As ever, views expressed are in a personal capacity only.
The links provided have information that is medically sound; as for my advice, it has “no basis more reliable than my own meandering experience.” Cheers, Mr Luhrmann.
Christmas 2001. The fairy lights were glitter-bright on the tree, winking at me as I stood in the middle of the lounge. Beneath them, as vivid in colour and evocative in memory, lay an open tray filled with fruit and wrapped sweets.
Past and present jumbled together.
I was the middle child of the house, torn up with that light-dark medley of nerves that I’ve often observed with introverted children; a desperate excitement and need to be involved vs. a sullen, tearful anger and desire to hide away, to be alone, to try to make sense of all the riotous feelings inside (and the company.) One moment I’d be careening around the house, jumping on every bed with my sister to the sound of Fairytale of New York, and pinching chocolates off the tree (blaming it on the cat, poor thing) … The next, I’d be hiding in my room, sat on the windowsill to watch the amber-struck snow and the starlit sky, burning up with an anger I couldn’t make sense of that had been brought on by all the people in the house. Wishing them a thousand miles away. Wanting to join in and finding no energy to do so, though I loved them all. I felt I had nothing to say, while having too many thoughts in my head.
This was where my paternal grandmother came in. She knew how it felt to see all the shadows on the wall thrown from flickering candles, to want the light and the dark at once. She’d sit with me, sometimes in silence, or telling me about her childhood in Tyneside; about all the little graves she would visit in the local cemetery, carved with our family names. She’d tell me of Christmases when her older sister combed out her hair because their mother had died while still a young woman, and their father not long after; about austerity, and that which didn’t come wrapped in shiny paper but was worth far more when placed in context of surroundings and circumstance.
The lights and the tree, the sweets, music and memories, came back to haunt me that Christmas in 2001. Something had come to take their place; something not dissimilar to the dense, invisible danger that lurked on the roads outside.
I had recently been diagnosed with anorexia by my GP. He’d seen me through the usual card-shuffle of childish coughs and colds, an early puberty before I’d hit my teens. Now it was he who, with the grave face of someone well aware that he couldn’t just offer me a lolly for being brave, had to tell my mother that I was desperately underweight for my age and height (16 years, 5ft 5in.) I was dying, very slowly, inside and out. I haven’t grown much taller since, due in part to the undernourishment / over-exercising practised in those formative years of adolescence. I’d stopped menstruating (amenorrhea) by late 2001. This compromising of oestrogen levels can affect the laying-down of crucial bone minerals for a strong skeletal structure. “Up to 90 percent of peak bone mass is acquired by age 18 in girls and by age 20 in boys, which makes youth the best time to ‘invest’ in one’s bone health.”
Believe me, by the time I learned of this in hospital some two years later, it was the kick up the backside that I needed to start getting well. Seeing a couple of 40 year olds on that ward, both in wheelchairs and hunched over with kyphosis, helped convince me. A DEXA scan in London confirmed that my lower spine in particular, resembled that of a menopausal woman.
This can sometimes be made reversible with improved nutrition and a sustained healthy body weight. Post-hospital, my GP also recommended resistance training, to improve bone mineral density and to build up supportive muscles in my back. He of course kept me under very strict guidelines, with staff at the gym well-informed of my condition.
Years later, I am still very much a gym fiend for the sheer pleasure of movement, and the paradoxical effect of calming my nerves / raising my spirits with endorphins.
Hitting my hospital target weight this year (2013) – which I’d managed to hold onto for all of 2 days after discharge, before rapidly losing it all again – has been no small achievement. I was quietly proud of myself, and utterly terrified, to read that number on the scales again a fortnight ago. Still, it seems fitting that it should be a decade later, and on my own steam this time.
But back in 2001, I had no way of knowing how long it would take; how many Christmases would come and go, each with their own forgettable stamp of Existence as opposed to Life.
This is a stressful time of year for anyone, let alone an anorexic. The constant through-traffic of relatives and friends, office parties, wrapping and unwrapping of presents, agonizing over who-sits-where and who-hates-what/who… The drive to achieve perfection, whether through culinary service or through presentation of self as the one who Has it All, and is willing to drop everything and share at a moment’s notice. For some, this turmoil can be enough to make the appetite disappear (anorexia.) For still others, it can be the unpinning of all that feels safe and secure, leading to a need for restriction of food intake and other symptoms of anorexia nervosa, so as to regain that control. Someone already suffering this illness may tighten their noose, as I did with each Christmas that came by.
