I’ve always been self-conscious about my body. When I was 13 I gained a lot of weight and I realized I was getting stretch marks. I didn’t really care back then, but when I turned 17 I noticed that I had stretch marks everywhere. I developed bulimia and anorexia at age 17.I believes I didn’t want to lose weight but I wanted to get rid of my stretch marks. Well, when I turned 18 I started self-harming to cope with all the hate I felt for myself.
I quit studying 2 years ago. I no longer have a social life or even get out of my room. When I do go out, I feel like a freak. I see all those beautiful girls with their gorgeous bodies, and how men turn their necks to see them. I feel awful, Inferior, useless and worthless. I have made my mind that no man will ever love me and I don’t allow myself to be happy.

It has come to a point where I’ve tried to commit suicide and do drugs because I’ve stopped caring about myself. Coming to realize that I’ll die alone. I have no propose, dreams or plans for the future cause I feel useless. Some people may think that it’s not serious and that I shouldn’t worry about it, but I can’t. I have no control over this. It’s too much hate on myself. I quit studying; I have literally no friends at all. I’ve been to a psychiatrist before, but my mom says I don’t need one. No one in my family knows about this body issue I have and how it ruins my life.

I don’t know how to deal with this anymore. I need help, but my mom refuses to get help for me cause she says I’m normal. I hate it when people compliment me cause I feel bad for myself.

I am exhausted. Mentally and physically, I feel old, tired and depressed. I no longer sleep at night and I rarely eat.

A: I am sorry you are having so much trouble with your self-image. But I do think that there are several things that you can do to gain support and feel better. The first thing I would do is look for an Overeaters Anonymous meeting in your area. These meetings are free and meet following 12-step principles on managing your food. Beyond the education you get at such meetings, you get a strong sense of fellowship of the members who attend. I think this gives you the best first place to begin.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

Hello, my name is Laura. I’m 14 years old. I suffer from depression, my mum had an eating disorder and bipolar. I’m really scared about putting weight on, I chop my food up into small/tiny pieces or hide it. I weigh myself every morning I currently weigh 39kgs and I don’t like that, I want to be skinnier. I do purge once or twice a week, but I usually don’t eat. The most calories I had today was 350 but I still feel like it was too much. I keep a food log. Do you think I have a eating disorder?

A. Hello Laura. I cannot know with certainty if you have an eating disorder but it is a possibility. You’re hardly eating. Eating only 350 calories a day is not enough for you to sustain life. You cannot do this for long and you shouldn’t be doing it at all. You are obsessed with your weight and don’t think you’re “skinny enough” despite your low weight. Food has become the center of your life. The fact that your mother had an eating disorder increases the possibility that you too might have an eating disorder.

You should receive help as soon as possible. Eating disorders are very dangerous. Your body needs food to survive. It cannot function properly without the proper nutrition and number of calories. Tell your parents that you want to see a mental health professional. If you feel as though you can’t talk to your parents, speak to someone at your school, a teacher you trust, a mentor, the school nurse, the guidance counselor or the principal. It’s important that you do not ignore the fact that you may have an eating disorder.

Without treatment, you risk the development of serious health problems or possibly death. Eating disorders have the highest mortality rate of all mental health disorders and this is precisely why they’re so dangerous. I hope that you will take my advice seriously and see a mental health professional as soon as possible. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice

I fall in love with the wrong people and it tends to make me more depressed. I have suffered from low self esteem for basically my whole life because i am over weight. So when i have a crush on someone, or fall in love with them its extremely difficult to accept the fact that they might feel the same way. I also have severe depression and added to the low self esteem it doesn’t help much.
I am right now in love with two people. One boy, ive been in love with for over three years and he is my best friend. Sometimes i feel as if he might feel the same way about me but other times i think its impossible because of how i look. The other boy, who is another really good friend of mine i am also in love with. Hes struggling with his sexuality right now, and hes taken an interest in me in the past.
I think ive made myself fall in love with him because i feel like i cant do any better than him. And i have recently found out he only was interested in me because he wanted to find out if he was straight or not.
The fact that im in love with two people who i feel as though i cant have is really depressing and more than anything i just want the feelings to go away. How do i do that? Or better yet how do i find out if the boy ive been in love with for three years feels the same way about me without ruining our friendship?

