Monday, February 24, 2014

A Self-Therapy Session: Asperger's, Relationships, and Self-Loathing

This blog has served multiple purposes for me. It has helped me to make a difference in other people's lives by showing solidarity with their struggles, showing that they are not alone. It has similarly helped, or at least I hope it has helped, to destigmatize depression and mental illness as a whole. Additionally, this blog has helped given me a foothold into mental health advocacy, and it was through the publishing of this blog that I was able to later give two speeches to two different middle schools about my struggles with depression.

But what has helped me the most in the publishing of this blog has been the therapeutic effect it has had on me. Through this blog, I have been able to expose my vulnerabilities, and in doing so, heal them. By communicating my own struggles to others, I also communicate to myself that it is ok to have these struggles, and to not be ashamed of having them. I destigmatize the struggles not only to others, but to myself. And I can not overstate how valuable that has been.

Today I am exposing another of the vulnerabilities, and a complex one at that. It's one I know many young people struggle with in one form or another, but in which I seem to be on one of the tail ends of the bell curve, out of the area where they resolve naturally with time but continue to remain, sometimes coagulating and leaving scar tissue behind, sometimes festering, and sometimes doing a twisted mixture of both.

I wrote the majority of this at 4 in the morning, after a bad cold has kept me awake for three hours so far. Excuse me if I get a bit sentimental.


A friend of mine recently came to me with wonderful news: She had begun dating someone she had been interested in for a time. To hear her talk about it, he's attractive, interesting, intelligent, everything she wants in a relationship. They'd gone on their first date a few days prior and when we talked about it later she was glowing. At that moment, she felt like she was on top of the world.

And yet I was upset.

When I heard about her having such a successful relationship, I felt something, I wasn't sure what. Jealousy, perhaps. Or resentment. I was upset because she seemed to be looking at the start of a successful relationship and yet I was still single. Aside from one troubled two-month relationship the year prior, I have always been single.

At this point I find myself struggling to find a balance between a balanced analysis of my feelings and falling into indulgent self-pity. Perhaps it is hard to escape that latter aspect of it. It hurts, to put it simply. It hurts to not have someone I can be so intimate with, to put my trust into so fully and see that trust reciprocated. I know that no relationship is perfect, and that a relationship will not solve all of my problems, but it nonetheless feels like something I am missing.

I can't speak to the legitimacy of that feeling. Many people are happily single, and to some extent I am content to be single as well, and have time to focus on myself and myself alone. I am hesitant to try for relationships because I know of how much of a commitment it is, and I'm unsure if I want such a commitment now.

But then that hurt.

There is a part of me that thinks I cannot have a relationship. It is a small part, and getting smaller as I get better, but for now it is still there. It took form in High School, and it was caused mainly by my Asperger's Syndrome and my difficulty with properly expressing and controlling my own feelings. Twice I had really good friendships. Twice those friendships developed into feelings for the other person. And twice those feelings led not only to no possibility of a relationship, but it led to the friendship as a whole falling apart.

I will not be ambiguous. This was not a case of incompatible personalities. If that is anything it is a distant factor. This was the case of me, and my issues, leading to the erosion of possible relationships and fulfilling friendships.

Both followed a similar pathway. After a certain point I realized I was interested in these friends romantically. Yet, mainly because of my Asperger's Syndrome, I did not know how to express that. So I expressed it with extra attention to the person, keeping in constant contact with them, and of course, obsessing about every little action they took in relation to me.

With the first person, in freshman year of high school, this manifested through making sure I sent them a text message every night, and worrying if I did not get a response back.  I greeted them every day and said goodbye to them everyday, and panicked if their response was tepid or otherwise subdued. I would try to talk to them as much as I could in between classes, and strained trying to figure out the right words, the right sequence of syllables, that would make things work out.

With the second person, which happened when I was a junior and she a senior, it was mainly an overbearing anxiety that clouded all of my interactions with them. I worried constantly that I had said or done something that would not only bother them, but would irreparably damage our relationship. I would take them aside and ask them, again and again, if I had done something wrong, convinced that I had, and time and time again they would say I did not, that I was fine. I didn't believe them. And the next week I would be there again, asking if I had done something wrong.

You can imagine the toll this took on the both of them. They naturally retreated from me, and because they retreated, I panicked more, and tried all the harder to hold onto what seemed to be slipping through my fingers. And because I tried all the harder, they moved away all the more. The end result was two people who did not talk to me, ignored me, and tried to keep their distance from me as much as they could.

I got a happy ending to one of these. A year after our problems in freshman year, I and my friend managed to reconcile and become close friends. I helped her through some tough times, and she helped me through some of mine.

The second time was not so lucky. We never reconciled. She stopped responding to my messages over Facebook. I had to unfriend her so I would stop seeing her on my newsfeed and getting upset all over again. Then I had to block her so I wouldn't see her in the search bar when I typed in names. Even just a mention of it would bring the memories and the hurt flooding back.

