How to deal with diet culture and triggering comments

"I don't care if you think your body is beautiful. Your body is not your power. I want you to not hate it, so you can go out and do meaningful things with your life." -Summer Innanen

I remember being just about two weeks out of the hospital, and still very unsure about my place in recovery, and if I truly had even wanted it yet. I was out to dinner with my mom, uncle and his girlfriend, something I had been reluctant about in the first place. I hated going out to dinner. I hated the uncertainty of not knowing the nutrition of my meal, and not knowing everything that went into it. Add the fear of liquid calories to the mix, and it's a recipe for overwhelming anxiety. At least it always was for me.

I had always had a fear of eating in front of people I wasn't comfortable with. Even though our company was my uncle and his girlfriend, I had not really talked about what I had went through the previous few months, and I felt like they would be judging what I ordered, how my body looked, etc.

Just looking at the menu gave me anxiety, but I ordered a vodka diet to ease my nerves a little bit. After I ordered, my uncle's girlfriend began to talk about how she had lost so much weight, how her pants didn't fit, how she had to see doctors, and how my uncle was pushing her to eat, but she just couldn't seem to find her appetite.

I grabbed my mom's arm and looked at her wide-eyed. Is she kidding me? I thought. As she went on and on, I whispered in my mom's ear that I was upset and that I knew I wouldn't be able to eat dinner tonight.

My mom had told me that unfortunately I will never be able to avoid diet talk, especially with women and I would have to get used to hearing that kind of talk at the table. I knew she was probably right, but also knew that I was extremely sensitive and in a vulnerable place.

Dealing with diet culture is hard. It's extremely intrusive on something that is such a personal decision and unique to each person. Not every diet will work for every body.

In order to be able to possibly avoid or reduce these triggers, it is important to note what triggers you. A journal can be a very helpful tool to note how you felt by certain things and keep track of progress.

For me, when I was very early in recovery, I seemed to be triggered by everything, which I assume would be common for most people starting their journey. I couldn't see or wear work out clothes, I couldn't work out, hear about anyone working out, hear about diets, or even what people were choosing to eat, without comparing it to what I had to eat. I couldn't read about diet or fitness. I couldn't hear comments about my changing and healing body.

An important step for me was to clear my feeds. I un-followed any accounts on social media related to food or fitness, whether 'good' or 'bad'. I was already thinking about it all of the time, I didn't want to think about it any more. I replaced my feed with positive quotes and happy pictures of animals or landscape. I unsubscribed to health magazines that came in monthly toting a new fad diet or quick fix.

Two of the biggest things for me during this sensitive time were: clothes and my body and other people.

As my body began to heal, I started not to be able to fit into certain clothes in my closet. I cried to my mom, and she reassured me that my body was never meant to fit in these clothes, anyhow. That when I fit into those sizes, my body was very sick and so was my mind. To avoid further frustration, I didn't let these clothes linger in my closet. I knew what clothes were the sizes that were not meant for me, and I removed them from my closet and placed them in a bin to donate to Goodwill.

I had always preferred clothes that fit loosely on me, because I had never been comfortable with showing off my body, so that is what I reverted back to. I wore what I felt comfortable in and I believe everyone should do the same to feel confident in their wardrobe. Trends don't matter if they don't make you happy.

Another big concern for me was that people would notice my body and comment.

"You have an ass now!"

"Your face/chest looks really full."

"You look healthy" (I don't know why this always seemed to be the worst one. In our disordered minds we equate healthy to mean 'fat' which is NOT the case, and certainly, not what the person meant at all. If you choose to respond to this you can simply say 'thank you' or 'I FEEL healthy (if that's true).)

During this time, it might help to know that no one who wasn't a close family member or friend ever commented on my body, besides saying that I looked healthy or well. During my recovery, my mom was my biggest supporter and aid in helping me cope with triggers and helping others understand which topics to avoid.

I would always tell my mom when I felt triggered or uncomfortable by something. My mom had told relatives to please not comment on my body or the food that was on my plate in advance to seeing me. She also reminded them not to discuss diet or weight in terms of themselves, which was a big help for me.

Sometimes, it seemed people couldn't help themselves and would make a comment saying I looked fuller or X body part grew, to which I asked them 'please do not comment about my body, as this makes me uncomfortable' or 'this is still a sensitive area for me, and I would appreciate if we could talk about something else.'

Overall, the things that made the most impact for me during this time was having open communication. I had my mom, who had grown to understand how my brain was working and what I was going through. I was able to talk openly with her about what was on my mind, and what was bothering me, and in turn, she was able to convey that to the people around us to help them better understand how to talk to me and listen with compassion. If  I felt comfortable enough, I would also take it upon myself to politely ask someone if they wouldn't mind steering the conversation in a different direction. As I am further along in recovery, this is something that has become easier and I don't mind telling people things that I have learned during my course of treatment. And lastly, if something is triggering to you, don't pour salt on that wound. I know sometimes with our disordered minds we might keep something around that we know is tempting to us thinking we will be un-bothered by it. However, then we get in a depressed or down mood, and we use that thing as an excuse to justify our bad behaviors. It is best to eliminate the potential trigger, before it becomes a problem.

My first experience with therapy

"Talking to a therapist, I thought, was like taking your clothes off and then taking your skin off, and then having the other person say, "Would you mind opening up your rib cage so that we can start?" -Julie Schumacher

 I started middle school just after my parents announced they were getting divorced.

For awhile, my relationship with both of my parents was pretty much nonexistent, while I tried to figure out how I felt. Growing up, none of my friends parents were divorced, so I didn't ever consider it an option for my parents. Until it happened.

I don't remember who was in touch first: whether it was my mom with the school guidance counselor, or her with my mom. But somehow the pair ended up working together in attempt to get me to talk about my feelings.

"I don't want to."

"Brianna Kwasnik to the guidance office," I heard over the loudspeaker one day during class.

I rolled my eyes, and told my teacher I would go in between classes, as an excuse to get out of it.

