I’ve always been volatile, but over the recent months of early summer I’ve noticed that the emotional extremes have been getting worse. If it were simply the elation of the high times and the despair of the low times I could deal with it, but it’s more than that. Of late I’ve had episodes of violent aggression, moments of such intense rage that I might do anything: attack someone, jump off a cliff, smash a glass into my face, open the car door and leap out while Tom is driving at 90 miles an hour on the freeway.
Last week, a van driver cut me off on Marylebone Road, then braked sharply at the red lights nearly causing me to crash into the back of him. When I drew up alongside and gave him the finger, he shouted out the window that “f*cking cyclists should get off the f*cking road” and I was a “stupid c*nt in need of a good f*ck.” Without a second’s hesitation I got off my bike, strode over to his window, and punched the door frame so hard that I still can’t bend my little finger.
When this anger comes upon me, it’s like a switch has been flipped inside my brain; there’s no rational cell left in my body, everything is on fire and I can’t even think for the red storm that is fogging up my synapses. I fling the pot of yogurt across the kitchen, hurl the dinner plate out of the window, throw my bike down in the middle of the Euston Road, and threaten a van driver. The rage is uncontrollable, and I simply don’t care about the action or its consequence. It’s like a hyperkinetic explosion in my brain. I know these episodes are dangerous; I know I could hurt myself or get into serious trouble. I don’t know what’s happening sometimes. I don’t know myself.
In desperation last week, I emailed my friend Deanne. We first met around six months ago when, in response to The Times column, she wrote offering help. She explained that she was not only a professional eating disorders counselor, but also a mindfulness practitioner. I was skeptical at first—the concept of mindfulness has always seemed slightly flaky to me—but agreed to meet. Deanne isn’t flaky but she is incredibly calm and thoughtful, a soothing presence to be around. We sat for hours over coffee in the Royal Society of Medicine talking about our lives, and have stayed close ever since.
Emma, stop for a moment. Take a deep breath. You sound so anxious. I understand about this anger. I would lay a bet that you aren’t becoming a nasty person, but these feelings are really scary. I don’t think you will ever know your nature until you have harnessed the energy in the anorexia to work for you; to trust you will be OK and human, with facets like a diamond. Sometimes these facets look dark if the light is behind you, while the same facet will shine if the light passes through.
Deanne tends to communicate in these wafty terms: “harnessing energy” and “shining like a diamond.” At first it made me roll my eyes, dismissive, impatient; I wanted practical solutions, not new-age abstractions. It was only when I concentrated on what she was actually saying that it began to make sense.
Anger is like a huge room; what you see of it depends on which window you happen to look through. From one window you can see that your rage is a consequence of change in anorexia: when you’ve bottled up your feelings for so many years they erupt like a volcano.
What’s wrong with you? Just a tsunami, Em . . . there must have been an earthquake underneath, so wait and see where the earth settles.
I agree with you that blame is useless; I agree there comes a point when we have to stop blaming anorexia, or our own shortcomings, or past relationships, or fear. The tsunami inside asks to be heard; to be faced, perhaps, and then you will be able to see it for what it is . . . You are on a really wobbly step right now, but I promise there are many other steps ahead. Perhaps consider letting someone help you leap to the next one.
What was wrong with me? “Just a tsunami ... wait and see where the earth settles.” What beautiful words. I hope Deanne is right. I hope it’s the process of recovery that is causing this instability. The surge of energy—from eating—seems to fuel all sorts of unexpected emotions. After so many years of anorexic numbness I find myself coming back to life in a whirlwind of feelings. And I feel like I’ve failed in some way, that the eating disorder has beaten me. I know I’m angrier and more impulsive than before; is this just the earthquake doing its thing? Sometimes I simply feel angry at the whole world—for making me confront this, for making me leave the anorexia behind. It’s part of me. I feel defeated.
And yet—it’s more than just extra caloric energy and awakened feelings. For too long, everything that’s gone wrong in my life has been blamed on anorexia. Even when Greg killed himself, I don’t think there was space for bereavement, not properly. Everyone was on the alert for my weight to plummet, for me to plunge back down toward 85 pounds; no one ever thought of what I’d already lost. Greg’s suicide had nothing to do with anorexia. I am so tired of hearing that everything would be fine if I just ate more.
