Sunday, July 30, 2017

Hunger Hurts But Starving Works: Part Three

This is part three in my series on the neurobiology of restrictive anorexia nervosa. As a reminder, the following information may be triggering or difficult for some readers. Please keep yourselves safe.

If you need to catch up, you can find parts one and two here.

Like the 5-HT neuronal system, dopamine is implicated in the neurocircuit function of AN-R. The dopamine system has often been referred to as the reward and pleasure centre of the brain. It is the neurotransmitter that rewards us when we do something we enjoy, and also rewards us when we avoid something unpleasant. It plays a huge role in addiction and addictive behaviours, and initially my paper was going to be on the question of whether or not eating disorders can be classified as an addiction, but that proved to beyond the scope of this assignment and its restrictive word limit. I did, however, read some very interesting papers about the addictive nature of eating disorders such as binge eating disorder, bulimia, and anorexia nervosa binge-purge subtype. Perhaps I will write a post about it in future.

The following is verbatim from my original paper with my added commentary in purple.
The dopamine neurotransmitter system regulates eating behaviour through the modulation of motivation for dietary intake and other reinforcement- and stimulus-reward associations (Frank, 2014; Volkow et al., 2003). In particular, the dopamine D1 and D2 neurotransmitter receptors are involved in motivated food approach and fear extinction, while the D2/D3 receptors bind in the ventral striatum, a region of the brain that regulates responses to reward stimuli (Kaye et al., 2009). Further, studies have suggested that restricted food intake and high levels of exercise engage the mesolimbic dopamine neurons—part of the brain’s reward system—thereby rewarding this behaviour in AN-R (Sodersten et al., 2016). The dopaminergic pathways, therefore, could be an important component of the neurobiology of AN-R. Hopefully this is clear enough as it is – it is basically saying, dopamine plays a role, and here’s how.

A number of studies have documented altered dopamine function in AN-R. For example, one study found that the major dopamine metabolite, cerebrospinal homovanillic acid, was reduced to about 30% in individuals with AN-R compared to healthy controls, suggesting decreased intrasynaptic dopamine levels (Kaye et al., 1984, cited in Frank, 2014). In a related study, positron emission tomography (PET) imaging revealed that, compared to healthy controls, individuals with AN-R had increased dopamine D2/D3 receptor binding in the anterior ventral striatum, suggesting a hypersensitivity to these pathways (Frank, 2014; Frank et al., 2005). This hypersensitivity may contribute to the altered reward processing seen in AN-R, whereby hunger is rewarded by a reduction in dysphoric mood (Kaye, 2008; Via et al., 2015).  So basically, compared to healthy controls/people without AN-R, people with AN-R have a hypersensitivity to dopamine. This hypersensitivity means that the wrong thing is rewarded; instead of finding food pleasurable and rewarding, people with AN-R find hunger rewarding because it reduces their anxiety. Further, there are some studies that suggest that starvation can feel euphoric and similar to the high that drug users get when they take their drug of choice. I was going to link to some articles here, but now I feel like they may be taken as encouragement or "tips" so I've decided not to. Moreover, D1 and D2 receptors [D1 and D2 are types of dopamine] can be found in human skin, raising the possibility that abnormal function of these receptor systems could contribute to the disturbances in body perception present in AN-R (Tammaro et al., 2012, cited in Frank, 2014).

This point needs to be emphasised. Have you, if you are a person with an ED – and maybe even if you aren’t but you do have body image issues – ever eaten something and then felt like you were expanding right then and there? And I don’t mean, oh, haha, I’m getting fatter/I need to burn off that doughnut/I ate too much and I feel bloated. I mean actually, distressingly, feel like you are swelling and blowing up like a balloon and soon you’re going to pop your buttons and soar out the window like Harry’s obnoxious aunt?
 
