When Your Eating Disorder Isn't Your Only Worry
I caught myself thinking the other day, "I wish I JUST had an eating disorder" or "I wish I JUST had bipolar." Meaning, of course, that I wish I only had to deal with one of my many mental health diagnoses as opposed to dealing with them all at once.
How much easier would a major depressive episode be if I didn't have to worry about falling out of my weight range if I missed a meal or two and finding my brain completely overtaken by the dictator? How much easier would it be to recover from this eating disorder if I didn't simultaneously have to contend with periods of depression and hopelessness so profound that I can barely move from my bed.
I imagine it would be a lot easier.
Unfortunately, this isn't the way of the world. There have been plenty of studies done on psychiatric comorbidity in eating disorder patients. (Comorbidity is the term for a person having multiple diagnoses at the same time.) Some studies estimate the rate of comorbidity between eating disorders and other Axis I diagnoses (psychiatric diagnoses, excluding personality disorders) to be as high as 89%.
To put this into real figures, let's say that 10 million Americans (men, women, boys, and girls) have eating disorders. This means that almost 9 million of them are also suffering with anxiety, depression, bipolar, schizophrenia, substance abuse, etc. etc. etc. That's a lot of people suffering from eating disorders and something else.
It's not pleasant -- in fact, at times, it's downright miserable. It's frustrating. It's maddening, really. However, I have discovered that there are a few ways to make things a little easier.
Tips for Dealing with Eating Disorders Plus a Comorbid Diagnosis
- Take your medication: As prescribed, every day. This is non-negotiable.
- Eat enough: Follow your meal plan. Have others help hold you accountable if you're struggling. (Inviting yourself over for dinner usually works for me.)
- Avoid mind-altering substances such as alcohol and drugs: Your poor brain is working hard enough to stay on an even keel without your throwing something else in the mix.
- Be honest with your support team: Your friends, family, and treatment team can't possibly help you if they don't know what's going on.
- Know where your eating disorder and comorbid diagnosis intersect: For example, are you more likely to binge and purge when you're depressed or when you're manic? Are you more likely to overexercise if you're experiencing high anxiety? Knowing these things can help you to head them off before they result in behaviours.
- Do something nice for yourself at least weekly: It's doesn't have to be something "big" like a mani/pedi. (Though if you've got the financial means to do that weekly and enjoy it, by all means, do it!) Buy a nice bubble bath and soak with a good book or magazine. Treat yourself to a Starbucks latte. Take 20 minutes out of your week to go to the park and swing. It doesn't have to be expensive. It does have to be something you enjoy.
- Have a little grace: We're all going to slip once in a while. One of the silliest, most anti-productive things I've done in my recovery is to start beating myself up about slipping. "Oh, I skipped a meal, I'm relapsing, I'm disappointing so many people, I'm terrible!!!!!!!" That's not helping anything. Remind yourself that recovery is a process. Remind yourself that you did the best you could in that moment.
Then get back on track. Do the next right thing for your recovery.
(Photo credit to teenskepchick.org)
Hudgens, J. (2013, January 10). When Your Eating Disorder Isn't Your Only Worry, HealthyPlace. Retrieved on 2020, May 25 from https://www.healthyplace.com/blogs/survivinged/2013/01/when-your-eating-disorder-isnt-your-only-worry
Author: Jessica Hudgens
Struggling with self-isolation due to extremely low self-esteem, unsuing depression (or depression leading to "nobody wants to be around anyone depressed), inability to find therapists knowledgeable about treating eating disorder folk, possible bi-polar II (hey! I'm doing better than having bi-polar I, right?), and a try, try, TRY to be good to myself attitude, and lastly, constantly attempting to STOP spending money on "things" to undo how 'low' I feel about myself, are constant companions. I yearn to be without and/or deal with these successfully - and will never give up. With all of your posts, and this wonderful blog, I find a burning ray of sunshine and hope - Thank You All!
Be sure to check out our blogs about Depression, Bipolar, and Self-Esteem here on HealthyPlace as well -- they can be valuable resources to aid in your recovery! Finding knowledgeable professionals who work with eating disorders is definitely a battle many of us face in recovery. I'll be sure to do a blog on it soon, as I'm sure you're not the only one who could benefit from it! In the meantime, don't be afraid to contact me on Facebook (facebook.com/dancelittlejean) or Google+ (Jess Hudgens) and I'd love to help you look for resources in your area!
Best of luck!
While it seems you speak for the anorexic/bulimic side of eating disorders, the same (or the very opposite) advice holds true for people suffering from binge eating disorder (BED) and another/other psychiatric illnesses.
The good news is that keeping food stable will also help keep mood stable. Science now shows through new tools like PET and MRI brain scans the addiction-related organic changes that take place in the reward system and the prefrontal cortex. This occurs across all additions, from drugs and alcohol to the newly discovered food addiction. This new pioneering research is also helping us to appreciate a holistic and integrative approach to addiction. I was first senior research fellow in the NIH Office of Complementary Medicine. Using food addiction as template, THE HUNGER FIX addiction plan integrates personal empowerment, spirituality, along with whole food nutrition and restorative physical activity.
Hard as these three points of action can be when one is depressed, they are also part of the medication for the depression. Better living through your own chemistry!
Thank you for your input and especially the information about the new research you were involved in. It's true that I speak mainly from the anorexic/bulimic side of eating disorders, because that is what I personally have experience with. However, as you mentioned, keeping food stable certainly helps stabilize moods -- in people with anorexia, bulimia, or binge eating disorder, and that is exactly the point I was trying to make. Thank you for stating it somewhat clearer than I did!
So true. I love the part about having self compassion; so key.
Self compassion is so key to recovery, but so hard for those of us with perfectionistic tendencies, isn't it, Kerianne? Hope you're being compassionate to yourself today!
Keen! Love your blog!
I only have one diagnosis -- oh and "genertalized anxiety disorder" which is really like...who doesn't and also a fancy way of saying "she's also very hungry"
Missy, the "she's also very hungry" part made me laugh. But it's true that starvation will cause your body to be on high alert all the time and can make you more anxious in the long-run! Sometimes it's very difficult, especially with depression and anxiety to determine if they are actually caused by the eating disorder. In fact, some therapists won't diagnose either of those with any certainty until after you've been free of symptoms for a few months.
Ah, Jess, once again you nailed it. I was just thinking yesterday how much easier or would be if depression and anxiety didn't complicate recovery.
Dawn, thanks for your comment -- I'm glad this article resonated with someone else! Have you found anything to help you navigate the waters, so to speak? If so, I'd love to hear it! I am only one person and I'm sure there are plenty of other tips for how to deal with this that I've overlooked!