Bulimia – Comments People With Eating Disorders Don’t Need to Hear

I have personal experience of eating disorders, and have fought anorexia and bulimia since the age of 10. I have been hospitalized many times and I almost lost my life. I have also supported and continue to support several friends with eating disorders. I have lost three people to eating disorders.

Eating disorders are notoriously difficult to talk about and to treat. They can have a devastating effect on both the individual with the illness and all those who care for them. Maybe you’re someone with anorexia, bulimia or another disorder, and you feel like the people close to you keep saying all the wrong things. Maybe you’re a family member or friend of a person with an eating disorder and you’re struggling to know what to say.

Eating disorders can appear to change a person. A seriously distorted body image and/or a lack of nutrition affects the way people think and how they see themselves. People with eating disorders may appear emotionally (as well as physically) fragile. They may be extremely sensitive, particularly around issues relating to food, size and body weight. They are in many ways being controlled by the eating disorder which distorts thinking and may want to push the person away from anyone who cares about them.

Family and friends usually do want to help, but eating disorders do not make sense to them. Why on earth would someone not eat? Why would someone want to look so skinny and ill? Why is their body image so distorted? Don’t these people get hungry? Why is my loved one hurting themselves and everyone around them like this? Why is my loved one starving themselves to death?

Often people seem to not know what to say to someone with an eating disorder. So they either say nothing or completely the wrong thing, unintentionally causing distress to the person with the eating disorder. So let’s start with what not to say.

1. “But you don’t look ‘anorexic’ — it can’t be that bad.”

Nooo! Weight loss is just one aspect of anorexia. People who have bulimia or binge eating disorder may be at “normal” weight for their body type, or even overweight. Weight can fluctuate massively and quickly. Also, many people with an eating disorder hide under baggy clothes and layers. You probably don’t know what they weigh — and it’s not about weight anyway.

2. “It’s your own fault.”

It might appear that way, but the person is mentally unwell. The eating disorder is controlling their thoughts and behavior. They don’t want this to be happening to them either.

3. “Let me tell you about my diet…”

Yes, you may be on a diet, but now is not the time to mention it. Yes, some celebrity may look fantastic in her bikini, but don’t even go there — please. I’m looking for examples of how to have a good relationship with food. Healthy eating is OK, but please don’t label foods as “bad” or talk about losing weight in front of the person with the eating disorder. Unintentionally, this may cause further distorted thinking and damage.

4. “Oh, you look better since you’ve gained weight!”

I appreciate this is a difficult one. This is what you want to see and possibly want to say, but when you say this, a person with an eating disorder might hear, “I look like I’ve gained weight? Well I’m fat. I need to lose even more.” Also, it’s worth noting in both eating disorders and other mental health disorders, it can be unhelpful to simply comment on how the person “looks” as this can invalidate how unwell the person feels.

5. “Wow, you lost weight and you look amazing!”

You don’t know how they have lost the weight. Even if the person is recovered, it’s still a risk. Body image distortion and eating disorders tend to remain kicking around in the background even when recovered. Also, once again, the person is being judged on weight. This is not good. The words, “You look amazing,” are fine, but saying “You are amazing,” is even better.

6. “People around the world are starving, and you are doing this on purpose?”

Yes, there are people starving due to lack of food and that is tragic. But your loved one is starving due to severe mental illness. This is also tragic and not comparable. This sort of thing just makes people feel guilty.

7. “I don’t care anymore,” or “I can’t deal with you anymore.”

Now, I know it can be challenging loving someone with an eating disorder. I really do. But please, don’t walk away from your loved one. Remember they are unwell. They are not doing this on purpose. They need your love more than ever.

8. Nothing.

Don’t be tempted to say nothing. This will not fix it. Your loved one is seriously ill and that cannot be ignored. It’s absolutely fine to talk about other things too, but don’t try and pretend like it isn’t happening.

Say something. Say you are worried, Say you want to help. Ask what you can do and be prepared to listen. Do your research. Talk to the professionals. Don’t give up on them. With the right help and care, people can get better. They deserve to get better. You deserve your loved one back.

Most Important Things I Learned in Eating Disorder Recovery

As a therapist, I meet too many people who feel like a slave to their eating problem. Many wonder if a preoccupation with food and body image can ever really disappear. For me personally, after living through seven destructive years of bulimia nervosa, I feel fortunate to say I’ve felt free from the shackles of food and body image preoccupation for several years now. I haven’t purged since August 1998, which marked a massive turning point in recovery. However, it’s been a more gradual progression from this point to where I am now — completely recovered in body and mind.

I’m writing this to instill hope and promise in recovery.

I know every recovery story is different. What has helped me might not always work for you. But I hope you can glean the bits that make sense to you.

Here are 10 lessons I learned in recovery:

1. It’s important to have hope.

Except when I was at my absolute worst point, I never saw bulimia as something that was around to stay. I believed in a bigger and brighter future, I just had no idea how to get there. This inner drive and hope propelled me forward. I have no doubt looking back, although unwittingly at the time, how helpful this was when I began to pull myself out of bulimia.

2. I needed to be persistent about getting help.

I was ill in the 1990s when eating disorder support was somewhat limited, to say the least. Unless you had anorexia nervosa and required hospital admission, it was unlikely you would get any support. I went down a few blind alleys before actually managing to access the help I desperately needed. But the persistence did pay off.

3. It’s important to focus on personal development.

I’ve always been an avid self-help reader, particularly in my 20s when I was looking for guidance and role models to inspire me. Reading didn’t bring overnight change, but the drip, drip of positivity and hope was effective cumulatively. At the time I was often frustrated by my lack of progress in self-improvement, but looking back I see how every book I read was another mini-stepping stone to change. I’ve still internalized many of the messages from these books to this day.

4. I needed to let go of unrealistic expectations.

For me to sustain my low weight, I spent my whole day in complete food preoccupation, accompanied by a strong temptation to binge, which I regularly succumbed to. One of the biggest shifts in reducing bingeing and purging was allowing my body to be nourished and restoring my weight. This was a massive shift in body acceptance. Now after retaining a healthy weight for me, I can appreciate recovery is more than weight gain alone.

5. It was important to balance my blood sugar.

Eating enough protein and good fats regularly throughout the day helps manage my cravings and keep my blood sugar stable. I don’t stick exclusively to this (to avoid eating in an obsessive manner) but generally try to apply these principles to everyday life.

6. I needed to break down the diet mentality.

Although I eat mainly with blood sugar balancing in mind, I also do permit myself to eat anything and everything if I fancy it. I also aim to practice mindful eating. When foods are categorized as “good” and “bad,” this actually fuels the dieting mindset and can intensify bingeing.

7. It was important to confide in my good friends.

I haven’t always been able to be open with my family, but a few close friends have helped me through tremendously. Being able to access and accept the right support has been incredibly constructive in helping me move on.

8. Stability helped with recovery.

In my 20s, my life sometimes felt like a wild roller coaster full of ecstatic highs but also deathly lows. I lived on impulse and spontaneity which often left me confused and vulnerable. I had no boundaries. Regular work, a stable relationship and a secure home-life all contributed to help me feel more settled. I could then take steps to manage my eating.

9. I couldn’t be a people-pleaser.

Learning to say no and setting limits with others is an ongoing lesson for me. When I had bulimia I was that classic people-pleaser who would always say yes. Outwardly I was a positive, happy, coping person. Behind closed doors, the bulimia allowed an outlet for all my inbuilt frustrations and anger. Accepting my emotions, good and bad, and managing them more constructively was another significant point of progress in recovery.

10. I would only be content if I learned self-acceptance.

For many years I criticized and blamed myself for not being the person others had expected me to be. Overtime, I’ve learned to let go and embrace who I am, limitations and all. Only when I do this can I experience an inner-contentment, peace and joy with life. I still get frustrated and overwhelmed at times, as we all do, but no longer do I need to channel this into food or my body.

It’s all a work in progress. I know in terms of personal development I still have much to learn, but I can embrace and manage these difficulties more effectively. The important thing is that I don’t turn to food to cope.

Stay hopeful — you don’t have to do it alone. You might take a few wrong turns before you find it, but there is light at the end of the tunnel. Good luck on your journey.

Common Misconceptions About Eating Disorders Debunked

I was recently diagnosed with bulimia nervosa. Before this shocking diagnosis, I never knew what it was like to be someone who had a known disorder. I only recently found my voice and decided it was time to fight back against the awful stigma that surrounds eating disorders. Here are a few misconceptions about them.

1. “Those who have eating disorders are underweight.”

This is probably the most common one. Even my own parents thought someone had to be extremely underweight to have an eating disorder. The truth is that eating disorders come in all shapes and sizes. With diagnoses such as bulimia nervosa and atypical anorexia, the individuals are normally at a healthy weight, whereas people with binge eating disorder are either at a “normal” weight or overweight due to the binges.

2. “Eating disorders are all about food.”

While having an eating disorder causes an individual to have an unhealthy relationship with food, it is often more about the control or lack of control. For those who struggle with anorexia, bulimia or OSFED (other specified feeding and eating disorder), they engage in harmful behaviors such as purging and restriction to have a sense of control in their lives. However, with binge eating disorder, food is seen as a comfort. After a binge, however, the individual may feel a lack of control, shame and guilt. It is a vicious cycle, but it definitely does not have to do with food 100% of the time.

3. “Eating disorders are a choice.”

Eating disorders are far from being a choice. In my case, I started using disordered eating behaviors as a sense of control due to being in an abusive relationship. Food was the one thing I could control in my life. Eating disorders can be caused by certain personality traits such as perfectionism. They can also be caused by trauma, biological factors and genetics. No one ever wishes for an eating disorder. It should not be seen as a fad or be glorified in any way. They are destructive and will kill you if not treated.

4. “Anorexia is the only eating disorder that can cause complications.”

