How Physical Health Problems Can Trigger Mental Health Problems

Last week I talked about a recent incident where my mental health, more specifically my eating disorder’s obsession with drinking a lot of water, had a detrimental affect on my physical health and in a hilarious twist of fate and example of bizarre symmetry (and by hilarious I mean literally the most unamusing thing to happen ever), this week I am talking about how the opposite can also be true, and how physical health conditions can end up triggering or making a pre existing mental health problem worse.

So when we last left off, I had explained how I had been admitted to hospital for water intoxication and was being treated for this problem via a strict fluid restriction plan to get all of my electrolytes back to acceptable levels (it is at times like this when I wish I had one of those “previously on” video clips that they show before episodes of various TV dramas…I should really look into that…ooh and a theme tune! I do love a good theme tune!)
Now, after a few days, the fluid restriction, whilst being incredibly annoying for me, seemed to be working, and my sodium levels kept improving until they were back to normal. Really, that should be the end of the story, the problem was solved so I should have been packing my bags and making my merry way home, but alas the story did not end there and developed into what I like to think of as an epic novel of utter ridiculousness.

You see whilst my sodium levels were improving, I wasn’t feeling any better which didn’t make much sense. I had been admitted for a problem that was being successfully treated yet bizarrely, as the days went on, I became more unwell with a pain in my stomach. The doctors couldn’t really make sense of this and before long I was in so much pain that I couldn’t stand or lift my head off the pillow and was in need of all the morphine I could get. A few tests were run but no answers were revealed so a surgeon was sent to have a look at me.

After thumping me in the abdomen with an iron mallet a few times (she said she was only going to “press gently” but trust me from the pain I am pretty sure that woman had a mallet and a vendetta against my stomach region), it was concluded that I might have a swollen appendix. I was told that normally the surgeons would book me in for an operation to whip it out just incase, however due to my already poor physical health from my eating disorder, they wanted to avoid taking me to theatre (alas the operating one and not the version where you get to watch The Sound of Music on stage whilst eating a little pot of ice cream with a spoon that is basically just a mini plank of wood with no resemblance to a spoon whatsoever), because they weren’t sure I would survive an anaesthetic.

Thus it was decided that they would only operate if they were absolutely certain that such a thing was necessary and therefore some more tests were scheduled to try and clear up what was going on. The problem with this was that by leaving time for tests, we were also leaving time for things to go downhill which they did fairly rapidly. Again the surgeon visited and again an operation was suggested but also feared so I was sent to yet another test in the form of a CT scan where I was basically shoved in and out of a tube a few times whilst doctors took photos of my insides (I really hope that my organs put on their best clothes and posed nicely for the occasion…it isn’t every day someone wants to photograph your intestines).

After the CT scan was complete it was around 1am and I was finally allowed to have some more morphine and attempt a snooze, whilst my sister, who had been sitting beside my bed for the past few days, went home. That was until 4am when another surgeon woke me up, to tell me that the scan had shown that things were rather serious and I was scheduled for emergency surgery immediately, my sister being called back in by the nurses having only just left. The next little bit of time is somewhat of a blur but from what I remember I was pumped with anaesthetic and taken to theatre (again, the operating one. I didn’t get so much as a lick of ice cream and I saw no children dancing in curtains. Livid.)
I was so knocked out that it was about 24 hours before I woke up from the procedure, dazed and confused with a tube coming out of my stomach and leading to a bag of some unidentified liquid.

It was then that I was informed that my appendix, in being left for so long, had ended up exploding. (The surgeon told me that I shouldn’t say that it “exploded” because in technical terms you should say that it “ruptured” but damn it I went through a hell of a lot of pain and nonsense because of what happened so if I want to say that my appendix literally exploded like a firework on the 5th of November then I will jolly well do so!)
Consequently my body had been filled with poison, hence the tube and bag scenario coming out of my stomach after the appendix had been removed, to drain the poison out (the poison being the funny liquid in that bag.)

Since then the job has basically been to free my body of poison, recover from the surgery and try to build my body back up after its internal beating, a job that isn’t going too well at the moment because this whole physical health problem extravaganza has triggered the life out of my mental health problems, more specifically my eating disorder.

Admittedly I haven’t been doing particularly well for a while now, but I have been clinging on to some sense of stability by rigidly carrying out the same routine meal plan via some form of repetitive autopilot action. Unfortunately, this event has utterly destroyed my autopilot “just do what you did yesterday” routine.

I think when you have an eating disorder, eating your meals is kind of like a recovering alcoholic avoiding the pub.
If you force yourself to eat the same meal plan every day, you get into a sort of rhythm, a rather bumpy and unpleasant rhythm that you can’t lead a good conga to, but a rhythm all the same. Missing one meal however is like an alcoholic downing one mouthful of vodka after a few months sober and then suddenly finding it impossible to stop.

Knowing that missing one meal will always make the next one harder is the reason that I fight so hard to complete my meal plan even on the bad days because I know that not doing so will make it harder for me in the long run, but in this whole “my organs are exploding” situation, missing a meal wasn’t something I had any control over.
For the first day of the hospital admission, eating was mentally impossible because I was in a different place with different foods. This problem was somewhat solved when family and friends hauled bags upon bags of my safe foods to my bedside, but by that point I was physically in too much pain to lift my head let alone grab a spoon to chomp down on some cornflakes. During all of these pain days I was also constantly being wheeled in and out of various tests that doctors were telling me I wasn’t allowed to eat before, and incase I was going to need emergency surgery after some of these tests, my stomach also had to be kept empty on the off chance that people would be whipping the scalpels out (apparently it is significantly harder to operate when one has just demolished a peanut butter sandwich…or any kind of sandwich…not that there is any other sandwich worth mentioning).

Post surgery I was finally allowed and encouraged to eat to regain my strength and I genuinely tried, but again there were hurdles. Firstly the combination of anaesthetic/poison/million medications made me extremely nauseas, and I was being sick multiple times a day. My taste buds had also suddenly gone haywire and for some reason I could not tolerate sweet foods which for someone who always picks sweet over savoury and who lives off sweet things like porridge and cereal, this was somewhat of a problem. Even the flavour in toothpaste made me throw up (all over my toothbrush I might add…suffice it to say my breath was not minty fresh), and shock of all shocks, I started to be repulsed by peanut butter. Me. Repulsed by peanut butter aka the food that was previously the holiest substance on earth? Who am I? I think I am going through some kind of identity crisis. You might as well start calling me Malcolm.

Therefore I was trying to find new foods that I could both mentally and physically tolerate, family and friends bringing in new groceries every day (including my parents who had had to cut their holiday short and catch an emergency flight back to the UK with fears that they might not get “back in time”…safe to say their relaxing trip to Malaysia was somewhat of a disaster this year..).

Excitingly, a new safe food that I could physically and mentally tolerate was discovered in the form of mashed potato, but by this point it had been so long since I had eaten properly even that was a struggle. I felt sick at every meal time and I could never be sure why. On one hand it could have been the “genuinely physically ill with poison and anaesthetic” sick that I shouldn’t have forced myself to fight as nothing I ate would be kept down anyway, or it could have been the simply sick with anxiety and fear of food sick that I really should have been challenging to prevent it getting any worse. Sometimes food would arrive and I would feel so ill that I wouldn’t risk a mouthful only for the food to be taken away, the sickness to go and me to realise that all that nausea had been anxiety as apposed to anything related to physical complications.

After multiple meetings with my eating disorder services who visited me a lot on the medical ward, it was decided that I would be discharged home incase eating became easier there due to familiar surroundings. Armed with a ridiculous amount of mashed potato, I really tried but a few days in found that I was struggling to swallow. Again I assumed this must be that whole “throat closing up with anxiety” thing, so I persevered, but then after finding some weird white nonsense all over my tongue and throat and a trip to the doctor, it was discovered that life had thrown yet another curve ball and in my weakened post surgery state, had given me tonsillitis and oral thrush, conditions that make swallowing rather difficult and would therefore interfere with anyone’s ability to eat…Oral thrush? I didn’t even know that was a thing? WHAT THE HELL IS GOING ON WITH MY BODY.

Now I am three weeks post surgery (happy no appendix anniversary to me!) and in positive news, the nausea from anaesthetic and poison is practically gone. Having started another lot of antibiotics and some weird throat drops I have also regained the ability to swallow but after so many physical preventions to eating, I am now mentally more terrified than ever at the prospect. I have been to my eating disorder unit and the scales say that I have lost weight yet somehow I feel bigger.
Doctors are telling me that I have to get back to my old meal plan immediately so that we can add new things in to regain all that I have lost but it feels impossible. I cannot comprehend how the hell I was managing to eat before, despite the fact I was doing it only a few weeks ago, because now such an ability has become alien and frightening. I am tied up in a bundle of fear over food, throwing up, weight gain, trying to eat whilst being laid up in bed unable to carry out my usual exercise routines and consequently recovery from surgery isn’t going very well because I don’t have the energy to recover. Both the physical affects and mental health problems are feeding off each other like my body is an all you can eat buffet, and ironically the one person not getting fed in this situation is me. I have been on the edge of collapse for months now, clinging to the edge of stability with all the strength I can muster, but this has thrown me. I have fallen off the cliff. I am spiralling.

…And on that jolly note, that is pretty much my explanation of how a physical illness can go on to affect/cause/trigger a relapse in a pre existing mental illness. As with a lot of my blog posts, it hasn’t been a particular barrel of laughs as far as topics go, but it is the honest truth, and as always, that is what I am determined to put out there in terms of raising awareness of mental health problems.
Now after all this typing, I think I am very much in need of a nap and then maybe I will give some more mashed potato another go. Eating food is the last thing I want to do right now and my stomach is already full from terror, but I promise, I really am trying.

Take care everyone x

AppendixExplode

“I Wish I Had The Self Control To Be Anorexic”

Several times in my life I have heard the phrase “I wish I had the self control to be anorexic” and, considering I am now writing this blog post about this phrase, you can safely assume that I have a lot to say about it.
You may be thinking “Katie, you already wrote a post about people wanting anorexia and how silly that is, why are you repeating yourself?” (a post you can find at the link here: A Message To All The People Out There Who Are “Pro-Ana”), but please hold that thought as I actually think that the problem with this phrase is not about people wanting eating disorders.
Indeed, unlike people who are “pro-Ana”, in my experience, people who say this are not actually craving the bulging rib cage and hip bone images promoted on “pro-Ana” websites. The mistake these people make is not that of idolising a mental illness, rather it is of completely misunderstanding what an eating disorder actually is and what it is like to suffer from one.

I think when it comes to illnesses such as anorexia, there is a misconception that when people with the illness don’t eat, it is because of their will power or an extreme superhuman ability for self-control. They assume that sufferers feel hungry and want to eat but powerfully override the primal urge to seek food because they are strong, yet in my experience, it is the total opposite, and it is in the times that I am unable to follow this primal urge that I feel the weakest that I have ever felt in my entire life (even weaker than the time I was beaten in an arm wrestle by an rather arrogant and ambitious sloth I met drinking tequila in a bar a few years ago…that was a BAD evening.)

Whenever I miss a meal or don’t eat a free sample handed to me in a supermarket, it isn’t because I implement my ability to make decisions/affect my actions as the word “control” implies. Instead, it is because I am not in control at all, a point I think is easier to explain if we take a trip down memory lane and travel back in time to any birthday I have had over the course of the last decade.

Most years, when it gets near to my birthday, if I am out shopping in a supermarket with my mum, when we walk past the birthday cake section, she will look at the birthday cakes and sigh. Following this signal, we may have a wander over to look at all the intricately decorated creations topped with thick white icing and pictures of various Disney characters (I don’t look at the plain old boring cakes for “adults” that simply say “Happy Birthday”. Seriously who wants one of those when you can have an sponge shaped like a minion or a giant chocolate caterpillar with a cheeky grin?!), and then after five minutes of eye wandering my mum will turn to me and ask the question “can I get you a birthday cake this year?”.
Now, if I had any degree of “self-control” when it comes to food and my ability to nourish myself, I can honestly say I would turn to my mother in these moments and say something along the lines of:

“Can you buy me a birthday cake? Why of course! There is no question regarding such a matter! It is my birthday in two weeks and I simply cannot celebrate the occasion without a cake! Quick! Let’s go around all the supermarkets and bakeries in the area to try and find the biggest penguin shaped chocolate cake available. I want nothing more than to share such a delight with all of my nearest and dearest friends! Ooh can I please reserve the chocolate beak for me because it is my birthday? I do love a chocolate beak! Hurry mother, let us away to the automobile and get started on this quest immediately!”.
I would probably then insist we head to the candle area to pick the most garish, brightly coloured candles on offer to adorn my perfect penguin centrepiece, poised and ready for the moment when I am ready to blow out the flames and make a wish that Helena Bonham Carter hurries up and marries me already.

That is the response of a Katie who is in control. Unfortunately though, we haven’t seen “In Control Katie” around much lately. That Katie popped out for bread about ten years ago leaving an out of control mess in place, and since then we haven’t heard anything (better be picking up some damn good bread is all I can say…I’m talking a good quality ciabatta or we are going to have issues).
Therefore, with “In Control Katie” otherwise engaged on a mission to find a tasty source of carbohydrates, it is the “out of control” one that turns to Mum year on year with a dejected look and says: “I wish. Maybe next time”, at which point we agree to try again next year before repeating the annual routine in roughly 365 days time.
I know it would mean the world to my mum to buy me a giant penguin birthday cake to share with her/the family, and I desperately want to accept her offer each time mainly because I want to see her reaction. I want to see her face light up with the brightness of a birthday cake candle, filled with hope that for once she can do something that normal mothers do rather than having to come up with some kind of eating disorder friendly replacement for her neurotic offspring (e.g. the act of sticking a candle in a pink lady…the kind of apple I mean…not an unsuspecting blushing female who doesn’t know what’s coming).
When I do not accept the offer of a proper birthday cake then, it is not because I don’t want to, it is because my mind throws up barriers that make me feel that I physically can’t.
It is like a “normal” person standing in front of a bonfire and wanting to put their hand in it to retrieve a particularly nice log. They can look into those flames and want to put their hand in to get the log (this person really likes logs), but no matter what, they can’t. Of course they are physically capable of moving their arm into the vicinity of the fire, but the fear of pain stops them (no matter how much they like logs).
Saying “I wish I had the self-control to be anorexic” then, is basically like saying “I wish I had the self-control not to put my hand on a bonfire”. Of course eating and setting yourself aflame aren’t the same thing, one is vital for life whilst the other is downright ridiculous and not something I advise anyone to try at home or anywhere else for that matter, but the similarity exists in the sense that both the person who doesn’t put their hand in the fire and the person with the eating disorder do not carry out their actions because of self-control, rather it is because they are both scared and fear the pain that could result from their actions.

Whenever you hear yourself or anyone wishing they had the “self-control” and “will power” to eat like someone with an eating disorder then, please know that when it comes to eating disorders, self-control has absolutely nothing to do with any of it. When someone is unable to keep themselves healthy by eating enough, it is because they are not in control, and because the reins of decision are actually being held hostage by an evil dictator in their head who is trying to kill them.
If I had self-control and willpower over my life I could write a list of about a million things I would use it for. The ability to fill my mother’s eyes with disappointment, to refuse sharing a dessert with a friend or turn down the offer of a birthday cake would not be on there.

Take care everyone x

ControllingPea

The Importance Of Seeing Food As Fuel When You Are In Recovery From An Eating Disorder

When I first thought about writing this post, as you can see from the title, I was intending to talk about why people with eating disorders need to see food as something to fuel them and keep them alive, yet now I have changed my mind (not that I am indecisive or anything…or am I…I’ll have to get back to you on that…). Ok this post is still going to be about the importance of seeing food as fuel, but actually I feel I should address why EVERYONE needs to start doing this, as it seems that in our society, whether you are mentally ill or not, food is primarily thought of in terms of what it will do to your weight.

For example, a few years ago during an inpatient admission, I was on bed rest which meant that, as you have probably guessed, I “rested” in a garage (only joking, it was in a bed. Just keeping you on your toes). Anyway, I was lying there and I was confused as to why I had to eat my meal plan when I wasn’t “doing anything” to burn it off. In my eyes, if I ate even a pea whilst lying down all day, I would gain weight because I wouldn’t have exercised enough to burn it off. I talked to one of the therapists about this and I remember her telling me that even if I wasn’t “doing anything”, I still needed to eat and still needed to have energy just for my body to work. Ok I may not be running around anywhere, but my body still needed the food so that all the bits inside could do their jobs and she drew out this chart as to how much food is actually needed just to sustain life without all the wandering in-between. I, by jumping from “eat X” to “gain weight from X”, had skipped a massive step and had imagined that whatever I ate would make me gain weight. Nevertheless, every time I was given a meal plan increase, my first thought was “that is going to make me gain weight”, without thinking of all the reasons and uses for food that come before the body even gets around to considering weight gain. Hearing that from someone with an eating disorder probably isn’t surprising, but at the same time the idea of food as a dictator of weight and nothing more is something that I see throughout society.

These days what you eat seems to be less about giving you energy to actually help keep your liver livering so that you can live your life and more about making choices based on what size jeans you want to fit into.
It is like those articles online or segments on daytime television, where they tell you what exercises you would have to do to burn off a certain food. I am pretty sure that a few years ago they were even considering adding that information to the wealth of nutritional guidelines scrawled across any packet of Hobnobs just so that people would know that if they ate one of the biscuits, they could easily burn it off with fourteen and a half press ups and a quick run through of the Macarena.
It just makes me wonder what on earth we think food is for if all we are doing is thinking about how it needs to be “burnt off”, skipping the state where we allow the body to actually use it, like I did all those years ago. Why do we need to be so obsessed with burning our food off? Know what happens if you “burn off” and “use up” every calorie by running on a treadmill? You win a prize? No. YOU DIE.

Think about the times when there is a cake in an office or people order desserts at a meal. Usually if someone turns down a piece, you can bet a good chunk of cheddar that their refusal will be something along the lines of “Oh no I can’t join in with that because it will go straight to my love handles”. It is rarely, if ever, someone will turn down food because they “don’t want it”, and is unfortunately usually down to this idea that whatever they eat will affect their weight which of course it won’t and that immediate connection is incredibly disordered.
The truth is, the primary purpose of food and indeed the necessity of food is to keep you alive and any other consequence is only a secondary consideration, yet it is the secondary consideration that people focus on all too much. Like I said when I began this post I intended to encourage people in recovery from their eating disorders to see meal plans as things that are there to keep them alive rather than seeing them as things that are going to cause them to gain weight. Ok weight gain may result if enough calories are consumed to allow that (weight gain that if you are on a re-feeding diet I highly expect is necessary), but that is not the first thing to happen. Indeed people with eating disorders, myself included, seem to focus so much on the effect of food on weight that they forget that it has any other purpose.
Years ago during another admission, I remember following my meal plan for months and eventually I did manage to gain enough weight to get me back in the healthy range and my first thought was “oh well I clearly don’t need to eat anymore because I don’t need to gain any more weight”. When the doctor told me to keep my meal plan the same I was confused as I had imagined he would say that I could stop eating now I had gained to the point where my body was healthy, what use did I have for food? What use did you have for food past Katie? Hmm let me think…TO KEEP YOU ALIVE BECAUSE THAT IS PRIMARILY WHAT FOOD IS FOR.

Food did not originate with the sole purpose of changing our bodies like those “eat me” cakes in Alice in Wonderland or that mushroom where if she eats from one side she gets tall and from the other side she gets small (I actually have a theory that all mushrooms have that power but because we tend to eat mushrooms whole aka we eat both sides, the magic of each side cancels the other out, thus we remain the same size…maybe don’t shout about that in public though…in my experience whenever I talk about magic mushrooms someone tends to call the police and I end up with a lot of explaining to do.)
No, unlike Alice’s wonderful mushrooms (or, if I am right, normal mushrooms), food is primarily there to keep the heart beating and that is it, yet like past Katie this seems to be something we have all forgotten.

Take the hellish old saying of “a moment on the lips, forever on the hips”. This makes it sound like the second you take a bite of a tasty salted french fry (after it has been dipped in ketchup of course), that french fry immediately sets off through your digestive system until it reaches the hip, at which point it will decide to set up camp and stay there as an extra piece of flesh. No. In reality, the first thing that french fry will do is go down your digestive system and start looking for things to do. Looks like the heart could use a little energy? Awesome, then the fry will head over there and give a few beats to keep the old ticker going. Kidney need a bit of help (or kidneys if you are one of those lucky devils who still has two), fine, that fry will head off to those kidneys and do a bit of filtering or whatever kidneys do. Without food those things don’t just keep happening! What do people think is keeping us alive if food is only there to dictate the width of our thighs? Do we think livers and kidneys run on fairy dust and pixie magic? HAS THE WORLD GONE MAD?

I just think that we all need to back up out of this disordered attitude of “things you would have to do to burn off a carrot stick” thing and be reminded that food is actually fuel that keeps you alive. If you are in recovery from an eating disorder, don’t get me wrong, I understand, and with every bite my head is focusing not on what that piece of food is going to do for my kidneys but what it is going to do to the number on the scales, but when those thoughts crop up remember that the whole weight gain aspect is a secondary thing and not the primary purpose of food as is made out in society. You do not need to be underweight to earn the right to eat cake on your birthday and you don’t suddenly stop requiring food the moment you are weight restored. No matter who you are or what your weight, you NEED fuel to survive like a car needs petrol. It doesn’t matter what colour the car is or what size the wheels, no matter what the physical composition of that car, it needs petrol to move just as you need food to breathe. YOU ARE THAT CAR. It doesn’t matter if you have small tyres, a huge engine, dodgy limp wing mirrors or a sizeable windscreen wiper, you need fuel to go, end of discussion.

