A Little More Time - Part Two

Saturday, February 16, 2013

This Life is Sweet post is a continuation from yesterday

The first sandwich I ate in six months was in a small room at the Ottawa General Hospital with five sympathetic women and a nurse. The Psych Ward housed not only the six-person inpatient eating disorder program – known as Symptom Interruption – but the rest of gen pop. Men and women with manic depression, bipolar disorder, schizophrenia and schizoaffective disorder roamed our halls, and because I was the only man in the six-patient ED clinic I shared a room with a revolving assortment of troubled gents.

I found one of my roommates standing over my bed one morning; for all I know he’d been staring at me the entire night. Another would moan and scream in his sleep as I lay awake, planning my escape. But I also met brilliant men who, after several days on the right medication, were as friendly and charming as anyone I’d met in my life. And the transformations were often startling; upon arrival, many would be inconsolable, screaming of unnamed evils and conspiracies, beating themselves in the head to alleviate the pain of intruding voices, of splitting migraines -- of their own impossible existence.

The person in charge of the eating disorder program was a charming man from eastern Europe who, like most consummate doctors, kept a professional distance from his patients. The nurses, however, all women, were my mothers, my caretakers and my therapists. I was in hospital for 10 weeks – two weeks longer than initially allotted – gaining weight and attending group therapy classes. I needed to reach a BMI of 20 – approximately 130 lbs– before they would discharge me.

The six of us, an assortment of people from across the province, each suffering from a unique diagnosis, would eat three daily meals, attend occupational therapy, cognitive behavioural therapy, dialectical behavioural therapy, weigh-ins, blood tests, movie nights and more. For over two months they were my best and only friends, my siblings and my crushes.

One of the side effects of starvation in men is a severe slowing of testosterone production. Although I have now returned to my pre-ED hormone levels, for nearly two years after my illness I could not ejaculate. For the first year I had no sexual desire, no need to masturbate or fantasize. As I slowly regained the weight I lost –too slowly, according to the doctors – I was able to recognize beauty in my fellow cellmates, but it was nothing more than an objective acknowledgement.

Though the therapy helped me gain an understanding of why people succumb to eating disorders – control, mainly – I had no insight as to how a simple diet so quickly morphed into a virulent case of anorexia. Meera was also anorexic, severely so, but most of the other women were there for more insidious and less obvious forms of disordered eating.

It was during this time that I learned about the four other types of disordered eating as recognized by the DSM-IV:

-          Bulimia nervosa: binge eating followed by purging, though the two are not always connected. Bulimics often follow a binge with a purge, but the former tends to be more common than the latter.
-          Eating disorders not otherwise specified (EDNOS): this is the newest entry into the DSM. It includes anorexics with bulimic tendencies; those who have disordered eating habits but are within a “normal” weight range; those who exhibit disordered eating tendencies of a different nature at different times such as periods of food restriction and starvation followed by periods of binging, or restriction followed by periods of binging and purging.
-          Binge eating disorder: compulsive overeating, “losing yourself” in eating food despite feeling satiated or nauseous. I later went through a period of binge eating and gained back more weight than I’d initially lost.
-          Pica: a compulsive craving for non-food items like chalk, paint, glue, etc.

Most people who entered the program were either anorexics or bulimics, but all of them, including me, landed somewhere on a spectrum. Disordered eating is about asserting absolute control over one aspect of life because other parts are lacking it. I now believe that I started regulating my eating because I was unhappy with the course my life was taking: I disliked my job and was overwhelmed by school. I was distraught moving home to the suburbs and was convinced that being thin and fit would bring me the happiness I craved elsewhere.

But it was about more than just control: anorexia can be likened to an addiction married to an obsessive-compulsive disorder. In the throws of my starvation, I rationally knew that I needed to eat in order to stay alive, but I was willing to let myself die so as not to disrupt a deeply satisfying compulsiveness. What began as a routine morphed into a regimen which became an anchor. I was no longer in control of my control; at some point my brain stopped functioning well enough to differentiate obsession from suicide. I clearly remember the point at which I gave up; I had decided to die because the way to health – nourishing myself – was a notion too unfamiliar to grasp.

Today it’s difficult to imagine going back there; even at my lowest, when I’m convinced things will never get better, I rarely consider restricting my food. But food controlled my life for nearly three years, as a functioning anorexic, as a non-functioning anorexic, as an inpatient, as an outpatient, as a binge eater, and finally as a survivor. The spectre of ED is so large, only my closest friends know what happened. That I am a man who went through and recovered from anorexia does not dictate whether I tell people, though it certainly complicates the situation.

Anorexia, and subsequently binge eating disorder, was about more than control. I was deeply dissatisfied with my life – both its present and its potential future. My parents had recently gone through an insipid, damaging divorce and my GPA had suffered as a result. I wanted to be a writer but was certain of failure. I hated my moodiness, my awkwardness, my inability to make friends. I was jealous of everyone, even the friends and loved ones who supported me as I lay dying.

Later, when I attended outpatient support groups at Sheena’s Place in Toronto, I was told never to refer to the disease as ‘my eating disorder’. It wasn’t something I willed, nor was it something I could fix on my own. But to this day I wonder, had I been more aware of what was happening to me, better educated about the disease and its effects, could I have prevented it? Does someone develop an eating disorder as one catches a cold? Or is it more insidious: was I predisposed to the disease, and depression, in conjunction with environmental factors, set it in motion? How much does one’s family history of mental illness play into the development of an ED, and why was it that I developed anorexia over manic depression or schizophrenia?

I am no neuroscientist, nor do I pretend to understand the correlation between genetics, environment and culture. I do know that I wanted to be thinner and found myself, six months later, nearly dead on the floor, a wasted mess, refusing to eat the apple I knew would save my life.

It took until 2009 before I stopped thinking about food all the time. It took falling in love to normalize my eating. And though I no longer restrict, I still evaluate what I eat in a way that many would consider disordered.

I want to refrain from judging the insidious culture that leads millions of women and men to certain self-hatred, but it should not escape unscathed. Though I am a heterosexual male, a member of the demographic least likely to develop an eating disorder in North America, I am one of a rising number. This disease in treacherous: it starts off as a meek cough and overnight turns into pneumonia. It kills people. It killed Meera.

Meera was one of my favourite people. She was so, so kind. When she was happy her laugh was infectious. When she hugged, it was with everything she had. I lost touch with her when I moved back to Toronto and re-entered the life I worked so hard to undo. I spoke to her a year before her death and she sounded as she always did – as we all did when we lied to ourselves – tortured by the certainty that she was out of control, and so painfully, mercifully, ready to die.

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