This is a big one which I always hear. Before being educated on the different eating disorder behaviors and how they can affect you, I thought this same thing. I didn’t think purging could be dangerous. Turns out, bulimia and OSFED have mortality rates that are similarly high when compared to anorexia. When someone purges, it can throw off the electrolytes in your body. Your sodium and potassium levels will drop and that can be deadly. With binging, weight gain can cause problems with your heart and cholesterol and be just as deadly as anorexia, OSFED and bulimia.

5. “You can recover from an eating disorder by just eating.”

While regaining positive eating habits is a big part of recovery, there are so many more parts. As someone who struggles with an eating disorder, I have learned that therapy is a big part of recovery as well. In therapy, you will learn how to cope with the thoughts “Ed” — your eating disorder — throws at you. He (”Ed”) will tell an individual they are fat, worthless and weak if they eat. Those thoughts are false. Through therapy, an individual struggling with an eating disorder will learn about those lies and learn techniques to get through meals with that little voice in the back of their mind. Be patient with your friend or loved one. They really are trying their hardest.

Being in eating disorder recovery has been the hardest part of my mental health journey so far. I have learned how to debunk those misconceptions in such a short amount of time. Eating disorders are complex and deadly. It is important that we, as a community, and society get educated so we can better help each other. For those of you struggling with an eating disorder, you are all so, so strong. You can beat this! All it takes is one day at a time.

‘Harmless’ Comments That Actually Hurt People With Eating Disorders

If you live with an eating disorder, you might be familiar with some of the seemingly “harmless” but incredibly hurtful things people can say to those struggling with them.

Sometimes these “harmless” comments come in the form of a question. (Why can’t you just eat?) Sometimes they come with a “solution” via personal anecdote. (You should try this new diet. It really helped me stop overeating!) Most often, they come from a place of misunderstanding eating disorders and mental health struggles in general. And even though these “harmless” comments may come from a good place, they can often invalidate the struggles of someone living with an eating disorder.

When someone with an eating disorder opens up about their struggles, oftentimes they aren’t looking for your “solution,” “advice,” opinions, dieting tips, etc. — they may just be looking for someone to listen and be there.

It’s important to remember what may seem “harmless” to one person may actually be hurtful to another. It doesn’t matter if you are struggling with binge eating disorder, bulimia, anorexia or any other eating disorder — your feelings are valid, and you deserve support.

Please be advised that the following comments could potentially be triggering if you live with an eating disorder.

Here’s what people shared with me:

1. “You’re too smart to starve yourself.”
   “‘What’s a smart girl like you doing starving herself? You know better than that…’”
2. “You don’t look like you have an eating disorder.”
   “A doctor looked me up and down then said, ‘well you don’t look malnourished.’”

“‘You don’t look like you have an eating disorder. Your hair is long, your skin is clear, your teeth are white and your weight is normal.’ This was after I told my doctor about my 11-year relationship with bulimia.”

“After opening up to a friend about my ED — ‘But you look fine.’ Part of me feels like I only deserve help with this problem if I ‘look the part.’ If I look ‘sick.’ It just makes me want to do even more damage to my body so I can finally be ‘worthy’ of help.”

3. “Don’t you know there are people starving in the world?”
   “’It’s disrespectful to throw up food like that, there are millions of starving people out there.’ I’m so sorry that I am so disgusted with myself that I vomit when I consume food. My body image nauseates me. I’ve had an eating disorder for years, and someone who hasn’t will never understand.”
4. “You look healthy.”
   “’You look good’ or ‘You look healthy…’ I’m a little over a year into recovery and I think these comments are meant to be complimentary, but all I hear is ‘You look good — even though you gained weight.’ I just wish people would refrain from any sort of comments on physical appearance in general.”

“’You’re looking so much better.’ I remember the first time I heard that when I took my first proper stab at recovery. It hurt more than I could possibly say.”

5. “You would be a knockout if you lost weight.”
   “’You would be a knockout if you lost weight with your beautiful face and figure.’ I cried. I hated my body so bad I developed eating disorders. Hearing this brought back self-hate and I fell into old patterns.”
6. “If you’re fat, then what am I? A whale?”
   “’If you’re fat, then what am I? A whale?’ or ‘If you’re fat, I must be obese.’ Sorry, but my disorder is based upon the perception of myself, not you. I don’t mean to upset you with my disordered thoughts.”
7. “You ate that so quickly!”
   “’Damn you finished that already?’ I heard that all my life, and I count my chews to ensure I’m eating slowly, I’ll hesitate on my bites as well, and still all I hear is: ‘You ate that quick.’ ‘You must’ve really liked that.’ ‘Oh damn, you tore that plate up.’”
8. “Have you prayed about it?”
   “’Have you tried praying about it?’ I am a strong believer, but it came from someone seemingly telling me to pray it away and they kept saying this over and over. Yes, I have tried praying about it.”
9. “I’m so jealous of how skinny you are.”
   “I will never forget my best friend at the time saying to me, ‘God, I’m so jealous of you, you’re so thin.’ This was a week before I went inpatient for treatment. She knew where I was going and why.”
10. “You need more willpower.”
    “I have binge eating disorder (BED) and the thing that hits me hard is people saying you have or need ‘willpower.’ Bingeing issues have nothing to do with willpower or [being] lazy — it is about emotions.”
11. “You need to focus on the positive.”
    “’You should be happy because [insert good thing] happened this week.’ Ummmm just because something positive happens in my life doesn’t mean all my other problems suddenly disappear. It makes me feel guilty and like an ungrateful child.”
12. “It’s good to see you gain weight.”
    “When I got out of treatment, ‘Wow you really have gained a lot of weight.’ This triggered my relapse two days later of getting to my home town after three months in treatment 10 hours away in airplane… I wish people were more empathetic and just took one minute to think before they say anything.”
13. “Have you lost weight? You look good!”
    “’You’ve lost weight! You are looking so good.’ You can’t tell someone has an eating disorder by looking at them. When I was losing weight, everyone thought it was a good thing because weight loss is so celebrated in our culture. It was invalidating to how much I was hurting. It was like I was being praised for suffering.”
14. “You’re lucky. I wish I didn’t want to eat.”
    “’I wish I had that problem.’ [I heard this] when I told my boss I couldn’t make myself eat more than a small snack a day. I don’t want to be like this. I want to have ‘healthy’ eating habits, but I feel physically sick if I eat much now. You have no idea how hard it is to hear that when I’m sick and have to force myself to eat.”

“’You must be so lucky not to want to eat.’”

15. “You just need to eat.”
    “’You don’t have an eating disorder, you just need to eat.’ Advice from a person a considered to be one of my best friends at the time when I finally got up the courage to tell her about my bulimia. Took me another six months after that to seek professional help.”
16. “Are you sure you have an eating disorder?”
    “’Wow, you sure ate a lot this weekend. Are you sure you have an eating disorder?’ [I was] crazy triggered to restrict for a long time after that.”
17. “A lot of people skip meals.”
    “’A lot of people skip meals.’ It made me feel as though my behavior was ‘normal’ and I continued to restrict what I was eating.”
18. “I’ve been so busy I haven’t eaten all day.”
    “’I’ve been so busy I haven’t eaten all day.’ I notice quite a few people say this and I’m not sure why it strikes a nerve. Maybe it’s the subtle ‘glorification of busy’ in addition to the self-comparisons that follow.”
19. “Make sure you don’t slide the other way.”
    “’Make sure you don’t slide the other way again and become overweight like you used to be.’ This hit me right where it hurts because nobody should have to hear that from their own family. I can deal with those comments a lot better now, but it was still incredibly insensitive to my feelings to say that.”
20. “It’s all in your head.”
    “’It’s all in your head.’ It’s more than that. It’s all I think about. Am I eating too much? Should I eat this? Am I eating too fast or too slow? It’s an obsession and it’s so hard and so many people just don’t understand and don’t care to try to understand.”

Mental Health Risks and Warning Signs to Recognize When You’re Starting College

Now that fall is in full swing, many teens have flown the coop in pursuit of what will hopefully be some of the best four (or five) years of their lives. While the idea of college for many young adults includes newfound freedom, football games, frat parties, (and oh yeah, those pesky classes), many teens have yet to discover the reality of the stress that comes along with it.

While the aforementioned is part of the college experience for many, it also comes with less structure, a demanding workload and comparison to peers. Because of this, college can often be a perfect breeding ground for mental health issues. According to the American Psychological Association, over one-third of first-year college students are impacted. Mental health issues can take many forms, but they commonly include depression, anxiety, eating disorders and addiction. It is important to recognize the risks and warning signs, and familiarize yourself with the resources available before it’s too late.

1. Depression

Many new college students have moved away from home for the very first time in their lives. Missing friends and family back home, late nights studying and adjusting to a new lifestyle can be challenging and stressful. So, how can students tell the difference between typical college stress, and something more serious? Recognizing signs of depression can be tricky. It is common to have days where you feel “off” or overwhelmed with life. However, when these days occur more frequently, and daily tasks or even getting out of bed becomes a struggle, this is cause for concern. Here are a few signs that might indicate depression is present:

Persistent feelings of sadness
Feelings of hopelessness
Lack of interest in things once enjoyed
Changes in appetite
Guilt
Difficulty concentrating
Feeling tired or having little energy
Thoughts of hurting oneself
Isolation
Mood swings

2. Anxiety

It goes without saying that college isn’t exactly a breeze. Whether it be meeting new people or realizing that classes are probably going to be tougher than they were in high school, many students will notice themselves experiencing some sort of anxiety. It is important to note that a certain amount of anxiety is OK, and can even be helpful. If you weren’t at least a little anxious about your anatomy final, you wouldn’t feel the need to pull an all-nighter studying. However, it is important to recognize when the appropriate amount of anxiety is escalating into something more harmful. While every person experiences anxiety in their own way, here are some general symptoms that might indicate help is needed:

Trouble concentrating
Sweating
Stomach aches
Insomnia
Shortness of breath
Irrational fears
Ruminating thoughts
Stomach issues

3. Eating disorders

There is no doubt college life is hectic. Due to this, it can be easy to skip the occasional meal or mindlessly consume half of a pizza during a late-night study session. But what differentiates erratic eating patterns from an eating disorder? A question I frequently ask my clients as it relates to food and behaviors is, “What are your underlying motivations?” Let’s use the “skip the occasional meal” scenario from above. A person with normalized, non-disordered eating patterns might occasionally become so wrapped up in what they are doing that something like missing a meal is an honest oversight. (What? I’ve been gazing at my crush from across the library— er, I mean studying for three hours — and missed lunch?) Once this person realizes they skipped a meal and recognizes they are hungry, they often head off to the food court or dining hall to grab something to eat. However, a person with an eating disorder might use studying at the library as an excuse to avoid eating. This can be due to a host of underlying issues, and rarely is it about the food.