I would have hall passes written for me and sent to my class to excuse me, but I would crumple them up and throw them in the trash.

The next day, one would came laminated. And I threw that out, too.

When I finally went to the guidance office, I stared back at the woman like she was speaking in a different language. She told me all of the things she was supposed to say to make me feel safe, like how her office was a safe space, and everything I said to her would stay between us.

I felt like I was wasting my time and hers, because I didn't feel like I was old enough to have any real problems. I didn't want to talk about my parents divorce, because than that would make it real, and I didn't want it to be real. When my parents first got divorced, it was a lot of back and forth with both my mom and dad trying to vent out their frustration with the other one, and me being the soundboard for those frustrations. I felt exhausted. I wanted to love them the same as I did when they lived in the house. I didn't want to think of them different or see them any less. I didn't want it to be real. But, I didn't want this stranger to know that. I didn't want anyone at school to know that. I didn't want anyone at school to know what was going on at home, it was none of their business, I thought.

I was really concerned about being seen walking out of the guidance counselor's office. I grew up with a stigma of sorts surrounding therapy, that talking to someone made you 'crazy' or weak, and I didn't want to be that, because I knew that wasn't who I was.

My dad was against it completely, and didn't want me talking to a stranger.

Eventually, I had warmed up to the idea, and when something would happen at home whether it be my dad talking poorly about my mom, or my dad not answering my phone call, or when he moved out of the house, I couldn't wait to tell someone about it and get it off my chest.

My school guidance counselor had sent my mom a list of therapists that I could see outside of school. I think her referral was a combination of not wanting to take me out of class anymore, and seeing how much my parent's divorce really affected my spirit and confused me.

It's always weird when you switch therapists, and you feel like another person knows your whole story, and this new person should just pick up where she left off. Like what do you mean I have to start from the beginning? Where do I begin? How far back do I go?

At first I did not want to talk to a new therapist. I never do, and usually spend the first two sessions having them prod me with questions and me giving generic one or two word answers, and nothing more. When I started going to counseling for the first time out of school, I had my mom sit in on every session. I wanted her there as extra support.

Once I felt comfortable enough to open up and talk about how I felt about what was going on with my parents divorce, it was like a faucet that wouldn't turn off. An hour came and went, and never in my life had felt shorter. Every week I didn't know I had so much to say.

The great thing about therapy, is that the person isn't there to judge you, but to help you make sense of a certain situation with an outside perspective.

If I was talking about my mom, maybe she would be able to help me see things from my mom's perspective. Maybe she would be able to give me advice on how to work things out with my mom. If I was talking about my dad, she might be able to point out a pattern in his behavior that I couldn't see.

In time, I was able to take her analytical skills, and when I would talk about things, I would share, then cut her off, already making my own inference about why things happened the way they did, or why I reacted in a certain way.

It quickly became a relief for me to get my feelings out and not have them pent up inside of me. I wasn't carrying around burdens that weren't mine to bear, and if they were mine to bear, I can put them down in her office, and move on. My therapist and my mom encouraged me that if a bad feeling came up that I wouldn't stew in it, I could open a journal, write about it in the moment and release those feelings on paper.

Between therapy once a week and writing in my journal, which I could do whenever I needed to, it felt like a purge. It felt like the feeling you get after an intense workout and the happy endorphins are released. You feel lighter, at ease.

Like anything else, everyone's experience is different, but I'd say therapy is always worth a shot. It's important to research therapists in your area- see if they take your insurance, maybe you prefer a female therapist over a male, or the other way around. If you're currently in school, see your guidance counselor or school therapist, most colleges include therapy in the school insurance plan- use it to your advantage! And most importantly, develop your own opinion on the topic and don't pay any mind to what other people think. If someone is putting down the idea of therapy, they could just not have a lot of experience with it or know a lot about it. If it helps you, that's all that matters.

My thoughts on medication

"All the commercials on TV today are for antidepressants, for Prozac or Paxil. And they get you right away. "Are you sad? Do you get stressed, do you have anxiety?" "Yes, I have all those things! I'm alive!"- Ellen DeGeneres

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I used to be extremely anti-medication to treat depression. That's just the way it was in my house, and the way we were led to believe that taking medication for depression or anxiety would alter your personality, or numb your feelings to the point of living in a zombie-like state. 

A large part of what turned me off from the idea of taking medication, was that it was the first 'solution' offered to help me with my depression.

I was eight years old when my doctor first recommended a prescription. I don't remember exactly what the medication was. My parents had just announced their divorce, and my dad would be moving out of the family house. 

Of course I'm depressed, I thought. My dad is leaving!

As I got more and more passionate about writing, I wanted to stew in the pain that I was feeling. I can use this, I told myself. I'm sure there's other kids who are feeling like me, who feel they are alone in receiving this news. When you're a kid and your parents announce they're splitting, you feel like that is the end; like you will never be part of a family again and that's it. Things don't look hopeful. Add in some messy components, with the transition of starting middle school soon, it's naturally a very turbulent time.

Most of all, I didn't want to feel like I wasn't normal, like I had to depend on a little white pill in order to feel alive. Why couldn't I just be alive? At the time, I was hiding the fact that I was going to therapy from my friends. If they had asked what I was doing after school, I would just say that I had plans with my mom. I couldn't fathom my friends finding out I had to go to therapy, let alone take a pill for my happiness. When you're a kid, you worry about these things, how people perceive you. 

My mom thought I was much too young to go on medication, she didn't want me to have to rely on a pill, and she thought that as my body adjusted to it, I would have to take more and more to get the same affect. We had no real experience in the side affects of antidepressants, because people around us just didn't talk about it.

Having been diagnosed with depression from such a young age, I have tried every natural remedy there is. I incorporated tea into my diet, I was already vegetarian and regularly consumed large quantities of fruits and vegetables, I minimized processed foods, I exercised more than anyone I knew, I did yoga, meditation, I listened to calming music. But as soon as the activity was over, the sadness was still there, roaring like a wildfire. 

