If you ask my mother, my mental illness began when I was 6 with the fatal car accident that left me with perforated intestines, broken bones, and high anxiety. If you ask my cross-country coach, my mental illness began when I collapsed in the middle of our conference meet from stress exhaustion. If you ask my doctor, my mental illness began when my BMI finally got lowered to the point of faulty organ function. If you ask me, I might deny having anything wrong with me at all—that within the very nature of eating disorders.
Eating disorders are serious illnesses with both biological, social, and psychological roots. Because they have biological implications of physical harm and side effects, they have the highest mortality rate of any other psychological disease. (Their multidimensional span of factors relating to onset are also what make them so difficult to pin causation on, hence the confusion on when the heck this whole shit show started).
The American Psychiatric Association defines the physical criteria necessary for diagnosis as including the loss of period (yep), sudden weight loss (yep), deterioration of muscle (yep), particularly heart muscle; this leads to irregular heartbeats and arrhythmias (yep), bradycardia (low heart rate <60, and yep), tachicardia (high heart rate >100), irregular blood pressure (yep), loss of hair (yep), deterioration of tooth enamel (HELL yep), and frequencies of symptom use. The one thing I didn’t meet in my criteria for Anorexia was what was considered a low BMI (under 18). My BMI got close to, but never quite at, the level at which doctors diagnose as critical malnutrition. As a young adult struggling with my ED, this made everything 10x worse.
Perhaps Coach Knutsen was right—perhaps it started with the collapse at the Chisago Lakes race. When he picked me up from the ground, I made a promise to myself that I was going to become the fastest and strongest runner on the entire team. It began, innocently, with the believe that weight loss and clean eating would help with this. Thus, I started in on the Whole30 diet with dreams of increasing my athleticism….boy, what a shit show that turned out to be. Remember the car accident 10 years prior? The intestinal surgery left me with permanent adhesions lining my internal organs, making digestion slightly more difficult than normal. You pair that with slowed digestion from lack of nutrition AND a diet primarily focused on raw fiber, and you get hospitalization #1—first bowel obstruction in 9 years.
You would think that this would have been a wakeup call that my so called “healthy eating” wasn’t so healthy after all. Instead, being put on NPO (aka no liquids or food) for a week only further encouraged my restriction. I continued down the path of starvation, exercising more and more every day. I began sneaking in sessions at the gym in the early mornings before school started, working out during PE class, staying back during lunch, and continuing for another hour after school got out—I was determined to be in shape for the upcoming track season, and to beat out everyone else. It became a lethal competition, no exercise was enough and no food safe.
Ironically, as the season began, I found myself slower than my previous times do to the muscle loss I had accumulated the months prior. The cardiovascular endurance I had craved for during the cross country season had been accomplished, but the speed necessary to be successful as a mid-distance runner in track was completely out of reach.
Hospitalization #2—on a Wednesday night after practice, I had my second bowel obstruction in 2 months after 9 years OB free. This time, my doctors finally picked up on my physical deficiencies. They closely monitored my deteriorating heart rate and questioned my weight, which had dropped a whopping 20lbs since the previous hospitalization. Being the sly dog it was, my ED covered itself up by denying any issues, claiming it was the work of stress and an athletic metabolism. This time, I had to undergo a surgery to correct my intestines—that meant several weeks of only liquids. It also meant my greatest fear was coming true…no more exercise.
Eventually I could slowly reintroduce running back in, towards the end of the track season. Though I had missed out on several weeks of it, I was glad to be able to hop back in again—perhaps a little too eager. Due to the severe lack of nutrition in the previous month, my excitement over reintroducing running lead to pushing myself a bit too fast. I soon developed several stress fractures, some of which still haunt me to this day. At the conference race for the track season, my 4×8 team won the conference title! This was one of the happiest moments I had during my early ED days, I was so incredibly proud of the work I had put forward to get there. My parents, however, were less than proud of the psychological grasp than food had on me.
The deprivation called for by my surgery awoke a second perspective of disordered eating—bingeing. Thus came hospitalization #3—3rd bowel obstruction, this time due to a binge that completely blocked my digestive tract and stopped it from contracting. This was incredibly uncomfortable and painful, and very shameful for me. I am able not to recognize that this swing in symptoms was a natural response to restriction; I was able to restore only some of my weight lost over the previous months, but to me it might as well have been 50 extra lbs. At the end of that track season, I finally agreed to seek treatment for an eating disorder.
I began outpatient at Melrose Center for Eating Disorders, where I first received my diagnosis. I didn’t take it seriously, in fact, I found therapy appointments quite obnoxious. I continued to exercise excessively, despite continued injury. Mileage was increased heavily every week, and I took pride in eating as little as possible granted the incredible force my parents had in my meal plan.
Hospitalization #4–at the end of that summer, I was deemed medically unstable from my heart rate and placed inpatient at Melrose, and I was once again temporarily pulled from the cross-country team. Upon discharge, I had just barely restored my threshold of weight, but it spun me into what felt like an uncontrollable downward spiral of bingeing on the food I had denied myself for so long. I attempted to reintegrate back into the team, but the shame of my weight restoration and stress from not running for two weeks straight led to yet another collapse during a race—I felt completely, utterly, and totally defeated. My coaches decided it was time for me to be done with the season, for my own good. This sent me into a deep depression, and my bingeing worsened in response. The shame and guilt accumulated higher and stronger urges, especially when paired with the memories of the body I had once had. Looking back now, I was never more than weight restored–I have never truly been overweight in my life. At the time, however, my marked distress with food showed my parents that I needed further treatment other than a two-week intensive at Melrose.