I remember my Nanna at our past Christmas parties, flitting back and forth between kitchen and lounge, checking in on the children, topping up glasses and still finding time to put the dogs out and feed the cats. She never once sat down, to the point where my grandfather would gently tease her into at least leaning up against a wall for a breather.
When I wasn’t hiding behind the sofa or down in the dark cattery with feline friends, I’d be helping her to carry dishes and talking in the kitchen. Later, when Christmas rolled around and anorexia gnawed at my soul and bones, I could no longer bring myself to sit in the kitchen with those smells; malnutrition had warped my mind, to the point where I actually believed I might inhale calories. I hid away for as long as possible, until called to the table by family. The sight of the food was as a bonfire lit beneath me while tied to a stake. I fled to the bathroom and stayed there for almost an hour.
It wasn’t just the food, really. It was the sight of my past as something I couldn’t reclaim – the happy faces, silly hats, crackers and chinked wine glasses. It was the knowledge that I hovered between two worlds, the adult and the child, and it was a hateful place to be. Wanting to recapture the tinsel-hung dreams, sitting in my bedroom with only the flicker-glow of a candle to read by – stories that were dark as sloe and bitter-bright as ice, of Snow Queens and fairies, wolves, and the abiding quiet of midwinter death.
How could I have known that these tales can become lodged in the eye of an anorexic? She who stares long enough into the mirror may finally break it with her fist, to find herself in a thousand eyes, like fairy-lights on the tree.
It was my Nanna once again who would poke her head around the door, asking if she could come in. We agreed that I could come and live with her, to try to knock this on the head once and for all. The love and familiarity of the surroundings was key to helping me around that stressful time; when she said I understand, I’m here for you, it was heartfelt and taken as such.
Use these words yourself, with anyone you are concerned about over the festive period. Don’t call them out over an eating disorder – it’s not an appropriate time to do so, what with the hustle and chaos, the change in routines, which are so very upsetting for a frightened mind that has been dialled down to something resembling the plastic tunnels that mice run through. This is the only way I can describe it. There is little room for spontaneity or creativity; because of malnutrition and a low body weight, thought processes become very “black and white.”
Routines are helpful in the early stages of treatment, in that they take away the decision-making from a very tired mind. Over Christmas and the New Year, it’s important to give anyone who is struggling a place to hide and feel calm, if they need it. Don’t allow them to take food or drink into this safe haven without company – sit with them, talk to them, encourage them for as long as is needed. And make sure you have that time to spare, because you’ll need it.
Watch for signs of compensation-exercise (jiggling feet, getting up and sitting back down multiple times, pacing) or disposal of food (in flowerpots, under newspapers, fingers through the hair.) I am cautious in listing these behavioural symptoms, for fear that someone might read them who is of the mindset to use them – but there are only so many ways to protect the world, and a carer must be aware of the signs. They of course differ from patient to patient – everyone’s back story is their own – but overall, they will be strikingly similar. I was spooked to find seventeen other women in hospital, all practising the habits I had thought were unique to me.
It’s about exerting control over what is essentially a neurological disorder. To only throw chemicals at it in treatment via antidepressants, is to quantify the sufferer as a patient only, a physical form, like a broken arm swept up in a sling and as easily repaired. But an arm, for all its nerves and responses, doesn’t have thoughts or emotions. It doesn’t have reasoning, which an anorexic must be encouraged back towards in gaining weight, with a combination of cognitive behavioural therapy and improved nutrition / rest.
While on the waiting list for hospital treatment (and afterwards, when I spun down into relapse) it was my Nanna who made every conceivable effort to simplify things for me. She took away the responsibility of food-choices and activity levels while I lived with her. Because her life is quite systematic anyway, it was far easier for her to sit with me for long periods of time, while I agonized over meals and having to sit still in order to gain weight. I was not allowed to leave the table until at least half the plate had been cleared, and because I loved and trusted her above any other family member, she was in the best authoritative position to make sure I damn well did it. She would also – on my therapist’s recommendation – replace any cooling food with fresh, which was enough motivation for me to eat, and at a “normal” pace. I was terrified that the replacement would hold more calories than had been there previously.
