More Confessions of a Body Positivity Failure

CW: Weight Loss, Diet Talk, Exercise Talk

Since last June. I’ve been swimming two or three times a week, having been fortunate enough to have found a community pool and then a rec center that are welcoming of people of all sizes, shapes, ages, and abilities. I’ve also made an effort to bring some more awareness to what I eat and how I eat it: whether I’m eating out of boredom or some other emotional reason and whether I’m eating what my body wants me to eat or just putting anything in that will serve for the next meal. I’ve done both these things because I didn’t feel good in my body, being largely sedentary and eating whatever, and I haven’t followed either an exercise program or a diet with any militancy. Still,  find that I’ve lost about twenty pounds and I’m in a smaller pair of jeans.

I’m deeply conflicted about these things, especially the food part, and I was before I started doing it.

I feel better. Days when I swim, I notice some elevation of my mood, although not a lot, and it may be due to the simple fact that I’ve gotten out of the house and done something rather than sitting on my ass bored and alone all day instead of any release of endorphins. I’m glad I’m back in my smaller pair of jeans, because I missed wearing them and they fit better than any other jeans I’ve had, and the manufacturer doesn’t make that style any more.

Still, I’m deeply conflicted about what I’m doing and why.

At our last session when I brought this up, my therapist asked me, “If you feel better in your body, what’s the problem?” I told her I felt like I’d betrayed my principles, and worse, betrayed my friends, some of whom are fat activists.

Maybe I’ve done what I needed to do for myself. But the truth is, I don’t believe in weight loss. I don’t believe there are right and wrong ways to eat or good and bad foods, or any of that. And I see myself falling onto the trap of feeling virtuous when I motivate myself to make a vegetable stir fry instead of sticking a frozen pot pie in the oven because it would be easier. Sure, my body often enjoys eating the stir fry and responds with a cry of “Yay, vegetables!” But maybe it would enjoy the pot pie just as much for other reasons. I like being able to wear the smaller jeans again, but isn’t the discontinuation of that style another sign of fat oppression? I don’t like to ignore that, but at the same time, I want clothes that fit and wearing ill-fitting jeans makes me upset and depressed. And I supposed to endure that for the sake of fighting oppression?

I also feel virtuous when I go to the rec center and swim. As I said, I don’t get a lot out of the activity for its own sake, and often the feeling that I really should go is all that gets me out the door and on the road. (It was easier during the summer, when the pool was outside and there was lot of sun, and it was hot out.)

I ask myself a lot, “Why am I doing these things if they go against what I really feel and believe in?” And those feelings of virtue have a lot to do with it, which I hate. They’re the antithesis of being fat positive, which I strive to be–and fail at miserably, it seems.

Maybe these questions wouldn’t trouble me so much if I weren’t so depressed just in general. I know they didn’t bother me much in the summer, when my mood was better. But with the seasonal shift, I’ve become more and more listless and uncaring. I have no internal motivation to do anything. Nothing feels good for its own sake; nothing interests me. When I do go to the pool, it’s not because I look forward to swimming. It’s because I feel I should go, or at best because I recognize that I’ll feel marginally better going than I would if I don’t, because sitting at home with no interests and nothing to draw my attention is bad for me. And with every “should,” there’s a corresponding “Why?” Going to the pool presents its own obstacles: It’s far away, and it’s cold, and I don’t actively enjoy it–in fact, I find swimming rather pointless and boring. So why do it? Eating better is hard when I don’t feel like cooking. Even making the weekly grocery list and doing the shopping can be torturous. I’d rather do things that are easy, most days. So why pursue a healthier diet? especially when I recognize that “Health” is relative and there’s no obligation to be “healthy” anyway, or to attempt to manipulate my body either for health or size reasons? Why do anything at all, except to be “good?” Which I’ve already said is something I don’t believe in as far as food control or exercise.

My therapist suggested I write this blog post. I was initially loath to do it, because I know the subject matter can be triggering to those around me.  But I decided to go ahead and do it, because the topic preys on my mind and because–again–it’s better than sitting around doing nothing. I don’t feel I’ve expressed myself very well, and I have no answers to the questions that keep bothering me. Maybe other people do.

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Empty

I don’t know what to say in this space.

For a long time now, I have felt exactly nothing. Nothing good, nothing bad. No highs or lows. I am am abandoned building; no one is home and no one is coming to visit. I am the level plain where nothing grows.

There are words for this state. Clinical ones like anhedonia, Which technically means the absence of ability to feel pleasure, so it misses half the mark. Or I can make up metaphors like I did above, intellectual games that don’t touch me. I don’t really feel the need to express anything about this state. To say that it’s awful would be a deception, for if it isn’t pleasant, neither is it unpleasant. It is nothing.

Sometimes, it is boring. With no drive to do anything one way or another, I spend a lot of time in my house staring at the walls, waiting for something to change, like my husband coming home so we can eat dinner and fill a couple hours watching TV. I never feel anything about it, unless an occasional mild amusement. I don’t really look forward to it, yet it’s something in the nothing: Something to fill the hours until bed and sleep.

