CHECK YOUR HEAD Podcast "Reboot" of Lindsey Stirling & Dr. Christina Wierenga speaking on Anorexia Nervosa recovery for Eating Disorders Awareness Week, 2025.
Mari Fong interviews Lindsey Stirling, singer-songwriter, violinist, and dancer, and Dr. Christina Wierenga, Professor of Psychiatry and Clinical Neuropsychologist at UC San Diego’s Eating Disorders Center for Treatment and Research.
Lindsey Stirling shares her story of anorexia nervosa and the depression and anxiety that came along with it. Lindsey’s anorexia started in college and she takes us on her journey to recovery and maintenance of her condition. Currently on her 2021 Christmas Program tour, Lindsey recently dropped "Lose You Now" featuring Mako. Next, mental health and eating disorders expert Dr. Wierenga shares new research on anorexia nervosa and the treatment steps that often takes a team of specialists to treat this serious condition.
“Be brave, ask for help, and be persistent in finding the mental help that you need.” For free and affordable solutions for mental health and addiction recovery, visit: http://checkyourheadpodcast.com/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_02 (00:00):
Welcome to the Check Your Head podcast, the podcast
where notable musicians andexperts share their stories and
solutions for mental health andwellness.
I'm your host, Mari Fong, amusic journalist and life coach
for musicians, and today we'recelebrating the holidays with an
entertainer who's built hercareer on being a
(00:22):
singer-songwriter, violinist,and dancer with music that
crosses from pop to rock to EDM.
Her albums Shatter Me and BraveEnough both won Billboard Music
Awards for Top Dance ElectronicAlbum, and she's collaborated
with musicians such as Amy Leeof Evanescence, Rivers Cuomo of
Weezer, John Legend, andChristina Perri.
(00:45):
Our featured musical guest todayis Lindsay Sterling, who's
currently on her Christmasprogram tour, singing holiday
tunes from her album Warmer inthe Winter and dancing with her
signature violin.
Lindsay shares her story ofanorexia nervosa, an eating
disorder, along with thedepression and anxiety that came
with it.
(01:05):
Lindsay shares her solutions forrecovery and the daily
maintenance that keeps both hermental and physical health in
top shape.
Next, we have expert Dr.
Christina Waringa, a professorof psychiatry and co-director of
the research program at UC SanDiego's Eating Disorders Center
for Treatment and Research.
Dr.
(01:26):
Waringa will share facts onanorexia along with the tried
and true treatments proven to bemost successful in combating
this condition.
But first, let's hear LindsaySterling share her story.
I went to your Artemis tour.
It's almost Broadway-likebecause you've got music, dance,
(01:46):
costumes, and so many differentthemes to your music.
And what I loved also is thatyou have this message of
empowerment, being yourauthentic self, and also going
for your dreams.
SPEAKER_01 (02:00):
Well, thank you.
My biggest hope is that they'llbe like, wow, that was really
fun.
And oh, gosh, I want to go outthere and do good things and I
can do it.
SPEAKER_02 (02:08):
Yeah.
And you know, you're doing thatwith mental health.
You have a song called ShatterMe.
It talks about overcoming youreating disorder and touches on
depression.
What condition or what situationcame first?
What did you notice first?
SPEAKER_01 (02:23):
I noticed the depression first.
That's what made me realizesomething was deeply wrong.
It came from me opening up to mymom and expressing to her.
I was away in college.
I feel like that's a very commontime for people to start to sink
into mental illness and mentalhealth struggles is because
you're away from home, you'reexperiencing a lot of
(02:45):
uncertainty, and you're tryingto decide who you are.
But also those people aroundyou, like your parents or your
siblings or your best friendsthat have known you your whole
life, they aren't there to beable to notice from the outside
that something's off.
Those people that can monitoryou because they love you,
they're not there anymore.
You're surrounded by newroommates and new friends, and
(03:06):
they think This is Lindsay.
But even through the phone, mymom was realizing that something
was deeply wrong.
There was a very specific momentwhere I realized something was
really off.
And it was the depression that Irecognized first, even though it
was the anorexia that camefirst.
The anorexia caused the symptomof depression.
But depression let me realizelike, oh, I need to peel back
(03:28):
the layers and figure out wherethis came from.
SPEAKER_02 (03:30):
Well, what was that specific moment?
SPEAKER_01 (03:34):
My sister was my roommate.
And...
We were best friends growing upand were inseparable.
And then she's my roommate incollege.
And by this time, I had becomepretty unhealthy and not myself.
I remember she was in the otherroom with our other roommates.
There were six of us that livedin this tiny apartment.
(03:54):
And they were all laughing atsome story that one of the girls
had told and just hystericallylaughing.
And I didn't even have theenergy to get up from my bed to
run in and be like, what's goingon?
Normally that's what I would do,normal Lindsay.
But I just didn't feel like Icould, didn't feel like I would
be invited.
I just didn't have the emotionalenergy to go and try to include
(04:15):
myself.
And then my sister Brooke comesinto our shared room and she
plops on the bed and immediatelystarted doing her homework.
And I remember wishing so badlythat she would tell me what they
were laughing at.
So I looked at her.
I thought, I don't even know heranymore.
Actually, I don't remember thelast time we laughed like that.
And I just became acutely awarefor that moment that something
(04:37):
was wrong.
Something was off.
If I couldn't connect with theperson that I connected with
better than anybody in thisworld.
And if I didn't feel the courageto say, hey, what was so funny?
I just didn't feel like I hadthat with her anymore.
And so that was the moment thatgave me not only the
realization, but also themotivation of like something is
deeply wrong inside of me.
And I need to figure it outbecause it's not worth
(04:59):
sacrificing that.
And so relationships, really, itwas the relationship with my
sister that made me willing tofight to figure out first what
was wrong and then willing tofight through whatever it was to
get it back.
SPEAKER_02 (05:12):
Well, you mentioned just in that short answer,
symptoms of depression, notwanting to get out of bed, not
having the energy and not reallyfeeling connected with even the
closest people around you.
I mean, I've gone throughdepression.
I know exactly what it's like.
It's so hard because these arepeople that you love, but you
can't feel that connectionanymore.
(05:34):
And then also, when you're verydepressed, things that are
normally funny are just not thatfunny.
And that is also really hardbecause good emotions are gone.
You're only left with these bademotions that kind of haunt you
throughout the day and night.
SPEAKER_01 (05:53):
Mm-hmm.
SPEAKER_02 (05:53):
But you said you first started experiencing your
eating disorder.
Would you consider it anorexia?
Would you consider it bulimia?
It
SPEAKER_01 (06:02):
was anorexia for sure.
I just stopped eating basically.
SPEAKER_02 (06:05):
Okay.
And then what was going on inyour life during that time?
And what was your whole mindsetabout stopping eating?
You know,
SPEAKER_01 (06:15):
I think I've been prone to it my whole life.
I have memories from being atiny child.
I think I was like six or sevenyears old and I was putting on a
snowsuit.
So I remember we were allgetting ready and my mom was
making sure everybody fit into acertain snowsuit and I put mine
on and I remember looking in themirror and just feeling like I
(06:35):
looked so fat in the snowsuit.
And I remember taking a belt andputting it around my waist to
give myself a waistline andspecifically bringing it to the
snow so that I could put it on.
I told my mom it helped me keepon the snowsuit, but it was
really because I just had to seethat I had a waist.
So that was at like seven yearsold.
So I think I've always had foodissues.
(06:58):
It finally manifested itselfwhen I was in college.
Like that's when it became aproblem and I sunk into it and I
allowed it to kind of take overmy life and control me.
And it came from the place ofeveryone saying the freshman 15
was a thing and I was determinednot to get the freshman 15 extra
pounds and also feelinginsecure.
And that's when I feel my eatingdisorder start to creep back in.
(07:20):
Even nowadays, like even thoughI'm past it, it's still like,
hey, tries to come back inwhenever I am overly stressed or
I'm feeling very unsure aboutwhatever it is I'm going
through.
And college was the first timethat I felt that that strongly.
SPEAKER_02 (07:35):
College is a time where it's very stressful in so
many different ways, right?
There's so many unknowns.
But you talked about insecurity.
You talked about stress.
And you also talked about howrecovery is kind of a day-to-day
thing.
SPEAKER_01 (07:49):
Absolutely.
I like to look at it like I wentthrough my recovery from A to B,
from that moment when my sisterwas on the bed next to me to
when I felt like I finally couldeat something bad for you and
feel good about myself.
That was a huge moment for mewhen I was like, oh my gosh, I
(08:10):
feel like I'd made it over thishuge mountain for the first
time.
Then there's those littlerelapse moments that happen I
never had an enormous relapsewhere I fully got sucked back
into it, thankfully.
I didn't allow that to happenbecause it was so clear to me
how that stole so much of mylife, feeding into this eating
(08:30):
disorder and allowing it tocontrol me and allowing it to
steal relationships and passion.
Everything became sacrifice tothat eating disorder.
Nothing else mattered besidescalorie numbers.
numbers that showed up on thescale when I stepped on it.
My whole life was consumed bythese thoughts of trying to
maintain this eating disorderand appease it.
(08:51):
It was such a strong, horriblememory of a person that I really
hated.
I hated myself when I was stuckin it.
It was enough for me to alwaysremember nothing is worth going
back to that.
Although sometimes it starts tocreep in, I feel like I've
learned to manage it prettywell.
(09:11):
I still have food issues.
And sadly, it's part of myrelationships still.
It's something that I have to beopenly communicative with people
I'm dating about.
The fact that I struggle withthis, sometimes I'm going to
have a little moment where myeating disorder comes back in
and makes me feel horrible aboutmyself.
And luckily, I've had reallygreat relationships that allow
(09:33):
me to have a safe space to talkabout that and say, I'm sorry,
this isn't about you right now.
This is because I am having amoment with my eating disorders
trying to come back.
And it's all mental.
It's not physical anymore.
It's not like I starve myselfanymore.
I don't go back to the physicalmanifestations of it so much.
It's the mental mindset ofself-loathing and self-hatred
(09:54):
over not exercising or eatingsomething bad or having a bad
weekend with food, likewhatever.
It's more the mental state whereI have to maintain to keep
pulling myself out of it overand over again.
Okay.
You're talking about yourmindset.
SPEAKER_02 (10:10):
Yeah.
So when you looked in themirror, you looked at your body.
I mean, were you focusing on thethings that you didn't like
about it?
I mean, how unrealistic was yourvision of what you saw in the
mirror was?
I
SPEAKER_01 (10:24):
mean, I know to this day, I still have a very
unrealistic expectation of whatmy body should look like.
And that's really sad because Iwork hard on staying fit.
In order to do the performancesI do, I have to be in a pretty
high caliber of fitness and Itake care of my body.
And yet I just have this veryunrealistic expectation of what
my body should look like.
And I just have to remind myselfthat that's really not possible.
(10:46):
And in order to get that bodythat I think I want, it takes a
sacrifice that I am not willingto give.
And that's where the mentalhealth comes into play.
It's like, if I was to look likethat, what I think I should look
like, My sanity has to go outthe door because I have to
sacrifice everything in order tobe that.
And weighing the pros and consis so obvious that like, no, my
(11:11):
expectation is just plainunrealistic for my body.
And so I need to accept that.
And it's something Icontinuously accept about myself
back in the day.
I didn't understand that.
And so I'd look in the mirrorand it would mean that I hated
myself because my hips were toowide or my stomach wasn't as
flat as I wished it was.
And so I was willing to give upwhatever it took in my own mind.
(11:33):
Because to be anorexic, it's afull-time job.
You literally don't think aboutanything else.
I remember going on dates andnot being able to focus on the
conversation because I'd bepanicking inside because he took
me to a pizza restaurant.
The thought of focusing on himwas out the door.
All I could do was barely keepup a conversation because in my
mind, I'm trying to make a plan.
(11:53):
I'm trying to make the plan ofhow I can eat just enough that
he can not think that I amanorexic and also the plan of
where I could go home and Icould run.
You're constantly making plansthat will hide slash keep you
from eating too much slashmaking up for whatever it is you
ate so that you can equal it outin your mind.
Like if I ate a piece of pizza,if I ran tonight and ran
(12:16):
tomorrow morning and didn't eatlunch, that will make up for it.
So anyways, it's just a constantmental blur so that you don't
have anything left to have afriend, to have a passion.
There's no room for it.
