cron-web.org

[A1CR]

A certain CRONie (name withheld) felt that before he knew
her that his wife may have had
http://en.wikipedia.org/wiki/Anorexia_nervosa and
http://en.wikipedia.org/wiki/Bulimia at various times in her
life. When she
was with me, she suffered from
http://en.wikipedia.org/wiki/Bipolar_disorder
also. She was quite restrictive of her food when she was in
the "low"
periods of her bipolar disorder mood swings, although it may
have been
unintentional. The opposite pattern was seen in her "high"
periods of her
polar disorder.

His thinking has been what may be considered to be beyond
the normal only for
an http://en.wikipedia.org/wiki/Eating_disorder
http://en.wikipedia.org/wiki/Eating_disorder_not_otherwise_specified
in its
nature. He was never able to voluntarily induce vomiting,
although a certain CRONie (name withheld) am highly subject
to vertigo and do suffer from
http://en.wikipedia.org/wiki/Vomiting and
http://en.wikipedia.org/wiki/Diarrhea when this occurs. He
has consumed foods that caused diarrhea unintentionally
also, but never taken the
http://en.wikipedia.org/wiki/Laxatives that are taken by
bulimics and
anorexia sufferers.

Now, is some science. It appears from a recent report (1)
that bipolar
disorder and binging type of eating disorders may be
associated. Another
recent report (2) chronicles, it seems the comments of
patients of anorexia
nervosa. We may be required to be informed of the nature of
the mental
processes that occur with the disease to be aware, should
such symptoms
arise during our various phases of our CR.

1. Kaminska K, Rybakowski F.
[Comorbidity of eating disorders and bipolar affective
disorders]
Psychiatr Pol. 2006 May-Jun;40(3):455-67. Polish.
PMID: 17037812

Eating disorders--anorexia nervosa, bulimia nervosa
and eating
disorders not otherwise specified (EDNOS) occur usually in
young females.
The significant pathogenic differences between patients who
only restrict
food, and patients with binge eating and compensatory
behaviours, such as
vomiting and purging were described. The prevalence of
bipolar affective
disorders--especially bipolar II and bipolar spectrum
disorders (BS) may
reach 5% in the general population. About half of the
depressive episodes
are associated with a "mild" bipolar disorder, and such a
diagnosis is
suggested by impulsivity and mood-instability. Previously,
majority of
research on the comorbidity between eating and affective
disorders focused
on depressive symptomatology, however difficulties in the
reliable
assessment of hypomania may obfuscate the estimation of the
co-occurrence of
eating disorders with BS. Epidemiological studies suggest
the association
between BS and eating disorders with binge episodes (bulimia
nervosa,
anorexia- bulimic type and EDNOS with binge episodes).
Co-occurrence of such
disorders with depressive symptoms probably suggests the
diagnosis of BS,
not recurrent depression. Bulimic behaviours, impulsivity
and affective
disorders might be related to the impairment of the
serotonergic
neurotransmission, which may result from the genetic
vulnerability and early
life trauma. ...

2. Dignon A, Beardsmore A, Spain S, Kuan A.
'Why I Won't Eat': Patient Testimony from 15 Anorexics
Concerning the Causes
of Their Disorder.
J Health Psychol. 2006 Dec;11(6):942-56.
PMID: 17035265 http://tinyurl.com/yby676
The following article describes the reasons given by
15 anorexic
patients for their illness. The patients were asked the
following question
in an open-ended interview-'What would you say were the
causes of your
illness?' In reply detailed complex narratives were gathered
from which a
number of themes could be identified. These included
unhappiness, control,
being in a downward spiral, obsession and perfectionism.
Most patients, for
example explained that they were unhappy. To address their
unhappiness, they
adopted a strategy of control over food. Being able to exert
this control
gave patients a sense of enjoyment and pride and enabled
them to address
their underlying fear that a loss of control may be just
around the corner.
This pride persuaded patients to restrict further their food
in the hope
they would experience even greater enjoyment. Patients were
thus caught in a
dangerous 'spiral' of restriction, weight loss, euphoria and
further food
refusal. This spiralling behaviour resulted in many patients
describing
their illness as an obsession. Several patients equated this
obsessional
behaviour with a perfectionist trait in their personalities.
In the
following article, these themes of unhappiness, control,
spiral, obsession
and perfectionism, are presented, along with the patient
testimony on which
each theme was based.

when I was younger I used to get bullied a lot
for being fat . . . they used to call me names
and everything . . . It was . . . when I was in
secondary school . . . it just went on through
most of school . . . even me own sisters used
to pick on me for being fat . . . my friends
would join in and make fun out of me as well
. . . they made fun of . . . me 'cos they could
always get a boyfriend when they went out
and I couldn't.

perhaps the person like myself who kind of
gets hooked into [anorexia] . . . had a gap that
needed filling . . . because . . . that gave me
something to fill the gap . . . whereas probably
. . . other people don't necessarily have one
. . . [U]nhappiness . . . perhaps it's as simple as
that . . . perhaps it's something to plug an
unhappiness gap . . . to prevent you . . . I
'don't know . . . but it just seems to me like
something that plugs a gap-with control.

control is the major part . . . of anorexia, really
it's . . . control . . . if you put control and food
together then that that brings you an eating
disorder because they're the two big things . . .
the two words that associate me to anorexia
is food and control.