A: At only 16, you have lots of time to figure out love and relationships. First things first. Have you been to a doctor to talk about your weight and depression? If you were seeing me, I’d want to be sure that your thyroid is working as it should. If not, it may be contributing to both your physical and emotional problems. If you are medically okay, we would then work on why it is difficult for you to lose the weight. Is it possible that you overeat to comfort yourself when you feel bad about yourself? It’s not an uncommon response. If that’s the case, we would work to find other ways for you to quiet your anxieties and to give yourself comfort.

The good news is that you make good friendships with men and can sustain those friendships for a long time. That’s a gift. I get hundreds of letters from girls who can’t figure out for a minute how to get along with the other sex.

I have a guess that if you could address your weight issues directly and get into shape, your self-esteem and your love life would immediately improve. I suggest you make that doctor appointment to make sure you are medically okay. If so, see a nutritionist and maybe a therapist to get the support you need to lose the extra pounds. Eat sensibly. Get to the gym or find a sport you can genuinely enjoy. Focus on loving yourself enough to take care of yourself. When you do, love will naturally come your way.

I wish you well.
Dr. Marie

I have problems gathering between being a bodybuilder and a normal person in the same time!
I love bodybuilding but when I start training this kind of sport, I find my self aggressive and violent and I find my self rating people with their strength in daily life not with their minds and other talents (since I find my self stronger than them).
Another problem when I practice bodybuilding is that I get very addicted to this sport and I over train and it spends most of my time in getting more experience and workouts where sometimes there are more important things to do than that like studying.
So how do I practice strength sports while in the same time be a normal wise person that becomes perfect in every field of his daily life without mixing strength in everything.
In other words, how do I concentrate my strength only at the time of my workout then forget about it until the next workout time?
Or lets say how do I isolate my talents, so when I’m in engineering study I become a perfect engineer, not thinking at all about anything except engineering and in the same time become a successful athlete.
If I was a great engineer I don’t want to be too serious and if I was a great bodybuilder I don’t want to be so violent.
I don’t want what I do to affect my attitude.

A: I have worked with other bodybuilders and I can appreciate your concern. Two things are important here—and almost all the bodybuilders who have spoken of aggressive and comparative tendencies have mentioned this. The first is the fact that many bodybuilders—dare I say most—use additives to increase their protein intake and often their testosterone. A number also use steroids or derivatives to enhance their size and strength. The secondary effect of these additives can often cause unwanted aggression.

I suggest you talk with your community of bodybuilders as they have likely had experience with this, then to a sports psychologist. This can give you some insight as to managing the intensity of training with the rest of your life.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

From New Zealand: That heading kinda said what was wrong but you might need a few more details. A couple of years ago when I was 17 my doctor put me on anti depressants as I was depressed for what I know of 2 – 3 years. Early the following year 5 days after my 18th birthday I attempted suicide and I had no reason for it. I just felt like I deserved to die. 2 years before I started getting depressed my grandfather died and we were close. I don’t know if it’s related. During high school I was teased a lot cause I am really shy. I wouldn’t call it bullying. But I don’t have friends, I never really have. My family laughs at me all the time when they know it hurts me. They used to joke about my depression before they knew how serious it was. My mother always yells and puts me down and she doesn’t really realise it. When I was younger my father used to verbally abuse me. He also hit and burned me as well. I know you are probably busy and don’t have time to answer this, but if you had a minute or two I would like to know your opinion. I’m always scared and hurt and upset. I cry all the time for no reason. I have no self worth/esteem or confidence. I really wanna know what’s wrong. I have no idea. Also a few years ago I got treated for an eating disorder, because I was restricting my food intake. I don’t think I had one. I just didn’t want to eat. And I also get insomnia at times.

A: It sounds to me like you’ve been living in an invalidating atmosphere for much of your young life. Your grandfather, the only person who loved you as you are, died on you. The rest of the family and your classmates have put you down, hurt you, and undermined your sense of worth and your self-confidence. You’ve become so used to their negative opinions of you that you are now treating yourself as they have treated you. You don’t nurture yourself with food or with self-love.

