It’s An Illness

“There’s something about addiction. When it’s about the people we care about we call it an illness. When it’s about someone we don’t know, we just look at them like criminals. I’m supposed to know it’s always the former. WE have a disease. But, it’s a disease we can treat. That’s my 5 year NA chip. I’m more proud of that than my MD. I want you to have it.” ~ Dr. Savetti, Code Black – The Same as Air

This heartfelt line by Dr. Savetti comes after, earlier in the episode, he chastised a patient who came in seeking narcotics. Prior to this line, he had not revealed that he also struggled with addiction. He has a really good point that we often think of mental illness/substance abuse differently when it is someone we love versus someone we don’t know. Furthermore, as he says, doctors are supposed to remember that mental illness and drug addiction and illnesses. This is definitely not always the case. I have had several doctors tell me that I should “know better” when it comes to the eating disorder, as if it was a simple choice just to eat or not.

I can also relate to what he says about his NA chip. Recovery has proven to me to be far more difficult than medical or graduate school. I have heard others in recovery also say it’s the hardest thing they have ever done.


Every Day

From Mom Season 3, Episode 18 “Beast Mode and Old People Kissing”:

Adam: Where you going?

Bonnie: We’ve got a meeting.

Adam: You just had a meeting last night.

Bonnie: I know, but then I woke up today and I was still an alcoholic. 

I recently started watching Mom on CBS, and I love it. Of course I love Allison Janney in anything, but I especially like the way the show deals with addiction and recovery. It shows that recovery is hard work, but possible with support. It also shows that relapses can happen, but also that it is possible to get back on track.

Bonnie (the Mom, who is in recovery) has the above exchange with her new boyfriend. He doesn’t understand why she goes to meetings so frequently until she shows him a tape of her drunk and out of control at a wedding.

Just that one line “I know, but then I woke up today and I was still an alcoholic” says so much. I know that for me it is easy to forget that I still have to be diligent about recovery and following a meal plan. I will have a few good days, and then think “see, I’m fine, I don’t need this.” This happened recently when I went on vacation – I was so focused on having a good time on vacation that I put having fun first and following the meal plan second. My therapist said that is like an alcoholic thinking “I can just have a few drinks, I’m on vacation.”

While I know that my therapist is right, it wasn’t until I watched this episode and heard this quote that it really struck me. Every day that I wake up, I am still a person that has an eating disorder. I may be in recovery, but I still need to be diligent about recovery every day. This quote is also a good reminder that while in recovery it is ok, and in fact a good thing, to continue to ask for help, whether that be going to meetings, going to therapy, etc.


ER Season 14 Episode 5: Under the Influence

Janet: You drank? When? Last night. You want to get to a meeting?

Abby: I don’t have time to go to a meeting. I don’t need to go to a meeting. I just I had a bad day, a very bad day, and it was just one time. I’m not going to start drinking again.

Janet: Really? Are you an alcoholic?

Abby: Yes, but..

Janet: Yes, but? All those years that you were sitting in meetings, were you an alcoholic then? Yes or no? OK, keep drinking. Do the research, see what happens.

Abby: I can handle this.

Janet: Just let me know how it works out for you. OK, I’ve got a clinic full of patients.

Abby: Janet, Janet, you’re my sponsor.

Janet: I was your sponsor, but now it’s very simple. If you’ve decided you’re not an alcoholic, I can’t help you. If you are, I’ll be your sponsor again and I’ll support you in recovery. Let me know what you decide.

This conversation between Abby and Janet reminded me of an internal dialogue I have with myself a lot – debating whether or not I really have an eating disorder, and thus whether or not I really need to follow my meal plan. My therapist often likens restricting a few exchanges to an alcoholic having one drink. Much in the same way that Janet responds to Abby, if I restrict a little she tells me that I need to get back on track ASAP, that it is a slippery slope. Too often though, I rationalize, just like Abby is doing here. I say that it’s not a big deal, that it could be worse, and that I’ll get back on track tomorrow. Kind of like Abby, I say “yes, but…”. There is always a “but.”

Sometimes though, the rationalizing goes even further. I’ll convince myself that I don’t really have an eating disorder – I’m not underweight, I’m eating enough, I’m not overexercising or purging etc. Then, the logic goes, if I don’t have an eating disorder, why do I need to follow this meal plan? Why do I have to keep eating even when I’m full, or make sure to be diligent about meals/snacks? Normal people don’t eat the same amount every day, so why do I have to follow this meal plan?