I find other things to fill the hours. Housework I can do, if it’s not too challenging. Big jobs are beyond me, because I would have to care about them, and even though I can see my house getting dirtier by the day, I don’t really care. No one ever comes here, so how can I care about the drifts of cat hair in the corners? Sometimes I go swimming at the rec center thirty miles away. That’s good for three hours, including travel time; I can stay in the pool about half an hour before it starts to become unbearably dreary, and another fifteen minutes if I stretch it out.

Sometimes I think I don’t want to go on another day in this nothingness. But I don’t care enough about that to be a danger to myself, either.

When I look back at the words I’ve written just now, I suppose this state must seem awful. It’s not awful; I’ve done awful. It’s something beneath awful, or maybe just above. Moving one way or another and starting to feel, maybe that would be awful. So when I try to express what it’s like, I’m stumped, because how do you express the utter lack of feeling? I don’t have any desire to go one way or the other, either to improve or get worse. Except sometimes, when other people around me are passionate about things in their lives, I feel the lack of any passion in my own life and I cry.

I’ve thought taking a step, any step, would be better (always understanding that better has little meaning to me because I don’t experience this state as being awful). When I took up swimming, I thought maybe it would open my feelings up to something else. But every step becomes more drudgery, a going-on without going-toward, and it becomes so hard to keep taking the steps at all. I’ve thought about sitting down to write again, doing NaNoWriMo next month, just making myself do it. But the idea of adding another thing for the sake of filling empty space makes me a bit angry; I don’t really believe it will get me anywhere and so why bother?

I don’t even know why I’m writing this except that I haven’t posted a blog in so long and I feel some sense of moral obligation.

I suppose this state could be an issue with my meds. I have had this thought. I can’t check it out now, because the med manager at Mental Health retired and they haven’t hired a new one yet (vague sense of dread at having to form a working relationship with a new person). It’s been suggested that this is a symptom of seasonal depression now that summer is gone. And that might be possible, except this emptiness was lurking under everything all through the summer, too. I could never be as involved in things like my garden as I thought I ought to be, because I just didn’t care enough. In fact, as to the garden, I’m (vaguely) relieved it’s dead now, so I don’t have to maintain a semblance of caring about something that I really can’t be all that bothered about.

Mostly, I feel that this state is beyond my control. I don’t think I can do anything about it, no more than the dry gulch can affect the weather that might or might not bring rain. I can only wait it out. I would say, “In the hopes that something will change,” but I don’t feel any particular sense of hope (or hopelessness). I’m resigned to the idea that I’m in a place beyond hope (or hopelessness): that maybe age or something else has put hope as far from me as every other feeling.

So my days are full of empty waiting. Waiting for anything to have meaning, to sink a hook in me, to hit my heart in a place where it registers as something other than a brief thought.

Waiting for people to come back to this empty house and light the fire.

Confessions of a Body Positivity Failure

TW: Weight loss, body dysphoria

I have a confession to make: I hate my body.

This is nothing new, but it’s become more and more unbearable in recent months. I hate my size. In the last seven years, I’ve gained a hundred pounds, going from a size 14 to a 2X. I feel terrible. It’s hard to climb stairs. I can’t work in the garden more than about an hour without wanting to lie down. I can’t find clothes that fit. The clothes I used to wear, clothes I loved, no longer go over my boobs, over my hips. I would give anything to be back to the size 14 I once was.

I have another confession: I am not willing to “do what it takes” to lose weight.

There are a number of reasons for this. Partly, I’m just lazy. I hate exercise for its own sake, and because I’m so out of shape, I can’t participate in a lot of exercise anyway. Partly it’s depression. I can’t get motivated to get up off the couch and do anything, much less something I don’t enjoy. The only things I DO enjoy to some degree are cooking and eating and sleeping, none of which are conducive to weight loss. As a survivor of a severe eating disorder, limiting food intake is literally bad for me. The only way I can make myself do any of these things is to beat myself up, making my days an unending round of punishment, which is something I don’t want to do. Even if I did convince myself to do it, I have no faith it would do any good.

Mostly, though, it’s that I do not want to participate in weight loss mindset. I don’t want to give my money to weight loss programs. I know they’re based on bad science. I know that all but 5% of people lose weight only to gain it back–often much more than they lost in the first place, and I’m proof enough of that. I’ve been through the cycle enough times to know.

I remember the last time I found myself in this place of despising myself and hating my body. It wasn’t nearly as bad as this time; I was much smaller and in much better physical shape to begin with. Still, I hated myself. I decided to DO SOMETHING ABOUT IT, so I went on Weight Watchers. The results, at first, were remarkable. I felt happy and in control. I lost about 40 lbs, enough to get me down to that size 14, but I still wasn’t satisfied. I never did reach my “goal weight,” and even when I was still on the weight loss program (rather than maintenance), I started gaining weight back. Eventually I got tired, tired of the food measuring and the limited portions and the altered recipes that were never as good as the real thing. Tired of exercising to exhaustion, doing things I didn’t really enjoy. So I stopped, stopped it all. And here I am, seven years later, bigger than I ever have been in my life and hating myself again. In worse shape than I’ve ever been in my life, because I can’t bear to do any exercise at all.