Gif from MuggleNet
 

I'm being facetious, but rest assured it is anything but funny when it is happening. It is a highly distressing, upsetting, and difficult experience. It is grabbing at your skin and groping your stomach and clutching the bones of your back, your hips, your ribs, because you’re sure there’s more flesh there than there was this morning, you’re just sure of it. It is trying on every pair of jeans you own at 3am because even though you wore jeans yesterday, they could not possibly fit anymore because you ate two apples today instead of one*. It is crying, hysterically so, at 12 years old at the dinner table because your mom said you have to eat your dinner but you can’t, you can’t, you can’t, your skirt is getting tighter by the second and your body is swelling like you’ve been stung by a million bees and why are they all just staring at you and not helping you when clearly you’re about to explode and flood the room with all the putrid bile-coloured fat coursing through your veins?? It is horrible and it is hard and it scary, and it is [theoretically, as this is a theory] because of the faulty dopamine circuitry in your brain. It is [theoretically] the D1 and D2 receptors in your skin going haywire and giving your brain misinformation. That misinformation can then be translated back to your eyes where you then look at yourself and see yourself as bigger than you are. Perhaps you have heard about – or experienced – the phenomena of being told you are underweight or that you’ve lost weight or that you look thinner or whatever people may say [PSA pls don’t comment on other people’s bodies unless they ask okay thx friends], or perhaps you’ve stepped on the scale and seen a number that is dramatically lower than it used to be, yet you look exactly the same. Or worse, to the sick mind, bigger**. That, my friends, is the dopamine. Perception is tricky as heck and what you see and what your brain interprets as what you see can be two very different things even without the dopamine deciding to further screw things up. Dopamine is one sneaky little bastard and can wreak havoc on the disordered brain.

Anyway. Moving right along.

Similarly, there is increasing literature suggesting that fear extinction consolidation relies on prefrontal cortical dopamine D1 and D2 receptor stimulation (Mueller, Bravo-Rivera, & Quirk, 2010, cited in Frank, 2014). Fear extinction consolidation means exactly what it sounds like it means – the consolidation of the fear extinction. You can overcome a fear and do the scary thing once, twice, ten times, but a fear is not extinct until that extinction has been consolidated and you are no longer afraid of that stimulus. In this case, the stimulus is food and weight gain, as I am about to discuss…Now. One of the core symptoms of AN-R is an intense fear of weight gain or becoming fat, and so altered stimulation of D1 and D2 receptors provides one possible explanation for this heightened fear response and the difficulty in overcoming it and associated fears regarding food intake. To be clearer, the dysregulation of D1 and D2 means that a person with AN-R has an impaired ability to extinguish/overcome fears, and given that a core fear for those with AN-R is food and the associated weight gain, this fear is even harder to tackle and overcome because a) the mere act of eating causes a whole host brain shenanigans, as discussed in parts one and two, and b) eating further messes with said D1 and D2 receptors, which messes with the ability to overcome fears while simultaneously sending faulty signals about the body to brain and telling the brain that the body is already too big or getting bigger or expanding and swelling and suffocating and choking and I can’t breathe under the weight of my own body I am crushing myself from the outside in…So yay. We be screwed. Lol.

 
And that cheerful note concludes part three. Lol. I’m kidding, by the way. People with AN-R are not screwed, but it is a very difficult disorder to treat and overcome as I’m sure you’re all starting to see, if you don’t already know from personal experience. Hopefully post this has been clear and informative. If my information or interpretation is incorrect, please feel free to let me know and provide me with further studies or information so that I may learn more and correct any mistakes. As always, my disclaimer here is that I am only a psych student, not a qualified anything to do with mental health, and the extent of my formal research into this topic was only this paper. I do not claim to know everything there is to know, nor do I claim to understand it all. Please take my interpretations as interpretations, not facts. The full reference list is under the spoiler, so if you’d like to read more, I used 30 or 40 research articles to put this paper together and you are more than welcome to follow these things up at their original source.


Coming up in my next post: Hunger Hurts But Starving Works Part Four: Dopamine, food hoarding, food obsession, and giving rats anorexia [this is a real thing. Madness.]
 
Feel free to drop me a comment via the comments, twitter, Instagram, tumblr, and/or askFM if you have questions or want to talk about any of the things I've discussed.
 
Stay safe.
 
 
*This is an over-exaggeration to make my point. Few people live solely on an apple a day. Some do. But most eat more, quite a bit more according to my research, but I am not going to talk about the actual numbers because it is not about that.
 
