Body Image: Remember the Future

Let’s talk about body image. It’s come up a lot, lately, and I went to the beach yesterday wearing my yellow polka dot bikini and could not help but bask in my own enjoyment of my body. I won’t lie–I did compare my body to the very thin body of the friend next to me and long for smaller thighs. But I smashed that thought like an ant at a picnic. I wouldn’t trade this hour glass for anything! And any kids I end up having will benefit from that hard-won attitude.

Take a look at few things I’ve come across just this morning (I did not google “body image”–this all showed up in my Facebook news feed):

Moms pass on body hatred to daughters: Your kids are listening.

Moms buy a children’s book about going on a diet for their daughters. No, I haven’t come across this in any of the homes I work in. If I do, I’ll be having a conversation with the parents, ASAP.

Yesterday:

Photoshopping Phoniness: Beauty altered out of reality and, often, out of beauty.

Fighting Childhood Obesity: The fight to improve childhood nutrition.

First, one unusually great thing about my childhood: my parents served really healthy food, and I’m now glad that I never won my campaign for white instead of brown rice and/or bread. Partly for financial reasons, we never had soda, sugary cereal or salty snacks just lying around the house. Treats were treats. You know what? I don’t want to spend my money on junk, either. So my body is thin and my skin healthy in part because I have always eaten healthy foods.

I didn’t manage to have a great body image, though. Not even a good one. I didn’t believe that I was pretty, not really, until I was about 19 years old. I was convinced that I was probably fat from the moment my body started changing; growing from a lanky, athletic, into a curvy woman was miserable for me. I didn’t know that there would be an awkward phase. I thought it was all supposed to happen so gracefully. Wearing the clothes that I thought I should fit into instead of clothes that actually fit me meant that I wore a B cup bra when I was already a D–in the eighth grade. To be perfectly honest, I still haven’t forgiven the boy who said, “Anne-Marie? Is she the one with the huge boobs?” I’d really rather never see him again. The point is that I didn’t look in the mirror to see how I looked, I looked at Seventeen magazine to see how I should look. I had days when I felt pretty, and I did not have any type of eating disorder or disordered eating. But I was most definitely hiding.

I directly my compulsive energy towards school. I did homework the way other kids played sports. I talked about colleges like other girls talked about boys; no really, I started researching colleges at age fourteen. Once I chose Barnard College in New York City, I wore my sweatshirt almost every day. It was too big and very comfy. I may have also stopped washing my hair… not entirely, just not every day or even every other day. To put it simply, I was unhappy. With myself, my body, my surroundings, my family, boys–you name it, I was angry at it. I didn’t feel like I could tell anyone, so I hid.

I was still hiding when I got to college, but I made friends. The best friends. They saved me. They helped me knock down some of the walls I had built around my real self. And they pretty much forced me to buy clothes that fit my actual body. Not the one I thought I had–not the overweight body that didn’t actually exist or the tiny, skinny body I had so wanted–but the body that I really had. I also became pretty active and ate less ice cream because, well, I got happy. So I lost a lot of weight. I bought a whole new wardrobe. And please, if you meet my friends from college, don’t mention “polo shirts” or “khakis” because they still enjoy laughing (with me, of course, not at me) about the over-sized polos and khakis I was wearing when I met them.

Here’s the big bad body image trap I sidestepped–I did not ignore my body enough to have sex too young or take too many crazy risks. I knew that there would be emotional fall-out from sex, so I waited. (It helped that, like I said, I hid under a hoodie during high school.) I made mistakes, but I knew they were mistakes while I was making them.

Here’s why I think it’s related to body image and therefore to self-esteem: if young people don’t like themselves, they don’t like their bodies and they don’t think that it matters if they take these risks. I suspect that this is true because when my self-esteem was at its lowest (oh, say, around the time I went to the psych ward), I stopped taking good care of my body. I ate sporadically because I just didn’t care. I stopped doing laundry because I just wore my pajamas. I know it’s gross. I didn’t shower often enough. I really just didn’t feel that it mattered. And my future? That seemed really, impossibly far away.

