Facebook is really unique in that EVERYONE (okay, almost everyone) is on it. If you’re an eating disorder patient, this means your professionals, the other girls/guys you’re in treatment with, past patients, your school / work friends who may not know about your eating disorder, your family members, etc. In what other realm do all of these people connect?
For most people, “Facebook stalking” means checking out what that guy you liked in high school is doing now (or some variation of that idea). However, for anyone in eating disorder treatment, Facebook stalking can mean following up on the girls you were in treatment with or tracking down all of the professionals you’ve worked with.
Luckily, there are privacy settings. Some professionals even know how to use them.
I was pretty convinced that facebook could be nothing but hurtful to recovery until a girl I used to be in treatment with told me how she and another woman used it to keep in touch. There’s probably a 20-year age difference between the two girls (for the sake of this example, let’s call the older one Kristy and the younger one Jackie), but neither of them had a lot of support outside of their families. In the evenings they would talk on facebook (something I haven’t gotten into yet — facebook messenger). Kristy would see the unhealthy things about dieting that girls would post on Jackie’s wall, with prom coming up, and they’d talk about it. Jackie saw all the cute pictures of Kristy’s kids. Basically, it served as an outlet for both of them — something that was missing in their outside world.
Now, you could argue that this isn’t different than email or IM, but I don’t think that IM bridged the age-barrier in the same way that facebook is now. IM also doesn’t have the public information that facebook has — you can’t see how others interact with someone.
So what do you think about facebook — helpful or harmful to recovery? Staying in touch with people you were residential with could definitely be triggering (especially if they are not doing well and you have access to their photos), but having the support of people who have been great friends is also valuable. And I’d love to know — do professionals ever search for their clients on facebook? Just out of curiosity? For the record, I have never tried to friend a professional myself — although I won’t lie, I have looked at a couple of profiles.
Food rituals are pretty common among individuals with eating disorders… cutting things into tiny pieces, chewing a certain number of time, mixing weird things, eating everything separate, picking food apart, etc. I’ll be the first to admit that I’ve never been terribly successful in eliminating my own food rituals. As I was miserably failing my goal to “eat a bagel normally” this morning, I was thinking about what it was that seemed so necessary about the rituals.
I don’t think that cutting food up changes the calories. I don’t pick things apart because it makes me eat more slowly. I don’t think that eating food with a fork makes it safe. For some reason, though, being able to do the food ritual makes that food manageable. It’s a nervous energy. Not picking the food apart KILLS me (well, or so it feels). I just feel so driven to do it.
So, my question is — where do you draw the line between ED food ritual and obsessive compulsive behavior? Of course the two diagnoses cross paths, but not everyone with food rituals has OCD (and vice versa). Is it a food ritual if you think the action makes the food safe or unsafe? Or if you think that somehow it affects whether or not you gain weight? Or is it only an OCD behavior if you have other OCD behaviors (checking, counting, etc.)? Can you be diagnosed with OCD if you only have food rituals? Is that enough of an obsession/compulsion? And, if your food rituals are more of an OCD issue than an eating disorder issue, do you approach treatment for that differently?
I have been extra tired lately. VERY extra-tired. I go through spells of this and am always fairly convinced that there’s something wrong with me. It’s not normal for someone to get eight hours of sleep and need one – two naps during the day. I end up having conversations with my fiance like this:
grey: I think that I’m anemic. fiance: oh? grey: I have all the symptoms — fatigue, headache, difficulty concentrating, pale skin, leg cramps… fiance: Funny, those sound like the same symptoms of anorexia.
Then, the next month…
grey: I think I have hypothyroidism. fiance: You don’t say. grey: No, really — I have all the symptoms. fatigue, dry hair, pale skin, cold intolerance, muscle cramps, depression, abnormal menstrual cycles…. fiance: Kinda like anorexia.
And again….
grey: I think I have mono. fiance: Let me guess — lack of energy, loss of appetite and chills. grey: Exactly! fiance: You don’t have mono, you have anorexia. grey: I could have anorexia AND mono. fiance: Do you have a severe sore throat? grey: Well…. not YET….
Humph. He is right — these could all be consequences of the eating disorder. For the most part I know this, but whenever I feel overly tired of cold or crappy, I really feel like it must be something else. My eating isn’t particularly worse that day — why should I feel worse?
