Lamictal side effect: Bulimia ????

Hi Stella

I'm sorry I don't have any experience of the medication you are asking about, but I do have a fairly longstanding history now of an eating disorder.

I was diagnosed with anorexia over 5 years ago and have been hospitalised twice because my weight was dangerously low. However, I've also experienced the opposite side of the coin - bulimia. In fact, that's mostly my current problem and for someone who is used to restricting food and keeping their weight low I do understand the distress that sudden, uncontrollable urges to eat can cause. It is extremely distressing and I believe you when you say it feels impossible to stop. I feel like that too.

I also purge by various means when I can and I know this is not easy and it is also very dangerous. It frustrates me that anorexia is taken so seriously and hospital admission is forced upon people and yet most NHS mental health professionals and doctors dismiss the dangers and problems that bulimia causes.

You may be right that your improved mood has improved your appetite but eating problems are normally a sign of trying to cope with other problems. Perhaps restricting food helped you cope when you were feeling low and that need has gone now you are feeling more stable. It is also part of the body's response to go into a kind of refeeding mode when food has been restricted so that could be happening too.

Purging is the real danger and I would suggest you tell your doctor that you are binging AND purging and that you are concerned this might be the start of bulimia. It is aleays better to catch these things sooner before they become entrenched.

In the meantime, try to have regular small meals through the day and keep a diary of your feelings and thoughts after you've eaten. Try distraction after a meal and being with other people can help too as it is impossible to purge that way. Getting help early is really key to this.

Let us know how you get on.

Karen

Karen- Thank you so much for your thought and time in replying. It was a huge comfort to read your words "I believe you" because I really feel like no one would. I just feel like no one could understand this. So while I'm sorry to know that you've gone through this hell, too, it's a comfort to know I'm not the only one.

I also take your words of caution seriously. Partly because I have watched myself become bulimic. And I hear myself making the same lies and excuses that are so typical of bulimics- "I can manage this." "I'll only purge once today." "I won't binge today.""What will it hurt to purge just this one time today?" Just like an alcoholic.

I don't know how I can tell my doctor I make myself vomit. I'm so ashamed and embarrassed. I'm a grown woman- I'm not a teenager- I have no peer pressure- no real reason. Like someone would wonder; Why should she be so vain that she'd want to do this to herself? I feel like if I say anything, it will just seem like I'm seeking attention. I feel like whenever I've mentioned the binging, she must think, "Yeah, no big deal, whatever." Granted I have had bigger issues for her to look at- like the depression. But there's a big part of me that believes people will judge me and think, "Well, just stop doing it if you don't like it." It's incredibly frustrating. When I binge, I feel so awful that purging is the only way I can feel somewhat, a little better and to shut up the urge calling me to get rid of the food I ate. When I binge and don't purge I obsess about it constantly and feel like a failure.

Thank you for the suggestions to avoid purging. Right now, I only vomit outside and when I know no one will be around. I'm not a very quiet purger and I look a mess afterwards- tears running down my face and flushed cheeks and blood shot eyes. I've taken laxatives and water pills to get my wieght down quickly. If I can't vomit, I do intense exercise, wear weights, and/or do hard labor of some sort. My partner has commented on how much exercise.

How did you tell your doctor? Or did your very low weight convey the message?

Hi Stella

I am so glad I was able to say something that could be a little comfort to you and to let you know that you are certainly not alone.

The thoughts and feelings you are experiencing right now are completely understandable. There are many people out there suffering with some form of eating disorder who never seek help due to feelings of shame, worries about not being believed and also due to fear. I too am not a teenager and any eating disorder is nothing to do with being vain, focusing on appearance or weight is just a way of dealing with great emotional distress and focusing on restricting food, or purging takes focus away from the underlying problems. I am now 40 and developed anorexia in my 30s, so I don't meet the 'stereotype' for people suffering from this illness either, but anorexia and bulimia can strike anyone at any age.

The fact that you recognise what is going on and that you are at risk of getting caught up in the addictive pattern of purging is a good sign because if you are able to seek some help, or find a way to help yourself then hopefully the pattern can be broken before it has had too much time to take hold. It is exactly right that this is like any other obsession or addiction, and it is so easy to think that this is the last time I will purge, or tomorrow I'll stop bingeing and 'be good' is one of my thoughts. Of course, to me, being good means being anorexic and starving myself again, so really I am still as entrenched in the illness as ever.

