When a lapse turns into a relapse

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Over the past 6 months, I have struggled with successive depressive episodes which has not only impacted my ability to get on with life but also, my relationship with food.

I think I knew when I made the decision to recover in 2018 that there was always a chance that I would have a recurrence of the kind of severe depression that I experienced several years earlier. It was in fact the severity of that depressive episode that led to a complete descent into eating disorder hell as I sought to find a way to escape the thoughts which were plaguing me at the time.

For the first two months of my recovery last year, I did not experience one depressive episode. In fact, I had not had one episode of depression in the previous 7 months. Hallelujah, I said to myself. I thought that perhaps, I was free of it and perhaps the joy that recovering from the eating disorder brought me would be the thing which freed me from depression.

Unfortunately, this has not played out as I had hoped. I have experienced more depressive episodes in the past year that I have ever experienced in any one year in my life and this has inevitably led me back down the rabbit hole of the ED.

One of the key features of depression for me is that it leaves me feeling unable to stomach food. It also increases my anxiety around eating because the distress brought on by eating sometimes worsens the depression. I tend to feel calmer when I am not full and I guess for me, I have used not eating or restricting as well as binging and purging as a way of helping me manage my moods. I have used it as a way of helping me function.

The first two episodes I had of depression last year occurred in the early stages of the refeeding process. I was still experiencing a lot of extreme hunger and my weight had been climbing pretty rapidly. Once the weight gain stopped ( I put on about 40% of my current body weight in about 5 months) and the extreme hunger stopped, I lost interest in food in a pretty spectacular way. My appetite lessened and I went from 6 or 7 meals a day to about 4. At times, my appetite would return to me and I would honour it but once the third episode of depression arrived at the end of last year, my appetite completely went south.

It almost feels as though the only way my mind knows to protect itself is to begin to reject food. Almost like a choice needs to be made between food and suicidal thoughts. It is not so much something I will into existence as something which seems to happen quite naturally. And so begins a return into the eating disorder. I think that human nature is such that we will always choose to fight for life, until we can fight no more. I will always choose to fight for my life but I do realise that I cannot continue to use restriction as a way of dealing with mental distress.

After the refeeding process stopped for me in the autumn of last year, I started allowing myself a meal off here, a snack off there but only when I wasn’t hungry. Whenever the depression kicks in, a meal off here and a snack off there turns into more meals off here and more snacks off there and less food on the plate and a general return to restriction.

So a lapse begins to morph into a relapse. And when this happens, my mind generally begins to have a less rational relationship with food and my body such that I can see that clearly, this is a recurrence of the eating disorder. So now, I am managing two things rather than just one.

What I have noticed in the past month is that for two, every fortnight, I begin to experience extreme hunger. I am always inclined to honour my hunger but this begins to set off alarm bells in my mind and I start thinking of returning to purging which is a hellhole like no other. And so this then increases the depression because I become very tired of the endless cycle of depression and eating disorder.

I tried for a long time to force myself to eat mechanically as I have heard it said so many times in treatment and for a while, I was able to do so but there comes a time when fatigue sets in and ‘je baisse les bras’ (I give up). I stop willing myself to eat when I don’t feel like it, I keep myself busy just so I don’t have to think about food or deal with it, I avoid eating around people I don’t know, I avoid eating outside of my home because I cannot make choices about what to eat. It all becomes so ugly and all-consuming once more.

I am at least grateful for a few things. In fact, I am grateful for many things since I started recovering but more specifically, I am glad that I am still honouring my hunger, I am glad that I am not throwing up anymore and that I am a year plus into that state of being, I am glad that I am still receiving some support from my brother and I am glad for the friends who encourage me when I am with them, to eat in their company. I am glad that I have the mental space to write from time to time and that my life feels fuller some days.

I do find that eating with people I am comfortable with, who know me, who I don’t feel in anyway judged by, helps me manage any distress I feel around eating but I am also aware that the ability to nourish myself independently, without support is still something I struggle with.

I want to be able to live a full, expansive version of life rather than a redacted version. I want to be able to eat freely, be free and just be. I also desperately want to be free of depression and it is the depression which induces a fear like no other. It is the latter that makes relapses of lapses.

