HAES, depression, social phobia, and EDs
Yesterday (or actually very early this morning) before I went to bed I read this post about living HAES on Good With Cheese. I fell asleep thinking how much harder some preexisting mental (and physical) health problems can make it to practice HAES and decided to blog on it first thing today. I think everyone with a basic knowledge of the nature of EDs and a shred of empathy can understand how HAES concepts such as intuitive eating and exercise for pleasure can be increadibly challenging to put into practice for someone either in the middle of an ED - any ED - or in the process of recovery. This is somewhat ironic, since HAES is pretty much the only approach to health that ever made sense to me when it comes to working on my specific brand of binge-eating disorder. HAES doesn’t focus on weight, but on healthy behaviors. For someone like me who has been caught in a diet-binge cycle for more than half of her life and who gets anxious whenever she gains weight as well as when she loses weight (partially because I am afraid of regaining, partially because I feel very ambigous about people’s reactions) not paying attention to external cues such as a number on the scale or others’ opinions and instead trying to cue in with my body is a radical and freeing concept. It is also damn scary and very hard to put into practice.
Actually, I haven’t had many major bingeing episodes recently - my life has been pretty crappy otherwise, but while I might have been “mildly overeating” on most days, I did not usually eat until felt stuffed and nauseous, something I do during a true binge. I think I have also started to notice and correctly interpret bodily cues that I haven’t noticed properly for a long time. For example, if I eat a lot of sweets (I am talking several ounces of chocolate here - as I said, I am a binge eater) a relative short time before going to bed I will wake up the next morning with an uncomfortable (but not nauseous) feeling in my stomach. The feeling is somewhat similar to hunger, but still clearly distinguishable from it, and while it gets better with eating something the best way to get over it is to just sit it out. After an hour or so it will disappear, for a while I won’t get a lot of messages from my stomach at all, and some time in the early afternoon I will get genuinely hungry - usually for something decidedly not sweet. I have also noticed that while the advice to drink lots and lots of fluid before eating in order to fill up the stomach is nonsense at best and dangerous at worst I tend to drink less on days on which I have binged - simply because the food keeps my stomach so full that why I feel thirsty it causes me discomfort to put more into my stomach. I guess all of this does mean that I have made some progress with the intuitive eating part of HAES.
On the other hand, being weight neutral in itself is a major challenge. I have (re)gained a lot of weight in a very short time recently and both my body’s outer appearance as well as the sensory input I get from my limbs and organs feels alien to me - much more so than before my last diet when I weighed approximately the same as now. My appearance is also where my social phobia kicks in. For a student I am in a financially good position. Still, clothes in my current size cost a lot of money and so I am stuck with a lot of ill fitting things that I bought when I was at a lower size. In addition, it is hard for me to find well fitting clothes at my current size - partially because I have very small breast and pretty much all clothes that fit me in the waist are too big in the chest. This means that I have a hard time dressing in a way that looks acceptable to me at this point and being a social phobic this means that my appearance alone (partialy determined by how my clothes look) often makes me not want to leave the house (not to talk about other factors).
My social phobia also poses a major problem doing any fun exercise. I have “dragged” myself to the gym several times recently - but this is not exactly something I enjoy. I used to do belly dance, but I haven’t been to classes since last summer and I have a really hard time going there with my “current” body. I was the biggest woman in the class before my weight gain, and while belly dancers including my teacher tend to be relatively size neutral I had women in class comment on weight loss etc. in the past. The fact that I am much more inflexible now due to not practicing makes my discomfort and fear of going back to classes worse. And then my belly dance clothes no longer fit of course…
Finally, there is my depression. And this is maybe the most daunting problem when it comes to HAES. On many days I literally don’t find anything enjoyable - and it is not just a problem of getting started. When I am walking or biking outside in the sun my body feels tired with every step, every movement I make. I can still walk for several hours, but I don’t enjoy it. I often don’t really feel the sun and when I go to the river to walk there I know that my surroundings are beautiful but I don’t truly experience it. In short, if I tune in with my body the message I get when it comes to physical and most other activities is that I don’t feel like doing it. ( Ironically enough I tend to push myself quite hard whenever I DO exercise - mainly because I am afraid that people will think of me as lazy, and that I AM in fact lazy, if I don’t.)
So how does HAES for someone like me look like? I try to do some things although they don’t feel good at this point in the hope that they will be fun again in the future. In addition I know that if I am not physically active at all it will become even harder and less enjoyable to move. But there is one problem with this: How long do I have to do an activity without enjoying it before I can put it aside in the knowledge that this is simply not the right thing for me and that I better go looking for something else? And how do I know when I am overexercising when not even mild exercise leaves me in any way energized? In my current situation it might not be the nature of the activity but my depression or the constant fear of embarrassing myself that comes with social phobia. So I try to just do something, anything really, regardless of how it feels and to give myself some credit for it. But giving credit to myself is difficult, too. I guess there are no simple answers at this point.
Filed under: BED, ED, depression, fat, health, mental health, social phobia
Hi there,
I’m not part of the FA community (although frankly I’m starting to think the weight-loss is no longer that major inspirational goal I once thought it was), so I feel a bit hesitant about leaving a message, but your post really touched me so I decided to take a risk.
