Expert: Jeanne Rust, PhD - 12/28/2010

Question
QUESTION: hi. 

i hope i can get some advice and even a solution. Ive asked on psychforums and still no help.

after reading into my problem i think i could have generalized anxiety, like a small case of anxiety, as well as mild depression. Low self esteem and the list goes on..

i have more of an anxiety problem. a disruptive eating disorder or something like that.

basically whenever i am out of my comfort zone i start to feel really nervous and always feel nauseous no matter what. i feel extremely sick in the stomach, ill, like i am about to always throw up, and needing to go to the toilet because i get stomach pains and churns.

this makes it so i cant really stomach any solid foods as well, making me truely physically sick as time goes on.

id like to explain that i am nothing of an anorexic or am self conscious of my weight, body or image. i dont control my eating habits or anything like that and I never have.

I know I could be underweight but I feel perfectly healthy apart from this problem.

its just when i am say at a party drinking, or not drinking, going out on a first or even third date. i just feel so sick that if i eat something ill throw it up. i get all worked up on the fact i feel sick and nervous and that just makes it worse.

i have been told by friends to just overcome the thoughts and the feelings and force myself to eat, that i will feel better after eating. however i have attempted so many times and well i either throw up or my mind refuses to stomach solid foods, making me feel even more ill.

I end up stewing about the whole idea of eating and get stressed, worried.
Sick of being pressured into eating told to eat, I feel like an idiot that I can't be normal.

If I don't eat anything solid or no one speaks about it I calm down a little.

im at the age where i need to do something about this.i have deprived myself from a active lifestyle, missing out on socialising and meeting new people because i can never feel 100% out of comfort zones.

once i have such an episode, my body just shuts down, and has problems eating food. this can last for a week or even longer, where i wont be able to eat a full breakfast, lunch or dinner. it will either be at several times during the day i am so hungry that my mind forgets about the sick feelings and so i eat something so i can get by. at random times of the day or i end up becoming so sick that i can only drink liquids without wanting to throw up.

when i am comfortable, in my home, alone, or with people i have became comfortable with entirely, i eat fine.

a week of not eating regular meals, the next week i could just become normal again and eating anywhere is not a problem.

a few personal examples is meeting a new person, going out on the first date and for the whole time feeling ill and trying to hide it.
going out and visiting the girlfriend and mealtime at the house and the whole time there not feeling healthy, feeling ill, and having stomach churns.

and everytime i go see this person now, who is my ex, i get the same problems. and once i am back at home, the problem slowly dies down and i can eat fine again, sometimes in a few hours sometimes having to recover slowly over a few days eating little by little each day until i am able to eat healthy again.

going out to parties, the same thing. starts of with nerves, stomach churns, the thoughts of feeling ill, physically being ill, all while trying to pretend that you are helthy and fine.

i am a slender body weight, healthy, underwight im pretty sure according to the BMI(body mass index) but like i said i eat healthy when im "normal" and i never put on weight even if i eat lots of food, exercise and eat food that should make you gain weight.

i never vomit intentionally or forcefully, and i barely ever do because i try to control the sick feelings, by staying away from solid foods.

i have tried forcing to eat

i have come to find that drinking liquids, water, smoothies, fuit shakes, yogurt, anything that was solid and is blended into a liquid i can consume fine in the problem situations.

and i have no problem eating watery foods like watermelon, celery, cucumber, tomatoes etc..

i am thinking about seeing a doctor or something to find a way to overcome this problem and even get rid of it for good.

i am just expecting no useful advice coming from the doctors though.

just came home from a party and i havent eaten properly since this morning. and i feel ill and i tried to eat before and i felt sick afterwaards again.

i have googled eating disorders, anxiety and i have not found anything that matches what i am going through.

apart from this problem i live a happy lifestyle and enjoy and feel good socialising and meeting new people.

i am really worried that i will damage my body if i keep living like this.

what is wrong with me?
Who should I see?
Thanks

Jamie.

ANSWER: Dear Jamie,

I'm so glad that you wrote me.  You've got several different issues at play here.  First of all what is your height and your weight?  That would help me tremendously.

Secondly, I have never known anyone with an eating disorder who does not suffer from anxiety and depression.  Your anxiety issues are not little -- they're severe.  They are definitely affecting your life.

In regards to bulimia nervosa, from what you've written, you don't have the typical bulimic diagnoses.  But there is something, I'm not sure what, that makes me suspect that there is somsething bulimic like happening.

The first thing for you to do is to see a doctor, either your regular doctor and/or a psychiatrist.  I'd like to have this anxiety and depression evaluated.  A good doc who knows about eating disorders or a good psychiatrist certainly will be able to figure out if there is an eating disorder piece there.  I wouldn't rule that out.

Please keep in touch and let me know what you decide to do.  Something is definitely wrong -- Let's get to the bottom of the problem.

Warmly,
Jeanne Rust, PhD
CEO/Owner
Mirasol, Inc.
www.mirasol.net
www.edrecovery.com
888-520-1700

---------- FOLLOW-UP ----------

QUESTION: Thankyou for the speedy reply Jeanne :)

I'm 20 years of age I am 5 foot 8 and my weight range is at around 60kg however I am guessing it is lower from the irregular eating habits I've been having in the last two weeks.

I have never seen a doctor since I was a kid and to be honest I am skeptical of doctors and anyone else. I keep thinking that I will not get a very clear answer or any helpful advice that I already know. Such as to fix my eating habits I need to use my own will power, and my question is I have trouble with will power with certain things. I do not want to be told about anything I already know.

I was thinking the same thing about the bulimic bit. There could be something going on without being aware of the control. After sort of taking some action on this I have noticed I am feeling a little ashamed of my body because I am fearing about my weight now. I thought shouldnt I be getting messages from my body to eat more? I have never seen myself as fat and wanted to lower my weight. I would prefer to gain some weight but not too much. I have a small thought that I prefer to never be overweight if that helps?

I have controlled my depression all by myself and I know how to stay happy. But with this anxiety I can't seem to find a way to control or even stop it. And I'm stumped lol.

I would like to know who would be the best one person to see straight up without being prescribed for a million irrelevant drugs or much running around? Doctor?, begin sessions with a psychiatrist? Or a natropath?

I feel embarrassed seeing anyone of these people, this is a big step for me, and very hard to actually go through with this.

Yours kindly,
Jamie

Answer
Dear Jamie,

I think that if there is a good naturopath in your town that might be the person to see.  They are trained as well as a regular doctor but their emphasis is on health whereas a regular doctor's emphasis is on illness!

If you have a piece of paper. in the right hand margin, draw a stick figure without a head.  In the left hand margin, draw a little circle.  This is a picture of a person with an eating disorder.   You might have a lot of "book knowledge, but your body has not internalized it.  This is the mind/body split or separation.

Recovery is all about joining the body with the mind again.   This is the value of good therapy with someone who specializes in eating disorders.  They can help you connect the information you already have with the reasons for the eating disorders and with your body!

I know it's scary to see someone -- but this is one of those times you need to just jump off the cliff!  Let me know what happens!

Warmly,
Jeannie