Eating disorders are extremely unhealthy and sometimes life-threatening coping skills. Research on the causes of eating disorders is constantly evolving, and we continue to gain more insight as to what the risk factors are which may contribute to the illness. Many of the reasons are multifaceted, and are the product of biopsychosocial factors that differ from person to person. Several major risk factors for eating disorders include: genetics, temperament, biology, trauma, lack of positive coping skills, sociocultural ideals and dieting.

Eating disorders can take on many forms, and a variety of types exist. With that being said, I will only touch on the three most common disorders and their characteristics.

Anorexia Nervosa

There are two common types of anorexia. They include binge/purge type and restrictive. Though two classifications of this eating disorder exist, both types exhibit similar symptoms, such as abnormal eating patterns and an irrational fear of gaining weight. Other common symptoms include:

Chronic restrictive eating or dieting
Dramatic weight loss
Dressing in layers to hide weight loss or to stay warm
Amenorrhea, or abnormal absence of menstruation
Depression or lethargy
Body image struggles
Ritualistic eating patterns
Lanugo, or a fine soft hair covering the body.
Preoccupation with weight, food, nutrition info and dieting
Dry hair
Distorted body image
Compulsive exercise
Bulimia Nervosa

Bulimia is characterized by binging — consuming a large quantity of food in a short period of time — and then purging. During a binge, a person often feels a lack of control over eating during the episode (i.e., feelings that one cannot stop eating or control how much one eats). This is often followed by engaging in compensatory behaviors in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, fasting or compulsive exercise. Common warning signs or symptoms include:

Preoccupation with weight
Food rituals
Extreme weight fluctuations
Swelling of cheeks or jaws
Excessive or rigid exercise patterns
Wearing baggy clothes
Repeated episodes of eating abnormally large amounts of food in one sitting
Evidence of purging behaviors, including frequent trips to the bathroom after meals, signs of vomiting, presence of laxatives or diuretics.
Calluses on the back of hands from self-induced vomiting
Binge eating disorder

Binge eating disorder is characterized by the repeated inability to control the consumption of large amounts of food at one time, often followed by feelings of guilt, shame and remorse. Signs and symptoms of binge eating disorder include:

Eating unusually large amounts of food in a specific amount of time, such as over a two-hour period
Frequently dieting
Eating even when you are full or not hungry
Eating rapidly
Eating to the point of discomfort
Eating alone or in secret
Unlike a person with bulimia, after a binge, one doesn’t typically compensate for extra calories eaten. A person may attempt to diet or eat regular meals, but restricting often leads to more binges. Causes of the disorder are unknown, but genetics, biological factors, history of dieting and psychological issues increase your risk.

4. Addiction

College is often a time for experimentation. The temptation to do drugs is strong because college students often feel like it makes socializing easier or helps them study harder. Of course, not all college students start abusing drugs or binge drinking right from the start, but regular use of these substances can lead many down the road to addiction. And while the type of drug a student may abuse can differ, the most consistent are alcohol, marijuana, hallucinogens and prescription pills.

College students turn to drugs for a variety of reasons. These can include academic or peer pressure, relieving stress and as an escape from their problems. In many cases, people are exposed to illicit substances in college for the first time. Students succumb to the pressure so they aren’t seen as the “odd one out.”

Signs and symptoms of addiction can vary based on the drug, but common signs and symptoms include:

Dilated pupils, red eyes
Loss of interest in activities once enjoyed
Mood swings
Reckless behavior
Drop in grades
Shift in sleeping patterns
Irritability
Financial problems
Resources

While admitting you are struggling can be difficult, it is important to know you are not alone. Tens of thousands of college students struggle with mental health issues, and the sooner you seek help, the sooner you can begin your recovery. There are a number of accommodations available, and often don’t require you to look much further than your college campus. Many colleges have health and counseling centers with services such as individual and group counseling, medication management and urgent care.

Groups such as the National Alliance on Mental Illness (NAMI) maintain campus clubs at hundreds of colleges throughout the country and provides an array of services. In addition to offering a space where students with mental health issues can meet, the group also strives to reduce the stigma associated with mental illness. This is done by bringing mental health awareness to campuses and educating faculty, staff and students.

If your college isn’t able to provide resources to students, or you just feel uncomfortable utilizing on-campus support, there are online, phone and usually local resources available to fit your needs. Your college’s health and counseling center can help you find local resources, as can a simple Google search. With more focus than ever on mental health, help is always available. You just need to be proactive about seeking it.

Mental health challenges can be difficult to tackle, but recognizing you need help is the first step. Shame and guilt may cause you to be apprehensive about beginning your journey toward recovery, for we have spent years believing mental illness is a sign of weakness, and something we should be able to just “get over.” However, in a society where we have so many pressures and demands put on us, particularly during our college years, it is truly a sign of strength to take the time to take care of yourself. Remember, you are worth it.

New Study About Eating Disorder Genetics

Researchers are launching a new study aimed at finding the genetic factors that contribute to developing an eating disorder in hopes of saving lives. The study, Eating Disorders Genetics Initiative (EDGI), is seeking more than 6,000 participants over the age of 18 who had an eating disorder at some point in their lives. A previous study called ANGI looked at genetic characteristics of patients with anorexia nervosa, but this new research will expand its efforts to include and explore the physiological factors of bulimia nervosa and binge-eating disorders.

The University of North Carolina is conducting the study and will be taking saliva samples from qualifying participants to break down their genetic makeup and identify differences in their genome that could make them more vulnerable to developing an eating disorder. Lead researcher and professor Dr. Cynthia Bulik explained that not only will they attempt to look at why some are more likely to have these conditions but try to decipher why some patients are more likely to have a hard time recovering, and why some eventually die from an eating disorder.

“The goal is to get the genetic information to help us answer some of these fundamental, critical questions about the underlying biology of these illnesses,” Bulik said.

But identifying the biological markers of mental illnesses like eating disorders could save lives by helping squash the stigma, she said. Eating disorders are often perceived as quests for weight loss that get out of control, but Dr. Bulik says that couldn’t be farther from the truth. “No one chooses to have this illness.”

Maris Degener, 22, has faced her own struggle with anorexia, and now shares her story as a blogger and yoga instructor. Her illness began with anxiety that escalated to panic attacks, purging and self-harm. After a doctor’s visit, she realized she had also been starving herself and was later formally diagnosed with anorexia. She was 14.

“The eating disorder demanded highly specific kinds and quantities of food and exercise, so my days were shaped around meeting these demands. Yet even when I fulfilled the eating disorder’s requirements, it was never satisfied. There was always something I didn’t take to a far enough extreme. There was always some way that I had ‘failed’. The more I restricted and purged, the less satisfied I was with my body, my self-image and my life,” said Maris.

Maris found hope in practicing yoga and the support she found within the community. But the struggle she’s faced to get better makes her an advocate for the study — an advocate for answers.

“Learning more about the genes involved in the development of eating disorders should open the door to more effective prevention, diagnosis and treatment, while hopefully challenging common misconceptions of the illnesses,” she said.

Treatment, lead researcher Bulik said, is so limited for people with eating disorders. According to Bulik, only about 30% of people with anorexia nervosa make a full recovery. There is only one FDA-approved medication for people with bulimia nervosa, one for binge-eating disorder and zero for anorexia nervosa.

“Part of the reason we don’t have those medications is because up until now we haven’t understood the biology,” Bulik said. “That’s the path that this research is taking us in.”

If you are interested in taking part in the study, you can visit EDGI.org and fill out the questionnaire. Participants who are chosen will provide a saliva sample via a mail-in “spit kit” that is prepaid.

Things I Want Parents of Someone Struggling With an Eating Disorder to Know

You might be concerned, scared or desperate after witnessing certain behaviors exhibited by your loved one. It could be something like avoiding dinner, hiding food, eating large amounts of food in secret or frequenting the bathroom after meals. At first, this may have seemed innocuous, but now it has become a bigger problem and you might not know how to help. I am not a parent, but I have heard from my mom and dad about their experience with my 11 year battle with anorexia and bulimia. And I want to share my experience with eating disorders and the things my parents wished they had known during the darkest years of my life.

1. You are not to blame for you loved one’s disorder.

My mom dreaded any family therapy session because she was worried she would be blamed for all my issues. She felt like my eating disorder meant she had failed as a parent. My mom and dad are not only amazing parents, but are also incredible people. They were far from perfect, but they did their best raising me and helping me the best way they knew how at the time. Sometimes, they did things that were not helpful and more hurtful. They had their own struggles because we are human and every one of us has the capacity for failure.

In those family therapy sessions, we were able to dive into unhealthy patterns that surrounded our family dynamic. When you are living each day a certain way and pick up certain habits, it becomes difficult to distinguish if that behavior is harmful. The family becomes accustomed to handling situations in this way as a unit. With my eating disorders, we all discovered ways each of us were contributing to unhealthy patterns, and with the help of a therapist, we learned how to better communicate our feelings and needs in a way that helped us grow in a positive direction.

While my parents did certain things that were hurtful and contributed to an environment that enabled my eating disorders to flourish, they were not to blame for my eating disorders. For me, it was a culmination of various factors that created the perfect storm for my eating disorders to emerge and take a vicious hold on my life.

