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Ana – Bulimia: The Never Ending Cycle , Age: 25

What have you struggled with? When did it become too much?

The Never Ending Cycle

October 24, 2009
Dr. E suggested I keep a writing journal along with the food journal, so here it is. She said to write about my progress (or lack thereof) plus anything else I want, and that it will be for my eyes only. I used to write in journals when I was younger, but opted out once I realized how much they brought my thoughts to life. Silly thoughts, dark thoughts, sometimes thoughts I never knew I had were all hastily materialized per blue ink scribbles. I soon learned that past me preferred to keep such thoughts from future me, and with that, the journaling ceased.
Today, the journaling commences.

October 26, 2009
I threw up today. I woke up knowing I would; not a single hint of doubt crossed my mind. I’m supposed to keep track of all the times I throw up and pursue possible motives, although I don’t know that there are any. My life really isn’t that hard, and I feel like naming “triggers” is just delegating blame. Have a bad day? Eat the problems away. Don’t like looking in that mirror? Try the toilet. Dropped a pencil on the floor? Go ahead and purge about it. And I do purge about it. I purge about this and that, every day.

October 30, 2009
Dr. E told me she doesn’t expect my habits to change overnight, and to not be discouraged on days like today, or like yesterday. She says once the new prescription kicks in (Prozac) that things should get easier. I’m finding it very hard to keep the food journal for reasons similar to why I couldn’t keep my childhood journals. Quantifying my binges makes me feel almost as sick as the binges themselves. I am aware that humans are not meant to bring so much food into their bodies. Before and during a binge my stomach has learned to disregard the concepts of “hungry” and “full,” and I’m not sure why.

November 5, 2009
Today’s therapy session brought up something I hadn’t thought about in years: when this all started. The first time I threw up was in the seventh grade. Recalling the details feels more like recalling a dream than an actual event that took place in a conscious state. It was in the bathroom sink, and I used a toothbrush instead of my fingers. The purge was both easy and painless, and I remember getting into bed that night thinking I had a new secret I would have to keep from the world. I lied down with a guileful grin, then drifted off into an effortless sleep. At the time, it was a solution to eliminating the perpetual discontent I had with my body. I thought I’d finally found the key to feeling more comfortable in my own skin. I felt I had discovered a covert loophole to the laws of physiology. Of course, it didn’t take long to realize that this wouldn’t be the incredible weight loss solution I had imagined (if anything I have gained weight since the cycle began), but here I am four years later.
That impassioned and temperamental middle schooler is worlds away from the young adult who stares back at me in the mirror now. Today I don’t ride the same emotional roller coaster. I don’t ride a tilt-a-whirl, or even carousel. I am stagnant in manner, aloof in presence. The anxiety and extreme self awareness we all encounter in our awkward pubescent stages had long been lifted, but nothing took their place. There is something quite magical about going through days uninfluenced by emotion. My ‘emotion log’ I was asked to fill out for Dr. E has the word “indifferent” written on Sunday, with an arrow leading it through the rest of the week. My boyfriend doesn’t get to hear the words “I love you” or experience any sort of sincere passion from my end. My friends are granted loyalty, honesty, confidence, but never genuine sympathy. My eyes don’t experience the swelling brought on by heart shattering tears, or by euphoric tears. I embrace the nothing. Nothing greets me every morning, then helps me sleep well at night. And through the years, my purges watched as the nothing slowly began to emerge.
Purges came long before the binging did. The latter was an inevitable aftermath. Once the two met, they linked hands, then chose my brain as their permanent place of residence. They haven’t parted with me since; they’re noisy and ornery and it’s impossible to forget them.

Nov 21, 2009
It’s been about two weeks since my last entry, and to be honest I’ve been avoiding writing in here. I told Dr. E I’m not fond of the journaling, but she says it might help me in the long run. I haven’t yet been given a reason not to trust her, so here is round two.
I threw up six times since Monday, and Dr. E said this is an improvement. I don’t exactly agree. The urges are just as bad, if not worse, and without them subsiding I don’t feel improved at all. For me, the urges are the worst part. Once one is triggered, it doesn’t go away. The urge to eat everything in plain sight takes over my thoughts until it is satisfied. This leads to the next urge, one just as strong, to relieve my body of every last bite.
I’m not proud to admit, even if it is just to future me, that I’ve relieved the urge in places outside of my own home. If the first hint of compulsion cannot be overcome, the cycle must reach completion. I’ve thrown up in friends’ bathrooms, I’ve thrown up in school bathrooms. One time I threw up in a bush in the backyard in the pouring rain, just to make sure I relieved the urge without my family hearing.
I really don’t like writing in journals.