Please try to speak to your doctor and ask for help, especially if the problem seems to have been exacerbated by the change to your medication. Your doctor will not think you are vain or seeking attention. I also find that bingeing issues are not always taken seriously, especially if your weight is around normal, or slightly low for your weight. I get the same brush off from my doctor every time I used to go in and complain about being 'fat' because I'd been bingeing again. However, when this turns to bulimia and you are purging regularly then the issue becomes much more medically serious and I think, or would hope, your doctor will take this seriously. Anorexia and/or bulimia cause the most deaths out of all mental illnesses, so it is definitely something that cannot be ignored.

But there's a big part of me that believes people will judge me and think, "Well, just stop doing it if you don't like it." It's incredibly frustrating.

I get that too from people who don't know me and who don't understand what it is like to suffer from an eating disorder. If it really was that 'easy' to stop then it wouldn't be a mental illness. I always felt no one judged me when I was in the full throws of anorexia, believing I couldn't help that because I was ill, but now bulimia is a major problem some people do say things to me about it being my choice to buy food and eat it. It really isn't. Something within me drives me to do it and I have no control of it. So, yes, I do believe you and I also know how hard it is.

I too feel bad when I don't purge. I feel ashamed with myself because of how much I have eaten, panic about the weight I am gaining and feel downright bad. However, I am trying not to purge and am still trying to find something that helps prevent the bingeing instead. I have read most of the theory, but putting it into practice is a little different.

How did you tell your doctor? Or did your very low weight convey the message?

That's a very long story but basically a very good friend of mine was instrumental in persuading me to go to my doctor and seek help. I have a fear of mental health professionals and psychiatrists in particular, so I didn't want to go. My weight was low at the time, within the anorexic bracket, but I was just above the level at which they could force me into hospital. Unfortunately, on two occasions in a period of 2 years my weight did fall dramatically and my doctor did instigate my admission to an eating disorder unit. It wasn't pleasant.

Sorry this is so long but I wanted to reach out to you as I do understand very well what you are going through as this hell has taken over my life for several years now. I would say that support from people who care, self help if you are able and possibly professional help if you are willing to engage can all help you get through this. And always remember you are not alone.

I don't often recommend stuff from my own website I set up but I think it might help you to read about bulimia and also the section about self help. I wrote this based on my own experiences and also the research I had gathered together when trying to help myself.

I hope some of this has been helpful.

Karen

My two cents; some drugs just make you feel more or less hungry. Stimulants generally suppress appetites and some anti-psychotics make you gorge yourself.

It might not have anything to do with how you feel. Adderall makes you feel GREAT but you still don't eat.

Hi Karen- Thanks so much for your company on this topic. It's very much appreciated. I did have a good look at your site. It was helpful. And gave me some good ideas. I like the coping bank. And the affirmations go right along with DBT- and something I've had very good results with in the past. I think these skills just go out the window b/c I feel like such a failure, I don't even want to try.

Purging is really awful. I can't stand anything about it- the way I sound, the dread and discomfort, the ridiculous "pep talk" I need to give myself before hand, chugging warm tap water to make it easier. It's a comfort to "talk" about it here. But telling someone face to face... I know I need to, but it seems horrible. I admire you for taking that step. You're very strong.

I actually have an appt. with my psychiatrist this week. I really trust her and have been able to tell her difficult things in the past. If I were to tell anyone, it would be her. Because I'm coming off a period of restricting my eating, my binging has actually brought me up to a totally normal weight. I get weighed at every appt. B/c of this, it appears I'm doing just fine. So I'm fearful she won't believe me and think I'm just being dramatic.

It's interesting you started in your 30's. I'm 36. It's odd to me also that anorexia is taken so seriously but binge eating isn't. It all comes from the same place.

Seta- Yes, I definitely feel the Lamictal has added to this problem- if not outright caused it. It's a mood disorder drug- neither an anti-dep. nor an anti-psychotic. It's supposed to be one of the most weight neutral drugs on the market- meaning it has the least incidence of weight loss/gain over most other drugs. Huh.

Hi Stella

Thanks so much for your company on this topic. It's very much appreciated.

You're welcome and I am glad if it helps to write to someone who understands what you are going through. I too find it hard to do the self help when caught up in the distress of it all - the bingeing, feeling I have to purge, the guilt and shame and all of it. But, I know that's what I need to do to try to break the hold the bingeing has on me, even if I can't do it yet. When I am fully distracted or engaged in other things it is sometimes a bit easier to let the binge cravings pass. Of course, treating the underlying cause is the long term answer.

