How a global pandemic can trigger an eating disorder

Everyone is managing a changing world! It’s Mental Health Awareness Week and I’m writing this blog to give insight into the world of eating disorders, not to say “my struggle is worse than yours” but to say, you never know what someone else is going to through – most people have hidden struggles and it’s not always obvious what’s going to trigger someone’s difficulties. Measures imposed by our governments have been vital to keep us safe but at what cost?

Change in routine

A routine for many people can indicate safety. Most of us find a change in routine difficult but someone with an eating disorder, routine can be the difference between them eating enough/regularly each day or turning to disordered behaviours for comfort.

Encouragement to exercise everyday

When in eating disorder recovery, exercise can be difficult to manage. Many struggle with exercise addiction as a way to manage weight and recovery from this may include not exercising or restricting exercise. The UK government’s lockdown rules allowed 1 trip outside each day for exercise. If one of the few things you’re “allowed” to do each day is exercise, it can feel like you’re being told you “should” exercise everyday and this only adds to the battle already going on inside your head about what your should and shouldn’t be doing. How many adults actually exercise everyday?! Not many, but for someone recovering from an eating disorder, this is a minefield!

Supermarket stress

Recovering from an eating disorder can include a strict diet plan. Panic buying lead to limited stock and then restrictions on items we could buy. While to the average family, these restrictions may have been inconvenient and caused them to use alternatives. This may have caused chaos to someone with an eating disorder. If the food item you need is not available, this could have triggered days without food altogether. While the queues at the supermarket are essential to keep numbers within at safe levels, this could cause extremely high levels of stress for someone who already finds the trip anxiety provoking.

Encouraged obsessive actions

While washing our hands is vital to prevent spread of Covid-19, with the UK government telling us to wash our hands often, this can play into the obsessive compulsive mind of someone struggling with an eating disorder prompting further ritualistic behaviours around food.

The wrong type of “vulnerable”

Those most at risk of dying from Covid-19 have been put on a vulnerable list in order to ensure we can keep them safe from catching the virus. This has meant that some support systems are no longer available for other people who usually use them. For example, people who usually use the online supermarket delivery systems haven’t been able to get slots. Going to a supermarket, for some people recovering from an eating disorder, is simply impossible. What do you do if you can’t get a delivery slot, because they’re reserved for other people?

Lack of therapy or online therapy

Therapy is a vital part of eating disorder recovery. Some agencies have completely shut down due to lack of resources. Some, fortunately have been able to continue online. Some people may prefer this and there are benefits, such as not having to travel. However, at times technical hitches can delay sessions and talking through a computer means some subtle communication is lost. I’m not alone in having a violent dislike of seeing myself on screen and a therapists sensitive use of physical touch is completely lost.

While the social distancing and lockdown measures have been vital to keep everyone safe – the repercussions on those with internal mental struggles, I have no doubt, without additional support, will be extremely long lasting.

How are you, really?

This week (18th May) is Mental Health Awareness Week 2020.

Let’s be honest, 2020 is not going how any of us thought it would! Some of our lives have changed beyond recognition, we had little warning and few of us had much influence over the changes!

How do you really feel about it all?

I have an extensive mental health history of severe depression and anorexia; recently I had anxiety and stress added to this list (stress isn’t a diagnosis but inability to manage it has a profound impact on ones health). I take medication and have had therapy to get me to a good, healthy place but I’ll always have a vulnerability to becoming ill if a number of factors aren’t controlled.

I’ve written various blogs in the past about how to maintain mental well-being. I’ve discussed the importance of being honest and how talking about feelings makes them less scary and more manageable.

As a society, we use the phrase “how’re you?” or “are you alright?” as a salutation and don’t really want the other person to go into detail, however, it’s at times like this (when the world is uncertain), when asking how each other are is of vital importance.

When I say “how’re you?” I always mean it and will always set aside time for the other person if they need to open up.

Unfortunately I have not always had the same afforded to me… I continue to struggle to open up, but knowing how important it is, I try to, then when the other person doesn’t respond or invalidates my feelings, I’m crushed. But when someone does really listen, it means the world to me.

Right now, you might be loving lockdown because you’re being permitted to stay inside and do what you want when you want. On the other hand you might be feeling angry, depressed, anxious or guilty because there’s so much out of your control and you’re being stopped from doing the things you want and need to do.

All feelings are valid and need to be expressed.

A silver lining to come out of this pandemic is the mental health is now on the agenda every day. The year, mental health awareness week is about kindness. Asking how someone is, meaning it and really listening to the answer is the simplest kindness you can offer and what’s great about it is you can do it on the phone, by text, by video chat or in person, socially distanced!

You don’t need a mental health diagnosis to look after your mental health. By being more open about how we’re feeling, it’s a good step towards being able to talk about more issues around mental illness.

Reality of depression

I write blogs to share my experiences. When a psychiatrist diagnoses depression, they’re looking for a specific set of symptoms described in the DSM V or the ICD 11 all or most of the time over an extended period:

  1. Depressed mood
  2. Diminished interest or pleasure in activities
  3. Decrease or increase in appetite
  4. Subjective slowing down of thought and movement
  5. Fatigue or loss of energy
  6. Feelings of worthlessness
  7. Diminished ability to think or concentrate and indecisiveness
  8. Thoughts of death, suicidal ideation without a specific plan, attempted suicide or planned for suicide.

I understand the need to be able to diagnose in this way but this is not how people experience depression. I’m writing this blog to give some insight to what it’s really like to be inside the mind of someone struggling with symptoms of depression.

In reality, people experience the following, jumbled and apparently nonsensical feelings:

  • I don’t want to make a fuss but I’m worried about how I feel
  • I feel sad, frustrated, angry, scared and numb at the same time
  • Sometimes I feel happy and then I feel confused and guilty
  • I feel lethargic and then I beat myself up for being lazy
  • I cry about everything and nothing but then sometimes I can’t cry when someone tells me something sad
  • Lying awake at nightI feel completely exhausted, during the day all I want to do is sleep then at night, I can’t sleep, I just lie awake
  • I’m not interested in going out, I won’t enjoy it and I have nothing interesting to say so what’s the point?
  • I don’t have any friends and I can understand why, I wouldn’t want to be my friend
  • I just want this pain to stop, it’s a pain like no other
  • I feel like I’m falling down a black hole, like my life is meaningless, is there any point?
  • I’m scared I’m going to lose my job, I just get a feeling I’m doing it all wrong
  • I can’t seem to do anything right
  • My life is fine, I should be happy but I feel like everything is falling apart
  • Life feels like a slog, I don’t think there’s any point in going on
  • I notice other people laughing and realise I’m not but the next day I can laugh and I don’t know what’s different
  • I wish I could go to sleep and not wake up

It’s the job of the GP or psychiatrist to take these experiences and attempt to make sense of them to see if a diagnosis of depression fits. A diagnosis is important so that appropriate support and treatment can be given. Symptoms of anxiety, psychosis, personality disorder, obsessive compulsive disorder, eating disorders or other psychiatric conditions overlap so it’s important to understand what the symptoms are in order to offer the right support.

I always like to offer some hope in my blogs. I’m living proof that from the darkest times, if you surround yourself with the right people, do whatever it takes (therapy, counselling, medication) it may not be easy or simple but recovery is possible.