**Worse to the disordered brain, not worse in general. There's nothing wrong with gaining weight and I don't mean to imply there is. I'm just talking about gaining weight from the perspective of a person with a disorder that makes weight gain seem like the scariest thing on the planet.
 
 
References
 

Wednesday, July 26, 2017

One More Light

The following topic may be distressing or triggering. Please keep yourselves safe and reach out for help if you need it.

I know many of you are expecting part three of my series on the neurobiology of anorexia. It is coming. I'm so sorry it has taken so long. I've been swamped with uni and life and I'm drowning in The Sea of I'm-So-Overwhelmed-Hey-How-Do-I-Uninstall-Anxiety-And-Depression. It's not a particularly pleasant place to be.

I wasn't intending to write about this. I wasn't going to make these thoughts and feelings public. But then tonight, at 3:33am, I started writing in my journal. As I was writing I thought, you know what, I'm probably not the only one who feels like this. So maybe I can post about it. Maybe we can all talk about it and mourn together.


The lead singer of Linkin Park passed away last week. You probably heard about it. His name is Chester B. Was Chester B. I'm still getting used to the past tense. I'm not sure I'll ever be used to the past tense.


It's affecting me more than it should.


Linkin Park were my go-to band when I was a depressed, angsty, anxious teenager. Some of you know this. I wrote about it once on my other blog, when they were touring with Thirty Seconds To Mars. I often say they were my Mars before Mars. The band who helped me through the darkest times of my teenage years. The lyrics of their first two albums -- Hybrid Theory and Meteora -- spoke of depression, anxiety, fear, hate, regret, worthlessness and disappointment, and perfectly expressed what teenage me was feeling. I can't tell you how many times I wanted to make a dumb choice but instead blasted Meteora and journalled or drew or wrote instead. They were my escape. They still are -- or were, again with the tense -- an escape. Or a release. Misery loves company, or so they say. Depressed angsty teenage me needed someone to understand, and finding a band who wrote and sang and spoke about exactly how I felt was like being understood. It was like finally being able to breathe. In fact they expressed how I felt so well, that I gave the lyrics to Somewhere I Belong to my very first therapist as an explanation of what was going on for me. I've always had a flair for the overdramatic.


It is strange to be in a world where the person who wrote the songs that were the soundtrack to my teenage years is no longer here of his own volition. It is hard to accept. It is hard to accept that things got so bad for him that Not Breathing became the best option. Death is always harder when it is deliberate. I mean, I understand it. I do. Believe me, I do. But it hurts to think about. It hurts to think that a person I so looked up to during the worst of my teenage years as proof that people have felt like I do and survived and gone to have a life lost the fight against the very thing he was writing about. I understand it, but it doesn't make it easy to accept.

Mental illness is a fucking bitch, you know? Please excuse the swearing, but seriously. It doesn't give a shit who you are. What you do. What you have. Who loves you. Who needs you. Who looks up to you. How much talent you have or how many people you inspire. It just takes and takes and takes until you have nothing left to give. This week I have caught myself thinking [and saying], if someone like that can't win this fight, someone with seemingly everything can’t win, then what hope do I have? What hope does anyone have? I feel ashamed of these thoughts because it's not about ME, but I can't help but wonder if there is any hope for me or you or anyone, really. If we're keeping score, the odds are never in our favour. Hell, look at me. 30 years old and still in bloody therapy. I mean, my therapist is great and I am endlessly grateful that I am able to access support when I know so many people cannot, but damn, I don't want to NEED therapy anymore. I'm sick of it. I'm sick of all of it. I want off this ride.


Some people say suicide is the easy way out. Let me tell you something: There is no easy way out. There are no easy options here. Please don't make that mistake. There is nothing easy about weighing the pros and cons of ending your life. There is nothing easy about debating whether or not your loved ones are going to blame themselves [spoiler: They are] or forgive themselves [spoiler: They're not] or get over your death [spoiler: They're won't. Yeah you can tell yourself they will. I do, all the time. But it's a lie. It's a lie your mental illness is telling you, just like every other thing it tells you. Everything it says is a lie.] All options are difficult and overwhelming. Living is hard. Dying is hard. Asking for help is hard. Not asking for help is hard. Treatment is hard. Not getting treatment is hard. There are no easy options or answers. I wish there were. I wish I could say suicide is never the answer, and although I wholeheartedly believe that, I also know it is very easy to start feeling like maybe it is the answer when things look their darkest. And that's a horribly tough place to be.