What if it goes deeper than that? Of course eating again has set off the volcano, of course my emotions are bubbling over, but I refuse to accept that it’s always about food. I believe there may be an underlying chemical imbalance, something wrong with my brain, spinning me on these rapid cycles from violent rage to numb despair. My inner chaos has always been more real and troubling to me than the eating disorder, but no one takes it seriously. Like Tom, they insist I will feel calmer when I start to eat regularly.
Until a few years ago I didn’t know what it was called ... I still remember the lightbulb moment when I read a description on the Internet of cyclothymia.
Cyclothymia is known as a “milder cousin” of bipolar disorder. Like bipolar, cyclothymia’s distinctive feature is its mood swings from high to low, although they tend to be less extreme than those of bipolar disorder. When you’re up—or hypomanic—you feel confident, energetic, omnipotent: anything is possible. There’s an exhilaration about everyday life; you could be a kite, soaring way above the Earth. In my upbeat phases I need hardly any sleep or food, I’m full of ideas and plans, creative, productive, and talkative, giddy with joy. But when you’re down, you feel useless: pessimistic, clumsy, and depressed. It’s hard to concentrate and hard to look forward with any hope: the future seems bleak. Physically, you swing from intense periods of activity to lethargic periods of paralyzing depression. The mood fluctuations with cyclothymia can be unpredictable: sometimes I feel quite stable for weeks, sometimes I cycle between severe highs and lows in a single day.
Have you ever read about a condition or an illness and felt instantly, Yes, that’s it? When I began to find out about cyclothymia it spoke to something that had been niggling at me for years. In some ways it’s a relief to have a label—an unofficial label—for my inner chaos.
Does mental illness run in families? We don’t talk about it, but there is a lot of psychological instability on the Woolf side of my family. Sometimes I wonder how my father has coped at all: both his parents committed suicide, both his sisters suffered repeated nervous breakdowns (as have many of our cousins and extended family), and my little sister has experienced serious episodes of depression. So my instability is part of me. Is it part of my family? And if it’s definitely genetic, a neurological condition rather than my own general messed-up-ness, should I still be taking something to control it?
I took Prozac for seven years and I still miss it. I’d love to be able to pop that neat green-and-white pill every morning. It makes you feel good—I often long to return to the speedy, zippy high of those Prozac years—although I barely slept and never stopped moving and was even more hyperactive than normal. But, since 2002 and Greg’s suicide, I don’t entirely trust chemicals.
It’s not that I “disapprove” of drugs; this is a personal, not a moral decision. I know mental illness is real: I know something in the brain has gone badly wrong. I know the right medication really does save lives. Prozac was a miracle for me. It worked its mysterious magic on my serotonin when I was at my thinnest. For a while at Oxford, I was so precarious that I could barely make rational decisions. My parents believe that Prozac rescued me when I might easily have gone on slipping down, into hospital and then death. But I have decided to deal with my own imbalances without chemicals. It may not be the right decision—it’s hell sometimes—but I want to live with the emotions and experiences as I’m feeling them. I want to do it alone. I want to learn to “deal with” life, raw. Back then I couldn’t have coped without Prozac, but I can mostly cope without it now.
Depression or cyclothymia or anorexia. A toxic mix, the three torments, all exacerbating each other. Whatever the science says, the stigma remains. I’m ashamed of my dysfunctional brain. I hate how demanding I am, emotionally, mentally. I need to talk and talk, euphoric, veering on manic. Then I fall silent, I stare down at my large stupid hands on the end of skinny arms. When Tom asks me what’s wrong, I can’t put it into words. I’m unable to go on, overwhelmed by the hopelessness of it all, crushed by my own sense of failure. No one understands. My family says I’m erratic. I wear myself out with the highs and then I crash and I suck all the air out of the room with my lows.
But I don’t know how to be stable. Is something broken inside my head? Am I going mad? I was never the world’s best sleeper, but the insomnia has gotten a lot worse over the last decade.
It was 5 a.m. and starting to get light when I got back from a night ride this morning, 20 miles through the deserted streets of London. Since I gave up running, the muscles in my legs ache and twitch painfully; my entire body misses the endorphin rush. Cycling isn’t quite as good, but it’s better than lying in bed awake. I cycle for hours and then I stand under the shower feeling empty and clean, but still not sleepy. I would give anything to sleep.