During this time, it is important to speak with love, listen with an open heart, and have a willingness to accept responsibility for actions that may not have been so helpful. You are human, and you are doing the best you can. Blaming yourself is not going to be helpful or healing for you, your family or your loved one.

2. Recovery is a marathon filled with ups, downs, constantly conflicting emotions and difficult decisions.

My parents fought for me when I refused to fight for myself. When I was 11, I was severely struggling with anorexia. I was entirely consumed with the exhaustion of fighting two sides: the side of me that was terrified, scared, and knew what was happening needed to stop, and the side of my eating disorder that promised happiness and healing from all the intense pain I was experiencing in my life. I was caught in the crosshairs of confusion, and I felt trapped in the very box that I knew would become my grave if I did not find a way out. I was losing air and my eating disorder was suffocating me. My parents opened the box and ran with everything they had to pull me out of the battle I was trapped in. My parents saved my life by making one of the most difficult decisions a parent can make for their child; they would not let me stay alone in my eating disorder, and they placed me in a hospital to bring me back to some sort of stability.

I would be lying if I said I did not hate my parents during that time. I was in a strange state of relief, confusion, and the intense desire to hang on to the very thing that was killing me. I felt like my parents had given up on me, when in reality, they did the only thing they knew they could do to help me. Deep inside, I knew my eating disorders were not only hurting myself, but they were hurting my family as well. Eventually, my anger subsided and turned into the most immense gratitude because I would not be alive today if my parents did not make the choices they did to try to help me. My parents did for me what I could not do for myself at the time. They were strong for me when I had no strength left inside. My parents gave me every opportunity to choose a happy, fulfilled life, with the hope that one day, I would be free from the disorders that threatened to take everything from me. My parents are my heroes.

When I was in therapy for bulimia, I had gone a long period of time without binging or purging, until one night, I was caught off guard and I engaged in the same behaviors that once helped me cope. I talked about it with my therapist and she asked if it felt different that time. I replied “yes.” My therapist explained how I had a taste of what recovery was like, and that my eating disorders would not be the same “release” as they once were. Anytime I engaged in previous behaviors, it no longer helped me in the same way my new healthier coping strategies do.

If your loved one is showing you nothing but anger and contempt, please know with each day of recovery, that it will not last forever. I say this as someone who had absolutely no desire for recovery, someone who planned how I would execute going back to anorexia after I served my time in the hospital program. That desire faded as time passed and I worked through the pain I needed to address.

It may take a long time, for me it was years, but the healing gradually came. Remember that your loved one is not their eating disorder. I found clarity once I went through the process of separating my voice from my eating disorder’s voice. My anger then shifted from my parents to my eating disorder.

3. Remember that an eating disorder is an external symptom of deeper underlying pain.

It can be incredibly easy to focus on what you see in front of you. My parents focused so much on my external behaviors that they did not stop to ask me what was going on internally. My parents wish they had known this during my recovery and relapses. When I came home from the hospital, my mom monitored all of my actions, without ever checking in with my emotions.

She thought the best way to help me was to take over every action for me. If I wanted to go grocery shopping, she went without me. This made it more difficult for me to adjust in a world that does not adjust to those who have eating disorders. She believed shielding me from any temptation was the best way to help, and she did this without stopping to ask what I thought would be the most helpful for me. I needed someone to ask me what I was feeling inside. I needed there to be a greater focus on what was happening internally rather than externally.

If you see your loved one sliding back or engaging in behaviors again, look at it as a sign that something is happening for them emotionally. Take the focus and pressure off of the external and show them you care about more than their actions. There were many times I did not want to tell my parents what was going on inside, but it meant the world to me and showed me that they cared about me when they did ask. This is not to say that you can’t confront your loved one if their behaviors are concerning, but make sure the focus is about how they are doing emotionally.

4. Remember to practice self-care.

During my eating disorders, my struggles became the focal point of our family. My family bent over backwards trying to do everything to help me. This felt suffocating, even though I knew it was out of desperation to make sure they did not lose me.

As children, we learn how to cope with difficult situations from our parents. I never knew what self-care was until my therapist gave me homework to make a self-care box to use whenever my emotions were overwhelming. My family spent so much energy caring for me that they stopped taking care of themselves. This only added stress to an already stressful dynamic.

What I wish my parents knew, was that it might have been healthier for me to see them taking care of themselves. They would have been a model to show me how to care for myself in a healthy way, and espouse the importance of making ourselves and our needs a priority. Since I have been able to have honest discussions with my parents about why I need to see them taking care of themselves, our relationship has become so much healthier and stronger. Self-care is not selfish. It is a necessity. Your needs are just as important during this time. Take the time that you need for you.

Recovery is a difficult choice to choose in the midst of battling an eating disorder. Many days, my eating disorder won. But it was empowering when my family celebrated the small battles I won. I can’t guarantee a full recovery for your loved one. Eating disorders are tricky and can emerge in the most unsuspecting ways. It is one of the most horrible truths about these illnesses. The best thing you can do is be supportive and loving during the battles those of us who struggle with eating disorders are facing. Celebrate health and love.

I know now, more than ever, that life is short, it is precious, and being present for the joys in life will carry us farther than we can imagine through difficult times.

I hope this is helpful and can open up a discussion between you and your loved one.

I’m rooting for you.

Travel Has Shaped My Eating Disorder Recovery

(From You) As we approach the first summer in five years that my feet may not stray from the pathways that have become my mundane, I question what it is to travel with an eating disorder.

For this writing, I approach travel as the voluntary act of temporarily being within, outside of and between any given space or place. I travel from a degree of privilege, of freewill and of leisure.

Wherever I travel, my eating disorder is there with me.

This is a realization full of irony, as for years I looked to travel as an escape from bulimia, the troubles that led me to it and the troubles it led me to. It is no mystery that an eating disorder is one ecosystem you can’t run away from by hopping on a plane, but that was a sobering reality I had to learn.

Yet, travel has still always been a break from life, an escape to Neverland and an open invitation to all you didn’t know you needed and for which your soul has always yearned.

For years, the promise of adventure is what got me through a lot of the times I wasn’t traveling, when I was in the pits on an undiagnosed eating disorder, in the torment of accepting a diagnosis and in the relentlessness that is illness and recovery. The promise of the bubble of travel has been, at times, the flavor or life I needed to continue to hold on to my will to live. The life I can see in the eyes of others and feel in myself on holiday, exchange and seasonal work, is what I fight for whenever the mental health struggles take me to the states of mind where there seems to only be defeat and darkness.

It is for this reason, that I have appeared to from the outside perspective put vacations as a priority before my health. I have taken months away from the much-stressed structured life and routine that some health care professions swear by as one of the fundamental to eating disorder recovery for living out of a bag, long days and sharing bedrooms, bathrooms and kitchens with strangers. I have left behind my primary health care providers for months of self-management and the odd page of a self-help book.

In the lands of the gap-years, this is not a particularly hard time for the backpacker, but for the person with an eating disorder, being around other people, other foods and other schedules can be difficult.

I have been on 17-hour trains needing to be sick, on seven-hour flights and 11-hour bus rides. I have eaten four different meals at three different food joints in an airport in less than hour while waiting for a flight. I have gone days eating only oatmeal as it was the only food I felt safe eating. Watched my weight drop, seen my weight build, changed outfits four times a day and avoided being seen in as little as a bikini for nearly an entire summer.

Getting dressed up for a special event has brought me to floods of tears. I have stood, twisted and pinched at my body before breakfast and the rest of the day thereafter.

But these are all things that I would engage with whether I was traveling or not.

Then there are times I ate a whole meal on a plane including cake without any complications. I have achieved some of my greatest accomplishments so far in recovery during times of travel. Most recently, I learned the importance of the role my surroundings have during meal and snack times in whether I am able to cope in this situation. Sometimes, I nearly almost enjoy eating if I choose carefully where I eat!

Traveling, despite my eating disorder, has been paramount in changing my belief that I was the illness to being someone who happened to have an illness.

Traveling introduced me to new people, cultures and support systems. From travel, those who I have met and become friends with during this process of freedom, I am learning the art of acceptance, the joy of change and the values that really create a home.

With travel I am learning to negotiate my recovery, my life, through a life I want for myself.

Without travel, for myself, I do not see recovery from my mental illness, as I do not see the development of skills such as being proactive with my own health, monitoring my own health and learning to uphold my health through many situations life will throw at me. I have become more resilient, more capable and more determined as an individual and especially as someone dealing with ill health and recovery.

Travel has allowed me to explore myself as much as the world as something distinctive from bulimia and has encouraged me to both be who I am, but to also keep on fighting for who I can be.

What Makes Anorexia Recovery Different

At this point in my eating disorder recovery, I often find myself consulting a friend who has been sober for five years. She gets it. She’s experienced addiction. It tore her life apart. She worked hard, and now, she is on the other side. Her insights have been invaluable, and I owe her more recognition than words.

As a special educator, I study human behavior at length. The cyclical patterns of behavior present in anorexia have been a long-standing interest of mine. It’s exciting to see research is beginning to focus on new methods to change the thought patterns and behaviors of individuals living with anorexia.

Psychology Today defines an addiction as a condition that results when a person ingests a substance or engages in an activity that can be pleasurable, but the continued use or act (of the substance or activity) becomes compulsive and interferes with ordinary life responsibilities. While anorexia is not clinically recognized as an addictive disorder, one could argue the symptomology and the level of impairment of people with anorexia equate to a clinically significant obsession or addiction.

The behavioral change process is a growing phenomenon in our society. A common misconception is all behavior change is aimed at decreasing or eliminating a behavior. Cutting out foods, spending less money and reducing bad habits are all examples of decreasing behaviors. Unsurprisingly, the behaviors of people with addictions, alcoholism and bulimia all fall into this category. With each of these addictions, one must eliminate or reduce a targeted behavior.