When I look at my body and ifI'm not happy with it, I stop
myself and I'm like, well, whatwould it take to get the body
(12:36):
that you think you want?
So even when I was doing all ofthose things and I was 20 pounds
lighter than I am now, I stillwasn't happy.
So I was like, okay, this is100% a problem in my mind.
And I remember learning that ananorexic mind, I can't argue
with logic.
Logic will always win because ifyou can talk facts to your mind,
(12:59):
if you keep doing that, it willwin over this ambiguous, like,
well, you're not enough.
Well, here's the fact.
So learning more about itincreasing my knowledge of
nutrition helped me to talksense to my brain and then
weighing the pros and cons.
It was quite a process to get tothis point where now I can talk
myself through it when I'mhaving those moments of like,
(13:20):
ah, but I may sound like I'msuper deep in it, but I actually
live a very happy, what I feelis very healthy and normal life.
I just have to have these littlesit down talks with myself
occasionally.
SPEAKER_02 (13:32):
Well, you know, I think that's an important point
to bring out because When peoplesometimes think of mood
disorders or eating disorders,conditions like that, it's not
like we live it day to day.
It's something that's there.
And then there's a maintenancethat happens.
And you're talking right nowabout maintenance and educating
(13:54):
yourself to know the tools tokeep it in check, recognizing it
and saying, you know what, thisis what I have.
And a lot of people, it takestime to even embrace to say, I
have depression or I haveanorexia.
Was that a tough journey foryou?
SPEAKER_01 (14:10):
You know, I was in denial about it for a really
long time.
I think my mom had mentioned itseveral times.
Like, I think you have aproblem.
Not everyone thinks like this.
And I remember just breakingdown one moment when I finally
realized it just all kind ofsunk in finally.
And it will sink in until youare ready to accept it because
(14:30):
all the signs were there.
Everything was there.
And finally there was a momentand I'm so grateful for my mom
because it was on the phone withmy mom.
And I finally voiced the words,I think I'm anorexic.
And gosh, I get teary-eyed justthinking about it.
But it was almost like a weightwas lifted off my shoulders
because her response was, youknow what?
That's okay.
(14:51):
And we can work with that.
We can figure this out.
We all learn to solve problemsour entire lives.
Learning to play the violin waslike problem-solving.
Oh my gosh, my pinky can't hitthat note.
Oh my gosh, this isuncomfortable for my hand.
You're learning every step ofthe way how to form your muscles
to be able to fit thisuncomfortable instrument that
(15:11):
doesn't make sense until itdoes.
And so being able to name it andput a label on it, it was like,
okay, now I know what I'mworking towards.
Now I know what I can do to tryto fix this and find the Lindsay
again that has been completelylost.
So for me, it was a huge relief.
It's such a constant journeywith mental health.
(15:31):
I've figured out new thingsabout myself even within the
last year.
Wow, suddenly I had pretty badanxiety and I didn't realize I
did.
A lot of people experienced thatin the pandemic and it was like,
oh my gosh, okay, since I nowrealize that I'm struggling with
this right now, now I can likeaddress it and I can say, hey, I
see you anxiety or I see youeating disorder and I'm going to
(15:53):
learn to understand you so thatI can now cope with it and live
the full life that I know I canlive.
SPEAKER_02 (16:00):
Yeah, it's a long journey and it's a lot of trial
and error to find out what worksfor you and your body
physically, your body mentally,all of these things.
But you said that you realizedyour anorexia when you worked in
a treatment center for troubledgirls.
Is that when you recognized thesymptoms?
SPEAKER_01 (16:21):
That's not what made me so much realize it.
It just was very ironic that Iwas going to school to be a
recreational therapist, And Iwanted to specialize with girls
with eating disorders.
So I don't know if my internalmindset was telling me, you need
to study this.
But then I started working atthis treatment center at the
same time, working with a lot ofgirls that have eating
(16:43):
disorders.
And so it did help me realize itby seeing these outward signs
from all these girls I wasworking with who were very
severely sick in this way.
So I think if I hadn't beenworking in that environment, I
don't think I would have to therealization myself.
So it definitely was like justmany little clues along the way,
(17:05):
you know, but it was through myclose relationships with my
family that finally had thereal, you know, I get it.
Okay, I see it now.
SPEAKER_02 (17:15):
It's so good to have a support system, whether it's
family or friends or even likean online support system.
Sometimes support can come fromstrangers or people you may not
know very well.
SPEAKER_01 (17:27):
To that point, I went to group therapy and I went
to therapy as well with anindividual therapist, but I
found group therapy to be by farthe most helpful.
And I went to the BYU counselingoffice and she said, there's a
support group of girls that havehad eating disorders and then
have had them and they pair youup and it's a, oh my gosh, that
(17:49):
was game changing to go to.
And it took so much courage.
I skipped the first week becauseI was too scared.
to go and say this aloud infront of people.
But the second week, I remembertelling my roommates I was going
to a study group and it was asuper secret meeting of girls.
So we all felt very safe there.
And I remember listening to themvoice their concerns and the way
(18:10):
they felt about simplest thingslike going on a date or going to
a party.
I was like, oh my gosh, otherpeople feel this way.
And it was really interesting togo from, like when I first
realized I was anorexic, it wasthis mindset of like, wait, not
everybody thinks like this.
Not everybody thinks about foodall the time.
Not everybody's like constantlyworried about, oh my gosh.
(18:33):
So first it went from noteveryone feels like this.
And then I felt so alone.
Wow, I'm alone in this.
And then going to group therapymade me realize there are other
people that feel like this.
This isn't a healthy or normalquote unquote mindset, but I'm
not alone.
Like this is a thing.
And so we can work through thistogether.
SPEAKER_02 (18:55):
sometimes our conditions can make you think a
certain way, negative thoughts,thoughts of worthlessness,
self-doubt.
Can you tell me some of thethings that you thought of while
you were in depression or whileyou were in your eating
disorder?
SPEAKER_01 (19:13):
Yes.
When I was severely depressedand severely anorexic, I mean,
it was to the point where Iwould look myself in the mirror
and just...
myself so much even voice thewords I hate you to myself
because I was so sad and Iwasn't always like that so the
person I'd become I hated thatperson who took away who I was
(19:36):
really like I didn't know whereto find the real Lindsay and so
I just felt so like so worthlessjust going back to that place
alone is what always motivatesme of like it's not even worth
going there
SPEAKER_02 (19:48):
the other thing that is difficult is you're talking
about being somebody that youfeel like you're not, which is
another thing that happens whenyou're in a mood disorder.
You don't even recognize who youare sometimes with your
thoughts, with your behaviors,and it's scary.
Was it ever a time where youactually thought about ending
(20:10):
your life or having suicidal
SPEAKER_01 (20:12):
thoughts?
I never struggled with suicidalthoughts.
It was purely worthlessness andhating myself, but I never got
to that point ever.
somehow.
SPEAKER_02 (20:23):
Okay, that's good.
But it's important to notebecause those can be thoughts
that go through your head duringthose times.
What encouraged you to reallystart talking about all of this
to your fan base and basicallyin general?
SPEAKER_01 (20:37):
It came pretty natural for me to talk about it
once I felt like I was in areally good place with it.
It didn't feel good to talkabout it when I was in the midst
of it.
But talking about mental healthto me was so important because
this is something I once felt soalone in and also something I
was so unaware of.
If I had understood at a youngerage that eating disorders or
(21:01):
that just unhealthy body imagewas a thing and body dysmorphia
and all of that.
I didn't even know about itreally.
I just knew they were words.
I think everyone goes throughsome kind of a struggle where
they realize, oh my goodness,I'm feeling really anxious or
I'm depressed right now.
It could be situational.
It could be seasonal.
It could be whatever.
I just feel like, wow, this isso normal and it should be
(21:24):
normalized.
And so that's what kind of gaveme the courage to talk about it.
I wrote the song Shatter Me andit almost felt like an easier
way to write about it was topersonify it.
And so I put it in theperspective of a ballerina stuck
in a snow globe because that wasan image that encapsulated how I
felt like I was trying so hardto be this image of perfection,
(21:45):
you know, this perfect ballerinaspinning and what kept her
perfect was snow globe.
That image first came to mebecause I remember being in a
little shop one time when I wasreally sick.
And when I was very anorexic andseeing the snow globe and
thinking I was that ballerina,she's stuck inside there.
Everyone thinks that that littleporcelain globe is just her
(22:08):
perfect little world, but it'sactually a cage.
It's not protecting her.
It's caging her.
That was what inspired the wholeshatter me ballerina story.
And it was the first time I'dreally expressed my anorexia.
It felt easier for the firsttime to do it through a
character.
Well, I think that
SPEAKER_02 (22:26):
describes it Perfectly, especially with
depression as well.
Sometimes you feel like you'retrapped inside something that
you can't get out of or peopledon't actually see what's going
on inside of you.
And sometimes you have thoughtsthat you can't even get out with
words because of a depression ormood disorder.
(22:48):
Now we're going to get to a timewhere things turned around for
you with the depression and theeating disorder.
What was that for you?
SPEAKER_01 (22:59):
You
SPEAKER_02 (22:59):
know, I can't
SPEAKER_01 (22:59):
even pinpoint a specific moment per se.
I just feel like there werelittle victories along the way
where I was like, you know, I'mgetting signs that I'm getting
better.
I remember my parents taking meout to Cheesecake Factory when I
wasn't doing well.
They didn't know yet that I wasanorexic.
And I remember we were so quieton the way home.
(23:21):
And it's because they could feelthat something was off about me.
And it's because I was inthis...
spiral in my head of hatingmyself based on what I'd just
eaten and punishing myself in mymind already.
And I could just tell somethingwas wrong and where they're
like, are you okay?
And I was like, yeah, fine,fine.
But I remember two years lateron my birthday, I told my
(23:41):
parents, I want to go toCheesecake Factory.
And I remember being so happythat I enjoyed what I ate and I
ate what I wanted.
And I didn't judge myself forthings.
And I remember just being soproud of myself in that moment.
because I chose that I was goingto eat that, and it's okay
because I eat healthy most ofthe time, and I sure as heck
deserve to reward myselfsometimes.
(24:01):
Occasionally indulging yourselfto eat what you actually want
and saying, I deserve this,that's a healthy mind versus
always telling yourself youcannot have those things.
Little victories like that justremind me that I'm still on the
right track, and we all deserveto indulge and feel okay when we
(24:22):
do that.
That's part of life.
That's what makes life beautifuland worth living are those
moments where we say, I'm goingto enjoy.
SPEAKER_02 (24:28):
Well, also celebrating wins, whether
they're big wins or small wins.
And I think life is full ofsmall wins, especially on a
journey that has to do with alot of trial and error.
But when you have something likeanorexia, at that point, there
could be some kinds of therapyor things that you had to learn
(24:49):
in order to eat in a healthyway.
What kind of therapies ortechniques did you learn to
start controlling that?
SPEAKER_01 (24:56):
I really did turn it into like a part or full-time
job.
Like I was going to college atthe time.
I was going to group therapytwice a week.
I was going to a therapist oncea week.
And then I also started to meetwith a nutritionist and I hated
going to nutritionists.
It was the worst.
They would just tell you thatyou need to eat more.
You need to eat more of thisfood, which included the
(25:17):
terrible word of fats.
And all these things that in mymind were like curse words to my
body.
I remember the moment when I hit100 pounds.
I remember crying because I wasso sad and realizing that fat
was being added to my body.
So as I sat there crying, as Ilooked at the scale, I also gave
(25:38):
myself a pat on the back becauseI was healing.
You know, anorexia is such aninteresting thing because one,
you're dealing with anaddiction.
It's a mindset addiction whereyou are addicted to this lack of
calories and you're addicted tothe habits.
It's very habitual and theresults are addicting of seeing
(26:01):
the scale go down.
And so when you start to seethis process reverse, it's weird
because it's measurable.
You have to face it every day,multiple times a day, and talk
yourself through it.
I remember sitting and eatingfood, and I would eat it and
hate it.
It was like a physical and amental process.
Because the eating disorder hastaken over your mind and your
(26:24):
body, it felt like it was me.
Looking in the mirror, I wouldsay, I hate you, because it felt
like it was me.
And it was really helpful tolearn to separate myself from
the eating disorder.
I read this great book calledLife Without Ed.
This girl decided to talk to hereating disorder and treat it
like a dysfunctional, abusiverelationship.
