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Posts Tagged ‘eating disorders are a mental health illness’

This is worth repeating again, thank you to PEDAW and VanCityBuzz

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Online chatter these days often illustrates there is a long way to go before many people fully realize what an eating disorder truly is: a mental illness, or a disease of the brain.

On February 2, we published an article detailing the struggles of a 21-year-old B.C. woman who has resorted to crowd-funding to treat her severe eating disorder. Some of the publicly posted responses highlight the common misconceptions about eating disorders, so we thought we’d take a look at the kinds of misinformation that gets in the way of the good work being done to help those struggling with eating disorders.

While many of those who responded to our story were supportive of the woman’s endeavors to receive help, another fair share could not understand why her disease warranted help, let alone a news story.

The issue is complex.

But those without the education, life experiences or personal struggles that create compassion for and understanding of eating disorders will continue to criticize the publicity of this disease. They will mumble under their breaths something like “just eat a hamburger” or whisper to their friends “she doesn’t look anorexic.”

And that is where a direct response to these comments is needed. For eating disorders to receive the support they need, the stigmatization needs to be removed and the harsh reality of the disease needs to be learned.

Here are some common misconceptions and comments made about eating disorders, along with responses to the issues from professionals:

1. Just eat if you’re anorexic.

“Having an eating disorder means having neurological or neuroanatomical organization of your brain that creates enormous barriers to eating normally. These barriers include visual and sensory distortions, impacts on reward centers and executive organization of the brain, distortions of senses of fullness and hunger, and over evaluation of body size and shape, in addition to other issues that may be present. The combination of all of these things makes eating incredibly hard to do.”

Dr. Mark Warren, Cleveland Center for Eating Disorders

2. Just smoke weed, then you’ll get the munchies!

“We definitely want individuals to eat and digest food in order to heal their physical bodies. This being said, balance is key, so optimally they will work with supports to find ways of eating without using other substances that further promote numbing out to their present experience.”

Natasha Files, Individual and Family Therapist, Looking Glass Foundation

3. It’s more important to donate money to underprivileged children who can’t afford to eat.

“Suffering takes many forms. I have worked with individuals from all socio-economic realms, with some people having money for food and others not. Please choose to donate money to what moves you, but know that eating disorders are an illness cloaked in shame and secrecy. Many individuals do not get help unless their loved ones encourage them to do so, meaning that asking for support takes significant courage.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

4. #firstworldproblems

“There have been many reports about eating disorders in Western countries in the late 20th century. It has been claimed that those with eating disorders have mostly been white women and that few cases have been seen in non-Western countries other than Japan. Recently, eating disorders have been reported in non-Western countries, such as the Middle East and the People’s Republic of China.These recent studies suggest that the prevalence of eating disorders has been rising among non-Western countries as well. However, eating disorders may present differently in different cultures, and diagnostic criteria based on Western norms may not always be appropriate.”

– Makino, Maria, Koji Tsuboi, and Lorraine Dennerstein. “Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries.” Medscape General Medicine 6.3 (2004): 49. Print.

5. There are people fighting cancer who can’t eat, and other people far worse off. Stop being so selfish and just eat.

“These kinds of statements just increase the guilt and shame of a person suffering from an eating disorder- which can lead to an increase in coping behaviours designed to avoid those uncomfortable feelings… cue the binge purge cycle or restriction!”

Trixie Hennessey MSW, RSW, Individual and Family Therapist

6. Anorexia is a serious disorder… but it’s not as bad as cancer or AIDS. We should focus on helping those people.

“Categorizing eating disorders as less deserving of support than other illnesses proves the ongoing struggle with stigmatization in our society. One outcome of struggling with an eating disorder is death. Eating disorders are the third most chronic condition among adolescent females (after asthma and obesity), yet have significantly less funding towards research and treatment.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

“Actually, more people die from eating disorders (350,000) than from breast cancer (approximately 40,000) every year. Females aged 15–24 are 12 times more likely to die of an eating disorder than any other cause of death. More people die of eating disorders than any other mental/behavioral disorder including depression.”

– Atlanta Center for Eating Disorders

7. You don’t look anorexic!

“Being the most lethal of psychiatric illness, eating disorders come with a number of serious health consequences, even if the individual looks “okay”. Low blood sugar, blood abnormalities (electrolyte imbalances), enamel erosion, dizziness/confusion, esophagitis, arrhythmias, acrocyanosis, edema, growth retardation in children and adolescents, and sometimes death. Eating disorders affect every system of the body, meaning that glancing at someone’s body shape does not determine the level of physical impact.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

8. You should be grateful you can afford to feed yourself. If you knew real hardship, you wouldn’t have this problem.

“Individuals who develop eating disorders are usually very sensitive.  They are physiologically more sensitive from birth than the average person. They are very in tune with the feelings of others and have a strong drive to want everyone around them to be happy. This often leads to perfectionism as they try to reduce any negativity that they or others will experience. As the disorder progresses they become caught in a vicious cycle where their attempts at being the best that they can be actually does cause others negative feelings — but at that point they can’t just stop. The attempt to be perfect is primarily a way to ensure that nothing about them will cause anyone else any distress and to ensure that others will not find fault in them, something that they are very sensitive about.”

