By Mirjam Mainland
Two pink lines. That means I’m pregnant, right? I double checked the instructions. One line means negative, two lines means pregnant. Pregnant. I kept repeating the word to myself. I was going to be a mother, something I had dreamed of since I was a little girl. I just couldn’t believe it. Numerous doctors had told me over the years that, after 8.5 years of secondary amenorrhea as a result of anorexia nervosa, I’d most likely never get pregnant. That message didn’t actually hit me until I was recovered.
I kept staring at the test result while tears rolled down my cheeks. I couldn’t wait to tell my husband, but in this moment, there was only one person I wanted to call immediately: my mom. “You’re going to be an Oma,” I said, when I FaceTimed her. Oma means grandmother in Dutch. FaceTime was all we had, since my parents lived in the Netherlands, where I’m from, and I lived in California with my American husband. It was such an emotional moment.
I think finding out that you’re growing a human inside of you is an emotional moment for every (expecting) mom; but for me, it had a deeper meaning. It felt like another step in my eating disorder recovery. It showed me that my body was resilient and able to heal so much of the damage that my eating disorder had caused.
I suffered from anorexia nervosa for almost a decade. It started in my late teens and lasted well into my twenties. When people who don’t know anything about eating disorders ask me when and why it started, I never really know what to say. Eating disorders don’t start overnight. You don’t go to bed feeling great and wake up with an eating disorder. It just doesn’t work like that. They are insidious and develop gradually. Looking back, I can see the subtle changes in my thoughts and behaviors. Cutting out some food groups, skipping a meal here and there, feeling restless when sitting down, and exercising just a little longer than usual.
I’ve always been extremely sensitive and insecure. I was that child who would always hold on to my mom’s dress or sit quietly in the corner assessing the situation until I felt comfortable enough to actually participate. I dreaded the moments in which I had to speak up in big groups (like at school) or walk into a room where I didn’t know anyone. It just made me nervous; and to be completely honest, it still does. At the same time, I desperately wanted to be ‘liked’ and I looked up to people who were considered more extroverted or ‘social’, because that was praised a lot more than being a sensitive introvert. Over time, this developed into the belief that I wasn’t good enough the way I was. I still don’t know where this came from. I grew up in an extremely loving family; neither of my parents would ever expect anything from me other than being happy with myself. For years, they, like many parents, thought, “What did we do wrong? What makes her think we have these expectations?” The truth was, they didn’t do anything wrong. They couldn’t have prevented this.
During my late teens, I was always praised with the fact that I was an easy learner. “You are so smart” and “It’s so good you’re working hard at school” were among the things that people would say to me. I understand that comments like these are made with the best intentions; but for someone who is already struggling with very low self-esteem and who is extremely perfectionistic, they can hurt more than that they are helpful. In my head I was hearing, “I need to be really good at school in order to be accepted and more worthy” or “If I fail in school it means I’m not good enough.” This is one of the reasons you will never hear me say these things to my own kids. I just know how it can have the opposite effect, well intended or not.
I became more and more rigid and my perfectionism started to really work against me. I created rules for myself. So many rules. At that time, I was just starting my undergrad program at VU University Amsterdam, the perfect breeding ground for my eating disorder. I spent countless nights studying, forcing myself to stay up until every page of a study book was read and highlighted. The belief that my work wasn’t good enough or I didn’t know enough kept me editing papers and presentations. It had to be perfect, otherwise I would feel stressed and anxious. I only had straight A’s, found errors in the most complicated textbooks, and would still think that it wasn’t enough, or that the professor made a mistake in commending me. The more people would compliment me for having high grades, the harder I would work for the next class. It was a never-ending vicious cycle.
Unconsciously, I started applying the same rigid rules to food and exercise. Only eating at certain times or after certain accomplishments (like studying for 3 hours straight or walking 2 miles on an empty stomach).
It wasn’t so much that I wanted to lose weight or look a certain way but seeing that number go down made me – in a really strange and dangerous way – feel more calm and worthy. I had no control over it anymore. It gave me a false sense of connection in the midst of living an isolated life dominated by my eating disorder. I didn’t see that the opposite was true. That in fact, it was keeping me hostage and it would never stop. Eating disorders don’t just stop. I can’t emphasize that enough.