(26:46):
Because the eating disorder willreward you when it feels like
you've done good and it makesyou feel good about yourself in
that moment.
But then it makes you turn toself-hatred the moment you've
messed up.
And so it really is an abusiverelationship where you feel
comforted by it.
and betrayed by it.
And so I would talk to my eatingdisorder and I would talk
through the facts and be like, Ineed to eat this meal.
(27:08):
This is good for me.
Fats can be good for you.
And I would talk through thethings I'd learned, the facts.
And when I passed 100 pounds onthe scale, I told myself, this
is good for you.
You're not even in your idealbody weight yet.
This is healthy.
This is what's going to helpyou.
I would talk to my eatingdisorder.
I didn't deserve to talk to thatway when it would tell me that
(27:28):
you're fat.
You should eat that.
I would talk to it and say, Idon't deserve that.
I deserve better and I don'tneed you anymore.
You were here for a time andmaybe you comforted me when I
thought I needed it, but I don'twant you anymore.
That process of learning toseparate myself made me start to
recognize when the real me wascoming back and this parasite
(27:48):
that had taken over me wasstarting to slip away.
SPEAKER_02 (27:50):
It's almost like a fish swimming upstream because
this eating disorder, thisanorexia, it can be very
charismatic in the way it talkswith you.
I'm curious though, if let's sayin your mind, you were able to
achieve this perfect body, whatwould that mean to you?
(28:13):
What would that bring to yourlife?
SPEAKER_01 (28:16):
You know, I don't think it would have brought
anything.
It was a mental disease whereyou're chasing after something
that one is never going to besatisfied.
I was so skinny and yet it wasnever enough.
But it's just kind of funny howthe chain reaction happens.
We all want to be loved becausewe just want to be happy.
Okay, well, being loved makesyou happy.
(28:39):
So how do I get love?
Oh, I need to just be whateverybody needs me to be.
And if I'm beautiful and if I'mthin, the guys will like me.
I better eat less.
And then all of a sudden, you'regiving up everything in order to
be thin.
But it's like in the search forbeing happy and being accepted
and loving myself, I gave up allthe things that actually would
(29:01):
have made that happen.
It's just like you were oncourse to get something and then
you just kind of got off coursechasing something completely,
completely different becausehaving a skinnier body wouldn't
have added anything to my life.
And at the end of the day, it'slike it never would have been
enough.
If it wasn't enough where I wasat, it never would have been
enough.
And that's the logic coming intoplay.
(29:23):
You know, and even now I'mdating a great guy.
And when I have like a momentwhen I turn to him and I'm just
like, I'm sorry, I'm beingreally quiet and awkward right
now.
It's because I'm having a momentwhere my eating disorder is
trying to come back and it'stelling me I'm worthless.
I think you're beautiful justthe way you are.
Like if me being thinner, whatis it for if it's not for the
person who loves me?
Like he doesn't need that.
(29:44):
And so what does this add to mylife?
Absolutely nothing.
You know, and it's that logicthat kind of helps.
UNKNOWN (29:50):
Yeah.
SPEAKER_01 (29:50):
You get back on track again.
Like it's never going to makepeople love you more to have a
skinnier body ever.
SPEAKER_02 (29:55):
Absolutely true.
And I think it's great thatyou've also included your
family, your friends, the guythat you're dating about what's
going on with you inside,because it's so important to
understand that to also havethem understand why you're
behaving a certain way.
Sometimes with depression oranxiety or any kind of mood
(30:17):
disorder, we can seekprofessional help.
And you did with a supportgroup.
Have you ever gone to apsychiatrist or had any kind of
medication that assisted you inany of those situations?
SPEAKER_01 (30:31):
Yes.
And, you know, actually it waslast year about this time.
I was struggling so badly withanxiety.
And, you know, it was an arena Iwasn't familiar with.
Finally, it was because of mysister.
She was like, you should justtry talking to a psychiatrist
about anxiety.
I think you have really severeanxiety and it's just getting
out of control now.
So I finally went and I gotmedication and it was some trial
(30:57):
and error to figure out theright dosage.
But oh my gosh, it was amazingwhen I kind of got through the
clouds of it all to be like, ohmy gosh.
I feel like myself.
I think a lot of times we don'twant to take medication because
you're afraid it's going to makeyou not feel like yourself or
it's going to numb you or makeit worse.
And it did for a second while Iwas in that process of trying to
figure out the right one and theright dose.
(31:17):
But once we figured it out, Ifelt like myself again, the self
I hadn't felt like for a while.
And it didn't cure all my baddays, but it made it so that
when I did have a bad day, oh,my tools actually work.
I can use the tools I've learnedfrom therapy.
Oh, I can use them because mymind is not so darkened that I
(31:38):
can't even turn to my tools.
It just gave me the ability.
And it made me realize, I waslike, dang, I remember I did go
to a psychiatrist when I wasanorexic and they prescribed me
medication, which I even pickedup, but I never had the courage
to take.
I really think it would havehelped a lot.
I really needed it, but I wasn'tin a place where I felt like I
(31:59):
could take it.
And I was almost like stubborn,like I can do this myself.
I can muscle my way throughthis.
I really think it would havehelped me a lot quicker if I
have allowed that to help me.
And I'm not saying everybodyshould run to that first.
So it's a great option to lookinto to see if it could work for
anyone.
SPEAKER_02 (32:17):
Yeah, oftentimes, just from the stories that I
hear on the podcast, is thatjust accepting what you have is
a huge struggle and alsoaccepting help.
beyond saying, I want to do itmyself.
Because I think that's thenatural course is I can handle
this.
I can do it myself.
I could figure this out, whichis what we do often in life.
But with something like aneating disorder, mood disorders,
(32:41):
getting professional help willgive you guidance toward what
can work and what has worked inthe past.
It is still a trial and errorwith medication and therapy
because not all medication isgoing to work well for you or
your body, but it can make youhave that stronger foundation
(33:01):
and also make you feel more likeyourself, which is what happens
when you find the rightmedication for you.
And you know, the answers maynot even be medication.
It could be lifestyle change.
There's a lot of other thingsthat could do.
It
SPEAKER_01 (33:15):
could be dietary.
It could be all kinds of things.
So yes, it's just interestinghow I remember I was like, wow,
I probably really could havebenefited from a little
SPEAKER_02 (33:25):
extra help.
You talked about noticing youranxiety during the pandemic, and
that's been a tough time for alot of musicians.
What do you do on the day-to-dayto help prioritize your mental
health?
What's in your mental healthtoolkit?
SPEAKER_01 (33:41):
Yes, I feel like one of the things that I did every
Every single day through theentire pandemic was I would work
out first thing.
It just started my day on theright foot by getting up and
knowing I had something to startmy day with and I would work
out.
Then I'd make myself a yummybreakfast of oatmeal or a shake.
At least started my day off withendorphins, you know, because I
(34:03):
think that's a big thing thatcan quickly make me depressed is
if I don't get the naturalendorphins from a workout.
And then also I end my day everyday with a gratitude journal,
which has been game changing forme to have that.
Throughout the day, I am just abig proponent of listening to
yourself, allowing yourself,understanding that I have
(34:24):
depression or sometimes I havedays where I get super anxious
and allowing myself to stop andbe like, you know, it's okay
that you feel this way.
It's okay.
But this doesn't mean it's true.
And I've really learned todifferentiate between Something
that can be so real inside ofus, like the fact that I felt
fat, that was real to me.
Or the fact that in my mind, I'mthinking to myself, oh my gosh,
(34:48):
this isn't going well.
And my anxiety starts to liketalk and talk and talk and take
over.
That may be real to me, butdoesn't mean that it's true.
It doesn't mean that it'sanybody else's reality.
So really like take thesemoments to let my brain talk to
itself and figure things out soI can stop a spiral that can so
easily take over an entire day.
SPEAKER_02 (35:08):
Oftentimes, mood disorders can lie to you.
They're really good at that.
It feels real when you'rethinking them, but knowing the
facts and having to combat thatinner voice that is trying to
take you down.
Oh, another
SPEAKER_01 (35:27):
thing, probably the most important thing.
I love self-help books or bookson wellness or podcasts such as
yours.
I just have...
some kind of audio on that'sreally positive in that way it
just puts myself in a reallygood self-awareness space of
like I get to make choices abouthow I feel about myself or
(35:49):
reminding me about positivity orreminding me about my ego and
not letting that overcome melike whatever the book is I'm
reading it's really good for meto just do a little dose of that
every day and I feel like to methat's almost more efficient
having that daily check-in witha positive thing than therapy.
SPEAKER_02 (36:09):
It's almost like therapy.
You're like absorbing all thisamazing knowledge and all that
amazing education that you canuse, you know?
So total props to you for that.
Now, I know that you've alsodone some charitable work with
places like, you know, AtlantaMusic Project.
You have the Upside Fun, whichsounds like you started
(36:29):
especially for the pandemic.
SPEAKER_01 (36:32):
I started it during the pandemic, but it was
actually stemmed from somethingI had been doing for a couple of
years.
But something that I'm justsuper passionate about is people
that get trapped in medicalbills.
And our system is so messy forthat.
And so many people get reallystuck in it.
After watching my best friendand my dad both go through and
(36:54):
then pass away from cancer andspending so much time in the
hospital with them.
And then it's such a heavy, hardexperience for anyone to go
through.
But then to also have to carrythe medical bills afterwards.
The Upside Fund is something Istarted to help my fans who are
going through a medical crisis,whether it's helping them pay
the bills or the medical bills.
(37:14):
Just helping people navigatethrough that situation is kind
of what the Upside Fund is meantfor.
SPEAKER_02 (37:18):
You have such a diverse fan base.
I noticed when I went to yourshow that you have people that
are adolescents.
all the way to grandmothers andgrandfathers in the audience.
It's almost like a whole familycan go to your show and be
completely entertained.
Is there anything else that youwould like to say about your
(37:41):
music, your tour, about mentalhealth in general?
SPEAKER_01 (37:45):
I feel so blessed that I'm getting to go out and
do these kind of shows.
It's been truly amazing.
You know, it's been good for mymental health for sure to be
able to go out and do what Ifeel like I was born to do and
get back up there and makepeople smile.
That's what I love.
So I just am so appreciative toeverybody who's come out and I
hope that it's been, you know, Ihope it's made them smile.
We're also really excited forour Christmas tour.
(38:07):
But as far as mental health, Ithink there's so much to be said
for just looking at yourself andjust giving yourself that time.
To be like, am I the person thatI really think I am?
You know, am I the best versionof myself?
Or has part of me been coveredup or slipped away?
If that has happened to anyone,there are ways to get back to
(38:27):
the person that you feel likeyou are.
And there's always hope.
I can honestly say I feel likeI'm back to living my fullest
life.
And, you know, and I'm sograteful for that.
The huge pitfall I hit once upona time because it turned me into
a person who's now self-aware ofmy health and my mental state.
The fact that I hit so low mademe no choice but to like really
(38:51):
investigate.
And so, yeah, I hope that peopletake a chance to look inward and
say, where am I at?
And am I my happiest?
Am I my fullest self?
Because there are answers andthere's always, always hope.
Who you are today is not who youhave to stay.
And I'm a huge believer in that.
SPEAKER_02 (39:08):
Next up, we have Professor of Psychiatry and
Clinical Neuropsychologist, Dr.
Christina Waringa.
Dr.
Waringa is also co-director ofresearch at UC San Diego's
Eating Disorders Center,specializing in the neurobiology
of eating disorders such asanorexia nervosa, and also
(39:29):
actively treats patients withanorexia.
Dr.
Waringa will shareevidence-based treatments along
with new research on anorexiathat will shatter old myths
about this condition.
Now let's hear Dr.
Waringa share her knowledge andadvice.
Lindsay Sterling was so goodabout sharing her symptoms, her
(39:51):
experience, her therapy, and howshe got better.
So we're going to focus onanorexia nervosa because this is
what Lindsay is living with.
Can you share some facts aboutanorexia?
SPEAKER_00 (40:04):
Absolutely.
You know, anorexia is a reallypuzzling disorder for a number
of different reasons, right?
If you think about just theability to starve oneself, that
is very difficult to do.
And most people that try to loseweight can stick to a diet for a
(40:26):
little bit of time, and thenthey usually rebound.
So diets and weight lossPrograms are not that effective.
Yet individuals with anorexiaare able to consistently starve
themselves and lose a lot ofweight.