Whether people have eating disorders or not though, collectively if I could do anything in this post it would be to urge people to see food less in the disordered “a moment on the lips forever on the hips” sense and in a way more akin to “a moment on the lips and then down to the aortic pump for a good few beats to keep me alive so that I can actually get on with my day and have a life”. Admittedly it isn’t as catchy, but trust me, it is far more scientifically accurate.

FoodIsFuel

10 Ways To Support Someone With An Eating Disorder

Living with an eating disorder is hell, but I think it is underestimated just how horrendous it can be for the people living with people who have eating disorders. I know many parents, families, partners and friends tend to feel pretty hopeless when watching someone they love slowly drowning, without knowing how to stop it. Almost every day my mum will ask me what she can do to help, like there is some problem solving action she can perform as easily as changing a lightbulb.
I know for a fact that if there were an action she could carry out, my mum would do it in an instant no matter how inconvenient or unpleasant (I think she would even play Pictionary and she HATES Pictionary…weirdo). Unfortunately, eating disorders don’t have quick solutions and no matter how much a loved one wants to help, they cannot fix the problem. They can however support the person, and often these little offerings of support are nowhere near as dramatic as people seem to think. Supporting someone with an eating disorder doesn’t require grand complicated acts of kindness, often you can support someone with little things that don’t take much time or effort at all. So today, I am going to share with you a list of things that I find help me at home aka 10 simple ways you can help someone with an eating disorder.

1. Don’t get angry with the person, get angry with their disorder – When you have an eating disorder in the house/in any relationship, you can guarantee it is going to cause some conflict. I have lost count of the number of arguments I have had with my mum with regard to eating disorder issues like what I am eating for dinner. I honestly don’t think we have ever had an argument about anything that wasn’t mental health related (bar one argument we had in 2002 because she wanted Will Young to win Pop Idol when I was firmly on the side of Gareth Gates. I would like it noted that I can now lift my hands up and admit I was wrong on that one). Just yesterday I am ashamed to say I had an argument with my mother and yelled at her for about half an hour because she tried to help, and unknowingly put my kidney beans in the “wrong pan”.
Afterwards I felt incredibly guilty/like the worst person in the world. This guilt would have eaten me up and is the kind of thing that makes me feel that I don’t deserve food, but after we had all calmed down and I had apologised, what I found helpful is the fact that my mum made it clear that she understood that I hadn’t meant to yell about a bean pan. She knew it had just been the eating disorder taking control, and though I need to work on managing that myself, the acknowledgement that I wasn’t this terrible person who worried more about what pan my beans were in than my mother’s kind attempt at assistance, made me feel more able to continue with the meal.

2. If you are eating with someone with an eating disorder, keep them distracted and don’t make the food the sole focus of the experience – Meal times with someone with an eating disorder are not the most relaxing of situations and can be pretty intense (like one of those awkward dinner parties you see on Come Dine with me only less bitchy and without a voiceover man commenting on every little thing that occurs). For this reason, when I have to eat a meal with someone, I find it really helpful for them to help keep me distracted and not make it all about the food. Silence allows thoughts to creep in at the table, so I would recommend conversation if the person is able or, if they are unable (sometimes I cannot talk very much/think of words because I am so anxious), have the radio on in the background or play a game. Sometimes in hospital we would even do things like crosswords or little quizzes which really helped keep your mind occupied by working on something else (my favourite thing about this was that when there were bank staff they would go through the pile of quiz questions without realising which ones we had already done so we were all able to provide correct answers instantly and looked like geniuses.)

3. Allow them to take baby steps in their recovery rather than expecting miracles overnight – When people are in recovery from any mental health problem, there is often a lot of pressure for progress to be quick so that the problem can be solved and forgotten about as soon as possible. However, recovery is a very slow process and this pressure is often detrimental as it can make a sufferer more anxious and stressed. To help someone who is struggling, allow them to make progress at a steady pace they are comfortable with rather than forcing them to make dramatic changes which ultimately will not be sustainable.