There are many ways things could have been different. If I had therapy that helped me to address these problems earlier. If they were more aware of my own personal struggles and knew how to respond to it. None of these matter. I lost a wonderful friendship, and to this day it remains a barely-healed wound, waiting for something to trigger it--a dream, resurgence of an old memory, saying her name--and reopen it and bring those feelings back to me again. Sometimes I still feel the urge to send her another message, because a part of me still believes we can be friends again. But even if she would respond, I wouldn't recognize her as the person I knew those years ago. It's been over three years since then, and we've both changed far too much. I don't send her those messages because I want to be friends with who she is now. I send them to her because I want my old friend back.

I did this again in college, nearly did it another two times, saved only by my developing restraint and the charity of the other persons. With all five occurrences came anxiety, depression, and mental breakdowns. It's not hard to see that a lot of the self-loathing and relationship issues I struggle with now came from these events. As I saw these relationships fall apart in front of me, I felt a sense of powerlessness. I knew, partially, what I was doing, and what it was leading to, but at the same time I couldn't stop. I didn't want to do it, but I didn't see what else I could do. In my warped perspective, my only option was to continue my flawed reasoning, and hold onto increasingly fictitious hope that there would be a happy outcome out of it.

I felt broken. I felt like I was dysfunctional in a fundamental and unchangeable way. In my mind, when I became too invested in a relationship, it would inevitably fall apart. I could not be happy, because I would sabotage my own happiness. I still deal with these feelings nowadays, and I don't doubt it has hindered recent attempts and considerations for relationships, along with a whole host of other things. Helpfully, though, I have not gotten to the point of losing relationships this way for a time. Perhaps I'll get my one-year pin soon.

There is a happy ending to all this, two of them in fact. One is somewhere in the future, when I've gotten better enough that I can let go of these problems, where the issues become so small they no longer hinder me like they used to. The other happy ending is simply I'm getting to that happy ending. Slowly, and in fits and starts, but I'm getting there. I'm improving, and will continue to do so, so long as I continue going to therapy, take medication, and look after my body both physically and mentally.

For now it hurts, and it will hurt in the forseeable future. Perhaps it will never stop hurting. But that doesn't mean I can't get better. Because I am getting better. I know it's something I say over and over again, but it is true. I am getting better. It's a slow process, and there's a lot of problems to wade through, but I am getting there. And it's posts like this that help with that.

Wednesday, February 19, 2014

Depression Is Not Me

I have depression, but depression is not me.

Depression knows me. It knows me very well. Well enough that it can take my greatest fears and strongest vulnerabilities and use them as daggers to my soul. Depression knows my weak points, and knows just where and how to cut.

Depression is a parasite that latches onto my mind and fills it with smog. Depression's only goal is to drain me of my joy, my energies, and my life.

Depression does not care for me. It may attempt to convince me that it is only looking out for my best interests, that it is trying to be "realistic" or "cautious", but it is a liar. Depression only cares about making me suffer, and will do everything to make that happen.

Depression will try to convince me that it doesn't exist. It will try to convince me that all the problems that are happening are caused by me and me alone, and as such I can only blame myself. Depression does exist, and it is making me have these thoughts.

Depression tries to isolate me. It tries to make me believe I am alone in the world, knowing that if I believe that I will unconsciously work to make it so. It knows that if I have support, if I have the presence of others to comfort and aid me and show me I am not the only one fighting it, its presence is tremendously weaker.

Depression begins with sickness and entrenches itself through habit. It repeats the thoughts it sends into my mind in the hope that after enough times I will begin to use those thoughts on myself without its encouragement. Its ultimate goal is that I will do its job for it.

Depression is merciless. It does not pity, it does not let up. Depression will never respond to begs and pleas for it to stop. The only way depression can be stopped is by fighting back, with therapy, medication, support, and yes, my own choices.

Depression never fully goes away, just as the temptation to drink never leaves for an alcoholic and cancer goes into remission but is never fully gone. It will always be there, and it always has the potential to come back. When I fight against depression, I do not seek to remove it, because it cannot be removed. I seek to minimize its effects that it no longer hinders my daily life. I can make it smaller and smaller and smaller but it will never fully go away.

And that is fine, because I am not defined by my depression, because my depression is not me. I can live a full and happy life while still having depression. I can still succeed with its presence looming over me. I can still get better when it is trying to make me worse. I can always get better.

Wednesday, February 12, 2014

Should I Go To Therapy?

If you are asking yourself that question, the short answer is yes.

That's not a difficult statement for me to make, as by and large, I believe most of us could use therapy. We all struggle with issues differently than others, and while we may eventually be able to surmount them ourselves, it never hurts to have a more knowledged voice to give us advice.