I think that I forget that how I treat (or mistreat) my body compounds over time. If my eating has been off-track for the past three ways, having a great day today isn’t going to guarantee that I feel okay. And, even on a larger scale, I think that years of disorderedness has taken a toll on my body. My eating disorder is nowhere near as severe as it was back in high school, but I still haven’t been 100% over the years. Now I notice how prone to headaches I am (very prone), how I often have stomach aches, how dysfunctional I am on minimal sleep, etc. I can’t get away with the things that I used to be able to. Because my weight is higher and I’m eating more, this doesn’t make sense to me — clearly something ELSE must be wrong with me (like anemia or hypothyroidism or mono). But… maybe all the years of the eating disorder has taken a toll on my body. Beyond the bone density and menstrual issues, maybe I am just not as resilient as I once was.
However… I am still going to have labs done at some point to rule everything out. You know, just in case…. (and in secret hopes of proving my fiance wrong!)
I have been extra tired lately. VERY extra-tired. I go through spells of this and am always fairly convinced that there’s something wrong with me. It’s not normal for someone to get eight hours of sleep and need one – two naps during the day. I end up having conversations with my fiance like this:
grey: I think that I’m anemic. fiance: oh? grey: I have all the symptoms — fatigue, headache, difficulty concentrating, pale skin, leg cramps… fiance: Funny, those sound like the same symptoms of anorexia.
Then, the next month…
grey: I think I have hypothyroidism. fiance: You don’t say. grey: No, really — I have all the symptoms. fatigue, dry hair, pale skin, cold intolerance, muscle cramps, depression, abnormal menstrual cycles…. fiance: Kinda like anorexia.
And again….
grey: I think I have mono. fiance: Let me guess — lack of energy, loss of appetite and chills. grey: Exactly! fiance: You don’t have mono, you have anorexia. grey: I could have anorexia AND mono. fiance: Do you have a severe sore throat? grey: Well…. not YET….
Humph. He is right — these could all be consequences of the eating disorder. For the most part I know this, but whenever I feel overly tired of cold or crappy, I really feel like it must be something else. My eating isn’t particularly worse that day — why should I feel worse?
I think that I forget that how I treat (or mistreat) my body compounds over time. If my eating has been off-track for the past three ways, having a great day today isn’t going to guarantee that I feel okay. And, even on a larger scale, I think that years of disorderedness has taken a toll on my body. My eating disorder is nowhere near as severe as it was back in high school, but I still haven’t been 100% over the years. Now I notice how prone to headaches I am (very prone), how I often have stomach aches, how dysfunctional I am on minimal sleep, etc. I can’t get away with the things that I used to be able to. Because my weight is higher and I’m eating more, this doesn’t make sense to me — clearly something ELSE must be wrong with me (like anemia or hypothyroidism or mono). But… maybe all the years of the eating disorder has taken a toll on my body. Beyond the bone density and menstrual issues, maybe I am just not as resilient as I once was.
However… I am still going to have labs done at some point to rule everything out. You know, just in case…. (and in secret hopes of proving my fiance wrong!)
The National Council for Community Behavioral Healthcare and AstraZeneca conducted a really interesting survey on the impact of bipolar depression on people’s lives. There were a couple of points in the study that really caught my attention:
The greatest concerns among people living with bipolar disorder are that their symptoms will have an impact on daily life, such as family, relationships, or job (73%), and that they will have long periods of depressive episodes (63%).
Ninety percent of people living with bipolar disorder said that they have difficulty managing or completing day-to-day tasks due to their bipolar depression symptoms.
When asked how they felt most of the time, only 27 percent of people living with bipolar disorder said they felt well-balanced and just 23 percent felt their depression was well-controlled.
The majority of people living with bipolar disorder agreed that bipolar depression causes difficulty in their ability to manage housework (73%), run errands (59%), groom themselves (53%), and pay bills (49%).
Sixty-one percent of people with bipolar disorder said their depressive episodes last longer than their manic episodes
Fifty-three percent of people living with bipolar disorder agreed that they would rather feel “less than perfect” than go through another medication switch.
These findings got me thinking — what are/were the most disturbing effects of the eating disorder on my life? I would have to say….