The thing about depression, my therapist told me one day, is the more you try to conquer it naturally, the more likely it is to come back, and the more severe it will be when it does, and the less time you will have between bouts. 

I was told this during my freshman year of college. I was having an extremely hard time being away from home for the first time and on my own, and had fallen deep back into the throes of my depression. I had a hard time getting up to shower, I didn't enjoy going to work, or exercising. Nothing seemed exciting to me. Life had begun to feel like a chore. 

I told the therapist my concerns, and fear of side affects. I was very in-tune with any changes to my body and how I was feeling, having managed my depression naturally for so long. But, she was persistent. And I agreed to try the lowest dose of Lexapro. 

The doctor warned me to give it some time for my body to adjust, but to take note of any adverse side affects I was experiencing. 

The first night, I woke up in the middle of the night with itchy skin. I felt like my arms and my back were burning. I walked to the sink and rubbed water up and down my arms and splashed it onto my back. 

The next day, I told the therapist it wasn't for me. 

She insisted that maybe that specific type wasn't the right fit, but to try another. 

I insisted my ability to conquer it on my own was greater than whatever concoction was inside that pill.

I didn't try another medication until the summer after my sophomore year of college. I was staying in my hometown for a few weeks, and my surroundings again were pretty new having not spent a long amount of time there in a few years.

I went to my family doctor and told him about the anxiety I was experiencing. Even in places I used to feel comfortable and with people I used to feel comfortable around, suddenly I'd become overwhelmed with anxiety.

My depression was not new, I had become more adept to dealing with it, but the constant bouts were causing me to lose hope of ever shaking it 'naturally'.

My doctor prescribed me a fairly large dose of Prozac. I was not hopeful, but I felt desperate to give anything a shot at feeling normal and comfortable again inside my own body. I would give it a longer shot for the side affects to wear off and even out.

About two or three weeks on the medicine, it was the first time I ever truly contemplated suicide.

I remember first losing track of time. I was laying in my bed with no motivation to get up, just staring at the wall. I felt hopeless that my life would always look like this and it would always be an up and down battle of bout between feeling sort of 'OK' and feeling restrained to my bed, buried by my depression.

After becoming afraid of the thoughts the medicine produced in terms of wanting to take my own life, I called my doctor and immediately went off the medicine. I decided it was just something that didn't seem to work for me.

I did fairly well managing my depression through a combination of writing, drinking tea, limiting alcohol intake, and exercising regularly.

However, my depression resurfaced during my senior year of college in a way that I did not recognize.

Suddenly, it became hard to eat. I felt like physically I could not sit down and eat a meal. I was too sad to take the time to slow down and have that time for myself. I became afraid of the food that I knew would properly nourish my busy days. I was scared of what would keep me alive.

In September of 2016, I was admitted to ICU for the second time with severe depression and anorexia. My heart rate was in the high 30s, and I signed a 'DNR' because I did not want to live anymore.

My doctors had asked me if I wanted to speak with a therapist, but I declined. I didn't think there was any way that they could help me. Just like the doctors had done, I had wrote myself off as being a lost cause. They recommended trying an antidepressant or an anti anxiety medicine, but I declined, because of how my body had reacted in the past.

Eventually, it became so overwhelming, where I was not able to properly take in food, or concentrate long enough to hold a full conversation, that I turned the corner and was willing to try anything one more time to give me a shot at life.

My doctors started me on a low dose of antidepressants, one I have never tried or heard of before. I had told them my previous history with medication, and she told me she had a high success rate for this one. I felt hopeful and trusted her.

Two days after I started the medication, I felt like a cloud was lifted from my thoughts. Things had turned from a dark shade of gray to a mild one. I was able to sit up in my bed and greet my mom. I was able to focus on our conversation and I felt like I wanted to talk. I wanted the company. Things were going in the right direction.

The medicine had helped me get my will back and slowly I began to care less about the food I was putting in my body. My brain was no longer rejecting it for whatever reason it could come up with to avoid the food. My brain wasn't preventing my life source.

I've been on the same medication now for over two years, and sometimes I am in awe of how my life looks like today. Having dealt with depression for so long, I didn't think it was possible for me to feel genuine happiness and feel comfortable in my own skin and my body. I think back to these low times and I feel grateful for those people that did not let me give up.

I have people ask me how I managed to get my depression under control, like there is a one-size-fits-all approach. Believe me, I know how disheartening it can be to feel like there is no hope. I know how frustrating it can be to try natural approach after natural approach and not see the results that you had hoped for. I know how scary it can be to try a medication that you have an adverse reaction to, or does not work well enough for you.

Treatment is a lot, a lot of trial and error. And ultimately, patience. First, decide what you want as a treatment approach is a very personal thing. If you believe your specific instance may require and benefit from medication, do your research and talk to your doctor. In talking to a doctor, I would question any doctor who jumps to prescribe you medicine before fully understanding your diagnosis and your situation. Are you in a particular time of stress? (moving, break up, loss of a family member, starting school, etc.) These may not require medication, but could benefit from journaling, or eating more fruits and vegetables, moving your body with exercise, talk therapy, etc.

I would recommend keeping a journal throughout your treatment to document how your mood changes with each treatment approach. This is the best way to find out what works for you and what didn't, and go back to the drawing board.

Remember: what works for one person will not work for everyone. Some people will benefit from a low dose of medication, and others may need a higher dose of a different medication. 

Trying on clothes post-recovery

Like everything else in my life post-recovery, I have a complicated relationship with shopping.

Through mainstream media and fashion, we are sold the idea that a size zero or size two equates to happiness: the best clothes, the hottest men, etc. 

For awhile, I bought this idea, too.

I worked hard to lean out my normally size eight body. I always ate well and exercised hard, so I couldn't understand why my body naturally gravitated and felt comfortable at a size eight.

That's too big, I told myself.

