When the “best years of your life” are an awkward disappointment: College and eating disorders

Seeing as it’s “that time of year again,” I wanted to write a blog about college and eating disorders. For a lot of people, college is the first time they ever live away from home. I think it’s pretty well known that major life transitions are common times for mental health issues to develop. However, transitions can be just as difficult for those already dealing with these issues.

I was very excited to go off to college my freshman year. I didn’t have that great of a high school experience, but everyone kept telling me that college would be so much better. “People are more mature in college. You can totally reinvent yourself and you’ll definitely fit in because there are no cliques or ‘popular kids’ in college. You’ll love it!” Well, maybe. I guess it depends on where you go. I went to a fairly small liberal arts school for my first three years of college, and I found it to be eerily similar to high school. My freshman dorm quickly became divided into high school-like cliques. There was drama and gossip and people still had to work hard to fit in. Honestly though, that stuff exists everywhere, even in the adult working world. I think I was just mildly disappointed that it wasn’t the drastic culture shift that so many people tried to to claim it would be.

At the time I was heading off to college, I had already been struggling with my eating disorder for six years. By the end of high school, though, I had at least reached a kind of stasis with my ED that I expected to maintain through college. After all, every one kept telling me college was so much better than high school, so I figured I’d be super happy throughout and have every reason to do well. I said goodbye to my therapist of five years; I figured I’d just go back to her if things started to slip but I really didn’t see that happening. This was definitely a mistake. Things did start to slip, almost right away, but I was too ashamed to admit that I wasn’t thriving in the amazing college scene so I suffered in silence for the first year.

I started having major issues accepting my body. Going in I could at least somewhat accept it– I was significantly bigger than I was at the worst of my anorexia, but I was still technically underweight and could see that most people probably still saw me as ‘thin.’ Within a couple months of starting college, that was no longer enough. I started really missing my old (smaller, sicker) body and my eating disordered behaviors intensified. This is when I first began to struggle with bingeing/purging, a behavior that still to this day remains incredibly shameful for me.

There were also certain factors specific to the college experience that probably didn’t help. For example, my dorm’s Resident Director (who managed all of the RAs) was really into encouraging us to record our calories and participate in these awkward weight loss challenges. She posted signs on the elevators advising us to take the stairs instead, complete with handy pictures of food crossed out with red x’s. Drink all the alcohol and smoke all the pot you want, but whatever you do– SAY NO TO THE COOKIES!!! Yeah, she was weird… I also had two friends who were always trying to get me to join their diet groups, even though they knew about my history with eating disorders. None of these things were solely to blame for my relapse, but they certainly made what I was doing seem more socially acceptable, at least at first.

It was also in college that my anxiety related to eating with others became pretty extreme. Eating with people was never an easy thing for me, but I could at least make myself do it when absolutely necessary and I went into college hopeful that I’d be able to eat with my friends from time to time. While I started the year off going to the dining hall with the few friends I made, this quickly became an almost impossible task for me, perhaps largely due to my increasing b/p behaviors which I kept strictly secret.

During the first few weeks of going to the dining hall, I noticed a girl who I knew had an eating disorder. She was quite thin, but even aside from that, it was clear to me. She had all the physical signs of chronic purging, and she always sat alone and ate the same exact foods in the same order. She would finish each meal with a huge bowl of ice cream and then would disappear. I’ll admit at first I was almost envious that she at least had the ability to eat out in the open like that, because my bingeing (and actually at that point, eating anything at all) always had to be completely secretive which made it harder to maintain this behavior that I hated and was so ashamed of but unfortunately couldn’t stop. I also just felt really bad for her though, and often wanted to run up and hug her (but yes, that would have been super creepy so I restrained myself).

I later learned from a mutual friend that this girl did indeed have an eating disorder, and that her original roommates had voted her out of the suite they were living in because they couldn’t deal with her b/ping. Little did I know at the time, this very same scenario would play out for me my junior year.

Now, I want to say something about college counseling centers. Some really suck. I’m sure there are good college counseling centers out there, but the two experiences I had (at two different schools), were really shitty. If you have access to a qualified therapist outside of the school, you’re probably best off sticking them them. I find a lot of therapists staffed at college counseling centers will claim to have experience with eating disorders when they really do not. I was dragged to my first college’s counseling center by my roommates and it could not have been more of a disaster. I was made to feel even more ashamed and at fault than I already felt, and I spent the rest of my time at that school going out of my way to avoid running into these crazy “experts.”