I feel stuck between a rock and a hard place and I don’t know how to get free. I don’t know how to come to terms with the body I have, this body that doesn’t work the way I want it to and doesn’t look the way I want it to. The way I see myself in my mind’s eye. I don’t want to participate in a diet culture that shames people of size for being the way they are. I would never, ever even think the thoughts about other large people that I think about myself. I know that fat people have a right to exist, that no one deserves shame, that many factors go into determining body size, that size isn’t a determiner of health or worth, that no one even has an obligation to be healthy at all. But I can’t stop hating myself.

A little while ago, during the course of another conversation, one of my sisters told me she basically lives her life on Weight Watchers and has for years. I don’t want that for myself.

What do I do? I am in such pain right now, crying as I try to write this post. The voice in my head says, “If you would just…” Just what? Try harder? Try at all? Push myself? Why? for what? What do I get? It would help if I wanted anything beyond being thinner, but I don’t. I try to say, “You don’t like that you’re weak and out of shape, so engaging in exercise could help with that.” I try to set goals that aren’t weight-related, like “walk around the block without getting out of breath.” But they always cycle back to weight. “And then I can walk more blocks, and then maybe I’ll finally lose some weight.” Nothing else is valuable for its own sake. And I know this is a fucked up attitude; I know it comes from fat phobia and the way our culture is so focused on thin bodies as a measure of worth, especially women’s bodies. I know that thin equals morally good and fat equals morally bad, and I don’t believe it, I don’t. Still, deep in myself I can’t get rid of it. Not regarding myself. I don’t want health enough to detach it from the pressure to be thin and pursue health for its own sake. I just don’t care.

And maybe all of this is depression speaking. I don’t know. This turmoil has been with me forever, when I’ve been badly depressed and when I’ve been less depressed (for there is never “not depressed;” that isn’t part of my reality, ever). I want strength and beauty and maybe health too, and all those things have a price tag too steep for me to pay. They all come attached to the idea of thin, and thin is too hard to achieve, and ephemeral besides.

I go around and around in circles, and end up sitting and doing nothing. I don’t know how to get off the merry-go-round or where this post ends. I’m a failure at body positivity, and I’m a failure at weight loss conformity. I reject societal standards of beauty and I have nothing to put in their place. I’m an empty person.

Empty, empty, empty.

Mental Illness and Relativity

As I mentioned a few posts ago, at the beginning of December I started a new medication, and it worked. It worked better than I dreamed it would, and it’s continued to work. I still have bad days, usually when the weather is icky. I’m not sure science will ever unlock the mystery of the relationship between weather and health; I’m not sure scientists give it as much credit as it deserves. However, my good days increasingly outnumber the bad ones.

This is new and strange. Perhaps the strangest thing is how much time I suddenly seem to have.

Mental illness is a time sink. I could fall into social media or casual games for hours and hours on end, and then when I lifted my head to see the sun setting wonder what happened to the day. I’d remember when I was younger, even as recently as ten years ago, accomplishing so much in a day. Getting up and not taking hours to move beyond drinking coffee and checking my notifications. Putting on clothes and going downtown, going for a walk, working in the garden, doing the daily maintenance on my home, cooking elaborate meals. Depression and anxiety, the two main manifestations of my mental illness, have limited me by limiting my time. Dragging myself out of the Internet and putting down my phone has often seemed a Sisyphean task, the effort only gaining me minutes of clear space before those twin rocks forced me back on line.

I have had a love/hate relationship with those rocks. They are smooth, presenting no challenges other than their existence. They have kept me safe from interacting with things I’m not ready to face. I think many mental illnesses still exist, evolutionarily speaking, because they DO keep people safe and keep the broken parts from grinding together; it’s just when they take over and become chronic illnesses rather than temporary traits that they become more problematic. On the other hand, I sometimes (frequently) have remembered times of being more functional and wondered, “Is this it? Is this as good as it gets? Is this my life now?” Living with an uncontrolled mental illness is brutal and unforgiving; there’s always a reason why it’s your own fault. There are always other people, more functional and successful people, with whom to compare yourself, so the things lacking in your life stand out in sharp contrast. It’s easy to forget that every day you survive is a victory.

