How Antidepressants Helped Me Beat 20 Years of Anorexia
I'd resisted medication for years, but treating my underlying anxiety and depression allowed me to finally deal with my eating disorder.
Strangely, it wasn't a desire to lose weight that sparked my nearly two-decade battle with anorexia. It was that I just didn't want to gain weight. I was 12 years old and didn't want to outgrow my expensive cheerleading uniform. If that seems like a small thing to cause such a big illness, all I can say is this: It didn't make any more sense at the time. No one in my house dieted. No one made fun of me for my body. No one ever told me that I was fat. But I did, it turned out, have a strong family history of depression, anxiety, eating disorders, and other addictive behaviors.
The Beginning of My Eating Disorder
The why of my anorexia quickly became less important than the how, though. I became hyperfocused on food and exercise. And not only was I successful in not gaining weight, but I quickly started to lose weight, starting the vicious cycle of weight loss and obsession that is an eating disorder. In seventh grade, I lost a third of my body weight. I'm still somewhat surprised that I didn't die.
My heart palpitated all the time. I fainted a lot, and my hair was falling out. But my eating disorder was also about so much more than weight. Controlling my food felt like a way to control my life-and a way to deal with chronic anxiety and depression. My parents forced me to see a counselor, but no one in our small town had any experience treating eating disorders, and she had no idea what to do with me. I lost more weight over the months I saw her.
Because I had always been a very active, athletic kid, when May rolled around and my school held softball tryouts, I signed up. I had no idea how impaired I was. I thought I'd go out there and be the starting first baseman-just like always. But at tryouts, my body was so wasted that I couldn't run around the bases. A teacher pulled me aside, yelled at me, told me that I was a liability to the school, and there's no way I could play. I wanted to play, so I tried to force myself to start eating more and gain weight. Unfortunately, the anorexia already had a grip on me.
A "Model Student"
On the outside, I looked like a model student. But in truth I was a high-functioning anorexic. I would gain enough weight so that my appearance didn't disturb people. I would get top grades, work a job, and volunteer-all while my eating disorder ruled my life. I have often wondered how different my trajectory of illness would have been if I hadn't been able to fly under the clinical radar so well. Perhaps if I hadn't been so "high-functioning," I would have got the help I needed sooner. For example, I got a perfect score on the SAT during a period in which I was consuming around 300 calories a day and exercising for hours. People desperately wanted to believe I was fine. I did my best to convince them I was.
But the truth was, I was not fine. Not at all. By college, my body started to show the effects of years of starvation and over-exercising. I had multiple scares with my heart, stress fractures, osteoporosis, and major dental problems (those are just some of the side effects that come along with an eating disorder). Not to mention I'd catch every cold that went around because my immune system was practically nonexistent.
Finally, after a terrifying scare with my heart where I thought I might actually die, I started seeing a psychologist. I really clicked with her. She was the first person I felt really understood what I was going through and how to help me. She started me on a form of therapy called cognitive behavioral therapy (CBT), which really helped. I honestly believe she saved my life. But then I got accepted to a master's program in a different state and had to move away from her.
For the next 16 years, I repeated the cycle: Lose weight; have a health scare that would motivate me to change; gain weight (although never enough to make it out of the "underweight" BMI category); then become anxious and return to my obsessive, ritualistic food and exercise patterns.
A Turning Point In Recovery
In late 2014, my grandmother-who helped raise me after my mother left an abusive marriage when I was 2 years old-passed away. Her death skyrocketed my depression and anxiety. On top of that, I had to go to another country for six months to collect data for my doctorate. While overseas, I automatically turned to restricting food and amping up exercise to exert control over one single thing in my life: my body. I spiraled into the worst relapse and lowest weight I'd been since I was a teenager.
I was getting weaker, more anxious, and more unstable. It was like being in an abusive relationship-and my abuser was my own brain. I was losing my grip on my relationships, my research, and my career prospects. It terrified me. As soon as I got back to the U.S., I sought treatment.
Back home in the U.S., at age 29, something hit me: I realized I'd never fully committed to recovering. If I wanted a full recovery, I was going to have to do things different-things that felt really scary. For one, I had always been resistant to any form of medication, even though every practitioner I saw recommended medication for my anxiety. I would refuse, telling them that I didn't want to risk side effects. But my biggest hesitation was actually that the medication would change my metabolism-and make me gain weight.
So this time I finally agreed to try something different: a selective serotonin reuptake inhibitor (SSRI) antidepressant called fluoxetine (Prozac). (Did you know only half of antidepressant prescriptions are actually for depression?)
It can take almost two months for SSRIs to begin to take effect. To be honest, I didn't actually realize the changes that were taking place at first. My boyfriend at the time was the one who commented on how much less anxious I was and how much more calmly I reacted to challenges. Once I noticed the changes myself, they were much welcomed. The way I described it to my mom: For so long, it felt like there was a hurricane of thoughts constantly consuming my cognitive space. With the Prozac, I was the same person but the background static softened to an occasional breeze.
It was life-changing.
Once the meds calmed my brain down, the recovery I'd sought for so long became infinitely easier. Changing my caloric intake or exercise regimen-and ultimately my weight-didn't result in overwhelming panic and all-consuming anxiety. I hadn't even realized how unbalanced my brain was until I was finally balanced out.
There's No Such Thing As a Cure-All
Prozac has not fixed all of my problems. Years of ingrained thought patterns don't go away overnight. I continue to see a psychologist and a nutritionist. I still have bad days too. But finally getting my anxiety and depression under control broke the chain between having disordered thoughts and feeling obligated to act on them. For the first time in over 17 years, I'm not obsessively tallying and re-tallying calories, weighing myself all the time, constantly body-checking, abstaining from social events to avoid challenging food situations, or skipping the rest of what life has to offer so as not to disrupt my workout schedule.
I am, instead, finishing my Ph.D. I plan to become a professor and hope to work as an advocate and activist for awareness about mental health issues, especially among students. Teaching and mentoring brings me more joy and fulfillment than anything else, and being a healthy and energetic role model to students is a big motivation for staying in recovery-something I never thought I'd have, much less be able to share with others.
For the first time since middle school, I'm actually living like a real person.
I couldn't be happier.
*Name has been changed