Yet many of us resist even considering therapy for a myriad of reasons. In this post, I'd like to take the time to address some of those issues.

To begin, I will preface by saying therapy is an enormously complex issue. There are numerous approaches to therapy, and there is debate among the effectiveness of the various forms. Additionally, not every therapist may be helpful for all people, and there are some therapists who may be helpful to very few people, if any at all. Yet in general, therapy is effective. Studies have shown therapy to be beneficial for the majority of those who take it.

It has certainly been helpful for me. In the beginning of my freshman year of college in 2012, I was struggling with the same issues I struggled with in school. I continued to have severe depressive episodes and frequent thoughts of self-harm, and on several occasions came very close to performing that self-harm. It was in response to those ongoing struggles that I worked with my mother to sign up for therapy with a therapist who specializes in treating people with Asperger's.

It has been less than two years since then, and I have improved enormously. Certainly, some of it might be attributed to adjusting to life at college and the effectiveness of medication, but all of it? The lessons he's taught me are now the lessons I incorporate into my own behavior, and much of the advice he has given me is the advice I have given to others, and it is often just as effective for them as it is for me.

Yet even when hearing about the effectiveness of therapy, it can be easy to have doubts, especially for those of us who have never had therapy before. Here are some of the more common reasons I have heard for why people do not go to therapy, and my own responses to them.

I don't have time for therapy

While this can be a legitimate reason for some, I feel this statement often hides other concerns and reservations, but speculating on that is beyond the scope of this post.

Therapy doesn't have to take long. I attend therapy every two weeks, and all it involves is an hour worth of commuting time and an hour's worth of therapy.  That's an hour a week of therapy. If I feel I need for more, I can ask for more. If I feel the need for less, I can ask for less. The point being it's on a regular basis.

It helps to think of therapy not as time spent, but as time invested, into better mental health. If you are more mentally healthy, then your performance in all areas of your life will improve as well. Your performance in your job can improve, and thus lead to a promotion. You can take greater joy out of life, and feel less stress. Your relationships can improve. Putting time into therapy now can pay dividends later.

If you feel as though you do not have time for therapy, I would ask you to consider what things you do spend your time on. Consider what needs to be done and what doesn't need to be done. Ultimately, it is up to you and what you prioritize to determine whether you have the time for therapy.

I can't afford therapy

Many believe they are unable to afford therapy, and often the costs for therapy are higher than many of us are comfortable, especially when we are dealing with something as ambiguous as internal problems. I am no expert on the subject, but this article on Psych Central seems a good place to start for finding affordable therapy and alternatives to traditional therapy.

Like my answer to the previous question, it helps to view therapy as an investment. You put time and money into therapy now so you will be better off in the future.

I don't have problems like other people who go to therapy do

There is common misconception that therapy is only reserved for people with severe mental illness. Yet therapists are not trained simply in dealing with severe mental illness. They are trained in dealing with many of life's struggles, as often the struggles accompanying severe mental illness are the same struggles that plague us in everyday life.

I have gone to my therapist for relationship advice, career advice, advice for dealing with numerous everyday problems. Indeed, as I've improved over the past year, it seems when I speak to him it is more and more often about more mundane things, and he is just as helpful with those as he is with the more unique and severe problems I've had to deal with.

There is no singular set of problems that are therapy-material. There are therapists who specialize in treating certain problems, such as family therapists and eating disorder therapists, but many therapists are able to counsel for a wide variety of problems, from marital problems to work-related stress to existential crises.

I don't want to waste the therapist's time with my problems when there are others who could use the time much better

This is, in some respects, another form of the previous argument. We argue that by taking up the time of a therapist, we are taking away that time for another person with "worthier" issues that the therapist can help.

Ignoring the question of what makes one set of issues worthier than others, I will point out that therapy is not a sparse resource. Indeed, the industry is growing. The Bureau Of Labor Statistics states "Employment of mental health counselors and marriage and family therapists is projected to grow 29 percent from 2012 to 2022, much faster than the average for all occupations."

Furthermore, The laws of supply and demand apply as much to therapy as it does to any other industry. The more people who sign up for therapy, the more demand there is for therapy, and the more therapists there are. By engaging in therapy, you do not take away another person's ability to attend therapy, but rather give another therapist the potential to provide those services to that other person.

I'm afraid of my friends and family finding out

A lot of this is related to the existing stigma surrounding therapy, which is itself related to the stigma surrounding mental illness. We view poorly people with mental illness, and mentally ill people often seek treatment through therapy. We fear that if we take therapy, we are admitting ourselves to have mental illness, and thus exposing ourselves to that same poor treatment.