This is what separates anorexia recovery from recovery of similar illnesses. For individuals with anorexia, rather than focus on the elimination of a behavior, an individual must significantly increase his or her energy. This not only includes consuming a greater quantity, but also a larger variety of foods and nutrients. Herein lies the dichotomy of this mental illness. No other addiction-based illness requires an individual to actively increase a single aversive behavior.

One could argue individuals with anxiety and depressive disorders must engage in non-preferred behaviors to manage their illnesses, too. For example, someone with depression may need to increase his amount of time out of bed, while someone with an anxiety disorder must increase her socialization. While these disorders require the individuals affected to engage in new behaviors, symptomologies associated with these disorders present in various ways with no single solution. No other mental illness requires those in recovery to increase a single, specific behavior without alternative options.

So, what does all this mean? Why does this matter? The treatment of anorexia is different. Individuals impacted must constantly come in contact with their addiction every day. While people recovering from alcoholism, drug use and bulimia can go “cold-turkey” and avoid their addiction, someone with anorexia must actively engage in a non-preferred behavior to cure their illness. This is not to say treating anorexia is easier or more challenging than treating substance abuse or other mental illnesses. It is just different.

In my opinion, this makes anorexia recovery exhausting. Every day, several times a day, I must make an active choice to eat. I must engage in a behavior I despise. I cannot avoid my fear or numb it; I must face it head on. I must learn to tolerate and then accept eating meals and gaining weight.

While it can become easier, the demand never fully goes away. This is an unbelievably terrifying realization. There are no days off or breaks. There is no finish line. I must continue to eat three meals a day for the rest of my life. In these moments when doubt and uncertainty creep in, I look to my sober friend and think: If you can eliminate liquor completely, I can choose to keep eating completely, too.

Things You Should Never Assume About People With Eating Disorders

1. You are visibly ill.

You don’t have to look sick in order to actually be sick. When people hear you have an eating disorder, their initial thought is usually, “Huh, well you don’t look like you have one,” or “You look healthy to me.” What they don’t understand is that it’s not all physical when it comes to an eating disorder. A large majority of an eating disorder takes place in the brain. An unseen battle takes place in the mind.

2. If you just simply eat, then it will all get better.

Simple enough, right? If you just stop and eat this bagel, then things will start to get substantially better for you. Wrong. Eating disorders go much deeper than food. Eating disorders take hold of a person’s way of thinking, and it becomes a lot more complicated than just simply eating.

3. There are only two types of eating disorders.

Once someone finds out you have an eating disorder, they feel like they need to place you in a category of which eating disorder you have. However, what they don’t realize is no eating disorder is the same for every person. Each individual has their own rules and own mindset when it comes to their disorder. Although, there are four common types of eating disorders: anorexia, bulimia, binge eating and EDNOS (Eating Disorder Not Otherwise Specified). It’s common for anorexia and bulimia to be the first that come to a person’s mind.

4. People with eating disorders are vain.

Vanity and eating disorders couldn’t have less in common if they tried. Someone who’s vain thinks highly of themselves. They carry a high self-esteem. Whereas, someone who is struggling with an eating disorder more often than not has an extremely, low self-esteem and can never see themselves as good enough in any aspect of their life.

5. Eating disorders are a choice.

Eating disorders aren’t a choice. Genetics and environmental factors play a huge role in development. About 50 percent of risk in developing a mental illness is due to genetics and or biological factors. The rest can be situational, trauma and/or societal factors. Some people are more susceptible than others.

Tips for Parenting Teens With Eating Disorders During Thanksgiving

Parenting is never an easy job, especially during the holiday season. Unfortunately, this job becomes even more complicated as our kids grow into teenagers.

As many parents know all too well, though, more teens than ever live with mental health conditions, and many teens struggle with some form of eating disorder such as anorexia, ARFID, binge eating disorder, and bulimia. These specific diagnoses are no walk in the park anytime, but they can be especially difficult to deal with during holidays that seem to focus on food, like Thanksgiving.

I will be the first to admit that I don’t always handle situations that occur at the dinner table perfectly. I will also say that every child and every situation is unique, so there’s never a one-size-fits-all approach. However, I do think that every parent can use these four tips to support and encourage teens who live with eating disorders during Thanksgiving.

1. Make time for conversation before Thanksgiving Day.
   Regardless of which specific disordered behaviors your teen engages in, chances are they are scared of the upcoming holiday and the urges they will encounter. Teens often keep these thoughts and feelings to themselves, though, so it’s your job as a parent to start those difficult conversations.

If you can, carve out a bit of time with your teen before Thanksgiving Day so you can discuss what emotions and concerns the holiday is bringing up for them. Avoid accusations or implications and just ask open-ended questions that give your child the space to open up and share. Also, ask them how you can best support them through the holiday and actively listen to their response. You may be surprised by their response and gain valuable insight into your child’s needs through this special exchange. Furthermore, your teen may feel validated and loved just because you took the time to talk to them about these specific concerns and genuinely hear them out.

2. Think through the meal and any possible complications.
   Holiday meals are challenging for people in any stage of eating disorder recovery for many reasons. While it’s impossible to predict every problem that could arise during your Thanksgiving dinner, it may help to map out possible issues and figure out ways to either avoid them or cope ahead with them before they turn into dangerous situations for your teen.

For some, fear foods can make plating and sitting through the meal complicated. In these cases, it may help to offer some preferred foods alongside more problematic ones. (Example: I’ll be serving a plate of chicken nuggets so my child with ARFID has at least one no-brainer item she can select.)

For others, the conversations that dominate both during the meal and after create uncomfortable situations that perpetuate negative thought patterns or urges to engage in specific disordered behavior. In these instances, it may help to have a signal or plan on how you can reroute problematic discussions so they land on a safer topic like the weather or the football game on TV — whatever works for you and your teen.

Whatever you decide, just make sure you check in with your child before you make any last-minute menu changes or shuffle the seating arrangements around at the table so they understand the thought process behind them.

3. Consult with your child’s treatment team and have a game plan ready.
   Unfortunately, even the most seasoned parents don’t know everything there is to know about their teen’s eating disorder. However, your child probably has a team of providers in place who are willing and able to help you determine the best approach to this food-filled holiday so that your child can still enjoy the day with your family.

If you can, set up a time to discuss ways you can support your teen and aid their recovery efforts all weekend long. This may mean that you have to walk a fine line between tough love and encouragement, or you may have to set some firm ground rules that your child (and you) will stick to before, during, and after the meal. At my house, I will try my best to get my child to put at least one problematic food on her plate so she can perform the various exposures her occupational therapist has recommended. For other households, these game plans may look completely different depending on your teen’s specific diagnosis.

Regardless of the specifics, though, your teen’s providers can tell you what actions you can take to help your child and which ones you should avoid so that your child has the best possible experience this Thanksgiving.

4. Remember that your teen is still a child — no matter how grown up they seem.
   As parents, we often forget that our teenage children are still just that — children. Underneath that hardened, adult-like exterior, there’s still a little kid inside who wants our love and approval more than anything else in the world.

Therefore, one of the best things you can do for them this Thanksgiving is to just show up for them in all the best possible ways. Remind them that you love them no matter what, and show them you’re proud of how far they’ve come in their recovery journey. By letting them know you’ll always be there to love them and support them, you’re making the day easier for them whether it feels like it or not.

Eating Disorder Can Impact Your Whole Life

(From you) I was first diagnosed with an eating disorder 15 years ago, but have struggled with “problematic” eating most of my life. Across this time it has varied from “disordered eating” to anorexia nervosa — both restrictive and binge-purge sub-types (the latter features elements of bulimia nervosa) — to OSFED (the “not otherwise specified” type where it doesn’t fit any distinct DSM diagnostic criteria). When it peaked in severity aged 16-18 and I was hospitalized for eight months, it was fairly clear that anorexia consumed my whole life and it almost took it. Through subsequent therapy I learned about what was going on underneath what seemed to be all about food, weight and body image — a lot of it about control, self-worth and difficulty regulating emotions (as it is for many people). And the behaviors that were part of my diagnoses have now massively reduced in frequency, as I have replaced them with healthier coping mechanisms as part of my recovery process.

However, what isn’t clear to others is just how much an eating disorder affects your whole life. How it goes so far beyond what people see on the surface. How it changes aspects of your personality, impacts your relationships and affects your choices even in situations unrelated to meals. Some people compare eating disorders to addictions and I can completely see why. For me, recovery is constant work and despite my significant improvements I don’t consider myself “recovered” by any means.

My body may be in a much better place now and no one would externally look at me and guess I have an eating disorder, but I do. Unfortunately, eating disorders are often simplified to a matter of BMI and being underweight, which means many people fall through the gaps in the system with concerning, life-affecting issues that don’t get addressed because they aren’t obvious or considered serious enough. People can have eating disorders at any weight or size, and they often start with disordered thoughts and beliefs around eating, food and weight. Binge eating disorder is the most prevalent of them, and orthorexia is increasingly common but is often missed under the guise of “healthy eating” (it does not have its own separate diagnostic criteria currently). Many people don’t even realize they are going down the road of an eating disorder because a lot of disordered behaviors and related beliefs are normalized in society as a part of diet culture.

It is exhausting inside the head of someone with an eating disorder, regardless of what type, what weight or size they are, whether they are diagnosed or if they are acting on their thoughts/feelings or not. It can truly affect your whole life:

It often makes you paranoid: whether it’s fears of food being able to magically enter your mouth just by you looking at or touching it, or paranoia that people can see you’ve gained a tiny amount of weight (or just binged, purged or eaten). Or a constant suspiciousness of others’ motives and behavior around food.

It makes you seemingly lose your ability to be logical: whether that’s repeatedly doing the same thing to no avail, yet believing the next time you do it will somehow be successful. You may begin fearing foods of certain colors. Or believing that someone has done something to your food, even though you literally just watched them make it from start to finish.