Sometimes people aren’t born into families they deserve. You might find it helpful to read an article I wrote some time ago because I was getting many letters like yours.

You are now 19. I hope you are doing the planning you need to do to get out on your own and build an adult life where you can find the friendships and love you deserve. The way you’ve been treated throughout your childhood doesn’t have to dictate the way you will live the rest of your life. A healthy place to start is to look for people who share the best attributes of the grandfather who loved you.

I wish you well.
Dr. Marie

I am looking for ways to fully accept my body. I have been in a long distance relationship for two years with an amazing man who loves me as I am. I just can’t fathom why he does. I have a huge abdomen, round rear-end, and a round face. Tips on accepting these parts of my body would be extremely heigl, especially when I am intimate with my boyfriend.

A: Self-acceptance is the key to well-being and emotional growth and much of this work involves compassion for yourself and others. I highly recommend the work of Karen Armstrong on compassion http://www.amazon.com/Twelve-Steps-Compassionate-Karen-Armstrong/dp/0307742881 along with an active program of mindfulness meditation. These are the building blocks of making the changes you want in your life.

I would also highly recommend this wonderful article on body image by Margarita Tartakovsky here at PsychCentral.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

My best friend is a 17 year old girl. For a while she has been depressed and suicidal, she recently developed an eating disorder (bulimia). She will not see a doctor or a therapist because of the fact she feels uncomfortable telling people things. She has had traumatic problems from her child hood that she has never gone into detail about to me. I feel like she needs anti-depressants and she does agree but she refuses to to tel her grandmother, who she lives with, that she needs help because she doesn’t want her to worry. Is there any way she can get anti-depressants without having to tell her grandmother? or having a doctor put her in a mental hospital again?

A. She might be prescribed antidepressants but it would be difficult to keep it from her grandmother. This situation requires more than antidepressant medication. It requires full-scale intervention.

You should encourage your friend to tell her grandmother. Her grandmother should be worried about the fact that she is depressed and suicidal and recently has developed an eating disorder. Those are all very serious conditions which require immediate attention.

The best way to assist your friend is to encourage her to both tell her grandmother and to see a mental health professional. If she refuses to tell her grandmother, then consider doing it for her. She might be upset at you for revealing her secret but sometimes you have to risk displeasing someone you love to protect them from serious harm. Her physical health and her mental health are at stake. All threats of suicide should be taken seriously and emergency help must be provided. Do what is necessary to help your friend. Please take care.

Dr. Kristina Randle

I have always had a difficult relationship with my mum. My dad was married to another woman and wasn’t around much. I believe my childhood with my mum was unstable. When we were toddlers she fabricated a story about having cancer, which she upheld for many years until it was outted as a lie. She sent us to live with her ex-husband, but maintained the pretense of caring for us to everybody else including my dad. She told lies and forced us participate, threw rages when confronted with her behavior by my foster dad including threatening total abandonment, or taking us away and denying him access, maintained our loyalty by sabotaging our attachment with him. She made frequent reference to his inappropriate fixation on me, though never did anything about this and used it as leverage. My dad decided to live with us age 11, so she removed us from our foster dad and omitted it from history as though it never happened, we were to uphold the pretense of having lived together indefinitely – denying our history, reality and attachment to our foster dad. If I ever questioned this I was punished. When I developed anorexia nervosa, as well as behavioral problems associated with ADHD in my teens, my mum seized the opportunity to appoint me scapegoat of the family. I was castigated for “airing dirty laundry in public” and was expressly forbidden from discussing the reality of childhood in therapy, though she talked about my problems to others at length, telling exaggerated stories and lies which left me ostracized among family. I left home when I could afford to at 19, though I was forced to return when I lost my job. If it were not for my dad passing away recently and the fact that I see my studies as my ticket to independence, I would not have stayed. To others my mum is sweet and vulnerable, people do not see her other side. I feel like her emotional punch bag, I’m heartbroken when I hear what she tells others about me. She continues to undermine my confidence, relationships and achievements and criticizes me constantly. I qualify as a nurse in January, and I’m looking at houses currently. I’m wondering if and how I can rebuild a relationship with my mum, or if I should take the opportunity to put some distance between us once and for all?