 

One thing I do know, unequivocally so, is that all feelings -- even intense, urgent, utterly devastating feelings -- can and DO pass. They do. I promise they do. They may not go away forever, but you cannot feel the same level of emotional intensity -- whether that's elation or devastation -- for an extended period of time. You physically can't, at the neurological level. Your brain is not equipped for sustained intensity. This means that when you're at your lowest and most depressed, when you're ready to not be breathing anymore, if you just wait it out -- an hour, a day, even 15 minutes -- the sheer intensity of that feeling will start to subside. I'm not saying that it will disappear forever on its own. Most mental illnesses require treatment of some description in order to show sustainable improvements. It may not go away forever, but if you just wait it out, or Surf The Urge as one of my previous therapists used to say, the feeling will lessen and become more tolerable. You can get through it. You will get through it, if you give yourself the chance.


Please give yourself the chance.


So. What can you do to get through it? Here are some things that help me.


First and foremost, talk to someone. Make contact with someone. Your therapist, if you have one. Friends. Family. Trusted others. You don't have to tell them how you're feeling if you don't want to. You can just message or call to say hi. But talk to someone. Don't isolate yourself if you can avoid it.

There are also many crisis support options available. In Australia, for example, there's the lifeline crisis chat, which is an online chat room that operates from 7pm to 4am. This is a great option for anonymous immediate support in a crisis. There are also numerous other options, which are listed here.

Sometimes you don't want to talk or human or be with people. I understand that. At times like that, these things can help: 

  • Play with your pet, if you have one
  • Watch funny videos on YouTube
  • Watch other videos on YouTube that you enjoy. I'm personally obsessed with documentaries, mukbangs, TED Talks, and bad Lifetime movies.
  • Scroll social media
  • Visit a support website
  • Take a bath or shower
  • Brush your teeth
  • Go for a walk
  • Scream into a pillow
  • Make a bucket list of all the things you still want to do
  • Eat or drink something comforting. Tea works well.
  • Watch a movie or TV series you love [my go-to is Harry Potter]
  • Read a book
  • Allow yourself to feel it because sometimes, feelings demand to be felt. Feel it. Think about it. Fantasise about it if you want to. But don’t act on it.
  • Take a nap or just lie down
  • Write a letter
  • Journal
  • Draw/paint/write/sew/dance/do something creative
  • Scribble on paper so hard that you tear it
  • Trash your room then clean it again
  • Blast angry music
  • Blast happy music
  • Blast depressing music
  • Blast any music
  • Allow yourself to cry
  • Curl up into the smallest space you can find
  • Play with a fidget toy
  • Pray, if that's something you do
  • Read the Bible or other spiritual/religious material, if that's something you do
  • Engage in some kind of self-care if that helps you
  • Focus on harm minimisation
  • Go into another room or another place if you can. Try not to stay where you are.

The important thing here is that you delay. Tell yourself you can do it tomorrow or next Tuesday or next time the moon is at its peak. Bargain with yourself. Give yourself time. You just need to give yourself time. You know, in Belgium, assisted suicide due to mental illness is legal. And do you know what they found? Even the most desperate people sometimes ultimately choose to stay their euthanasia. They have the option. They have a guaranteed and painless method. Yet when it comes down to it, although the depression or anxiety or other mental illness is still there, the intense desire to Not Be Here subsides. They choose to live and fight another day. There's a really interesting and heartbreaking documentary about this on YouTube here.

