“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

Recovery isn’t about never making mistakes

Setbacks will happen, because life happens.

Whether you are just starting recovery or have been on the the path for some time setbacks are inevitable.

It’s okay. It doesn’t mean you can’t recover, I absolutely believe recovery is possible.

But not preparing for setbacks is setting yourself up to fall. After all perfectionism is part of the issue right?!

I am happy that I will one day consider “succeeding at anorexia” as my biggest failure. A setback or relapse does not mean you have failed at recovery.

Setbacks teach you things and pave the way for what might be ahead. They prepare you for a fulfilled life without your eating disorder.

I’m hoping my latest setback will help you.

I’m not ashamed I momentarily took my foot off the recovery pedal. It happened, I’m back in control and wiser for it.

Why did it happen?

Well if you’ve read any of my previous posts you will know I am a firm believer that eating disorders have a strong neurobiological component fueled by energy deficit. Energy deficit being the match to the flame if you like. The physical and psychological symptoms that follow being the fire that is contributed by everything else such as environment, stress etc. The important thing is the match in the genetically vulnerable.

I have just finished a set of night shifts. Night shifts to the average person without a history of an eating disorder can reap havoc on health, both physically and mentally. They disrupt your natural circadian rhythms, they can be socially isolating and routine can become difficult.

I’ve worked shifts for years. I know it’s a time where previously I have allowed my eating disorder to thrive. Therefore, armed with this knowledge I planned to avoid falling into the trap of my eating disorder.

Knowing I cannot allow myself to slip into energy deficit I made preparations to attempt to combat this. I ate more before work and before I slept, I planned out snacks to take with me.

But life happened. I missed some breaks and a few snacks. I was lacking sleep and so my appetite was lacking, I hadn’t made self care and routine a priority.

I didn’t think much of it in the craziness of the shifts, but when I found myself unable to eat 3 meals a day when I came off my shifts I knew I had slipped.

I haven’t had “fear foods” for sometime.

I haven’t thought about engaging in disordered behaviors such as concealing what I was/ or wasn’t eating, for months.

I haven’t listened to the voice tearing me to shreds in the mirror for the longest time ever.

But suddenly it was all there I was right back in it. I found myself wanting to control my intake, to compensate for every “ unhealthy” choice I was making. I recognised a familiar welcome feeling of emptiness that in truth I had actually forgotten. The emptiness euphoria made me contemplate giving up on recovery. After all if I’ve fallen so easily after so long, what’s the point in continuing? The intense draw to the scales returned, I had to fight to not give in to the temptation. I know that no number on that scale would have had any importance, but to my eating disorder it would have been used as firewood.

I danced with the temptation of a full blown relapse. However, I reminded myself it was all lies. If I didn’t put this match out I’d be amidst a wild fire that only wants to destroy.

I needed help. I needed support. I’m not ashamed of that.

My eating disorder tried to make me carry the weight of shame. But that’s another reason I knew I needed to put the match out.

I enlisted support from my support network. I chose to let them in. For the few days following, making decisions around eating felt like an impossible task. The thoughts were so loud. I have now reinforced routine, I challenged the “fear foods” that re-emerged and I prioritised taking care of myself by resting, talking and eating. Instead of pulling myself apart and focusing on “failure” I’ve chosen to treat myself with compassion.

I feel back on track. Ive bounced back. With more knowledge and information for my next set of nights- I need to prepare further. I will carry more snacks on my person. I will increase my intake. Self care, such as yoga, journalling and talking each day will be a priority and not an after thought.

My tool kit is more substantial.

Recognising a slip is vital to enable you to seek help and the support you need.

Recognising it early can help you get out quickly.

It’s obvious to me these slips came from:

Skipping meals (no matter how innocent)

Eating in isolation.

Blasè attitude “no big deal”

These are known triggers for me. Knowing your triggers can help you prevent and identify potential setbacks/ relapses.

Preventing setbacks is not always possible.