I've said this before, but often we build up the stigma of mental illness as being more intense than it actually is, particularly with our family and friends. The same applies with the stigma of therapy. We fear that if they find out we are taking therapy they will reject us, but very often that fear is only because we understate the bonds of those relationships, and think they are more fragile than they actually are. Very often they are not, and the things we were so afraid of turn out to be far less important to them than we thought they were. They want us to live better lives, and if therapy is what is needed for that, often they are willing to accept that. This does not apply to all cases, of course, but it should be borne in mind.

Regardless no one needs to know you are attending therapy. Your business is your business. You are free to keep your therapy to yourself.

These problems are just a temporary thing. They will pass

It is easy to believe that something will go away on its own and so we don't need to take time out to address it directly. But ask yourself these questions: For how long have you had these problems? How do they impact your life? Do they pose significant obstruction in your life? Do they often make you feel uncomfortable? Do they take away enjoyment from normally enjoyable things?

Imagine also the desired outcome of therapy, which is that these problems you struggle with are controlled, or perhaps even gone entirely. How does that compare to how you are living now? Is the change worth a few hours of therapy every month?

If I need therapy, it means I can't handle my own issues

Many people view receiving treatment as an admission of their own incompetence, that they cannot handle their own issues and so they need outside help to deal with it. Ostensibly, we view ourselves like this because we want to hold ourselves responsible for our actions and encourage ourselves to change on our own. Yet so often this does not work out as we intend it, as often the problems we have are out of our control. This applies not only to brain-based mental illnesses but also to trauma like the death of a family member or a car crash, where dysfunctional responses are unfortunately very common. To think we are weak for suffering from these is akin to thinking we're weak because someone else broke our arm, and the logic of withholding treatment for mental issues is as irrational and unhealthy as withholding treatment for physical issues.

Therapy is not meant to be a replacement for our own effort and will, but rather is meant to enhance it. Therapy is designed so that we learn coping mechanisms and solutions for our daily struggles, and it is still up to us how we implement what we learn. Therapists often provide us with perspectives and possible solutions which we may not have come up with on our own.

Rather than thinking about what we must lack for using therapy, we should think instead of what we have to gain from it.

My past therapist(s) didn't help me. How can I be sure my next therapist won't do the same?

You can't, unfortunately.

Therapists, as with many treatments, are a trial-and-error process. Some therapists have methods and personalities that are helpful only to some people, and some therapists are helpful to no one at all. You may have to go through several different therapist before you find one that works for you.

I had two therapists before my current one. While both were helpful, I never felt as though I were bettering myself so much as I was maintaining myself, and whatever changes I had were not dramatic enough for me to notice. My current therapist is experienced specifically with dealing with young people with Asperger's, and the effect his therapy has had on me was immediate and noticeable and vastly more effective than my previous therapists. A year ago, I would not have considered writing this blog, or working as much as I am now. Yet here I am, and I'm considering working even more.

What if I find out I have a mental illness?

Then you know it's something that can be treated.

This question, and most of these questions, are at their root hiding a central motivation: We don't want to go to therapy because we fear the stigma attached to it.

Mental illness stigma is present in our society, and we fear if we are associated with it, we will suffer the negative effects of stigma. We fear that going to therapy means we are admitting to ourselves that we are sick, in ways beyond our control.

Yet therapy is effective. It enables us to address our problems and concerns in a safe and stress-free environment. We are aided by a trained professional who can aid us in viewing the nuances, subtleties, and solutions of our problems when we may not be able to alone, and for however long we are in their office, the therapist's attention is devoted wholly to us. As my own therapist put it, therapy is a place where we can be selfish.

Wednesday, February 5, 2014

"Ella -- You're Anorexic" : Guest Post by Ella Michaelson

Today's post is by a person who goes by the pseudonym of Ella Michaelson. She has given me permission to share her story, which details her own experiences with having an eating disorder. It is a powerful piece that deserves to be read, not only for her bravery in disclosing it, but for how similar it is to many who have experienced eating disorders. Her story is the story of many of us, yet it is also uniquely her own, and is presented in full below.


I didn’t realize I had an eating disorder until four years after I had fully developed one.

To be clear: I knew what eating disorders were. I’d read books about them, learned a bit about them in the Health class we were required to take in middle school. I knew what anorexia was. One of my favorite books was about a girl with bulimia. I was not completely ignorant on this matter.

“Completely” being the operative word here.

In my freshman year of high school I became friends with a girl a few years older than me who had been through an ED recovery program. She noticed that I had a tendency to skip meals frequently. At least one every day, at that point.

She said to me, “Ella – you’re anorexic.”

I denied this furiously. Firstly, that was a ridiculous notion. I was not anorexic! Anorexics did not eat. I definitely ate. Too much. I ate, and when I did, I always ate too much. That’s why I had to skip meals! I had to balance everything out! Secondly, anorexics were skinny. Which I definitely was not.

It was impossible for me to fit into this category, to have this disease. I ate food, I did not throw it up, and I was not underweight. Clearly I did not have any disorder of any kind. Clearly.