It makes you think you’re the exception to every rule: whether it’s thinking you’re the only one who needs to exercise a certain amount (it’s OK for everyone else to do less) or you will gain large amounts of weight from eating one calorie more, or you are guaranteed to explode from slight fullness/if you eat a full meal. Thinking that everyone else needs a certain amount of food to function though you need less, or you are the only human in the history of mankind who can survive without food or drink.

It makes you seemingly blind to the obvious: whether it’s being unable to see that you have lost or gained significant amounts of weight (body dysmorphia can become a prominent issue), being unable to see your repeated injuries are related to the amount you are exercising, or being unable to accept that purging food doesn’t actually rid you of your difficult feelings.

It affects your ability to do everyday tasks: from having difficulty making meals due to anxiety or risk of bingeing, to not going to the supermarket due to anxiety/fear of buying food. From struggling to bathe or shower due to body image issues, to feeling overwhelmed by the sight of food that putting away a food shop makes you feel panicked that you’ve got to eat it all now, to having difficulty putting out rubbish bags at risk of bingeing from the bin.

It affects your romantic relationships: from making you secretive and act in ways that make you feel ashamed, to consistent lying and deception about disordered behaviors. From disrupting things like date nights, celebrations etc. because of the food component, to angry outbursts about changes to plans. From making your body image or self-worth so poor that you can’t be intimate in any way, to refusing to believe your significant other could possibly love you or think you’re attractive (and therefore pushing them away).

It affects your social life: from missing social or festive occasions due to the anxiety that the food/eating component brings, to not being present during conversations due to mentally obsessing about food, to worrying about being triggered or upset by diet talk, or even withdrawing entirely due to anxiety or associated ill health or hospitalization.

It can impact you financially: whether it’s purchasing large quantities of food for binges, or lots of exercise equipment or gym memberships to feed an exercise obsession, or having to purchase specific foods to accommodate food rules, or ending up throwing away a lot of foods. Or having to miss or give up work (or even be fired) due to the impact of exercise obsession, other behaviors or ill health.

It can contradict all your other beliefs and values: whether it is interfering with religious beliefs or practice e.g. not being able to take communion because of concern about calories, or meaning you lie or steal. Or whether it’s spending a lot of time on public bathroom floors while purging despite anxiety about contamination, or throwing away lots of food despite your hate of food waste. This in turn can be incredibly distressing.

It can make you do things you often know are objectively ridiculous: whether it’s looking up the nutritional information for non-foods (e.g. a fly), refusing to touch a food that you’re not going to eat (in case the calories count), refusing to eat a meal because one component wasn’t “just right,” choosing what to eat entirely dependent on nutritional information rather than what you actually like or don’t like, purposefully eating foods you don’t like or intentionally cooking food incorrectly to ruin it so you “don’t like food.”

It can affect your whole personality: you might normally be seen as a smart, logical person but be convinced by complete illogical nonsense when it comes to food or weight. You might normally be a really social person who loves meeting friends, but withdraw and avoid social events due to anxiety about food. You might generally be a very friendly, gentle person but if plans change around food become snappy, rude and argumentative. You might generally be very honest and trusting but become secretive and suspicious. You might normally be an upbeat person and become low, withdrawn and negative due to the depression that often accompanies eating disorders.

In the grips of my eating disorder I behaved in ways I never thought I would and occasionally I still say or do things that horrify me later in a calmer moment; and that is where looking at the disorder as a separate being is important. However, for true progress and some form of healing I had to take responsibility as well. Responsibility for the choices I make now, and for the impact it does have on others around me. It is a difficult balance to strike, but awareness is key for me.

This involves identifying when things are getting worse, knowing and managing my triggers and recognizing what is irrational or illogical. I frequently check myself mentally, evaluating whether my motives and behaviors are healthy or not. I sometimes have to check facts with someone close to me, as my own reasoning can get warped. Recognizing the way my eating disorder impacts the rest of my life has helped me to be more patient with myself and seek support when I need it, which in turn, enables me to maintain the more stable point I have reached in my recovery.

When Your Eating Disorder Has Taken Control

My eating disorder is twisting and turning himself into my being. He is a sickness. I try to eradicate him, but he is like a leech, sucking out my life-blood. If I don’t fight him, who will? An eating disorder is not just anorexia or bulimia. He’s hatred, loathing and harm. I am not safe when I am with him. I am not alone.

I am haunted.

He’s hissing and screaming in pain. When I’m surrounded by this, I cave. I put a band-aid on his wounds, and tell him I will take care of him. I take my focus off of me, and my hurts and wants. Suddenly it’s all about him. There’s no room for my thoughts or feelings, barely any room for those who love me. His howls drown out the important parts of my life, as he tries to scare away those who care about me. The panic he instills in me. The rules and regulations he says I must live by “or else.” That is fear and anxiety. My eating disorder and I feel like one and the same. I am him. He is me. Or is he?

I catch a glimpse of me. The real me. I almost don’t recognize her.

Who am I? What am I? I no longer know. He’s taken me, like an abductor. He has padlocked and chained me up. I live in the filth of my own lies and fear. I am so hungry, starving. Because of him. Even when I do escape, I don’t know how to properly take care of myself. Everything is foreign to me. So much has changed… he has taught me all I now know. I have forgotten my life before. Who am I? What am I? Am I him? Is he me?

He steals my hope and joy, taking it all for himself. Should I call this self-sabotage?

I am not my eating disorder. Please tell me I’m not that monster. He gave up for a while, but I can feel his grip tightening on my heart like handcuffs. Please, no. Please. For so long he was my only comfort and companion. I hated him, but what choice did he give me? He became my savior. He told me lies I believed, he hands them out like candy. Tasty little bites and morsels that melt on my tongue like snow.

My heart hurts. My very being wants to disappear. I have taught him the best punishments, and in turn he has taught me how to implement them.

I know people are out there looking for me. Isn’t that how it always goes? A missing girl, taken suddenly. Leads and hints to her whereabouts. Will she ever be found, and if so will she ever be the same? I know about the posters and the reward. I bet my picture is being broadcast on all of the websites and TV stations. I want to be free, you have to believe me. I have to believe me. I’m still here.

I’m still here.

Reasons Waking Up Early Helps My Mental Health

They say you’re either an “early bird” or a “night owl.” From my experience, resisting sleep-ins and getting up earlier has helped me out of the darkest patches of my mental health. It’s helped me stay energized and positive for the day. Most importantly, it’s opened up opportunities to form healthy habits that contribute to my well-being. Here are my nine reasons why being an “early bird” helps mental health:

1. Resisting the snooze button is empowering.

You may purposely set your alarm a little earlier than intended, just so you can have the satisfaction of pressing the snooze button several times before getting up. I know–I’ve been there. But resisting that inner urge is enough to kick-start a lot of good feelings for the day. It eventually makes me feel strong for fighting the urge and more determined to face the day, capable and motivated. On a low day, I feel a great sense of dread for the waking hours ahead. The sound of the alarm going off is enough to cement my anxiety. But getting up right away stops me from prolonging the torture my illness wants to feel. Staying in bed longer would feed my anxiety, and if I do that, I can face a slippery slope if I’m not careful.

2. That first cup of coffee tastes even better.

Even though coffee, at any time of day, always hits the spot for me, nothing beats that very first cup after waking up in the morning. When I know I’m up early, sipping my cup while the world is still quiet outside, I can appreciate the taste. I have more time and clarity to focus on one of the things that makes me truly happy. As I drink that fresh first cup, it feels like I’m taking in a new day with optimism, almost like I’m cleansing away those early morning anxieties.

3. Planning my day feels clearer and more complete.

Being awake a little earlier than I need to be allows me to connect with my plans for the day. Since recovering from anorexia, I’ve managed to shake off the rigidity it encourages, so I have to be careful not to get carried away with planning my day. What has changed for me is when I’ve planned out my week, I am open to changes. I make room for life to happen. During my early mornings, I like to reshuffle what’s to come for day while writing out the little things I hope to accomplish. When I can see it in black and white, this settles my anxieties. I feel capable, which plants a seed of peace in my head for the rest of the day.

4. There’s an open window of time for exercise.

Getting outside for a jog or going to the gym first thing in the morning sets me up in a stronger place mentally for the day. Although some days I dread exercise and my head makes excuses for all of the other things I should do instead or my poor body image drags me down, I know that once I’m home, I’ll reap the benefits. As someone with a history of an eating disorder, separating exercise from body image is an ongoing challenge. If I want a lifelong, healthy relationship with food, I need to recognize that the most important benefit of exercise is mental and physical health combined. I used to think exercising and losing weight would boost my self esteem, and when I was encouraged not to exercise during recovery, I associated exercise with weight loss. This was so hard to disconnect. I am in the process of connecting exercise and mental health – which will release endorphins, get the blood pumping and make me feel strong. Being out in nature when jogging naturally lifts my spirits. I’m lucky enough to live opposite the seafront, so that’s my go-to location.

5. Time feels like it has more quality.

This is a lovely feeling. Though it’s tempting to set my alarm just before I need to wake up, having an hour or two head start makes me feel more at peace. I no longer wake up in a panic or feel overwhelmed. Instead, it gives me time to reflect before getting on with my day, and I’m able to check in with how I’m feeling. Time becomes about quality when I no longer need to rush into each task for the day.

6. I am more creative and productive.

Mornings are the times my ideas and ambitions flow best. I’m able to think more clearly about what I want long-term in life, and what really makes me tick. Then I’m able to narrow that down to thinking about what small steps I could do today to help reach my goal. For example, I want to publish an illustrated book based on my mental illness recovery. Because I go through patches of finding writing daunting and convinced it’s some humongous thing that will crush me if I try, I have to remind myself that starting somewhere will get the ball going. So I trust it’s something I love to do, then commit to write something smaller to get some practice. This gradually increases my confidence. These small things involve writing articles about things I am passionate about, or writing a post on my recovery blog.