A: Your thoughtful question is heartbreaking. The safest way to proceed is to limit your expectations about the kind of relationship that is possible with your mom. As sad as it is, it is limited and the limitation must be honored. My encouragement is to stay connected to ways in which your vulnerability with your mom is limited and keep evolving in your studies. The goal now is to honor that you can have a limited relationship with her, but a deeper investment in your growth lies elsewhere.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

I am over 300 pounds. I used to be 130 pounds. Dieting is very difficult for me. Exercise is worse in that I am disabled. I noticed one day that when I think about myself in various situations, I see myself as thin again. When I dream, I am a thin person. I’m not an unhappy person! I don’t get out much, but I’m happy and enjoy various aspects of life. I don’t like to look at myself in the mirror because I hate what I see. I am a recovering alcoholic. I quit 15 years ago. Immediately I went to food. And that hasn’t stopped.

I understand about cross addicting because I’ve done it several times in a variety of ways.

What I’m wondering is whether a possible reason for my eating is that body image in my head which keep telling me I’m much thinner. I hope this makes sense.

A; It absolutely makes sense. Often an eating disorder is at least partly due to a skewed body image. In the case of anorexia, for example, the person sees herself as never thin enough. She doesn’t believe what she sees in the mirror. The same is true for you. Your inner image of yourself doesn’t match your outer reality.

You understand cross-addiction. However, you don’t seem to be motivated to do something about it. I can see why. You’re happy and enjoy your life. A doctor’s concerns that you are overburdening your heart or shortening your life are abstractions that are hard to hold on to. Maybe you’ve made peace with your life being shorter than it could be. Maybe the idea of dieting is worse than the idea of dying 10 years or so sooner than you otherwise would. It’s your life. You are the only one who can decide if getting back in physical shape is worth the effort.

I wish you well.
Dr. Marie

Hi there, My parents separated when I was 3. Was raised by my mom that was working all day so she could afford to raise me and help my grandparents. Was underweight since I was probably 4 maybe because I started growing super fast. Had a horrible acne so pretty much it destroyed my confidence so I was never going out or anything. Pretty much stayed home all the time and watch TV.

When was 18 moved to US so I could get a better life for my future kids. Had a great business… got screwed by my business partner + my apartment got completely robed of everything I had 2 years back. Was starving at first and barely survived everything that happened. It was a horrible time even used a plastic bag and tried to kill myself several times. I guess didn’t have it in me.
Finally got a job… and working 70 hours a week now. For all that time borrowed a lot of money so everything I do is just to pay back. So pretty much I work every day and when come home watch TV and go to sleep cuz I don’t have energy for anything. I can’t take a day off because my expenses are equivalent 70 hours of work. So here you go. Desperate unhappy and extremely lonely. Btw tried to kill myself couple month back but thanks GOD didn’t succeed cuz it would brake my mom’s heart. The thing is I am really social and fun to talk to at work but it’s just FAKE ME. I really don’t want to talk to anybody. So here you go. I know it’s a mess but the sad reality I will have to work like this for next 2-3 years just to get back up but I really don’t have the energy. Even thou I am 24 already got some grey hair and still super skinny, almost anorexic. Thing is that all my life I had something on my mind and I never really wanted to eat so maybe that’s an issue.

Anyways. I know it’s a mess and you probably wont answer. But I really do need help. Better to say a scream for help but I don’t know what to do and don’t have time for it. I can’t take day offs… just can’t. So I am trying to figure out what I should do to at least work on resolving my issues somehow. I hope for your help and thanks you very, very much.

A. You are most certainly welcome. You have endured many hardships. There was a time when you nearly ended your life. Thankfully you survived. Not only did you survive but you thrived. You began a successful business that eventually faltered seemingly through no fault of your own. Time and time again you have rebounded from difficult life circumstances. That makes you a very resilient person. Your resiliency is a major strength. Don’t minimize that important life-sustaining quality.

Having to work 70 hours a week makes you an extremely busy individual but your mental health is suffering. It’s vitally important to address the psychological issues that have been plaguing your life. As you noted, you’re not happy and you feel very lonely. Those unresolved psychological problems almost led to the end of your existence. That’s proof of how pervasive these psychological issues have become.

