You ended your letter by saying that you have to solve this problem before it “gets too far.” Please realize that this problem has already gone too far. It’s been out of control for a significant length of time. You’ve had an eating disorder that sometimes involves simply not eating at all and other times you can’t stop eating. You’re constantly tired. You’re now at the point where you’re losing large chunks of memory. You’ve stolen from a friend and have no recollection of having done so. As you noted in your letter there may be other things you’ve done that you can’t remember as well.
If you’ve ever read my column you’ll know that I usually cannot offer a diagnosis over the Internet. That’s because to be able to accurately diagnose an individual it would be necessary for me to meet with them and ask them many questions about their history, what they’re currently experiencing, and many more questions. Unfortunately I do not have much information regarding your situation so it makes it difficult to offer you a diagnosis over the Internet. Even though I can’t offer a specific diagnosis I may be able to help you to understand, with the information that you have provided, what you may be experiencing.
The concern with your situation is that you are experiencing significant memory loss. It’s difficult to know if the memory loss is related to your eating disorder. Memory loss, along with many other physical problems, can be a side effect of an eating disorder.
The memory loss may be a side effect of the eating disorder but another consideration is disassociation. Studies have shown that individuals with eating disorders may be at a greater risk of experiencing disassociation. The memory loss you are experiencing may be a form of disassociation. Disassociation is an unconscious mental process that disrupts a person’s thoughts, feelings or memories. People who have dissociative episodes report having gaps in their memory. Disassociative episodes are associated with trauma. Individuals who experience trauma are at a greater risk of having dissociative episodes as well as being diagnosed with an eating disorder. Research has shown that there may be a link between all three—disassociation, trauma and eating disorders. If I were able to interview you I would want to know if there was ever a period in your life that you find difficult to recall. I also would want to know if you have a history of trauma that would include sexual abuse as a child, physical abuse, emotional abuse or any other type of very difficult or significant life experience now or in the past. These questions would help me know whether your memory loss is the result of your eating disorder or if you’re experiencing dissociative episodes.
Even if I had the answers to the above questions it still may not be possible to know what exactly the memory loss is caused from. What we do know is that you’ve had an eating disorder for a significant period of time, you lack energy, you’re constantly tired and these are all related to eating disorders and so may be the memory loss. The memory loss you’ve reported is more extensive than what most individuals with eating disorders report. Again it’s difficult to gauge exactly what is causing the memory loss.
If I were your therapist I would have you undergo a thorough medical exam as well as a neurological exam. The purpose for this would be to rule out any medical causes of the memory loss. A medical doctor may be able to determine the cause of the memory loss. After you underwent medical testing it would then be important to focus your attention on treating your eating disorder. I’m not sure if you’re aware of this but eating disorders are the most deadly of all mental health disorders. More people die from eating disorders than any other mental illness. It’s important that you seek treatment for your eating disorder. Eating disorders terrorize your mind and your body. Usually they are a sign that something more significant is going on in one’s life. Some people believe that eating disorders are an attempt to control aspects about one’s life that cannot be controlled any other way. For some people the managing of food makes them feel like they have some level of control in their life. It’s an illusion however to believe that managing food will help one gain control over one’s life. If you have not sought help for your eating disorders please do so immediately. As I mentioned in the opening response to your letter you are worried about this problem going too far but it has already grown out of control. You need help now and not later.
I would strongly advise you to be evaluated medically. You’ve been living with an eating disorder and it’s important to assess the damage that has been done to your body. It’s also imperative that you get into treatment for the eating disorder immediately. As I mentioned before eating disorders are deadly. They should never go untreated. I hope that you will seek help as soon as possible. Please consider writing back and letting me know how you’re doing. I wish you luck.
This article has been updated from the original version, which was originally published here on May 4, 2009.