Living with an Eating Disorder

This section of the site is for people who have an eating disorder and are currently unwell or still in their journey towards recovery.

It describes ways in which you might try to cope with the distress you are facing, and develop strategies to get well and stay well. It explores the concept of recovery and all the different things that recovery might mean to different people.  It should also be a resource for people who feel they are really struggling with their eating disorder and just want to know how to contain and manage those feelings.

Mental well-being

Our mental well-being or mental health is how we feel in ourselves day-to-day, and our ability to cope with the stress and uncertainty that everyday life presents. Our mental well-being is changeable, and good mental health includes feeling and expressing a wide range of emotions, including sadness and anger. When our mental health is at its best we should feel:

• able to accept ourselves for who we are and judge ourselves by realistic expectations
• engaged with other people and able to maintain positive relationships
• able to live productively and achieve our goals, whatever these might be.

Poor mental health is when we struggle to cope, or when how we feel interferes with our ability to function normally and live well. There are many reasons why someone might experience a period of poor mental health, such as social deprivation or isolation, unemployment, a physical health problem or significant trauma or loss. Sometimes there is no clear reason at all. Poor mental health over a prolonged period means you are more likely to experience a mental health problem, such as an eating disorder.

Whilst recovery from an eating disorder is possible, it can be difficult and may take some time. Whatever stage you are at in your recovery, you can expect your mental well-being to vary over time. During times when you are unwell, your mental well-being might be poor and you may need to seek greater support from others or input from professional services. At other times you may feel more able to cope and able to manage your condition and your life without becoming unwell again.

Building Resilience, Getting Well and Staying Well

Resilience describes the capacity to cope and stay mentally well during hard or difficult times in our lives. Resilience is something we all have which we can develop and strengthen to help us to cope better and manage not only our day to day lives, which come with their own difficulties and stress, but also times when life really challenges us.

Developing and strengthening your resilience is a crucial part of recovery. Building resilience throughout your recovery journey will also ensure that when you feel well, you have a better chance of staying well and preventing relapse back into illness. Below are some ways in which a person can strengthen their resilience. You may want to read each point and think about how you could introduce these changes into your life, step by step:

Talk to someone about how you are feeling

Talk to someone you know and trust, whether it is a family member, friend or a professional. Something as simple as being listened to, and understood, can make a big difference to how you feel. Talking with someone might also help you to work through your problems or gain a new perspective on them.

Stay connected to friends and family

When we feel bad, we tend to shut other people out and self-isolate, which can have a damaging effect on our relationships and on our mental well-being. Staying connected to friends, family or carers when you are unwell is important, as they can offer vital support and encouragement in your recovery journey. Mental health problems can put a lot of strain on relationships at times, but communicating openly and honestly with loved ones can go some way to maintaining or repairing these relationships.

Build up your social support

If you have a long-term mental health problem you may feel that people you were once close to have drifted away somewhat or that your social network has become smaller than it once was. It is also understandable to find it difficult to let new people into your life at a time when you are not feeling yourself. Having to learn to trust people again, feeling vulnerable to rejection or afraid of what other people might think are all valid fears that you might experience.

A good first step can be exploring some of these issues in a safe environment, such as with a mental health professional or a trusted friend or family member. There are also lots of voluntary organisations which offer a befriending service. A befriender is someone who can spend time with you and can support you to attend social occasions, perhaps things that you previously enjoyed doing, or new things that you have always wanted to do but may have lacked the confidence to do on your own.

Identify triggers and tell people what helps

It can be helpful to identify what triggers negatives mood states or emotions. It may be an event or situation that has triggered the emotion, an interaction with somebody else, or perhaps it is a thought, memory or bodily sensation making us feel the way we do. Start writing down when you feel any strong emotion such as sadness, anger, or hopelessness and write down what happened immediately before you felt like this. This can help you to identify repeated triggers to low mood, anxiety or negative feelings, and therefore put strategies in place to deal with these. Share your triggers with other people, verbally or in writing, so that they can support you and help you to cope with these.

