Managing & coping with a mental condition like Anorexia can be tough but it doesn’t have to be.
Many things contribute to anorexia and each person will have an individual experience of the illness. For most people the illness will really disrupt their thinking and behaviour, put constraints on their life and stop them from living how they would want to.
Maintaining an eating disorder:
In this exercise you can start to identify the thoughts, feelings and behaviours that appear as well as your body’s reaction to these. The following exercises are best carried out with a health professional who can support you.
Here is an example of how Hannah looked at her difficulties of body weight and shape. Hannah used the techniques below to recognise how her beliefs about her body weight and shape made her think critically of herself, feel worthless and ashamed with an urge to control her eating, change her behaviour by having strict rules about food intake and restricting food and her body’s reaction to this restricted calorie intake; with weight loss, exhaustion and mood swings.
Hannah’s cycle of thinking, feeling & behaviour might look like this:
As you can see from the example, finding out how your thoughts, feelings and behaviour are connected can show you how the problem can be maintained through a cycle which is hard to break on your own. You might be able to see from this example how this may be true for you - a health professional can help you do this.
For example, using Hannah’s experience above, she was able to see how thinking differently could help her see alternative ways of looking at her situation.
- You probably feel very afraid of putting on weight. Understand that this fear is part of your illness and try to listen to people when they tell you that you should not be losing any more weight.
- Don’t compare yourself to other people – you are an individual
- Don’t punish yourself or give yourself a hard time about how much you eat or how much you weigh.
- Try to explain to someone you trust what you get from having anorexia. If you feel you need to starve yourself in order to maintain control over your life, or to suppress other emotions you may not feel able to deal with then tell someone this.
- Concentrate on and remember the good things about yourself and your life - don’t focus on the bad things - try and keep a diary of things you have enjoyed or achieved during the week to remind yourself of this.
- Imagine what you would say to a friend if they had negative thoughts about themselves?
- Talk yourself better with positive self-talk - when you start to feel down you can try the mind-over-matter approach of self-talk to get yourself through any uneasy feelings. You could try saying things like
I can manage. I have been through this before and I managed
I am confident and in control
I don’t need to do this – if I do I will feel worse later
I can cope for another hour / 20 minutes / 5 minutes and take it one hour / 20 minutes / 5 minutes at a time.
I am doing ok. Right now I am well and ok
Today is the first day of the rest of my life and I will take notice of the many positive things this day has to offer
Try these practical suggestions of help alongside any professional help you may be receiving:
- Read up on eating disorders and speak to people you trust if you think you have a problem.
- Find out what your ideal weight should be for your height. Weigh yourself weekly but not more often than this.
- Try to be honest with yourself and those close to you about what you are or are not eating
- Keep a diary of what you eat and how you feel when you do and do not eat to help see if there are any connections between the two.
- Try and change one small thing every week in relation to food, e.g. eating one less thing or one more thing per day or being around food more often and feeling ok with this.
- Create a simple menu plan (such as three meals and three snacks per day). Do this with your health care professional.
- Keep regular meal times daily to create a routine
- Join a self-help group or make use of help lines or online support for your eating disorder. Find local support groups in Birmingham
- Consider what your eating disorder has cost you and stopped you from doing. Write a letter to your eating disorder if it helps you to get this down in words.
- Spend time with family and friends doing things you enjoy
- Don’t spend longer than you need to looking in the mirror it will only add to any insecurities you may have
- Avoid websites that encourage starvation or purging - they are damaging and used by people who will encourage you to take on their bad, unhealthy habits.
- Avoid celebrity magazines whilst you begin your process of recovery.
- Treat yourself kindly. Take a relaxing bath, read a book, go to the cinema or listen to your favourite music.
- Keep a journal, if you don’t feel able to say what you need or want to, try writing it all down and show this to someone who is involved in your care or someone you trust. If you can’t find the words to explain how you are thinking and feeling this is an easier way to express yourself.
- Write about your life without an eating disorder. Imagine what this would be like and what would be different for you.
- Take an assertiveness course to build your confidence.
- List things you can do and the positive qualities about yourself and praise yourself for them
- Learn a new skill. Develop new aims and goals to work towards. This will help you to focus your energies on achieving positive outcomes.
- See our real life stories to see how other people have coped successfully
- Practise relaxation to manage your stress and anxiety. Watch our films or download the information sheets on breathing and relaxation techniques-
Step 1: Talk to someone you trust
This could be your best mate, parents, boyfriend, girlfriend or tutor. It might feel difficult, especially if you have kept things to yourself and avoided talking about your eating disorder before. Other people in your life may have noticed you are not well but may be waiting for you to approach them or hoping you will start the discussion..
