When I first began abusing laxatives, I was 17 and I’d already been purging after every meal for a year. I started by taking one laxative a day, because I thought it would help me lose weight; three years later, I was taking seven at a time. I don’t remember exactly what happened in between, except that I began to feel nervous, because the laxatives seemed to be getting less effective. This feeling ended up setting the course for the rest of my life. Because today, I’m 32, and though I’m a decade past that soul-breaking period in my life, my body is still broken. What I’m saying is: I can’t poop.

As anyone who’s ever read the warning label on a box of laxatives knows, using them for more than a week can make your body become dependent. That’s why I kept increasing my dosages — to try to force a reaction after my body had become used to that one daily pill. What the box didn’t tell me is that after relying upon laxatives for years, the body’s allegedly natural ability to expel waste can just… stop. It's not that my body has stopped producing waste; it just doesn’t go anywhere. It stays in the intestines, where it causes painful gas and bloating until I hit my breaking point and seek help.

But the more I obsess, the more my body seems to hold back, as though my bowels have stage fright.

According to the Mayo Clinic, "regular" constipation involves fewer than three bowel movements a week, while chronic constipation (which is what I have) entails infrequent or nonexistent bowel movements for several weeks or longer. It can cause anal fissures, fecal impaction that requires surgery, diverticulitis, and a whole host of issues.

When the average person is struggling in this area, laxatives can help. But when one abuses and becomes dependent on laxatives, like I did, it causes what's known as a "cathartic colon." According to studies, abusing stimulant laxatives on a long-term basis can actually change the physiology of the colon, damaging something called "haustral folds" which, in a healthy system, help move poop through the colon. If your haustral folds are not in great condition, neither is your ability to poop.

Since college, I’ve tried every herbal supplement, over-the-counter powder and prescription drug on the market, to varying and brief degrees of success. I've had many colonic irrigations. I’ve listened politely with a rising rage as well-meaning people provide utterly insipid tips like “eat fiber!” and “more water!” But nothing works consistently; the only constants are a belly bloat, a feeling of discomfort, and the knowledge that the stuff my body produces is simply hanging out in there.

"I continued to feel, as it were, full of sh*t."

I sometimes go for stretches of two to three weeks without a bowel movement before I give in and take some kind of laxative; my record for poopless-ness is one full month.

“But wouldn’t that kill you?” friends ask when I share this tidbit.

“I wish,” I usually say, three-quarters joking.

I spent that long month just hoping my body would somehow be pushed into repairing itself; since the poo had nowhere else to go, I hoped stuff would just kind of eventually be forced to, you know, come out. But it didn’t.

Courtesy of Courtney Enlow

These periods of extreme constipation consume me, both physically and mentally. My body feels uncomfortable, dense, crampy, and my brain becomes fixated. I try to mentally will my body to work, as though I was having an internal — very internal — dialogue with my intestinal waste: "Please. Please, poo. Please get out of me. And please get out of me before this meeting, or drinks with my friends. My pants don't fit. GO AWAY."

I become obsessed with pooping. But the more I obsess, the more my body seems to hold back, as though my bowels have stage fright.

Eventually, I give in and see a doctor; they usually prescribe a colonoscopy prep. If you’ve never had one, it involves an entire day spent torturing yourself by swallowing a strong dose of laxatives, followed by drinking a half gallon of liquid filled with poo-inducing compounds. The liquid is tasteless at first, but there is a chemical taste that grows stronger and more sickening the more you drink; I’ve done this six times in my life, and I’ve never made it through without vomiting. While the medication works fairly speedily, I’ve also never come away feeling like it truly did the job. I continue to feel, as it were, full of sh*t.

