This recent post by my friend Sarah Ravin got me thinking. She writes
Like many psychiatric illnesses, eating disorders are often characterized by periods of exacerbation and periods of remission – a general waxing and waning of symptoms at various times. Symptoms may or may not be present at any point in time, but the predisposition is life-long. Stress of any kind has the potential to trigger a setback or a relapse.
We all have stress in our lives. Some stress is unavoidable, some foreseeable, some self-imposed. We can’t really predict or control certain major life stressors, such as natural disasters, car accidents, or the death of a family member. But we can control some of life’s stress – we can decide whether and when to make certain major life changes.
It's something people didn't really explain to me when I was sick. I was discharged from IP and, while still underweight and basically a raving lunatic, encouraged to go back to school since "it would be good from me." I made it less than two weeks before my school told me to leave or I would be kicked out for being a danger to myself.
Barely holding a normal weight, I went off to grad school. I hung on by the skin of my teeth, since I didn't want to repeat a one year program. Instead of consolidating my recovery, I took a high pressure job. I lasted months instead of weeks, but still, the anxiety, depression, and anorexia caught up with me again.
Yet from the outside, most people judged me "ready." My weight was (what everyone thought was) "normal" and I could spin a good tale. Sometimes, I actively bullshitted people. Mostly, I really did believe I was ready. Patience is not my strong suit- never was, never will be.
The problem is how I was measuring "ready." If I compared how I was doing at the time to how I am at my sickest, I had made heaps of improvements. But if you measured "ready" by how able I was to cope with life when life went pear shaped, then you would have had a different measure. Weight and behavioral stability are important, yes. I'm not doubting that. But that's not the sole definition of "ready" to move on to more of life's challenges.
The biggest hurdle for me was learning how to ask for help, and seeing my ED as a problem rather than a solution to whatever other problems were in my life. I had to be knocked on my arrogant ass, again and again and again until I finally got it thatI could only fake recovery for so long before everyone would find out. I had to risk appearing marginally stupid in the beginning to keep from looking like a complete jackass several months later.
The other part that took me a really long time to understand was just how long it takes to build new neural pathways and new responses. I seriously underestimated that. We're apt to see one meal eaten without a meltdown as I'm cured! So how about that college thing? I needed to eat three meals and two snacks each and every day for several years before I could reliably do it on my own.
I suck at behavioral and cognitive flexibility. What this means is that as long as life is chugging along, I can do just fine. Low stress, and I might almost appear normal, even to seasoned observers. Stress and change and all of the other uncertainties that life brings, however, made all of that fly right out the window. Life does generally settle into a cadence after a period of stress, and it was easy to think that I would manage just fine. Except I really didn't. Stress and anxiety meant eating disorder behaviors in my brain, and disconnecting the two things took years for me. I still have trouble with it. I'm much better at catching it and halting it than I have ever been, but the connection is there and probably will always be there, lurking.
The moral of the story is this: recovery is stressful enough. You don't have anything to prove by trying to cure cancer or whatever while recovering from an eating disorder. Master recovery first. Once you do that, everything else will seem really easy.