When Your Eating Disorder Isn't Your Only Worry

I caught myself thinking the other day, "I wish I JUST had an eating disorder" or "I wish I JUST had bipolar." Meaning, of course, that I wish I only had to deal with one of my many mental health diagnoses as opposed to dealing with them all at once.

How much easier would a major depressive episode be if I didn't have to worry about falling out of my weight range if I missed a meal or two and finding my brain completely overtaken by the dictator? How much easier would it be to recover from this eating disorder if I didn't simultaneously have to contend with periods of depression and hopelessness so profound that I can barely move from my bed.

I imagine it would be a lot easier.

Unfortunately, this isn't the way of the world. There have been plenty of studies done on psychiatric comorbidity in eating disorder patients. (Comorbidity is the term for a person having multiple diagnoses at the same time.) Some studies estimate the rate of comorbidity between eating disorders and other Axis I diagnoses (psychiatric diagnoses, excluding personality disorders) to be as high as 89%.

To put this into real figures, let's say that 10 million Americans (men, women, boys, and girls) have eating disorders. This means that almost 9 million of them are also suffering with anxiety, depression, bipolar, schizophrenia, substance abuse, etc. etc. etc. That's a lot of people suffering from eating disorders and something else.

It's not pleasant -- in fact, at times, it's downright miserable. It's frustrating. It's maddening, really. However, I have discovered that there are a few ways to make things a little easier.

Tips for Dealing with Eating Disorders Plus a Comorbid Diagnosis

• Take your medication: As prescribed, every day. This is non-negotiable.
• Eat enough: Follow your meal plan. Have others help hold you accountable if you're struggling. (Inviting yourself over for dinner usually works for me.)
• Avoid mind-altering substances such as alcohol and drugs: Your poor brain is working hard enough to stay on an even keel without your throwing something else in the mix.
• Be honest with your support team: Your friends, family, and treatment team can't possibly help you if they don't know what's going on.
• Know where your eating disorder and comorbid diagnosis intersect: For example, are you more likely to binge and purge when you're depressed or when you're manic? Are you more likely to overexercise if you're experiencing high anxiety? Knowing these things can help you to head them off before they result in behaviours.
• Do something nice for yourself at least weekly: It's doesn't have to be something "big" like a mani/pedi. (Though if you've got the financial means to do that weekly and enjoy it, by all means, do it!) Buy a nice bubble bath and soak with a good book or magazine. Treat yourself to a Starbucks latte. Take 20 minutes out of your week to go to the park and swing. It doesn't have to be expensive. It does have to be something you enjoy.
• Have a little grace: We're all going to slip once in a while. One of the silliest, most anti-productive things I've done in my recovery is to start beating myself up about slipping. "Oh, I skipped a meal, I'm relapsing, I'm disappointing so many people, I'm terrible!!!!!!!" That's not helping anything. Remind yourself that recovery is a process. Remind yourself that you did the best you could in that moment.

Then get back on track. Do the next right thing for your recovery.

(Photo credit to teenskepchick.org)