There is the aura of suffering and reflection here, Ruthie -- but its most powerful message can be summed up one sentence. You are a survivor. This image is as powerful in its way as the images of holocaust survivors were in their way. Emaciation and pain are common denominators. But so is resolve. As Ray says, we share your pain, and you need to share it, as well.
Ruth - you have so effectively conveyed the power of the demons here. It compels the viewer to share the pain, although the spotlight is firmly on you. And I understand that need.
I also see this as part of an awareness campaign poster; thoughts I had on some previous work of yours.
I think I'll be coming back to this.
Take Care. ~V~