In this way, she exerted her own loving control over the anorexia. I believed her when she told me I wasn’t alone in the fight, and above all, that what I was doing was “right.” You may find this is a recurring theme, as it certainly was for me, and other patients I spoke to in hospital. It’s that black-and-white thinking, mixed with a “typical” anorexic’s natural desire to please. I was obsessed with getting things right – reading up on government health recommendations of calorific intake and exercise, while forgetting that each body has its own individual needs. And in the end, I never stuck with those guidelines anyway. An anorexic will always find some way to chip just a little bit more off their intake / up their activity, and I found that once it was gone or something had been increased, I could not go back. The same had to be applied the next day, and the next. All or nothing.
My Nanna and I also refused to demonize the illness. Though in recent years I have lapsed into this, referring to anorexia as a “demon”, it only occurred once I was within the boundaries of reasonable thought. I still make the distinction that this is NOT an evil entity to be talked to, befriended, cursed, as though it has personal feelings. It certainly cannot be reasoned with or manipulated – quite the reverse. I twisted my family around my fingers.
It’s the strangest thing, to know that something – a chemical imbalance – is working through you, making you say and do things that can upset others. Believe me, there were times when I did feel possessed – especially one Christmas just before hospital, when I elbowed my mother in the gut as she tried to stop me pacing in the house late at night. The earlier disruption of festivities had shredded my normal routines of existence. I was a bag of nerves, raging at the audacity of all these people who were friends and family, bustling through the house with their plates full of food I couldn’t touch, drinking alcohol that I wanted to drown myself in but couldn’t, because of the calories. The crossed-wires of self-denial and superiority (“hah hah, look at me, I’m going to stay skinny while you all get fat”) made for a real shocker when they came into contact with my terror and loneliness …and of course, the actual physical hunger, which drove me into that adrenalin-fuelled pacing in the first place.
To be taken so far from those I loved, by an illness that chilled my head and heart… it was at once a comfortable numbness, and the keenest pain. I didn’t want to upset or disappoint anyone. I didn’t mean to disrupt their festivities, to make them have to think ahead about what to say or not say around me. Those egg-shells were brittle indeed.
I found the Something Fishy message board/forum an absolute godsend over the Christmases to come. It offers well-sourced guidance regarding treatment, and a range of topics across the board threads, which can answer just about any question a sufferer or carer may have. Crucially, these threads are kept apart, and the Mods are very keen to make it so. Sufferers often feel a need, as I did, to offload in private (though of course, mentioning numbers, calories or behaviours is strictly forbidden, and rightly so) – the same applies for a carer, and my mother made good use of the forum in her own capacity, when I drove her to despair.
We all deserve a shoulder to cry on, particularly when dealing with something as frightening and complex as an eating disorder. I found the encouraging atmosphere of the forum to be about as close to a positive hospital environment as is possible online. Plus, it’s a 24/7 service, to be logged into whenever you need to talk. Where anorexia and the underlying problems were concerned, talking about how much pain I was in wasn’t a viable option; I believed it would “punish” me somehow. But the Mods would always encourage us to speak out in “real-time.” It’s all very well offloading online, but if no one in your vicinity learns of the problem then nothing can actively be done to help.
As for those fairy lights – they’re still beautiful to me, as are the sweets gathered below this year’s tree, in the house of a woman I respect and admire very much. I’ve still got a way to go before food will become associated with pleasure and (above all) social enjoyment; I still prefer to eat alone.
But believe me, dear reader, this year I shall eat what I’ve prepared, and it won’t stick in my throat. It will be enough to satisfy this now-healthy body, and it will help me to make new memories, in anticipation of more Christmases to come. The twins and I will unwrap our presents around the tree, while the dog tries to snaffle the paper, and I will feel at home again. Not as a child, for that’s the twins’ place to be, with its innocence and giggles and scarfing sweets.
For me, this strange half-light time is once again full of the magic of quiet midwinter, the dark of the night and the ice, which can stay outside and not in my heart.
It’s the simple elegance of blue starlight in the trees
and the bated breath of a new year, ushering itself in on the golden glow of a pub’s open log fire, turning the air purple with memories and hope.