So that makes you wonder, whatis it that enables these
(40:47):
individuals to successfullystarve themselves?
And there's new research comingout suggesting that anorexia is
really a brain-based disorder.
So there are a lot of myths.
about anorexia, which hascontributed to the stigma over
the years.
People assume that eatingdisorders, anorexia is a choice,
(41:10):
that it is a disorder ofprivileged white women, sort of
a vanity disorder.
And what we're learning is thatit is in fact hereditary.
If someone, especially if awoman has someone in their
family family that also has aneating disorder, they are at 11
(41:31):
times more likely to develop aneating disorder than a woman
without a family member that'saffected.
And so there is strong genetichereditary components.
We're learning that there'sbrain differences in those with
eating disorders.
These are real biologicallybased disorders.
It's not somebody's fault.
(41:52):
So it alleviates the blame ofThat's often associated in the
guilt that's associated withhaving a mental illness.
And so often we share thisinformation with our patients
and parents in particular,because in something like
anorexia, when a child isrefusing to eat, the child's
(42:13):
experience is one of anxiety andfear of weight gain, fear of
what this food is going to do.
The parents' experience isthey're being willful.
They're being obstinate.
They're being difficult.
And when a parent can learn thatwhat's actually happening
emotionally for this child isthat they are terrified.
And they're terrified becausethe signals that the brain is
(42:36):
giving them is telling them thatthis food is risky, that it's
not rewarding, that there'snothing good coming from it.
Parents are able to step backand say, oh, okay, I understand
where this is coming from.
I can manage this without...
getting upset at my child.
And patients have said to us,oh, now there's hope that I can
(42:57):
recover because this isn'tsomething I did to myself.
And I know that I can rewire mybrain through behavior and
practicing new skills.
And that's, this isn't somethingthat I did to myself.
So I don't have to feel guiltyabout it.
I have hope that recovery ispossible.
SPEAKER_02 (43:16):
We could say the same about mood disorders.
Sometimes people feel like wecan control it or we've caused
it ourselves in some sense.
And we can also control gettingout of a mood disorder.
And if that was the case, mooddisorders would not exist
because they're really sochallenging and so difficult to
be in when you're in a bad boutof mental illness.
(43:39):
And I know that you've doneresearch.
You've done neural imaging onthe brain.
And so are you saying thatthere's a certain part of the
brain that is activated forpeople that have a
predisposition to eatingdisorders?
SPEAKER_00 (43:55):
Yes, that's exactly right.
And I love that you use the wordpredisposition because that's
exactly what we think is goingon is that there are individuals
that carry these risk factors orvulnerability factors that put
them at greater risk fordeveloping diseases.
an eating disorder.
Their regions of their brainrespond differently than people
(44:16):
without eating disorders.
And so I mentioned thehereditary component is a risk
factor, but how genes translaterisk is actually what we're
beginning to realize is throughpersonality.
And so individuals with eatingdisorders tend to share a lot of
personality traits.
And these include things likebeing perfectionistic, maybe
(44:38):
tending towards high anxiety andobsessionality, high achieving.
So in combination with weightloss, which can exacerbate these
personality characteristics, itcan throw somebody into
developing an eating disorder.
And Lindsay mentioned this, howdifficult it is to get out of a
(45:01):
a mood disorder or an eatingdisorder, oftentimes you don't
realize when you're developingone.
Lindsay did not realize that shewas developing anorexia until
she was doing very poorly.
That sort of speaks against thisidea that it's a choice because
most of the patients that I'veworked with have not chosen
their eating disorder.
(45:22):
They slowly realize thatsomething is wrong and it takes
them a long time to figure outwhat is going on.
SPEAKER_02 (45:29):
That is what happened with Lindsay.
And she said that even as earlyas six or seven years old, she
remembered looking in the mirrorand wanting to cinch her
snowsuit because she wanted tosee a waist.
That's her first memory ofreally being very body image
conscious.
But when she went to college,that on top of feeling insecure
(45:51):
and the stress of college, thatit came out as full-blown
anorexia where she had symptoms.
And she also experiencedfeelings of depression and
anxiety.
So oftentimes there's concurrentthings that are going on, right,
with an eating disorder.
SPEAKER_00 (46:08):
Exactly.
What Lindsay's experience washighlighting what we sometimes
call premorbid, predisposingfactors like insecurity or
discomfort with your body.
Things that exist, they're notproblematic.
until somebody experiences otherstressors.
And sometimes those stressorsare environmental trauma,
(46:30):
bullying.
Sometimes those stressors arerelated to puberty and hormonal
changes.
Eating disorders tend to onsetduring adolescence when there
are a lot of brain developmentchanges, hormonal changes.
And what happens is oftentimesthat increases depressed mood
and it increases anxiety and onereaction.
(46:52):
to that is to restrict foodintake, whether it's intentional
because you're uncomfortable andunhappy with your body.
And so this dietary restrictionand weight loss then contributes
to this vicious cycle.
So in the short term, it servesto regulate those emotions.
It reduces the anxiety.
It might numb out some of thedepression, but weight loss in
(47:17):
the case of anorexia actuallythen exacerbates long-term
depression and anxiety.
And you find yourself in thisvicious cycle of restricting to
feel better, but then theeffects of starvation actually
amplify those negative emotionalexperiences.
And that's when it becomes veryhard to get out of that vicious
(47:38):
cycle.
You know,
SPEAKER_02 (47:40):
she did talk about depression.
And I had a bad bout ofdepression.
I lost my desire to eat.
I could not feel the hungerresponse.
And it scared me, of course.
And I had to force myself to eatbecause I knew I had to.
But in the meantime, I waslosing weight.
Do people with anorexia havethat hunger response?
(48:01):
Do they have it and they denyit?
Or what is it that's going onthere?
SPEAKER_00 (48:05):
That's such a good question.
And I think there's individualdifferences.
A lot of people with anorexiawill say that in the depths of
their eating disorder, they lostthose hunger signaling.
And that's sometimes a sign ofrecovery is when those hunger
cues come back.
Other individuals will say thatthey could still feel the hunger
(48:27):
signals.
Our brain imaging researchactually suggests hunger is such
a motivating factor to drivesomebody to eat, right?
And in individuals withanorexia, hunger in and of
itself does not activate thereward circuits of our brain to
drive drive eating.
So there's some indication thatwhether or not somebody
(48:51):
subjectively feels hungry,somebody with anorexia, their
brain response to those hungersignals is dampened.
So hunger doesn't serve tomotivate eating like it does in
people without an eatingdisorder, which can help explain
why they're able to avoid thetemptation of eating.
It's just not as rewarding.
SPEAKER_02 (49:11):
One of the things we didn't talk about as much is
that anorexia has the highestmortality rate of all the
psychiatric disorders.
So it's very important to starttreatment as soon as possible
because most people I wouldthink come to you, they've
already lost a lot of weight andthere's already been negative
effects that have happened withtheir body beyond just losing
(49:34):
weight.
SPEAKER_00 (49:36):
Absolutely.
And that is such a scarystatistic.
And it's such a real statisticthat anorexia has the highest
mortality rate of anypsychiatric disorder.
And it's at 10%.
10% of individuals with anorexiadie from either medical
complications related to thedisorder or death by suicide.
(49:56):
So there is a critical urgencyto intervene and intervene as
soon as possible becauseSomeone's life is at stake here.
And unfortunately, the treatmentis actually asking the patient
to do what is most scary forthem, which is gain weight and
eat.
And your experience when youwere depressed and had no
(50:18):
appetite, and I've been theretoo, where it feels impossible
to eat.
And that's what therapy foreating disorders entails.
Something called intrasception,which is your sense of your
body.
altered interception or alteredsense of their body.
So even eating a tiny little bitcan feel incredibly distressing.
(50:41):
You can have terrible GIsymptoms and feel full when
you're not full.
And so although it's absolutelycritical, it is what makes
recovery and treatment also veryscary and difficult.
SPEAKER_02 (50:55):
Can you take me through the steps of treatment,
what you normally recommend forsomeone with anorexia?
Absolutely.
SPEAKER_00 (51:03):
Now, Anorexia, because it involves such severe
medical symptoms, it's reallyimportant that people who have
anorexia and bulimia, becausebulimia is also very dangerous,
seek treatment by specializedproviders that are well
experienced in treating eatingdisorders.
(51:25):
Because oftentimes it reallytakes a team.
It's important to have aphysician who is monitoring
weight and ensuring medicalstability, a nutritionist.
who is helping with mealplanning and making sure that
individuals are meeting theirnutritional sufficiency in a way
they're able to eat because itis so challenging.
And then psychologists andpsychiatrists for med
(51:47):
management.
So I work at UCSD and we offer apartial hospitalization program,
which is considered higher levelof care.
So what that means is thatindividuals who are in treatment
with us are in treatment sixdays a week.
10 hours a day.
So it is very intensive.
And that right there speaks tothe severity and the need for
(52:11):
treatment for eating disordersbecause they require oftentimes
a high level of care to helpweight restoration and helping
with emotional factors as well.
There's lots of people that areperfectly able to be treated at
an outpatient basis.
And coming from an academicmedical center, we really...
emphasize the importance ofevidence-based treatments where
(52:34):
they've been studied andresearched and shown to be
effective, the reality is eatingdisorder treatments are not very
effective.
And about 50% of people relapseafter treatments.
And so we as a field need todevelop better treatments.
And people that are seekingtreatment, it's really important
that you find treatments thathave an evidence base.
(52:58):
And one way to do that is byidentifying academic medical
centers or seeking treatmentthrough programs that are
affiliated with universityhospitals and colleges.
SPEAKER_02 (53:09):
That's great advice.
Lindsay mentioned also theimportance to her to be involved
in a support group.
Can you tell me the advantagesor the benefits of a support
group?
Absolutely.
SPEAKER_00 (53:22):
I think it is invaluable to participate in
group therapy.
And I can't tell you the numberof times that I've said
something and it falls flat.
And somebody with livedexperience says it and it
resonates because it isauthentic.
It's coming from their ownpersonal experience and it is so
(53:43):
powerful.
Here at UCSD, we do lots ofgroup therapy.
Most of our curriculum isgroup-based.
And we have parent supportgroups.
One thing that I haven'tmentioned is just the importance
of having some support whenyou're going through recovery,
whether it's a parent or aspouse or a roommate.
(54:04):
It's really hard to do recoveryon your own.
Lived experience is important.
So valuable because it providesa more authentic perspective
than anything else.
SPEAKER_02 (54:18):
And there's nothing like having someone by your side
that has been in your shoes.
They could speak from anemotional standpoint and also
talk about their recovery andgiving that person hope that,
yes, you can do it.
I did it.
You can do it too.
You know, we talked a lot abouttherapies.
(54:39):
Are there any medications thatprove to be a good supplement
when you have an eatingdisorder?
SPEAKER_00 (54:44):
There's only one FDA-approved medication for
eating disorders, and that isVyvanse for binge eating
disorders.
So what is typically done isoff-label treating other
symptoms of eating disorders,like Abilify or Lamictal.
tend to be really helpful intreating anorexia.
(55:07):
And in part, because they workon both the dopamine and the
serotonin systems, which areboth implicated in anorexia.
So those tend to beantidepressants and mood
stabilizers.
Atypical antipsychotics tend tobe prescribed the most.
SPEAKER_02 (55:24):
You've educated us a lot on anorexia.
Is there anything else that youwould like to say about anorexia
or about mental health ingeneral?
SPEAKER_00 (55:34):
I am just so grateful that you are opening
the conversation.
One of the reasons I loveworking with folks with anorexia
is that the personality traitsthat put them at risk for the
disorder are also traits thatset someone up for immense
success in life.
It is really exciting to be ableto help somebody change the
(55:58):
course of their life so thatthey're able to achieve the
things that bring value to them.
hoping that this will bringpeople hope that recovery is
possible.
A
SPEAKER_02 (56:09):
big thank you to our musical guest, Lindsay Sterling,
and our mental health and eatingdisorders expert, Dr.
Christina Waringa.
For more information on LindsaySterling and to purchase tickets
to our 2021 Christmas programtour, visit lindsaysterling.com
and follow Lindsay on hersocials at Lindsay Sterling and
(56:30):
at Lindsay Sterling Music.
For more information on Dr.
Christina Waringa and UCSD'sEating Disorders Center, visit
eatingdisorders.ucsd.edu andfollow them on their socials at
UCSDEDC.
