On turning 40

Tomorrow I am going to turn forty. Those who know me know that I have been looking forward to this birthday for a couple of years now...unlike so many folks, I cannot wait for this milestone birthday. The primary reason for this is that, as a runner, I can finally exit the "open" ranks and move up to "masters". After chasing around speedy, much younger women for the past few years I am really, really excited about this.

There is also another reason that I am excited to turn 40 though, one that is much more private to me but that I think really needs to be discussed more. I am going to do my best here; if I jumble my words, please forgive me.

In short, I am in awe of the fact that I am about to turn 40 for the same reason that I was in awe when I got married and when I became a mother...because there was a time when we (my family and friends and I) didn't know if any of this was ever going to happen. See, half my lifetime ago, I wasn't the healthy, strong, incurably optimistic gal I am now...I was this girl:

I was 72 pounds and I had literally forgotten how to eat. I was in danger of dying, right then.

As you may have guessed, that photo was taken when I was in the throes of anorexia. It was actually taken the day I checked myself into my second inpatient treatment program, midway through my junior year of college. And, fortunately for me, it was taken at my turning point. That was, quite possibly, the greatest day of my entire life. 

But before we get to the turning point, the upswing, let's talk about the downward spiral and the illness.

If you follow popular culture, you may have surmised that I became anorexic because I felt fat or (since I am now a runner) because I wanted to be thinner to run faster. While those are the commonly held beliefs they are simply untrue, both for my situation and for the bulk of women who have struggled with eating disorders. I became sick when my life fell off its axis and I became stressed beyond a degree that my body and brain could manage solo. I needed a coping mechanism and I fell into controlling my food much by accident. 

Every eating disorder has a trigger: an event or phase of life that, for a healthy, strong mind would be tough but manageable, but for someone predisposed to an eating disorder is decidedly unmanageable. For me, the trigger was twofold. First, my oldest, most treasured friend needed to step aside from our friendship to take care of her own stuff. At 17 years old I couldn't understand what had happened and I blamed myself, thinking that the problem was that I had failed her as a friend. I was never angry, just confused. As an adult I now can totally understand the situation but at that point I just became unmoored. Almost simultaneously my family began the toughest period of our existence, one that was overwhelmed by not knowing if we were going to be able to keep our house, the company my dad had built over decades, anything. It was under these circumstances that I went off to college. I was stressed to the max and felt very alone. Heartburn became a daily occurrence and the only thing I could do to combat it was not eat. At the time it seemed so sensible. That said, I felt physically awful all the time. I was intensely confused and afraid...I wasn't eating because I was afraid to feel physically horrid if I did but I began to feel pretty darn awful because I wasn't eating. When I dipped down to 68 pounds my family and I realized we needed to pull the plug and I went home for inpatient hospitalization. 

At this point none of us understood that I had an eating disorder. The explanations we were given made no sense for me. All the professionals I encountered at that time seemed to think that anorexia was for models and runners who wanted to be thinner, not for stressed out, type-A, perfectionistic but always feeling inferior women. I know now that they couldn't have been more wrong, that I was, in fact, the poster child for this psychiatric and physical illness.

Let's skip to the nitty gritty. My first hospitalization was unproductive, and actually pretty counterproductive. No one explained the truth about eating disorders to us at the time, the just kept slapping labels on me and making inaccurate assumptions. Yes, I gained some weight, but sadly I didn't gain any understanding of the predicament I was in. It actually took a few more years to fully understand the truth about eating disorders:

It's not about the food. It's not about being thin. It's about control. It's a coping mechanism.

When I say it's a coping mechanism I don't want to confuse you into thinking that by restricting food I was coping with life well. I really wasn't. I felt pretty out of control and miserable (physically and emotionally) during the years I was sick. But I suppose that my eating disorder distracted me from the situations that triggered it. Unfortunately, once the eating disorder settled in, I didn't really know how to kick it. I think that this is pretty typical: fear or a traumatic event tends to trigger an eating disorder but once the habit forms it becomes very hard to let it go. There is a massive codependency between the patient and their eating disorder. And because the illness itself messes with brain chemistry due to malnutrition it is next to impossible to be reasonable. 

I was stuck in that loop for a good 2 years. Looking back, I kind of lived a double life: I was excelling in school, carrying a dual major and enough credits for 2 minors, coxing the varsity 8 boat, having, for all intents and purposes, a wonderful college experience. But all the while my illness kept me on the sidelines, slightly detached from the whole experience. When one is sick with an eating disorder it is really impossible to fully participate in and enjoy life; the eating disorder just demands too much energy. 

