The Link Between PTSD and Eating Disorders
Thursday, February 19 2015 Michele Rosenthal
Within five years of the start of my posttraumatic stress disorder (PTSD) symptoms I was deep into self-destructive food restrictions that caused me to drop an enormous amount of weight. My parents had tried to get me into therapy after my trauma but I flat out refused to discuss it. With the weight loss, they forced me to see eating disordered specialists, none of whom knew what to do with me. I wouldn't eat and I wouldn't talk. Back in the early 80s the clear connection between PTSD and eating disorders wasn't well documented or understood. Now it is and the data is clear: the link between PTSD and eating disorders is real and very common.
Eating Disorders As Coping Mechanisms for PTSD
I didn't consciously think about becoming anorexic. Rather, I began using anorexia (excessive food restriction) as a way to calm my PTSD anxiety: The more I controlled my body, the more I felt in control of what was happening to me, which reduced my fear that something bad would happen. This also tied into the distorted belief that the more stress I put on my body, the more likely it would be ready (i.e. trained like an athlete) to survive the next trauma.
I'm not unique in using an eating disorder to cope with PTSD. In fact, these statistics show how often eating disorders are linked to the PTSD experience:
- 66% of all eating disorder patients have trauma in their history.
- Research suggests that trauma alone is a strong predictor for eating disorder behavior.
- Studies confirm that PTSD itself is a risk factor for eating disorders.
Since founding the Heal My PTSD community and working with survivors on their recovery journey, I've met many who have also incorporated eating disorders as coping mechanisms for PTSD. In addition to anorexia, many practice bulimia (excessive overeating followed by depression, guilt shame and purging via vomiting or fasting) and binge eating (compulsive overeating enormous amounts of food while feeling powerless and unable to stop).
It makes sense that in a world that feels dangerous and out of control we turn to methods that allow us to feel safe and in control. That drive is often what fuels our desire for isolation, dropping activities we used to enjoy and withdrawal from relationships too.
Healing PTSD and Eating Disorders Together
In a presentation about eating disorders and trauma, Steven J. Karp, Medical Director at Rosewood Treatment Centers, suggests these ideas in crafting a healing strategy for PTSD and eating disorders together:
- Understand what causes and maintains the problem behaviors.
- Identify and implement evidence-based therapies.
- Recognize how eating disorder behaviors help facilitate PTSD symptoms.
In my own journey to wellness I found that the more I worked on trauma resolution, the more my PTSD symptoms reduced, the more my anorectic behavior reduced too. The more safe I felt in my body, the more I wanted to take care of it rather than diminish it. Slowly, I brought myself up to a healthy weight and continue to maintain it today.
A similar experience happened to another survivor I know, a woman with binge eating disorder. The more she addressed her past and made peace with it, the more her PTSD symptoms declined, the more she realized that those binges were driven by deeply unsettling emotional needs. With the gradual release of PTSD and a resolution of the emotions she found she was more able cope with the desire to binge: she started appropriately resisting it and then altogether releasing it by the time her PTSD recovery was complete. To date she has lost 60 of the 75 pounds she had gained.
February 22 - 28 is National Eating Disorders Awareness Week. If you think you or someone you know might be struggling with an eating disorder check out this eating disorder screening for direction and guidance.