You, in all likelihood, would not ignore a potentially cancerous lump on your back and likewise you shouldn’t ignore your psychological symptoms. I would recommend seeing a therapist. You might be surprised at how quickly a competent therapist could facilitate a positive change in your life. Depression is highly treatable. There’s no reason for you to suffer when effective treatments exist that would greatly enhance the quality of your life.

The best way to find a competent therapist is to call at least four or five and ask detailed questions about how they would treat you. Choose the therapist with whom you feel the most comfortable.

You are working long hours. Your mental health is important but so is your physical health. Nutrition is important, as is rest. You should also see a physician to ensure that you have the physical stamina to continue your work schedule.

At this point, it simply a matter of choice. You must make the decision that you want help and then make the effort to receive it. You deserve to be happy. Please take care.

Dr. Kristina Randle

I have a friend with severe problems. She’s 16, she is at distance from me. She has claimed to have tried suicide many times, sometimes even talking about committing suicide while I was talking to her. A friend posed the possibility that the suicide attempts were fake, and that she was calling for attention. One, I want to know if it is possible for her to actually want to commit suicide, while announcing it to us. I ask this because a friend of mine insists that suicide is only committed by people who don’t even mention it, or who mention it once and attempt it. Two, if she is attention calling, how can I help her? She is a great friend of mine, and I want to help. She was/is bullied, she’s bisexual, and that already got people to bash on her, she was beaten by her father, and occasionally still is. She cuts herself. Doesn’t eat for large amounts of time, because she thinks she’s fat. She is ignored by her mother, etc. I wonder if it’s also possible that she exaggerated her description of the problems, in order to call for attention.

A: Your friend is lucky to have a concerned friend like you. While you can help, it’s important for you to remember that you can’t save her from her problems. It sounds like your friend could benefit from intensive therapy. Are her parents or extended family members a resource for her to get help? Please encourage her to get a mental health evaluation as soon as possible. You nor I can determine whether she is indeed suicidal, especially in this forum, but a licensed mental health professional can. Watch the video for the complete answer.

Take good care of yourself!

Julie Hanks, LCSW

A couple of years ago, I lost about 40 pounds due mostly to a supplement I was taking. I quit taking the supplement about a year ago, because info I read led me to believe it might not be safe. I have gained back most of the weight and I’m mad at myself and feel that the people who had admired me for my previous weight loss are now disappointed in me. Ironically–since I made up my mind that I was going to try again to lose the weight–I am actually thinking about food more, craving high calorie food more, and recently have started binging. I almost gag when I try on clothes or look at my body in the mirror. I’ve already been through counseling for other issues, and feel like a failure going back again. I can’t afford exercise classes o gym or weight-loss group memberships. My boss has paid for me to go to a conference this summer, but am considering backing out of going because i don’t want to deal with adorable petite colleagues, feeling self-conscious and guilty about what I’m eating, and seeing the disappointment of people that thought I was doing so well with my weight, and clothes that don’t fit right. What am I supposed to do–I’m about to give up and accept that I’m an undisciplined fatso in a world made for petite Barbie dolls.

A:  Thank you so much for writing in. So many people struggle to manage a healthy weight.  I understand the social pressure to look and appear a certain way, but you seem to be equating your weight loss and gaining it back with your worth. Just because your weight loss wasn’t successful doesn’t mean that you are a failure. Watch the video for the rest of the answer.

Take good care of yourself!

Julie Hanks, LCSW

i think i am bipolar… i go from being happy and normal to being extremely irritated and really angry. little things can ruin my day to the point where i shout and swear at people who did nothing wrong, while i am doing this i feel outside of my body where i tell myself to stop but i cannot and then i end up hating myself and my life (not nessecerally because i shouted at my friends or family for nothing just in general)and feel like my life is irrelavent and everybody would be better off without me… sometimes it leads to me feeling alone with no real friends or people that love me and bursting out into tears (and crying is unusual for me) i usually feel so alone, i isolate myself and think, which leads to more tears and anger and thoughts of suicide. i have also created a fantasy world for when things get too crazy for me… which is filled with everything i wish i had in my life today.
i dont know if this is relevant but i do have a father who purposely chooses to be absent from my life and have nothing to do with me, and i have been anorexic and bulimic in the past, which i have never fully gotten over (i still am bulimic and mildly anorexic).