I know a lot of this sounds like just another load of psychobabble that They tell you to fill your head with rainbows that fade faster than smoke, but I'm not talking about long term solutions. I know none of these things will make you All-Better-Congratulations-You-Are-Cured. If they did, mental illness wouldn't exist. I'm just talking about riding out the most desperate and dangerous urges. It is possible. You can make it through. I promise you can. And once you make it through, you can seek help and support -- either professional or through online resources or from your friends and family or a combination of all three -- to deal with the underlying issues that are causing you pain. Once, upon returning to my doctor to discuss treatment options for the umpteenth time, I told him I was tossing up between asking for help and killing myself. He laughed and said, Well, at least you have options. And it's true. You always have options. Isn't it better to exhaust every single one before you give up? It sounds terrible, but you can always make the decision to Not Breathe tomorrow or next week or next year if you want to. Why not try absolutely everything else first? That option isn't going anywhere. It's a bad option and I hope you don't take it, but the fact remains, it is there and always will be. But so will every other option. And only one is irreversible.

I wish we lived in a world where no one ever felt so low that the only viable option is Not Breathing anymore. But we don't. We do, however, live in a world full of people who want to help. If you need it, please seek help.

 

Stay safe. Xx 

I'm not sure who wrote this. Credit goes to the author, whoever they may be.
 
 
Mike Shinoda's Twitter avi
 
 
Title lyrics: One More Light by Linkin Park

Thursday, July 13, 2017

Hunger Hurts But Starving Works: Part Two

This is part two of my series of blog posts about the neurobiology of restrictive anorexia. If you missed it, part one is here.

As a reminder, this is a paper I wrote for university. I have edited it to make the information more accessible and easier to understand, however, it can still be quite technical at times. I’ve included some [hopefully] helpful hyperlinks where applicable and have tried to paraphrase my original paper into clearer terms, but this has proved to be harder than I thought. If you have any questions, feel free to ask me here, on Twitter, on Tumblr, on Instagram or askFM.

As with the introduction, I will be including all the original intext citations as this was a literature review, not my own original research, and it is important to credit the authors and researchers. The complete reference list will be in a spoiler at the end of the post.

 Please proceed with caution as again, the following information may be triggering to some.

 





Hunger Hurts But Starving Works: The Role of Serotonin and Dopamine Anorexia Nervosa [Part Two: Serotonin]



Serotonin (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter that plays a role in regulating aspects of the brain and body such as mood, emotions, and appetite. Monoamine transmitters are crucial in emotion, arousal, and cognition. Note that ‘arousal’ in this context does not relate to anything sexual; it simply means a state of readiness, alertness, awareness, and other ness words.


Serotonin will be referred to as 5-HT for the rest of this post, as its scientific name is 5-hydroxytryptamine, which is abbreviated to 5-HT.


The following paragraph is verbatim from my paper. I have included it as the simplest way I can think of explaining this information with evidence is to provide it word for word and then explain what it means. You may skip this paragraph and jump straight to explanation, but I think it’s important because a) It is necessary to back up claims with empirical evidence, and b) A lot of my Instagram followers requested that I share the actual science side of what I learnt, so here it is.


The 5-HT neurotransmitter system extends throughout regions of the brain classically involved in feeding behaviour, thereby contributing to the regulation of appetite (Compan, 2013; Corwin, Avena, & Boggiano, 2011). Brain imaging studies have consistently shown that compared to healthy controls, individuals with AN-R have elevated binding potential for postsynaptic 5-HT1A and 5-HT2A receptors (Kaye et al., 2003; Tiihonen, 2004, cited in Kaye et. al., 2009). Evidence of this can be found in the cerebrospinal fluid of patients with AN-R, which contains reduced amounts of 5-hydroxyindoleacetic acid (5-HIAA) compared to healthy controls (Schwartz, Woods, Porte, Seeley, & Baskin, 2000). 5-HIAA is the major brain metabolite of 5-HT, thus reduced amounts in cerebrospinal fluid is thought to reflect increased extracellular 5-HT concentrations (Schwartz et al., 2000). Increases in intrasynaptic 5-HT have been shown to reduce food consumption, therefore this suggested increase may contribute to the restricted food intake characteristic of AN-R (Kaye et al., 2003; Kaye et al., 2009).