But planning what to do in the event is key.

Make your relapse prevention plan. Update it with each learning experience.

Seek help.

Most of all- choose to get back on track. Choose to put the match out, don’t start the fire. A moment of struggle doesn’t mean failure. Be kind to yourself and keep going

Check these out:

Relapse prevention plan mirror-mirror: https://mirror-mirror.org/recovery/607-2

Relapse prevention/ recovery maintenance sheets from cci: https://www.cci.health.wa.gov.au/-/media/CCI/Consumer-Modules/Overcoming-Disordered-Eating—Part-B/Overcoming-disordered-eating—09—Relapse-Prevention.pdf

Vacationing with an Eating Disorder..

Vacationing then vs Now

We have just returned from a few days holiday, which I feel incredibly lucky to be able to do for numerous reasons, 1. We live in a place we can travel at present and secondly my eating disorder was not allowed to dictate my behaviour for the first time in many years.

Why are holiday’s so hard for people with an eating disorder? Often in the midst of an eating disorder we use behaviours to cope with uncertainty, change or triggering situations. Firstly, you are away from home, your regular environment. This can be full of uncertainty and planning can go out of the window. Tonnes of food challenges can arise. Challenges you may not have foreseen, such as not being able to follow a regular schedule, a meal plan. Eating out and experiencing new dishes. All of these things can be extremely triggering. It’s hard to imagine if you’ve never experienced an eating disorder.

Here’s how a holiday for me used to look like:

Weeks leading up to vacation:

Enormous anxiety and dread. Escalation in behaviours in response to increased thoughts and fears regarding the uncertainty of said trip. I would buy into the “ prepare for the summer body diet culture crap” and it would set my eating disorder into a frenzy.

Then the event would arrive, no matter how much “ event restriction/ compensation” I had undertaken I would still feel ridiculously out of control and fearful that my constant was about to change. I would not be able to predict every meal and therefore calculate my intake. Holidays can be inactivity. This used to terrify me, how was I going to hide my “craziness’, fit in my ridiculous workouts in new territory? All the while Hitchhiker ‘HH’ would be telling me I was disgusting. How can anyone be present and relax on holiday when this is going on?

Changing experience of holidays’ with time and at various points in recovery;

Once I commenced recovery the anxiety around the trips shifted to a different kind of anxiety. When you start recovery, especially early on, you need to eat very regularly. Holidays can make important established routines very tricky to follow. I would worry if I would be able to eat the food available. Eating in front of people can be immensely anxiety provoking and largely, trips involve eating out. It’s a point where you are challenging ‘fear’ foods and there’s all kinds of food challenges that can happen on trips which for the person experiencing an eating disorder is overwhelming.

Some restaurants very unhelpfully have nutritional values on their menus which can be a minefield for those of us trying to recover from an eating disorder. Trying to do the “ right thing for recovery” when in an already stressful situation and then presented with your demons on a plate, in every sense is really freaking hard. I used to use one hand to block out the numbers. Or ask someone I trusted to look at the menu, find something I’d like and pick until I could deal with this. Until I got to this point, my eating disorder was too strong and it would not allow me to choose what ‘I desired’. This adds to the stress, feeds the eating disorder and makes the time really challenging. It gets better, I promise.

You can’t switch your calculator of a brain off overnight. It takes time and practice and many situations and repeated actions until your brain doesn’t equate the numbers with relevance. But it can be helpful to go to places you don’t know the nutritional value, because your well trained brain sometimes doesn’t switch off for familiar items. Now I can go to a restaurant with the nutritional values and choose what I desire without coercion. It irritates me that the diet industry even seeps into the catering industry and influences our choices. (I spent ages in recovery with a black marker pen scrubbing out nutritional values on boxes etc) Now I don’t automatically read or know the content of EVERYTHING. IT is possible to train your brain to stop paying attention with effort. Black marker pens are brilliant for this.

