Eating Disorders & Comorbidity: When An ED Isn’t The Only Disorder
Today, I’m honored to present a guest post by author Nicole Johns. Below, she talks about the underlying issues that fueled her eating disorder, and how she recovered by addressing both.
I first learned about Nicole when I reviewed her book Purge: Rehab Diaries for Psych Central. (You can read my review here.) In short, I loved the book for its raw honesty, hopeful message, myth-busting and accurate information.
We’ve been in contact ever since, and I think she’s an incredible person and a great advocate for eating disorder awareness and recovery.
By the way, Nicole recently wrote about how lucky she is to be doing what she loves, such as speaking, teaching and writing. I know I can’t imagine how hard recovery is, but this post definitely speaks to why it’s so worth it!
Eating disorders do not exist in a diagnostic vacuum. Often, anxiety, depression, chemical dependency, and other co-morbidities are intertwined with an eating disorder. I believe that it is of the utmost importance to treat the co-morbid condition(s) along with the eating disorder.
It was not until I started the recovery process that I realized that a large portion of my eating disorder (EDNOS) was fueled by unfettered anxiety.
I have always been an anxious person, but I did not make the connection that my anxiety was fueling my eating disorder until I started seeing a therapist who pointed out the relationship between the two diagnoses.
In order to mute and control my anxiety, I engaged in eating disorder behaviors such as bingeing and purging, restricting, and compulsively exercising. These were unhealthy coping mechanisms, but coping mechanisms nonetheless.
In residential treatment for my eating disorder, I learned healthy coping mechanisms for dealing with eating disorder urges. It was hard to implement these strategies when I was so used to using eating disorder behaviors.
This left me with unresolved anxiety. I had the tools for eating disorder recovery, but my untreated anxiety was hindering my recovery efforts.
A month or so out of treatment, I had an eating disorder relapse, largely due to being unable to cope with everyday stressors. Using eating disorder symptoms seemed like the only way I could deal with the anxiety of everyday life and graduate school.
I was able to turn this relapse around by going to therapy regularly, utilizing my support system, and going on an antidepressant. While I initially resisted taking an antidepressant, my anxiety was so overwhelming that I decided to give it a try, along with a benzodiazepine on an as-needed basis.
I also learned coping mechanisms for dealing with my anxiety, such as: exercise (in moderation), deep breathing, journal writing and yoga. My anxiety did not miraculously vanish overnight, but it did begin to recede with medication and therapy.
Shortly after starting the medication, I was able to pick myself up from the eating disorder relapse. There were additional external factors that motivated my eating disorder recovery, but getting my anxiety under control was crucial to overcoming my relapse.
Eventually, seven years later, I was able to taper off of my antidepressant (always have a doctor supervise your taper) and not experience overwhelming anxiety. In those seven years, I worked with a therapist and solidified my recovery from my eating disorder.
I also worked on how to deal with my anxiety in a healthy manner. Initially, I was scared to go off of my antidepressant, but it has gone well.
I believe that addressing both my eating disorder and anxiety has provided me with the tools to stay in recovery.
If you’re struggled with an eating disorder, do you also struggle with anxiety, depression or other issues? How were you able to recover? If you also struggle with anxiety, what helps you?
Tartakovsky, M. (2011). Eating Disorders & Comorbidity: When An ED Isn’t The Only Disorder. Psych Central. Retrieved on February 12, 2016, from http://blogs.psychcentral.com/weightless/2011/03/eating-disorders-comorbidity-when-an-ed-isnt-the-only-disorder/