As I fell down further of the path of restricting, the weight started to slip off my body. Fast.

One would think this would have made me happy, but I was more uncomfortable than ever before.

Trying on clothes, I wasn't sure what to do. I have always preferred my clothes to fit me loosely rather than tight. It's a combination of the fact that I live in Florida, and want lighter, and looser fit clothing in the heat, with the added factor that I have always been uncomfortable with my femininity. Having what I deemed a 'larger' body, i.e a bigger chest, bigger legs, etc. I didn't want to show that off. 

I was always sold the message of small, and to do what you can to make your body smaller, take up less space. 

Now that my frame was smaller, I thought I might try on smaller, tighter clothes. Having a distorted perception of my body, I thought I looked good and wanted to show it off. 

But I was still unhappy. 

My body started to feel like a shell. An overworked, under-nurtured shell. There was no longer anybody home. No one inside.

As I looked in the mirror trying on clothes, I would begin to get upset as bones replaced where skin once protected what was inside.

I looked away before the tears started to fall.

I was sold the idea that a size zero would make you happy, you would look your best, feel your best, etc. However, having strayed so far from where my body felt naturally comfortable, I was anxious all of the time. This wasn't my body. 

I would throw the clothes over my head quick enough to tell if it fit, than I would take it off just as fast and decide whether or not I would make the purchase. 

I need to have something that fit.

I was going through clothes fast, and I couldn't stop.

Even my underwear began to slide off my body inside my shorts. 

It was too big. Nothing fit.

It felt like a direct daggar to my heart to watch my moms face fall as she watched me go into the fitting room with the smallest women's size in the store, and come out with three fingers in the side of the jeans, demonstrating it was too big.

My mom cried, and I returned to the fitting room so I could, too.

When the doctors told me that it was no longer safe for me to exercise, I gathered up all of my activewear from my closet and hid it in a drawer in the corner of my room, that I knew I wouldn't open and have to come face-to-face with on a regular basis.

It hurt me to see them. It tempted me to see them. I wanted to exercise.

Living in South Florida and being dangerously underweight, I spent most of the year, and all of summer in over-sized sweaters. I was always cold. 

I will never forget the feeling of immense shame when my mom had to take me to the kids section of Walmart in order for me to find clothes that fit.

I was just released from the hospital and desperate to get out of my clothes from the hospital closet. I wanted to throw them away, and never think of them again.

My mom picked out a few T-Shirts, and long sleeves from the boys section in various colors, and two sweatshirts to keep me warm.

As we walked, I held up my underwear with one hand to keep it from sliding down into my pant leg.

I was embarrassed to admit to my mom that I needed underwear that fit me. Having to hold it up throughout the day was making me angry and filling me with shame that my body was disappearing more and more everyday.

I whispered to her, and without a second thought my mom went over to the girls section to look for a pair that might fit me.

A 21-year-old woman should not have to be shopping in the girls section for clothes, let alone for underwear.

As a group of hot guys my age passed, my mom held up a pair of Halloween underwear with cat ears on them,

"how about these honey?" 

I looked at the boys and in that moment hung my head and wanted to sob. This was anything but sexy.

My once curvy body has been diminished to that of a six-year-old girl, and to add shame to the already blazing fire, it had cat ears and glitter.

As my body healed and I began to recover, my body started to fall back to it's natural weight, where it functioned best and felt healthiest finding clothes that fit again became a source of stress.

Luckily for my budget, I hadn't thrown away my old clothes before I had gotten sick, but in some way, it felt like a loss as they started to become less and less loose on my body.

My mom helped me accept the fact when she said, 

"just remember, these clothes [referring to the smaller clothes I had purchased] were never supposed to fit your body."

Rather than becoming disheartened when the smaller sizes didn't fit, I took my mom's advice and stopped trying them on. They were never my clothes. That was never my body. 

I rounded them up in a bag for GoodWill, and donating them, almost as if disposing the evidence that they had ever existed in my closet. They were never intended to be mine.

When it came time to purchase new clothes, I reunited with my old enemies- the fitting room, and the mirror. 

I tried not to look at the sizes of clothes past the point of picking them off the rack. 

If they fit and I felt comfortable, I would buy them, if not I would simply return them to the rack and try again.

To this day, I hate trying on clothes, but I take a few steps to make it easier mentally on myself.

First, I try not to judge my body. Which is the most difficult of all. If I am feeling bloated, I opt not to go into the fitting room at all, knowing the disordered part of my brain will have a field day dissecting my flaws and reminding me of them. In relation with this, once I feel that disordered part of my brain start to pick, I take it as a sign that it is time to stop. Shopping is no longer fun, and it is time for me to call it a day and do another activity.

Second, I don't focus too much on the size. I choose the size that I feel most comfortable with, which is a larger, looser option, and if it doesn't fit, I don't berate myself on why I can't fit into that given number. Every store has a different cut of clothing, so in some stores, you may be a different size than in others. In some stores, the clothing runs small or runs large. 

Third, I'm trying to put in practice more to stop following trends and what I see in magazines, and stick with what I know I like and feel comfortable in, that way the pieces will have longevity for me, and will be a staple in my closet.

For me, I like activewear, leggings, shorts, and T-Shirts when I'm at home, when I'm working, I like a loose blouse with pants, or a dress and cardigan. Those are my staples and what I feel best in. It works for me, may not work for everyone else. It's not supposed to. That's why they call it personal style.

I think given my past of distorted body perception, trying on clothes will always be a source of stress for me. But, I'm slowly realizing that it doesn't have to be. There are steps to make it easier and a more pleasant experience. 

What is 'extreme hunger' and how to deal

Potential trigger warning: this post contains numbers as related to calories and may contain description of my own personal diet. This is not intended to be followed, and any individual should discuss with their doctor to determine what works best for their body. I am not a dietitian, psychiatrist, or any of the sort, just talk about my own personal experience in my anorexia recovery journey in hopes of helping others. 