You can also find thisinformation by visiting
(56:52):
checkyourheadpodcast.com for along list of mental health and
solutions for recovery.
So until next time, be brave,ask for help, And be persistent
in finding the mental healththat you need.
(57:25):
at Check Your Head Podcast.
Watch us on YouTube and supportus with a kind donation on
checkyourheadpodcast.com.
Check Your Head Podcast issponsored by a 501c3 nonprofit
with all donations being taxdeductible.
Thank you for your support andthank you for listening.
Welcome to the Check Your Head podcast, the podcast
where notable musicians andexperts share their stories and
solutions for mental health andwellness.
I'm your host, Mari Fong, amusic journalist and life coach
for musicians, and today we'recelebrating the holidays with an
entertainer who's built hercareer on being a
(00:22):
singer-songwriter, violinist,and dancer with music that
crosses from pop to rock to EDM.
Her albums Shatter Me and BraveEnough both won Billboard Music
Awards for Top Dance ElectronicAlbum, and she's collaborated
with musicians such as Amy Leeof Evanescence, Rivers Cuomo of
Weezer, John Legend, andChristina Perri.
(00:45):
Our featured musical guest todayis Lindsay Sterling, who's
currently on her Christmasprogram tour, singing holiday
tunes from her album Warmer inthe Winter and dancing with her
signature violin.
Lindsay shares her story ofanorexia nervosa, an eating
disorder, along with thedepression and anxiety that came
with it.
(01:05):
Lindsay shares her solutions forrecovery and the daily
maintenance that keeps both hermental and physical health in
top shape.
Next, we have expert Dr.
Christina Waringa, a professorof psychiatry and co-director of
the research program at UC SanDiego's Eating Disorders Center
for Treatment and Research.
Dr.
(01:26):
Waringa will share facts onanorexia along with the tried
and true treatments proven to bemost successful in combating
this condition.
But first, let's hear LindsaySterling share her story.
I went to your Artemis tour.
It's almost Broadway-likebecause you've got music, dance,
(01:46):
costumes, and so many differentthemes to your music.
And what I loved also is thatyou have this message of
empowerment, being yourauthentic self, and also going
for your dreams.
SPEAKER_01 (02:00):
Well, thank you.
My biggest hope is that they'llbe like, wow, that was really
fun.
And oh, gosh, I want to go outthere and do good things and I
can do it.
SPEAKER_02 (02:08):
Yeah.
And you know, you're doing thatwith mental health.
You have a song called ShatterMe.
It talks about overcoming youreating disorder and touches on
depression.
What condition or what situationcame first?
What did you notice first?
SPEAKER_01 (02:23):
I noticed the depression first.
That's what made me realizesomething was deeply wrong.
It came from me opening up to mymom and expressing to her.
I was away in college.
I feel like that's a very commontime for people to start to sink
into mental illness and mentalhealth struggles is because
you're away from home, you'reexperiencing a lot of
(02:45):
uncertainty, and you're tryingto decide who you are.
But also those people aroundyou, like your parents or your
siblings or your best friendsthat have known you your whole
life, they aren't there to beable to notice from the outside
that something's off.
Those people that can monitoryou because they love you,
they're not there anymore.
You're surrounded by newroommates and new friends, and
(03:06):
they think This is Lindsay.
But even through the phone, mymom was realizing that something
was deeply wrong.
There was a very specific momentwhere I realized something was
really off.
And it was the depression that Irecognized first, even though it
was the anorexia that camefirst.
The anorexia caused the symptomof depression.
But depression let me realizelike, oh, I need to peel back
(03:28):
the layers and figure out wherethis came from.
SPEAKER_02 (03:30):
Well, what was that specific moment?
SPEAKER_01 (03:34):
My sister was my roommate.
And...
We were best friends growing upand were inseparable.
And then she's my roommate incollege.
And by this time, I had becomepretty unhealthy and not myself.
I remember she was in the otherroom with our other roommates.
There were six of us that livedin this tiny apartment.
(03:54):
And they were all laughing atsome story that one of the girls
had told and just hystericallylaughing.
And I didn't even have theenergy to get up from my bed to
run in and be like, what's goingon?
Normally that's what I would do,normal Lindsay.
But I just didn't feel like Icould, didn't feel like I would
be invited.
I just didn't have the emotionalenergy to go and try to include
(04:15):
myself.
And then my sister Brooke comesinto our shared room and she
plops on the bed and immediatelystarted doing her homework.
And I remember wishing so badlythat she would tell me what they
were laughing at.
So I looked at her.
I thought, I don't even know heranymore.
Actually, I don't remember thelast time we laughed like that.
And I just became acutely awarefor that moment that something
(04:37):
was wrong.
Something was off.
If I couldn't connect with theperson that I connected with
better than anybody in thisworld.
And if I didn't feel the courageto say, hey, what was so funny?
I just didn't feel like I hadthat with her anymore.
And so that was the moment thatgave me not only the
realization, but also themotivation of like something is
deeply wrong inside of me.
And I need to figure it outbecause it's not worth
(04:59):
sacrificing that.
And so relationships, really, itwas the relationship with my
sister that made me willing tofight to figure out first what
was wrong and then willing tofight through whatever it was to
get it back.
SPEAKER_02 (05:12):
Well, you mentioned just in that short answer,
symptoms of depression, notwanting to get out of bed, not
having the energy and not reallyfeeling connected with even the
closest people around you.
I mean, I've gone throughdepression.
I know exactly what it's like.
It's so hard because these arepeople that you love, but you
can't feel that connectionanymore.
(05:34):
And then also, when you're verydepressed, things that are
normally funny are just not thatfunny.
And that is also really hardbecause good emotions are gone.
You're only left with these bademotions that kind of haunt you
throughout the day and night.
SPEAKER_01 (05:53):
Mm-hmm.
SPEAKER_02 (05:53):
But you said you first started experiencing your
eating disorder.
Would you consider it anorexia?
Would you consider it bulimia?
It
SPEAKER_01 (06:02):
was anorexia for sure.
I just stopped eating basically.
SPEAKER_02 (06:05):
Okay.
And then what was going on inyour life during that time?
And what was your whole mindsetabout stopping eating?
You know,
SPEAKER_01 (06:15):
I think I've been prone to it my whole life.
I have memories from being atiny child.
I think I was like six or sevenyears old and I was putting on a
snowsuit.
So I remember we were allgetting ready and my mom was
making sure everybody fit into acertain snowsuit and I put mine
on and I remember looking in themirror and just feeling like I
(06:35):
looked so fat in the snowsuit.
And I remember taking a belt andputting it around my waist to
give myself a waistline andspecifically bringing it to the
snow so that I could put it on.
I told my mom it helped me keepon the snowsuit, but it was
really because I just had to seethat I had a waist.
So that was at like seven yearsold.
So I think I've always had foodissues.
(06:58):
It finally manifested itselfwhen I was in college.
Like that's when it became aproblem and I sunk into it and I
allowed it to kind of take overmy life and control me.
And it came from the place ofeveryone saying the freshman 15
was a thing and I was determinednot to get the freshman 15 extra
pounds and also feelinginsecure.
And that's when I feel my eatingdisorder start to creep back in.
(07:20):
Even nowadays, like even thoughI'm past it, it's still like,
hey, tries to come back inwhenever I am overly stressed or
I'm feeling very unsure aboutwhatever it is I'm going
through.
And college was the first timethat I felt that that strongly.
SPEAKER_02 (07:35):
College is a time where it's very stressful in so
many different ways, right?
There's so many unknowns.
But you talked about insecurity.
You talked about stress.
And you also talked about howrecovery is kind of a day-to-day
thing.
SPEAKER_01 (07:49):
Absolutely.
I like to look at it like I wentthrough my recovery from A to B,
from that moment when my sisterwas on the bed next to me to
when I felt like I finally couldeat something bad for you and
feel good about myself.
That was a huge moment for mewhen I was like, oh my gosh, I
(08:10):
feel like I'd made it over thishuge mountain for the first
time.
Then there's those littlerelapse moments that happen I
never had an enormous relapsewhere I fully got sucked back
into it, thankfully.
I didn't allow that to happenbecause it was so clear to me
how that stole so much of mylife, feeding into this eating
(08:30):
disorder and allowing it tocontrol me and allowing it to
steal relationships and passion.
Everything became sacrifice tothat eating disorder.
Nothing else mattered besidescalorie numbers.
numbers that showed up on thescale when I stepped on it.
My whole life was consumed bythese thoughts of trying to
maintain this eating disorderand appease it.
(08:51):
It was such a strong, horriblememory of a person that I really
hated.
I hated myself when I was stuckin it.
It was enough for me to alwaysremember nothing is worth going
back to that.
Although sometimes it starts tocreep in, I feel like I've
learned to manage it prettywell.
(09:11):
I still have food issues.
And sadly, it's part of myrelationships still.
It's something that I have to beopenly communicative with people
I'm dating about.
The fact that I struggle withthis, sometimes I'm going to
have a little moment where myeating disorder comes back in
and makes me feel horrible aboutmyself.
And luckily, I've had reallygreat relationships that allow
(09:33):
me to have a safe space to talkabout that and say, I'm sorry,
this isn't about you right now.
This is because I am having amoment with my eating disorders
trying to come back.
And it's all mental.
It's not physical anymore.
It's not like I starve myselfanymore.
I don't go back to the physicalmanifestations of it so much.
It's the mental mindset ofself-loathing and self-hatred
(09:54):
over not exercising or eatingsomething bad or having a bad
weekend with food, likewhatever.
It's more the mental state whereI have to maintain to keep
pulling myself out of it overand over again.
Okay.
You're talking about yourmindset.
SPEAKER_02 (10:10):
Yeah.
So when you looked in themirror, you looked at your body.
I mean, were you focusing on thethings that you didn't like
about it?
I mean, how unrealistic was yourvision of what you saw in the
mirror was?
I
SPEAKER_01 (10:24):
mean, I know to this day, I still have a very
unrealistic expectation of whatmy body should look like.
And that's really sad because Iwork hard on staying fit.
In order to do the performancesI do, I have to be in a pretty
high caliber of fitness and Itake care of my body.
And yet I just have this veryunrealistic expectation of what
my body should look like.
And I just have to remind myselfthat that's really not possible.
(10:46):
And in order to get that bodythat I think I want, it takes a
sacrifice that I am not willingto give.
And that's where the mentalhealth comes into play.
It's like, if I was to look likethat, what I think I should look
like, My sanity has to go outthe door because I have to
sacrifice everything in order tobe that.
And weighing the pros and consis so obvious that like, no, my
(11:11):
expectation is just plainunrealistic for my body.
And so I need to accept that.
And it's something Icontinuously accept about myself
back in the day.
I didn't understand that.
And so I'd look in the mirrorand it would mean that I hated
myself because my hips were toowide or my stomach wasn't as
flat as I wished it was.
And so I was willing to give upwhatever it took in my own mind.
(11:33):
Because to be anorexic, it's afull-time job.
You literally don't think aboutanything else.
I remember going on dates andnot being able to focus on the
conversation because I'd bepanicking inside because he took
me to a pizza restaurant.
The thought of focusing on himwas out the door.
All I could do was barely keepup a conversation because in my
mind, I'm trying to make a plan.
(11:53):
I'm trying to make the plan ofhow I can eat just enough that
he can not think that I amanorexic and also the plan of
where I could go home and Icould run.
You're constantly making plansthat will hide slash keep you
from eating too much slashmaking up for whatever it is you
ate so that you can equal it outin your mind.
Like if I ate a piece of pizza,if I ran tonight and ran
(12:16):
tomorrow morning and didn't eatlunch, that will make up for it.
So anyways, it's just a constantmental blur so that you don't
have anything left to have afriend, to have a passion.
There's no room for it.
When I look at my body and ifI'm not happy with it, I stop
myself and I'm like, well, whatwould it take to get the body
(12:36):
that you think you want?
So even when I was doing all ofthose things and I was 20 pounds
lighter than I am now, I stillwasn't happy.
So I was like, okay, this is100% a problem in my mind.
And I remember learning that ananorexic mind, I can't argue
with logic.
Logic will always win because ifyou can talk facts to your mind,
(12:59):
if you keep doing that, it willwin over this ambiguous, like,
well, you're not enough.
Well, here's the fact.