I understand what you are saying about purging. It is not a pretty sight and it makes a person feel awful. At the time I've binged I feel I have no choice than to purge, but oof course once purging I just feel awful and dirty. Afterwards though I feel clean and empty, which is why it is a hard behaviour to stop.

It's a comfort to "talk" about it here. But telling someone face to face... I know I need to, but it seems horrible. I admire you for taking that step. You're very strong.

Believe me, I am not strong and I hate admitting that I binge and purse. Admitting to anorexia was different as in a perverse kind of way I always felt proud of it. In any case, there is no pressure on you or rush to talk about it before you are ready. If it is safe to write here then keep doing that. The more you talk to other people or even write down what is happening and how you are feeling, eventually you'll be able to take the step of asking for some help for yourself.

Perhaps your psychiatrist would be a good person for you to work up to telling. Perhaps you could write it all down if you find it difficult to tell her. I know I find it easier to explain myself in writing. Just because your weight is 'normal' does not mean this is not a serious problem that needs help and I am sure she will see that. Bulimia is every bit as dangerous and destructive as anorexia, and many people with bulimia are a normal weight, which is why it is not so easier recognised as a problem. Let me know what you decide to do.

It's interesting you started in your 30's. I'm 36. It's odd to me also that anorexia is taken so seriously but binge eating isn't. It all comes from the same place.

Yes, very true. I think it is because anorexia causes more deaths than any other mental health problem when it becomes serious. A lot more people seem to be developing eating disorders in later life. It is not a teen problem at all.

Karen

Hi Stella,

You mentioned your BP Depression has faded. I know this is not what you want to hear but have you considered that you might be entering a manic phase? Impulse control is a factor in bulimia as well as mania. I think you should talk to your doctor about all of these changes and I wish you the best.

Also, I cannot find anything related to Lamictal and Eating Disorders other than a low incidence of anorexia (less than 1%).

PsyChris wrote:Hi Stella,

You mentioned your BP Depression has faded. I know this is not what you want to hear but have you considered that you might be entering a manic phase? Impulse control is a factor in bulimia as well as mania. I think you should talk to your doctor about all of these changes and I wish you the best.

Also, I cannot find anything related to Lamictal and Eating Disorders other than a low incidence of anorexia (less than 1%).

You're right- Lamictal is supposedly one of the most weight neutral drugs on the market. But I've NEVER been bulimic since Lamictal - in fact, I've thought up to recently that bulimia sounded like a terrible thing to do just to manage weight. Well now I FULLY understand it!

I think you might be onto something suggesting this could be a manic phase. It all feels based in a lack of impulse control. I can't NOT eat. And then I can't NOT purge. It's like this problem has ME, not that I have it. Thanks for this input.

Hi Karen,
I wanted to report that I came out to my DBT class last night about the binge/purge stuff. You're right- "talking" about it here seemed to make it more feasable to talk about it for real. I was a nervous wreck- I could hear myself talking a million miles a second- but it wasn't so hard b/c everyone in that group (it's a small group- about six of us) has some major and embarrassing problems. One woman talks openly about her phycsically abusive behavior, a few others have compuslive eating issues they talk about, another has chemical addiction. So this made it a bit "easier" to bring up. No one seemed to judge me poorly. That was a relief. But I still felt sh*tty afterward and like I wanted to crawl in a hole. But at least I did it.

The class faciliator said I, of course, need to tell my individual therapist ASAP. And she also suggested that one place I could start is to keep a daily account of every thing I eat. That's what I do when I'm in the throes of anorexic behavior - I mentally log every tiny morsel I eat in a 24 hour period in order to keep track of calories. So to me, that seems obsessive dysfunctional. So I'm not sure why that would help, but she said it's a good starting point toward beating the disorder. I think you also suggested this. Can you tell me how this would help?

When I am fully distracted or engaged in other things it is sometimes a bit easier to let the binge cravings pass.

This is a good point to make. I'm hardly working at all, these days. The recession has caused us to lose an amazing amount of work. Our "bread and butter" is carpentry work. I have a horse hoof trimming gig on the side that makes us grocery money, but I've even lost some important accounts in that. I'm working probably 80% less than this time last year. I can go 4 or 5 days with no work. All that time at home- not good for a budding eating disorder!

We do keep busy with house work- spend about 5 hours a day involved in intensive projects. We have an old farm and have been working on rebuilding the back house and getting the old basement cleared out and fixed up. These are the last two major jobs on this place and it will be finished. We've completely overhauled every last square inch of this farm over the past 6 years. So even that work is coming to an end.