Some of the fab rowers who loved
me dearly when I wasn't doing a
great job of loving myself.

As I limped along throughout college, I was really extremely fortunate that I continued to have the absolute support of my family away from home: my crew coach and all my rowers. Looking back I really can't imagine how frightening the whole experience must have been for them at times. I know that none of them had any understanding of what I was going through, but through it all they saw me for ME: a friend, a coxswain, a teammate, not just as an anorexic. The normalcy of my life as a collegiate coxswain gave me a life-line to the real world that I really believe kept me from spinning entirely out of control and helped give me purpose to take just enough care of myself during the years when I didn't have the motivation or know how to do so for myself.

Fortunately for me, by my junior year of college I was reaching the end of my patience with the existence that I had slogged through for well over 2 years. I wanted to be well again but unfortunately by this point I simply didn't know how. I had forgotten how to eat, I had forgotten how to structure my life without my eating disorder. I came to realize that I needed the illness at that point; I needed the discipline and the focus. And I knew that until I found a better coping mechanism I had to keep forging along with this one and hope for the best. Every night for months I would lie in bed and pray that my body would just hold on long enough, that I would wake up in the mornings until my mind found a better coping mechanism. 

And then, one day, everything just changed. My roommate, whom I barely knew, sat down next to me on my bed and asked, very simply, "what can I do to help?" I realized that I had no answer for her. And in that one moment I knew that if I couldn't answer such a basic question then it was time for me to get myself some serious help. Within a week I had withdrawn from school, again, and entered a month-long inpatient treatment program. Checking into the hospital was the biggest relief of my life. I was, all of a sudden, ready to get better. 

Being type-A, I set out to be the best patient on the planet, but in this case I was doing so because I really, truly wanted to get better, not because I wanted to please other people. I relished the opportunity to have people teach me how to eat again. I had truly forgotten. And I studiously ate everything that was put in front of me. I dedicated myself to repairing my bone density and followed a nutritional program that supported that with incredible zeal. I went to therapy, I journaled, I learned how to meal plan, everything. And one day I literally walked to the end of the driveway, thanked my eating disorder for helping me get through my toughest stretch, and told it that I didn't need it anymore. And I knew, deep, deep down, that I would never, ever get sick again. And guess what? I haven't. By recognizing that at the time I had become sick I had needed the anorexia as a way to cope with stress but that I now had an entire arsenal of better ways to handle the curve balls life would inevitably throw my way in the future, I felt confident that I was never going to need this one deadly, miserable illness. 

Over the years that followed I managed to become physically and mentally whole again. I graduated from college magna cum laude. I got married to a wonderfully patient husband. I became pregnant on the first try and gave birth to a happy, healthy boy who is the absolute joy of my life. With each one of these little victories my years of being sick faded father and farther into my distant memory.

I even finished an Ironman, which to many would sound like a very bad idea for someone who had a history of not caring for their body very well. But I registered for the race with the intention to use it as a very private test: I wanted to prove to myself that I could train for something incredibly extreme in the most rational of manners. For me the Ironman was a fitting metaphor for the stresses that would be thrown at me throughout the remainder of my life. That 10 months of training was like a final exam of sorts in terms of my ability to care for myself physically and mentally; it was physically exhausting and mentally and emotionally challenging. But ultimately I knew that I passed the test with flying colors. Even before the race itself began I knew that I had succeeded; race day itself was a huge celebration for me. And while the experience was nothing but positive for me, I also found the sport of triathlon to simply be too intense and stressful for my tastes so I was mighty happy when that experience, too, was in my review mirror. Obviously as a competitive runner I do still enjoy purposefully pushing myself physically and mentally on a regular basis. But while I love to train hard and push myself to meet goals of time or pace, at the end of the day I run because I love the  camaraderie of the sport, the social aspect of training and racing with a group, and simply the way I feel when I am in motion. 

If I were you, I would wonder what kind of coping mechanism I replaced restricting food with. I was actually asked this recently and I instinctively and immediately replied that I replaced anorexia with optimism. The one phrase that dictates my whole life nowadays is the deceptively simple statement that "everything's going to be okay in the end. If its not okay, it's not the end." My husband recently referred to me as an "unstoppable positive force of nature"; a description that I strive to embody every single day. Just like anything else, there are times when it is HARD to be optimistic! But honestly, this happy, sunny side of the street version of me is just a much more authentic representation of who I have always been at my core. So in a way this is an even more natural way for me to cope with the stressful situations life throws my way. 

I don't want you to think that because I am naturally happy these days there haven't been some really dark periods in my life; there have been. None of the issues that triggered my eating disorder were even resolved when I began to get well. And it isn't even like I bid my eating disorder farewell and was instantly "normal" again. That couldn't be further from the truth. It took years and years of hard work to get back to a place that I think is fairly healthy. But, from the moment I gave up my illness I have had the patience and faith to move through the anxieties and sorrows and angers and freak outs that come with daily life, knowing all the while that, eventually, things will get better. I also want to be perfectly clear: I am definitely not "perfect" when it comes to my relationship with food. I have, and probably always will have, a bit of a skewed relationship with it. The effects of forgetting how to eat have long, long term ramifications on this front. Fortunately I get more and more "normal" every year. That said, I honestly don't know a single person who is "normal" about food. We all have our quirks, but when you know my history mine may stand out more because of it.

Ultimately though, I have to tell you that I am grateful for my experience with anorexia. Granted, it cost me dearly in self confidence and achievement and long term memory (many thanks to my friends who have filled in the holes over the years), and I still have some permanent physical issues (such as high cholesterol). But I am more grateful for what I gained from the experience than what I missed out on. Because of my illness I have an incredibly close bond with my parents; they moved mountains for me and loved me through a situation that was unimaginably frightening for them. I am actually grateful that my best friend and I missed out on each other's toughest years. Obviously I was initially devastated that I had to be apart from her, but I can now look back and see that the wonderful friendship we have today is blessed to not be clouded by having had to go through our darkest times together. I am incredibly blessed by the relationship I have with my husband of 11 years. I nearly married the wrong man and then my inquisitive, philosophical, drive-me-crazy-but-force-me-to-see-myself-more-honestly husband came along. I fought him kicking and screaming for a bunch of years (still do sometimes) but he has encouraged me to accept myself for who I am much more than I think I ever could have without him. And although it is completely cliche, I simply wouldn't be who I am today without having gone through those difficult years. And you know what? You couldn't pay me all the money in the world to trade the person I have become for that version of my self.

Now that you have read through all of this, I want to ask a favor of you. Maybe you can think of it as a birthday gift to me.  When I was ill I searched and searched for success stories, stories of women who really, really beat their eating disorder. I couldn't find any. That was both frightening and demoralizing to me. Because of that it has always been my hope that perhaps someone in a similar position will see my journey as an example that they can become well again, and permanently. Whenever I see a visibly ill woman in the grocery store, out on the running trail, wherever...I want to stop her and hug her and tell her that everything can be alright again if she just has the patience and faith and bravery to work through the process of becoming well, of truly understanding the root of her individual illness and taking the steps necessary to rebuild her life. But I can't hug everyone out there who is struggling. I also wished for my family and friends that they could have known the right words that might have helped them to help me earlier on. So, if you have a friend or loved one who you suspect is ill with an eating disorder, I would like to ask you to be brave and to ask them the same question that was asked to me 20 years ago: "what can I do to help?" And while you are at it, you may throw in another: "what's really going on?" Those simple questions can sometimes be enough to reach through to a person who is suffering. Compassion can move mountains. And someday, when they are on the road to recovery and they, too, are looking for little beacons of hope, please feel free to tell them about what I went through and where I got to. I am far from the only person who has slogged through this illness and made it out intact, but I am offering myself up as an example in hopes that it can help some other folks who are still stuck.

Fortunately for anyone who is brave enough to reach out to a loved one who is struggling, the mental health profession has come a long way in the last 20 years and there are now some amazing resources available for individuals who are ill with an eating disorder. If you or someone you love is in this position, a great first point of contact is the National Eating Disorders Association: http://www.nationaleatingdisorders.org/ When I was hospitalized for a second time I went to the Renfrew Center in Philadelphia, PA. They continue to be leaders in eating disorders treatment and now have multiple facilities around the country: http://renfrewcenter.com/

If you would like assistance finding further resources, please contact me directly.

Thanks for reading this. It is never easy to put an experience such as this into writing and I hope that I did it justice. And as I go off to celebrate my fortieth birthday with my incredible circle of family and friends I hope that this post, hard as it was to write, may someday, in some small way, help another woman to make it through her struggle so that she too can see a milestone she never thought she would see.

With my son throughout the years. Running is great, but being his mom is AMAZING. I am so grateful every day for this life I have.