You don't have to be underweight to have an eating disorder
COVID-19: how to deal with an eating disorder during coronavirus lockdown
The COVID-19 pandemic is affecting many people's mental health in ways we might not have anticipated. For anyone dealing with an eating disorder, the coronavirus lockdown poses some unique challenges. We explore some strategies that may help.
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Living with an eating disorder can be tricky at the best of times. If you are one of the 1.25 million people in the UK who falls into this category, or if you care for somebody who does, you are no doubt used to taking things day by day and meeting the challenges as they arise.
However, the coronavirus pandemic is an unprecedented situation and with that come unprecedented difficulties. For anyone dealing with anorexia, bulimia, binge eating disorder, or another type of eating disorder, the pressures imposed by lockdown may weigh on you especially hard.
For one thing, we are all grappling with changes to our normal routine, and facing many unknowns. Beyond that, the situation has thrown up many food-specific challenges - think empty shelves in supermarkets and concerns around food shopping - along with rules around exercise and socialising which may exacerbate your anxieties.
"Changes in day-to-day life and routine could have a very real effect on the management of an eating disorder," says Katie Bell, a lecturer in psychology at De Montfort University. "For example, changes to the way you exercise, living with someone who is stockpiling food and resisting urges to binge eat, and being unable to access your normal one-to-one or group appointments with health professionals, could all have an impact."
Dr Elena Touroni, a consultant psychologist and co-founder of the Chelsea Psychology Clinic, adds that lockdown has stripped us of many of our healthy coping strategies. Because of this, we might find that old habits start to resurface.
"For those with eating disorders, long periods of time spent at home are likely to trigger very specific anxieties, symptoms and ways of coping," she says. "For those who have found unhealthy coping styles creeping in, it's about finding healthier new ones that they can use during these current circumstances."
Specific challenges you may be facing
Counsellor Lynn Crilly, who is the author of Hope with Eating Disorders, points out that there are quite a few potential stumbling blocks to be aware of. For instance, meal planning can become more complicated when certain 'safe' or regular foods aren't available.
"Food scarcity can play into the eating disorder sufferer's way of thinking, letting them believe that others need the food more than them, which of course is not true," she says. "And the media's hyper-focus on body image and home workouts can have a negative effect on how they feel about themselves, and again feed into their distorted mindset."
She adds that, since most eating disorders thrive on secrecy, being stuck in a house with others can make the eating disorder 'rules' hard to maintain. Equally, if you're living alone, the isolation can cause harmful coping strategies to become more entrenched. Then there's the fact that it's harder than normal to structure your daily routine.
"Many people suffering from eating disorders want to feel in control," she says. "But with the restrictions to their everyday life now governed by outside forces, they may feel they are out of control which will no doubt cause high levels of anxiety."
In some cases, somebody who has suffered with an eating disorder in the past may find old issues making a recurrence.
"Long-term management techniques for most eating disorders emphasise managing your lifestyle to reduce the risk of relapse. Having the ability to manage your lifestyle taken out of your hands can be a trigger for many sufferers," says psychotherapist Noel McDermott.
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Strategies to help
If you are grappling with any of these issues, the key thing to remember is that your worries are worthy of attention. While the media focus is, understandably enough, on coronavirus itself, the sad stories we're hearing do not diminish the struggles you're going through.
Crilly points out that many people will find the day-to-day fight with their eating disorder even harder to win.
"But please remember it can and will be won," she says. "Communication is key. Talking to someone you trust about how you are feeling, and coming up with an action plan together of how to stay on top of it going forward, will help."
It's important to keep to your daily routine as much as possible, and stick to a regular eating plan that works for you. Crilly suggests writing a plan for each day the night before, so you know what you're doing from the minute you wake up. You could also make a rough food plan for the week ahead, so that you aren't caught unawares.
"Keep regular sleep patterns, limit your time on social media and try not to engage in your negative behaviours - easier said than done I know," she says. "Write a 'reasons to stay in recovery' list, which should remind you of why you're doing what you are doing and how you need to stay on track. Keep a day-to-day diary of how you are feeling and the positive steps you have taken that day. And work out how best to factor exercise into your day, recognising that everyone's needs are different."
Dr Touroni points out that learning how to self-soothe is vital. This might take the form of a 'self-soothing kit' that can assuage the difficult emotions you're trying to manage.
"Using the five senses can be helpful - for example, listening to calming or energising music when you're feeling triggered," she says. "Or for touch, putting fresh clean sheets on the bed, or for sight, looking at something beautiful. Write down a list of the different things you find comforting, and use this as your toolkit to mediate any triggers."
It's also a good idea to keep up with your treatment plan or therapist, even if that's all done virtually. Many therapists will offer telephone or video-based appointments at this time. There are also helplines you can call, which, while not a substitute for therapy, can help you in times of crisis.
The eating disorder charity Beat offers a full range of support services, including helplines, online support groups, and one-to-one web chat. You may also find some helpful resources via the mental health charities Mind and Sane. And it goes without saying that if you find yourself developing an eating disorder for the first time, it's important to consult your GP.
While this situation is undoubtedly challenging, it does not have to be 'bad' per se. As Crilly points out, it can even be used as a time to introspect and push your recovery forward.
"We have to have bad days to know what good days are. On the good days, celebrate the steps forward that have been made, no matter how small they are,” she says. "Above all, please remember, recovery is always possible, there is no right or wrong way to achieve it, everyone is different and therefore their recovery is and will be unique to them. Never give up - there is always hope."