So, this morning, I saw a discussion on the Pigtail Pals Facebook page about young women’s attitudes about casual sex and unplanned pregnancy, and I read that Melissa Wardy finds it “Shocking in how cavalier they are towards their bodies, health, and futures.” I felt like I was zooming back through my own sexual experiences and my friends’ stories about their sexual experiences.

Let’s pause for a minute: I have always been shocked at a cavalier attitude toward body, health and future, in my peers, in younger women, in older women, in men of all ages, but the reason for this is odd. You see, I was raised by a puritanical father to believe I could control any and every sexual impulse. He liked to lecture. “What would people think of me if I wore a short skirt! What would people think of me if they knew that I had spent time alone with a boy!” He actually made sure that I knew he would be sleeping on the couch for the few weeks we lived with my stepmother before he married her. I was eighteen at the time. I believe that my reaction to that was “Daaaaaaaddddd! I don’t want to know!” In my house, before I left for college, any conversation about sex was pretty over-the-top. I swallowed, hook, line and sinker, my dad’s line about sex being this peripheral, almost unnecessary thing we don’t really need to talk about. I thought as a teenager that I would become a Self-Realization Fellowship nun so I talked to quite a few. (SRF doesn’t have much in common with the Catholic church, but our nuns do practice celibacy.) For the record, my dad’s craziness is not even similar to anything you would ever come across in any official SRF text or in any conversation with a monk or nun. Fortunately, I did finally realize that all of my dad’s nonsense was, well, nonsense, to put it mildly, partly through talking to actual nuns about why they practice celibacy and why “householders” deserve equal respect to “monastics.” But. Back to the real topic.

Let’s just say that eventually, I got around to exploring my sexuality. The sheer force of sex and my own desire knocked the wind out of me. By that time, though, I was mature enough to handle all those emotions and to take care of my body. I had the bad habit of thinking of my body as something that I couldn’t really trust, but I didn’t have the bad habit of using sex to feel beautiful or valuable. As you might imagine, I am still working through some serious Daddy Issues, and I looked for Daddy’s approval via proxy in plenty of my past relationships. For many reasons, though, I did not go out and look for casual sex in order to feel good about myself. I’m lucky, because the risks I did take never resulted in a sexually transmitted infection or an unplanned pregnancy.

Fast forward: my high school and college classmates and I are going to turn 27 in the course of the next year. More of us are getting married. More of us have kids, or like me, are preparing to have kids. And I can’t help but wonder. So many of us took such poor care of our bodies. So many of us did not really believe that our futures would really, truly, catch up to us. We punished our bodies with alcohol, cigarettes (my vice of choice), unprotected sex, eating disorders. For most of us, it was just for a few years. I quit smoking. I don’t know many friends who still binge drink. For most of the people I’m close to, unprotected sex was not ok, even when casual sex was fun and frequent. But it really is just anecdotal knowledge taken from a small sample of just the people I know well enough to hear such intimate details. Do I know someone whose body is haunted by a mistake she made? Do I know a woman who got an STI when we were young, still has it and must factor that in to current relationships and future plans? Do I know someone who will not be able to become pregnant because she contracted an infection or suffered complications after aborting an unplanned pregnancy? Do I know a man who has become infertile as a result of an early encounter? I don’t know. I don’t know if I want to know. It’s painful to think about consequences actually having stayed with anyone this long after one of our parties or nights out.

It still doesn’t seem real that the cigarettes I smoked could mean cancer later in life. And if I’m honest, that knowledge is not what got me to quit. I quit because I could not be around babies and small children if I smelled like smoke. I don’t just mean that no one would hire me; they wouldn’t. But I couldn’t bring myself to carry that into their worlds. Why could I do it for them, but not for me? The really bad choices–the ones we can only make after silencing the voice that says “Use a condom!” or “You’ll get cancer!”–would anything short of a snapshot of the future stop us from making those mistakes?

The Whole Truth: Planning a Pregnancy + Mood Disorder = Change, Part II

Just the name of my most helpful prescription medication used to bring me comfort: Klonopin. Also known by the generic name clonazepam, it’s an anti-anxiety medication, and about an hour after I take it in the morning, I can feel it kick in. My heart rate slows, and my thoughts proceed at a more leisurely pace. While I used to take it three times a day, I take a much smaller dose, now, and only in the mornings, mainly because I wake up feeling more anxious than I feel at any other time of day. It was supposed to be a “bridge” drug. It was supposed to help me transition from no medication to the SNRI [Serotonin–norepinephrine reuptake inhibitor] that needed time to build up in my system before becoming effective. This plan, like so many made in a doctor’s office, was interrupted.