The next few years went a little something like this: Skip. Starve. Power. Binge. Weakness. Exercise. Love. Eat. Hate. Restrict. Better. Restrict. Better. Starve. Better. Exercise. Better. Binge. Hate. Exercise. Good. Eat. Anxiety. Anxiety. Anxiety. Anxiety.

At this point, in someone else’s story, you might hear them say that they started to black out frequently, that their grades dropped, that they were so obsessed that they couldn’t focus on anything else, that people started to notice they were sick. But this is not someone else’s story, it’s mine.

So here’s the truth:

I never blacked out, only ever got faint or woozy on occasion. My grades didn’t drop, in fact, I never got below an A in any of my classes. I had other priorities in my life – friendships, relationships, passions. Nobody noticed that anything was wrong. My weight stayed within the same four-pound fluctuation for four years. I remained physically healthy. So clearly I was fine, right? Clearly.

Anxiety. Anxiety. Anxiety.

Every time I put food in my body, I felt guilty. At the end of each day I wanted to pull chunks of flesh off of myself and throw them down the garbage disposal. Every morning I planned how I would manage to eat less during the day. If I went a day without exercise, it sent me into a downward spiral. I had panic attacks if I felt that I was failing to attain my goal.

My goal? No specific weight, really. My goal was To. Be. Perfect.

Someone else’s story might be about the calorie counts that they got down to, goal weights, losing their period, not feeling comfortable enough with their body to have sex. This is not someone else’s story. This is not someone else’s pain.

This was my pain: Kneeling in front of a toilet after a particularly large lunch, sobbing because I couldn’t bring myself to throw up. Waking up in the middle of the night with the worst stomachache and being unable to go back to sleep because I’d taken three laxatives before going to bed. Getting up at five-thirty in the morning, sharp, to get in a solid workout before making it to school. Rejecting sweets at parties, on Christmas, New Year’s, Halloween, on my birthday, because I was afraid of what would happen if I accepted them. Becoming a vegetarian, considering veganism, to force myself to fill up on food with next to no calories. Going from an early breakfast to a late dinner without anything in between. Trying to learn how to run on empty.

Clearly I was not –

In my senior year of high school, I stumbled across some blog posts written by people who could recognize otherwise. Eating disorders are psychological, they said. Mental. It’s all in your head. There’s no such thing as “not being sick enough.” There are more disorders than just anorexia and bulimia. EDNOS. BED. COE. Purging disorder. Rumination. Diabulimia. Night eating syndrome. Orthorexia nervosa. Drunkorexia.

The same sickness manifests itself in many different ways. And I displayed many symptoms from several of these different versions.

But that’s the issue, isn’t it? What we show. That’s how we’re diagnosed. By what we can see. And like most mental disorders, you may not necessarily be able to see the effects of an eating disorder. I had a friend who was so sick that she would wake up in the middle of the night and have seizures because her body was shutting down from lack of sustenance. That’s her story, not mine. But the root of our problems, we share. Perhaps we suffer from different physical symptoms, but our mindscapes look the same.

In senior year of high school, I sat in my Spanish class the morning after coming to the realization that I had EDNOS. Not a weight problem. Not too much fat on my body. Not a need to eat less and exercise more. I had a mental disorder. My heart started to race and tears sprung into my eyes as I took a sip of my breakfast smoothie – all fruit and protein and fewer calories than I’d burned in my workout that morning before school. I took a deep breath and tried to calm the anxiety building itself up inside of me.

I couldn’t do it.

I excused myself from the room and stood outside, leaning against the wall as if it could stabilize my mental state as well as my body. My best friend came outside as well.

“What’s going on?” she asked.

So I told her. I told her that I had developed this disease inside of me, from goodness knows where, that I didn’t know how to cure it, that I didn’t know if I ever could. I cried – for the first time, not from anxiety about my imperfections, but from anger. Anger at how I saw the world and how I saw myself.

Because clearly, something wasn’t right with me. And it needed to change. Clearly.

-Ella Michaelson

Monday, February 3, 2014

What to Do When You Can't Help: Learning to Let Go

This post has been a difficult one for me to approach. I've delayed and avoided it at various times, wrote and rewrote it and often while writing it I had to pause because I wasn't sure if I was fully convinced of what I was saying. Nevertheless I feel like this is a discussion worth having, even if I am not the best at talking about it.


You know the scenario. It's the relationship where you have to force yourself to speak to the other person regularly. It's the relationship where you dread getting a call from the other person, because you know it will only be them talking about their struggles and their miseries, and that while you'll listen, you know you're not going to solve their problems. It's the relationship where the other person says "You're only doing this because you feel bad for me" and you say no, no, no--even though you know that's exactly why you're doing it.