ALSO, FOR THOSE WHO NEED TO HEAR THIS, I’M GOING TO SAY THIS ONCE: CALORIES IN DOES NOT EQUAL CALORIES OUT. OUR BODIES ARE WAY MORE INTELLIGENT THAN THE PEOPLE WHO CAME UP WITH THIS LIE.

What my life would look like after I returned from a holiday:

A completely false sense of guilt for the “loss of control”. I say false because, I was not in control on any of the trips. I had abided by my eating disorder rules and stipulations. I might have eaten something slightly outside of ‘HH” rule book and paid an enormous price of guilt, shame and most importantly regret for all the things ‘HH’ made me miss out on because I listened.

I would return from holiday, unhappy, compensate for my warped view of the trip and over value I placed on it and nothing would change because an eating disorder is a constant event planning, life of restriction.

A Vacation now:

Leading up to the holiday, the old neural pathways are fragile and the ‘HH’ thoughts do get louder. The thoughts around compensating return. But the big difference now, I know these thoughts are lies. The do not lead to me feeling happier, more confident on my holiday, more relaxed and present. No the complete opposite. Therefore, I have to be vigilant I have to make an effort to do the opposite.

Vacations are a trigger. Knowing triggers, helps you plan and prevent slips or relapses or in the event of either recover from them quicker.

My husband and I talked about the trip prior. He knows my triggers pretty well now.

For me, this meant, making sure we always have ample snacks around incase we get caught somewhere ( we spent 6 hours driving and quite remotely at times).

We knew some of the foods would be challenging- so I set myself some food challenges. Like eating spontaneously on the road, eating foods that are deemed as “unhealthy”. When realistically no food is unhealthy it’s all fuel.

It was going to be the first time on a beach in my togs since I weight restored. This was a huge one. Putting on swimwear for the first time, since weight restoring is a whole new chapter in recovery. I’ve gotten used to wearing larger clothes to my previous weight restored body. That was a challenge in itself. But putting on swim wear is next level discomfort and vulnerability. Society tells us, to go to the beach we need to be “bikini/ beach/summer body ready”. Just putting it out there now, “bikini/summer body’s” do not exist. It’s a societal fat phobic term, the body you inhabit in, is beach ready whenever. If it can get you to the beach, it’s ready!

Learning to adapt. This has been a massive one for me. Whether it’s adjusting to body image, which is something that naturally creeps in on vacation. Being surrounded by different body sizes, it is important to feel as comfortable in your skin as you can. Wearing clothes that make you feel comfortable helps. My body is very different now in recovery, feeling confident and comfortable is hard. It is possible my friend, you shift your focus to the activities you are participating in, rather than the body you are in. I am grateful to this body because it’s this body that allows me to enjoy rather than fixate and agonise. No matter what body you are in in the midst of an eating disorder you won’t be happy.

But for the body image stuff: I tried to think about it this way..

Why is it, the least interesting thing about someone, their appearance is what we judge them on so heavily?

Personally, I think I have nice eyes, but that is one of the least interesting things about me.

There is nothing interesting about your, shape, weight or appearance. I don’t care how much you weigh or size jeans you wear.

This has helped me this week when I found my thoughts drifting to judging my recovering body. Instead I know I was mean on a paddle board, I am funny and a kind person, that’s way more interesting than worrying about the other crap.

I’m at a place in my recovery where I can eat out, and this can be regularly. I found this really difficult previously. Even so, my old thoughts were there on occasion but each meal I challenged them and moved on. That doesn’t mean I found the holiday as easy as someone who has never experienced an eating disorder. I still had to choose recovery at least 3-6 times a day and not let those decisions impact upon my plans or activity. But I did not engage in the ‘HH’ thoughts.

The holiday was more free and flexible. I felt present. I wasn’t bone cold in 25 degree heat. I wasn’t calculating. Goofy yes, calculating no.

This level of flexibility and freedom is something that has come with persistence and time.