In early 2007, despair grew like mold inside me. I felt increasingly hopeless, useless and helpless as rejection letters from twelve different graduate programs conspired with letters from my father, full of accusations that I had aggravated his own deteriorating mental condition. I still don’t know why I thought it would be so simple, but I actually emailed my psychiatrist, whom I had met about twice at that point, and casually mentioned that I thought I might be suicidal and could he perhaps increase my dose of daily medication. After spending a few nights involuntarily committed to the Pyschiatric ER (the worst place I have ever been, without question), I voluntarily entered an inpatient program at Columbia-Presbyterian Hospital.

I worked harder during my two weeks in that hospital than I had ever worked at anything. I put my body and soul into therapy, group therapy, art therapy, journalling, knitting, playing their out-of-tune piano–I pushed everything else aside and tried with all my might to just be. Thanks to the support of everyone from deans to faculty members at Barnard College, where I was a senior, I was able to truly put my outside activities on hold. I also took higher doses of my medication. [Note: I have never and will never take medication *without* going to therapy. My doctor has said that he would not prescribe mediation for someone with my diagnoses unless weekly or, preferably, twice-weekly psychotherapy accompanied the pharmaceutical component.] By the time I got back to my dorm room, I felt like I had gone twelve rounds in a boxing match while my friends had been on spring break. But I did get into one graduate school–a good school. I was on track to graduate. I “had a future.” Most importantly, however, I understood that “getting better” meant continuing to believe that my accomplishments were simply things that I did, not the things that make up a meaningful life. I’m still working on that one, but I’ve come a very long way since those awful nights in the Emergency Room.

When I finally went off the Klonopin, the “bridge drug” that was always supposed to be temporary, I did it properly. With the advice of my doctor, I decreased my dose by a half-milligram at a time over many weeks. When it was finally out of my system, I stopped leaving my apartment for a days at a time. I took the breakup of a long-distance relationship so badly that I actually started self-cutting. (In this state of mind, it seemed like a small cut, on the arm, in my case, would be a welcome distraction from all the pain swirling around on the inside. Yes, it’s hard to imagine for someone who has never felt the urge. Yes, it’s really unhealthy. Yes, it’s a sign that one needs help immediately. Yes, I told my doctor.) As you might imagine, I went right back on the drug.

This summer, a new crisis finally erupted, after spending almost five years as a tiny spot on the horizon. Taking less Klonopin and less often was working out well, but now that I want to have a baby, I am trying to come off of it again. We only know about its effects on a fetus from experiments on rats, but the evidence is scary enough to land Klonopin deep in the NO! category of drugs for pregnant women. A new job and a move to a new apartment meant putting on hold the difficult process of “stepping down” Klonopin; essentially, it’s hard to tell if one is dealing well with anxiety when two of life’s biggest stressors hit at once. My anxiety told me that if I put it on hold, I would never “get off” and would never be able to have a child. “Never” is a word that comes up often when my anxiety takes over my mind.

How does all this land me with a diet of whole foods and natural supplements? Well, to start with, read this nice explanation from the Mayo Clinic, and you’ll understand why I make myself swallow a half teaspoon of lemon-flavored fish oil from the fancy brand Nordic Naturals twice a day. I’m making an effort to eat small meals every two and a half to three hours (except breakfast, which, as I mentioned before, is not a small meal anymore) and this has helped decrease my “baseline” level of anxiety. Jan, The Amazing Nutritionist, explained that this is helping even out my blood sugar over the course of the day, preventing the glycemic spikes and drops that cause the body to produce adrenaline. If you’ve ever felt anxious about anything, you can understand why an immediate decrease in my adrenaline levels would be an exciting prospect!