Talking it over is important for lots of reasons:
- It can be a weight off your mind to say it out loud;
- You will need their support if you are struggling;
- Someone just being there can help you relax and feel less isolated;
- They can offer reassurance that things will get better;
- They can motivate you when you cannot motivate yourself; and
- They can help you find help or help you with practical things like booking appointments.
We really recommend talking to someone but if you feel you can’t talk to someone you know then try a national helpline, like Samaritans.
Step 2: Self-help
Self-help therapies are a range of techniques you can apply yourself to help cope with stress and feel in control. Self-help will not treat anorexia alone but may work alongside any other therapy you may be having; discuss this with your health professional if you see one.
Self-help could involve completing exercises that you read, watch, listen to or complete online, it could be using relaxation training or it could be attending a support group.
Have a look at our resources for anorexia.
Step 3: Find professional help and support
Anorexia is a serious illness and you don’t need to handle it alone - there’s a lot of understanding and available support out there.
See the section above on 'Getting help' to read more about your options.
NICE (National Institute of Health and Care Excellence) recommend that treatment should be mainly psychological and involve the following stages:
- You should be seen as an outpatient (usually at a clinic or in the community) and offered psychological treatment from a service that is skilled in assessing and treating eating disorders.
- If psychological treatment on an outpatient basis is not having an impact or you feel worse during this time then a more intensive therapy like family work or day inpatient care could be added.
- If you do require inpatient treatment (in a hospital) you should be admitted to a ward that can carry out careful physical monitoring, psychosocial interventions and if needed as a final option re-feeding.
- Family interventions that directly address the eating disorder should be offered to children and young people with anorexia. Family members, including brothers and sisters, should normally be included.
You could contact your GP for a referral to your local specialist eating disorder team, or to counselling or psychological therapy. For more information on services see our map of local help in Birmingham and Solihull.
Step 4: National Contacts
- Anorexia and Bulimia Care is a national charity working to support all those who struggle because of eating disorders. It is staffed mainly by recovered sufferers. You can call their Helpline: 0300 011 1213 – Option 1 for parents, option 2 for sufferers and option 3 for self-harm help or email them at Mail@anirexiabulimiacare.org.uk.
- B-eat is a charity that helps support young people with eating disorders. Their Youthline is open: Mon & Weds, 10:30am-7:30pm; Tues, Thurs & Fri, 10:30am-6:30pm. Helpline open from: Mon & Weds, 10:30am-7:30pm; Tues, Thurs & Fri, 10:30am-6:30pm. You can also email B-eat at firstname.lastname@example.org
- Caraline (Eating Disorders Couselling and Support Services) provides a confidential counselling and support service for people with eating disorders.
- International Eating Disorders Centre provides 120 day rehabilitation programmes to enable clients, over 16 years of age, to return to normal lives following an eating disorder.
- National Centre for Eating Disorders provides effective treatment solutions for all the eating disorders.
- Film or videoProvided by: B-eat charity and mediabox
Speak to parents and siblings about how anorexia and bulimia can impact on the whole family
- Fact sheetProvided by: Youthspace
Eating disorders: a youthspace booklet covering causes, symptoms, treatment and recovery in anorexia, bulimia and binge-eating disorder
- Fact sheetProvided by: Rethink 2009
Rethink 2009 Detention under the Mental Health Act leaflet: what is the MHA, what happens and what are your rights?
- Research paperProvided by: The Future Vision Coalition
Written by the The Future Vision Coalition in 2009
- Research paperProvided by: Centre for Mental Health
The Mandate identifies five ‘priority areas’ for the Government ‘where it is expecting particular progress to be made’
- Self help toolProvided by: Youthspace
Changing your feelings about Depression Worksheet provided by Youthspace
- Fact sheetProvided by: www.legislation.gov.uk
- Fact sheetProvided by: NICE
Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders
- Research paperProvided by: Youthspace. Dr Charlotte Connor (Senior Research Fellow, Youthspace).
SchoolSpace has partnered with secondary schools in Birmingham to study the factors which precede the onset of eating disorders.
- Research paperProvided by: Youthspace. Presentation by Clare Barker (Research Fellow, Youthspace).
An overview of Anorexia and Bulimia, the factors affecting outcome and the evidence base for universal and targeteted interventions.