My little brother and I were discussing sleep last week in the pub. He does circus trapeze and walks the high wire; he thinks sleep is all a state of mind. I told him about my insomnia. He looked at me for a moment, his head on one side, and said, “Actually, yeah, I can’t imagine you sleeping ever. You’re kind of too intense.” I feel desperate because it’s true. I don’t know how to turn off. I wonder if I slept as a baby.
For me, trying to describe the experience of insomnia would be like trying to explain the pain and loneliness of a severe migraine: I can’t find the words. You spend hours staring into the dark while the rest of the world slumbers; you go from hope to frustration to rage to despair. There’s nothing you can usefully do at 3 a.m. and, anyway, you’re exhausted. You would like to be asleep.
At night I lie next to Tom and watch him sleeping. I wonder what he’s doing right and I’m doing wrong. He lies face up, on his back, like a corpse. He can sleep when there’s light or noise, even when he’s stressed: he has learned how to lie down and switch off. Sleep deprivation takes you beyond reason, it makes you irrational, sends you mad; that’s why it’s an established form of torture. Sometimes I wake Tom up and he strokes my hair and turns my pillow, gives me a massage with lavender oil. We talk for hours, making plans and working out problems, and the darkness seems a little less endless.
And now I have added insomnia clinic to the list of appointments: acupuncture, yoga, mindfulness. If I could learn to sleep I think everything else would fall into place: I would be calmer, life would be less of a battle, I would be rational about food. But it’s all or nothing with me, it’s always been that way. Either I have rigid control or everything is wildly out of control; there seems to be no middle way. I can’t sleep because I can’t unwind; I can’t start eating because I might not be able to stop. If I’m not skinny, surely I’ll be obese. It’s so tiring, the internal conflict and the guilt and the endless fight: isn’t it time for a ceasefire?
There’s nothing cool about being this screwed up. And poor Tom. It’s wearing us both out, this unpredictable soaring and plunging from happy to wretched, empty to full. At the heart of it all is the desperate longing for balance. But if the chemicals in my brain have gone haywire, how will I find equilibrium?
Mental illness is not easy to experience, nor is it easy to be around. So when I suggested to Tom that he take a break from me, I was absolutely sincere. It wasn’t something that just popped into my head on the freeway; I’d been thinking about it for weeks. This is a conflict of my own making and I don’t have any choice but to fight—but Tom does. The strain it’s putting on him makes me hateful to myself. I didn’t fall in love with Tom when I first met him; it’s been incremental falling over these past two years. It surprises me now, how precious he is to me, how it hurts me to hurt him like this.
Sometimes I’m overwhelmed by Tom’s kindness: I’ve never felt I deserved to be so loved by anyone. I don’t mean romantic declarations or grand gestures either; I mean the little things he does on a daily basis, without reminder, without reward. Whenever we go away, for example, he packs his pair of soft blue tracksuit bottoms that I love because he wants me to be cozy. Even though I normally put on a bathrobe after my evening shower, still there have been cold bedrooms, or hotels without bathrobes, or the heating doesn’t work, and he can’t bear me being chilly or uncomfortable. Every single trip, even if we don’t need them, he always makes sure to bring the navy tracksuit bottoms; then he takes them home and washes them, remembering to use fabric softener. This is why he keeps asking me to move into his flat; because he wants to look after me, he wants us to be together all the time, not just when we’re traveling.
I remember a recent evening in Edinburgh, a bitterly cold Easter weekend. After an eight-hour drive from London we arrived at the hotel, checked in, and were shown up to the fourth-floor “Da Vinci suite.” It would have made a stunning art gallery, but it was unwelcoming as a bedroom, sterile in the way that high-concept interior design often is. And it was frigid, the trendy exposed radiator far too minimalist to heat even a quarter of the cavernous space. Tom disappeared while I was running a bath—I assumed he’d gone downstairs to ask for an extra blanket. It turned out he’d walked from the hotel into town in the pouring rain, and spent £80 on a cashmere sweater for me from the only shop still open. I hadn’t complained about the chill—I could improvise with a couple of tops, and I wouldn’t have wanted him to go out into the rain—it was my own fault for not packing enough warm clothes. But he dashed out anyway, and returned half an hour later with this elegant ribboned Whistles bag (containing the softest sweater I’ve ever owned) and a bunch of white lilies. “For being lovely, Em. For always coming with me to endless hotels, even when we just want to stay at home ...”
