Going the extra mile: Life with Anorexia Athletica

23/06/2014 at 05:45 (Anorexia, Personal) (Anorexia, Anorexia Athletica, Blogging, Eating disorders, Exercise addiction, Kick-Back, perspective, psychological, Responsibility)

With parents who had both served in the RAF, I spent my early childhood accustomed to a spotless house and routine lifestyle. This may not be the case in every such military household, but it was standard practise in mine to meet expectations fairly sharpish. We visited outlying family members each weekend when living in the UK, and spent holidays in the north with my Ma’s side, in Cheshire. Yet each situation would find me traipsing off at some point, to be alone, when the colours of each voice got too bright and the company too claustrophobic. I loved them all dearly, but there is always a need to be silent and still when irritation begins to itch behind the eyes. This generally meant hiding behind a floor-length curtain with a book, or clambering up a tree in the green-black woods surrounding my paternal Nanna’s home, or beating a path over the gorse and purple heather on the moors.

To be alone, was to dictate my moods and follow my own thoughts. For the most part, I was left to it – better this than to deal with a fractious and hyperactive child. From my first year to around age 9, I had suffered with universal eczema, and was hospitalized with red-raw skin while we were stationed in Germany. The bandages wound about my fists had not been protection enough; my nails sought out the ant-sting itch that seemed to go as far down as my bones. But for all that – or perhaps because of that – I was lively, over-eager to get into everything, and drove my parents to distraction with the energy of about three children rolled into one. It got to the point where, for fear I would never sleep at night (though nursery school would find me curled up and sparko on the reading-carpet), my poor mother was advised by the doctor to give me a mild sedative around bedtime. Anything to keep me calm, so that the frail skin under my bandages would heal.

Wandering off down the heat-cracked pavements, I didn’t give a thought to leaving a note behind for my parents; besides, I couldn’t write much English at the time. This absent-mindedness went on well into double-digits, until I grew old enough to care about such things as consequences, and other people’s feelings.

But until that point, there were mugs left on my windowsill with old apple cores stuck inside, and books strewn across my bedroom floor. There were midnight-wanderings with no shoes on my feet, to leave dark trails of mud and mulch on the carpet with my return. When asked to help with housework, or to wash up, or to get my homework in on time, I simply rolled my eyes and – as with most things that involve responsibility – wandered away.

Retrospect is a bitch.

Then came my parent’s divorce, and the breakdown of our family unit. Long silences, which weighed out heavy as tarpaulin full of rainwater. My ignorant behaviour became more than just an irritant, then. I will never forgive myself for making the already-fractured lives of my family, that much more difficult. As it was, something dark was crawling out of my mind.

Solitude became isolation.
Creative flare became stagnant silence.
Running for pleasure became training to die.

I turned in on myself, full of hate and guilt for the things I had done (or more comparably, not done). Each moment I was awake and alive, was spent going to every conceivable length to make amends to people … Or so I told myself, and keep on telling myself.

When an anorexic cooks for people, she will not feed herself. She will appear to be catering for the needs of others, while simultaneously denying herself nourishment. “Some persons with eating disorders may get vicarious pleasure from watching others eat, and enjoy being in control while others give in to the fattening foods.”

Whatever symptoms of anorexia nervosa and anorexia athletica – its compulsive-exercise counterpart – are made apparent, their instigation seems to stem from the same source: a desperate cry for order and control, in the face of chaos, emotions which cannot be expressed in words, or trauma. I cannot speak for every sufferer, but I was well aware – even while being admitted as an inpatient – that with the push-pull of Self vs. the Illness, I wanted someone else to take the reins for a bit; to take the onus off me. If I was forced back to health with the threat of being sectioned, I could (reluctantly) cede, and tell myself / the eating disorder, that I’d had no choice.

Then again, there was still the hot-eyed denial.
“Leave me alone. I’m doing just fine. I’m being healthy – isn’t that what everyone wants, to eat well and exercise? Stop trying to control my life.”

Always, other people’s opinions mattered more than my own.

***

Twelve years down the line, I am slowly extracting myself from the obsessions and neurosis that had fed into the cycle of subsequent compulsions, which in turn had strung up my life on an exhausting loop of starvation and over-exercising. To be perfect wasn’t really the goal; only to be strong, to put up a decent image of mental and physical independence, with the parallel hope that if I trained hard enough no one would want (or be able) to hurt me again. To block out all emotions, meant I didn’t have to give a damn about anyone or anything; the paradox of this being, I cared all the more with every kilo lost, so that the obsessive cleaning and silently-passive behaviour, were my compensation for the shitty attitude of my teens.

I would take that 20-year old by the hand now, and tell her that every adolescent acts up. But I still don’t think I would believe myself. We would end up laughing at each other, with a hollow sound.