According to EDinstitute.org, extreme hunger is a common experience for almost everyone recovering from any kind of eating disorder. During this time, you may want and will need far more than the Homodynamic Recovery Method intake guidelines suggest, and find yourself consuming anywhere from 6,000 to 10,000 calories in a single day.

Before I was released from the hospital, I made a promise to my doctors that if they discharged me, I would stick to any meal plan they gave me at home.

The numbers at the time scared me. I was still severely underweight and had to gain a significant amount to be in a safe, normal weight range for my height.

Although the numbers given to me scared me, my doctors encouraged me not to focus on the numbers, not to focus on the long-term in terms of how far I still had to go, but to take it day by day. My doctors had also told me that the more I ate, the more my body would start to trust me again, and I would actually become hungrier. My hunger cues would return, but I wasn't yet at the point where I could only rely on my hunger cues. Sometimes I would have to eat when I wasn't hungry, trusting that my body needed the fuel to repair and rebuild the damage that had been done.

My doctors never told me about extreme hunger.

That would be something I would learn first-hand, on my own, with no one to explain what was happening to me.

The first time I heard my stomach growl outside of the hospital, I cried.

I was scared of my hunger cues. I was scared to feel hungry, after becoming comfortable with feeling empty for so long.

My stomach growled almost immediately after my mom and I had finished breakfast.

She had plated my food for me, as we were at our hotel breakfast buffet, and she knew full well if I was left to decide for myself, the choice of what I should have to eat would paralyze me with anxiety.

She had plated my meal like the doctors had instructed her: a carb, a fat, and a protein, what they say every meal should look like. Plus, I needed a little extra in order to ensure I would gain during the week.

I was having problems with feeling overly full, because I was just starting to eat normally without my feeding tube, so eating a full meal and everything on my plate was extremely uncomfortable and unsettling for me.

It felt like so. much. food.

But, it wasn't.

This was how people ate breakfast everyday.

But coming out of such a prolonged period of restriction, I had to work up to being able to eat normal meals again.

In my lowest periods of restriction, I would sometimes eat as low as under 600 calories a day, and not replenish calories burned from my workout.

My doctors wouldn't give me the number of calories I was expected to eat for fear that it would scare me. Instead they told me I would be able to eyeball it and know if a component was missing, I should add it to my plate for a more complete meal.

Almost immediately when I started eating full meals again and had access to food that wasn't hospital food, my hunger was ravenous.

I still thought about food all of the time, I worried about what I was expected to eat next and when, and I thought about the foods I was afraid to eat, and those I called my "uncompromisables" the food I wouldn't even dare challenge myself to, it was just a no.

I started waking up in the middle of the night hungry.

At the time, having heard nothing about extreme hunger, I was really worried that after severe restriction, my body might swing to the other extreme and start bingeing. For me, this didn't seem too illogical, considering some of these foods have been "banned" from my diet for almost five years! Now I was expected to eat it, encouraged even!

But, I would wake up in the middle of the night anywhere from midnight to 2 a.m. hungry, but with a very specific craving. For the most part, I always wanted peanut butter sandwiches.

I could wake up in the middle of the night, have a sandwich, go rest my head on the pillow, and I'd be hungry again!

I would look at my stomach as if to scorn it, "you just had one!" I whispered.

In the beginning of my recovery I would pace back and forth next to my bed, maybe go get some water, and hope the feeling would pass.

I would not become overweight, I thought. I couldn't believe this was happening to me.

After being unable to fall back asleep for an hour, I would have one, even two more sandwiches until I felt satisfied enough to go to sleep.

In the morning I would wake up starving!

I couldn't wait to go down to breakfast.

I felt like my body was betraying my mind.

These were foods I had been scared of just three weeks prior, and now my body could demand five peanut butter sandwiches in one sitting.

Mealtime still gave me immense anxiety, I was still scared to eat, but now my body had the hunger cues. It was asking to be fed, and I seemingly had no option but to give in.

Extreme hunger can provoke more anxiety for the person experiencing it, because a lot of doctors and therapists, even friends I have encountered didn't understand or had never heard the term before!

At the time I had thought they had never heard the term, because maybe I had made it up or something of the sort, but, they had most likely never heard of it because they themselves haven't experienced an eating disorder or had known someone who had.

I've had people tell me that I was binging, that I was compulsively eating, sleep eating, etc. This had really upset me, because I had vocalized that this had been such a big fear of mine. But the way that I ruled out binging or compulsive eating, and all that, is because with binging, you feel as if you have no control over the amount of food you are taking in and it is a short period of time. I always tried to be very mindful, especially when extreme hunger was particularly rampant. I would ask myself 'what is it that I feel like I need/want right now?' 'how would this nourish me?'

For example, during my period of extreme hunger, which lasted probably three-four months, I mainly wanted peanut butter sandwiches. During my periods of restriction, I had completely eliminated fats from my diet, and rarely, if ever consumed bread.

As my doctor explained, fat is necessary for cell growth and for energy, and our brain is made up of fat. So, it only made sense that I was craving what my body needed for repair, having been without fats for so so long.

I had read up a lot about extreme hunger, and I tried my best to explain to my family what it was and what I was experiencing. My family was really supportive, I think they were just so happy to see me eating properly again. I told my mom, mainly, too, because sometimes, as much as I tried to embrace and accept what was happening, it was exhausting.

She would encourage me to try eating more calorie-dense foods, so I wouldn't feel the need to take in a high volume, which scared me- the sheer quantity. However, it didn't seem to help. Sometimes after a day the scale would read a larger number, or my hunger cues just wouldn't rest, I would feel emotionally and physically exhausted, and need someone to talk me through.

I didn't share with everyone what I was experiencing, because as I mentioned, a lot of people who have never experienced eating disorders are not familiar with it. I felt embarrassed by the quantity of food I had to eat, but I knew it was essential for my recovery. My organs were showing signs of shutting down, and had begun to feed off of themselves I had been restricting for so long, so my body desperately craved these nutrients and in large quantities!