At the end of my junior year I got stuck in a cycle of revolving door inpatient admissions that eventually led to me taking an extra four years to finally graduate. Today, at the old age of 32, I can recognize that while this seemed like the end of the world at the time, it actually wasn’t. I did eventually graduate and even went on to get a master’s degree. That said, if I could magically go back in time I would absolutely do things differently. Sometimes it really is necessary to leave school and get more treatment. I don’t regret ever doing this, I just regret doing it as many times as I did. I wish I would have put more effort and time into making the first few rounds really worthwhile, so that the subsequent times wouldn’t have been necessary. There were also times when I wish my treatment team would have given me more of a chance to turn things around on my own, instead of throwing me back in treatment as soon as I struggled. Hindsight is 20/20 though, right?

I used to get really sad when I’d hear people talk about the great college experiences they had. Mine were filled with lots of shame, secrecy, tears, and hospitals. Can I go back and do it all over again? Like, the whole freshman dorm experience? It could be a reality show– 32 year old ‘cat lady’ poses as a college freshman and infiltrates most popular dorm. Will she finally be cool??

I no longer let myself get sad. I had lots of experiences, and not all of them were good, and some were really, really bad. However, I eventually managed to move on and had it not been for those crazy eight years, I probably never would have ended up here, in Los Angeles, with a graduate degree and a life I finally like.

Sleep: A Strange (or Not-So-Strange) Enemy

I’ve gone through large portions of my life being chronically sleep-deprived for one reason or another. In the early years of my eating disorder, I didn’t like sleeping because it felt like a waste of time that could be spent doing anything else that burned more calories. I would pace around my room for hours every night forcing myself to stay awake until the last possible moment, when I could no longer keep my eyes open. Once I started binge/purging, I was often kept up by that. I would be so tired but also so hungry that the urges were impossible to ignore. Nine times out of ten, I would choose b/ping over sleep. Some nights I would get less than an hour of sleep before having to leave for class or work the next morning. I struggled to stay awake during these daytime activities and sometimes crashed as soon as I got home, which then just led to an even later start to my nighttime b/ping. It was a vicious cycle.

When I first started writing this blog, I remembered my sleep issues all occurring in the presence of my eating disorder. Then I recalled a funny conversation I had with some family members several months ago that made me realize I was actually weird about sleep even before my ED officially began. My mom and my aunt were talking about taking long family car trips and my mom said, “My kids usually slept most of the way, except Rebecca- I don’t think I ever saw her asleep in the car. I guess she just never got tired!” This sparked memories of those long 10+ hour car rides we used to take to visit family out of state and I replied, “It wasn’t that I never got tired, it was that I always forced myself to stay awake in the car. I was miserable!” I saw sleeping as a sign of weakness. At 5, 6, 7 years old. What a weirdo. No one ever told me sleeping was bad or anything; I came to that conclusion all on my own.

When I first got into therapy, a lot of professionals tried to insinuate that my parents held me to unattainable standards or even that they put strict limitations on what I could eat, do, say, etc. That couldn’t have been further from the truth. My parents held me to very reasonable standards and were not at all restrictive about how I lived my life, what food I could eat, etc. No one ever told me I was only allowed to sleep X hours a night or that I couldn’t eat X type of food. All those rules came entirely from my own strange brain. And not only that, but once I imposed those rules and had people take notice of my weird behavior, I thought it was absolutely essential to uphold that version of myself. Once I became known as the kid who didn’t sleep in the car, I had to be extra careful about never to allowing myself to fall asleep in the car. Once people knew me as the kid who never ate in front of people, I couldn’t let that version of myself die either. It made no rational sense but it was the way I lived most of my life.

One of the first things I noticed about inpatient facilities for eating disorders was how obsessed they were with sleep. Upon my first admission, I was immediately put on medication to help me sleep, before I was even asked if I had trouble sleeping. If a nurse noticed me still awake during one of their routine checks during the night (usually every 10-15 minutes), they would ask what was wrong and if I needed more meds to sleep. Apparently anyone who took longer than 15-20 minutes to fall asleep at night had severe insomnia!

