Eating Disorders, Anxiety, Depression, Oh My

The stories from our childhood make us who we are—but also, so does adulthood.

I tend to agree with this statement from the late humanist psychologist Carl Rogers: “what is most personal is most universal.” There is some definite truth here, and I have seen it to be so in my own writing—whenever I do share something more personal, more people have some kind of ‘reaction.’ When I write explicitly about my struggles with anorexia, for example, it garners the most response of anything else I write. How interesting, right.

Actual Honesty is a tall order. It’s hard to be actually honest, especially with yourself; especially with the people who might be affected by your honesty. It is no secret that I was afflicted with anorexia since my preteen years, and that for better or worse it has shaped “who I am”. Sharing that doesn’t feel ‘vulnerable’ to me, it feels like talking about something that happened. However, it is with embarrassment and what is probably vulnerability that I admit to anyone in my life that it—the anorexic voice, that is—is not gone; that it still remains. On certain days, and in certain moods, I still listen to it, that voice, despite the presence of stronger, more intuitive, kind voices within me. I haven’t met the criteria for the diagnosis in many years, but that disordered voice is still as a part-of-me as all the other voices. Except when I’m not, I’m usually able to ignore it, or circle around it, or turn the volume down. I often wonder if I can ever be entirely rid of this anorexic voice, which wants nothing but to control, belittle, and shrink me, my body along with my spirit. Maybe never, is a possibility I am resigned to. Maybe a “perfect recovery” is bogus—perfection is, as it turns out, the dangling carrot anorexia will make you run toward but never let you eat. Perfectionism itself is a brutal beast as well, as I’m sure many of you know.

Perhaps this perspective, that I may always live with a tormenting eating disordered voice in the back of my head, is a cop out—maybe it is my own fault, maybe I keep it going. I know the manifestation bloggers would be thrilled to take me on in a private coaching session and tell me how to ‘reframe’ my identity or unpack some more baggage in my psyche.

But while I dance with being a dreamer and a realist, the realism wins out in this case: while I do know that I can functionally operate as not-an-anorexic anymore, and have for years now, I do not know yet that I can ever lose the anorexia itself. It seems to have affixed itself to a part of my brain like a haunted shadow. Maybe someday I’ll find out if all I need is “more therapy,” or “more time,” or “more confidence.” In the meantime, I guess I’ll keep writing about and learning from it.

. .

I recently finished

Jonathan Haidt

’s critically acclaimed new book, “The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness.” Many of his claims and theories about adolescent mental health are not hard to believe—and in many instances, hearing what the research indicates elicits nothing short of a “yeah, duh” response. As in, “yeah, duh, looking at models on Instagram before you’ve gotten your first period can lead to a warped view of what a healthy woman’s body looks like and cause demonstrably low self-esteem.” and, “yeah, duh, gaming all day and night as an adolescent may very well produce adults who do not have a job or community outside of their bedrooms.”¹ Mainly, Haidt posits, using social media (and living the smartphone lifestyle in general) during the formative years of childhood and early adolescence is correlated with virtually every negative outcome. Yeah, makes sense.²

There is one point Haidt presented that I found quite compelling, regarding “cultural critical periods” in adolescence. Critical periods, which my college professors covered extensively, are periods of development that mark the time frame in which a key stage of development typically occurs. For example, the time frame when eyesight develops (in utero until about 12 months), or language/speech (the first few years of life). Critical—or “sensitive”—periods are usually talked about in reference to early childhood, like when a baby starts being interested in picking up objects or coordinating movements. During a critical—or “sensitive”—period, the brain and organism is primed to reach and pass a certain milestone.

As research has begun to indicate, there is a sensitive period in adolescence during which our brains are extremely open to cultural and social learning. That period is between the ages of 9-15. During this time, our brains are primed to learn about the kind of culture we live in, what is “normal” and appropriate, and how we fit into this society. The stimuli our culture presents to us are particularly impressionable on our adolescent brains, which in turn affect how our adult brains are conditioned and constructed.

(Here is an interesting study that backs up this sensitive period theory, called, “A Sensitive Period for the Incorporation of a Cultural Meaning System: A Study of Japanese Children Growing Up in the United States.”)

The “cultural sensitive period” theory hugely supports the claims The Anxious Generation makes: consuming social media “culture” during these critical years of brain development can have more damaging effects on mental health than if children were to wait until they were out of that sensitive period to use social media—say, at least 16 or 17. If we are engaging in social media “culture” during the years of 9-15, this means our brains are shaping to be most responsive to that kind of culture: we are more likely to be influenced by it in a more lasting way. If we think about what kind of culture social media fosters, it’s one that is driven by status and number of likes, and typically involves filtering pictures of ourselves, viewing airbrushed models, and being peer pressured to “reshare” content to demonstrate moral superiority.

I can already hear a counterargument, that Western culture at large is like social media anyways: largely focused on accumulating status, being popular and beautiful, and earning a lot of money. So, kids are bound to be conditioned by this kind of culture anyways. Sure, that’s true. And, at least as it seems, social media heavily amplifies this conditioning when used in childhood and early teenage years, and it’s not showing to have great impacts on those children or teenagers. Plus, I am not a pessimist: there are many, many beautiful aspects of culture in the “real world” that are so worthy of conditioning our children with, if we have any say in it. Let us teach them real-life interactions, and real-life community, and real-life love.