Holiday’s are a time for rest and recuperation from the craziness of our day t day lives, for people with eating disorders they can instil extreme anxiety which diminishes any prospect of relaxation and enjoyment. But there are ways of managing them. As outlined above I think some of this will depend on the stage one recovery to the extent of planning and support required around them. But they should not be as stressful, so I hope if you are someone with or supporting someone with an ED, you can find someways of reducing the anxiety.

Things that I have found to be helpful when planning trips:

1. Talking with your treatment team before (and after)

2. Planning for potential triggers

3. Identifying potential triggers and a plan in the event of trigger-what’s in your toolkit

4. Planning food challenges for the stage of recovery, with appropriate support.

5. If following a meal plan, how the trip might be helpful or detrimental and planning around this

6. Wearing clothes that make you feel good.

7. Making sure you always have appropriate fuel available

8. Do you need to know where you are eating? (again I think very individual) I did at some stages.

9. What activities will you be participating in

10. Who are you going to be travelling with, are you supported/ triggered by them.

All of these are or have been part of my own trigger prevention and plan. This is growing/ changing as I encounter potential triggers or progress through recovery. You might have some similarities but you WILL have your own.

What we want to tell you about our eating disorders, but find hard…

Eating disorders are secretive, preoccupying and feel extremely shameful. They are rarely openly discussed and stigmatised.

Below are things I would have never felt able to share with others before I found my voice in recovery. However I wish I had said them sooner to help you understand. Hopefully this might give voice to other’s experiencing recovery and wish they could share some of the things going on in their heads.

1. Weight restoration does not equate to recovered. In fact, this part is probably the toughest, most brittle part of recovery. On the surface I may appear “well, healthy or recovered” but I am just about holding it together. You have no idea based on my appearance how I am. Likely I am fighting strong thoughts and urges to undo this courageous work. Mental recovery takes so much longer than the physical recovery.

My eating disorder was at its loudest when I reached my “target weight” and then exceeded. Regaining weight, gaining weight is harder than you will ever know for someone who is recovering from an eating disorder. They are fighting every thought, every second, every minute of every day waiting for a moment of inner peace. Weight gain is a small part of recovery, but possibly the toughest part. Once we regain weight, (weight we should never have lost) often people assume we are recovered and support lessens. This is arguably the point we need your support the most, please help to encourage us to keep going. And so I implore you, please do not comment on my appearance. Well placed comments can fuel this cruel deceptive eating disorder voice that I am trying so hard to move away from.

Statements, however true and well meaning, such as “you look healthy or better” can really harm someone’s recovery. Comments such as have you lost weight? Can ignite the path to destruction or send my brain into a frenzy that I have failed at recovery. I cannot win when it comes to body shape comments. So please keep them to yourself.

2. Recovery is a choice I have to make, every minute of every day. You cannot make me recover or do it for me, but I value your support. My recovery is my responsibility. My choices, my decisions are what keep me on the path to recovery. It is a full time job. One incorrect decision can set me back. BUT….. If I do slip, please do not give up on me. Recovery is not linear. Hope is a very important value of my recovery. I will very likely get back up again and continue on my journey to recovery. Please help me to see that a small slip does not mean I have failed at recovery but if I need reminding how far I have come, help me to see past this lapse. Hold hope.

3. Things you do not pay any thought to such as trying something new to eat, eating out at restaurants may be very hard for me. People with eating disorders are ridiculously good at hiding what’s going on beneath the surface, but know that just because I appear cool calm and collected there is likely a tornado rushing around in my brain. Sometimes I just want a distraction, I always want to hear you and not what’s going on in my brain and being present with you.

4. Never, ever comment on my food choices, volume or timing of food. You do not know how hard it is for me to eat 5-6 times a day or alongside others. Likely if I am eating with you, I trust you. Comments like, are you really going to eat that?, congratulating me for eating, Don’t you like XYZ?, are only going to feed unhelpful thoughts and make eating and decision making more uncomfortable than it likely already is.