And on the occasion when a medication actually does work, pooping becomes my whole day. Knowing my bathroom experience will last, on average, 20 minutes (often with intermittent unplanned trips afterward), I have to plan my dosages around my schedule. If there’s a work day full of meetings, I have to skip taking medication until I get home. And if someone else comes into the shared restroom while I’m dealing with my broken body, I’ll hold it until they leave — even though my sense of intestinal urgency is often so light that if I don’t take advantage of it immediately, it fades, and the substance that was trying to burst forth retreats back into the inner reaches of my body. Where does it go? Who knows. (At this point, I imagine the entire inside of my body as the cave from The Descent.)

When I began purging, I thought bulimia would give me complete control over my body. But I now see that I was never in control. And today, because of that quest for control, I now have less control than ever.

"We’ve absorbed the idea that femininity means silently destroying our bodies."

Bulimia scratched an itch I didn’t anticipate. In high school, I suffered from general anxiety disorder and major depression — diagnoses I wouldn’t receive until well into my 20s. At the time, I simply experienced them as fear: fear of my friendships (most of which were fraught with classic high school toxicity); fear of being unattractive; fear of the future. I needed to feel like there was something in my life that I was completely in charge of. I came to thrive on the adrenaline rush of trying to finish the task of purging as quickly as possible, of knowing which foods to pick or how much liquid I needed to consume in order to throw up easily. And when laxatives joined the party, I felt a sense of unloading, as though I was emptying all of my pain and confusing feelings along with everything else in my body. I wasn’t just drawn to bulimia and laxatives because I wanted to be thinner; I felt a compulsive need to completely remove from my body anything but the parts it needed to run.

It is somewhat ironic, then, that I’ve never felt physically or emotionally emptied since.

The formal diagnosis I got for all of this is “irritable bowel syndrome with constipation” or IBS-C, which I’ve learned is not so much a condition but a catch-all term for “something wonky is happening to you in your butt region, but we don’t really know what.” I’m constantly trying different “elimination diets” to see if anything makes a difference — decreasing dairy, increasing protein, cutting gluten, lowering protein, increasing oil, cutting back on fat, eating more, eating less, and so on and so on. Doctors suggest things and prescribe other things, and finally order that hideous half-gallon of awful liquid, but never really seem like it's a big deal or anything to be worried about. The casual attitude I've gotten from doctors about this has always been about as emotional as if I was coming in with a mild cold. To them, this is, if not normal, then at least not something concerning. But for me, it’s this chronic reminder of what I did to myself.

It’s also a source of shame. On a particularly bathroom-centric night, I heard my 5-year-old asking my husband where I was; when he said, “She’s in the bathroom again,” the “again” sounded louder in my mind. On a busy work day, I stress that I’m making people wait for me, that they’ll notice I’m gone and will come looking for me. I feel the need to hurry so I’m not letting them down or drawing attention.

Courtesy of Courtney Enlow

As women, we already have this sadly ingrained sense of humiliation surrounding the wholly natural (for most of us, anyway) act of defecation. As University of Houston sociology professor Samantha Kwan noted in a 2013 Daily Beast article about female pooping anxieties, women are raised to believe that they must always be neat, clean, and pretty, and as such, “There is a lot of shame and anxiety when it comes to violating the rules.”

Many of us have trained ourselves to be stealthy and secretive about our bowels, to make this act as unobtrusive as possible, to never be heard, and leave no clue behind. We’ve absorbed the idea that femininity means silently destroying our bodies, in some universal act of invisibility.

I’m unafraid to talk about many things that society tells us are taboo, like mental illness — but talking about my intestinal struggles, and the eating disorder that led to them, is difficult. The unspoken societal rules that girls and women shouldn’t discuss bodily functions are deeply entrenched in me, and reinforced by my personal shame about this whole situation. The truth is that I’m not over my eating disorder, and I might never be. While my fixation on food and my body has dissipated over the years, it is still present, like a phantom pain. As embarrassing as it is to talk about my poo issues, it’s harder to talk about the fact that I have purged as recently as the last few months.

We're not supposed to discuss things like this. But over years of being honest about the ugliest parts of my life, the stuff we’re not supposed to discuss, I’ve learned that, for me, talking about it is the only real way to eliminate the pain.