On Madness and Body Image

I lied yesterday.

There is one reason I like mania.

It, more than anything else I have ever tried, cures my belly woes.

When I am manic, I have no IBS symptoms. I can eat with reckless abandon and nothing will touch me. I will not bloat, I will not cramp, I will not have pain for days on end after the purposeful or accidental ingestion of something forbidden.

Two days ago, I ate The Worst Meal Ever. It is also one of my favorites. It is white bread slathered with sundried tomato cream cheese as an appetizer, pasta with cream and Gorgonzola cheese with bacon and chicken as an entree, and flourless chocolate cake for dessert. I have ingested this while not in the throes of mania, and have suffered its consequences for days: bloating, gas, pain, cramping, constipation or diarrhea. I eat this meal only when I think I can handle it, when my belly isn’t already distended from some other food issue, when I really want the food and am prepared to suffer its consequences.

This is how much of my relationship with food has been over the last number of years. What I enjoy eating has to be weighed in terms of how much pain it will cause me over how many days. It is almost formulaic.

Except when I am manic.

Mania is such an interesting proposition for my body, body image, my weight and my IBS. When manic, I have dropped weight in the blink of an eye. In my eating disordered days, it has been during times of mania that I have dropped the most weight, because mania is a natural appetite suppressant. Sixty pounds in three months? No problem. Mania did it for me. There have been days where I have been simply so enamored with my own thoughts and doings that I literally forget to eat. The concept of hunger does not factor in. I used these times to diet, and extended the manic episodes indefinitely with ephedrine when the natural high wore off and hunger returned.

When I am hungry, I crave bizarre foods. Crackers and cheese for lunch.  Peanuts for dinner. Whipped cream for breakfast! And I indulge, indulge, indulge. Yesterday I ate six 100-calorie cupcake packs over the course of the day and washed it down with soda. I eat more fast food. I do all of this because I can. Because on days when I am not manic, my stomach revolts at, literally, the mention of these foods. I think of saccharine nonsense like frosting and immediately my colon cramps, it has become that Pavlovian. Mania somehow stops the IBS from happening, and I am so thankful that I just binge on things I cannot eat 75% of the time without becoming significantly impaired.

IBS contributes to fair amount of my body dysmorphia. I can be bloated so uncomfortably for days. I don’t know how visible this is to the population at large, but for me, the visibility isn’t what matters: It is how I feel. I have considered giving up eating for good, and simply fasting for days on end just to avoid the discomfort of bloating. It is a nightmare. I feel sluggish, ugly, my clothes don’t fit well, I imagine I am the fattest person in the world, unlovable, disgusting, vile, obese, tragic, and hideous. The image in the mirror is so distorted when I am bloated: I appear twisted and three times the size I actually am. If I don’t feel right, I don’t look right.

But with mania comes a reprieve from IBS. There will be no bloating, no trying to figure out what foods to eat in what combinations or when or how. There will be no accidental ingestions. I feel good, and slippery and slick, like a silver fish swimming in a stream. It’s smooth and right. My body just feels nice when I am manic, and that’s the best feeling of all.

I am not sure why all of this is. I have been thinking about it a lot this past week. When I am just a regular old person, not mixed, not rapid cycling, not depressed, and not manic or hypomanic, my bowels are ornery and cranky. They require a certain kind of care. Certain foods must be avoided, certain restaurants are really bad. I can’t have soda with meals. A bathroom must always be nearby.

And I’ve noticed other things, too: When I am depressed, or in a dysthymic state, I am more prone to generalized pain all over my body. My back hurts more, my shoulder flares up. I’ve noted I get worse migraines in the winter, a time when I am typically more dysthymic. Mania cures all of these physical ailments better than any pill. The elevated levels of neurotransmitters is the balm for all my troubles.

If nothing else, it continues to be proof for the mind-body connection. On my end, I just enjoy the body goodness while I can. I try to keep myself in check in my mind, try to be present for important conversations while my mind is singing inside, try to corral myself when I need to sleep, try to keep a leash on my ever expanding euphoria. But I revel, absolutely revel in how wonderful I feel in my skin. I eat whatever I want and know that soon my intestines will not be so forgiving. I place my hands on my flattened belly and take comfort in knowing there are no extraneous grumblings. I move with ease, not bent over slightly from pain. For me, this is the best part of mania, it’s gift to me: Remembering what it’s like to have a normal body.



  1. stefanie said,

    April 25, 2008 at 11:04 am

    I am really interested in the mind-body interface. *Something* in your body is different when you are in a manic state. If there was a way to find out what it was, maybe it could help you with your IBS and other inflammatory issues when you are in a dysthymic state. This is why I personally don’t agree with the automatic suppression of symptoms approach to therapy, when it’s applied thoughtlessly. (Obviously some symptoms *need* to be suppressed if they’re life-threatening.) Maybe it’s just because I go to a homeopathic physician, and he’s really interested in stuff like that – what gets better or worse when, and under what conditions.

    It sounds like you’re trying to keep yourself cognitively in check re: sleep, eating, etc. I hope you can be well and discover what’s going on.

  2. thoughtracer said,

    April 25, 2008 at 11:17 am

    Yes! There has to be some biochemical change that occurs in my body at the onset of the mood shifts that affects not only my mind but also my body .. or my mind simply affects my body that greatly, I don’t know which.

    I know I am not trying to do that much different physically. I am taking all my meds at the same time. I am going to bed at the same time. I am making sure to get the same amount of sleep, even if that means I have to take prn medication or smoke, because for me, less sleep means more mania. I am seeking homeostasis. Some people crave mania. I crave stability. The more I cycle, the more I will cycle in the future. It is progressive. I know this, I know all of it. I knew it when I got diagnosed, and I took it seriously. It became a job to manage this illness.

    I am less serious about managing my IBS, I will be honest. I care for my mind and my emotions a lot better than I care for my body. Maybe because I have felt, for so long, that this body is not good enough or pretty enough or right enough that there is no point in tending to it or taking care of it, so why fucking bother. My mind, though, I have cherished. I fiercely protect it.

    My body is staging a revolution, though, at this imbalance, and it shows through migraines and IBS and all of my other general ailments.

  3. Autonym said,

    April 27, 2008 at 11:49 am

    This was really interesting to think about, because I just realized this week that my all over body fatigue and my body pain were gone! I had attributed this to my prozac finally taking hold, and that may well be the case, but if I think about it this was my most hypomanic period in six months. I also notice that my pain threshold is really high and I keep hurting myself without realizing it. I’ve used more bandaids in 2 weeks than I have in a year!

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