This highly science-y paragraph means:

 1. Serotonin contributes to the regulation of appetite;

2. Too much intrasynaptic serotonin has been shown to reduce appetite;

3. Intrasynaptic means that it is within the synapse;

4. Elevated binding potential for post-synaptic 5-HT (which is serotonin, remember), means that more serotonin can bind to the synapse and therefore more serotonin will be within the synapse;

5. Ergo, studies have shown that when you compare a healthy individual to an individual with restrictive anorexia using science, the individual with restrictive anorexia will most likely have more intrasynaptic serotonin than the healthy individual;

6. Which, remember, reduces appetite;


7. Thus could be one possible contributor to the reduced food intake seen in restrictive anorexia.


I would like to point out that it is a myth that people with anorexia never get hungry, or that they hate food, or that they never eat. It could very well be that some people don’t experience any hunger, or genuinely hate food, or never eat at all [the never-eaters quickly end up tube-fed, or sadly, pass away]. However, the more likely scenario is that despite the ever-present hunger, the cost of eating is weighed against the distress it will cause and the conclusion is drawn that, eating equals anxiety equals I don’t like anxiety equals I want to avoid the thing causing me anxiety.


This concept is further explored in the following paragraph, which again is largely verbatim from my original paper, but with my added commentary in purple.


Importantly, the precursor to 5-HT, tryptophan, is an essential amino acid only available in the diet (Kaye et al., 2009). Carbohydrates elevate levels of brain tryptophan and accelerate 5-HT synthesis and release, while proteins block these effects (Kaye et al., 2009). Eating, therefore, could potentially increase anxiety in individuals with AN-R, as disturbances in 5-HT pathways have been linked to increased anxiety (Charney et al., 1990, cited in Kaye et al., 2005). As I said above, individuals with AN-R tend to already have too much serotonin, which reduces appetite. Now add to the fact that not only can too much serotonin reduce appetite, it can also increase anxiety. THEN add the knowledge that certain foods speed up the delivery of serotonin to your brain, which is already overwhelmed by serotonin all on its own, and now this food is fast tracking even more serotonin to your brain, and you begin to see why AN-R is consistently called one of the hardest mental disorders to treat. Oh joy. Indeed, studies have shown that the food-mood relationship in AN-R differs to that in healthy controls. For example, a 2009 study by Kaye et al. found that in healthy subjects, food and eating were associated with pleasure, and hunger was aversive. Conversely, food and eating triggered anxiety in individuals with AN-R, while hunger reduced dysphoric symptoms (Kaye et al., 2009). [Dysphoria means anxious, unpleasant feelings] A potential explanation for this is that when people with AN-R eat, their extracellular 5-HT levels increase, stimulating the postsynaptic 5-HT1A and 5-HT2A receptors and causing distress (Bailer, 2007). This distress makes food, and by extension, weight gain, anxiety-provoking and aversive. However, reducing anxiety via a restrictive intake might drive further restriction, thereby promoting AN-R symptoms and creating a cycle that is known to be resistant to treatment (Frank, 2014; Kaye et al., 2009).


So what have we learned so far? Let’s review.


1. Too much intrasynaptic serotonin reduces appetite in most people. This is why some antidepressants that work on the serotonin system can either stimulate or reduce appetite; serotonin is part of the system that regulates appetite.


2. Too much serotonin also causes anxiety in some people.

3. Individuals with AN-R tend to have too much serotonin.

 4. The precursor to serotonin is called tryptophan and it is found exclusively in the diet. Meaning, you have to eat to make serotonin.

5. Now, if you are a person with AN-R, and you already have a low appetite and high levels of anxiety due to having too much serotonin, you might find that eating certain foods stimulates the production of more serotonin and makes you feel more anxiety.


6. Of course, you won’t know this. You won’t think, hmm, that bread I ate had tryptophan in it and that stimulated the production of serotonin and I already have too much serotonin and now my brain is SO FULL OF SEROTONIN and it’s making me SO ANXIOUS. What would probably happen is you would think, I feel anxious, I ate this bread, now I feel MORE anxious, hey that’s happened before, wait, I'm always more anxious after I eat bread, maybe the bread is the cause, I should avoid bread, hey look it worked, I’m less anxious, guess I’m not eating bread anymore. This is obviously a VERY simplified explanation, but that is the underlying message in this paragraph. I chose bread for the example because high carb foods contain the most tryptophan, but really this applies to anything.


