American Culture

Anorexia: I am still physically ill. You just can’t see it.

The brain = a physical part of you. Therefore, “mental” illness is physical illness.

I am weight restored, and I have been steadily maintaining this weight for months now.

My blood labs are all normal.

silhouette of a person highlighting the brainMy heart is beating at a safe rate.

I am eating a healthy amount of calories for my energy expenditure.

I can run, I can lift weights, and I do not constantly feel like I will pass out.

I can remember things.

I can eat a meal without trembling in fear.

I am grateful and proud of all the above statements — but less than a year ago, none of them was true. Less than a year ago, any person who saw me walk down the street would have told you they were worried I was going to collapse. I looked frail, sick, and hollow.

Today, those same people would tell you I look lively, fit, and strong. Today, I look healthy. Again, this is something I am extremely grateful for and proud of. However, I have come to realize that the appearance of health comes with certain expectations from others, and when these expectations are not met, it can be devastating.

My life is a carefully calculated regimen right now. Everything I do has a purpose. It doesn’t mean it will always be this way. It just means that right now this regimen is how I am able to manage my continuing recovery.

I can’t go always go out to a random restaurant because I am not comfortable with new or “unsafe” foods.

I can’t skip meals or snacks like some people my age do when they get busy. Usually, when they skip a meal, they will “make up” for those missed calories without even thinking about it (think Friday night pizza and beer). I know if I skip, my eating disorder won’t let me make up for it later. Skipping meals causes me to skip more meals because my eating disorder says, “It’s all or nothing.”

Sometimes I don’t get my homework done because my eating disorder has caused me to agonize for three hours over which shirt made me look fatter or whether a sweet potato is a “healthier” carb than rice.

I can’t run out of a food I routinely eat because if I don’t have it, I don’t eat. I am not always capable of exchanging a snack for something else.

When the stove in my campus apartment breaks and my roommates say, “It’s not the end of the world,” they don’t realize that it’s a big deal for me. I can’t eat at the dining hall, not just because anorexia caused me to develop several allergies and food sensitivities, but because I am scared of food I haven’t made myself.

I can’t eat the baked goods people make for me, even if they are allergy friendly, because I am scared of other ingredients in them.

I get panicked if I sleep in. I don’t like to sleep in. It throws off my schedule. It makes the voice of my eating disorder say that I am “lazy and worthless.” It’s obviously not true but it still causes me pain.

I have to take my rest days from the gym seriously. I can’t go on a hike or a long bike ride. I need to actually rest. If I don’t, my exercise habits are likely to spiral out of control. I think, “Hike a little longer, burn a few more calories.” Then a week later, I decide, “Why not just go running? Last weekend I hiked.” It quickly escalates.

I feel uncomfortable when people see me eat, ask me about my food, or make comments about my food.

The truth is, these things don’t worry me. I know that one day, I will be able to do all of them and more. If someone expects me to do these things with ease, though, I am severely affected. I become paralyzed, I feel sick to my stomach, I shake, I isolate from others, I get headaches, I can’t sleep. I get angry at myself for being “weak.” I think that I am inadequate. I think that I am failing at recovery.

I am not weak, inadequate, or failing. I am actively working on healing myself from a physical illness.

I appear to be physically well by most people’s standards, but if people knew about all the difficulties I listed above, they would quickly decide that I am not “mentally well.”

That is where the problem lies. To those suffering from anorexia or any other mental illness, the term mental illness is damaging because it carries with it the connotation that the illness is not physical.

Allow me to give a simplistic (and rather unscientific) anatomy lesson: The brain = a physical part of you. Therefore, “mental” illness is physical illness.

The takeaway?

1. If you are suffering from a mental physical illness, do not be ashamed of saying no. Do not be ashamed of inability to meet expectations. Do not feel guilt. Remember: the strongest thing that you can do is exactly what is best for you and your own wellness.

2. If you aren’t sick, try to understand that a mental illness is just as physical as the flu. Try to remember your friend could be suffering when they change their mind about your plans for the fifth time within an hour.

3. Stop saying: “mental illness.” We need to begin thinking of mental illnesses as we do any other physical illness.

Michael Nelson, a survivor of anorexia nervosa, is a journalism student at St. Bonaventure University. She writes at Your Mind Comes Too.

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