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Dr. Patel gently places his fingers on my still intensely bruised ankle. Behind him is a medical resident. The resident looks at the x-ray of my ankle with a skeptical look on his face, as if to say, I wonder how that’s going to heal.
“It doesn’t hurt,” I say for the second time during the visit, even though it isn’t true.
He and the resident exchange glances.
I want to heal. “It feels better.”
With a sigh, he turns to the computer monitor and starts typing. “Do you know what happens when you break a bone?” He clicks the keys. “The bone bleeds. Your bones contain blood vessels, and when the bone breaks, they clot and pool around the broken ends. That clotted blood has to become solid bone.”
The gravity of what he’s saying, the tone of just slow down, let yourself heal doesn’t register. “How close are we to being out of the boot?”
He continues typing, eyes on the monitor. “We’re only in phase two.”
I ask how many phases there are.
“Three, basically. You’ve been through the inflammatory phase, fracture hematoma formation. The blood clots have done their job. Your ankle is now in the repaired phase.”
I like that it’s called the repaired stage, not repairing or potentially repairing. It’s repaired. Healing is inevitable—a done deal—so unlike the way the many mental health clinicians I saw spoke of the psychiatric diagnoses they gave me over twenty-five years.
He points to the X-ray on the computer monitor. The resident looks over his shoulder.
I ask if I can get the short boot, the quaint one that looks more like a shoe than a Storm Trooper boot.
They turn to me, their expressions an almost audible no. “This is the deep healing phase. Fibrous tissue and cartilage have to form a soft callus at the ends of the broken bone. They’ll join, and the hard bone will replace the soft tissue. This is serious.”
“And then we’re done?” What they don’t understand is that I’m also trying to heal from mental illness. My new psychiatrist has said it’s possible—even for me, whom other doctors had condemned to lifelong suffering—and although I doubted him at first, I want it desperately. It’s taking too long too.
“We’ll see,” he says, standing. “Stay in that boot.”
*
To speed up my mental health recovery, I could—maybe—change what I eat. The branch of medicine called Nutritional Psychiatry exists for a reason. Diet is key to mental health—everyone knows that.
My diet is pretty clean. One of the beneficial byproducts of the years I spent obsessing over my weight and food as someone with anorexia is that I know way too much about nutrition. In one of my obsessive periods, I ate by color: only green foods, only orange foods, only purple. Eating by color—the ROY-G-BIV diet—wasn’t yet a thing, but within the decade would appear in Food & Wine and on the Food Network. I learned about it from Dr. Terry Wahls, who cured herself of multiple sclerosis by eating three massive plates of kale every day and making sure her diet consisted of three cups of green foods, three cups of cruciferous foods, and three cups of color foods before she ate anything else that day.
Plus, I’m privileged. I live in a city and have access to fresh foods. Dinner doesn’t come from a convenience store. I’m not a child or teenager fed lunches packed with chemicals in the school cafeteria and left to go hungry at night.
But my love of sugar is deep. At the age of seven or eight, I stole money from my mother, silver dollars she received from my grandfather, to buy candy. While the other kids played outside, I snuck away to the corner store and bought a Lik-a-Stix Fun Dip (beware of foods that drop vowels and consonants), a powdered candy you eat by licking a hard candy stick and dipping it in a magical concoction of primarily corn syrup, sugar, artificial flavors, and dyes. Never a good liar, I returned home with my lips and tongue blue from the artificial dyes and was caught in the act. When I was about six, I received one of those toy baking ovens for Christmas, the ones where you mix the powder and water, and (somehow) a bulb cooks a mini-cake. I’d go in the closet and eat the sugary powder, coughing, trying not to be heard. In kindergarten, I pocketed extra Flintstone vitamins for the sugar rush, trying to eat them surreptitiously on the reading rug.
When I had anorexia in my teens, a perfectly measured half cup of Breyers Mint Chocolate Chip ice cream was the only thing I ate all day. There’ve been periods of abstinence but not many.
I eat ice cream every night—and a lot of it. Of late, I’ve joined in the pretend-sugar-is-healthy fad. Agave syrup, which it turns out is worse than high fructose corn syrup. Invert sugar. Beet sugar. Brown rice syrup. Stevia. Erythritol. Monk fruit sweetener. Coconut sugar. I’ve eaten pints of absurdly expensive, not-tasty coconut milk ice cream, almond milk ice cream, soy milk ice cream—all with different sugars, all calling to me from the freezer aisle because, yes, of course, they must be healthy.
But all forms of sugar should have been an obvious no for someone experiencing anxiety, distractibility, impulsivity, mania, depression, and panic. I’ve been on enough sugar highs and glycemic lows to know that. A 2017 study showed a link between sugar intake and depression. A 2015 study demonstrated an association between soft drink consumption and depression. In a 2019 animal study, rats that binged on sugar and then fasted were anxious. (The poor little rats. I’ve spent many nights trying to figure out how researchers knew the rats were anxious.) Sugar has been shown to suppress a hormone that people with schizophrenia may be deficient in.
Years from now, I’ll speak with Dr. Chris Palmer, a Harvard psychiatrist and professor posted at the renowned McLean Hospital, Harvard’s teaching hospital. Dr. Palmer’s book Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health—and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More will be published. In our interview, he’ll explain his metabolic theory of mental illness. His theory, which goes against traditional psychiatry’s view of mental illness as solely a brain disorder, argues that mental illness is a metabolic disorder. Metabolism is how we get energy from food. A disorder occurs when we have abnormal chemical reactions from that food. Dr. Palmer has had success treating patients with the ketogenic diet, which (though this is a breezy definition) consists of eating a lot of fat, protein, and almost no carbohydrates. I don’t want to restrict my diet to that degree anymore. I’ll tell him that cutting out sugar and flour from my diet helped me heal. After a beat, he’ll say, “Sugar alone could have done it.”
The afternoon of my appointment with Dr. Patel, I go to the freezer and throw away the two gallons of ice cream that are in there. Memories flood back, all the times I’ve eaten one bowl, then two, feeling the rush, then my heart beating in my chest. Then the sick feeling in my stomach and the crash.
As I hobble away, the ice cream in the garbage, I wonder if it’s really necessary to cut out sugar. It’s so extreme, so Puritan. And it’s been mere seconds and I’m seriously considering pulling it out of the garbage and eating it.
A whiney, child’s voice says, Other people get to eat sugar. Yes, but other people aren’t trying to do what’s supposedly impossible: heal from mental illness.
» Continue to Chapter 23.
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