So learning more about itincreasing my knowledge of
nutrition helped me to talksense to my brain and then
weighing the pros and cons.
It was quite a process to get tothis point where now I can talk
myself through it when I'mhaving those moments of like,
(13:20):
ah, but I may sound like I'msuper deep in it, but I actually
live a very happy, what I feelis very healthy and normal life.
I just have to have these littlesit down talks with myself
occasionally.
SPEAKER_02 (13:32):
Well, you know, I think that's an important point
to bring out because When peoplesometimes think of mood
disorders or eating disorders,conditions like that, it's not
like we live it day to day.
It's something that's there.
And then there's a maintenancethat happens.
And you're talking right nowabout maintenance and educating
(13:54):
yourself to know the tools tokeep it in check, recognizing it
and saying, you know what, thisis what I have.
And a lot of people, it takestime to even embrace to say, I
have depression or I haveanorexia.
Was that a tough journey foryou?
SPEAKER_01 (14:10):
You know, I was in denial about it for a really
long time.
I think my mom had mentioned itseveral times.
Like, I think you have aproblem.
Not everyone thinks like this.
And I remember just breakingdown one moment when I finally
realized it just all kind ofsunk in finally.
And it will sink in until youare ready to accept it because
(14:30):
all the signs were there.
Everything was there.
And finally there was a momentand I'm so grateful for my mom
because it was on the phone withmy mom.
And I finally voiced the words,I think I'm anorexic.
And gosh, I get teary-eyed justthinking about it.
But it was almost like a weightwas lifted off my shoulders
because her response was, youknow what?
That's okay.
(14:51):
And we can work with that.
We can figure this out.
We all learn to solve problemsour entire lives.
Learning to play the violin waslike problem-solving.
Oh my gosh, my pinky can't hitthat note.
Oh my gosh, this isuncomfortable for my hand.
You're learning every step ofthe way how to form your muscles
to be able to fit thisuncomfortable instrument that
(15:11):
doesn't make sense until itdoes.
And so being able to name it andput a label on it, it was like,
okay, now I know what I'mworking towards.
Now I know what I can do to tryto fix this and find the Lindsay
again that has been completelylost.
So for me, it was a huge relief.
It's such a constant journeywith mental health.
(15:31):
I've figured out new thingsabout myself even within the
last year.
Wow, suddenly I had pretty badanxiety and I didn't realize I
did.
A lot of people experienced thatin the pandemic and it was like,
oh my gosh, okay, since I nowrealize that I'm struggling with
this right now, now I can likeaddress it and I can say, hey, I
see you anxiety or I see youeating disorder and I'm going to
(15:53):
learn to understand you so thatI can now cope with it and live
the full life that I know I canlive.
SPEAKER_02 (16:00):
Yeah, it's a long journey and it's a lot of trial
and error to find out what worksfor you and your body
physically, your body mentally,all of these things.
But you said that you realizedyour anorexia when you worked in
a treatment center for troubledgirls.
Is that when you recognized thesymptoms?
SPEAKER_01 (16:21):
That's not what made me so much realize it.
It just was very ironic that Iwas going to school to be a
recreational therapist, And Iwanted to specialize with girls
with eating disorders.
So I don't know if my internalmindset was telling me, you need
to study this.
But then I started working atthis treatment center at the
same time, working with a lot ofgirls that have eating
(16:43):
disorders.
And so it did help me realize itby seeing these outward signs
from all these girls I wasworking with who were very
severely sick in this way.
So I think if I hadn't beenworking in that environment, I
don't think I would have to therealization myself.
So it definitely was like justmany little clues along the way,
(17:05):
you know, but it was through myclose relationships with my
family that finally had thereal, you know, I get it.
Okay, I see it now.
SPEAKER_02 (17:15):
It's so good to have a support system, whether it's
family or friends or even likean online support system.
Sometimes support can come fromstrangers or people you may not
know very well.
SPEAKER_01 (17:27):
To that point, I went to group therapy and I went
to therapy as well with anindividual therapist, but I
found group therapy to be by farthe most helpful.
And I went to the BYU counselingoffice and she said, there's a
support group of girls that havehad eating disorders and then
have had them and they pair youup and it's a, oh my gosh, that
(17:49):
was game changing to go to.
And it took so much courage.
I skipped the first week becauseI was too scared.
to go and say this aloud infront of people.
But the second week, I remembertelling my roommates I was going
to a study group and it was asuper secret meeting of girls.
So we all felt very safe there.
And I remember listening to themvoice their concerns and the way
(18:10):
they felt about simplest thingslike going on a date or going to
a party.
I was like, oh my gosh, otherpeople feel this way.
And it was really interesting togo from, like when I first
realized I was anorexic, it wasthis mindset of like, wait, not
everybody thinks like this.
Not everybody thinks about foodall the time.
Not everybody's like constantlyworried about, oh my gosh.
(18:33):
So first it went from noteveryone feels like this.
And then I felt so alone.
Wow, I'm alone in this.
And then going to group therapymade me realize there are other
people that feel like this.
This isn't a healthy or normalquote unquote mindset, but I'm
not alone.
Like this is a thing.
And so we can work through thistogether.
SPEAKER_02 (18:55):
sometimes our conditions can make you think a
certain way, negative thoughts,thoughts of worthlessness,
self-doubt.
Can you tell me some of thethings that you thought of while
you were in depression or whileyou were in your eating
disorder?
SPEAKER_01 (19:13):
Yes.
When I was severely depressedand severely anorexic, I mean,
it was to the point where Iwould look myself in the mirror
and just...
myself so much even voice thewords I hate you to myself
because I was so sad and Iwasn't always like that so the
person I'd become I hated thatperson who took away who I was
(19:36):
really like I didn't know whereto find the real Lindsay and so
I just felt so like so worthlessjust going back to that place
alone is what always motivatesme of like it's not even worth
going there
SPEAKER_02 (19:48):
the other thing that is difficult is you're talking
about being somebody that youfeel like you're not, which is
another thing that happens whenyou're in a mood disorder.
You don't even recognize who youare sometimes with your
thoughts, with your behaviors,and it's scary.
Was it ever a time where youactually thought about ending
(20:10):
your life or having suicidal
SPEAKER_01 (20:12):
thoughts?
I never struggled with suicidalthoughts.
It was purely worthlessness andhating myself, but I never got
to that point ever.
somehow.
SPEAKER_02 (20:23):
Okay, that's good.
But it's important to notebecause those can be thoughts
that go through your head duringthose times.
What encouraged you to reallystart talking about all of this
to your fan base and basicallyin general?
SPEAKER_01 (20:37):
It came pretty natural for me to talk about it
once I felt like I was in areally good place with it.
It didn't feel good to talkabout it when I was in the midst
of it.
But talking about mental healthto me was so important because
this is something I once felt soalone in and also something I
was so unaware of.
If I had understood at a youngerage that eating disorders or
(21:01):
that just unhealthy body imagewas a thing and body dysmorphia
and all of that.
I didn't even know about itreally.
I just knew they were words.
I think everyone goes throughsome kind of a struggle where
they realize, oh my goodness,I'm feeling really anxious or
I'm depressed right now.
It could be situational.
It could be seasonal.
It could be whatever.
I just feel like, wow, this isso normal and it should be
(21:24):
normalized.
And so that's what kind of gaveme the courage to talk about it.
I wrote the song Shatter Me andit almost felt like an easier
way to write about it was topersonify it.
And so I put it in theperspective of a ballerina stuck
in a snow globe because that wasan image that encapsulated how I
felt like I was trying so hardto be this image of perfection,
(21:45):
you know, this perfect ballerinaspinning and what kept her
perfect was snow globe.
That image first came to mebecause I remember being in a
little shop one time when I wasreally sick.
And when I was very anorexic andseeing the snow globe and
thinking I was that ballerina,she's stuck inside there.
Everyone thinks that that littleporcelain globe is just her
(22:08):
perfect little world, but it'sactually a cage.
It's not protecting her.
It's caging her.
That was what inspired the wholeshatter me ballerina story.
And it was the first time I'dreally expressed my anorexia.
It felt easier for the firsttime to do it through a
character.
Well, I think that
SPEAKER_02 (22:26):
describes it Perfectly, especially with
depression as well.
Sometimes you feel like you'retrapped inside something that
you can't get out of or peopledon't actually see what's going
on inside of you.
And sometimes you have thoughtsthat you can't even get out with
words because of a depression ormood disorder.
(22:48):
Now we're going to get to a timewhere things turned around for
you with the depression and theeating disorder.
What was that for you?
SPEAKER_01 (22:59):
You
SPEAKER_02 (22:59):
know, I can't
SPEAKER_01 (22:59):
even pinpoint a specific moment per se.
I just feel like there werelittle victories along the way
where I was like, you know, I'mgetting signs that I'm getting
better.
I remember my parents taking meout to Cheesecake Factory when I
wasn't doing well.
They didn't know yet that I wasanorexic.
And I remember we were so quieton the way home.
(23:21):
And it's because they could feelthat something was off about me.
And it's because I was inthis...
spiral in my head of hatingmyself based on what I'd just
eaten and punishing myself in mymind already.
And I could just tell somethingwas wrong and where they're
like, are you okay?
And I was like, yeah, fine,fine.
But I remember two years lateron my birthday, I told my
(23:41):
parents, I want to go toCheesecake Factory.
And I remember being so happythat I enjoyed what I ate and I
ate what I wanted.
And I didn't judge myself forthings.
And I remember just being soproud of myself in that moment.
because I chose that I was goingto eat that, and it's okay
because I eat healthy most ofthe time, and I sure as heck
deserve to reward myselfsometimes.
(24:01):
Occasionally indulging yourselfto eat what you actually want
and saying, I deserve this,that's a healthy mind versus
always telling yourself youcannot have those things.
Little victories like that justremind me that I'm still on the
right track, and we all deserveto indulge and feel okay when we
(24:22):
do that.
That's part of life.
That's what makes life beautifuland worth living are those
moments where we say, I'm goingto enjoy.
SPEAKER_02 (24:28):
Well, also celebrating wins, whether
they're big wins or small wins.
And I think life is full ofsmall wins, especially on a
journey that has to do with alot of trial and error.
But when you have something likeanorexia, at that point, there
could be some kinds of therapyor things that you had to learn
(24:49):
in order to eat in a healthyway.
What kind of therapies ortechniques did you learn to
start controlling that?
SPEAKER_01 (24:56):
I really did turn it into like a part or full-time
job.
Like I was going to college atthe time.
I was going to group therapytwice a week.
I was going to a therapist oncea week.
And then I also started to meetwith a nutritionist and I hated
going to nutritionists.
It was the worst.
They would just tell you thatyou need to eat more.
You need to eat more of thisfood, which included the
(25:17):
terrible word of fats.
And all these things that in mymind were like curse words to my
body.
I remember the moment when I hit100 pounds.
I remember crying because I wasso sad and realizing that fat
was being added to my body.
So as I sat there crying, as Ilooked at the scale, I also gave
(25:38):
myself a pat on the back becauseI was healing.
You know, anorexia is such aninteresting thing because one,
you're dealing with anaddiction.
It's a mindset addiction whereyou are addicted to this lack of
calories and you're addicted tothe habits.
It's very habitual and theresults are addicting of seeing
(26:01):
the scale go down.
And so when you start to seethis process reverse, it's weird
because it's measurable.
You have to face it every day,multiple times a day, and talk
yourself through it.
I remember sitting and eatingfood, and I would eat it and
hate it.
It was like a physical and amental process.
Because the eating disorder hastaken over your mind and your
(26:24):
body, it felt like it was me.
Looking in the mirror, I wouldsay, I hate you, because it felt
like it was me.
And it was really helpful tolearn to separate myself from
the eating disorder.
I read this great book calledLife Without Ed.
This girl decided to talk to hereating disorder and treat it
like a dysfunctional, abusiverelationship.
(26:46):
Because the eating disorder willreward you when it feels like
you've done good and it makesyou feel good about yourself in
that moment.
But then it makes you turn toself-hatred the moment you've
messed up.
And so it really is an abusiverelationship where you feel
comforted by it.
and betrayed by it.
And so I would talk to my eatingdisorder and I would talk
through the facts and be like, Ineed to eat this meal.
(27:08):
This is good for me.
Fats can be good for you.
And I would talk through thethings I'd learned, the facts.
And when I passed 100 pounds onthe scale, I told myself, this
is good for you.