From here, I began my first ever stint in a residential treatment facility. I stayed at the Emily Program for a little over two months, and continued doing online school through a teacher they had come in from the Minneapolis public school system. It was probably the most beneficial form of treatment that I’ve received as of yet, especially when paired with a step-down intensive day-treatment program to help with the integration going back home. I was actively in recovery and remission from my eating disorder for 10 months after, until I had yet another obstruction. This was, once again, interrupting a cross country season from which I had to reintegrate back into after properly healing. This time, it was my senior year, and while I maintained composure it still was incredibly hard on my ED urges. I may have physically recovered from the lack of nutrition during the time of the surgery, but my mind was psychologically still impaired by awoken eating disorder thoughts.
Slowly but surely, I lost more and more weight. I knew I wasn’t going to be allowed to run track in the spring, so I auditioned for and got cast as the lead in the school’s spring musical. Rehearsals were almost wrapping up and performances were drawing near. Because it was so gradual and I wasn’t actively running or working out in the months following, my parents weren’t so quick to suspect weight loss, but my theatre directors could notice the lack of focus and strength I had. For the sake of the show and for my own safety, they decided to pull me from the show and cast an understudy to fill my place. This threw me into the lowest spot I have ever been and hopefully will ever be in—that night, my parents called the Emily Program for another residential referral, and I overdosed on a bottle of my father’s blood pressure medication.
Hospitalization #5—rushed to the ER with critically low heart rate and blood pressure, and sent to the ICU at Minneapolis Children’s to stabilize. I stayed there for a week detoxifying and was later sent to the psychiatric ward at Abbot Northwestern. I never considered myself to be suicidal, but rather wanting to get away from the world and my problems in it. After being psychologically cleared, I was sent back into my second stint of residential at the Emily Program. This was the hardest round of treatment for me, and it was followed by yet another round of intensive day programming—this time, I tried my hand at adult programming. I danced
through the process with hopes of getting out as soon as possible, and was eager to get off to college so I could be alone with my ED. College, it turned out, was no field day.
4:00am, the alarm would scream from below. Wincing in pain, I dragged myself out of the loft in that 8th floor dorm room, fumbling to silence the clock so not to awaken my roommate. Time to run—it was a daily ritual that couldn’t be ignored for fear of judgement, failure, and worst of all, weight gain. The streets were silent, cold, and empty as I would begin to pound at the pavement. Streets blurred into dark mazes, steps into miles, and minutes into hours until the pale pink light of dawn stretched over the city. This was the signal that I could finally end my run, though I knew I deserved to be punished by it.
Classes came and went. I attended, I took notes, I left. I went to the gym. Walking past a board covered in posters, a sign that advertised body positivity caught my eye—anything that had to do with the words body, fat, or food seemed to draw my attention in those days. I decided that I’d be able to love my body once I lose more weight, so I would go ahead an force myself into another hour of working out before I could leave again. I showered in the solitude of the empty women’s locker room, washing the blood off my blistered feet. I walked up and down the stairs of Minard Hall, just to get a few more in. Still not enough. By the time I finally allowed
myself to eat, it would be nearly 10:30 at night—the worst part of my day. Walking into the West Dining Center was like the entrance into hell—noise, people, chaos, and most dangerously, unlimited access to food. The worst form of torture I could ever apply to myself. It was the perfect storm, beautiful chaos, and time to fill the void in my body with further symptom use–downing disgusting amounts of food with gallons of water, I filled myself until I felt like I might explode. Wishing that someone could see the pain I’m in. If only they knew the madness in my head. If only someone could stop me when I lost all control. To everyone else around me, I was just a hungry student athlete. To everyone else around me, I just had a hefty appetite. I was normal. I was healthy. I was fine.
That poor toilette in the single stall bathroom at the lobby of Seim Hall would beg otherwise. Purging and vomiting until nothing but the bitter taste of stomach bile scorched my throat, and I achieved that tell-tale feeling of emptiness, satisfaction, and success–nothing felt as good as feeling nothing. Crawling up the unforgiving flights of stairs back to room 803D, each step was a reminder of my weakness, failure, and shameful body. I’d falter a few times, catching myself on the railing so I wouldn’t fall back down the stairs again. I might pause to regain my blotted-out vision by leaning up against the wall of that whitewashed stairwell, catching my
breath. By the time I would make it up to the top, I couldn’t even acknowledge my friends who waved at me from the lounge. I stumbled into my room and slammed the door behind me, finally safe from the eyes that I was positive were judging me for the spots of vomit still staining my sweatshirt. With the last bit of strength I had in me, I would pull myself up on that loft to pass out safely on the mattress—only to do everything all over again at 4:00 the next morning.
This was my routine every day, for 5 months straight. When the corona virus hit the Midwest, school closings sent all of us at NDSU back home in early March. While others groaned and complained of online classes for the rest of the semester, I secretly felt relieved of the support being at home provided. Without being able to access unlimited amounts of food whenever I wanted, bingeing and purging ceased and my weight consequently dropped from the replacement of bulimic symptoms with the return of anorexia. The dangers of my symptom use over the previous months, while reduced greatly since being home, sent me back into the Emily Program residential facility, this time for adults.
As I write this, I’m sitting against a wall in the group room Anna Westin House West, painfully aware of the way my sports bra squeezes the bloated fat rolls of my bulging stomach. While I know those physical features are nonexistent, they still send waves of disgust throughout my body as I sit in anticipation of the dinner that I’m supposed to eat in the next 5 minutes. I don’t know where my recovery journey will go from here, but I hope and pray that things can improve for me.
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