Naturally, reading this book made me think about my own preteen/adolescent years. I was nine when the iPhone was released, and 12 when Instagram began, which was the same year my eating disorder settled in. Those events weren’t related; I think I was 15 when I had an iPhone and created an Instagram account, and during that first year or so, employed it only to silently “follow” other girls who were documenting their recovery from anorexia. I remember feeling so seen by their shared twisted love of the disorder that we all knew was killing us. One girl I followed was named Emmy, who lived in the UK, and she was so small and beautiful that I grew to deeply envy and simultaneously despise her. She would meticulously document her food intake every day—very small portions that she claimed were ‘recovery’ portions—and subsequently post her intense discomfort with the amount of food she had consumed. 

At this time, circa 2015, I had just begun treatment. My parents were involved with me in a recovery program called “family-based treatment”, which gave them, during those first months, the authority to determine the appropriate amount of food for my meals, and ensure that I ate it. Anything I ate away from the view of one of my parents did not “count” toward my daily intake; so I refused to eat anything at school, and ate lunch when I returned home, around 3:30pm. This early treatment was absolutely agonizing—agonizing because of my disorder, the humiliation accompanying it, and the utter loss of control I was faced with. The nature of the treatment itself is why I am alive today, and it is indeed an effective form of treating adolescent eating disorders. My parents, who are reasonable and healthy people, certainly would never have let me ‘get away’ with such small portions as Emmy from the UK. And thank goodness they hadn’t; at that time in my recovery, my brain was in such a perpetual caloric deficit that hardly anything it said could be trusted.

I wondered, last week, when reading about ‘cultural sensitive periods,’ about how the age my eating disorder began, 12, was right in the middle of that period. Is this why I haven’t yet been able to shake it? Is it that I took on the culture of anorexia in my brain during my most sensitive developmental period, and that this culture is what part of my mind still lives in?

After musing about it for a few days, I’ve come to realize that it doesn’t really matter, and that framing it in such a way threatens to push me toward a helpless victim mindset that I’m not interested in. Sure, it’s definitely true that I know well the lens of anorexia, and can rattle off the number of calories in hundreds of different portions of foods, and maybe that’s because I learned it at such a ripe age. But ultimately...whatever. If the timing of my childhood eating disorder means I’ll forever hear the echoes of its voice in the back of my head—so be it. I won’t let that limit me; I’ll work around that. Most people have troubling self-destructive parts of their minds, and have to learn to live and thrive with those parts.

I cannot attest to The Anxious Generation’s theory that social media use in childhood/adolescence may be causing depression, eating disorders, and anxiety (among other things). I don’t know. For me, and for many adolescent anorexics, it was a combination of uncontrollable biological and environmental factors that led to a disorder that honestly served us for a while. It helped us cope, and control, and deal with emotions we were unable to face by starving them away. Frankly, I don’t agree with the implication that there is a single cause or reason—or even a couple of causes or reasons for anything—everything in this world is a composite of everything that came before.³ It is impossible to attribute an outcome to just one or two causes.

. .

Kayla

from Substack’s Honestly Unorthodox recently wrote about her own treatment from anorexia, and I cannot seem to find it on her website anymore. It was a great piece, and while I cannot directly quote it, I want to conclude with an idea she wrote about. Kayla mentions being grateful not for anorexia, but for the rigorous treatment she went through for it. This is such a simple and perfect way to describe the blessings that often come from hardship. It is not that terrible or difficult things “have to” happen in order to learn something. It’s that terrible things just do happen, and it’s up to us to continue, and learn, and pave the path we grow on. It is what we do with something awful or hard that creates purpose: the awful thing itself does not exist to be purposeful.

I love the way she framed this, and it urged me to reframe my own gratitude. I’m not grateful for anorexia, though it has led me right here, where I want to be. I am incredibly grateful for what has come from it: the closer relationships I have with my parents; the never-ending pot of resilience that I have access to within me; the relentless quest for beauty and meaning that propels me. Were it not for the treatment I have experienced, I would not be who I am today. And I like who I am today! For that, I am incredibly grateful.

So, while I still hear that critical and belittling anorexic voice in the back of my mind on most days, most days I am able to set it aside. It doesn’t have to be shameful that I have not eradicated this voice entirely yet, and may never be able to do. I’m open to that, but it might not really be up to me.

Let me briefly touch on the epidemic of childhood mental illness, and say this: we must consider ourselves as the resilient, capable beings we know we are. Yes, social media and iPhone culture is bad for kids, and is a contributing factor to poor mental health in young people. And, those young people—all of us, young and old—are still smart, and resilient, and capable of overcoming challenges. Reminding ourselves and each other of our strength is important. Reminding each other not to attach ourselves to diagnoses, or to voices in our heads, is also important.

Yes, it’s true that our early childhood experiences shape who we are—but this is not an end to our growth and development. Our adult experiences, and what we do with them, also shape who we are. As adults, it’s up to us to use our agency to guide our growth, no matter what our childhoods consisted of. Let us guide ourselves forward as well as the children of today.

All my love,

Maggie

1. These are my own examples based on content covered in Haidt’s book.

2. As humanity is wont to do, there is pushback to the book, and to the claims made in between its pages. I won’t be discussing that here.

3. Haidt’s book doesn’t explicitly indicate that the only reason for poor mental health in Gen Z is because of social media; he also largely attributes it to a decrease in “Play” during childhood. Together, the decrease in playtime and increase in social media/technology has poor effects on mental health.