You're not even in your idealbody weight yet.
This is healthy.
This is what's going to helpyou.
I would talk to my eatingdisorder.
I didn't deserve to talk to thatway when it would tell me that
(27:28):
you're fat.
You should eat that.
I would talk to it and say, Idon't deserve that.
I deserve better and I don'tneed you anymore.
You were here for a time andmaybe you comforted me when I
thought I needed it, but I don'twant you anymore.
That process of learning toseparate myself made me start to
recognize when the real me wascoming back and this parasite
(27:48):
that had taken over me wasstarting to slip away.
SPEAKER_02 (27:50):
It's almost like a fish swimming upstream because
this eating disorder, thisanorexia, it can be very
charismatic in the way it talkswith you.
I'm curious though, if let's sayin your mind, you were able to
achieve this perfect body, whatwould that mean to you?
(28:13):
What would that bring to yourlife?
SPEAKER_01 (28:16):
You know, I don't think it would have brought
anything.
It was a mental disease whereyou're chasing after something
that one is never going to besatisfied.
I was so skinny and yet it wasnever enough.
But it's just kind of funny howthe chain reaction happens.
We all want to be loved becausewe just want to be happy.
Okay, well, being loved makesyou happy.
(28:39):
So how do I get love?
Oh, I need to just be whateverybody needs me to be.
And if I'm beautiful and if I'mthin, the guys will like me.
I better eat less.
And then all of a sudden, you'regiving up everything in order to
be thin.
But it's like in the search forbeing happy and being accepted
and loving myself, I gave up allthe things that actually would
(29:01):
have made that happen.
It's just like you were oncourse to get something and then
you just kind of got off coursechasing something completely,
completely different becausehaving a skinnier body wouldn't
have added anything to my life.
And at the end of the day, it'slike it never would have been
enough.
If it wasn't enough where I wasat, it never would have been
enough.
And that's the logic coming intoplay.
(29:23):
You know, and even now I'mdating a great guy.
And when I have like a momentwhen I turn to him and I'm just
like, I'm sorry, I'm beingreally quiet and awkward right
now.
It's because I'm having a momentwhere my eating disorder is
trying to come back and it'stelling me I'm worthless.
I think you're beautiful justthe way you are.
Like if me being thinner, whatis it for if it's not for the
person who loves me?
Like he doesn't need that.
(29:44):
And so what does this add to mylife?
Absolutely nothing.
You know, and it's that logicthat kind of helps.
UNKNOWN (29:50):
Yeah.
SPEAKER_01 (29:50):
You get back on track again.
Like it's never going to makepeople love you more to have a
skinnier body ever.
SPEAKER_02 (29:55):
Absolutely true.
And I think it's great thatyou've also included your
family, your friends, the guythat you're dating about what's
going on with you inside,because it's so important to
understand that to also havethem understand why you're
behaving a certain way.
Sometimes with depression oranxiety or any kind of mood
(30:17):
disorder, we can seekprofessional help.
And you did with a supportgroup.
Have you ever gone to apsychiatrist or had any kind of
medication that assisted you inany of those situations?
SPEAKER_01 (30:31):
Yes.
And, you know, actually it waslast year about this time.
I was struggling so badly withanxiety.
And, you know, it was an arena Iwasn't familiar with.
Finally, it was because of mysister.
She was like, you should justtry talking to a psychiatrist
about anxiety.
I think you have really severeanxiety and it's just getting
out of control now.
So I finally went and I gotmedication and it was some trial
(30:57):
and error to figure out theright dosage.
But oh my gosh, it was amazingwhen I kind of got through the
clouds of it all to be like, ohmy gosh.
I feel like myself.
I think a lot of times we don'twant to take medication because
you're afraid it's going to makeyou not feel like yourself or
it's going to numb you or makeit worse.
And it did for a second while Iwas in that process of trying to
figure out the right one and theright dose.
(31:17):
But once we figured it out, Ifelt like myself again, the self
I hadn't felt like for a while.
And it didn't cure all my baddays, but it made it so that
when I did have a bad day, oh,my tools actually work.
I can use the tools I've learnedfrom therapy.
Oh, I can use them because mymind is not so darkened that I
(31:38):
can't even turn to my tools.
It just gave me the ability.
And it made me realize, I waslike, dang, I remember I did go
to a psychiatrist when I wasanorexic and they prescribed me
medication, which I even pickedup, but I never had the courage
to take.
I really think it would havehelped a lot.
I really needed it, but I wasn'tin a place where I felt like I
(31:59):
could take it.
And I was almost like stubborn,like I can do this myself.
I can muscle my way throughthis.
I really think it would havehelped me a lot quicker if I
have allowed that to help me.
And I'm not saying everybodyshould run to that first.
So it's a great option to lookinto to see if it could work for
anyone.
SPEAKER_02 (32:17):
Yeah, oftentimes, just from the stories that I
hear on the podcast, is thatjust accepting what you have is
a huge struggle and alsoaccepting help.
beyond saying, I want to do itmyself.
Because I think that's thenatural course is I can handle
this.
I can do it myself.
I could figure this out, whichis what we do often in life.
But with something like aneating disorder, mood disorders,
(32:41):
getting professional help willgive you guidance toward what
can work and what has worked inthe past.
It is still a trial and errorwith medication and therapy
because not all medication isgoing to work well for you or
your body, but it can make youhave that stronger foundation
(33:01):
and also make you feel more likeyourself, which is what happens
when you find the rightmedication for you.
And you know, the answers maynot even be medication.
It could be lifestyle change.
There's a lot of other thingsthat could do.
It
SPEAKER_01 (33:15):
could be dietary.
It could be all kinds of things.
So yes, it's just interestinghow I remember I was like, wow,
I probably really could havebenefited from a little
SPEAKER_02 (33:25):
extra help.
You talked about noticing youranxiety during the pandemic, and
that's been a tough time for alot of musicians.
What do you do on the day-to-dayto help prioritize your mental
health?
What's in your mental healthtoolkit?
SPEAKER_01 (33:41):
Yes, I feel like one of the things that I did every
Every single day through theentire pandemic was I would work
out first thing.
It just started my day on theright foot by getting up and
knowing I had something to startmy day with and I would work
out.
Then I'd make myself a yummybreakfast of oatmeal or a shake.
At least started my day off withendorphins, you know, because I
(34:03):
think that's a big thing thatcan quickly make me depressed is
if I don't get the naturalendorphins from a workout.
And then also I end my day everyday with a gratitude journal,
which has been game changing forme to have that.
Throughout the day, I am just abig proponent of listening to
yourself, allowing yourself,understanding that I have
(34:24):
depression or sometimes I havedays where I get super anxious
and allowing myself to stop andbe like, you know, it's okay
that you feel this way.
It's okay.
But this doesn't mean it's true.
And I've really learned todifferentiate between Something
that can be so real inside ofus, like the fact that I felt
fat, that was real to me.
Or the fact that in my mind, I'mthinking to myself, oh my gosh,
(34:48):
this isn't going well.
And my anxiety starts to liketalk and talk and talk and take
over.
That may be real to me, butdoesn't mean that it's true.
It doesn't mean that it'sanybody else's reality.
So really like take thesemoments to let my brain talk to
itself and figure things out soI can stop a spiral that can so
easily take over an entire day.
SPEAKER_02 (35:08):
Oftentimes, mood disorders can lie to you.
They're really good at that.
It feels real when you'rethinking them, but knowing the
facts and having to combat thatinner voice that is trying to
take you down.
Oh, another
SPEAKER_01 (35:27):
thing, probably the most important thing.
I love self-help books or bookson wellness or podcasts such as
yours.
I just have...
some kind of audio on that'sreally positive in that way it
just puts myself in a reallygood self-awareness space of
like I get to make choices abouthow I feel about myself or
(35:49):
reminding me about positivity orreminding me about my ego and
not letting that overcome melike whatever the book is I'm
reading it's really good for meto just do a little dose of that
every day and I feel like to methat's almost more efficient
having that daily check-in witha positive thing than therapy.
SPEAKER_02 (36:09):
It's almost like therapy.
You're like absorbing all thisamazing knowledge and all that
amazing education that you canuse, you know?
So total props to you for that.
Now, I know that you've alsodone some charitable work with
places like, you know, AtlantaMusic Project.
You have the Upside Fun, whichsounds like you started
(36:29):
especially for the pandemic.
SPEAKER_01 (36:32):
I started it during the pandemic, but it was
actually stemmed from somethingI had been doing for a couple of
years.
But something that I'm justsuper passionate about is people
that get trapped in medicalbills.
And our system is so messy forthat.
And so many people get reallystuck in it.
After watching my best friendand my dad both go through and
(36:54):
then pass away from cancer andspending so much time in the
hospital with them.
And then it's such a heavy, hardexperience for anyone to go
through.
But then to also have to carrythe medical bills afterwards.
The Upside Fund is something Istarted to help my fans who are
going through a medical crisis,whether it's helping them pay
the bills or the medical bills.
(37:14):
Just helping people navigatethrough that situation is kind
of what the Upside Fund is meantfor.
SPEAKER_02 (37:18):
You have such a diverse fan base.
I noticed when I went to yourshow that you have people that
are adolescents.
all the way to grandmothers andgrandfathers in the audience.
It's almost like a whole familycan go to your show and be
completely entertained.
Is there anything else that youwould like to say about your
(37:41):
music, your tour, about mentalhealth in general?
SPEAKER_01 (37:45):
I feel so blessed that I'm getting to go out and
do these kind of shows.
It's been truly amazing.
You know, it's been good for mymental health for sure to be
able to go out and do what Ifeel like I was born to do and
get back up there and makepeople smile.
That's what I love.
So I just am so appreciative toeverybody who's come out and I
hope that it's been, you know, Ihope it's made them smile.
We're also really excited forour Christmas tour.
(38:07):
But as far as mental health, Ithink there's so much to be said
for just looking at yourself andjust giving yourself that time.
To be like, am I the person thatI really think I am?
You know, am I the best versionof myself?
Or has part of me been coveredup or slipped away?
If that has happened to anyone,there are ways to get back to
(38:27):
the person that you feel likeyou are.
And there's always hope.
I can honestly say I feel likeI'm back to living my fullest
life.
And, you know, and I'm sograteful for that.
The huge pitfall I hit once upona time because it turned me into
a person who's now self-aware ofmy health and my mental state.
The fact that I hit so low mademe no choice but to like really
(38:51):
investigate.
And so, yeah, I hope that peopletake a chance to look inward and
say, where am I at?
And am I my happiest?
Am I my fullest self?
Because there are answers andthere's always, always hope.
Who you are today is not who youhave to stay.
And I'm a huge believer in that.
SPEAKER_02 (39:08):
Next up, we have Professor of Psychiatry and
Clinical Neuropsychologist, Dr.
Christina Waringa.
Dr.
Waringa is also co-director ofresearch at UC San Diego's
Eating Disorders Center,specializing in the neurobiology
of eating disorders such asanorexia nervosa, and also
(39:29):
actively treats patients withanorexia.
Dr.
Waringa will shareevidence-based treatments along
with new research on anorexiathat will shatter old myths
about this condition.
Now let's hear Dr.
Waringa share her knowledge andadvice.
Lindsay Sterling was so goodabout sharing her symptoms, her
(39:51):
experience, her therapy, and howshe got better.
So we're going to focus onanorexia nervosa because this is
what Lindsay is living with.
Can you share some facts aboutanorexia?
SPEAKER_00 (40:04):
Absolutely.
You know, anorexia is a reallypuzzling disorder for a number
of different reasons, right?
If you think about just theability to starve oneself, that
is very difficult to do.
And most people that try to loseweight can stick to a diet for a
(40:26):
little bit of time, and thenthey usually rebound.
So diets and weight lossPrograms are not that effective.
Yet individuals with anorexiaare able to consistently starve
themselves and lose a lot ofweight.
So that makes you wonder, whatis it that enables these
(40:47):
individuals to successfullystarve themselves?
And there's new research comingout suggesting that anorexia is
really a brain-based disorder.
So there are a lot of myths.
about anorexia, which hascontributed to the stigma over
the years.
People assume that eatingdisorders, anorexia is a choice,
(41:10):
that it is a disorder ofprivileged white women, sort of
a vanity disorder.
And what we're learning is thatit is in fact hereditary.
