“Recovery Burnout”

Maintaining momentum in recovery is exhausting.

Some days feel like you are cruising along. But I want to talk about the days where you feel exhausted by recovery itself, when motivation wavers.

I feel it’s important because without acknowledging, this “burnout” has the potential to hinder one’s recovery, through frustration, boredom or just sheer mental fatigue.

Burnout has been defined as a state of complete mental and physical exhaustion resulting from prolonged stress, where a person’s ability to meet demands is impaired. Often, through feeling overwhelmed and/or emotionally drained. Not surprising the pandemic has resulted in high levels of this and likely far more to come.

This definition is also applicable to recovery don’t you think?

When I was all consumed by my eating disorder, if I’m honest, I found every day exhausting. Living by the constraints of so many rules and behaviours made every waking minute punishing , not to mention the insomnia. Oh my god the insomnia that results from a starving brain, it’s like a waking nightmare, you’re haunted by the food “you won’t allow yourself” and all the while your brain is trying to scream at you to eat. Your brain wants you to live and in doing so constantly reminds you about food, 24/7 it doesn’t sleep and so you don’t sleep.

Life with an ED was sapping, but I didn’t appreciate this at the time, partly because I was permanently living in a high state of stress all the damn time, my body didn’t allow me to feel it. It’s the fight or flight mode, the product of an overactive sympathetic nervous system. But I was tired.

When you enter recovery your body has the chance to pause and take a breath when you finally stop. It begins to heal. Healing hurts, when you injure yourself, it’s the inflammation and body’s response to healing that’s sore.

I’m not going to sugar coat it, this moment of stopping, everything might hurt. All the injuries, the pain your body has concealed from you, just so you can “keep going” hits all at once. It’s a wall like I have never faced before and barely have words for. This fatigue and pain gets better as you feed yourself, rest & heal.

Early recovery is exhausting. There’s so much healing and adjusting to do, but the anticipation of better days ahead kind of pushes you through. You and most people around you expect tiredness in the early days, it makes sense from what your body has been through.

It’s what I’m going to discuss next that I think has been a difficult concept for me to grasp or allow myself not to become overwhelmed by.

Recovery is boring. Really fucking boring at times. Realising you will likely need to deal with recovery each day to varying degrees. Recovery still has to fit in your world. It has to so that you don’t fall into a pithole.

For example as we get further along in recovery, so many things change, mostly positive let me just get that out there now.

However…as your world starts to get bigger and your eating disorder brain is taking up far less of your mental space, you start to see who you are and what life without your ED can be. You start to have goals and dreams that are “normal” people dreams, not unrealistic eating disorder standards. You don’t want your ED to even factor in, but for a while to protect your future it has to.

You know in order to realise these aspirations you still have to have recovery goals, because how can we dream of a life without an ED if we don’t put the work in to recover?

It’s more like an irritation on these days where you are mostly free, without the constant barrage of intrusive thoughts, you have room to deal with life, “normal” thoughts & goals. Here, I try to reframe my thoughts to be grateful for these days because the alternative of not being bored, sucked.

There are days like today, when I have lots of things I am focussing on, career progress, my job in hand, family, where we will be living in a few months etc that it irks me that I have to spend any extra energy thinking about recovery. Today this meant a bit of extra attention to meal structure because I’ve lost my appetite. I can’t afford to fall into that trap and I have to focus on fueling myself properly on top of the other things. Frustrating as it is, that recovery still has to fit into that world and those future plans, it’s helpful to reframe this thought process, I am happy to inhabit a big world that my recovery has made possible.

Other times where I think recovery can become arduous is when we ruminate on the past. I often experience regret for lost time to my eating disorder. I no longer feel ashamed about it for the most part, but I do feel sad. I find this regret prevents the resentment to recovery orientated thinking/ behaviours when I’m feeling “over it” because I don’t want it to be my future as well.

This can be emotionally draining. I think it’s important to return to your self care toolkit on these days. I think becoming tired of dealing with recovery is real but I would choose to be here, rather than be a slave to it any-day. Recognising how you feel and that you can’t make massive progress EVERYDAY is ok, Burnout is ok. Be kind to yourself. Acknowledge that this is a good sign.

If you’re feeling the recovery burnout I hear you. One day you won’t have to use as much energy to protect your health legacy. So be grateful for the boredom and keep going

Arrested State of Development

Last week I was setting my intentions for the New moon. Whilst beginning to manifest and set in place the foundations of those intentions, I had a realisation.

When we are experiencing an eating disorder we are living in a state of “arrested development”. Loosely this is defined as a cessation of growth, this can be both psychological and physical. Initially ALL of our focus and energy is used in sustaining our eating disorder, then it becomes recovery orientated, both requiring substantial energy and attention.

I’m in the process of some major life changes and upheavals over the coming months with a ton of uncertainty. I’d been ruminating over the fact I wasn’t where I wanted to be, in terms of the standards I’d set myself for my career, my life. I was feeling resentful to the time lost to my eating disorder and to some extent recovery.

It dawned on me, for the last two years I have been fighting for my recovery, fighting to have a life not dominated by and eating disorder and before that I was expending all of my energy on the disorder itself, leaving room for very little else. I was feeling frustrated that I was now “no longer considered the best doctor of my cohort”. This is an egocentric attitude I need to work on anyways, but I have always been a perfectionist and through uni I had never settled for second place. Now, academically I am viewed as “capable”, but not excelling. There is nothing wrong with this, it’s how my brain processes this that is the problem. Now, I’m the doctor who has the good rapport but hasn’t necessarily recalled every hazard ratio from every journal ever written, but this was me, a long time ago. Before my life priorities had to change.

I realised some of the standards I’d set myself had become external expectations and now I don’t match those either. Again, this is not a problem, it’s how you react to this. The thing is I have been trying to be “that standard”, but I’m not, I can’t be right now. I essentially took two years out. If I was a professional athlete I couldn’t expect to compete at the same level after two years out, it’s the same here. The difference is, the people with those expectations don’t necessarily know I have been trying to survive and recover again, this was because I kept my eating disorder hidden through fear of stigma and so why would they? It was only recently I felt able to be open about my journey.

It’s only now that I was beginning to feel “bored of having to be recovery orientated” and have so much more mental capacity I could see unmasked I had been living this state of arrest. It’s releasing, I’m ok with who I am. I’m proud of what I have overcome and where I am. Letting go of unrealistic standards and expectations is what’s helping me in my health legacy and provide my patients with care. I think it would be unhealthy and unrealistic to want to be the same person we were before recovery.

How can we develop and grow when our worlds are so minute and focused on such specific details such as weight or that grade. I didn’t have the energy or time to be reading the journals I now am, when I was merely trying to survive.

I worry about my colleagues, the pandemic will fuel burnout, but unless the healers have a place to heal themselves this won’t go away. I wish for the unforgiving environment that is the healthcare profession to become a more open and compassionate one. One that does not depict personal struggle as failure. I shared my struggle not so long ago, because this unrealistic image of what a doctor should be is harming those that look after you, the more we normalise the narrative the healthier the healers.

I do think recovery burnout is a thing, it’s emotionally, physically draining, it becomes tedious but for the days where recovery is not boring it’s important to keep recovery orientated.