I've known people who have struggled with these issues. I've known people who have stayed in friendships and relationships, not because they wanted to, but because they felt obligated to. I've known people who have sacrificed their own time and energy in an attempt to better someone else, to comfort someone else when they were distressed, only to see that person continually take that effort and do little with it, unknowing of how much strain it was on the other person. I've seen people fake affection out of the hope it would make the other person feel valued, and encourage them to change.

The unhealthiness of these arrangements should be readily apparent. The effort put into it often goes wasted, as the other person is usually unconscious of the effort and energy we go through and what we ultimately want them to do, and thus do little to try to achieve that. Often our friendship and affection does not so much give them an impetus to get better as it gives them a comfortable safe zone, where they don't feel the need to change, because they know we are already there for them. And finally, the whole arrangement is cruel, as the other person believes we are spending time with them because we enjoy their company, while in truth we are only doing it because we want them to change. For the better, certainly, but it is still us trying to use friendship as leverage to get them to change.

Yet it also feels cruel to do nothing. Even if we don't feel affection for the other person like we used to, if indeed we ever, we still feel obliged to help them. We know them, we know they're suffering, and to stand by and do nothing feels selfish.

To give one example: I had a friend who struggled with untreated bipolar disorder. I listened to him and talked with him through his episodes, and gave him advice for what I felt he should do. He did not follow through on my advice, and no matter how many times I talked with him he would inevitably have more episodes, as frequently and as intensely as when I first met him.

I expended a great deal of energy trying to help him. Our relationship was not one of mutual benefit. I spent hours of my time listening to his problems, trying to help him with his problems, yet he expressed comparatively little interest in my own. Sometimes I even gave up sleep so I could stay up and help him with some problem. At the time, I justified it saying that he needed help more than I needed sleep, yet as the days went on, and I found myself more exhausted physically and emotionally, and his situation none the better, that justification lost some of its vigor.

That alone did not dissuade me from trying to help. Many people have struggles that aren't easily remedied, that doesn't mean the presence of a friend to help them cope is useless. Yet I began to wonder if my presence was not helping him cope, but rather providing him with a safety blanket. He would meet with me, tell me about all the people and situations that were bothering him, and I would listen and try to suggest to him solutions, which he inevitably shot down, or promised to do at some unspecified point in the future. I wondered if by staying there, by giving him that support, that he felt like he didn't need to change to improve, that I gave him enough comfort that he was willing to tolerate his unhealthy situation, unaware of the toll it took on me.  Perhaps even, I was making that desire not to change all the worse.

I felt like I was giving and giving and giving, and he was taking and taking and taking.


I'm talking about letting go.

Letting go is one of the hardest things to do. It sounds like abandonment. It sounds like giving up. Perhaps it has elements of both of those things. At times it can feel cold and loveless. Yet letting go is also an act of love, perhaps not to the person we are letting go, but to ourselves, and to the friends and family in our lives who are hurt because of the energy we put towards someone else and not them.

The time I spent trying to help my friend was time I could have spent developing myself, developing my relationships, or simply recharging for the trials of the next day.  I was eighteen at the time. I was just getting started on my own recovery, and had plenty of obstacles of my own to deal with. Yet they all went by the wayside when I was with him. In those moments, my life wasn't my own, but a supplement to his. I was lessened in service to him. We want to help people, it's part of our nature. But what happens when the things we do to help aren't of benefit to them, or the benefits are not so great as to justify our own effort into it?

The entire endeavor is a confused one, both selfish and with a confused altruism. We do it because we value friendships, because we care about their well-being. But we also do it because we think it's what we're supposed to do, because we feel we're obligated to put some sort of effort towards helping them, even if the effort is meaningless and ineffective. But so often it is little more than an act of self-harm, of bashing our hands against a brick wall hoping it will give way before we do. In these cases, when we can't stop the other person from being hurt, often the best thing that can be done is to keep ourselves from getting hurt as well.


The fact is, in cases like this, there isn't much else we can do.

For those of us struggling with mental illness, a healthy social life is immensely valuable to recovery. But it must be sincere. If it is not, if the other person is staying with us for some reason other than genuinely enjoying us, and we find out, we feel betrayed. We feel lied to. We feel as though we're not good enough to have actual friendships, and that the ones we do have we have only because they pity us, or because they want something from us.

The fake friendship or relationship cannot be sustained forever. It will break. And when it does, it will hurt. The question is whether and how we can mitigate that hurt, how we can control the breaking, so that it happens on our terms, and not on accident, where the effect will be much worse.

And I don't know if we can do that.

I wish I did. I wish I had solutions that could apply to every scenario, but either I don't know them, they vary from person to person, or they simply don't exist. I've tried telling them up front, and sometimes it works and sometimes it doesn't. I've tried simply to distance myself from the other person, and the end result is the other person either avoids me or simply stops seeking me out, and I don't know how they're feeling. When I break away, I know that I am better off. I can't say if the other person is.  I don't feel as burdened, as drained, as powerless as I did before, but whether they're helped by it, or harmed, I don't know.