With my mental illnesses in relative check, I have so much more time. The time starts right away, first thing in the morning. I sleep better. I don’t have to take a sedative every night just to find my way to dreams. I go to bed and get up at times more “normal” for me. I need less sleep, too–still a solid eight hours, but not nine or ten or more. I can even function for a day on six or so, as I did last week when I had jury duty, which is another task that would have been impossible for me even to face before. It doesn’t take me two hours to get up off the couch and wash my face. Where I used to see the sun set and wonder what had happened to the day, now I’m functioning before noon most days. It still instills me with a sense of wonder, but now I’m wondering what to do with all this time, rather than wondering where it all went. In the past little while, I’ve crocheted a hat for a friend, started work on a sweater for the same friend’s tortoise (so they can match), cooked more, cleaned more, picked up yoga again (until I injured my ankle, at least), even gotten a start on a couple writing projects. The last two have remained difficult, as are any dedicated creative endeavors; contacting my heart causes me pain that brings everything to a screeching halt. Last night I even went with my husband to an open mic he wanted to play at. I looked forward to it all day. I put on makeup! And I had a reasonable time, experiencing some feelings of annoyance and alienation, but not nearly the feelings I would have just a short time ago, when I’d have been ready to leave an event five minutes after walking in the door–if I went in the first place.

All these things may seem small to a person who hasn’t struggled as I’ve struggled the past 10+ years, but to me they’re huge. And people (my therapist, my med manager) have told me in the past that losing time was an aspect of my illness, but I really didn’t get it until now, when that time is spread gloriously before me. Depression sapped my will and my motivation to do anything at all. I couldn’t even see how dirty my house got until six months had passed since the last time I’d mopped the floor and I made myself do it because I simply couldn’t stand it anymore. Everything became a matter of “which is worse: doing or not doing? How much can I stand?” Anxiety crippled me with a sense of dread at the prospect of engaging with life on any level at all. Much better to fend it off with games, with chit-chat, with Netflix, with anything I could use to numb the fear.

I don’t fool myself that all this is gone now. As I said, I still have bad days, and those days are BAD. Perhaps the worst thing about them is slipping back into self blame and recrimination, all the unproductive ways of thinking that, though I’ve worked forty years to loosen their grip, still take hold of me at those times. That I’m irredeemably bad and awful, that I have no value, that I’m weak and lazy and all the rest. That life is grey and dreary and will continue to be so until the day I mercifully die. Those days, I simply have to grit my teeth and bear it, try not to listen to the messages, and do what I need to do to get through. I have no illusions that I could survive in a capitalist institution like a “normal” job, or that routine “work” wouldn’t send me back into the spiral of suicidal ideation. A warning sign is that even saying those things sounds to me like making excuses for laziness, and right now my brain is berating me for wanting “special treatment” and “wanting to be taken care of instead of carrying my own weight.” Those are the signs of my sickness, and I think I may never be altogether free of them.

But right now, there is time. In the words of T. S. Eliot, “Time for you and time for me; time yet for a hundred indecisions, and for a hundred visions and revisions before the taking of toast and tea.”* And those indecisions, visions, and revisions, don’t scare me to death. And that’s good.

I believe this is how Einstein explained relativity: “A minute looking at a pretty girl goes my in the blink of an eye, but a minute sitting on a hot stove lasts a lifetime.” For me, a day consumed by anxiety and depression passes in an instant, and a day without their weight expands with infinite possibility.

I much prefer the latter.

*From “The Love Song of J. Alfred Prufrock,” 1917

Reality Quicksand

A little while before Yule, my mental health medication provider suggested I try a new (new to me, that is; it’s actually quite old) medication for my anxiety.

Pause. I probably need to explain that my anxiety isn’t “normal.” It’s rare I experience invasive thoughts; though they can be a factor, they’re more likely to figure in my depressive episodes. Instead of that, or obsessing over perceived mistakes and subtext, I tend more toward a somatic experience of utter terror with no apparent connection to anything happening around me. My heart races, I feel sick at my stomach, I clench my jaw and fists, I feel driven to hide and make myself small, all without having any idea why and without anything having happened to trigger such a response. (This led my previous psychiatrist to scoff and tell me “You can’t be anxious without being anxious about something!”) The overall tension prevents me from sleeping; until recently I had to take a high dose of Temazepam every night to be able to sleep at all.

My med manager thought that this phenomenon was more a manifestation of my bipolar disorder taking the form of a mixed state where the manic side of things manifested as irritability and anxiety than of anxiety per se, and that it accentuated the symptoms of my CPTSD. The medication she suggested is indicated for controlling bipolar mania. Being rather at the end of my rope, and being all too aware that taking sleeping pills every night is not a good practice, I said, “What the hell; let’s give it a shot.” Since I’m notoriously resistant to drug treatment, neither of us expected much from the small dose she started me on.

However, the new med worked better than I had imagined. Within a couple doses, I had given up the sleeping pill except on especially stressful days, and by the time a couple of weeks passed, I felt more “myself” than I had in years. I started a new writing project. I committed to doing my physical therapy, even adding some extra yoga and Pilates to my morning routine. I pulled out my guitar and figured out the chord progression to a song I wanted to learn. None of it occasioned the overwhelming feelings of personal peril I’d come to expect.