My mental state was starting to frighten those around me, and my weight was going down at an alarmingly fast rate, reaching dangerously low numbers. It was clear that this eating disorder wasn’t going anywhere and only had one goal: to destroy me and everyone else in my family. It ruined the relationships with my parents and my brother to the point where he preferred to not come home over the weekend. Our home, which used to be loving and warm, wasn’t a fun place to be anymore. My parents fought more than ever, because they too had to learn about eating disorders and the hell it created in a family.
My parents, who felt more and more powerless, sent me to our family doctor countless times, hoping for a referral. He was a great doctor, the father figure type, but he knew nothing about eating disorders and would suggest medication or a few counseling or dietetic consultations. Obviously, that wasn’t going to work. The healthcare system in the Netherlands is very different from the United States; although everyone has access to care, specialized care options are very limited. As a result, waiting lists are endless. During the first 6 years, I was able to convince every therapist, dietitian or doctor who I had to see that I was fine. Without exception, they all told me that I was “going to be okay”, but just had to eat a little more. “You’re a smart young woman and pretty self-aware,” they said. This happened even at so-called accredited and specialized eating disorder clinics. Everyone who knows the disease even just a little bit knows that it doesn’t work that way. In fact, this only served to feed my anorexia even more.
I took a gap year between my undergrad program and grad school to “work on myself.” I convinced everyone that a student exchange program to the United States would help me recover. As desperately fearful as my parents were at that point, they let me go, being scared to death, but hoping and praying that this was going to help. It didn’t. I relapsed hard and ended up in the hospital. While the other students were exploring California, I was sitting in my room, having blood work done at least 4 times a week to check on my electrolytes, and having ECG’s to make sure my heart wouldn’t give up. On top of that, because of my compromised immune system, I developed shingles and probably had 40 blisters on the bottom of my feet. But I kept walking… at least 5 miles a day.
Back in the Netherlands, I seemed to be stable as my weight was no longer dangerously low and my mental state improved significantly. This is when I started grad school. Because I didn’t look sick people who didn’t know me well would think I was doing fine. My eating disorder used that to strike even harder this time. After I graduated, my weight plummeted again and I got more and more depressed. I applied to jobs in industries that I couldn’t care less about and ended up at one of the big 4 accounting firms. In this performance-driven and what I consider ‘empty’ world I became even more rigid. I also moved out into an apartment in the city of Amsterdam. My parents and brother, who have always been my biggest support system, were at a loss. My dad started searching for specialists all over the world and was willing to do anything and everything to find the right treatment. I truly believe that I wouldn’t be here if it weren’t for their unconditional patience, dedication and determination to help their daughter and sister.
It was then that I met the psychiatrist who would eventually help me recover. I always say she did 80% and I did the remaining 20%. She would probably argue and tell me I did the full 100%. She was this extraordinary doctor who worked at one of the Academic Hospitals in Amsterdam, about to retire, but with a full private practice on the side. She fought for me during and after office hours, on weekends, and on her vacations. She helped me respect myself enough to take the necessary baby steps forward that I needed to take in order to do the hard work that comes with recovering from eating disorders, both physically and mentally. I saw her for about 3 years, first weekly, then bi-weekly. I truly love her. She really cared, deeply cared, about her patients. About a year after I recovered, she took me out to dinner where we laughed, drank wine, and talked about my American fiancée. When I went home last year with a broken heart when my dearest dad passed away from non-smoking lung cancer, she came and met my oldest (now 2 years old) daughter. There are incredible providers out there; I think the main barrier to overcome is that it isn’t easy or straightforward to find them.
To me, recovery is a gift. It’s something I hold sacred, and I will never take it for granted, not even for a single day. It allowed me to find my husband, and fulfill my deepest wish: becoming a mother, twice. My daughters are 2 and 9 months old and truly are my whole world. I often times sneak into their rooms when they are sleeping and just stare at them. Having two daughters of my own has made me even more determined to advocate for those struggling from eating disorders and to do anything I can within my power to prevent others from going through what I went through.