My goal is not to replace drugs with food. What I want is to be as healthy as I can be, because with a healthy body and mind and plenty of energy, I am simply better able to deal with difficult emotions. If my life is in balance, emotionally and physically, before I get pregnant, then that balance acts like the control group in a scientific experiment. By comparing my moods and thoughts during pregnancy/trying to get pregnant to my moods and thoughts beforehand, I should be better able to spot the irrational fears and manage them. I will feel anxious. I might feel depressed. I will probably want my drugs back. But I will be as well-prepared as anyone can be for this unknown and unpredictable experience.

The Whole Truth: Planning a Pregnancy + Mood Disorder = Change, Part I

My heart rate is often abnormally high in the mornings. I know this because I tracked my pulse for awhile, determined to understand this feeling that I’ve just run a mile in my sleep. Sure enough, sometimes, when I wake up and sometimes when I’m lying in bed trying to sleep unsuccessfully, my pulse hovers around 100 bpm, which is at the very high end of healthy. Why does this matter? My pulse goes down soon enough. What’s the big deal? Well, this:

“According to the American Heart Association, mornings are really the best time for women to measure their resting pulse rate.” via Normal Resting Pulse Rate For Women | LIVESTRONG.COM.

Yeah, okay, but… not for me. For me, it’s upside-down, Wonderland-style. I knew the answer to this riddle before I even asked the question: my brain. I live with what psychiatrists classify as three different “disorders”–Generalized Anxiety Disorder, Panic Disorder and Major Depressive Disorder. I use the example of my “resting” heart-rate to illustrate how my anxiety is different from that of your garden-variety worrier. I regularly feel panic in my sleep, in the absence of any specific circumstances that might explain anxiety-ridden dreams or nightmares.

When my psychiatrist told me about my diagnoses in late 2006, he put it something like this: “These words don’t seal your fate or define you. We use these terms so that we can establish categories useful for everything from research to insurance claims.” To which I replied, “Those are actual medical terms? Because I could have told you that, in general, I feel more anxious about everything than other people. I hyper-ventilate about things like doing my laundry and panic about going to the grocery store and the ATM. And after awhile, it all makes me really exhausted and really miserable.” He told me that this was a pretty accurate summary.

At this point in time, all three of my diagnoses are considered Highly Hereditary (I don’t have a source for you, but my doctor does have an MD and a PhD, and he graduated from both Harvard and Columbia). I also learned that because of the large hereditary component, I had probably been experiencing symptoms all my life. Suddenly, the tantrums I threw when I did not want to go to school (I was not being a brat, I tried to explain, I really was inexplicably terrified of going to school), the insomnia that plagued me throughout elementary and middle school, the childhood stomach aches that came and went seemingly without reason–it all makes sense now.

Not everyone in my family wakes up feeling like she’s run a mile. More of us do feel this way, though, than people in families with no history of anxiety or depression. That seems to be how it works, but doctors don’t know why. Again, I cite my doctor with fancy degrees in neurology and psychiatry–all we can tell from looking at brain scans is where we see the highest blood flow. We can learn a lot from that, but despite what you read in the newspapers, we can only guess at why I feel crippling anxiety while my sister just doesn’t. But I do not see this as an inheritance split unequally or unfairly. Obviously, I love my sister and wouldn’t wish any of this on her. But she was also eleven-years-old when I was born. It’s hardly surprising that we turned out a little differently. And, for purely selfish reasons, I love having a sane and usually calm sister. She helped raise me. She came out of our crazy, chaotic family with an uncanny ability to stay calm in a crisis. Scientists are a long way off from isolating the precise factors that produced these differences, but it is proof that genetics are not fate. At the moment, I really need that assurance.

At my baby shower: Mom, Dad, Sister & Me as a fetus made up my immediate family of four. Now that I'm married, my sister is married with children and my parents are re-married to other people, it's much more complicated. But when we're talking heredity, this is where it starts.

The whole truth behind my new whole foods diet and supplement regimen is this: in order to become a parent, I need a non-pharmaceutical alternative to the treatment that has been working so well. Just to be clear: these pills helped SAVE MY LIFE. But one drug in particular is simply not safe for a fetus. In my next post, I’ll write more about that drug, why I take it and why it’s been so difficult to stop taking it. I’ll also explain how Jan, The Amazing Nutritionist, gave me new hope and energy when she explained some science behind how diet and nutrition can help me.