Nov 24, 2009
I didn’t ever plan on going to therapy. I knew I had a problem, but I was convinced that I could stop the purging whenever I felt like it. I was convinced I was in control. I didn’t make a connection between the eating issues and my degrading emotion for a long time.
In the ninth grade my mother heard me throwing up. She called me into her bedroom after the fact and sat me down. I remember being caught off guard by her reaction; she wasn’t upset or worried, but rather angry and disappointed. In her eyes I was a young tenacious warrior, resilient to the petty pressures of adolescence. “This has to stop now,” she told me, “you need to be stronger.” I nodded and went to bed.
I didn’t receive any follow up questions or check-ins after the incident. The issue was brushed under the rug, and I couldn’t have been more relieved about it. The only thing I hated more than having the problem was talking about it.
Then one day, two years later, I finally recognized that hiding the problem wasn’t helping make it disappear, and that talking was my only other option. This time I called my mother into the room and sat her down. I admitted to my continuous struggles with the binging and purging between hysterical sobs. She cradled my shaking body, holding my head close to her heart. My mother may not have been able to identify with the problem, but this time it seemed as if she sincerely understood and accepted her daughter’s indecent flaw. Those were the first tears to escape my eyes in over a year, a prolonged imprisonment of emotions begging to be let out. I let them all out. A week later I found myself in Dr. E’s office.
I was nervous for my first day of therapy, as I had never talked to anyone about purging, let alone a perfect stranger. My mother offered to accompany me to the primary session for support. I accepted this offer.
I am at a loss for words to appropriately describe the feeling of having my mother in therapy that day. She had to hear her perfect little angel confess to the purges, describe them in their utmost detail. She had to listen to me define what a typical binge consisted of down to the last calorie. She took this all in silently with a blank face, and I have no idea what went through her mind. My voice trembled as it filled the cumbersome office air. It was the first time I’d verbalized any of this.
I was relieved when I first met Dr. E. My first impression was that she was very amicable, a good seven inches shorter than me with ivory white hair and a truly sympathetic demeanor. When I attend our weekly visits she listens thoughtfully and intently for the entire sixty minutes. She often wears a smile, which helps me feel relaxed. Her face is aged from a lifetime of grinning and laughter. In one of our earlier sessions we discussed the option of me going to a month long rehab clinic for other ‘bulimic’ adolescents where they’re given communal meals and daily therapy. I declined this offer, but it is still on the table if I decide I need the extra help. Judging by my food diary for this past week, it is still a viable option.

Nov 29, 2009
Today I was in math class when something happened. The back of my head began to swelter and pulsate, my vision blurred, and I lost feeling in my hands. I felt my brain liquify and begin to drip, drip, slowly down the inner lining of my skull. I became both unaware and hyper aware. Time stood still. I watched myself from a place within my own head, but also from a place thousands of miles away. For those few moments I was certain I was going to die. Once my legs were able to bear my weight, I stood up and walked out of the classroom. I paid no mind to the rest of my peers or the teacher. I had no mind to pay. I sat in the school bathroom until I was physically able to conjure thoughts and words, and to call my mother. Even though the hysteria was descending, she offered to pick me up if I didn’t feel comfortable staying at school. They say the crazy don’t know they’re crazy, but anyone who’s experienced this delusional reality can say that for those brief minutes, which feel like days, they are crazy. I left early with my mother that day. And for the first time in a long time, I was scared.

Dec 4, 2009
Dr. E isn’t surprised about the panic attacks. She says they’re probably a consequence to letting a lot of demons surface by talking about my struggles for the first time. Her words don’t help me because it doesn’t make them go away. She says only I can make them go away, but it’s difficult to believe her.
They have been coming out of nowhere, an abrupt assault of my most guarded possession: my mind. It is such a dreadful realization that I am no longer in full conscious control of my mind. At any moment, something beyond my scope of awareness can prompt its kidnap, and I am left to deal with the consequences. I don’t know where I’ll be when they come, and I am still not convinced that they’re harmless or temporary, so getting out of bed has become a real drag.

Dec 24, 2009
It’s been awhile since my last entry, and things are actually a bit better. The Prozac has finally come into full effect and has helped me more or less regain control of my psyche. I can now feel when the panic attacks are coming on and sometimes I can even make them go away before they fully surface. With the panic becoming my main priority, the binging and purging have taken a backseat in my mind.

Dec 27, 2009
Today I met with a nutritionist. Dr. E suggested it be the next step, since the frequency of purging has gone down, along with the urge. My older sister Maya asked to accompany me. My parents have always viewed her as the fragile, over-emotional daughter, while I was thought to be more stable and calloused. Maya, too, had problems with throwing up at my age, but never sought help. I admire her for being able to get through it on her own, something I could not do. Despite the dichotomous character roles assigned by our parents, I believe she is much stronger than I am, although she says she wishes she would have spoken up and gotten help like me.
The nutritionist gave me a couple of tips on how to eat healthy and to avoid food deficits because they trigger binges, which are followed by purges. She had a bunch of plastic food to help visually represent meal portion sizes. I’m pretty sure they were from those kid kitchen sets, so I couldn’t really take her seriously.