The most effective tool in my tool box against purging is my partner. She doesn't have the slightest clue about the bulimia behavior. And I'm VERY careful to make sure she doesn't find out. She would be horrified. So there are times when I eat too much- and it dawns on me I can't purge b/c she's home. I'd have to wander way out on the farm to purge- and sometimes depending on what we're doing, it would seem odd and out of place for me to all the sudden just up and go for a walk in the fields or woods. I've done it- but if I made a habit of it, I know she'd notice and wonder what I'm up to. She's very perceptive and keen.

The other helpful thing is to not have the "bad" foods in the house. The junk foods. I can binge on vegetable soup and not have the need to purge b/c I know it's fat free, full of good fiber and very low calorie. It's when I binge on high carb, fatty, junk foods that I'm compelled to purge. Still the binge behavior in itself feels out of control- no matter what the food.

I have some positive news. Today I had a regular appt. scheduled with my psych doc. (I meet with her every few weeks just to touch base regarding my meds.) Coming out to my DBT group last night regarding my ED (very scary and hard but I did it) was the stepping stone I really needed to muster the courage to tell her about all of this mess. She's the one person I really trust to be fair and not judge me too harshly. Still, it was so hard to actually speak the words. I totally struggled and tripped over myself- I changed my mind a hundred times in the span of a few moments on whether or not to actaully say the words outloud- it was ridiculous. But I did finally admit it. She was kind about it, of course. I don't know how else I thought she'd respond.

Anyway, she wants me to talk about it withy my individual DBT therapist. She says obsessive compulsive stuff is complex and therapy is very important. She also gave me an Rx for 10 mg of Prozac, which I've started today. She says it can help settle the compulsive urges.

I feel a huge weight lifted, having reached out for help like this. I still have the compulsions but at least I don't have the panic feeling of dealing with it all by myself.

I'm interested to see how the Prozac helps. I'm still on the fence about talking with my DBT therapist. I don't trust her like I do my psych doc.

Hi Stella

I just wanted to say how very proud of you I am for the huge steps you've taken in the last couple of days. I know very well that it is not easy to admit to bingeing and purging, let alone to tell others. I think it was a huge and very positive step that you told your DBT class and your psychiatrist what has been happening. I also hope the fact that no one judged you and in fact they were supportive will enable you to feel able to continuing talking about the problems you are having and seeking help.

And she also suggested that one place I could start is to keep a daily account of every thing I eat. That's what I do when I'm in the throes of anorexic behavior - I mentally log every tiny morsel I eat in a 24 hour period in order to keep track of calories. So to me, that seems obsessive dysfunctional. So I'm not sure why that would help, but she said it's a good starting point toward beating the disorder. I think you also suggested this. Can you tell me how this would help?

I would suggest asking your DBT therapist when you see her, but personally I think it can work either way and it depends on how it is done. With anorexia and restriction I know myself it is definitely obsessive behaviour and counting calories becomes part of the way I get even more entrenched in the behaviour. However, when I'm in a bulimic phase, I think because I can't face it and I feel ashamed, I avoid keeping any kind of record of what I am eating or how much. It is a way of avoiding the issue.

Also, instead of just noting down what you are eating, I would suggest keeping a journal of how and what you are feeling and thinking at the time. Are you feeling low, depressed, bored, lonely, or high even? What are you thinking at the time? Looking back at the correlation between thoughts and feelings and bingeing can be a way to help break the pattern. I am sure your DBT therapist could help with this.

Another trick I have learned is whenever I feel like bingeing, I try to write down how I am feeling, or talk to someone, and say to myself that I will wait 5 minutes, or 10 minutes (if I can wait that long) and see if I still feel compelled to binge. It is hard to do because quite often I get the compulsion and then before I know it I am stuffing myself with food, but it is worth a go.

It sounds like you have a lot to keep you busy at home, but like you say, I do find having a lot of time alone, by myself, with nothing to do seems to make the bingeing compulsions worse. I am not able to work and being agoraphobic too it is often difficult for me to go out anywhere and I spend a lot of time indoors by myself.

The most effective tool in my tool box against purging is my partner. She doesn't have the slightest clue about the bulimia behavior. And I'm VERY careful to make sure she doesn't find out. She would be horrified.

It is good to have a reason to help you battle the bulimia, but I wonder whether she would actually be horrified. Does she know about the bingeing? A lot of people do find it hard to deal with the fact someone they care about is purging, because it is such a self destructive behaviour. However, letting her in and asking for her support could help. Only you can judge that.

