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Mental Health: the diary of a broken mind
written by: Steve Pearson
I have a poor relationship with food. I just can't seem to stop at full and will sometimes eat until I feel physically ill. Why do I do it? Well I know I'm doing something that can ultimately have a detrimental effect on my health and yet I still do it. Surely everyone has heard of the idiom, 'Naughty, but nice.' What does that mean? To me it means that you know 'this' on some level is something you really shouldn't do but hey, you'll get some kind of reward from it. In my case of course, we're talking about perhaps a cream cake, or a sausage roll, and the reward for me is that cream cake, or sausage roll. Someone suffering from Anorexia Nervosa or Bulimia Nervosa has the same reward mechanism at play, but enacted at the extreme edges of diet. Their reward is that in some way they see themselves advancing towards their goal, through their actions. Of course, they will never arrive at that goal, whatever the goal may be, because the disorder itself is immutable without intervention, so the goal becomes a constantly moving destination seen through the distorting lens of their illness.
Make no mistake about it, eating disorders are complex mental health issues and telling someone to 'just eat' is like telling an alopecia sufferer to 'just grow hair'. Misconceptions about eating disorders typically start with family and friends who just can't fathom how their loved one became so 'self-absorbed' as to care so much about their body image that they are prepared to starve themselves even to death. Society at large have the same broadly skewed view of a condition that appears to them to shine like a theatrical spotlight. Of course this couldn't be further from the truth. It's about body image and the hopeless pursuit of a distorted idea of a perfect body. Like two north facing magnets, the 'perfect body' moves away as the actual body approaches. Or it's about low self esteem, where taking extreme control of their bodies, such as binging and purging, will make them feel better, about themselves. Ultimately a sufferer will hopefully receive treatment while others may meet a tragic end.
Whichever route sufferers take to arrive at the disorder, they will usually arrive with certain baggage that will to a greater or lesser extent be similar to their fellow sufferers. They may be working in a high pressure 'thin' environment such as working as a dancer, or have perhaps been criticised for eating habits throughout childhood. They may have had a torrid time with weight issues, with friends, family or just a common or garden playground bully focusing on their weight or shape, or both. Still others may already have an anxiety disorder or have suffered an abusive relationship. Others may have triggered at times of high stress, such as a family death, loss of employment or struggling with the pressures of school. For some, their baggage is a family history of addiction, depression or eating disorders that has inexorably delivered them to their inherited destination.
Once under the influence of an eating disorder sufferers can often be drawn into the miasmic world of pro-ana (pro-anorexic) websites, where tips for and encouragement to achieve the anorexic look serve to draw sufferers deeper into their illness. The spread of such sites have proved to be a magnet to real anorexics and those drawn to its quasi rebellious pretext. Moves to close these sites down have proved difficult. Whilst some have been banned others have persisted, whilst others spring up in place of those successfully removed. Reasonable sounding arguments in support of pro-ana sites can't hide the harm they inflict on vulnerable sufferers while purporting to offer support. This fall into co-dependence helps to feed the feeling that their extreme world is where they belong while the rest of society sits a world apart.
There have been high profile sufferers in the past who have lost their battle, most famously Karen Carpenter, one half of the iconic American pop duo, The Carpenters. In Britain the Scottish child star Lena Zavaroni achieved international fame at the age of ten, but was struggling with anorexia by thirteen. Karen Carpenter died in 1983 aged just 32, less than one month before her 33rd birthday, and Lena Zavaroni was lost at just 35 years and 11 months of age. Both died of complications caused by their eating disorders. For some time afterwards the media light shone on this lonely and insidious struggle but, once the public's appetite for the story waned, it returned to its secretive roots. Eating disorders have one of the highest mental health mortality rates inevitably as a result of associated behaviours, such as substance abuse. Though the terrible loss of life as a result of mental illness, and within this context - eating disorders in particular cannot be overlooked, the great majority of sufferers will survive. But what does the life of a survivor look like?
Generally the life of a survivor is a mix of standing a careful watch over their emotions and of knowing how to repel the demons of starvation, binging and purging, abusing laxatives, abusing appetite suppressants, anti-diuretics, and of recognising their endless comparison of body shapes and sizes as a trigger. They can also be dragged back into their disorder, which they may have struggled for years to control, by their tremendous sense of competitiveness when they are around innocent dieting, where another person's simple striving for a different body shape might trigger in the sufferer another destructive episode of driving their body down the same old hard traveled road. They also suffer from the oldest mental health story, as stigma and bigotry rain down upon them from a society ignorant of their needs and troubles.
I have talked over the subject of eating disorders with people. Some seem to think it a wholly modern phenomena enacted by over-socialised, terminally-anxious people too bound up in self. Wrong. There is evidence scattered throughout history and all over the world of the great and the good binging and purging, and stories of starvation used in religious contexts as a means of showing devotion: the most famous of which being Catherine of Sienna (1347 - 1380) who died of a stroke after years of flirting with abstinence and eventually succumbing to extreme starvation. In 1873 the medical malaise of self starvation was given the name Anorexia Nervosa by royal physician Sir William Gull, in his paper "Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica)". At about the same time the French psychiatrist Charles Lasegue rooted eating disorders firmly within the spheres of mental health, identifying it to family pressures, rebellion and the control of self, essentially defining the disorder 144 years ago. So, the condition and its links to mental health is a long known, well documented disorder and whilst it could be argued that eating disorders, fuelled by famous cases, has become a mass media picture show, clearly the actual disorder, the thing often dismissed as a modern, attention-seeking lifestyle choice, is really as old as history. So much for modernity. So much for stigma.