With my friend struggling with bipolar, I simply stopped talking to him. I would respond to the messages he sent me less and less, and would sometimes make sure to be offline at the times he was online. It was not the best way to approach it, not by a long shot. It was clumsy and uncertain and probably hurt him more than it had to. But at the time I didn't know how else to do it. Should I have tried talking to him, to tell him my concerns? In retrospect I feel like I should have, but if the time came, would I have done that? Or would I have been afraid of the reaction, afraid of seeing the hurt rather than simply imagining it? If I'd asked my therapist for help on how to do it, would he have been able to make it easier? Or is there really any way to make it so?

It's good to learn how to make it as painless as possible, but after a point we need to get on with it and risk what cuts may come, to us or them. At a certain point, we need to learn to be self-concerned. Not selfish, but self-concerned. To know how to put our own needs above others, and to give ourselves the care we try to give to others, with the knowledge that we at least will be better helped by it.

The other person needs help. They need support, they need self-actualization, they need trained professional help. But whatever they need, they're not getting it from us, and the only thing we're doing is making ourselves feel better.

If that sounds cruel, that's because to some extent it is. But sometimes we need to be cruel to save ourselves and others from greater cruelty in the future.

Often times there are no easy answers. Often times there are no hard and fast rules. Often they are as filled with as much nuance and ambiguity as every human being. Sometimes, all we can do is ask ourselves, as honestly as possible, if what we're doing is worth what we're doing.

And sometimes it doesn't mean the end of the relationship. In some cases, setting boundaries and distancing oneself can help to strengthen the relationship in the long run. It enables those involved to take a step back and reevaluate, to reestablish themselves in relation to one another, and to take care of vices and bad habits that may be getting in the way. It does not always happen, but sometimes it does.

And whether it does or it doesn't, remember this: You are not a bad person for letting go.

You gave yourself, your time, and your energy, to help this person. You withdraw it not because you dislike them, or because you wish to hurt them. You withdraw it because you need to help yourself, and help those you love, in ways you feel work the best. You withdraw it because you need space, you need comfort, and it doesn't make sense to take that away just to try to give that same comfort to someone else.

But I can't guarantee that it won't hurt. It very likely will. It's hard to let go. But sometimes we need to do it.

Saturday, February 1, 2014

Body Dysmorphia, Body Image, and How Society Makes Us Hate The Way We Look

Wikipedia, in its ongoing quest to catalogue everything ever, includes a list of models who have died during their careers.  These were models who were still at an age and appearance where they could have continued modeling. I invite you to read it, and in particular, note how many of the models died from suicide, drug overdoses, or anorexia.

On first appearance, it seems odd that one of the most frequent causes of death among these models was an eating disorder. These are people who have careers as the epitome of beauty, their bodies are the closest thing to our society's ideal bodies. Why would they be the people to suffer from eating disorders?

Yet apparently eating disorders are endemic to the modeling profession. Consider the testimony of former model Carre Otis, who suffered from eating disorders throughout her modeling career:
“Since I wasn’t eating enough I’d lose lots of my hair in my brush and in the shower. In fact, sometimes the hairstylists had to pin extra pieces of fake hair to my head or give me wigs just to compensate for what wasn’t on my head.”
“My ‘flawless’ skin was only flawless in pictures. If you saw my face in real life you’d have seen pimples, dry patches and rashes, all consequences of constant flying, dehydration, lack of nutrition, stress, cigarettes, heavy make-up and sleep deprivation.”
Even the people designated as the vanguards of fashion and what we should look like cannot keep up with the unrealistic images they portray. Indeed, those closest to that ideal body seem to be some of the ones most hurt by it.

I am considered "attractive". People routinely cite my physical appearance when giving compliments. I am 5'11" and weigh 160 pounds. This does not remove anxieties about body image. For me, being so close to society's ideal image creates an anxiety about maintaining it. I have feared my body, and I have feared it changing. I have worried constantly about what I eat and how much I exercise. There was a point, around when I was fourteen and fifteen, where I was obsessed with maintaining my body. I would carefully restrict my meals, I would run every day. On the days I didn't, or when I ate a donut or other "fattening" food, I felt increasingly stressed. I felt like because I missed a single day of exercise, or ate some sweet, I would become "fat". I felt like within a few days my belly would swell, I would get a double chin, all the things society told me were bad. I felt as though I were constantly on a tightrope walking a narrow line of attractiveness, and that a single misstep would lead to me becoming "ugly".

That took its toll. Because I exercised so much but did not eat the amount I should, my weight stagnated. I was supposed to grow to 6'2", but because of my weight, my predicted growth decreased, and I am at nearly the same height as I was at fifteen.

