Posted by Chairman_MAO on May 8, 2005, at 19:33:05
In reply to Re: Wellbutrin and anorexia in best friend » Chairman_MAO, posted by Racer on May 7, 2005, at 21:37:57
You completely misinterpreted my comment, both in meaning and spirit, I think.
The misunderstanding is that one has to be that on top of things, that in control; that the world is such a scary place; that you aren't adequate as you are without restricting/purging (this does not necessarily have to have anything to do with actual physical appearance/weight, and as I understand it usually doesn't).
I'm not sure if I'm even expressing it right, but it's kinda ineffable. I believe, anyway, that the psychological mechanism behind an eating disorder is the same as that behind any addiction: Fulfillment gained through an activity, engagement, enmeshment, etc. that the one invovled doesn't think they can get or is not able to get any other way in the world [that is less [self-]destructive. I have 3 1/2 years of rather severe drug addiction (which was for those 3 1/2 years the way I learned to cope with the dysthymia which was there for a lifetime)
in my past, and have spoken at length with three bulimics and two anorexics (at least) while in and out of institutions. My academic advisor at one of my colleges also was a former bulimic. She and I used to talk sometimes, trading experiences and sentiments about our mental illness, and I am thoroughly convinced that what underlies drug addiction and what underlies eating disorders--psychologically and probably neurologically--is the same. It's some kind of inability to feel satisfied with oneself, this strnage feeling of perpetual emptiness, a constant problem that always needs fixing that always metamorphoses into something else whenever you think you've got it under control. The misunderstanding is that there is no "it" to get under countrol, no group of "normals" judging you, etc. I may fail to explain it in a way that makes any sense to you, but I'd like to think that's because "it" is actually a really intense, complex, and baffling bundle of emotions.I took a philosophy seminar in "self-deception and weakness of will", and read some good literature (Susan Bordo) on the subject. So again, I hope I am not a complete moron in my understanding of it.
The involvement of the opioid system in eating disorders, drug addiction, etc. also makes a strong case that they have similar substrates. The number one addiction/involvement of the sort we're talking about here, of course are dysfunctional, codependent love relationships, the sort of relationships where each participant cannot ever be without the other, etc. I'm a big fan of Stanton Peele's (www.peele.net) taken on addiction, although I don't agree with everything he says.
Additionally, I did some digging and thinking, and I remembered the thing about wellbutrin is simply what I read @ www.preskorn.com a long time ago:
http://www.preskorn.com/columns/0001.html
"Patients with anorexia or bulimia nervosa, who have
lean body mass and the potential for rapid drug
absorption have an increased risk of seizures."Given that the SR formulation was developed to even out the pharmacokinetics to lower the seizure risk, I came to the perhaps spurious conclusion that the reason those with eating disorders are at risk is the lower BMI / quicker rise to peak plasma. If this isn't the case, I'm sorry and hope I didn't offend you or anything.
poster:Chairman_MAO
thread:494808
URL: http://www.dr-bob.org/babble/20050504/msgs/495334.html