Anorexia, for me, was a bubble in which I hid. It kept me safe from the outside world. All the things I used to worry about before no longer felt important. It was just me and the destructive illness that is anorexia. I didn’t plan to become ill; it crept up on me and caught me unawares. Before I knew it, I was its helpless puppet on strings, bowing to its every rule. I saw the number on the scale decrease, but could not see that weight loss when I looked in the mirror. The thought of eating filled me with extreme anxiety. This is why I see anorexia as an addiction.
The euphoria of starvation
In the midst of a chaotic and stressful time of my life, food was the one thing that I felt I could control. Restricting my food intake, exercise and weight loss gave me a sense of great power and achievement. It was something I was good at. I became addicted to the euphoria of starvation and the miraculous energy I found to exercise, even though my brain and body were malnourished, was intoxicating.
I became a master of manipulation; lying, deceiving and playing my parents off each another, in order to skip meals or to exercise more. Of course that wasn’t me but was the monster that is anorexia. It took over my mind and body to the point that I (Liv) barely existed anymore. I wonder how those aspects of anorexia as an addiction are any different to other addictions such as drugs and alcohol?
Anorexia blocked the pain out
A person who abuses substances will most likely do so to deal with psychological underlying factors such as depression, anxiety, trauma, low self-esteem etc. Drugs and alcohol block all the pain out. They create a distraction and you will do anything to get that next hit of your chosen substance in order to keep that pain numbed. Anorexia was just another distraction for me. Whilst my mind was focused and consumed with thoughts of food and weight, I wasn’t worrying about my family, school, exams, friendships or my future.
There is an increasing amount of evidence suggesting a link between eating disorders and addiction. Primarily how they can co-occur, but studies also look at interpreting an eating disorder such as anorexia as an addiction in itself. As a Psychology graduate and aspiring Psychologist with personal experience in this, I am interested in the neurobiology of both addiction and eating disorders and the similarities of behaviour patterns.
The link between eating disorders and addiction
I will refrain from going too much into the neuroscience, but if you like that sort of thing, then check out these articles: http://www.scienceofeds.org/2012/06/12/anorexic-brain-neurocircuits-behaviour and http://www.eatingdisorderpro.com/2012/07/20/anorexia-addiction-and-the-three-part-brain-model.
Both addictions and eating disorders manipulate the limbic system; from a reward perspective animal studies have already found that food restriction increases the reinforcing effects of various drugs. Also, although more research is needed to confirm this, it is suggested that weight loss produces changes in the reward system. This resembles the effects produced by drugs of abuse, making weight loss and/or starvation rewarding.
Addiction as ambivalence
I recently took a course on Intuitive Thinking Skills: a relatively new approach to addiction. It is an educational programme promoting achievable abstinence from drugs and alcohol. Intuitive Recovery defines addiction as ambivalence. This means holding two clearly opposing opinions on something, causing uncertainty and indecision, for example: “I really want to use. But I really don’t want to use”. The part that wants to use is termed ‘addictive desire’ and has no real control over us. A person ultimately chooses whether to use or not. If this is how they define addiction then surely eating disorders fall under that definition too, and anorexia as an addiction makes sense.
I was in a constant state of ambivalence when I was ill. I desperately wanted to eat and get better but I also had a voice in my head telling me not to. The degree of choice I had in that is somewhat controversial. Yes I did have a choice, I could choose not to listen to the anorexic voice. But it would berate me for hours and days after I had rebelled against its demands, causing anxiety and distress. Anorexia as an addiction is much more complex than general addictions. This is specifically because of the strain you put on your body and brain during starvation.
Learning how to feel again
What is evident though is that eating disorders and addictions are manifestations of psychological distress. It’s this distress that needs to be the focus within treatment. There is little point in a person with anorexia regaining weight or an alcoholic abstaining from alcohol if those psychological factors are not being addressed. Psychological support is just as important if not more so, to avoid relapse or swapping one destructive behaviour for another.
In my own recovery, I needed to learn how to feel again. For so long I’d pushed my feelings down, and once I recovered I felt exposed and vulnerable. I had to build myself up and find who I am. Mental illness strips you of your identity and in recovery you find yourself again. It can be painful and difficult but with the right support there is a light at the end of the tunnel. Recovery gives you your life back and it’s beautiful; it’s time to start living.