Today, I still have problems of body image, though not to the extent I used to. When I look at myself in the mirror, I pick out flaws. I note the slight jutting of my abdomen over my hips, which is so meanly referred to as "flab". I pull my head back into my neck to see if I have suddenly grown a double-chin in the past day. When I sit down, I examine how my thighs look, and wonder if that's how they're supposed to look when I sit down.


Before continue further, I need to preface substantially.

When I talk of body image, I am not talking about the health effects of different body types, only how society perceives it. Habits of good nutrition and regular exercise are beneficial for mental health, but how different bodies show that good nutrition differs from person to person. Two people of the same height, performing the same amount of exercise and eating the same food at the same amount, can have dramatically different body shapes. Similarly some people have a genetic predisposition to obesity. Additionally, when someone becomes obese, it is often near-impossible to permanently lose the weight. Obesity and body shape is an extremely complex issue which differs from person to person.


Consider this ad:

"Underneath the skin you see is the skin you want." Advertisements for skin care teach us to loathe and fear our natural skin, so that we might buy their products in order to fill a need that they created. They uphold an standard of beauty which is, by design, unattainable. If it were attainable, they would not continue producing fashion advertisements, because we would already have products that takes us to that standard.

This is practiced not only by skin-care products, but by anti-aging creams, weight-loss programs and diet pills, fashion magazines, and so on. They are reinforced by movie and television stars all handpicked to fit a type as perfectly as possible--handsome male lead, lithe female supporting character, and so on--and then given make-up so that every single human "flaw" is never seen on camera.   Even our news reporters, who are meant to supply us with impartial information, are themselves handpicked based on attractiveness and attended to with make-up before the camera rolls. Consider this list of the most popular news anchors, and consider how many of them we would consider attractive.  Rarely do you see someone on screen who is overweight, or who has acne or moles or liverspots. Even more rarely, if ever, do you see them in leading roles. All of this combines to create a media narrative where being thin, fit, and "attractive" are the norm, and those which deviate from that norm (i.e. most of us) are believed to be abnormal, and of being lazy, or unintelligent, or simply "bad".

Bear in mind that there have been numerous ideal body's throughout human culture. In Europe in the Middle Ages, obesity was considered a sign of wealth and statusIn some parts of Mauritania, obese women are still considered desirable, and in some cases are force-fed up to 16,000 calories a day in order to comply with that ideal image. Society's ideal body shifts from time and place, and is likely changing even now. Who's to say that our current ideal body will still be the ideal body a hundred years from now?

Indeed, considering the numerous differences--some subtle, some pronounced--between 1950's sex symbol Marilyn Monroe, and modern day "most beautiful woman in the world" Aishwarya Rai, the ideal body of our future may turn out to be something radically different than it is right now.

In other words, society's ideals of beauty are fluid and change from year to year, and what is attractive here and now is certainly not universally considered attractive. Yet these standards remain firmly planted in our mind, and whether we fit that standard or not, we nonetheless feel that pull to fit that standard, and if we already fit that standard, then to maintain.

But we can't maintain that body image. None of us can. That body image is reinforced by media depictions which are themselves digitally altered. Society's ideal body does not exist except in computers.

And of course the stresses of body image are much harsher on women than they are on men. In large part, this is owing to the objectification and stereotyping of women throughout society, which judges them far more on their appearance than men, and often equates their value to how men find them attractive.


Most of us are aware of the unattainability of the ideal body image on an intellectual level, yet that does not stop many of us from being influenced by it. The staggering numbers in this article are testament to that.  Here are a few highlights:

  • Of women surveyed on a college campus, 91% attempted to control their weight through dieting, 25% have engaged in binging and purging activities.
  • Eating disorders affect one-half of adolescent girls, and one-third of adolescent boys. 
  • Of all mental illnesses, eating disorders have the highest rate of mortality.
What is most revealing about these statistics to me is the sheer number of people I know who likely have such body image issues but do not discuss it. Like with mental illness as a whole, we are encouraged to hide our own anxieties about our bodies, and that very hiding helps to perpetuate the unhealthy standards. If people do not talk about how society's ideals pressure and hurt them, then we are less likely to take a critical eye to those ideals and how they affect us.  Because people do not talk about their own body image issues, many of us who struggle with it do so alone, because we do not know of anyone else who struggles, and do not know if we will be supported. 

Our best way to address this is by talking about it. I recall how, in one of my classes, a young woman stated, openly and without shame, that she had suffered from eating disorders in the past. When I later told her how much I appreciated her speaking out, she argued that only by talking about it, by no longer making it a taboo subject, are we able to accept and address eating disorders. 

And there are many ways we can talk about it, from sharing it among our friends, to talking about it in one of the many support groups, online and offline, to sharing it in blog posts such as this one. The important thing is that it is being talked about, and our experiences and challenges are collectively shared and therefore collectively solved.