Then I got sick, and I was seriously ill for almost three weeks. Still, when I started to recover, I went back to the activities I’d remembered I enjoyed. For a while. After a few days, the anxiety returned to torment me. But this time, I wasn’t sure if I’d become tolerant of the new medication, or if it was something else.

Today I’m fairly sure it’s something else. I’m equally sure that something else won’t respond to medication.

Yesterday, for the first time since starting the new med, I woke up and did not want to get out of bed. Everything seemed too hard. My life seemed overwhelming and bleak. All day I was barely functional, and today isn’t much better.

This may seem like a tangent, but it’s not: I follow a certain astrologer on social media, one who specializes in reading the planets and stars as they relate to my sign, Scorpio. This young woman is exceptionally gifted. I can honestly say I haven’t ever run across a better. (If you’re interested in this kind of thing, check out @ScorpioMystique on Twitter and Instagram. I think she has another account where she reads for other signs, but I can’t bring the handle to mind right now.) Yesterday, her horoscope mentioned the Full Moon energy and all its benefits, but added, “If you woke up feeling exhausted and emotionally drained…” and went on to mention several reasons this might be, notably having an unbalanced relationship between your professional life and your home life. I commented that I did, in fact, wake up emotionally drained and exhausted, but the balance question didn’t resonate. She answered, “What about your relationship with yourself? Maybe you need to focus more on self care.”

Ouch. That hit home. Self care is a difficult area for me. I never know what it is.

Today’s horoscope advises to “write down a list of your most pressing dreams and goals…what feels right for you.”

Great. I’m not so good at that, either.

After I started recovering from the Great Plague of 2016-17, when I brought my mind back around to what I wanted for myself and how to achieve it, well. That’s when the increased anxiety hit. And I know why. It’s because for nearly twenty years, I was programmed to believe my goals and what I wanted for my life were selfish and wrong. A lot of people in my circle will understand this. It seems to be part of The American Way. So practicing self-care, even when I know in my head it’s good and the right thing to do, is a horrible struggle against voices telling me I am bad and wrong. On top of that, because I’m fat and because I have a history of eating disorders (or maybe it’s brain chemistry in part, IDK), I have a tendency to A) never believe anything I do in terms of my physical being is enough and B) go overboard until I damage myself or burn out. And all of it spirals around and around in my brain until it literally incapacitates me and I have to curl up in a ball on the couch and cry.

Twenty-plus years of near constant gaslighting has turned my reality to quicksand: dangerous to navigate and prone to sucking me under to drown. And though my Buddhist college promoted being “grounded in quicksand” as a positive development, I can’t think they had any experience with the actuality, because it sucks. (I’m sure they meant it as a metaphor for non-attachment, but be real.)

Days when I’m on a more or less even keel, it isn’t so bad. The problem is, the more positive things I do for myself, the louder the negative voice get and the less steady I become. I go from getting up, having coffee and farting around on the Internet a bit, and doing my morning PT+ routine without much hassle to this:

Me: I’m not feeling so great today. Maybe self care looks like taking it easy.

Inner Voice: You can’t do that. If you skip PT ONE TIME, you’ll NEVER go back to it.

Me: Physical activity brings up a lot of shit for me and I don’t know if I can cope today.

Inner Voice: That’s because you’re a LAZY PIECE OF SHIT. You have to prove you’re NOT a LAZY PIECE OF SHIT by doing MORE PT!

Me: This conversation is really hurting me.

Inner Voice: You DESERVE to be hurt! You DESERVE to be punished! Excessive exercise is the only way of redeeming yourself!

Me: Don’t I deserve some comfort?

Inner Voice: Comfort is for LOSERS! How will you ever achieve anything if you concern yourself too much with being comfortable?

And on and on, until the warning that if I skip one day I’ll never accomplish anything again becomes a self-fulfilling prophecy as I try to shut out that awful voice and protect myself. It’s a fight I can’t win. Being gentle with myself and taking things slow, at the pace I need to be able to continue, becomes a sign of what a terrible failure I am. Everything I like is dangerous and tainted, because I can’t do it just a little; I have to do it until I’m exhausted and in pain.

Sometimes it goes the other direction. I get a creative tickle and think, “Huh, maybe I’d like to pull out my flute or my guitar.” And the awful voice says, “Yeah, you better. You realize it’s been five years since you played any music? What the hell is wrong with you? Some musician you are. How dare you pretend you are one!!” Same with writing, or physical activity, or anything I want to engage in in a positive way. It all gets weaponized against me.

Trying to describe this process makes my brain feel like it’s about to implode, by the way. And I don’t know what to do about it. I have no control. If I “give in” to the awful voice, things I love (or even like, or vaguely want to do) become punishments, and doing them reinforces the idea that I need to be punished. If I resist, I feel worse and worse as the voice gets louder and louder, until it encompasses every single thing about my day. Hungry? If I eat, I’m an evil glutton. Tired? If I sleep, I’m a lazy shit. The most human activities are transformed into crimes against nature, proving I have no right to exist at all.

