die-agnosis

10/14/2024

(content warnings: eating disorder, suicide, mentions of weight/bmi)

haha geddit aren’t i soooo clever *shot to death*

anyway...

had my intake with an ed program last wednesday. wasn’t really my choice to go, my doctor gave me the referral without me asking and i’m too much of a spineless bitch to say no at any step of the process. it went okay, felt like i was being pushed more towards recovery than what i’m comfortable with but i expected that. i got some tests done and everything came back normal, except my liver enzymes are decreased, which is far better than what i was expecting. thank god i still have normal potassium levels

i was more surprised to read my diagnosis: anorexia nervosa, binge-eating purging type.

the difference between b/p anorexia and bulimia is nebulous at best, if not outright non-existent. purely looking at the dsm criteria, the only distinguishing characteristic between the two is bmi: under a certain point, you’re automatically anorexic, regardless of behavior. this is completely stupid, since eating disorders are behavioral disorders and weight probably shouldn’t be a factor in diagnosis, but i digress.

i would understand if i was diagnosed as b/p anorexic when i met the weight criterion. the problem is, i don’t anymore. my bmi’s currently half a point above, so i have no idea why my diagnosis is what it is. i’m not at a substantially low weight, nor am i losing weight rapidly, nor do i really restrict - i’m probably not eating quite ‘enough’, but i’ve either been maintaining or losing at a snail’s pace for years by this point. i am in no way anorexic.

usually i get access to visit notes from appointments at this hospital, but it’s been five days and i still have nothing. i’d at least like to know the rationale behind the diagnosis, if there was any. i’m just confused.

speaking of diagnoses, it was suggested that i have ocd during my visit. i was initially dismissive of this, i’ve considered it in the past but eventually wrote it off since autism and eds have so much overlap with ocd. i probably wouldn’t have responded at all if it weren’t for someone i follow online posting about their experience getting diagnosed with ocd; a lot of what they went through and their rationale for denial prior to their diagnosis was relatable to me. i’m still unsure, i brought it up to my therapist today but we got sidetracked talking about general feelings of guilt and shame that i struggle with so i’ll need to wait another week at least.

part of me almost hopes i have ocd. not because i want another mental illness, but because it’s something i can fix. i’ve always felt like there’s just something wrong with me, deep down at my core, and for the last five years i’ve been trying my damndest to starve, sweat, and puke out whatever is so rotten inside of my body. being able to explain it with a diagnosable condition would give me hope. it would mean it’s not intrinsic, that it could be treated. that i’m not too far gone.

the fact that i want it probably means it's not real.

i turned twenty today. it was a day of little fanfare. birthday magic faded around the time i turned seventeen and became increasingly suicidal with each passing year. now that i’m no longer planning my own death, it’s just empty. at least i had fifty pills and a bottle of tequila to look forward to when i intended to die. i suppose that’s still an option - i keep the pills around for safety purposes, and my mother is somehow convinced that i couldn’t have a problem with alcohol despite the burgeoning signs of an addictive personality - but i know it isn’t. not really. i have the ability to kill myself, but no will. i’ve never been the most proactive.

life is so much waiting. i have at least three-and-a-half years of college left, potentially another two minimum if i decide to go for a master’s. i want to live and i still feel so deeply unsatisfied. death felt like an expression of autonomy at least, something to work towards. now, even if i decide what i want, i’m just going through the motions. most of what i want feels unattainable anyway. i’m supposedly free yet i feel more confined than i’ve ever been. i wonder if i ruined my life years ago and i’m just now realizing it.

i feel more helpless than i have in years.

~april