... the control sort of thing [is most important in
anorexia] rather than my appearance. It's the
buzz that I get . . . the controlling . . . the
feeling that I'm good at something . . . and
that I'm being tight, I'm being organized, I'm
being precise, I know what's going to happen,
I know that I'm having say this for dinner, this
for tea . . . Everything, it's . . . like my life it's
. . . a book.

I just think that I'd-I suppose that I'd be
losing control, that I hadn't sort of kept something
tight- . . . it's sort of that I've let something
go . . . I don't feel as skinny as I did and
I don't like that feeling . . . It feels dangerous
to me. It makes me feel out of control.

you have the control-you've done something
with your body nobody else could do-you've
done it. That's . . . really really hard-handing
that control over . . . watching your body grow
and grow and you're thinking don't let it go
too far, don't let it go too far.

It's it's the the one part of your life that you
can control what you eat . . . it's commonly
the one thing in life that you can control and
. . . it's just sort of well a means of that control
isn't it you know.

I think . . . it's a way of gaining control over
your life. If you don't feel in control over sort
of like your feelings . . . you have control over
your food and it's something that like nnobody
can take away from you.

losing that bit of extra weight that's kind of
got the same effect from doing another day
without that piece of food-yesterday and the
day before I needed that but today I don't
need it . . . and . . . that was the new level
going on from there.

the trouble was the goalposts kept shifting
because . . . when I started restricting I started
off with saying 600 or 700 calories a day but
then that wasn't good enough that had to go
down and it just kept going down and down
and down until I wasn't eating much at all and
trying to live when you're not eating-you
just sort of, well you lose a grip of things-I
didn't see that at the time-I thought I was
coping.

I never wanted to be full . . . I had to be
absolutely starving hungry . . . for when I
went home so that I could eat at least eat
something at home, er but whatever I ate . . .
it had to be the smallest amount I could . . .
possibly eat.

I was quite good at it you know er like moving
my day around even when I was at work I
could sort it out so that things would happen
in the way I wanted them to rather than like
be affected by other things and certainly if
they were going to be affected by other things
I would always have plan B ready to er like
suit whatever circumstances I thought were
coming up.

The bad part is that every waking hour of the
day and sometimes even the night you think
about food. You you constantly crave food . . .
and you think of ways . . . where you can get
out of eating it.

I have a very high . . . standard that I've set
myself and you know whatever I do I think
I'm not good enough . . . I think I ought to
perfect a sort [of] certain thing all the time
and it er it really affects me . . . I thought . . .
I weren't being hard enough on myself . . . I've
got to be stricter.

no matter how intelligent you are somehow
on some level you do kind of buy that . . . and
. . . think they they just look so happy and
glamorous and everything you think well you
know maybe if I if I looked like that maybe
that's what's making them [feel] so good
about themselves . . . it's everywhere isn't it
now y-you know . . . you seem to be
constantly bombarded by not just images of
like slim women but like the whole sort of film
industry record industry-all those things and
I suppose it does make people susceptible in
that it's it's there all the time-it's not something
you can escape from . . . all those images
that you're fed, drip fed.

no matter how intelligent you are somehow
on some level you do kind of buy that . . . and
. . . think they they just look so happy and
glamorous and everything you think well you
know maybe if I if I looked like that maybe
that's what's making them [feel] so good
about themselves . . . it's everywhere isn't it
now y-you know . . . you seem to be
constantly bombarded by not just images of
like slim women but like the whole sort of film
industry record industry-all those things and
I suppose it does make people susceptible in
that it's it's there all the time-it's not something
you can escape from . . . all those images
that you're fed, drip fed.

Conclusion
According to the data gathered by this study, a
series of complex and interrelated social and
psychological factors contribute to the development
of anorexia nervosa. Patients were honest
and generous in re-telling their stories. While
often underpinned by psychological discourse,
patients' accounts nevertheless uncovered a
broad range of both social and psychological
antecedents. These have included the centrality
of unhappiness, control and excitement, leading
to a spiral of food restriction, enjoyment and
further food restriction. Patients have also identified
the importance of social institutions such as
school, family and the media in contributing to
their illness. Many of the pre-cursors to anorexia
identified by patients (such as body dissatisfaction
and perfectionism) could readily be
interpreted from a feminist perspective. We may
conclude that patients' own descriptions of their
experiences are lucid and insightful. By volunteering
their testimonies they have enriched
and enhanced our understanding of anorexia
nervosa.