7. I remember to take my medication.

When I’m less rushed, I have no excuse to miss my medication. There have been many times when I just haven’t prioritized my medication because my head feels jumbled, and I’m focused on what I ‘‘need’’ to do, which leads me to forget to take care of myself. Now that I’ve developed a routine in the mornings, it’s something that has become a habit.

8. Watching some morning news with my breakfast makes me feel more connected to the world.

I’m not big on keeping up with the news, but I find that catching the main headlines helps me feel more alive. Being aware about what’s going on in the world makes me more in tune with the present moment. It helps me focus on the fact it is a new day because I can get caught up in the same everyday habits. Also, thinking about how many hours the news anchors have already been up for work puts things into perspective and makes me see I’m not up that early at all!

9. I am more present with those around me.

This has to be one of the most important advantages of all. When I am with people throughout the day, be it anyone from my therapist to my Dad, I feel like I’m really there as opposed to worrying about this and that. I’m less worried about the next thing I need to do. Waking up early gives me a clearer and more realistic perspective on the day; I’m less hard on myself when I don’t get everything done. But the best thing about feeling more present with those around me is my ability to have more meaningful conversations.

We’re each so extraordinarily unique, so these things may not necessarily work for everyone. But for me, they’ve been especially essential to my bulimia recovery and my generalized anxiety. Every day really is a new chance; being an “early bird” sets me up better for that.

We Need to Stop Romanticizing Mental Illness

The mental health space can be difficult for many people to understand. Whether you’re someone struggling, a friend trying to understand, a teacher wondering how to introduce your lesson, a doctor trying to decide on a diagnosis or simply a campaigner trying to reduce stigma, it can be a chasm of chaos.

Romanticization used to be simple. You’d go and watch a play, for example, “Romeo and Juliet.” The suicide scene came on between the two lovers and you knew it was romanticization. But that’s OK, it was expected. It was expected that you would see how overpowered by love Romeo had become and how he could not imagine his life without the “apple of his eye.” But what about when it floods in to real life? What about when we romanticize real suicides from real people?

Mental health issues aren’t a fictional story. They aren’t made up by an author. They are palpable pain and they continuously change lives. So why, as a generation, do we often make them out as fairy stories? Why is Tumblr filled with emaciated young girls wearing flower crowns, laughing, having fun and hashtagged “thinspo” as if the fact that they haven’t eaten a meal in over a week is a positive thing. As if to suggest not eating is the only way to have a happy ending. Panic attacks? Oh yes, everyone wants one of them! They’re so cute, I love feeling so overwhelmed my body shuts down and I feel completely out of control. You stayed up until 5 a.m. writing that essay, I bet you struggle with insomnia, you must be so clever. You’re depressed? Oh wow, that’s hauntingly beautiful. Those cuts are so artistic, I wish I could decorate my body like you.

I hope you read the above paragraph and thought, “How could you say that?” Because I know every time I read a comment like that or a quote on Tumblr or a retweet on Twitter I want to scream you are incredibly fallacious. Romanticization of mental illness is a terrible attempt at making them “beautiful.” I am unsure whether this stemmed from trying to destigmatize mental illness or whether it came from the Tumblr blogs made to connect with people in similar situations. It has created a kind of “sad girls club” that is toxic. Why? Because just like the name suggests — they are illnesses. They hurt and they harm people on a daily basis and I cannot comprehend why anyone would want to portray this lightly. Speaking out about mental health is incredibly brave but also exceedingly difficulty, yet others seem to view it as quirky and an “admirable” personality trait.

By making mental illness out as something “cool” to have, you take the focus away from real people struggling. People who self-harm no longer receive help because their parents view it as a trend rather than a cry for help. Those struggling with bulimia aren’t taken seriously because they can’t wrap their fingers around their wrists. Depressed teenagers are “just trying too hard to fit in,” so their doctor brushes away their concern about having not left their bedroom in over a month. Suicidal students are being turned away by their teacher because who hasn’t tagged a friend in the “I want to die” Facebook meme? People aren’t receiving help because others are portraying mental illness as something lighthearted.

I think where the line of romanticization often becomes a little blurred is within mental health awareness and education. It is often too easy to slip into the trap of “storytelling.” After all, the less “blunt” the article seems, the less likely people are to be put off by reading it. Why is that? Why do we feel we have to buy into writing in flowery language to talk about such a serious topic? It’s probably because people are still uncomfortable. People still don’t know how to handle it and so if we are blunt in our discussions, many switch off. Friends start to disappear, teachers become distant, parents get mad. You can often feel the shift the minute you mention it.

Although we have come a very long way, the stigma still remains. We need to open up the conversation. We need to be less airy-fairy and more blunt. We need to confront it head on, it’s how the issue will change. On the flip side, storytelling isn’t always bad. Poetic pieces can be hauntingly beautiful for people who are really struggling with mental illness — these are the posts that are often more relatable. People who have written from the heart about their struggles; who have’t sugarcoated it or portrayed it as “desirable,” but haven’t been so incredibly blunt that it sounds like they’re talking to a stranger. From experience, these are the articles that help people the most.

A friend once told me that my work was “beautifully harrowing” and was the reason she told her mum about her own struggles because she felt she could use my words to convey her point because before she’d been unsure. It’s a fine line to walk, but it is most helpful to include a resolution. It often opens up conversation more effectively if it’s written creatively but still accurately. Rather than writing poetically about your struggles and leaving it in a pit of despair, write a resolution. Explain things that have helped you or things you want to do to get better. Make it clear that although “X” isn’t great, “Y” can make it better. It is OK to write creatively, as long as it is still honest. This is the line many people will disagree on. Some people will think your creativity is romanticization while others will see it as the harsh reality of day-to-day life put into less “harsh” words. Please don’t let that put you off to writing or talking about it though.

In summary, romanticization is a complex issue. Much of society has formed this ideal that mental illness is “beautiful,” “trendy” and “desirable.” They think it might bring them attention and sympathy and happiness. People don’t always know how to handle mental health and people who are really struggling probably know how isolating of an experience it can be.

You might think people will pity you for your black and white post about self-harm, but most will just become uncomfortable. This can be toxic because it desensitizes the public to the idea, and then you’re less likely to get help. I had people in my life who used to believe I did it for attention. I suppose I did, but for attention in the sense that I needed help — and this was the only way I knew how to reach out. If this is you, please try and communicate in other ways. If someone reaches out after your post and asks if you’re OK, tell them no. Tell them you need help and something needs to change. If you can, speak to a parent or teacher or trusted friend. Write it down, poetically or not, if that makes reaching out easier.

Sadness isn’t beautiful and it doesn’t make you more attractive. No amount of pastel quotes on Instagram or artsy photos of pills on a plate or a gun shooting flowers will alter the fact that mental illness isn’t an art form that you can “perfect.” It is an experience that can make every day painful. Mental illnesses are not an “aesthetic” — they’re tears, trauma and tantrums. They’re therapy, medication, suicidal thoughts and self-destruction. They’re losing all your motivation, losing your friends and family and messing up your education. They are a daily battle that can feel impossible to win. Pain doesn’t equate to pretty. Pain equates to pain.

Please stop invalidating a real illness just because you want to be “on trend.” Please stop contributing to an already toxic stigma.

Books That Might Save Your Life If You Live With Suicidal Thoughts

If you are one of the millions of people living with a mental illness, you may spend a lot of time feeling lonely. You may struggle with a depression that has stripped all the joy from your world. You may have intrusive thoughts. Chances are your brain will make you believe you’re the only person who’s ever felt this way so maybe you don’t tell anyone how you’re feeling.

Whilst everyone’s circumstances are unique, I can guarantee there is someone alive right now who has felt as desperately awful as you do on your worst days. When the darkness surrounds you and life doesn’t really feel worth living, you need to first ask for help — whether from a doctor, a friend or one of the hundreds of fantastic mental health charities in existence. While you wait for help to arrive, you should read one (or all) of these books. There are dozens of academic books about mental health, but I don’t need to hear from a scholar; I need survival tips from someone who’s lived with mental illness.

Disclaimer: these books are not intended to replace medical advice, but they should make you feel less alone.

1. “Reasons to Stay Alive” by Matt Haig

Writing lists is one of my favorite pastimes. My desk at work is littered with lists, as is my home. In my 20s, I wrote a list with two columns — one was “Reasons I Want to Die,” and the other, “Reasons I Want To Live.”

I’m sure I’m not the first or last person to ever write that list. Sometimes, when everything in life has gone wrong and you are desperate for escape, dying seems like the only option. If you’ve ever felt like that, you should read this book. In the introduction, novelist Matt Haig states: “There is no right or wrong way to have depression, or to have a panic attack, or to feel suicidal. These things just are. Misery, like yoga, is not a competitive sport.”

What unfolds is a three-year decent to the depths of despair from the author’s 20s to recovery via conversations across time where the suicidal author speaks to his future self:

“THEN ME: I want to die.

NOW ME: Well, you aren’t going to.

THEN ME: That is terrible.

NOW ME: No. It is wonderful. Trust me.”

The chapters are short and easy to read but the page “Things people say to depressives that they don’t say in other life-threatening situations” really made me stop and think. People with mental illness are often told to “get over it” but you would never say that to someone with cancer or another life-limiting illness. Or maybe you would if you were a terrible human. This book is not only a lifeline for those of us who have hit rock bottom; it’s for their loved ones too. Sometimes, when you are depressed or anxious, it feels like you’re talking in a language “normal” people don’t understand and in that respect, Haig feels like a translator between the well and unwell. And something to remember from the chapter “Reasons to Stay Alive:”

“Things aren’t going to get worse. You want to kill yourself. That is as low as it gets. There is only upwards from here.”

2. “A Manual For Heartbreak” by Cathy Rentzenbrink

Cathy Rentzenbrink knows true heartbreak. Her brother was knocked down by a car at the age of 16 then spent eight years in a vegetative state before a legal battle enabled his life to end. Her family experienced pain that made them realize there were fates worse than death.