Up until now, the only way I’ve found to get out of the cycle is to back off everything until my mood changes on its own. One day, if I hold out long enough, I’ll hit an upswing. Then I can start all over again. But this means I can never actually achieve anything, because I’m always taking two steps back for every step forward.

There are things I want out of my life. There always have been. I want to write again. I want to be in better physical shape. I want to look different than I do. At the risk of sounding less body-positive than I believe I am, I do want to shed some weight–not because society tells me that’s the only way I’ll ever have value, but because I don’t like the way my body feels at this weight. I want to get back to playing music, singing, growing a garden. And all those things…it’s like the only way I can protect them is not to do them at all, because if I admit to wanting them the awful voice will find a way to turn them against me. Turn every pleasure into pain.

I have no sword to cut this Gordian knot. I already know “just pushing through” is futile. I’ve tried that strategy over and over for going on thirty years and it doesn’t work.

Reality sucks me down like quicksand, and I drown.

What I Can’t Forgive

CW: Infertility, discussion of weight loss and eating disorders

If you’ve been around the fat activist or body positivity communities, you may have heard the axiom “What gets diagnosed in thin people gets prescribed for fat people.” What this means is the medical establishment often encourages fat people to engage in behaviors that would be seen as warning signs in thin people, or overlooks symptoms in fat people that would have them sending thin people to specialists, because ANYTHING is better than being fat, amirite?

For a person born female or assigned female at birth–by this I mean a person in possession of a uterus and ovaries and all those childbearing parts–a BIG warning sign is the cessation of menstrual periods before the age of normal menopause, which, in the United States, is 48-54 years. It often occurs in women with eating disorders, both because of weight loss and the tendency to engage in excessive exercise. Generally speaking, it takes a loss of 10% of body weight to cause amenorrhea.

Let’s look at those numbers. Say a woman who weighs 125 lbs loses 10% of her body weight, or 12.5 lbs. This leaves her weighing 112.5 lbs. If she’s 5’6″, which is an average height in the US, her BMI would be 18. (Personally I despise the BMI as a rating of anything, but it’s what the medical establishment uses, so.) Hey, that’s underweight! Better address that.

Now let’s apply the same reasoning to another 5’6″ tall woman who weighs 200 lbs. She loses 10% of her body weight, or 20 lbs, bringing her weight to 180. Her BMI is now 29. Guess what? She’s still overweight. It doesn’t matter how she lost the weight, or whether she engages in ritualistic eating patterns, or if her periods have stopped. No one will even ask about that. She has to lose over 60 more lbs (achieve a weight of 115 or less) before she hits underweight. I personally know people who started out average, who’ve been hospitalized for an eating disorder at that weight. But if you start out fat, you’ll be congratulated. If you live.

I started menstruating at twelve, and I stopped at fourteen. For five and a half years. My eating disorder hadn’t yet kicked into full force when it happened; I think I’d dropped from 145 lbs to 130. Perfectly within the normal range for a 5’7″ adolescent, despite the way my pediatrician “tsked” over my being “tubby.” No one commented on it. I was just as glad, frankly. Issues of sex and reproduction and sticky fluids disgusted my mother, who left it to the sixth grade film strip to explain matters. When I needed sanitary supplies, I took them from her box of Kotex in the hall closet without mentioning it to anyone. She didn’t hit menopause until after my cycles stopped, so that was convenient. I doubt my dad ever thought about it, despite being the one who did all the shopping for our family. Maybe he believed I got my own supplies somehow. How he thought I achieved this, having no money of my own, I have no idea. My pediatrician complimented me on “slimming down;” later, when I got a bit too thin for his liking, he sent me home with cases of liquid nutritional supplements. They piled up in the pantry, untouched.

Common wisdom is that your cycles are supposed to start again once you gain weight. Mine didn’t. It took a therapist’s intervention and several courses of Provera before that happened.

The reason I rehearse all this old, old information is this: the exact same thing happened the last time I turned my will toward losing a bunch of weight. I was bigger than I’d ever been (though not as big as I am now), and I hated it. More, I hated myself for it. I tried to talk to my then-psychiatrist; I wanted him to understand why it was so difficult and loaded a topic. Despite knowing I’d almost died of anorexia, he just said, “Well, you know how to lose weight. Eat less and be more active. If you really care about your weight, you need to do what’s necessary, not whine about it.”

Deep breath. Can I just take a moment to say how despicable it is for anyone in mental health to use the words “If you really care…?”

Anyway. It took a while, but I decided he probably knew best–he was the doctor, after all. Maybe I was just whining because I was lazy. So, I joined Weight Watchers and boosted my activity. A lot. It worked for a long while. I lost so much weight in the first few weeks that clothes I had just bought fell off of me. And my periods stopped. Again.

