A few months ago, the first case of COVID-19 (or as it’s more colloquially known: coronavirus) was discovered, and since then, it has spread like wildfire. So far, nearly 250,000 cases have been reported with just over 10,000 of those cases resulting in death. Fortunately, there are more survivors of the illness than deaths, but, all the same, the illness is a serious one and should not be taken lightly. And one of the ways we can cope is to continue to behave sensibly and with consideration of those who may be in the percentage of more serious and critical cases. But, as you have seen in the media and in person, this has not been the attitude of many, many people. Walk into any supermarket and you will struggle to find just about anything. Toilet paper, hand wash, hand sanitiser, aloe-vera gel to make hand sanitiser, shower gel, tissues, paracetamol… and, most importantly, food. The shelves are cleared, and within moments of them being stocked up, they are cleared again.
People don’t know what’s happening. And when people don’t know what’s happening, they panic and they do everything they can to prepare. Unfortunately, as we live in an individualistic society, our preparedness comes at a price. We become selfish and inconsiderate and we do not prepare appropriately. As a result, people are affected in ways that others do not realise.
One of these groups of people are people with eating disorders.
Recently, I wrote a tweet that discussed this very fact and within the day I had amassed some traffic with people reaching out through direct message and through replies about their concerns in how to support someone with an eating disorder during this time. Many also drew attention to the fact that others who are not so affected by eating disorders would not realise the rippling effects of panic buying or, a pandemic in itself, on people with eating disorders and their support network.
Put simply, eating disorders heavily rely on disturbances within an individual’s life to thrive and manifest. A pandemic is the perfect situation for an eating disorder. It will use this to its advantage, knowing full well that a pandemic and the societal behaviours that exist within a pandemic will play on the mental health of someone with an eating disorder. Every day, we are consuming climbing figures of coronavirus cases, the pressures on the NHS, deaths, the people who are now being made to work at home. Our social medias and our mainstream medias are continually reporting on the virus and it’s affecting everyone else. So, as an individual with an eating disorder such as one that follows a restrictive eating pattern, already so consumed with the idea that we are worthless and nothing, our eating disorders allow us to come to the conclusion that we are not allowed to eat because we are not deserving of food. We see empty shelves and we think that people need this food more than us therefore we are better to go without. We do not deserve the food. We do not deserve to look after ourselves. We are not worth a thought. We are not worth any support or consideration. We don’t want to be a burden. So, we go without.
Not only do we go without food, but we also go without discussing our anxieties and our eating disorder-related thoughts and feelings. For many with an eating disorder, we are now laden with the idea that we are not worth your time and there are worse things out there right now. Sure, the coronavirus is probably one of the worst things out there right now. But our feelings are further invalidated by the toxicity of our mental health disorder and we are made to feel that we should not talk about our illness. We’re full of guilt for even thinking about our eating disorder. Yet, that’s what it wants. It wants us to feel guilty. By feeling guilty, we don’t talk about it and when we don’t talk about it, it grows more powerful because no one knows it is there. Our eating disorders make us feel ridiculous for reaching out. For looking for support. You’re looking for support about a silly little problem like this when people are literally dying. Eating disorders are taunting you with this. They make you doubt the sincerity and severity of your illness. They shrug off your illness as something small, something menial, something not worth thinking about.
As I mentioned, panic buying leads to empty shelves. Staples such as bread, eggs, fruit, veg, and soup are gone. We include them in our weekly shops without a second thought. To someone with an eating disorder, they are “safe foods.” When I was unwell, I had a list of safe foods. Foods I could be sure would grant me the control over my weight and would appease my eating disorder. And for many in their path to recovery, they are essential in maintaining their weight and in helping them to relearn to eat. Therefore, safe foods are a welcome ‘fall-back’ for someone in recovery. In this pandemic, many are facing the situation of no safe foods being available. As a result, they are overwhelmed with anxiety and feeling beyond vulnerable. So, they will cope by going without any food. Their eating disorder remains in their mind, and it will attempt to reintroduce that coping mechanism that was used before: if there is nothing safe, nothing that your eating disorder thinks is safe, then you may go without. Your eating disorder knows it can offer that feeling of control, that when things are unusual and things are difficult, then you can control it through your food.
And, on the other side of the eating disorder spectrum, those with binge-eating difficulties may find that they are worried they may panic-buy out of fear, just like others are doing, and then due to the lack of control within their lives throughout this pandemic e.g. self isolation, working from home, being in environments which illicit anxiety, so they may cope by overeating/binging. For people with purging involved in their eating disorder, they may then attempt to regain control by purging. It is difficult with any eating disorder to feel like you are in control, or any appropriate amount of control. So with an excess of foods or no food at all, the individual will fall into a way of disordered eating again to cope. To get any form of control or alleviate any anxieties.
People with eating disorders are so overwhelmed with the prospect of trying to cope and recover already so throw in the element of a pandemic, which is causing others to react in a panicked state, often leaving our most vulnerable even more vulnerable. This may lead to an increase in behaviours and a decrease in reaching out for help and general self-care of themselves. Many are stuck, and simply don’t know what to do.
Beat, the UK’s leading eating disorder charity, has put together advice from a team of clinicians on how to cope with coronavirus if you have an eating disorder. It’s a phenomenal resource, and one I recommend taking the time to read. However, as someone with lived experience, I am putting together some advice myself. I’m hoping to put some resources out myself with Beat and another health care resource I work alongside called Alliance Care Scotland.