I know I have a long way to go. As I am often told, recovery is not a linear process. I know. Now please give me pound coin.

But I think I oftentimes end up choosing the calm of not eating over the distress of eating simply because I want a break from the depression. In the long-term, this cannot and will not be the way forward.

If I end up with a complete relapse in terms of the eating disorder, I will inevitably end up in a very dangerous place mentally and that is not something I want.

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The challenge of reading fiction during the fog of depression

I had a conversation with someone recently about why I have struggled to read works of fiction over the past seven months. I have completed one fiction book in the past seven months: The Palm-Wine Drinkard by Amos Tutuola.

I told this person that I do not have the patience for reading about made-up things and that I much prefer reading about real people’s lives at the moment.

The person I spoke to about this fiction/non-fiction split asked me why I am not interested in the escapism which fiction brings. I do not really know the answer it but I guess I just have less patience at the moment with made-up stuff. I have never really been one for escapism, low mood or not. I think reading for me has always been about the use of language. I am not pretentious but I do love words and how people combine words to connect to a person’s soul. So I can and do appreciate fiction. Not so much because it takes me elsewhere but because it connects me to somewhere.

Of late however, I have struggled to connect with works of fiction. One of the symptoms of depression is an inability to take pleasure in things. This inability to take pleasure in low moments has significantly affected my desire to read. However, over the past 3 weeks, there has been somewhat of a change in this which has coincided with a shift in mood.

I want to read about the battles (of the mind) people face and how they have overcome, sunk under the weight of or managed those battles.

I guess it gives me hope that just maybe, there is a way forwards for me too.

In the past seven months, I have had more than a few episodes of depression. Apart from the fact that this makes it difficult to read or write anything, what I have noticed most is my declining interest in reading or writing fiction and my growing interest in non-fiction books.

I have read about 9 works of non-fiction in the past 3 weeks. Something came over me during the last episode of depression and it was as though books were the only thing which gave me an ounce of comfort whereas normally I would not even be able to lift a book much less open and read it. Weird.

Some of the books I’ve read include:

  • Caroline Elton: Also Human: The Inner Lives of Doctors
  • Emilie Pine: Notes to Self
  • Dr Graham Easton: The Appointment: What Your Doctor Really Thinks During Your Ten-Minute Consultation
  • Arnold Thomas Fanning: Mind on Fire
  • Marya Hornbacher: Madness: A Bipolar Life

In each of these books, the writer talks about the challenges they have faced or the challenges of others they have come in contact with, and how things subsequently unfolded.

The challenge of blogging about my mental health is that I am not over the mountain. In fact, some days, I am not sure where I am on the mountain. Some days I cannot see the top of the mountain so I cannot even estimate my journey time. At times, I wish someone would wake me up when it’s all over. I am like the child shouting in the car ‘are we there yet?’ Only to be told not yet.

I hope to fall in love with fiction again at some point. In the meantime, I am trying to gently rekindle my love for it by reading short stories. I am currently reading a collection of short stories called The Book of Tehran (Reading the City), edited by Fereshteh Ahmadi. I am also planning to reread some of my favourite short stories including:

  • Vladimir Nabokov: Symbols and Signs
  • Jhumpa Lahiri: A Temporary Matter
  • Raymond Carver: Cathedral
  • Flannery O’Connor: Everything That Rises Must Converge

Short story writing has always been a source of comfort to me. Knowing I could start and finish something inspired me to get back into writing when I abandoned my first novel ten years ago after my mental health took a leap into the pit of hell.

I have struggled to read or write when my mental health has been at its worst. I think I had a period of 3 years within the past ten years when I did not read a single book. I am a long way from that but I do go through months where reading is a struggle. It is like the words become disjointed so that my eyes are unable to form sentences. My eyesight changes and my ability to make sentences out of the words is lost. I am grateful that at the moment I am able to read something.

I know these seasons come and go but I guess for me, it is better to read something which nourishes me in some way than to force myself to read fiction for the heck of it.