That was almost exactly ten years ago; I was forty-four. And while that’s not an unreasonable age to hit menopause, it isn’t quite normal, nor is it normal for women in my genetic line. My mom had cycles well into her fifties, and one of my sisters had her last child at forty-one. I asked my psychiatrist if one of my medications could have caused it; he said no. I asked my primary; she said it was probably perimenopause and my periods would probably be irregular for a number of years, blah, blah, blah, the usual stuff. Which didn’t make any sense to me; they didn’t get irregular, they simply stopped. But no one related it to my weight loss, which, incidentally, they praised. I didn’t bring it up because I was proud of it, and I didn’t want to hear that for some inexplicable reason my body reacts to the slightest weight loss by becoming infertile, which I suspected, and had since I was a teenager. There was still the matter of believing I’d have children some day, despite my age and my mental health issues.

Much later, an acupuncturist told me it probably was the weight loss rather than my age that caused my cycles to stop just then. She may have been saying that to make me feel better, I don’t know. I do know the main reason I stopped “watching my weight” and “let myself” get fat again was that I hoped desperately that, by some magic, it would restore my fertility. It didn’t. The lack of ANY other menopausal symptoms let me hope for a long time, but I’m coming to the place where I think I have to accept that I blew it; I missed my chance for children of my own. It’s hard. I’ve swallowed a lot of bad stuff in my life, but this one…I just can’t seem to get it down. And people suggest adoption (too expensive) or fostering (no space for a person older than three, and I have doubts that we’d pass muster as a foster family), or working with Partners or some other volunteer group, and none of that is what I want. Humility aside, my husband and I are intelligent and educated and self-aware, and I wanted to keep that genetic code in the pool. Too many stupid people breed. I really think that, so sue me.

I can’t forgive my doctors of ten years past for blowing me off. For giving me the easy answers, whether or not they were true (I found out later that Depakote, the mood stabilizer I took at the time and that I’m taking now, has been known to cause PCOS and infertility. I stopped taking it for a long time because of that). For not saying, “Hey, you have a history of anorexia and you’ve lost over 10% of your body weight. Maybe there’s something in that.” I can’t forgive the medical establishment for privileging a specific body size and type over actual health, to the point where the health concerns of those outside that type are routinely ignored. Even at my lowest weight recently, I was still “overweight” by a few points. So obviously there could have been no connection between my early amenorrhea and my weight loss.

But most of all, I can’t forgive myself. As much as I repeat to myself I was in a bad state and in no condition to challenge those with perceived power over me, I can’t forgive myself for not doing it. I can’t forgive myself for not pointing out the correlation between my weight loss and the cessation of my cycles, for not bringing up the similarity to my previous experience. Maybe it wouldn’t have made a difference. At least I would have tried. The thought haunts me, the same way it haunts me how readily I crumpled after two miscarriages when I know women who’ve had three, five, ten, and gone on to have healthy children. Even women in their late forties. As I would have been, had I spoken up.

And sure, there would have been obstacles. Maybe a lot of them. There still would have been my mental health and the financial burden to address, the need to talk my husband around; I might not have been capable of those things. Some people think it’s “selfish” for older parents to have children; there would have been that judgment to face, along with all the judgments parents face. That’s if I even managed to carry a pregnancy to term, no telling what more failures would have done to me. I thought at the time I couldn’t face another miscarriage. Now I see that as cowardice.

Aslan, the godlike Lion in C. S. Lewis’s Narnia books, always tells the human characters, “You can never know what might have been.” My imagination amply provides me with “might have beens” every day, and none of them seem worse than where I am right now. I’d give everything I have for one more chance.

I think this grief and blame and regret will follow me the rest of my days.

 

 

How Did I Come to This?

“Where now the horse and the rider? Where is the horn that was blowing?
Where is the helm and the hauberk, and the bright hair flowing?
Where is the hand on the harpstring, and the red fire glowing?
Where is the spring and the harvest and the tall corn growing?
They have passed like rain on the mountain, like a wind in the meadow;
The days have gone down in the West behind the hills into shadow.
Who shall gather the smoke of the dead wood burning,
Or behold the flowing years from the Sea returning?”

J.R.R. Tolkien, “Lament for the Rohirrim,” The Two Towers, Book I

The Two Towers was always my favorite book of Tolkien’s epic trilogy, and to me, the most powerful part of Peter Jackson’s film adaptation was Theoden’s (Bernard Hill) recital of the above lines as his steward arms him before the Battle of the Hornburg. (In the embedded video clip, the speech starts about a minute in.)

I’ve felt a good deal in common with Theoden of late. Trying to put myself back together after leading a largely ineffective life for so many years, I often echo his question: “How did it come to this?” Yesterday, I had some vague idea of engaging with my physical world. In the deepest parts of a depressive episode, I lose the ability to act on my environment in a meaningful way. I can see the cat hair piling up in corners and the grime in the bathroom sink, and I have some idea these are unwelcome. But the effort of doing something to change them, to clean the sink or sweep the floor, requires some investment I don’t have. I know my environment is filthy, possibly disgusting, and I know I wouldn’t want anyone to see how I live, but I don’t care. No one besides my husband is going to see it, and even if I tidied up, things would get dirty again anyway, sooner or later. Why bother to begin?

