or someone you know has had thoughts of self-harm or suicide, contact the Crisis Services Canada (1-833-456-4566), which provides 24/7, free, confidential support for people in distress. 

Next: How I’m Managing My Eating Disorder During Coronavirus

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Originally Published in Best Health Canada