– Atlanta Center for Eating Disorders

9. Starving yourself to death is a choice, just like taking drugs or drinking too much.

“There is no choice when it comes to an eating disorder. There is a choice to start out with behaviours such as dieting, exercising, fasting, etc… but there are many people that diet, exercise and overeat that do not have an eating disorder. There are many people unhappy with their weight and shape who do not have an eating disorder. Eating disorder treatment is complex and an intense process. I would encourage you to question this assumption, as I feel it perpetuates the stigma and feelings of shame that keep people from reaching our for help if they need it.”

– Trixie Hennessey MSW, RSW, Individual and Family Therapist

“Someone can make the choice to pursue recovery, but the act of recovery itself is a lot of hard work and involves more than simply deciding to not act on symptoms. In most cases, the eating disorder has become a person’s primary way of coping with intense emotions and difficult life events.  In order to heal from the eating disorder, a person needs appropriate treatment and support regarding medical monitoring, nutritional rehabilitation as well as learning and practicing healthier ways to manage stress.”

– The Center for Eating Disorders

 

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Watching my two children I can see so clearly the difference that sets apart an eating disorder. To say that it is an attitude, bad behaviour or choice illness is to give the ED the illusion of being a rational, logical illness that can be cured easily with straight talk.

We were watching my son who was underweight and making sure his weight didn’t fall lower so that he might trigger an ED. But it is far more than that.

It is not about the weight. It is not the weight that determines whether an ED is going to happen.

imagesRather it is the mind and only the mind the starts the ED illness. My son was able to be talked to, he understand fully and was able to respond rationally and normally.  He accepted he was underweight and was able to stop the slide down. He increased (slowly) his food intake. He didn’t want to lose weight, didn’t see himself as ‘fat’. He didn’t need to sneak or hide, manipulate or lie about food. He didn’t hear voices. So with support and medication he is back to a very good weight. Still very depressed/suicidal/anxiety ridden, but not in the realm of an eating disorder. His depression is not part of an eating disorder.

I can see why though some doctors think it is depression and not an eating disorder. The low weight and lack of food to the brain causes problems in itself and causes depression at a deeper level. My daughter, unable to eat couldn’t feed brain or emotions and continued down lower and lower. My son, able to eat, is now not as deep in depreciation and his mind is functioning clearer with the added weight.

Whereas …

My daughter when underweight she couldn’t begin to eat more nor understand why she should. It was like she was on another parallel or left her mind behind somewhere. The anorexia mindset was already in full residence about 4-6 months before the weight started to decline. Healthy foods, vegetarian,  etc., accompanied by this intense, black/white focus. She wasn’t rational about her weight or the amount of food needed to gain weight. Her head was full of a voice that continued to control and push her down.

Relating to the two is also so different. On any level to do with food, clothes, weight and self my daughter was totally negative and unable to communicate normally at all. My son and I can still talk to about all these things and not have a negative blast back from him. He is still himself. Whereas my daughter lost herself and become an entirely different person.

I don’t know whether I have explained all this enough to show just how that eating disorders are based in the mind. If I had only one child, I wouldn’t have noticed this difference so much. But having two, with similar symptoms, but developing into two different paths, has shown me just how different an ED is and how much it affects the mind and personality.

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How do you know if your son or daughter is going to be the one to gain full recovery?

How do you know if they will be one of the luckier ones that have the eating disorder for a few years?

How do you know if yours will struggle for years or a lifetime?

How do you know if Maudsley will work for your loved one? What if they become adults before you complete the treatment? What if Maudsley does work, but later on they relapse at university?

Bottom line – you don’t. There is no guarantee when you start this where any of you will end up. Eating disorders as a mental health illness are unique and linked explicitly to each person and their personality. Two people using the same treatments will not end up with the same outcome.

It is a stressful and unknown time for both sufferer and family. But not trying and not moving toward recovery is also not an option. Despite how you get there or how long it takes,  recovery is a real hope and it can and does happen for many people. You simply cannot ever compare your journey through this with someone else’s. All that does it setup of guilt, inadequacies, failure, anger, etc. It’s a no win situation. Sufferers feel they are letting their carers down, carers feel like the sufferer is not trying enough.

If you try to find outcomes or quantify/analyse how long or what ‘type’ you may is pointless. Setting the bar too high or low is detrimental. The best you can do whether carer or sufferer is to start recovery. Don’t stop, don’t look back or around. Just stay focused on you and your environment. If parts of your treatment aren’t working, find other ways. If a therapist has stalled in their approach, find another one if need be. Don’t align yourself with other sufferers who could cause you to relapse.

As a carer and parent, I look at other girls around my daughter at their stages of recovery. I know many of these parents all used the same techniques, FBT, similar support team compositions, even using same therapists etc. But each girl is different and in very different stages of recovery. Some have stalled, some creeping forward, some falling backwards, some making big decisions forward. You simply cannot predict how your loved one will respond. And most importantly you MUST work with what you have. I have learned not to put any expectations on the questions I outlined in the beginning of this post. I cannot and it wouldn’t be fair. After this is Sophie’s life we are talking about and as such, the bottom line and responsibility belongs to her now.

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