He didn’t want thanks, he just wanted me to be warm.
Remember how my mother and I joke that I’ll never find the perfect man because she’s already found him? Like my father, Tom seems to have an endless capacity for giving, a bottomless well of love. After renewing my pledge that I will eat more—after eating my chocolate in the library as I promised—I get an email from him. It’s around 10 p.m. and I’m reading in bed (Jude the Obscure) when the red light on my BlackBerry flashes.
Em-love—hope you’re OK and getting an early night—fantastic weekend but tiring. Avoided traffic jams driving back from yours, crashed out on sofa and watched Chelsea lose, then I wrote up action plan for you, as threatened. The plan takes us to the last Sunday in July, when I’ve booked us tickets to see The Cherry Orchard at the National Theatre. Seemed like a nice way to celebrate! I’ll list the main principles—and put simply, after so much talk, and so many manifestos, this is the one that has to come true. This is the real deal. Don’t wince when you read this: it has to happen now, or the summer will disappear, no progress will be made, and that would be incredibly sad. Action Plan—a.k.a. The Six Weeks That Changed My Life
• As agreed, you will eat three meals a day. Each meal must be a proper, balanced meal.
• A proper breakfast consists of a large bowl of muesli with milk, fruit, handful of Brazil nuts, vitamin pills. Alternatively it could be toast with jam, fruit, nuts, and vitamins. It must include carbohydrates of some sort. On no account can “breakfast” be a piece of fruit and low-fat yogurt (see below). The word “breakfast” involves the breaking of a fast, not the continuing of a fast.
• A proper lunch consists of a cheese sandwich with a piece of fruit on the side. Alternatively a baked potato with beans. Or a pot of couscous with a roll, or vegetable soup with roll. Note: it must include carbohydrates and some protein in the form of beans or cheese, etc.
• A proper dinner might be vegetable chili with baked potato, grated cheese, and a side salad, or it might be a vegetable curry with brown rice and a salad. Or pasta arrabbiata with cheese sprinkled on top, or vegetable lasagne, both with salads on the side. You need to branch out and try different dinners that include proteins and carbohydrates.
• You must keep a food diary covering the three meals a day (I don’t want to hear your usual objections to this). Be it as simple as “breakfast: muesli, lunch: cheese sandwich, dinner: baked potato and veg chili.” This way you can, quite crucially, keep tabs on what you are eating, making slip-ups impossible.
• At the end of each week, we’ll assess the week gone by. There must be no gaps. No missed meals whatsoever.
• Low-fat yogurts and fruit do not count as meals.
• Steamed broccoli and a roll does not count as dinner.
• There must be no buying of “low-fat” items: those items are for people on a diet.
• No resumption of running (but remember the best gym in London).
• All of this starts now.
I believe that after six weeks of a new diet your body will be much healthier, the sense of well-being and happiness will pass into your subconscious, and your body will send messages to your brain that “this is good” and “I rather like this.” Until you were nineteen you never had difficulties with food: you enjoyed it! By being systematic, never cutting out a meal, and never pretending that certain food counts when it blatantly doesn’t, these six weeks can provide the jolt that is required. Don’t think about anorexia. Those attitudes have to go in your personal trash can. Just follow the program and see what happens. It’s like watering a neglected plant, remember?
I hate to be so forthright, but really this is it. Everything that can come from this is positive. I believe that we should do this together: how else is a child made? And I promise you a new writing desk, if you want to move in properly and commit to living together. Remember sitting by the river in Dresden, last summer, discussing the future? Imagine, we can sit by the Thames before The Cherry Orchard at the end of July and things could be so different. You can do this xx
Excerpted from An Apple A Day: A Memoir of Love and Recovery From Anorexia by Emma Woolf (Soft Skull Press, 2013).
Emma Woolf is the great-niece of Virginia Woolf. She studied at Oxford University and worked in publishing before becoming a freelance journalist and writer, contributing to The Independent, Harper’s Bazaar, Red, Grazia, The Times, and The Mail on Sunday. She lives in London. You can follow Woolf on Twitter: @ejwoolf.