If someone, especially if awoman has someone in their
family family that also has aneating disorder, they are at 11
(41:31):
times more likely to develop aneating disorder than a woman
without a family member that'saffected.
And so there is strong genetichereditary components.
We're learning that there'sbrain differences in those with
eating disorders.
These are real biologicallybased disorders.
It's not somebody's fault.
(41:52):
So it alleviates the blame ofThat's often associated in the
guilt that's associated withhaving a mental illness.
And so often we share thisinformation with our patients
and parents in particular,because in something like
anorexia, when a child isrefusing to eat, the child's
(42:13):
experience is one of anxiety andfear of weight gain, fear of
what this food is going to do.
The parents' experience isthey're being willful.
They're being obstinate.
They're being difficult.
And when a parent can learn thatwhat's actually happening
emotionally for this child isthat they are terrified.
And they're terrified becausethe signals that the brain is
(42:36):
giving them is telling them thatthis food is risky, that it's
not rewarding, that there'snothing good coming from it.
Parents are able to step backand say, oh, okay, I understand
where this is coming from.
I can manage this without...
getting upset at my child.
And patients have said to us,oh, now there's hope that I can
(42:57):
recover because this isn'tsomething I did to myself.
And I know that I can rewire mybrain through behavior and
practicing new skills.
And that's, this isn't somethingthat I did to myself.
So I don't have to feel guiltyabout it.
I have hope that recovery ispossible.
SPEAKER_02 (43:16):
We could say the same about mood disorders.
Sometimes people feel like wecan control it or we've caused
it ourselves in some sense.
And we can also control gettingout of a mood disorder.
And if that was the case, mooddisorders would not exist
because they're really sochallenging and so difficult to
be in when you're in a bad boutof mental illness.
(43:39):
And I know that you've doneresearch.
You've done neural imaging onthe brain.
And so are you saying thatthere's a certain part of the
brain that is activated forpeople that have a
predisposition to eatingdisorders?
SPEAKER_00 (43:55):
Yes, that's exactly right.
And I love that you use the wordpredisposition because that's
exactly what we think is goingon is that there are individuals
that carry these risk factors orvulnerability factors that put
them at greater risk fordeveloping diseases.
an eating disorder.
Their regions of their brainrespond differently than people
(44:16):
without eating disorders.
And so I mentioned thehereditary component is a risk
factor, but how genes translaterisk is actually what we're
beginning to realize is throughpersonality.
And so individuals with eatingdisorders tend to share a lot of
personality traits.
And these include things likebeing perfectionistic, maybe
(44:38):
tending towards high anxiety andobsessionality, high achieving.
So in combination with weightloss, which can exacerbate these
personality characteristics, itcan throw somebody into
developing an eating disorder.
And Lindsay mentioned this, howdifficult it is to get out of a
(45:01):
a mood disorder or an eatingdisorder, oftentimes you don't
realize when you're developingone.
Lindsay did not realize that shewas developing anorexia until
she was doing very poorly.
That sort of speaks against thisidea that it's a choice because
most of the patients that I'veworked with have not chosen
their eating disorder.
(45:22):
They slowly realize thatsomething is wrong and it takes
them a long time to figure outwhat is going on.
SPEAKER_02 (45:29):
That is what happened with Lindsay.
And she said that even as earlyas six or seven years old, she
remembered looking in the mirrorand wanting to cinch her
snowsuit because she wanted tosee a waist.
That's her first memory ofreally being very body image
conscious.
But when she went to college,that on top of feeling insecure
(45:51):
and the stress of college, thatit came out as full-blown
anorexia where she had symptoms.
And she also experiencedfeelings of depression and
anxiety.
So oftentimes there's concurrentthings that are going on, right,
with an eating disorder.
SPEAKER_00 (46:08):
Exactly.
What Lindsay's experience washighlighting what we sometimes
call premorbid, predisposingfactors like insecurity or
discomfort with your body.
Things that exist, they're notproblematic.
until somebody experiences otherstressors.
And sometimes those stressorsare environmental trauma,
(46:30):
bullying.
Sometimes those stressors arerelated to puberty and hormonal
changes.
Eating disorders tend to onsetduring adolescence when there
are a lot of brain developmentchanges, hormonal changes.
And what happens is oftentimesthat increases depressed mood
and it increases anxiety and onereaction.
(46:52):
to that is to restrict foodintake, whether it's intentional
because you're uncomfortable andunhappy with your body.
And so this dietary restrictionand weight loss then contributes
to this vicious cycle.
So in the short term, it servesto regulate those emotions.
It reduces the anxiety.
It might numb out some of thedepression, but weight loss in
(47:17):
the case of anorexia actuallythen exacerbates long-term
depression and anxiety.
And you find yourself in thisvicious cycle of restricting to
feel better, but then theeffects of starvation actually
amplify those negative emotionalexperiences.
And that's when it becomes veryhard to get out of that vicious
(47:38):
cycle.
You know,
SPEAKER_02 (47:40):
she did talk about depression.
And I had a bad bout ofdepression.
I lost my desire to eat.
I could not feel the hungerresponse.
And it scared me, of course.
And I had to force myself to eatbecause I knew I had to.
But in the meantime, I waslosing weight.
Do people with anorexia havethat hunger response?
(48:01):
Do they have it and they denyit?
Or what is it that's going onthere?
SPEAKER_00 (48:05):
That's such a good question.
And I think there's individualdifferences.
A lot of people with anorexiawill say that in the depths of
their eating disorder, they lostthose hunger signaling.
And that's sometimes a sign ofrecovery is when those hunger
cues come back.
Other individuals will say thatthey could still feel the hunger
(48:27):
signals.
Our brain imaging researchactually suggests hunger is such
a motivating factor to drivesomebody to eat, right?
And in individuals withanorexia, hunger in and of
itself does not activate thereward circuits of our brain to
drive drive eating.
So there's some indication thatwhether or not somebody
(48:51):
subjectively feels hungry,somebody with anorexia, their
brain response to those hungersignals is dampened.
So hunger doesn't serve tomotivate eating like it does in
people without an eatingdisorder, which can help explain
why they're able to avoid thetemptation of eating.
It's just not as rewarding.
SPEAKER_02 (49:11):
One of the things we didn't talk about as much is
that anorexia has the highestmortality rate of all the
psychiatric disorders.
So it's very important to starttreatment as soon as possible
because most people I wouldthink come to you, they've
already lost a lot of weight andthere's already been negative
effects that have happened withtheir body beyond just losing
(49:34):
weight.
SPEAKER_00 (49:36):
Absolutely.
And that is such a scarystatistic.
And it's such a real statisticthat anorexia has the highest
mortality rate of anypsychiatric disorder.
And it's at 10%.
10% of individuals with anorexiadie from either medical
complications related to thedisorder or death by suicide.
(49:56):
So there is a critical urgencyto intervene and intervene as
soon as possible becauseSomeone's life is at stake here.
And unfortunately, the treatmentis actually asking the patient
to do what is most scary forthem, which is gain weight and
eat.
And your experience when youwere depressed and had no
(50:18):
appetite, and I've been theretoo, where it feels impossible
to eat.
And that's what therapy foreating disorders entails.
Something called intrasception,which is your sense of your
body.
altered interception or alteredsense of their body.
So even eating a tiny little bitcan feel incredibly distressing.
(50:41):
You can have terrible GIsymptoms and feel full when
you're not full.
And so although it's absolutelycritical, it is what makes
recovery and treatment also veryscary and difficult.
SPEAKER_02 (50:55):
Can you take me through the steps of treatment,
what you normally recommend forsomeone with anorexia?
Absolutely.
SPEAKER_00 (51:03):
Now, Anorexia, because it involves such severe
medical symptoms, it's reallyimportant that people who have
anorexia and bulimia, becausebulimia is also very dangerous,
seek treatment by specializedproviders that are well
experienced in treating eatingdisorders.
(51:25):
Because oftentimes it reallytakes a team.
It's important to have aphysician who is monitoring
weight and ensuring medicalstability, a nutritionist.
who is helping with mealplanning and making sure that
individuals are meeting theirnutritional sufficiency in a way
they're able to eat because itis so challenging.
And then psychologists andpsychiatrists for med
(51:47):
management.
So I work at UCSD and we offer apartial hospitalization program,
which is considered higher levelof care.
So what that means is thatindividuals who are in treatment
with us are in treatment sixdays a week.
10 hours a day.
So it is very intensive.
And that right there speaks tothe severity and the need for
(52:11):
treatment for eating disordersbecause they require oftentimes
a high level of care to helpweight restoration and helping
with emotional factors as well.
There's lots of people that areperfectly able to be treated at
an outpatient basis.
And coming from an academicmedical center, we really...
emphasize the importance ofevidence-based treatments where
(52:34):
they've been studied andresearched and shown to be
effective, the reality is eatingdisorder treatments are not very
effective.
And about 50% of people relapseafter treatments.
And so we as a field need todevelop better treatments.
And people that are seekingtreatment, it's really important
that you find treatments thathave an evidence base.
(52:58):
And one way to do that is byidentifying academic medical
centers or seeking treatmentthrough programs that are
affiliated with universityhospitals and colleges.
SPEAKER_02 (53:09):
That's great advice.
Lindsay mentioned also theimportance to her to be involved
in a support group.
Can you tell me the advantagesor the benefits of a support
group?
Absolutely.
SPEAKER_00 (53:22):
I think it is invaluable to participate in
group therapy.
And I can't tell you the numberof times that I've said
something and it falls flat.
And somebody with livedexperience says it and it
resonates because it isauthentic.
It's coming from their ownpersonal experience and it is so
(53:43):
powerful.
Here at UCSD, we do lots ofgroup therapy.
Most of our curriculum isgroup-based.
And we have parent supportgroups.
One thing that I haven'tmentioned is just the importance
of having some support whenyou're going through recovery,
whether it's a parent or aspouse or a roommate.
(54:04):
It's really hard to do recoveryon your own.
Lived experience is important.
So valuable because it providesa more authentic perspective
than anything else.
SPEAKER_02 (54:18):
And there's nothing like having someone by your side
that has been in your shoes.
They could speak from anemotional standpoint and also
talk about their recovery andgiving that person hope that,
yes, you can do it.
I did it.
You can do it too.
You know, we talked a lot abouttherapies.
(54:39):
Are there any medications thatprove to be a good supplement
when you have an eatingdisorder?
SPEAKER_00 (54:44):
There's only one FDA-approved medication for
eating disorders, and that isVyvanse for binge eating
disorders.
So what is typically done isoff-label treating other
symptoms of eating disorders,like Abilify or Lamictal.
tend to be really helpful intreating anorexia.
(55:07):
And in part, because they workon both the dopamine and the
serotonin systems, which areboth implicated in anorexia.
So those tend to beantidepressants and mood
stabilizers.
Atypical antipsychotics tend tobe prescribed the most.
SPEAKER_02 (55:24):
You've educated us a lot on anorexia.
Is there anything else that youwould like to say about anorexia
or about mental health ingeneral?
SPEAKER_00 (55:34):
I am just so grateful that you are opening
the conversation.
One of the reasons I loveworking with folks with anorexia
is that the personality traitsthat put them at risk for the
disorder are also traits thatset someone up for immense
success in life.
It is really exciting to be ableto help somebody change the
(55:58):
course of their life so thatthey're able to achieve the
things that bring value to them.
hoping that this will bringpeople hope that recovery is
possible.
A
SPEAKER_02 (56:09):
big thank you to our musical guest, Lindsay Sterling,
and our mental health and eatingdisorders expert, Dr.
Christina Waringa.
For more information on LindsaySterling and to purchase tickets
to our 2021 Christmas programtour, visit lindsaysterling.com
and follow Lindsay on hersocials at Lindsay Sterling and
(56:30):
at Lindsay Sterling Music.
For more information on Dr.
Christina Waringa and UCSD'sEating Disorders Center, visit
eatingdisorders.ucsd.edu andfollow them on their socials at
UCSDEDC.
You can also find thisinformation by visiting
(56:52):
checkyourheadpodcast.com for along list of mental health and
solutions for recovery.
So until next time, be brave,ask for help, And be persistent
in finding the mental healththat you need.
(57:25):
at Check Your Head Podcast.
Watch us on YouTube and supportus with a kind donation on
checkyourheadpodcast.com.
Check Your Head Podcast issponsored by a 501c3 nonprofit
with all donations being taxdeductible.
Thank you for your support andthank you for listening.
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