The Diagnostic and Statistical Manual – 4th Edition (DSM-IV) recognizes two distinct eating disorder types, anorexia nervosa and bulimia nervosa. If a person is struggling with eating disorder thoughts, feelings or behaviors, but does not have all the symptoms of anorexia or bulimia, that person may be diagnosed with eating disorder not otherwise specified (EDNOS). The following section lists examples of how an individual may have a profound eating problem and not have anorexia nervosa or bulimia nervosa.
- A female patient could meet all of the diagnostic criteria for anorexia nervosa except she is still having her periods
- A person could meet all of the diagnostic criteria for anorexia nervosa are met except that, despite significant weight loss the individual's current weight is in the normal range.
- A person could meet all of the diagnostic criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur at a frequency of less than twice a week or for duration of less than 3 months.
- The person could use inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food (e.g., self-induced vomiting after the consumption of two cookies). This variant is often called purging disorder.
- The person could repeatedly chewing and spitting out, but not swallowing, large amounts of food.
- Binge-eating disorder is also officially an EDNOS category (see separate fact sheet for BED): recurrent episodes of binge eating in the absence if the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa.*
I often feel like I am invisible. I often wonder if I am the only person who feels invisible about 50% of the time. I think that I am mostly to blame for this, by sticking close to home, and not going out. I haven't left the house since Friday, but then again, I was not invited by anyone to do anything, either. Do I blame myself or do I blame others? This is tough for me, because I'm apt to blame myself, given my penchant for self-destructive thinking. I had a brief discussion with one of my far-away friends about this today, and I begin to wonder what I did wrong to repulse all of the people I keep close all at the same time. I feel like I've been doing really well. I've been upbeat and positive, I've tried to be helpful and compassionate, and I've tried to treat others how I wish to be treated. I know that my ability to isolate myself is a huge factor in the relationships I have with others - I sometimes turn down opportunities to go out and be social for the simple reason that I don't feel like going out and doing anything. I don't like to think that I do that often that people will stop asking me to go out, but that's going to be my best guess as to why I've not been invited to go out and do things much in the last two weeks. The other reason I'll say no to going out is if I can't afford to, and that's what happens more often than not. I'm doing the best I can to be responsible with what little money I have, and I can't just go out on a whim and spend $30 or some similar amount of money without really thinking about it first.
I think I'm going to continue to struggle with loneliness and abandonment issues for awhile. Those aren't things that just go away on their own, and I'm still reeling from the issues I'm dealing with, with regards to Former Bestie. All I can do is move forward, take things one at a time, and grow and heal as best I can. I know that I have to sort of build a wall up around my heart to prevent myself from getting hurt as deeply as I've been hurt before.
Tomorrow is day two of my new job! Another 9.5 hours in Downtown Boulder! I get to decorate the building's Christmas tree, and I am no longer "training" as I will be at the front desk all by myself all day long! I'm excited to see what I'll discover about the place and the position and the people, and interested to see what I do with 9.5 hours of time where I'm really just answering phones and making conversation with others. Here goes nothing!
*"NAMI | Eating Disorder Not Otherwise Specified (EDNOS)." NAMI: National Alliance on Mental Illness - Mental Health Support, Education and Advocacy. Web. 28 Nov. 2010. <http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=65849>.