During this time, I mainly surrounded myself with my family and made my primary focus my recovery and getting to the weight I needed to be at.

I'm not trying to say that the process is easy- it most certainly is not. But, I put into practice some tips that made it a little bit easier for me.

• If you have been in a period of restriction for a long period of time, accept that extreme hunger is extremely possible for your body. Try to ask yourself what it is your body needs, or what it is you might want to nourish yourself [trying to throw away any previous food rules you might have followed].
• Understand that if you had lost a significant amount of weight, it will come back. This is not a bad thing and do not be scared of this. You are not gaining weight, necessarily. This is your body trying to get back to its natural, healthy state, where you can function best.
• Keeping that in mind, if your doctors/therapist, etc. needs to weigh you- don't look! Cover your eyes, step on the scale backwards, and don't be afraid to let them know not to talk numbers. You. are. not. a number. And there is no number goal in recovery. The numbers are for the doctors to worry about, not you. They will let you know when you're in a healthy range and if you start to slip below that. 
• A big thing for me during recovery was having restricted for so long, and loving shopping like I do, I had bought a lot of clothes that were not my normal size. When I started getting healthy again, these clothes no longer fit. Like I said above, know that this was never your size. This was never the healthy size you were intended to be. If knowing these clothes no longer fit will upset you, don't try them on, simply toss them into a donate pile, and don't give them a second thought.
• Explain to a few people close to you what it is you're going through so they'll be better able to understand and to help you when you hit rough patches.
• Do not compare what you're eating to what the people around you are eating. You are in recovery. Your body requires more than someone whose body has not experienced damage.
• Understand that the period of extreme hunger will not last forever, that it is temporary while your body rebuilds may help to reduce the anxiety you feel. It does not last forever. Your hunger cues will go back to normal.

My Best Day in Recovery

"What progress, you ask, have I made? I have begun to be a friend to myself." Hecato

          "I finally think I understand it now," my mom said. 

          She had just arrived for her daily hospital visit. I was tired and restless. I have been in this bed for at least the last four weeks, and I was craving sunshine. Every day she would arrive, I would ask her what it's like outside. Is it sunny? Does the weather feel nice? What's it like?
          I could watch the weather on the news, of course. But it wasn't the same as feeling the cool air kiss my skin, and looking up to the sky and squinting as the sun reflected in my eyes. The last time I've been outside was the brief moment I was rolled on the stretcher from my hospital room to the waiting ambulance and transported to a new hospital across town better suited to treating patients with eating disorders. 
          The window from my room had an obstructed view. I could tell if it was light or dark, but not much else. 
         As my depression worsened and rapidly manifested itself as an eating disorder and a severe fear of food and properly nourishing my body, I was desperately searching for the words to explain to my family what was happening to me.
          "I don't feel good," I said. "I'm not happy," "It hurts," "It's not my fault."
          "Just eat," they pleaded.
          My sister reminds me now the saddest thing I told her while I was deep in my struggle, searching for a way to explain to them what I was going through.
          "It's always been like this," I told her. "Just now how I felt on the inside is starting to show on the outside."
          My sister cried at the thought, finding it morbid. But to this day, I still think it's the truest explanation. 

          I remember the first day I felt I physically could not eat my lunch. It was not like me to skip a meal. Actually, in university, it was my favorite part of the day, because it allowed me a break from school and work, and just an hour of downtime to sit with my friends, or in front of the TV and enjoy a meal, without the pressure of thinking about anything else.
          I didn't feel hungry, but I knew I had to eat, as I had to head off to work in less than a half an hour. I was happy that the cafeteria was serving sweet potatoes that day, one of my favorite foods. I pulled my chair closer to the table, and looked down at the plate in front of me, and I cried. 
          I was stressed out and had a lot on my theoretical plate, and my mind. 
          I don't know how much of my reliance on food restriction was a conscious choice, or how much was just instinct, a feeling that I had control over some aspect of my life. But, at the time, it felt good that I didn't feel hungry. I felt superior over the demons I was fighting. I felt like I could have everything: classes I loved at school, work I was proud of and co-workers I was happy to work alongside, but I didn't need this. Maybe other people did, but I was sure I didn't. 
          
         
          "The part of your brain that is refusing to allow you to eat," my mom said, "that's not you, that's not my Brianna- that's the bad Brianna."
          This was something my mom pondered about before. I've been through a lot in the past four weeks of the hospital. I showed little progress and hadn't been able to gain any of the weight I lost back, but every now and again I would show signs of hope that I would get better. That was the hope my mom held on to- that maybe, just maybe, I would come out of this alive, with minimal long-term damage to my organs.

          The first day my mom arrived at the hospital, I didn't know she was coming. I had been admitted the night before, because my heart rate was dangerously low- in the 40's. I was almost immediately checked into the Intensive Care Unit to be monitored over night, because the situation would be dire if my HR were to drop any lower. 
           Nurses wrapped me in blankets hoping to preserve my body heat and avoid any further drop in HR. Before I fell asleep, the nurse asked me that in the event of an emergency, would I want the doctors to do everything they could to revive me and save my life. 
          I told her no, and signed my name on a "DNR." 
          I was 21 years old, labeled a 'fall risk', having my heart rate closely monitored, and told the nurses that if anything were to happen overnight, to let me die peacefully. This is what I wanted, I was sure. I signed my name on the line. 
          When I woke up in the morning, I was told my mom was on her way, a four hour drive from where she lived to the hospital. 
          The nurses said they didn't believe I was making decisions that were in my best interest, so my mom was now in charge of making all medical decisions for me, and she should be here within the hour.
          

          When my mom arrived at the hospital, she rushed to the side of my bed. I could see the worry in her eyes, but if I were to have seen mine, I don't think there would have been much reflected in them. They were empty, just like I was.
          She hugged me and kissed my forehead.
          "Why are you here?" I said. "You shouldn't have come."
         I was angry that the right to make decisions for myself were taken away, and I was taking it out on my mom, who only wanted to help me, who only wanted me to stay alive. 


          I had sent back several of my meals already at the hospital, and my nurses and doctors were quickly becoming fed up with me. I had already been diagnosed with delayed gastric emptying, so even a little quantity of food would make me feel so full that I felt physically ill. I felt like I couldn't take in any food, even if I had wanted to. 
          The doctors threatened a feeding tube.



         As visiting hours came to an end, my mom was getting ready to leave, and I grabbed her hand.
        "Mom, do you have to leave?" I pleaded with her. 
           Even though I initially questioned why she was there, she knew that wasn't coming from me. She knew it was the disorder lashing out at her, because she was trying to save my life, and the disease was doing everything in its power to attempt to take over my mind, and break down my body. 
          Knowing that I would probably get a feeding tube placed that night, I was scared. I didn't want to be alone. My concentration was poor, and I wasn't able to hold a full conversation, because I was tired all of the time, I wanted my mom's company and the safety she provided me that somehow, everything would turn out OK. 



          "It's like there's two Brianna's," my mom said, "There's the good Brianna, that's my sweet girl, that she cares for people and loves school and work and wants to live and beat this, and there's the bitch Brianna, the disorder that's trying to take your life."
          I was so relieved when my mom made this connection, that she showed signs of understanding what was taking place in my mind, why it wasn't as simple as "just eat" or "do something that makes you happy." What was going on in my mind was bigger than me, and I needed some help. After searching so desperately for months for the right words to explain what I was going through, what I was dealing with, and ending with both of us getting frustrated and upset, my mom was finally getting it. We were on the same page and would work to beat this together, whatever it took.


          When my mom had that change in mindset, I had one, too. I was willing to accept medication to get well, accepting that what I had been fighting for the majority of my life was bigger than me; it was bigger than natural remedies, it was bigger than going out in the sunlight, getting exercise and eating right, it was greater than anything I had tried to heal myself. It was beating me, and I wouldn't stand idly by and accept it. Now that my mom and I seemed to be on the same page, I didn't feel alone anymore. We both knew what we were up against. 



            I had always been reluctant about taking medication, because of the possible side effects. But at the point I was at, I figured, it couldn't possibly be any worse. I spent a lot of my day sleeping, laying in bed with my knees tucked into my chest and crying. I couldn't sit up and hold a conversation without losing focus, needing a nap, or wanting to cry. The hardest thing for me was losing my faith. Being a strong believer in Buddhism, I couldn't read the Buddhist texts I once loved, I questioned everything. 



          After about three days of regularly taking an antidepressant, I felt well enough to sit up in my bed and have a heart-to-heart conversation with my mom for the first time in probably three months. I was so happy. We went for a walk up and down the hallway in the hospital. Being on the same page, she understood how hard it was for me to get through a meal, and how when the nurse delivered my meal tray, I would black out, riddled with anxiety. She would try to distract me with conversation, but I just couldn't seem to get past how afraid I was by the amount of food that appeared on each tray. My mom remained patient, and she sat with me during each meal, ensuring me that she was there when things got difficult, and we talked through it. We took it day by day, meal by meal, and I couldn't have gotten through the rough patches without having her on my team. 

         From that moment when my mom proved to me she was starting to understand what I was going through, we encountered many challenges in my road to recovery, but I didn't feel as frustrated by setbacks, because I felt confident in knowing that I had a team of people on my side who were rooting for me and my recovery. I knew I had people counting on me to pull through. There were times when my mom would become frustrated by my lack of progress or if I experienced a setback. I had told her that for us, recovery would look a little like swimming as one vessel; if she could kick, I would try to move my arms as fast as I could. We were both tiring out, but ultimately, we were moving forward, and that's better than nothing in my eyes. 



          

Does 'recovered' ever truly mean recovered?

 Lao Tzu once said, “A journey of a thousand miles begins with a single step,”

Me and my addictive personality have always thought that was a load of crap. I wanted to reach my destination now. I didn’t much care for the scenic route.

I’m slowly learning that it’s only when you can discipline yourself to slow down that you can truly appreciate the route you take.

I’ve also learned: slowing down is hard.

Almost exactly a year to the day that my recovery journey started, though involuntary, I chose to reflect on my progress.

Recovery is hard. It hurts. It’s messy and confusing and scary. It’s not beautiful, but at the same time, it is. It takes time. A lot of it. You will mess up, you might mess up a lot. But, that’s OK, too, that’s part of the journey and the lessons learned contributes to your growth.

Almost a year into recovery, I often wonder if ‘recovered’ ever really means recovered. Maybe it varies from person to person. Maybe for some, it’s possible to make it on to greener grass and relax there for a little while. For some, their footing in recovery is a little more solid.

Not for me.

My footing in my recovery constantly feels like I’m on wobbly ground, or as if I’m re-learning to walk again. Because I have. Literally. And I am. Figuratively. I always feel as if I’m one insult or comment about my body, or one triggering food or situation away from backpedaling. I am always on guard, and so is my body, refusing to let me restrict my way into nothingness for a second time.

My recovery journey started out of necessity, rather than by choice.

It was my second attempt. My second time being admitted in the ICU after a two month fight against it. The first go-round in the ICU, I was there for four days, and against some of the doctors best wishes, released back home. Against their professional advice, I chose to forego inpatient treatment, and instead focus on my upcoming graduation, just a few months away. The truth is, I wasn’t ready to choose recovery. Nobody else could choose it for me, regardless of how bad they may have wanted to.

Having returned to campus against doctors and school officials wishes, I wasn’t allowed to seek treatment on campus, unless it was an absolute emergency. With my mom living on the other side of the state, we often stayed in touch throughout the day over text message.

Knowing that my mom took a chance on me, understanding how much school meant to me, and how badly I wanted to finish my schooling when I was supposed to, I was also sure that I was always honest with her.