I knew a girl on one inpatient ward who, when not required to, would not move an inch. She reluctantly joined us at the dining table, crawling through each meal and snack, until our spines were rigid. The system worked with peer pressure – a calorie drink would be issued to anyone did not or could not finish eating within a set period of time. While this may seem severe, it was essential for regulating the fear that was trying to grind us all down, and to re-teach us how to eat at what may be deemed an appropriate pace, before the food got too cold and was wasted. Aside from this habit, the girl engaged in no more behaviours that might “buck the system.” But to try to get her out on a group walk, or into any kind of physical therapy, was a wasted cause; she would curl into a ball and hide. The same thing tended to happen when she was called upon to express an opinion, on pretty much anything. She was a living shadow, a restrictive type of anorexic.

I was, on the other hand, what the doctor called a “purging type” – which basically means, I restricted calories but also used methods to be rid of them. In this case, exercise came to the fore – and believe me, I played that “I was hyper as a child!” card, as well as “But exercise is good for you!”

Which is true. But, as with anything, too much activity can be a bad thing, whether an individual has an eating disorder or not. Top athletes may work through sustained injuries, only to lose out in competitions due to lack of rest.

Put into the context of an eating disorder, compulsive exercise can be deadly. Which is why I find it startling that the illness is not yet recognized by mental health standards, considering its prevalence among athletes who engage in sports that necessitate a small body / lightweight frame. Training is bloody hard work – so is competition. I once danced ballet, and am well aware of the pressure to stay linear, to appear at once made of steel wires and seashell. To stay in control of racing thoughts, to quell any emotional reaction that might get in the way, I have always resorted to exercise.

That girl was, perhaps on a subconscious level, taking back control in whatever way was available to her, while steadily refusing to lift her voice. I was told by one member of staff that I ought to take notes from her, since it was usually my heels heard thrumming up and down on the thin carpets, pacing away the calories that were supposed to make me well. In practising this illicit exercise, I prolonged my stay on the ward. I wasn’t ready to relax my guard, to admit that the exercise I deemed “healthy”, might actually be doing more harm than good. For a person of well mind and body, such levels of activity would be a positive thing – but I simply couldn’t see my own fragile state. I thought the government guidelines for daily levels of activity in adults, should apply to me too – and then some.

I couldn’t understand how that girl managed to stay so still while so full of food, as I was; with a racing heart and shaking hands, full of (what seemed to me) useless energy, that might well have gone towards a bloody hard run outside. It was for this reason that I was taken off of group walks, and put onto 15-minute checks. My blood results kept coming back with low glycogen and haemoglobin levels – all relating to a low weight, in conjunction with compulsive exercise. The staff tried to keep me alive, while I systematically tore my room apart in a blue-black rage.

Now, twelve years down the line and with a broader perspective of health and experience, I think I know where that girl was coming from, and why the staff were so desperate to keep me still.

Anorexia Athletica – or Hypergymnasia / Compulsive Exercise Disorder, as it is sometimes known – occurs when an individual participates in levels of exercise that may be deemed excessive in light of its effect on social, physical and emotional aspects of life. When a woman takes an evening spin class in favour of sitting before the TV, this is a positive move away from a sedentary lifestyle – particularly if she has been inactive during the day.
But if the same woman takes a spin class in conjunction with not eating enough calories to fuel the exercise and as part of a rigorous training program / in favour of socializing / because she feels “fat/lazy” without the activity, then there are underlying problems, based upon a negative cycle of thoughts —> obsessions –> compulsions.

Post-hospital, my GP referred me to a local sports club to build back up my bone mineral density, skeletal muscle strength and cardiovascular health – though the latter wasn’t such a priority, since it would involve aerobic activities that tend to promote weight-loss, as opposed to the lean-muscle gains he wanted me to make with anaerobic exercise.
My mother was horrified.
“Surely that’s the worst kind of environment for you?”

She may have been right, at least in the early days. I was still fiercely competitive, and watched other gym-goers with the burning eyes of one who knows she can – must – do better. I abused the control that had been handed back to me, by over-training on just about every machine available. Unable to sustain the calorie intake prescribed while on the ward, my weight dropped, and with it my mental health. I stopped attending outpatient therapy, since I was determined to do things “my way” this time … and couldn’t conceive of the fact that what I was doing was in fact, wrong.

Needless to say, the fitness staff and my GP soon amended my view, and took a very stern hand. I was faced with a) Quitting the gym and the A Levels I had recently returned to, and going back on the inpatient ward or b) Listening to staff, and allowing them to take control by plotting out a very basic training programme, aimed at weight gain with the use of resistance machines – while keeping me well away from the treadmills and cross-trainers.

I conceded.