I never liked taking meds for sleep because they always left me extremely sleepy in the mornings. I would struggle to stay awake in groups and sometimes even meals. As if meals weren’t hard enough, I had to continuously pinch myself to stay awake. When I would ask to be taken off the meds or when I refused to take them, it would go down in my chart and I’d be labeled a “difficult patient,” all because I didn’t want to fall asleep in my cereal.

This was a theme throughout most of the inpatient and residential facilities I passed through over the years. Many places had doctors prescribe patients powerful antipsychotics as sleep aids. I remember the first time I was handed Seroquel; I was so confused. I knew my meds, and I knew that Seroquel was an antipsychotic. Why was I being given an antipsychotic when I displayed no psychotic symptoms? I quickly learned this was becoming the new trend in the mental health world– prescribing antipsychotics for their “off-label” uses, many of which included drowsiness. Seroquel, Risperdal, Geodon, Zyprexa– I’ve been on them all that some point, mostly for the sole purpose of helping me sleep, even when I never asked for help in the first place. Speaking of Zyprexa, it is also commonly prescribed to anorexics to “help them gain weight,” as weight gain is a common side effect of the drug. Because, you know, that is totally the answer– give someone who is already terrified of gaining weight a drug with a known side effect of weight gain. That will totally work! They won’t suspect a thing! That one is wrong and ineffective on so many levels, but doctors still use it.

There is nothing inherently wrong with using medication to treat (actual) insomnia. The problem I had with these facilities’ obsession with sleep was that they did what this article referred to as “medicalizing sleep.” Sure, there are countless physiological processes that occur during sleep, many of which have been studied in depth. However, the overall concept of sleep itself is impossible to measure. We’re also constantly being fed mixed messages about sleep. We’re repeatedly being told how important a good night’s sleep is, how adults require a solid X hours of sleep per night while children and the elderly need X (it’s always changing). Entire clinics are devoted to helping people learn to “sleep smarter” and doctors are handing out medication for sleep like it’s candy, including powerful antipsychotics. On the flip side, we set multiple alarms to make sure we wake up at the same ungodly hour each morning, and some professions have people working 60 and 70 hours a week. How do we reconcile these two mindsets? We’re being told that the quantity and quality of our sleep has critical implications, and yet we’re being expected to endorse lifestyles that make getting sufficient sleep impossible.

The idea of sleep being a sign of weakness was probably not completely invented by my own strange brain. My parents did not instill this into me, but modern society might have. When we run into people we haven’t seen in a while and they ask how we are, chances are both sides will say something like “I’ve been so busy!” It’s good to be seen as busy. It makes us feel productive and useful and sometimes it can even be a source of competition. We’ve all probably been a part of many “who’s the busiest?” conversations, either at work or amongst family or friends. “I am so busy this week. I have to do x, y, and z, all while managing Project A.” Then someone chimes in, “Is that all? That’s nothing compared to my week. I have to do a, b, c, and d on top of managing Project x, y, and z.” And so goes the game of one-upping; everyone wants to be seen as the busiest. Bonus points for mentioning how much sleep you’ve sacrificed.

There are countless parallels that can be drawn between sleep and eating. I know I’m not the only person with an eating disorder to have these warped ideas about sleep. I like to think that the distorted thoughts and behaviors I have (or had) around sleep developed much like my distorted thoughts and behaviors around food did. No one single person drilled these ideas into me, nor did society force them upon me. It was likely a combination of my innate personality traits interacting with the messages I received and interpreted (in my own way) from society. I’m lucky to have, over time, cultivated a progressively less black-and-white view of these things. Sleep is not all bad or a sign of weakness, and neither is food. I can admit to liking both now, which seems like such a silly thing to even point out. Sleep and eating are both basic human needs, and yet for so long I could not allow myself to admit to liking either one. Well shit, the secret’s out. I do love sleep. And food. Never believe an anorexic who says she/he dislikes food. Everyone likes food, and I’d even venture to say that most people who develop anorexia (or any eating disorder) probably “like food” even more than the average person. Otherwise, there would really be no disorder… but that’s a topic for another blog. 😉