I also try to make sure I don't have what I consider 'bad' foods around and when I had my own flat and lived alone I used to go to extreme levels to make sure I had no food whatsoever at home. I'd throw everything out at the end of the day and I even had a friend look after my money and cards so I couldn't go out and buy anything. My situation is different now and I can't do this, but I also realise that whilst it was helping me to feel safe, it wasn't solving the real problem. I will never get over my fear of food that way.

I'd be interested to know how you get on with the Prozac. I've considered trying that in the past but have been worried about possible affects on my appetite and weight gain, even though some studies show that at high doses it can help some people control the compulsion to binge.

I think you are doing very well and should be very proud of yourself.

Karen

briary wrote:Hi Stella
I just wanted to say how very proud of you I am for the huge steps you've taken in the last couple of days. I know very well that it is not easy to admit to bingeing and purging, let alone to tell others. I think it was a huge and very positive step that you told your DBT class and your psychiatrist what has been happening. I also hope the fact that no one judged you and in fact they were supportive will enable you to feel able to continuing talking about the problems you are having and seeking help.

Thank you, Karen. It's so helpful to hear this. I'm so glad I posted this thread- it's been a huge help for me.

I did tell my DBT therapist, too. It's getting easier to talk about it each time I try. I don't feel at all like anyone I've told has judged me. But I do confess a new scared feeling, in a different sort of way. The addition of Prozac was good for my morale- like a "quick fix" effect (even though I know it could take time to kick in therapeutically.) But other than that, I can't help but feel like I put myself out there with this and haven't gotten a whole lot of tangible feedback or support. I don't know what I was expecting, but I feel worried. I've told all of these people my dirty secret, and I'm still bingeing and purging. I guess I had this irrational hope that it would all go away once I came out and asked for help. But it's still there- I'm still bingeing and purging. I've already done so once today- which means I need to make it through the rest of the day - I've made this deal with myself that I can only do it once a day. My therapist suggested I consider an inpatient clinic- but that's really not an option right now. And I do feel like it's not that out of control, that I can get a hold of it, esp. since I'm taking some good steps in the right direction.

With anorexia and restriction I know myself it is definitely obsessive behaviour and counting calories becomes part of the way I get even more entrenched in the behaviour. However, when I'm in a bulimic phase, I think because I can't face it and I feel ashamed, I avoid keeping any kind of record of what I am eating or how much. It is a way of avoiding the issue.

This makes a lot of sense, in terms of why my DBT coach told me to keep a record of what I eat. I think you've described why I'm resisting doing it. I can't fathom how many calories I eat sometimes in one sitting- facing it would just highlight my failure- and how deep a hole I'd dug calorie-wise. I'd rather just get rid of it as soon as possible and know I have a clean slate.

Also, instead of just noting down what you are eating, I would suggest keeping a journal of how and what you are feeling and thinking at the time.

My therapist suggested this as my homework for the week. The problem is the urges hit me out of the clear blue, and quite suddenly, and I'm really not sure what I'm feeling. It's like I'm in "do" mode and "think" mode is shut off. But maybe if I force myself to consider it, something will come to mind.

Another trick I have learned is whenever I feel like bingeing, I try to ... wait 5 minutes, or 10 minutes (if I can wait that long) and see if I still feel compelled to binge. It is hard to do because quite often I get the compulsion and then before I know it I am stuffing myself with food, but it is worth a go.

This is actually how I get through my restricting phases. I'll feel a big hunger pang and tell myself to just wait it out. Sure enough, in 10 minutes or so it's gone and I'm not hungry at all. I'll try it with the binge urges. I feel doubtful it will work- they're just SO intense and strong. But like you said, it's worth a go.

I am not able to work and being agoraphobic too it is often difficult for me to go out anywhere and I spend a lot of time indoors by myself. I also try to make sure I don't have what I consider 'bad' foods around and when I had my own flat and lived alone I used to go to extreme levels to make sure I had no food whatsoever at home. I'd throw everything out at the end of the day and I even had a friend look after my money and cards so I couldn't go out and buy anything. My situation is different now and I can't do this, but I also realise that whilst it was helping me to feel safe, it wasn't solving the real problem. I will never get over my fear of food that way.

That sounds very hard. You do have amazing strength and insight to take care of yourself. You sound like you can be very kind, nurturing, and fair with yourself. I know we can be have extremely high expectations of ourselves. And knowing you need to deal with the real underlying stuff around food seems like an insightful, important step.

