Do You Have Bulimia?

I think most people with bulimia are pretty aware that they have it. If you’re reading this and  you think someone else may have bulimia, here are the DSM-V guidelines. (The DSM is the psychology/psychiatry diagnostic manual) If anyone else who binges or purges reads this, it may change the way you view your condition, because the limitations on a diagnosis of bulimia are different in this DSM versus the last one.

A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

(1) Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time under similar circumstances

(2) A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications, fasting; or excessive exercise.

C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least once per week for 3 months.

D. Self-evaluation is unduly influenced by body shape and weight.

E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

B is really where the change was made, because in the old diagnostic manual, one with bulimia would purge at least twice a week. With the change made to once a week, more people with eating problems can be diagnosed and treated appropriately. However, there’s also the fact that some people who binge and purge, once they receive a more a seemingly more serious diagnosis (although in reality EDNOS is just as serious as bulimia), will face more serious stigma and other consequences. 

Bulimia Comorbidity

I hope the chart above is readable, because I think it's rather intriguing. 

After reading about comorbidity (having two disorders at once) of depression and bulimia, I got curious and researched comorbidity of psychiatric disorders with eating disorders.

The table below is what I found, and I think it’s pretty interesting.

Apparently depression is the most common comorbid disorder among ED patients, which I suppose makes sense, although dysthymia might also make sense, even though the scores on that one are low. Alcohol dependence and substance abuse is also common in bulmia, and I’m thankful I don’t have that, because that would make life a hell of a lot worse. 

Necessary Precautions

Eating disorders are remarkably heritable. This means that if your parents had eating disorders, you have a higher chance of getting one. It also bodes ill for your kids and your siblings. I know neither of my parents ever had eating disorders, although I’m not sure about one of my grandmothers, but in my sister I see the makings of mine. It would kill me to see her go through what I’ve gone through, so I want to take every precaution with her. I talked a little bit with her about her eating habits to find out what kinds of things were precursors, and I pay attention to how she reacts to food and body image. I just don’t know what to do. I don’t want to tell her I have bulimia because I don’t want to destroy her image of me. I don’t know how to sit down with her and warn her not to go down my path.

At least if I notice that she develops one I can alert my parents immediately and tell them useful things to do. 

Am I Depressed?

According to statistics 70% of bulimics also suffer from depression. Scientific Daily reports that a lot of bulimics suffer from dysthymia. I know what those two mental illnesses are, and chances are if you’re bulimic you know as well, but these two articles along with being exposed to clinically depressed people who have spoken about how they feel have made me reconsider my diagnosis. I don’t think I’m depressed, but then again a lot of the time I don’t necessarily enjoy everything I do either. The depressed people I’ve observed in the clinic don’t seem overtly depressed but rather ambivalent.

I keep reminding myself that I’m not depressed. I don’t want to be depressed. But the way the mental health field defines depression is such a gray area that I could in fact have a mood disorder and simply be ignoring it.

Just something to watch out for. 

Writing Helps

My main reason for doing this blog is because I want to reach out to at least one other person who’s going through what I’m going through, and I hope this blog can be a source of help to someone out there, someday. However, a less major reason for doing this is so that I have a reason to write about my bulimia.

Writing stuff about it does kind of alleviate some of the feelings I have this illness. It doesn’t really make m change my behaviors, but it’s therapeutic to write the feelings I have about it down. Putting it in blog format just incentivizes the writing process, since if I’m sharing information there’s more reason to write it.

I didn’t think writing about it would help so much. I’ve kept a diary for a looong time, so as soon as I started being bulimic I did write about it, but when I switched from pen and paper to a computer it was so much easier to write everything down that I wanted to say, and writing turned from a chore to more of a pleasure again. Once I did this, I could get down every single feeling I had and as soon as I finished an entry and closed the page, all the bad feelings sort of washed away. I can’t explain why, but it works for me. I recommend writing things in a diary, because even if you have told someone about your illness, they’ll get overwhelmed if you talk about it as much as you need to. A diary will always be open to your thoughts, no matter how often you’re down or how often you talk about sticking your fingers down your throat. Of course, telling a live person will help more than a diary ever will, but a diary is at least something, if you feel like you can’t tell anyone else yet.