This statement you wrote spoke right to my heart: “On many days I literally don’t find anything enjoyable - and it is not just a problem of getting started.” As a person whose been grappling with clinical depression for over a decade, I can second that emotion, and god, does it suck! Sometimes I feel like if I followed my intuition, I would never ever ever leave the couch, much less go for a walk or get some other form of physical activity. It’s like gravity is much heavier on those days and I’m pinned down.
Or maybe that isn’t the intuition telling me to stay on the couch; maybe it’s the depressive, negative voice in my head, which bossily drowns everything healthy out. BLEH.
Definitely, absolutely give yourself major credit for every step you take, however small it seems! It takes courage!
Comrade GoGo - welcome, and thanks for your comment. I am not one of the people who get comfort out of knowing that others feel bad, too - if anything I think this is a reason to feel worse, not better, and I hope you find a way to feel better. But it IS comforting to know that someone understands, truly understands how it is when you don’t get any enjoyment out of anything, even out of activities that you cognitively know are enjoyable.
You know, this is something I struggle with, too. I don’t think I can truly seperate my depression from who “I” am - my depression is a part of me, not the only part, but still a part. It has shaped me and continues to do so. And I think that some of my personality traits that I myself find positive overall also make me more vulnerable to depression. But that does not mean I don’t want to get out of this. I just don’t think that “getting out of it” means to go back to some “pre-depressive state” (something I have not really experienced in my adult life anyways) but instead that it means learning from my depression and going THROUGH it. And of course I will most likely always remain vulnerable to slipping back into depression even if I get out of this.
As for fat acceptance - as far as I am concerned you are very welcome to comment on this blog as long as you steer away from actively promoting dieting and intentional weight loss (and as long as you don’t make disparaging remarks about fat people - but after your comment I really don’t see any danger there). I can of course only speak for myself, but my impression is that this is the position of most people in the fatosphere.
BOY can I identify with that! When I stopped dieting, I gained weight so fast my skin hurt, no kidding. I think I have finally come to a point where I don’t catch myself in the mirror and think, “Who is that fat woman wearing the same dress as I am?” or just feel so bizarre occupying my actual body. I had similar problems with clothes and social anxiety/depression. Nothing fit, so I didn’t want to get dressed, which meant I didn’t want to shower, which meant I didn’t want to leave the house and down and down I went. And then I would spend the day berating myself for hitting the skids so hard over something so “trivial.” “It’s just clothes, you shallow jerk! And if you didn’t get so fat, this wouldn’t have happened” That, obviously, did not help matters.
So much of HAES goes back to trust in yourself, and that is so hard to come by. I think that spending more than half my life on diets has completely destroyed my ability to trust myself in so many ways, because “successful” dieting means learning to ignore the most basic physical instinct of hunger. And that’s without BED (aside from deprivation-induced binges, which I differentiate because they were unrelated to stress and once I stopped dieting, I stopped binging) which I can only imagine makes that trust even harder.
I think part of HAES for you would be getting treatment for your depression and social phobia. Are you on any medication or going to any counselling?
As for social phobia making it difficult to do fun excercise, do you have or can you afford a tv and a dvd player? I like to buy belly dance and dance dvds and do them in my living room. I also find that water aerobics are good because (in the classes I go to at least) there are a lot of fat people and a lot of people who are not in good shape as far as excercise goes. It makes it easier not to feel self conscious.
Oh, I’m sorry, I should have read a few of the older posts before I responded to this one. I see you have tried medication and counselling without much success. I hope you find something that works for you.
my own general guideline for personally-enforced physical activity: if something physically hurts in a long-term-type way (not acute pain, but sore muscles or something), i give it no more than ten minutes to feel better. if something is not causing any pain at all, then i try go for fifteen or twenty minutes before i fall apart, although sometimes ten is the most i can push to. if something produces acute pain, i stop right away.
(clinical depression since age six wheee….)
Anhedonia how I hate thee, let me count the ways…
Gardeners tend to be middle-aged comfortably plump women who wear a lot of sweats and jeans. If you have a local botanical garden, you can get some quiet walks around on the paths, which are often winding and semi-private in my experience. You aren’t likely to overexercise if you take a half hour walk every few days, and that should be enough to maintain your health. Most of the people there will be much more interested in the plants than the other people, another point for privacy in public spaces.
I think it is worthwhile to make sure you get some exercise, even if you don’t feel like it due to depression. Depression screws intuition up, so I think in this particular case you need to pay attention to your brain more than your intuition. It’s no fun and hard to do right.
You might also want to consider digging in the dirt yourself:
http://www.bristol.ac.uk/news/2007/11797584419.html
A soil bacterium may help stimulate the brain to be less depressed.
There was another press release on sciencedaily today about a new drug being tested for efficacy on people resistant to treatment with SSRI’s, you could talk to your doctor about whether you could join a study, or since it’s a battlefield anesthetic if he could do an off-lable prescription for you.
Here’s a link, if you’re interested:
http://www.newsdaily.com/stories/l02842132-depression-ketamine/
It particularly made me think of you because the center of the brain it normalizes also deals with anxiety, and I remembered you were socially anxious.
If I’m being obnoxious, please let me know, I don’t want to be.