Jan 2, 2010
Since the cycle was broken, it really hasn’t been as hard to keep it that way. I’ve heard the first three days of being cut off from an addiction are the hardest, and then it slowly gets easier. As horrible as panic attacks are, they may have been just enough of a distraction to get over that initial three day roadblock, a blessing in disguise. I haven’t thrown up once since my last two entries, which may be the longest I’ve gone since the cycle began in seventh grade.

Jan 6, 2010
I have just finished my final scheduled therapy session. Dr. E agrees that I’m strong enough to no longer need sessions on a regular basis. Now that I’m not throwing up anymore or frightened with panic, we’ve honestly ran out of things to talk about. I never thought there would be such an abrupt end to such a perpetuated problem. The Prozac has helped with more than just controlling the cycle and panic attacks; I also feel less like a robot and more like a human being. I feel it has almost been too easy.
So, I guess this means bye bye journal. You’ll be going into the box in the garage along with the rest of them. You may have served your purpose these past couple of months, but now that my journey is ending I prefer to keep you with the rest, where I don’t have to see or think about these things anymore.

What’s your life like now? What have you been able to accomplish, and what are you working towards?


Flipping through that journal so many years later fills me with mixed emotions. It brings me back to a time I hate to remember, but a time that is still relevant to me today. I wish I could say that hiding the journal meant closing the door to these problems, but over the years I’ve learned that it doesn’t. All my former struggles with the cycle creep up from off those pages, slither under doorways and around corners, then silently make their way up my unsuspecting body and into my head. I can go weeks, or even months feeling carefree, and then an urge will hit me, the same urge that has always hit me.
I would be lying if I said I could always suppress the urge to throw up again. I have had occasional relapses within the past years, though never as serious or prolonged as the original problem. I do still feel like an addict. As the years progress, I become more confident in my belief that bulimia is a real addiction.
When the urge surfaces, just as in the past, a switch is flipped in my mind that is much more difficult to turn off than to leave on. If left on, I stop thinking clearly. I get anxious and aggravated with the people around me. All I want to do is follow the same cycle I’ve grown accustomed to, and then the urge, with all the negative passion it brings, will go away. First, I eat. A lot. Then, with two fingers, I unearth the lowermost point of my emotions, as I reach the pit of my stomach. There, I find shame wearing relief’s disguise.
Thankfully, I usually do manage to switch off the urge when it first surfaces. Although, this isn’t quite as satisfying as it may sound. It leaves me with somewhat of an empty feeling that must slowly be forgotten throughout the course of the day. This feeling, however, pales in comparison to the awful feeling that overcomes me after a purge.
For every urge I’m not able to overcome, I tell myself that it will be the last time. I come to this false conclusion where I am certain I’ll remember how horrible that awful post-purge feeling is, and that I’ll never want to endure the same guilt again. The guilt of being too weak and hurting my body. The guilt of making a mess and wasting food. There is enough uncontrollable guilt in the world, and by relieving my urge, I add to the pool.
I used to not understand what perpetuated the cycle. The yearning to be thin would never be satisfied by this habit, which was something I learned soon after it began. There was instead something else, a different driving force only wearing the mask of addiction, which strongly persisted to be met. Addiction starts as a means to catch a high, but over time becomes the only feasible method of coping with life. The neurosis that built around the habit acted as a distraction from dealing with thoughts and emotions I felt powerless to. Addiction stands in for control, but it is nothing more than an illusion.
Throughout the years, the panic attacks have mostly retreated, along with my dependence on the little white serotonin boosting capsules of Prozac. It’s been a slow process, but I’ve been able to better accept emotions of all kinds as they initially arise. With a passion for love comes the pain of disappointment, and the thrill of risks brings the anxiety of failure, but in the end, living life makes much more sense to me in the context of emotion rather than the indifference I had once chosen.
Even with all the positive changes, I know I still have a lot of growing to do. I’m confident that, while I don’t think the urges will ever fully dissipate, they will continue to fade away and become easier to recognize and deal with as I become older and wiser. I am confident that one day I will be able to embrace my emotions fully instead of feeling the need to control them, or hide them behind a mask of binging and purging. I am confident that one day, opening the old journals won’t be such a dreaded experience. But, until that day, they will remain in that box.

The only thing I hated more than having the problem was talking about it. I finally recognized that hiding the problem wasn’t helping make it disappear, and that talking was my only other option.

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