Keep Trying
Author: Joanna Fensome
This Unsinkable story discusses cancer, death, eating disorder, depression. We invite our community to read it only if it's the right time for them! If you're struggling, please reach out to the Crisis Text Line or Kids Help Phone.
When I was 14, I went to a doctor’s appointment with my mom. As we sat in the familiar examination room in the clinic I had been going to since birth, my heart was beating much faster the usual. This was the first time I went to the doctor for anything that wasn’t routine or easy to diagnose and treat. I had recently told my mom that I thought I might have an eating disorder and she had encouraged me to seek help. She and I were close, and I was glad she was at the appointment with me.
After the usual 10–15-minute wait in the examination room, my family doctor waltzed in, grabbing my chart off the back of the door on the way. He sat casually down onto his swiveling chair and, still looking down at the chart, asked me what I was in for.
I don’t remember the exact words I used, but the jist of it would have been that I was struggling, obsessing constantly about exercise and food, to the point that I wasn’t sleeping, had lost 30 pounds, and my period hadn’t started. What I do remember is what the doctor said next (finally looking up at me): “I just ate a couple candies from the table out there, does that bother you?”
*****
I’ve always experienced anxiety. And though I had a happy, privileged childhood, a knot of anxiety has been settled in my throat and chest for as long as I can remember.
The tendency to fixate and ruminate on the unexpected, the uncomfortable, and the undesirable to the point of panic has always been present. Once, at age 8 or 9, I made the drive home from a family camping trip miserable after I realized I had lost the cap of my blue pen, for which my parents refused to make a multi-hour detour to look for. The image of the pen cap, sitting alone in the abandoned campsite, dominated my thoughts on a loop for several days.
Then, when we were 12 years old, my best friend died after a 10-month battle with cancer. It happened during our transition from elementary school (grade 6) to junior high school (grade 7) and it all seemed to happen so fast. I remember feeling confused and deeply ashamed that I hadn’t made more of an effort to spend time with her during the last days of her life. My life split into before and after.
In my grief, paired with my preexisting tendency to ruminate, I focused inward on my shame and trying not to make any more mistakes. What had previously been mostly manageable tendencies towards conscientiousness and introspection took root in my teenage brain as perfectionism, preoccupation with planning, people-pleasing, and sensitivity to criticism. In the process, my experience of the things I had previously enjoyed – soccer, figure skating, choir, school, hanging out with friends – soured. I gradually retreated from my friend groups and stopped all extracurricular activities except for ballet, in which I channeled my energy, without enjoyment, in the pursuit of perfection.
I quickly developed an eating disorder, no doubt fueled by the dance world’s obsession with thinness as well as broader societal fatphobia and fixation on women’s bodies. Rather than through social media, the methods of the day were unrelenting commentary (on daytime and nighttime talk shows, sitcoms, food packaging, health class) on weight loss, “health”, and “wellness”.
I still vividly remember watching infomercials late at night about weight loss supplements, exercise contraptions, and smoothie blenders that would result in miraculous, and obviously desirable, bodily transformations. Ballet teachers were constantly commenting on the size of everyone’s bodies, including mine and their own. Not long before going to the doctor’s office for the first time about my eating disorder, I was told my hips weren’t the right shape (she probably meant my actual bones, but that’s not what I fixated on at the time).
As I struggled, my parents were able and willing to support me, emotionally and financially. But the medical system had no idea what to do with me.
*
My family doctor referred me to a dietician, which was probably about the worst thing he could have done. In the subsequent series of appointments with the dietician, in her windowless office in the basement of a hospital, I honed my skills in calorie counting and planning meals.
As I spiraled deeper into my disorder, my mom helped me to switch family doctors and I did get some support: a prescription for antidepressants and a referral to talk therapy. The series of therapists I saw helped me to build awareness of my thought processes, if not to alleviate the discomfort I was experiencing because of them.
My mom always encouraged me to keep trying, consistently reaching out to help me climb out of the hole I felt stuck in. She didn’t always know how to help me, but she was always there, trying. It was around this time that she first started encouraging me to volunteer, to do something that would force my focus outwards to the world and my community. This continues to be one of the greatest lessons in wellbeing I have ever learned.
Keep trying.
I finally started seeing the psychologist who would help me to overcome my eating disorder when I was 18. I worked with him during my undergraduate university studies. Through the lens of Cognitive Behavioural Therapy—a triangular focus on how thoughts, behaviours, and emotions (or physical sensations) affect each other—this psychologist helped me unravel my eating disorder incrementally through a series of exercises that I’ve since integrated into my life:
Eating 3 meals and 3 snacks every day;
Engaging in physical exercise that I enjoy (have fun, release those endorphins!),
Trying again each day anew even if the previous day sucked (some days just suck); and,
Making a list of short simple activities that give me joy or comfort to draw from when feeling depressed, even if I don’t want to do anything (e.g., a hot shower, a short walk).
Gradually, over the next few years, I was able to shift my focus away from my body and food and towards my schoolwork and socializing. My life opened up and I started having the experiences, like going to parties and dating, that I had dreamed about while imprisoned in my eating disorder.
But I also transferred energy to new self-destructive behaviours, to taking drugs and exercising poor judgement in my dating life. Instead of distracting myself with the rules and routines of my eating disorder, I started distracting myself by taking risks and causing chaos for myself and others. Because the eating disorder was a symptom of a deeper discomfort.