A: I can’t make a diagnosis on the basis of a letter, of course. What I can tell you is that you have cause for concern. You need to see a doctor and a mental health professional to get a proper evaluation. Please see your physician first. There are many medical conditions that can cause a person to feel depressed and irritable. You want to be sure that you are medically healthy, in spite of the anorexia.

It could also be that what you describe as “mild” anorexia is more serious than you are admitting, in which case you may be suffering from the effects of malnutrition. Your doctor might also refer you to an endocrinologist to make sure your hormones are in balance. The teen years are often a time when there are hormonal difficulties. It’s worth checking out.

If you check out as medically healthy, then see a mental health professional for an evaluation. It’s important for someone to meet you and to get your whole story, not just what you can put in a short letter to me. Once you’ve had a session or two to explain what is going on – both inside and in your world – a counselor will be able to advise you about what may be wrong and what to do about it.

I wish you well.
Dr. Marie

I am still as lost as ever, desperate for guidance, please :( I have had bulimia/EDNOS since i was 14 (6 years) and have been through periods of severe self harm in order to cope with it. My life is continually falling apart because of it bit by bit and I am frightened because so many times I have wanted to just end it as i feel i have no other option. I am emotionally closed with everyone around me and all i ever think about revolves around food, i loathe the way i look regardless of whether I have lost or gained weight but especially at the moment with living back at home there is food everywhere and i frequently have the house (and kitchen) to myself. I hate what I have become and am losing faith in ever getting better I do not know what to and cannot commit to any form of therapy as bulimia and self harm, despite their destructiveness are my only thing i have left to hold on to, i do not understand how to let them go but its killing me. please, what can i do.

A. As you stated, bulimia “has been ruining your life.” This problem is out of control. It requires professional help.

You stated that you “cannot commit to any form of therapy” but it may be more accurate to say that perhaps you have not been willing to commit to any form of therapy. Generally speaking, therapy is more like work than pleasure. Many people like the idea of exercise but don’t do it because it takes work and a dedication to the process. If surveyed, many people in therapy might say that they would rather not attend therapy but yet they do so. They realize that without it, they their life would be worse. Therapy may not be what you want to do but it is necessary to treat your eating disorder.

If you have yet to try professional help, then you have yet to give yourself a chance. Before beginning therapy, many people believe that there is no hope for them. After attending therapy, their lives improve dramatically. You have the opportunity to experience life improvement but you have to be the one who decides that you are ready to receive help.

Bulimia can be a deadly disease. Your life is at stake. It is important to seek professional help at this time. Force yourself to do it, even if it’s unpleasant. It could save your life. Please take care.

Dr. Kristina Randle

My parents have been very concerned about my eating lately. They tell me that I’m not eating enough and I’m losing weight too fast and exercising. I know that I don’t eat as much as my family, but they are all overweight. I generally eat under 500 calories a day, and walk 3-10 miles, enough to burn at least all that I ate. I don’t throw up often, and I make sure I get my medicine in after I have purged if I do so. My parents and psychiatrist are not aware of my purging behaviors. I don’t see anything wrong with them, so there is no reason to worry them. But to ease their worries, I decided to ask here. If nothing is wrong, I can show them.

A: The people who love and care about you are concerned because they can see the pattern of your behavior that you may not be able to see right now.

What I can tell you is that if a young 15 or 16 year old young woman came into my office for a consultation and told me what you so bravely explained here, I would know three things: The first is that there is a pattern of behavior that orbits around gaining weight; secondly that the exercise burns what was consumed, which means there are calories being lost every day. (The normal processes of living and breathing and walking and talking, etc. use calories and if daily activities and exercise burn what was consumed there will be a systematic ongoing weight loss.) Finally a person who purges, keeps it a secret and thinks it is okay shows a contradiction in their behavior. If it really is okay—why not tell those who love you? Why keep the secret?

These things would prompt me to ask the young woman to talk to the psychiatrist and parents about the purging and to get a nutritional consult.

I believe these actions would be the right course of action for you to take at this time. By the way, I notice that you close your letter by saying that if there is nothing wrong you would show your parents and psychiatrist. I hope you can you show them what I have written here.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral