Author: miraterdiman

        One year ago, on July 19th, 2017, I was diagnosed with anorexia nervosa by my psychologist in San Francisco. The diagnosis fell on the same week as my family’s beloved beach vacation to Stinson Beach, which is usually a time to appreciate friends and food and to love each other. I was taken into San Francisco on that foggy Wednesday morning to attend one of my routine check-up appointments with my doctor. Until that point, no official diagnosis had been made; rather, my family and I were under the impression that I was simply underweight with no mental illness. I stepped on the scale, my psychologist told me to guess my weight, and I felt my stomach sink when my guess was over three pounds heavier than I actually was. In truth, I hadn’t gained weight since my last appointment, which was around a month prior.

        I hoped nothing would come of this after my psychologist asked to talk to my parents “alone,” and I walked out of his sickeningly blue office and into the waiting room. I tried to fall asleep, wishing that I wouldn’t have to wake up and hear what the adults had to say.

        Against my desires, I was woken up, taken home, and told that I officially had an eating disorder. I was told that I couldn’t go to sleep away camp, and I was told that from now on I would have to come back to this office every single week to get checked on. All those thoughts whizzed around and bounced off the walls in my locked bathroom upstairs. My parents banged on the door, insisting I come out. Sometimes I wonder if they thought I was going to kill myself.

        I remember the first lunch I ate after my diagnosis, back in Stinson Beach. A PB&J with two chocolate chip cookies. I remember exactly how my dad put it all on the plate for me, and how I couldn’t protest or even suggest something I wanted to eat more. I had to accept that this is what is was going to be like, probably for a really, really long time. I remember feeling as if I was perpetually stuck in a haze, unable to really see or enjoy anything. The rest of my week was tainted with texting and calling my friends, trying to explain something I didn’t really understand.

        A full year later and I’m sitting in the same house in Stinson Beach. It is an ordinary day for everyone but me. The fog is slowly rolling out over the ocean, my parents are drinking coffee, and everyone is gathered around the counter where I ate that dreaded PB&J. In a way this makes me feel alone, enforcing how overlooked eating disorders really are. I can still see the traces of my anorexia everywhere, continuously overshadowing who I am. But more overpowering is the feeling of peace that I can sense, because I believe I really am okay, and I really am getting better. It is hard for me to believe I will ever be perfect, but I can confidently say that I’m a different person than I was 365 days ago. I’m prouder of that than I am of any other superficial successes that have come my way.

        If you read this, thank you for hearing me out. And thank you for your love. I didn’t navigate this year on my own, and I’m grateful for that every single day.

        The month of June had been exceptionally strenuous. After finishing a week of finals, I began my summer with a wisdom tooth extraction. Days of pain meds and restricting my eating to “soft foods” left me weak and sleepy, barely able to walk around or leave my house. Immediately after I travelled to Europe with my family. Traveling had recently been a challenge for me, especially in regards to meals. Not knowing the types of food I was eating, or whether I would like it, or how much exercise I was able to do, always left me in a gray and confusing area to navigate. I hated that some of the joy of travel had been taken away from me, but decided to put eating in the back of my mind.

        The result of this month was me, stepping on the scale, and seeing the number light up in the small screen at the top. At first, I almost felt pleasantly surprised. It took me weeks of reflection to recognize this feeling, because in the moment I was so ashamed of it. How could I be pleasantly surprised after all that I had gone through? I had lost 6 pounds in one month, and I was terrified by how easy that was compared to my efforts to gain weight last summer. After a moment, my surprise was superseded by fear and panic. I knew that once I had lost weight, gaining it back would always be difficult. No matter how far along in recovery I was, or how many years it had been since my first diagnosis. I was also terrified because I knew my parents would find out, and I knew how they would react. All the feelings of isolation, exhaustion, and fear that were so prominent an entire year ago slowly expanded in my chest, until it felt almost hard to breathe.

        The first person I told about my weight loss was my therapist. Since May, I have been going weekly to see a therapist for depression and low mood as well as my anorexia. She was very understanding, but the concern that was so clearly displayed on her face made me feel defeated. I knew that when it comes to things like this, it is hard for anyone to believe in me, or to trust me.

        On the drive home from my appointment, I kept thinking about the different ways I could tell my parents. What explanation would cause the least distress? Should I even say anything? I wondered what they might take away from me, or how I might be punished, even though it would be “in my best interest.” I was upset, because this seemed to be a perfect example of how my anorexia would never become a thing of the past, but rather something I always needed to think about. I questioned if I had really made any progress since my diagnosis, or if this weight loss meant I was back at square one.

        However, it suddenly occurred to me that I could use this dreadful circumstance as an opportunity, rather than be afraid of my own mind and self-control. Last year, a weight loss of this nature had catapulted me into an incredibly dangerous and terrifying place, and there was no doubt that I could easily return there without any warning. However, now was as good a time as any to prove to myself that I am not the same person that I was.

        I truly felt my recovery in that moment, because I could easily see the option of getting better, of gaining weight. It was not hidden anymore, or shadowed by my illness. I devised a plan about how to regain the weight I had lost, and I did so on my own, without the encouragement of my parents or my psychologist. I began to feel hopeful, especially after that moment of fear when I thought I may still be the exact same girl I was an entire year ago.

        I have gained two pounds since that car ride and, surprisingly, I feel good about it.

        Two friends sat on a paddle board, the waves of the lagoon lapping gently along the sides. It was 8:30 pm and the sun was only beginning to set, and the water was warm and eerily inviting. One friend looked at the other and asked,

        “What word scares you the most?”

        “What word?” replied the other friend, confused by the question.

        “I don’t know, like, what word gives you chills? Or makes you cringe?”

        The second friend thought about it for a second. The waves continued to lap against the paddle board, and the sun continued to set.

        “Eventually,” she said, looking out towards the neck of the lagoon. Towards the ocean.

        “Eventually?”

        “Yeah, eventually.” Why eventually? It seemed like a false promise. It seemed open ended. Like something that would never be real but always had the potential. The paddle board floated out slowly towards the ocean, and the friend stretched their arms out as far as possible. “Eventually, I’ll get better.”

        During the past week, I had two separate conversations about mental health with fellow high school students. Although each interaction went differently, I ultimately walked away with the same understanding: many people within my community do not know half as much as they should about mental illness.

        I realize that sounds like a condescending generalization, however; I do not mean to entirely exclude myself from it. Until around a year ago, I was as unaware and uneducated as both of the people I talked to last week, and I’m sure I would’ve said things very similar to what they did. In fact, I’m sure I still do. I know many of you reading this probably do know about mental health! And being uneducated but willing to learn isn’t really the pressing problem. But after having conversations with both people my age as well as adults, I realize that when ignorance becomes hurtful and demeaning, and when people are opposed to learning new information about uncomfortable issues, something’s got to change.

        Because of this, I’ve decided to write a little bit about the neurological aspects of anorexia nervosa. I am fully aware that there is a plethora of mental illnesses/disorders that I won’t be able to speak to here, probably because I also don’t know half as much as I should about them. That being said, I think the first way to dismantle the stigma surrounding mental health is to educate ourselves, and learning a little bit more in any way we can is the first step towards doing this.

        The first overlooked concept that needs to be addressed is the difference between disordered eating and eating disorders. Over 90% of teenage girls experience disordered eating, while only less than 1% fall into eating disorders. They line between these two things is very blurred, however I’ll do my best to distinguish them: let’s say you went on a diet, and you wanted to lose 5 pounds. Someone with disordered eating would lose 5 pounds, be satisfied, and stop their diet. Someone with an eating disorder may lose 5 pounds, and be unable to stop. Those who have eating disorders are very goal-centered and determined, and would struggle to stop dieting or gain any weight back that they had lost. Although disordered eating is very challenging, and something that plagues people of all ages, it is not a neurological illness.

        Anorexia nervosa, which does constitute as a mental illness, as stated in a paper by Walter H. Kaye, is “characterized by restricted eating and relentless pursuit of thinness.” I am sure most of you know that. What you might not know is that those who suffer from anorexia experience widespread, acute changes of brain function. The characteristics that contribute to and are developed during anorexia can be categorized under two names: state and trait.

        An example of a trait-related alteration, to put things simply, would be the ability to put off immediate rewards for the promise of something greater. Although this trait can be incredibly beneficial to an individual (possibly better their work ethic, increase determination) it can also be detrimental in regards to having an eating disorder. Before my diagnosis, I was able to put of eating entire meals for the promise of having one cookie at the end of the day. Trait-related alterations play a huge role in determining who is prone to eating disorders; studies show genetic, heritable traits account for 50-80% of the risk of their development.

        State-related alterations include neurological effects of anorexia, such as reduced brain volume and altered metabolism. People with anorexia have demonstrated an increased amount of certain neurological systems, including ones that impact impulse control, and executive functioning—essentially, your brain can override your desire to eat. After going to my first doctors appointment, I was informed that my mental illness was preventing the myelin in my brain from forming adequately (due to the striking lack of fats I was consuming).

        Having anorexia prevented me from enjoying food or other activities I used to love.  Not only can this illness reduce your bone density, impact your heart rate, your brain development, and even your fertility, but from a social aspect, it is incredibly isolating. 1/3 of people diagnosed with anorexia never recover, and even for those who do, certain harmful traits persist well into their recovery. Eating disorders have been linked with other mental illnesses, including severe depression and anxiety.

        I hope, in some way, that this was able to emphasize the legitimacy of eating disorders. This is NOT something that people make up, and most definitely NOT something that is even remotely in their control. There are biological and neurological aspects to this illness, just like there are to any other. It is also important to note that eating disorders impact both men and women, and we should not limit our view of eating disorders to the very stereotypical, female image that may appear in our minds. No one can be “too heavy” to have an eating disorder, and no one can be “too light” either. The stigma surrounding eating disorders is perpetuated every day by those who refuse to learn and talk about them. Being a high school student, I’ve learned that going to school with an eating disorder can be very tiring and hard to navigate.

         Some might be thinking, “How can my high school be inaccessible to someone with a mental illness? They can walk around campus…They can do their homework?” Here is my response:

        Last year, I spent nights unable to do my work because I was either too focused on the cookie I wanted to eat, or too distraught over the extra helping I took at dinner. I spent many lunches alone, afraid I would be judged for choosing to eat nothing. A mental illness is as debilitating as any other disability, sometimes more so because no one can truly visualize how much you are suffering.

        We all have the power to dismantle the stigma surrounding mental health. I hope this helped, to people who wanted to learn, and people who needed to be reminded that what they are going through is real and hard, and that they are strong. I know it is easy to forget that sometimes.

        As a freshman, I was the fastest on my cross country team. It felt as if winning came easy. I hate that I thought that, but I also took the feeling for granted. One and a half years later, and now I’m anorexic. Sometimes, it feels like that is the only thing I am.

        A few weeks before I was allowed to run during my sophomore season, it was an unassuming sunny afternoon and I was hanging around at practice despite the fact that I couldn’t run. My parents had told me no. My pediatrician had told me no. My psychologist had told me no. My body kept telling me no. But I was so desperate to regain that part of my identity back, that I thought it was better to watch and wish than to simply ignore it.

        While standing with my coach, he asked the question that had been in my head for every second of every day: “So, when do you think you will be back to running? To the team?” I thought about this carefully. I compared myself to another injured athlete, who had returned to running before he was fully healthy, and had to drop out again. I turned to my coach and referenced this story, explaining, “Well, we know how that person didn’t take enough time off. And they are out again. I want to learn from their mistakes and make sure I only come back when I’m READY.” Instead of getting a compliment on my thoughtfulness, I got this response:

        “Well Mira, that individual has a real problem. Something that physically prevents them from being a good runner. You are just taking off time to become a better athlete when you get back.”

        A real problem.