I told her when I was tired, if I was having trouble walking, if I felt faint, if I was upset, and I admit when I made mistakes and cut corners.

One day at a time, one meal at a time, that’s what they told me. This wasn’t going to be easy.

I sang “Eye of the Tiger” to myself any time I had a particularly challenging moment surrounding meal time. I called my mom or sister while I was cooking or sitting down to eat, in hopes of alleviating the chance for a panic attack.

My second go-round in the ICU, I was on my way to my second class of the day at university, and feeling rather exhausted. At 21-years-old, I could barely make the seven minute trek across campus, without every muscle in my body feeling sore. I texted my mom, unsure if I would make it to my classroom.

“I can’t do this anymore,” I cried.

It felt like the muscles in my legs were abandoning me, suddenly we were on different pages, and they weren’t wearing my team colors.

Through the insistence of one of my kind, and patient professors, she told me that she would allow for me to miss that days class if I agreed to take myself to the hospital.

I thought about telling her that I did, and they chose not to admit me, and instead go home and go to bed early. I would try again tomorrow. But, for some reason, this time felt different, I wasn’t fully confident that I would see tomorrow, if I didn’t get help now.

I still wasn’t ready to choose recovery, but at minimum, I would need to be stabilized and have my electrolytes checked.

I was admitted to the ICU almost immediately, where I would spend the next week on bed rest, hooked up to various IV’s and fluids, and have a feeding tube inserted in my nose for the first time.

Sometimes when I’m feeling unstable in my position in recovery, I recall the pain of having three nurses crowd over my bed, wiggling the feeding tube down my nose, and how it burned as it curled in my stomach.

They had to readjust the tube three times after an X-Ray showed it was tangled in my stomach.

After a week, I was transferred to a medical unit, where I lived for six weeks.

Doctor after doctor told me about the toll eating disorders have on your body, and how serious my case was.

“If you were to leave here right now,” my doctor said, “you will not live, do you understand?”

I might have rolled my eyes, because I’ve heard it before.

The doctor had told me due to my limited intake of food, my organs started to feed off themselves, and were refusing to release waste.

“Just because you’re here,” one doctor said, “you can still die,” he said, “you are certainly not in the clear.”

I told my mom to ask him to go, because I thought he was being mean to me.

Even when I didn’t have a release date in sight, and doctors told me it may be months, I never felt sad, or scared, or much of anything, really. The only thing I cared about was school.

I wished I could work and complete school, without having to do any of the hard stuff.

Recovery was painful, and I still wasn’t ready to choose it.

I still cringe looking back at the journal they gave me during this time.

It was supposed to be used as a form of therapy, I guess, to get out my feelings, but instead, I logged what meals I ate and what percentage, trying to get around how much they made me eat. I wrote down new ‘food rules’ for when they finally discharged me, and I wrote how I couldn’t wait to get back to eating how I normally ate, how I couldn’t wait to be able to walk around the mall.

It’s been almost a year since I entered the hospital for what I would like to say was the final time. But like I said, recovery is not perfect, it’s not easy, and sometimes you mess up.

For me, my eating disorder is an addiction that resurfaces when my depression does, in times when I’m feeling stressed, or lonely. I’m addicted to the feeling of emptiness, it masks itself as a form of comfort, although I know it’s not, I have nothing else.

The beginning stages of recovery were hard. H A R D. hard. Hard.

Having lost over 60 lbs, meant I had to gain that weight back. And it came back faster than I was prepared for.

With my body refusing to trust me or let me restrict, my depression seemed to search for other ways to find that ‘comfort,’ other forms of self-harm for it to rear it’s ugly head and try to convince me that the beast was in control.

Recovery is messy. Sometimes that beast won. More often than I’d like to admit.

I’ve messed up, and weighed myself, knowing full well that I would not like the result. I’ve told doctors that I could handle the number, that I wouldn’t be upset and that they should tell me, ‘so I could be sure I was healthy,’ I lied, knowing I would use it against myself later. I stepped on scales at other people’s homes, because I wasn’t allowed to have one in mine, and hold it against myself later.

I’ve messed up, and restricted when I was feeling stressed.

I’ve messed up, and read labels, knowing that once I knew, it wasn’t something I could just unknow.

I’ve messed up, and worked out longer than I should have, than I knew my body could handle at the time.

I’ve messed up, and took more than I was prescribed.

I’ve messed up, and spent a few days in the hospital.

I’ve messed up, and never deleted the apps that track how many steps I take, or how many miles I bike.

Those apps send me ‘friendly reminders’ when I haven’t been as active as the previous day, or I haven’t burned as many calories as I did last week.

Those memos still send me into a frenzy.

“Why are you tracking your steps?” my mom asked. “You shouldn’t be tracking your miles, this is not a job,” she reminded me.

Quickly I became defensive, feeling the need to justify why my step count is so high, or why I feel like I need to ride X amount of miles X times per week.

My mom is very keen to my disordered behaviors, and not shy about calling them out.

I know she’s right.

I can recognize when my behavior is disordered, too. But I can’t stop. That’s part of the addiction.

It’s a challenge with myself in a battle against myself. It’s a numbers game. For someone who hates math, I get a little high off seeing the number higher than it was the last time I was on my bike, or the last time I went for a walk, because I can’t be trusted to jump on the scale and see what that number tries to deem my fate.

It’s a numbers game and nobody wins, but I’m addicted.

I still feel the need to excuse myself from conversation when I hear beautiful women, whom I admire talk negatively about themselves.

I feel that emptiness when I hear these women talk about their perceived flaws, or how much weight they think they need to lose, or what ‘magic diet’ they think will finally work for them. It’s not the kind of emptiness I’m attracted to, and I excuse myself from the conversation.

I still don’t know why I don’t allow myself the same courtesy when I start talking negatively about myself.

I’ve messed up more times than once, but like Lao Tzu said, “A journey of a thousand miles begins with a single step.”

I may have taken a lot of steps, but this journey is far from over.

In fact, it’s still only just beginning.