Whether this latest dip is starting to let up or whether I simply let things go too long, the mess has been getting to me more and more over the last few days. So I did tidy up a bit yesterday. I didn’t tackle the bathroom, as I meant to, but I swept and dusted the living room. It took me an hour, and by the end of it, I was exhausted and in pain. Once again, I asked myself, “How did I come to this?” I was a dance major in college. A walk of three or five miles was nothing to me. How did I allow myself to get in such terrible shape that an hour of light cleaning had me in tears?

Still shot from "The Two Towers"
Still shot from “The Two Towers”

Tolkien adamantly denied that his works were allegories for anything, but readers always find meaning that authors never intended. Part of the poignancy of that arming speech, for me, is that Theoden knows the answer to his own question. He listened to the voice of depression, in the guise of his adviser Grima Wormtongue, and it turned him old. He left the work of ruling to others. When Rohan was meant to be the Western shield against enemies bent on invading Gondor, he refused those who would keep the old treaties any aid, although it cost him his only son. He drew into a small world where his depression ruled and hope was futile. And it resulted in the last stand at the Hornburg, and arming children for war. How did you come to it, Theoden? You did it. You did it to yourself.

And so did I.

I’m not implying that I could in any way have fought off my mental illness by force of will. I spent many years saying “This too shall pass” on bad days and getting through as well as possible. When “getting through” became impossible, I got help–or as much as I could. I do have a tendency to consider low level depression normal, so it takes my being in a bad state, indeed, for me to look outside for answers. And a lot of the help I got was barely better than the alternative. I don’t hate or blame myself for my depression, most of the time.

I think I could have responded to my circumstances better, maybe. Some of what I did, I did for good reasons. I gave up “dieting” because I truly believe it’s more hurtful than helpful. I renounced excessive exercise in the name of weight loss for much the same reason. The trouble is, as I’ve mentioned elsewhere, I stopped moving at all. Like Theoden, I drew inward. My world contracted to the size of my house. It was comforting, and besides, why challenge myself to walk downtown to the post office if my husband is willing to pick up the mail, or to join him on weekly shopping trips if he’s willing to do them alone? Many “self improvement” systems, good and bad, make much of getting out of one’s comfort zone. This is hard for me, I admit. I’ve had little comfort in my life; choosing to do uncomfortable things is not high on my list of priorities.

So now my legs and back hurt if I’m on my feet for any length of time, I have asthma and no stamina, and there is no Gandalf coming to fight my demons for me and restore me to health. Medication and therapy will only do so much to banish my personal Wormtongue. The rest is on me.

Because of my background in dance, I know what to do. My back hurts because my abdominal and core muscles have atrophied for lack of use. My legs hurt for much the same reason. I’ve lost most of my flexibility, which I once prized. A combination of yoga and Pilates would go a long way to remedying these things, as would getting out of the house and simply walking around the block a few times a week. I know doing these things would help, not only with the pain and the muscle atrophy, but with my constant hunger. The problem is doing them. I’ve always found my motivation in self-hate and bullying myself into doing what I didn’t want to. These even made up a great deal of my life as a dancer: “Look how fat you are even moving as much as you do! You can’t ever stop or you’ll be disgusting! No wonder your boyfriend wants to hook up with other women!” I’ve managed to avoid going back to that mindset so far, but I’m terrified it’ll return the moment I start moving. Moving, you see, wakes up the damaged child inside me (and, by the way, I feel extremely silly using those terms), and starts it crying. All it wants is to be left alone and let to sleep and feel no pain. I’m not sure it can feel anything but pain, and that terrifies me. I don’t want to re-experience that every day of my life; it’s horrible. How does one integrate something like that? Of course, beating myself up, telling that damaged child to suck it up and stop whining because that’s getting us nowhere, doesn’t help, either.

How do I deal with this? What do I do? My former therapist used to tell me, “Baby steps,” but baby steps are abhorrent to me. I’m made of all or nothing, highs and lows. Why bother taking a step so small you can’t see you’ve gone anywhere? Why bother with a small step if even that causes inner weeping? If I sit on the couch on my ass, my back doesn’t hurt either. My current bad health distresses me, but in a distant way. On another level, it doesn’t matter to me at all. It’s as if, perhaps, the shrieks of that damaged child are so loud and demanding I have no attention for anything else. I suppose parents feel something similar when a colicky infant won’t stop screaming for days on end and all they want is for it to SHUT THE FUCK UP! I don’t know any way to silence my internal screaming other than to remain still and small. The damaged child inside me controls my whole life.

When last I saw my doctor, I got a referral to physical therapy. My first appointment is tomorrow. I’m toying with the idea of doing Pilates again. Both these things terrify me. If I can’t find some internal meaning and positive motivation, they’ll go the same way as everything in my life: I’ll do them for a while, maybe even a long while, and then give up.

How did I come to this? The real question is “How do I get out and never come back?” I haven’t got a clue.

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