The problem is, as Janet points out, this doesn’t end well. As she says, “do the research, see what happens.” Just like an alcoholic eventually starts drinking more than one drink, I start restricting more than one exchange. One exchange becomes two, two becomes three, and then those three never come back. I think Janet’s point to Abby is that she has to recognize that she has a problem and that she has to take certain steps (perhaps going to a meeting), to overcome it. In the same way, I need to stop rationalizing and accept that I need to follow my meal plan in order to achieve recovery.

My Brain Works Differently

I’m an alcoholic. I don’t have one drink. I don’t understand people who have one drink. I don’t understand people who leave half a glass of wine on the table. I don’t understand people who say they’ve had enough. How can you have enough of feeling like this? How can you not want to feel like this longer? My brain works differently. ~ Leo, The West Wing, Season 3 Episode 10 – Bartlet for America

I was watching this episode yesterday in anticipation of The West Wing Weekly podcast about it, and this quote really stuck out to me. Leo is talking about his experience as an alcoholic, but I can relate this very much to the eating disorder.

For most people, restricting their food intake is an adverse experience. They don’t have a chance to eat lunch or a snack one day, and they feel like crap and think “I am definitely going to make sure I have that tomorrow.” However, for me the opposite happens. I get this sort of high, and think “I want this feeling to continue.” I want to keep feeling that hunger, that emptiness. As Leo says, my brain works differently.

This is also why restricting is such a slippery slope for someone with anorexia. Just like Leo cannot have one drink, I cannot have one missed meal or snack. It just leads to more restricting. There are many days were I want to miss a little, and think it’s not that big of a deal. But if history is any indication, pretty soon that one exchange or one meal becomes two or three, and it just keeps on going. Why? Because as Leo says “My brain works differently.”

Talk To Someone

I have to give kudos again to Code Black for bringing up the important issue of mental health and therapy. The following exchange is from the Season 1 finale “Blood Sport”:

Angus: I killed someone, and now I can’t walk in here without thinking about it. The pills let me not think about it.

Mike: I made a mistake when I told you not to talk to anyone about this. I pressured you, and it made you think you could go around this problem. But you can’t go around it. You can only go through it.

Angus: How do I do that?

Mike: Well, for starters, we find someone you can talk to. Would you let me help you with that?

For the record, I have never killed anyone, but I can relate to what Angus says. I don’t abuse substances, but the eating disorder does the same thing – it allows me to numb out to things I don’t want to think about. No one ever directly told me not to talk to anyone about things, but for years I acted the way Angus has been acting – trying to go around the problem. I figured that if I just flew under the radar, that things would be ok. For many years, that strategy “worked” in that I stayed out of treatment, finished college, had a great internship, and started medical school. However, the eating disorder was always there, and eventually it caught up to me.

I have learned the hard way that what Mike says is true – you can only go through it. It really stinks, and there are many days where I feel like the “solution” is to quit treatment and go back to flying under the radar. But, when I am in a better place, I know that I can’t really live like that. I have to go through it.

Furthermore, I love what Mike says about talking to someone. I wish there was a pill that could fix the eating disorder, just as Angus wanted a pill to fix his mental health problems. But, therapy really is the way to go, and as hard as it is to talk about this kind of stuff, that’s what needs to happen.

Finally, the way Mike asks Angus “would you let me help you with that?” is just perfect. I think too often friends and family try to be the solution, rather than helping their loved one get help. Mike doesn’t judge Angus for using the pills, and he doesn’t try to fix him. He simply offers to be there and help him get professional help. Absolutely perfect.

What it Feels Like

I stumbled across this article courtesy of Facebook: The Jumble of Chronic Mental Illness

I just got back from vacation with a friend that I know from treatment, and we were both remarking at how we have “old lady” pill boxes.  I could also relate to where she says “Every therapist I have had (I am too embarrassed to say how many) has done some gentle prodding, asking if maybe I suffered abuse as a child, since many of my symptoms seem to align with those of people who have. I spent years racking my brain, trying to remember, wondering if there’s someone I could blame in all of this. In some ways it would be a relief to know that something caused all of this.”  I am very lucky to not have had major trauma in my life or a bad childhood, but in a way it would be nice to have a reason or a cause to point to.  Instead, I just feel guilty because I am still depressed in spite of having every opportunity a person could ask for.