Note that this hasn’t even touched on what is happening outside the body, such as the triggers individuals may have, their motivations, co-morbidities, their environment…This is only looking at the underlying neurobiology. Once you add in all the extraneous factors and variables, the picture becomes much, much murkier.


Have I lost you? I hope not. Let me know in the comments if you have questions, suggestions, or if you think I’m completely wrong and stupid. Remember that I am only a student, not a licensed anything [except driver!], and so this is my interpretation of the research. I could be wrong. If you know something indicating that I am wrong, please do let me know. This is meant to be educational, and therefore, needs to be accurate. I will say that I gave a copy of my original paper to my therapist and he is a licensed magical unicorn psychologist, and he said the information was accurate. Also obviously I submitted it to be graded and my grade indicated that the information was accurate, but you should always be critical when reading another person’s work. I have some degree of confidence that the verbatim parts of my paper are correct based on the feedback I’ve received from those smarter than me, but my interpretations and explanations should be taken as just that; my interpretation. Not the gospel truth*.


Stay with me, if you’d like, as in the next post I shall move onto the role of dopamine, which as everyone knows, is the feel-good neurotransmitter that gets us to do some things and avoid others for that all-powerful dopamine rush.


The text reads:

a n x i e t y
how do you expect me to eat when this lives in my stomach?



 









References

Wednesday, July 12, 2017

Hunger Hurts But Starving Works: Part One

As many of you know, last trimester I wrote a paper on the neurobiology of Anorexia Nervosa for one of my units at university. This was a literature review, so I did not conduct any research of my own; I simply read and synthesized the information available.


A lot of you asked to read it when it was finished. I said I would make it available after it was graded, provided I received a grade indicating that the information and the paper as a whole was correct and, you know, not horrible. I’m happy to say that after months of waiting, I’m finally able to share what I’ve learned.


Monday, June 19, 2017

Atelophobia


Hello there, again.


It seems I have a habit of disappearing.

It has been weeks since I last wrote a blog post. Almost three months, if you want to get specific.

Not for lack of ideas. I have an entire notebook filled with them in a drawer in my desk.

Not entirely for lack of time, although that has played a role in my lack of bloggable words (yay exams…totally yay. They haven’t been soul-crushing at all.)

Not because of computer failures or fun life events or even particularly sad life events.

No. My absence has been due to one thing, and really, one thing alone.

Fear.

I have been afraid to write.

Wednesday, March 22, 2017

I'm not okay, I'm not okay, I'm not o-fking-kay


Today I’m going to talk about therapy.

As I’ve said before, I have been in and out of treatment since I was 14. This year I am turning 31. So, a long-ass time. I use the term ‘treatment’ quite loosely here: at age 14, for example, I was seeing a counsellor at my church, rather than a licenced therapist. I’ve also seen social workers, psychiatrists, psychologists, dieticians, general practitioners [GPs], and other types of counsellors.

 I am a barrel of fun, let me tell you.

 


I often receive messages from people saying that they want help or they can recognise that they need help, but they are scared to involve a professional. There are a number of reasons why people might feel this way, and honestly, it can be scary scary scary to feel like you might be Crazy Enough™ to seek professional help. I can completely understand the reluctance that so many people have expressed to me, as despite being in and out of treatment for the majority of my life*, I still feel so much fear, anxiety, and yes, embarrassment and shame, when I know that it’s getting to the point where I need to seek professional help.
 
The reasons for this can be very individual, so I can only talk about my own experiences. In my experience, I’ve been reluctant to seek professional help due to the following thoughts:
 

 “I’m not really that bad. I’m just having a bad day. Week. Month. Year. Lifetime.”
 

“They will think I am making it all up OH GOSH WHAT IF I AM MAKING IT ALL UP I A TOTALLY MAKING IT UP WHO EVEN AM I WHAT IF MY WHOLE LIFE HAS BEEN A LIE.”

“Other people have it worse and so they need the treatment more.”

“I’ve been worse before so I can’t ask for help unless I get that bad again, or even worse than my worst.”