Constant preoccupation with food that took away from my ability to concentrate on school / work.
Low blood sugar and tiredness that further inhibited my school / work efforts.
Heightened depression, anxiety, and panic attacks.
Tension among family members due to their frustration/concern and my irritability.
Avoidance of most social situations in fear of the event involving food.
Isolation from friends.
Lack of interest in all hobbies and many relationships, and. the inability to motivate myself to care about the things I once cared about.
I could probably make a list three-pages long, but these are probably some of the most upsetting elements of the eating disorder. It would be interesting to see a similar survey to the Bipolar Depression Treatment Dynamic conducted for EDs.
“You get to define which experiences are traumatic for you, whether or not it would impact others in the same manner. It’s not the objective facts that determine whether an event is traumatic, but your own emotional experience of the event.”
This is just a quick post, but I read this on a trauma blog tonight and thought it was so well-put. This is something that i struggle with a lot — whether or not something “counts” as significant. Maybe I am making it up. Maybe it was no big deal and I should have been fine. Maybe I am fine and am just crying wolf.
I’m not even limiting this to trauma — of course I can extend it to eating disorders, too (because I have to somehow relate everything to eating disorders, or so it seems). There’s always that fear that maybe I’m not sick enough to actually need help. It’s not that I want to be sicker; I’m just afraid of asking for help that isn’t justified. What if someone else in my position wouldn’t need help? What if I’m actually okay-enough?
It is such a good reminder for me that my “own emotional experience” is my reality — and in the end, that’s what is important. Regardless of whether or not it should “count” as significant, it affects me, my sense of self, my relationships, and my future.
“You get to define which experiences are traumatic for you, whether or not it would impact others in the same manner. It’s not the objective facts that determine whether an event is traumatic, but your own emotional experience of the event.”
This is just a quick post, but I read this on a trauma blog tonight and thought it was so well-put. This is something that i struggle with a lot — whether or not something “counts” as significant. Maybe I am making it up. Maybe it was no big deal and I should have been fine. Maybe I am fine and am just crying wolf.
I’m not even limiting this to trauma — of course I can extend it to eating disorders, too (because I have to somehow relate everything to eating disorders, or so it seems). There’s always that fear that maybe I’m not sick enough to actually need help. It’s not that I want to be sicker; I’m just afraid of asking for help that isn’t justified. What if someone else in my position wouldn’t need help? What if I’m actually okay-enough?
It is such a good reminder for me that my “own emotional experience” is my reality — and in the end, that’s what is important. Regardless of whether or not it should “count” as significant, it affects me, my sense of self, my relationships, and my future.
I’d never heard of a “Sober Coach” until watching VH1’s “Sober House.” In the last episode (I think), Will, who is Seth’s Sober Coach, accompanies him to his first concert and make sure that nothing happens to jeopardize his sobriety. While watching this I thought, “Well that’s convenient — I could use someone protecting me from anything eating disordered.”
Upon thinking about it a little more, though, I wasn’t sure what this Anti-ED Coach would protect me from. Would he make sure no one served me diet coke? Or that we only went to public places with healthy-weight people? Or would he stand outside the bathroom (any bathroom) and make me count? Okay, so maybe the idea was silly.
However, then I went and Googled “Sober Coach,” and found a website that explains what a sober coach does. Wow, they do a lot… they really seem like “life coaches” to me. If I had to adapt the list from this website for eating disorders, it would look something like this:
24 Hour Crisis Support
Phone support available 24 hours a day, 5 days a week.
Education on how to ask for help.
Daily, Weekly, & Weekend Planning
Creating an hour by hour schedule when necessary.
Learning to deal with free time and/or unstructured time.
Establishing weekly goals.
Physical Well-Being
Nutritional consulting.
Support with eating disorder issues.
Support for anxiety and depression.
Creating a personalized self-care plan (acupuncture, yoga, body coach, personal trainers, etc.)
Career / Academic Guidance
Finding a job / volunteer work / internship.
Support with changing careers.
Fun / Passion / Purpose
Learning how to have fun & explore different hobbies.
How to build fun into weekly schedule.
Finding one’s own aspirations and dreams.
Recovery Support
Help in finding appropriate treatment.
Daily relapse prevention plan.
Support in establishing healthy friendships and relationships.