These two paragraphs were my favorite: “I do not like being like this. But I have accepted it. It’s not like a cancer that you can fight, and maybe it will go away for good. For a long time I thought it was, and expended energy I didn’t have trying to draw a demarcation line between the illness and myself, pretending we were two separate entities. Now that I have accepted it as something that will most likely always be a part of me, it is easier…there are things you have to do to keep yourself sane that other people will not like or understand, and sometimes those people end up being collateral damage. On those days when your own brain is your mortal enemy, other people are going to suffer too. You can only apologize so many times, and it’s easy to understand that there comes a point where the apologies seem meaningless, where people assume you are just willfully fucking up again and again, too lazy or unconcerned to act differently. I’m not excusing the genuinely shitty things I have done. But there are things that were not my idea, and although it may sound ludicrous for me to say there are times when I cannot control myself, it’s true.”

Recently, I have been working on accepting that I have, as my therapist says, a “persistent” mental illness.  I am working on accepting that I may have to make accommodations in my life to keep myself healthy and out of the hospital.  I desperately want to be “normal” and be able to skip a meal or snack here and there, have nights where I don’t sleep much etc.  However, every time I do those things I end up back in a cycle of eating disorder behaviors and exhaustion.  So, I am going to have to accept that there are things I have to do to keep myself healthy, and also accept that I am not going to be perfect all the time.  While I don’t want to make others suffer (as she says), I also can’t just keep pretending that everything is fine all of the time.

Natasha Lyonne Interview

I recently watched “Orange is the New Black” on Netflix, and I highly recommend it to anyone reading this.  One of the actresses on it is Natasha Lyonne, and a few weeks ago I listened to an interview she did with this comedian Marc Maron on his “WTF?” podcast.  I also highly recommend listening to his podcasts.  They mostly involve him talking to other comedians/actors about their career and upbringing.  Since he is Jewish and is also in recovery from drugs and alcohol, he often talks about those topics with guests who are Jewish and/or have a drug use history, and his interview with Natasha Lyonne is no exception.
Here is a link to the podcast:
The actual interview starts around 12:20. The whole interview is worth listening to, but here are the parts that really stood out to me:
1) Around minute 37 she starts talking about how she admires people who can just be in the moment without trying to interpret every action/thought or overthinking “is this right? Why? What if it’s wrong?”  If you go back a few minutes she talks about how some of that questioning is related to her Jewish religious education, which is based around questioning and interpreting religious texts.  I have blogged previously about my tremendous problems making decisions and overanalyzing things, so I could really relate to this.
2) Around 1:02:30 her and Marc maron talk about how hard it is to stay clean. She talks about how she wasn’t really interested in getting clean at first, but after awhile she got more into it. This part really resonated with me because I still often struggle with being “interested” in treatment.  I want to have a life, but eating still feels like such a chore that most days I just not interested in doing it.  However, I am hoping that with time I will get more into it.  Marc Maron then talks (around 1:05:20) about how for him the urge to use subsided with time, and also the competition factor – how after having a streak of clean days he is motivated to stay clean because he doesn’t want to start back over at zero.  The urge thing really resonated for me with regards to purging, and I like the idea of using “I don’t want to start back over at zero days” as motivation if the urge gets strong.
3) He then talks about how moved he is by peoples’ stories with regards to addiction and recovery, and how people who have not struggled with something like this don’t understand that it’s not that easy to just stop (1:06:10). He says they don’t get that you are “fighting with a monster.”

4) Natasha then talks at 1:07:00 about hating herself, and they move on to talk about this idea that you are never quite good enough.  I also struggle with having ridiculous expectations for myself, as discussed here and here.  I’m lucky that my parents never pushed me like hers did, but I  do it to myself.  As she says, it’s the idea that “if you’re not exceptional, you are basically a waste of space.”  (just to clarify – I don’t think this about other people, just myself, and my parents never told me that, I just told it to myself).  Damn double standards.  Because I set that standard for myself I don’t relate to what she talks about next, which is how she rebelled against that idea, but it’s still interesting to listen to.

Happy Listening!