Know when you need help, and ask for it

Eating disorders are difficult to fight on your own. If you are usually strong-willed or stubborn, so will the voice of your eating disorder be. There is nothing shameful in knowing you need help, and asking for it. Ask for help from a professional when you feel you are not coping, or when you recognise the signs of a relapse. This might be your GP, or if you are already in touch with a specialist eating disorder service, this may be your support worker, nurse, or therapist.

Also try to remember that the only way another person can understand what is going on for you, is by you telling them how you feel. Professionals are not all knowing, and if you know when something works or does not work for you, do let them know. Any care and treatment you receive should be informed by what you want, so don’t be afraid to voice your opinion.

Be kind to yourself

Have self-compassion: Self-compassion is actively caring for yourself which means allowing yourself to recognise your own needs in life and take care of these. To do this you need to be aware of your own thoughts and feelings, be able to tolerate your emotions without being critical of them or shutting them away, and have empathy with yourself and for your own suffering. Put simply, self-compassion is treating ourselves how we would treat a loved one, which is something many people find difficult to do.

Self-compassion is particularly important at times in our life when we experience illness, feel vulnerable, or are not coping. People living with an eating disorder often report experiencing shame, guilt and frequent self-criticism but remind yourself regularly that you are not to blame for your eating disorder. By understanding what your eating disorder helps you to cope with and by recognising the difficult journey that you have been on, you can learn to allow yourself a bit of ‘time out’.

If you are struggling, try practicing self-compassion for a short length of time each day and build from there. Acts of self-compassion could include buying yourself something you want rather than need, taking a break, engaging in an enjoyable or relaxing activity or spending time with someone who makes you feel good.

Have realistic expectations of yourself: It goes without saying that nobody is perfect. The recovery journey is one that can be difficult and your expectations of yourself need to be realistic. Recovery is achievable, but it can be helpful to accept that there will be periods when you struggle and there will be setbacks. There will also be times when you will make positive steps forward. Not every day will be good, and we sometimes need to accept that we will not do as well as we hoped or would have liked. To help deal with feelings of disappointment you can view every setback as an opportunity to learn. Without setbacks we might never know what it is we need to do to move forward.

Introduce relaxation into your life: Relaxation is about taking time out to stop and breathe. This can be difficult to do at times when you feel distressed, worried or anxious, but relaxation is a very important part of maintaining your mental well-being. Some people find that breathing exercises are helpful, or alternative or complementary therapies such as aromatherapy, reflexology or reiki can be beneficial. A technique called Mindfulness is a popular practice and can be very simple to do and introduce into your life. There is more information about Mindfulness and relaxation techniques later in this section.

Look after your physical health

Seek help with eating: Eating disorders can be physically damaging to our bodies, and have long-term consequences for your health. Our bodies require us to eat regularly and eat a well-balanced diet for nourishment and energy. An essential part of recovery therefore will be developing a healthier relationship with food. Treatment for an eating disorder, either through self-help, or through a professional service, can help address any issues with food, shape or weight and some of the psychological or emotional issues that may underlie the disorder.

Improve your sleep hygiene: When we are tired, we can be irritable with others and less motivated to face the day ahead. Getting a good night’s rest can make a big difference to how you feel. There are many ways to improve your sleep hygiene, such as establishing a regular bedtime routine, writing down any worries that are troubling you before bed, and reducing your caffeine intake. If sleepless nights are a frequent problem for you, there is lots of help online, such as the NHS Choices website.

Develop a healthy relationship with exercise: Exercise can help you to improve your overall health by increasing your physical fitness, strength, or suppleness. When you have an eating disorder however, exercise can also be problematic if it is excessive. Exercise can be described as excessive if it is undertaken solely to influence shape or weight, in a rigid and obsessive manner, or if being prevented from exercising results in intense guilt. Excessive exercise may also take more subtle forms such as always being ‘on the go’, pacing, excessive standing or constant restlessness. Physical injuries such as stress fractures or frequent joint pain can also be a sign that you are exercising too much.

If you struggle with excessive exercise you should seek advice from a professional, such as a specialist physiotherapist, who can help you to manage your exercise more effectively or may recommend alternative, lower impact forms of exercise. If you are trying to reduce your activity levels in the meantime, try engaging in a distracting or restful activity when you experience the urge to exercise.