Team Approach
Works with psychiatrists, therapists, dietitians, and outpatient programs to provide a team approach.
Referrals to various professionals as needed.
If you look at the original website, you’ll see that I didn’t have to add much. If Sober Coaches really do all of the above, that’s pretty amazing. I need someone to educate me on “how to ask for help” and “how to deal with free time and/or unstructured time” ! I also like the idea of someone coordinating things with a treatment team. I think that often professionals don’t work well as a team or they don’t necessarily consider the input of the patient (when appropriate). It’s a nice thought to think you could have someone advocating on your behalf in those meetings…
I realize that this is probably realistic, but it’s an interesting thought. An Anti-ED Coach could play a role that I don’t think really exists right now in treatment. Many of these responsibilities don’t fall under the job description of your doctor, therapist, or dietitian. It’s tricky relying on your spouse / family members to serve all of these functions, too, because they all don’t necessarily mess with the nature of the relationship. For instance, if I’m having a bad night and freaking out about something food-related, I don’t really want to make my fiance listen to my possibly irrational rant about calories. At the same time, though, it wouldn’t be appropriate for me to call or email my dietitian about this, either.
I am fortunate enough to have ED friends in recovery who can support me and give me advice during tough times, but that’s still a different relationship that with a Sober or Anti-ED Coach. You always have to consider if you are hurting or triggering the friend with your ED thoughts and behaviors.
According to Twin Cities, the patient load at Park Nicollet’s Melrose Institute/St. Louis has increased by 36 percent from one year ago, while the patient load at The Emily Program/St. Paul has increased by 20 percent for the same time period.
For instance, he says, people who suffer from an obsession with their weight, but who exercise to control weight gain rather than starve themselves, may no longer be able to afford their gym memberships. In that case, Jahraus says, they may decide to limit their food intakes, which can lead to eating disorders.
Oh, this article could have been so interesting! It was an interesting thought. The part about not being able to afford your gym membership and therefore developing an eating disorder killed the article (for me), though. Oh well…
Still, I wouldn’t jump to the conclusion that a bad economy spurs eating disorders… but rather that a bad economy motivates more people to get help for their eating disorders. Why is this?
Well, I think that there are several reasons….
A big barrier to treatment is work. You have responsibilities… you can’t just disappear for a month or two to go into treatment all day. If you are laid off, though, suddenly you are available in the middle of the day. You don’t have another commitment. You have time to get the treatment that maybe you’ve needed for a couple of years but never felt you had time to get.
Feelings of disappointment, shame, and embarrassment. These are tough feelings for anyone, but are especially tough feelings for someone with an eating disorder. It’s not unlikely for someone with an ED to take being laid off personally… as if they somehow failed. They might think it is a reflection of themselves — they’re not good enough. What are they going to tell friends and family? Others will be so disappointed. When you’re feeling this depressed and hopeless, you’re more motivated to go and get help — you don’t want to feel like this.
Lack of structure. Many people with eating disorders struggle with endless periods of free time. Work provides a daily structure that’s helpful. When you are missing that, sometimes things fall apart. Maybe getting intense treatment will help you with that transition… to either help you figure out how to cope with the free time or to tide you over until you get a new job.
Friends and family have time to notice your issues. If you’re at work all day, your friends and family might not realize how little you’re eating or how much you’re exercising. When you’re suddenly at home all the time, they have a much clearer picture of what your eating/exercising habits are like during the day… and they might be concerned and encourage you to get treatment.
If you haven’t noticed, I’ve added a poll to Grey Thinking’s sidebar (on the front page of the blog). I’ve thought about doing polls before, and while this one is not particularly creative, it is something that I’ve been wondering — how did you find out about GT?
I promise that future polls will be more interesting….
There have been many blog posts written on facebook and pro-anorexia, however, lately I’ve been thinking a lot about facebook and recovery in general.
Food rituals are pretty common among individuals with eating disorders… cutting things into tiny pieces, chewing a certain number of time, mixing weird things, eating everything separate, picking food apart, etc. I’ll be the first to admit that I’ve never been terribly successful in eliminating my own food rituals. As I was miserably failing my goal to “eat a bagel normally” this morning, I was thinking about what it was that seemed so necessary about the rituals.
Grey Thinking 