A few years later, working in a health spa, I was sent on a free course for training as a fitness instructor. I had no intention of taking such a role, but the experience proved to be of incalculable value for someone in my situation. I was given the chance to come at the obsessive-compulsions and rigid ideas surrounding exercise, from an entirely different angle. The course focused on the figurative dissembling and reassembling of the human body; on a four-day fast track, we learned the names of every single bone and muscle, their connections to one another and relevant exercises to work them to optimum strength; as well as finding constructive ways to balance mental, emotional and physical health (breaking this down to relationships, employment, leisure time, etc.) It was the equivalent of taking a clock apart to see how each part of the mechanism works, before putting it all back together and listening to the familiar ticking, with an awareness of what to do should something go wrong inside.

If seeing the DEXA scan results of my spine while in hospital was a tap on the shoulder, then that course was a kick up the backside, to keep going. I finally twigged what I was doing to my body – to the bones, muscles and internal organs. The knowledge frightened me, and broke another of anorexia’s chains.

However – there are still restraints. I am not completely in the clear. The crunch-point always comes when I try to take back control by refusing the voice in my head, if I wish to engage in other activities (socializing, dining out, writing.) It’s then that the Panic Button is pressed, with attacks of this kind never a fun experience. The results are invariably worse when there is an external force involved; then, my mind will go into a white-out lock-down. The blinkers will go on, and I become irrationally angry, frightened and desperate for escape.

I once elbowed my way out of a conference, because the press of bodies around me – the sound of all those voices – was too cloying. It felt as though my movements were being restricted, and I had to get out.

This is the reason why, since hospital, I have refused every job that does not involve some physical activity – the livelier and more structured, the better. Weight-training appeals to me on the same basis – the force of the movement vs. the control it takes to lift and lower smoothly, appeals to my nature. However, this does mean that I have put on weight. I must confess to you all that I am terrified, every time I look in a mirror and see this evolved adult form. It feels as though I have lost control; as though I have “given in”, though to who or to what, I couldn’t tell you.

But on the flipside, I am thinking more clearly than has been possible for over a decade. I’m writing this confession down in an article which, among others, I would not have dared to put into print. Not even for the fear of other’s opinions, but for the fear that anorexia would somehow “punish” me.
Now, I have creative sparks that give the same dizzying rush as completing a decent run.
I can wake on a golden Sunday morning, and not immediately leap out of bed to go and do Whatever. Lie-ins are a revelation.
And I have known love.

I wouldn’t have any of these things, had I not gained weight and recovered my health. That being said, it’s also essential for anyone in recovery to have therapy run in tangent with weight gain, to offset the inevitable mood swings and to provide a vocal outlet, as opposed to a physical one. Which is one of the reasons why I have gone back, after ten years without speaking to a professional about what is going on inside.

Still, there is that last wraith of the illness, hovering over my future with its sunken sullen eyes, and a malevolent whisper.
You’ll be unhealthy, if you slacken off the exercise.
Look at all the muscle gains you’ve made (oh it’s cunning, isn’t it) – do you want to see that turn into fat?
But why does it all have to be so black and white?
It never has an answer to that.

My world now, the world of a synaesthete (this too has become more apparent, with improved mental health), is alive and vivid. It is populated with people, some of whom I care for and who care about me; others who couldn’t give a damn, and that’s fine too. I don’t need to please them, or to gain their attention.

There are days, usually after insomniac nights, when I am plagued by self-doubt and the need for reassurance, for someone else to take the reins. Other times, I am red-black with anger and fear, after someone has overstepped a mark and seemingly taken more from me than they deserve –
A look
A word
A hand on my shoulder.
Get. Away. From. Me.

But as a male friend recently brought to my attention, not everyone is out to get me. There are lives, experiences and emotions behind every word and action. A look may not be a leer. A word could be something other than flirtation or slander. A brief touch, is not immediately a desire to control my movements.

Which is what it all comes back to, I suppose. The sexual abuse in my teens, changed me in ways I am only now starting to realize, let alone understand.

But he was right, and I was humbled by his mild words. This passive-aggression is exhausting (adrenalin only runs so far), and is by turns infuriating, upsetting and off-putting for others. Now, with the new therapist, I’m working towards being less reactive, while simultaneously trying to break the last rigid routines around exercise compulsions. I want to try different careers, perhaps to work in foreign politics; to travel, to see the world as I dreamed I would in childhood, when things were so much easier. When wandering off down a sun-struck Mercy Street, veering off the beaten track of humanity and following cats around corners, was as natural to me as blinking, breathing.

To trust everyone at first glance would be a mistake. But to constantly prejudge people based upon personal experiences, would be a far worse outcome. My hope is that if I start laying off on myself about things that cannot be changed, then perhaps I’ll ease up on others, too.

Which is where I’d like to leave you all, with this thought: Where does the buck stop? When do we start taking responsibility for our own thoughts, actions and reactions? The obsessive-compulsive cycle cannot be based upon the future, because it is stuck in the mad rush of instant relief – before the fear comes creeping back in.

Recognizing the problem and asking for help, are the first steps forward. The rest is your own open road.