*****
I saw a psychiatrist for the first time when I was 25.
I had returned to Canada a few months earlier, just before Christmas, after living and teaching kindergarten English in Thailand for over two years. I had taken the opportunity to explore as much as possible, wanting to see what life had to offer. But my openness often verged on the edge of recklessness, and by the time I arrived back in Canada, I was heartbroken and exhausted. I had “allowed” myself to be adventurous, but I was still running towards distractions, avoiding examining my discomfort.
After returning to Canada, I fell into a deep depression. I felt aimless and somehow both sick of, and sorry for, myself. I felt deep shame and an anxious desire to escape myself. I kept thinking about how, objectively, I had no reason or excuse to be this sad. I saw my depression as a deficiency in myself, a failure.
The discomfort was physical, emanating from the bottom of my throught, deep in my chest, and vibrating down my spine. My behaviour became increasingly erratic – sometimes I would spend entire days in bed in silence, while others I would jump from one activity to the next without making time to eat or sleep, pursuing “love” interests I don’t think I even liked, hungry for distraction. I started having panic attacks, my frenzied thoughts catching in my throat, forcing me to fall to the ground on all fours struggling to breath.
With the encouragement of the psychologist who had helped me to overcome my eating disorder (keep trying) and the ongoing support of my family (keep trying), I asked my family doctor to refer me to a psychiatrist. She was initially reluctant, but eventually referred me to see a resident psychiatrist in a community mental health clinic.
Despite my family doctor’s reluctance, the appointment took place within a couple weeks of the referral, on a bright, cold, late winter’s day. The clinic was in a multi-purpose room in the community centre where I had learned to skate and swim as a child. The large room had been divided into half a dozen examination rooms by fabric partitions. It was a good thing there was no one else there except me and the resident psychiatrist because privacy and patient confidentiality would not have been possible in this set up.
The resident psychiatrist checked me in and pointed me to the examination room where the appointment would take place. I sat in the dimly lit and sparsely decorated cubicle for at least ten minutes before he joined me and asked me to tell him why I was there.
I explained my story, my long history of depression and anxiety, of self-destructive behaviour and fixation. I explained how I felt out of control and as if there was nothing I could do to make my life better and more comfortable. He advised me that there was nothing more that could be done for me medication-wise (I had been on the same brand and dose of anti-depressant for 10 years…), that I seemed to lack a sense of self and should try taking up running. After which he dismissed me with no plans for follow-up. The entire appointment was no more than 20 minutes.
In retrospect, I think he was right that I needed to work on my relationship with myself and about the potential positive influence of physical exercise on mood. But I have since learned that he was wrong about the fact that nothing could be done medication-wise to help me. And above all, the delivery of his “advice” left a lot to be desired – it was devoid of compassion. I left the appointment feeling dismissed, foolish, and more helpless than before. Afterwards, for not the first or last time after a doctor’s appointment, I sat in my car sobbing for a while before driving home.
Keep trying.
Over a year later, after moving to Vancouver and starting to see a new therapist, I was able to access the psychiatric care I needed.
My new therapist’s approach focused more on self-compassion and mindfulness than on understanding my behaviour and thoughts. She introduced me to Dialectical Behaviour Therapy, which focuses on emotional regulation, distress tolerance, and interpersonal effectiveness around a core of mindfulness. Our work together helped me to empathize with my younger self and land in my body again after years of avoidance.
In addition to adding these new strategies, my new therapist also took my discomfort seriously. She referred me to see a publicly funded psychiatrist who also listened to me, diagnosed me with Generalized Anxiety Disorder, and took all the time that was needed to figure out what medication, if any, was right for me.
*****
Over the past 5 years, I’ve continued to struggle, including to convince family doctors to take my anxiety seriously. But I’ve also experienced excellent care from publicly funded psychiatrists (after a year wait, but I’d like to think that would have been shorter if my needs were more acute).
Last year, I stopped biting my nails after more than 25 years of being told it was a disgusting and childish habit. Along with innumerable instances of biting them to the point of pain, I just stopped. I can’t tell you why—it was unexpected and not gradual—but I think it’s a sign that my efforts to manage my anxiety are finally paying off. I’ve come to accept my anxiety rather than resist it. With the help of the occasional health care practitioner, I have been incrementally building the foundations of resilience and wellness.
In all of this, I am deeply grateful for the love and support of my parents, my family, my friends, and my community—they have truly been a lifeline. With this gratitude comes a deep empathy for those who suffer, but do not have the support, privilege, or access to resources that I have had (let alone those who have been systematically oppressed, discriminated against, and abused).
I could (and sometimes do) wallow in a sense of injustice, shame, and guilt about the way things are, but I know from experience that this isn’t helpful to me or others.
Keep trying.
Instead, I try to channel my empathy to learn about the experiences of others with compassion and a sense of solidarity in our shared suffering. As my mom recommended years ago, I continue to volunteer and find little ways to extend a helping hand to others as they have done, and continue to do, for me. Life is hard, but if we keep trying and work together, I have learned there are moments of relief, and even joy, to be found together.
I am Unsinkable because I keep trying with the help of my family, friends, and community.