        In the moment, I could not think of anything to do except mumble, “Yes, of course,” and slowly walk away, making sure my coach couldn’t tell that I was about to cry. I was choking on the fact that I didn’t know how to feel. For the past four months I had been wishing and wishing that I didn’t have a “problem.” Wishing I was normal. Wishing I was the same person I’d always been. But the second someone told me my problem wasn’t real, I felt weak and useless. Like I had wasted time trying to cure something that wasn’t even there. I wondered for a long time about this seemingly harmless phrase, and months later I’m still wondering: I don’t have a real problem?

        I don’t have a real problem because I still wasn’t even as skinny as most of my friends.

        I don’t have a real problem because, after every meal, I would weigh myself, and hate the fact that I went up on the scale.

        I don’t have a real problem because my heart rate was 36 beats per minute.

        I don’t have a real problem because of the unrelenting, shameful body hair that was beginning to grow faster than I could control. Because I hadn’t gotten my period in sixth months.

        I don’t have a real problem because I ate mango and granola every day for lunch. Because I ate the same flavor of Siggis yogurt everyday for breakfast, since it was barely any  calories.

        I don’t have a real problem because my pediatrician told me I had to gain weight every week. Because I couldn’t go to sleep away camp and be separated from my family.

        I don’t have a real problem because, apparently, my brain is shaped a little differently than most peoples’.

        I don’t have a real problem because I could not stop thinking about the donut I ate for breakfast.

        I don’t have a real problem because the snacks my mom put in my bag before school everyday would end up in the garbage outside the caf.

        I don’t have a real problem because I went from running a 5:10 mile to barely being able to walk without being told “slow down!” Without telling myself “slow down.”

        I don’t have a real problem because I would wear as many sweatshirts as I could to my doctors appointments, and hope he wouldn’t make me take them off when I was weighed.

        I don’t have a real problem because I told my parents I hated them after they made me drink a soda.

        I don’t have a real problem because, on the cross country team, the boy who comes back from a broken toe or a torn muscle is a hero. But no one wants to talk about the girl with an eating disorder.

        I don’t have a real problem because at my first cross country race after my diagnosis, another competitor turned to me and said she was glad I “recovered from my stress-fracture.” Because I just nodded and didn’t tell her. Because I felt like I had too much explaining to do, and it wasn’t worth it.

        I don’t have a real problem because when girls say the phrase “let’s just eat a ton and get fat,” I wince and feel afraid and angry at the same time.

        I don’t have a real problem because it’s all in my head right? Just fucking eat something!

        I don’t have a real problem because I still can’t look at myself without wanting everything to change.

        I don’t have a problem because the word “anorexia” casts a menacing shadow over the rest of my identity.

        I don’t have a real problem because I will never be the same as I was.

        I don’t have a real problem because sometimes, it feels like I was chosen to go through this. Like I deserve it. 

        It was Sunday night and I was sitting upstairs on my bed, glancing sideways at a crumpled ice-cream sandwich wrapper that rested a few inches away. I’m labeled as “recovered,” but in my opinion, the words read something closer to “work in progress.” The ice-cream I just ate wasn’t really an indulgence for me, more an acceptance of defeat. It was one of my bad days today. I hated my body, the number on the scale. I decided I should give up. It doesn’t make sense why, for me, this food was a representation of my problem, an assessment of my quality and health as a person, but for other people, it’s just fucking ice-cream.

        My experience with anorexia has prompted this jealous and wanting feeling within me. I envy those who can eat a cookie and just let it be a cookie, who don’t calculate how many more calories it adds to their day, or how much they will weigh after. Who don’t have to live around an eating disorder, to work so hard when nobody else can even tell. I am jealous of people who don’t think about food for nearly every second of every minute. Where life is about homework, and sports, and family and friends. Not about how their stomach looks when they sit down, or if the extra three pounds will slow them down on the track. It all sounds like a cliché but it is so disturbingly real. I’m jealous of people who can sit down and enjoy a meal, laughing, smiling, conversing. Who don’t take every bite as if it is going to be there last one, because they are so used to starving themselves. I’m jealous of my old self, because I know that I used to be like that. It’s like part of my was taken away, chewed up, and then spit back out. I hate myself because I know, for some reason, I deserved this. I don’t understand what happened. I don’t know if what I used to be is what I really am, or if this is. Where did I go?

Where did I go?