4. Praise them…or don’t praise them at all – I have many friends who appreciate a little “well done” or similar nudge of encouragement after a meal to make them feel supported and like their hard work hasn’t gone unnoticed, so offering those words of praise can be a great way to support a loved one. That said, I know there are others, (me included) who actually find this more unhelpful, as they like to leave the table and forget everything rather than acknowledge the meal that has just been consumed. Denial may not be the best way to deal with mealtimes, but at the moment denial is how I cope, so I am helped by nobody commenting on how fantastic it is that I have cleared my plate. For this one then, maybe ask the person you are supporting to see whether praise would be helpful to them before whipping out the party poppers to celebrate an empty bowl of cereal.

5. Try to be as relaxed as possible at the dinner table – When I sit at the table, I am always anxious, and when I can see that other people are anxious, it makes me more anxious. This then makes them more anxious and before you know we are left with a table of people panicking about a meal that hasn’t even happened yet. For this reason when supporting someone at a meal time, if possible try to be calm and relaxed to show that the situation isn’t anything to be afraid of, rather than freaking  yourself out and condoning the “THE TABLE IS A SCARY PLACE” fear.

6. Seek support for yourself – People with eating disorders need support and so do the people around them. As important as it is for carers to have an outlet somewhere to discuss their concerns and worries though, it is helpful to make that outlet someone other than the person who is struggling. When you feel that you are a terrible person who is ruining everyone’s lives because you cant eat normally, emotional outpourings condoning that are only going to make things worse. Ultimately then for this one, support someone by finding support and seeking help for yourself too.

7. Keep diet talk to a minimum if you are on a diet – Obviously when you have an eating disorder, people being on diets can be rather triggering. That said you cannot dictate that nobody who lives with someone who is struggling is allowed to have any say in what they eat. Naturally we all have needs and some people may be prescribed special diets from a doctor which of course they should follow. If this is the case however, the best way to help the sufferer manage the situation is to not make a song and dance about it (aka no conga lines for the fact you have switched to low fat yoghurt and if possible none of those “I LOST THREE STONE” certificates which diet clubs award people plastered all over the fridge).

8. Know their meal plan – Again this one depends from sufferer to sufferer but personally I find it helpful when those around me know what is on and what is expected of me in my meal plan as it makes me accountable in some way. Obviously the goal is to get to a point where I don’t need people to know what I should be eating and am able to be responsible myself, but right now my mum having a copy of my meal plan supports me every day. That way, when I am struggling and want to miss things out, I know that it is not a case of “nobody will notice so just throw the bread out of the window” as my mum would immediately wonder where the soft wholemeal has gone (and why there is half a loaf of Hovis stuck in the garden hedge)…

9. Don’t treat them like a disorder – When people see or think of me, I always feel they think of me as “the one with the eating disorder” and that I have no other identifiers to me as a person. It is therefore helpful when living with someone with an ED, to treat them as a normal person with other interests and hobbies so as to remind them that they are more than their disorder and will ultimately still have an identity left, even when the disorder is gone.

10. Do not comment on their meal plan or their body weight – This last one is probably fairly obvious but nevertheless very important so I had to include it. Whatever you do and if you only follow one of these tips as to how to support a loved one, make it this one and for the love of all that is holy NEVER comment on how much weight someone has gained on their recovery meal plan and NEVER comment on how big someone’s meal is. Eating disorder recovery meal plans may look totally normal but there are some that may perhaps be bigger than normal. Whatever the meal plan though, the person will need all the food prescribed to treat their malnourished body and repair all of the damage that has been done internally. If someone is soldiering through their meal plan trying to reassure themselves of this, the last thing they need is a comment like “blimey that is a lot of food, I couldn’t eat that”. Hand on heart a bank HCA in hospital with no experience in eating disorders sat next to me one meal time and after I had finished my main/was picking a spoon up to dive into my rhubarb crumble with custard, they commented “I don’t know how you can eat that. My main course was half the size of yours and I am already too full to eat another bite”…THAT IS NOT HELPFUL INFORMATION.

So there you have it, ten ways in which family/friends can support people with eating disorders (at least in my experience), without actually having to do much at all. Being desperate to help a loved one and wanting to support them doesn’t have to be carried out in dramatic acts like white water rafting or playing Pictionary, Sometimes all you need do to be the most helpful and make the biggest difference, is the little things like asking them for help with a crossword over their cornflakes or giving an encouraging nod at lunchtime.

Take care everyone x

supportsomeonewithed