Avoid mood-altering drugs: Tobacco, alcohol, caffeine or recreational substances like cannabis are all types of drugs. Drugs are chemicals and they interfere with the naturally occurring chemicals in your brain, altering your mood and behaviour. The brain is also responsible for your mental well-being and therefore drugs can have a detrimental, long-term effect on your mental health. Prolonged use or abuse of any type of drug can exacerbate an existing mental health problem or trigger a period of poor mental health.

The use of alcohol or recreational drugs may help you to temporarily mask or avoid feelings you find too difficult to deal with, or help you to express feelings you normally feel unable to, however these are short-term effects which are likely to pass when the drug leaves your system. If you think you may have a problem with drugs including alcohol, you can get professional help by going to your GP and discussing your needs.

Do something you enjoy

Think about what you enjoy, or used to enjoy, and allocate time in your day for doing this. It might be reading a book, listening to music, attending an event or group or just being creative with some art or craft materials. Whatever your hobbies or interests are, they can provide a great distraction by diverting your focus away from distressing thoughts or behaviours. Creative activities such as drawing or painting, sculpting, writing, drama, or playing music can also help you to explore or express feelings difficult feelings in a more positive, therapeutic way.

Try something new

If you don’t know what you are interested in, or it has been a long time since you had a hobby, try something new. Learning a new skill or craft can be a great boost for your self-esteem. If you join a local class or group to learn a new activity, it can also be a great way to meet and interact with other people. Low mood or lack of confidence can affect your motivation and sometimes this might mean doing something even if you don’t feel like it, however not doing anything at all is far more likely to maintain the illness, or make it worse.

It is common for people to believe that they need to ‘feel better’ before they are able to do something new or different. Waiting to ‘feel better’ however rarely leads to change and it is often the doing that needs to come first.

Remember that the above points are just a starting place and they may take time to consider and put into place. You could ask a friend, family member or professional to help you work through each point if you like and think about the ways you could bring about positive change in your life. There are also some useful self-help books in our recommended reading list that may help you to expand on some of the above points. You’ll find the reading list here.

Distraction

Sometimes we need to be able to deal with difficult emotions or stress in a more helpful way than resorting to eating disordered behaviours such as starving, binging or purging. There are some ideas below for ways of coping with or distracting yourself from distressing feelings. Some are suggestions from NHS staff and patients that work for them. You may want to use some of these ideas or come up with a list of your own. It may take some experimenting to see what works for you.

• Write down your problems – keep a diary, or write things that are troubling you on bits of paper and then rip them up or destroy them
• Write down positive things about your life or yourself and stick them up around you as a reminder
• Listen to your favourite music, sing or hum out loud
• Do something creative – draw, paint or make something out of things you can find around the house. Go back to childhood and make potato prints or finger paintings, or play with Plasticine (or blue tac)!
• Phone a friend or relative who might be available to talk
• Meet up with a friend, relative, or support worker and do something together
• Pop bubble wrap, tear up newspaper or scrunch tinfoil
• Build with lego, blocks or cards; build a tower and knock it down
• Spend time with a pet
• Have a warm bath or shower
• Take a leisurely or mindful walk, search for and collect items as you go such as twigs, shells or daisies
• Watch television or put on your favourite film
• Go to the cinema, by yourself or with another person
• Read a book or magazine
• Take a deep breath and count from one to ten, then from ten back to one again
• Do a puzzle or crossword, or write your own
• Count loose change, or objects around you
• Throw a pillow or bean bag at a wall (or any soft object!)
• Use relaxation skills – play a relaxation CD, light a candle or incense, meditate or practice mindful breathing
• Visit a quiet public space – library, your local place of worship or university/hospital chaplaincy
• Visit a museum or art gallery (lots have free entry!)
• Go to your favourite “safe” place (park, beach, woods, playground)
• Think of advice you would give someone else, and apply it to your own situation
• Phone a helpline (see Resources section for numbers)
• Change your environment – move rooms, change what you can see, touch, hear or smell
• Talk to yourself, answer back to any critical inner voices and challenge them
• Say what you feel out loud, even if it means crying or yelling
• Use imagery – visualise a safe space or imagine a comforting image and focus on this