What can you do as a person with an eating disorder or as a carer? There is a large quantity of problems that you may find surface as you go through these next few weeks/months of the pandemic. But, always know there is something you can do about it. And that something does not involve your eating disorder taking over. Know that it will try, but you are stronger than this, and if you have a plan then you can keep the eating disorder at bay, and you can maintain recovery.
First things first, forgive yourself for the feelings you are experiencing. The world is in a chaotic stage, and was in a chaotic place beforehand. Your eating disorder does not stop for this. It is always fighting for control of you. You cannot help thinking about it, and in this time, you are going to feel out of control. Your eating disorder loves this and it will try to jump on this panicked time. Your eating disorder will try to riddle you with guilt. Why are you focusing on yourself? Why are you being so selfish? You shouldn’t be thinking about yourself. It doesn’t want you to focus on recovery, or speaking about it. It just wants you to not focus on yourself, and effectively not care for yourself. It’ll want you to fall back into your old coping mechanisms, because it’s something you are used to and it’s “easier” to deal with than trying to manoeuvre recovery. So, I want you to forgive yourself for focusing on your eating disorder and wanting to remain recovered. It was there before the pandemic, and it’ll still be there. You can still focus on your recovery. And you should.
In the midst of the panic buying, you may feel overwhelmed about the prospect of going out to the shops. So, now is the time to collaborate. Carers of someone with an eating disorder may find that this is a great opportunity to work alongside the person and even learn more about how the eating disorder interacts with their loved one. If you want to go to the shops then go with someone who can help keep you focused and work through your anxieties. If you cannot go with someone, then communicate on the phone. Send them a list of what you are buying so they can collaborate with you and keep you focused. If you decide to do online shopping then do it alongside someone or communicate via FaceTime, Skype or a phone call. You may feel it would be easier to go alone, or to go without food altogether, but this will give the eating disorder the opportunity to have control. If you work in a collaborative approach then you will share responsibility, while also having a chance to have a level of control. You should be involved in what you eat, but should not give your opportunity to your eating disorder to establish full control.
If you are missing safe foods due to panic buying, collaborate with others in your lives to share what they have in terms of food (safely and with consideration of their stocks too.) Do they have some fruit they can spare? Do they have a loaf of bread? Can they batch some meals or prepare some meals/snacks and prepare some extra which you can take? If this is proving to be difficult, sit down and plan out some meals and snacks, make a list of your safe foods, and then plan some alternatives. This is when collaboration could come in handy. Carers may find it helpful to work with the person to think through alternatives, as they may feel overwhelmed by the prospect of introducing relatively new foods or different versions of safe foods into their lives. They may feel stressed by this and it could result in a lot different negative emotions coming to the forefront. As a carer, you have to be prepared for this and understand that this is a complicated and distressing situation for someone with an eating disorder. Have breaks, work through the list as slowly as they feel comfortable, think about each food carefully, and remind them that you can get through it together and the eating disorder does not have a say but rather they do.
Some people feel that self-isolation may give them the opportunity to not eat, particularly if they live alone. Some feel they can’t eat at home and prefer to eat out, because it encourages them to eat. An idea may be to set time aside to eat your meal, and FaceTime or Skype someone to have your meal with them. It allows you to talk about other things that aren’t focused on eating. It may also give you the chance to speak through anxieties you are experiencing right now when you are eating. It may be fun to treat your meal time like a restaurant or a cafe. We’re all having to social distance right now, so treat your environment like a cafe. Eat together, but maybe not right next to each other. But, don’t eat in separate rooms. You wouldn’t eat in separate rooms in a cafe. This allows you to eat in company, but perhaps not provide the same amount of pressure a family mealtime may have.
On the other side of the eating disorder, it may be a good opportunity for you try new foods. If you feel comfortable, and are struggling to find your safe foods, introduce a new food whether this is an alternative to a safe food or a brand new food. Do this where you are comfortable. I acknowledge that this may cause a great deal of anxiety, so make the small steps that are necessary for you to do this.
Most importantly, now is the time to talk to people. We are in self-isolation, so it can be a very lonely time for us all. We are social creatures by nature, and having social interactions are very important, if not essential, to maintaining good mental health. We are social distancing, but not socially withdrawing. We are in an age of AI and assistive technology so we should use it. If you can’t see someone, pick up the phone and talk to them. FaceTime or video call to have or prepare a meal. Have you just watched a show and want to discuss it with your friend? Go ahead and phone them. Give some designated time to discussions around the virus to get it off your chest and then end all discussion around it. Keep up with your therapist if you are seeing one; enquire if they are doing telephone support, which many are likely doing. If you can, visit online forums on places like Beat. They have just launched The Sanctuary which is a daily service, running between 12-8pm. They have a variety of chat rooms and online support services. This will allow you to stay connected and give you the opportunity to talk about your eating disorder, whether it is anorexia, binge eating, bulimia etc., Join a Facebook group that is relevant to your area, and seek out help if it’s needed. It may seem like the world is incredibly selfish right now, but there are people out there who want to help. A lot of people are turning to online resources to broadcast their services such as yoga classes, drag quiz shows, cooking classes etc., If you are on social media, investigate your community or check out new communities. There are people there who want to connect.
Remember, don’t feel guilty for worrying about your eating disorder in this crisis. Don’t feel like you are selfish. Right now, your eating disorder can thrive in this situation. It will try its hardest to take control of you. Try to not give it the chance to do so. You are stronger than it, even if you don’t feel that way. You are deserving of recovery. You are deserving of food. You are deserving of good things. Have a plan, reach out, and you will get there.
Keep safe. Keep healthy. Wash your hands.