I'd be interested to know how you get on with the Prozac. I've considered trying that in the past but have been worried about possible affects on my appetite and weight gain, even though some studies show that at high doses it can help some people control the compulsion to binge.

I'll keep you updated on how it goes. You may want to reconsider. I actually think it's helping some, already, with the impulsivity. I've noticed a decrease in the intensity of my cravings, which gives me a tiny bit more control over it. My big binge yesterday was only of veggies, and so that was a good thing. But it could be from having asked for help and being able to talk about it- maybe that's alleviated some of the stress that feeds the urges. Prozac can be a fast acting drug - some people are even prescribed to just take it for a week at time just during rough spells. I haven't noticed any increased appetite. I do have nausea for an hour or two after taking it, but I count that as a plus. (B/c I don't want to eat when I feel sick!) The only thing that's worrying me regarding Prozac is I've had some of the old feelings of depression the past 24 hours. It might be completely unrelated, but I'm paying attention to it. I don't react well to anti-depressants- I've tried a few and they tend to make me much more depressed- even suicidal- for some reason.

For this morning, I'm camped out at the University library with my computer. My partner is gone for the day- and I know if I'm home alone it will be too much temptation. I have to work this afternoon, and then run an errand this evening.

So I'm hoping for a good day. Wishing you the same!

Hi Stella

Thank you, Karen. It's so helpful to hear this. I'm so glad I posted this thread- it's been a huge help for me.

I am glad you have found it helpful and also pleased it has given you the strength to speak to your psychiatrist and therapist, and also to mention it in your support group.

I can't help but feel like I put myself out there with this and haven't gotten a whole lot of tangible feedback or support. I don't know what I was expecting, but I feel worried. I've told all of these people my dirty secret, and I'm still bingeing and purging. I guess I had this irrational hope that it would all go away once I came out and asked for help. But it's still there- I'm still bingeing and purging.

It would be nice to have a quick fix wouldn't it? I also wish there was some 'magic fix' that would suddenly make the bingeing and purging stop, but unfortunately it doesn't work like that. These eating problems haven't started overnight and will take time, help and support to resolve. I realise the bingeing and purging is a fairly new part of the eating issues for you, but restricting isn't and it is all part of the same disorder. I have trouble coming to terms with the fact that anorexia and bulimia are different sides of the same coin. I want to make the bingeing stop, but a big part of me wants anorexia back and to hold onto it. I think this is probably why I find it so hard to make any progress. I haven't felt able to let go of my eating disorder altogether.

It is ultimately your decision about inpatient treatment. I'm in the UK so I think the system is different. Here admission only really happens for severe anorexia and when a person's weight has reached dangerous levels. I personally am not a fan of inpatient treatment but that's probably partly because I've been forced to go into hospital twice against my will when my weight was low and I didn't want help then. I certainly didn't want to gain weight. I have a mistrust of the mental health system here due to numerous things that have happened, but sometimes I do wish I could go somewhere 'safe' where I wouldn't be able to binge any longer. The problem is any inpatient treatment, I find, just treats the emergency and does nothing to help in the long term.

This makes a lot of sense, in terms of why my DBT coach told me to keep a record of what I eat. I think you've described why I'm resisting doing it. I can't fathom how many calories I eat sometimes in one sitting- facing it would just highlight my failure- and how deep a hole I'd dug calorie-wise. I'd rather just get rid of it as soon as possible and know I have a clean slate.

Yes, I would say that is a distinct possibility. The mind doesn't really want to 'know' what it can't deal with. I feel proud when restricting so I obsessively note how little I am eating, but I can't cope with knowing how bad things are the other way.

Regarding keeping a note of your feelings, I can see it is difficult if you are not able to identify what you are feeling before a binge starts. So, how about keeping a diary through the day of what is happening and any emotions you do notice, and then write down how you feel afterwards - by that I mean what bingeing has done for you - was it for comfort, because you were not occupied, were you upset. Maybe a pattern will emerge that will help you avoid the situations that trigger a binge.

You do have amazing strength and insight to take care of yourself. You sound like you can be very kind, nurturing, and fair with yourself.

Actually I don't and do many self destructive things. I know the all the theories of what can possibly help with this and what might make changes but putting them into practice myself is difficult.

Thanks for keeping me updated about the Prozac. I have always been too scared to try it, but if it helps you maybe I'll have to give it some more thought.

I hope you are having a good day and things are better for you today.

Karen