Heartbreak and grief are ubiquitous, although the way we respond may be vastly different. In the last decade, my life has been shaped by grief that often felt life-ending. I couldn’t breathe when traumatic memories invaded my sleep and waking days. I spent months masking my pain so I didn’t upset anyone but realized, as did the author, “For us to truly know one another, we must be able to share our heartache.”

I found this book by accident when I was teetering on the brink of a breakdown. I took comfort in the words right from the introduction, which states: “I’m sharing my way through. I think of this book as a verbal cuddle, or a loving message in a bottle — tossed into the sea to wash up at the feet of someone in need.”

Without the pages that followed, I am not sure how I would have navigated that mental collapse. The book gave me hope I would survive, that I wouldn’t suffocate under the weight of my own sadness. This book isn’t just for people in pain; it’s for their friends, their family, their loved ones. It gives advice on how to support the grieving, what not to say and how to be a better human. I wish this book had existed when I was going through a divorce or when my mother died but now my well-worn copy lies by my bed with passages highlighted to help soothe my soul when life gets unbearable.

3. “Remember This When You’re Sad” by Maggy Van Eijk

By the time Maggy Van Eijk reached her late 20s, she’d had three therapists and three different mental illness diagnoses. Her most recently diagnosed condition, borderline personality disorder (BPD), is one we both share. I was diagnosed with BPD in 2015, then promptly ignored it after a quick consultation with Dr. Google told me I would likely die alone, probably of suicide, after ruining my own life and those around me.

The book isn’t specifically about BPD; the explanations of the effect mental illness can have on your life, work, friendships, relationships, self-esteem and body image are universal. The book is grouped into sections which correspond to inside your body, such as, “Remember This When You’re Scared of Your Own Brain” and to the outside world, “Remember This When You’re Losing Your Job.” The easily digestible chapters are a blessing for anyone whose depression has robbed them of their ability to concentrate and each chapter is concluded with a handy list which is often as humorous as it is helpful.

The book is brave, candid, amusing, and at times moved me to tears. It covers everything from falling in love to falling apart. To say I identify with the author’s memoir is an understatement; whole passages of the book could have been plucked from my own head. In “Remember This When You’re Having Sex,” Van Eijk recounts using sex as a form of self-harm, something I wish I’d read while in the grip of it myself.

I’ve read this book when I’m “well” and I’ve read it on days I don’t want to live anymore. I get something different from it every time. The last paragraph of the acknowledgments always makes my heart swell: “To everyone who has found themselves in the pages of this book. You’re not broken. You’re not losing it. Keep going. Take baby steps.” I have given a copy of this book to friends and who are now able to understand me and my actions on a deeper level and for that, I will be eternally grateful.

4. “Mad Girl” by Bryony Gordon

Bryony Gordon first experienced symptoms of obsessive-compulsive disorder (OCD0 at the age of 12. She woke up convinced she had AIDS and engaged in rituals of obsessive hand washing, repeating phrases under her breath and worrying her family was going to die. At 17, she experienced intrusive thoughts that convinced her she was capable of murder and after speaking to her GP was diagnosed with OCD and clinical depression.

“Mad Girl” narrates the double life that Gordon led for the next 15 years. To friends, colleagues and the public, she was a talented, witty newspaper columnist with the world at her feet; privately, life was imploding with bulimia nervosa, reckless behavior and drug dependency taking over her life. So much of what happens to you when you are mentally ill feels like it’s what you “deserve,” but as Gordon states, it can be a self-fulfilling prophecy: “Only when I started to believe I deserved something more than misery did I get something more than misery.”

The book recounts falling in love and having a baby all while in the grip of mental illness, but rest assured, this isn’t a case of “I got married and everything was magically better” because that’s not real life. Gordon is at pains to state this is a memoir, not a self-help book, but the searing honesty in her battle with the monsters in her head will encourage others to tell their own story. Loneliness is one of the worst qualities of any mental illness in my opinion, but in this book, I found a kindred spirit and I hope you do too. As the author herself says, “Everyone has degrees of madness in them, everyone has a story to tell.”

5. “How to Survive the End of the World (When it’s in Your Own Head): An Anxiety Survival Guide” by Aaron Gillies

Comic writer Aaron Gillies (AKA Technically Ron on Twitter) has achieved the impossible — he’s written a mental health book that’s as hilarious as it is insightful. It’s a survival guide for how to deal with the threat to life that exists only in your head.

Gillies was diagnosed with depression in his early 20s and had experienced mild anxiety before, but says: “I just never knew that anxiety, real full-blown life-altering anxiety, was a thing.” His first panic attack was triggered by the simplest thing — the dropping of a mug in his kitchen — but the description of the terror that enveloped him is relatable to anyone who’s ever been in that position: “Until this my anxiety had been a constant hum in the background; this was the unexpected crescendo.”

The writer doesn’t just struggle with generalized anxiety disorder (GAD) — he also experiences social anxiety, separation anxiety, insomnia and dermatophagia (biting the skin around your fingers, often until they bleed). The book mixes personal anecdotes with input from mental health professionals and fellow people who struggle and includes some excellent advice on everything from how to get a better night’s sleep to how to manage anxiety-related agoraphobia.

A mixture of cognitive behavioral therapy (CBT), medication and making fun of his illness has brought Gillies to a stage of being able to cope with his anxieties. This book doesn’t offer a cure; it teaches you how to manage everyday worries before they spiral out of control. There’s also an important section on gender stereotypes and the stigma men face when discussing their mental health. Toxic masculinity is producing a generation of men who would rather die than open up about their feelings; silence is killing thousands of men every year. I truly believe books like this will start conversations that will change (and save) lives.

6. “The Recovery Letters: Addressed to People Experiencing Depression” — Edited by Olivia Sagan and James Withey

The question I ask myself repeatedly when I am in the grip of depression is: “Will I ever recover from this?”

James Withey thought a lot about recovery during his short stay in Maytree, a “sanctuary for the suicidal” in London in 2011. He thought about the importance of hope and what he could do to help others who were experiencing the kind of depression that feels terminal. The following year, “The Recovery Letters” blog was born.

“The Recovery Letters” is a simple premise; people recovering from depression write a letter to those who are currently struggling. Addressed to “Dear You,” the inspiring and honest letters provide optimism and encouragement to those experiencing depression and are proof that recovery is possible.

This book is an anthology of some of the many letters received over the years from people struggling with different kinds of depression, including clinical depression, bipolar disorder and postpartum depression. The beauty of the book is you don’t have to read the letters in any order; you can dip in and out or skip any piece that doesn’t resonate with you. There’s no right or wrong way to read this.

Writing and receiving a letter is such an intimate exchange and the ability to bare your soul to a stranger must be as scary as it is liberating. As Withey states in his introduction: “Their letters don’t disguise how painful depression is but they simply and beautifully say that it won’t always feel that way.”

The act of reading these letters always has a calming effect on me and I have a few favorites I’ve read so many times I’ve committed them to memory. Quite simply, when you’re drowning in sadness, these letters throw you a lifeline.

Things to Do When You Feel Undeserving of Eating Disorder Recovery

Being in recovery from bulimia is exhausting. Some days I feel like I am walking through a pit of fire, and it occasionally feels like I am unworthy of living a recovered lifestyle. It isn’t often when this thought pops up, but when it does, I get stuck on it. I wonder about the validity of my eating disorder, if I ever really had one and if I even need recovery. I wonder if I am capable of living in recovery, and if I am even worthy enough to put the time and effort into achieving a healthy life for myself. Even if I can’t agree that I deserve recovery, I can agree to do the next right thing.

Here are five things I do when I don’t feel like I deserve recovery:

1. I pick up the phone and I call a friend who understands my struggle.

I ask her to talk about her own recovery and the steps she takes on a daily basis to feed and take care of herself. It is imperative that I reach out to other people in the eating disorder world for a couple of reasons. One reason is that I need to be reminded of how bad it can be if I were to go back to my eating disorder. Another reason is because they show me an immense amount of strength on a daily basis. I have a few people in my life who are solid in their recovery and it gives me a lot of hope to see they are fighting the fight.

2. I eat an apple.

I eat apples when I am despairing in the restriction of my eating disorder. But an apple is still nutritious, and sometimes it’s all I can feed myself. After I eat the apple, I am able to reflect on my ability to nourish my body, and how important that is. I want my brain to function well, and to do this I must give it food. If I recently binged and purged, eating may feel impossible. My thoughts turn to calories and I must do my best to mute those thoughts and move on with my day. Nothing good has ever come from eating disorder behaviors.

3. I contact my dietitian.

When I need a fire lit underneath me, she is the person who manages to do it. She knows what to say, and understands this is a difficult battle other people may know nothing about. We make a meal plan and I make a verbal contract to follow that plan. It is important to have somebody who believes in me, even when I don’t believe in myself. Eating disorder recovery is hard, and having professionals to reflect my work back to me helps me move forward.

4. I make a list of all of the people I love.

I want to be an active participant in my life. Today I can make the decision to show up for the people I care about. Sometimes I must remind myself I cannot be my best self when I am choosing my eating disorder over other relationships. When I spend all of my mental energy on thoughts that are incongruent with the life I want for myself, I am unable to show up for my friends and family. I must put those thoughts aside and focus on those I love. Making a list of people in my life whom I care about allows me to remember my importance as a human being on Earth.

5. I make art.

Being creative allows me to be present and mindful while also creating something beautiful. I am constantly searching for meaning and purpose in my life, and when I make art, I feel like I have achieved those things. It gives me the opportunity to get outside of my own loathsome thoughts and focus on the task at hand: making a messy and fun piece of art. It leaves me with a sense of accomplishment that nothing else does. I often feel refreshed and like I can take on both my internal and external worlds after I complete a painting or poem.

Doing the next right thing allows me to move on with my day without focusing too much on the negative thoughts my eating disorder brings into my mind. These are actions I can take to move towards recovery and further from the hell that was my eating disorder. I may not always feel worthy of recovery, but I am always capable of doing the next right thing.

You are not alone…