5. I do not ever want to hear about your “weight loss attempt, diet”. If you are someone close to me, know that sharing this with me is insensitive, unhelpful and extremely triggering. I have worked incredibly hard to reframe my implicit biases and unlearn this detrimental cognition.

6. I do not want my eating disorder to be an elephant in the room. I want to be able to be open with you. Talking about it as you would any other medical problem will help break the shame cycle. I do not wish to be defined by my eating disorder, there is so much more to me than this, however my recovery is an important part of my life. I want you to be part of my life, my authentic life.

7. Shame is something I feel very deeply, it fuels my problem. I feel frustrated and angry I am in this position and it makes it hard for me to ask for help and talk openly as much as I wish I could. I am grateful that you show up for me especially when I am finding it hard to show up for myself.

8. I do not think everyone else is fat. I do not see myself how you see me. Regardless of how much weight I lose I will never feel satisfied. But it is not about weight and food. The sicker I became the more warped my view of myself became, making it really hard to see myself and the crazier and more lost I felt. We are fully aware of the self destruction but that makes it harder to think rationally because we do not understand why we cannot stop. The impossible standards my eating disorder held for me, are not the same standards I hold for everyone else, so no I do not see everyone else as “overweight, or fat” I just simply cannot see myself.

9. No one would choose to have an eating disorder, Choosing a life of rules, unhappiness, isolation and emptiness is not a choice anyone would make. I did not choose to develop an eating disorder, I didn’t wake up one day and decide to have anorexia it’s not how it works.

10. It’s not as simple as eating and that being the end of the story. I have many neural pathways and thought processes I have to unlearn. I believe in full recovery. I need to believe in full recovery. But I do not know how long it will take. Right now I see myself in recovery, meaning for me I have “disordered thoughts” which can disappear for days and then return out of the blue. In certain situations, I can still feel extremely distressed at times.

I’m not sure that recovery is a destination, I think it’s a process where these thoughts and associated emotions do disappear with time and effort. But likely remaining “recovered” and preventing the cognitions from returning will require much less energy. I believe this effort becomes like second nature, similar to riding a bike. Once you’ve learned you don’t forget, its more like protecting yourself from falling off at times of risk.

See a post I recently wrote for recovery warriors magazine: https://www.recoverywarriors.com/how-i-broke-the-rules-by-ordering-movie-popcorn/

If you find this helpful, feel free to share!

Fullness. Is not the enemy.

During recovery from an eating disorder you require at times “abnormally” large amounts of food.

Makes sense when we have deprived ourselves for so long. When you start to eat again and repair the damage it requires energy. Food is that energy.

I’m writing this because fullness was something I avoided at all cost in my eating disorder. I feared it. I felt “cleanest, euphoric” when I was empty. But that’s not clean and it’s not healthy.

I’ve talked about extreme hunger on previous posts. But I think it’s something that is really feared because as a society that breeds “clean eating or orthorexia” as normal eating it makes the process of nutritional rehabilitation even more frightening and shameful. It’s harder to learn to eat intuitively when “wellness blogs”, magazines, platforms are subtly promoting orthorexia. Orthorexia is not healthy. It’s a disorder in itself. Obsessing about eating cleanly and healthily will not help you to recover from a restrictive eating disorder.

I am wary of any social media platform or magazine that calls itself “wellness or healthy living” because they focus on eating and exercise as if they are the only things that factor into a person’s health. I feel anyone from an eating disorder background should steer clear of the information from these types of platforms because it’s 1. Not helpful to our recovery, 2. Feeds the obsession with numbers, 3. Reinforces false beliefs that you have to micromanage your body and lastly they promote the societal stigma around shape.

Rant over.

I have just come off a set of nights. Nights have always been a playground for my eating disorder behaviors. The altered routine, long hours and busyness has allowed my “HH” to justify restriction, skipping meals, compulsive movement. This set of nights I was adamant “HH” would not get to dictate.

Knowing that old situations tend to stir up old pathways I wasn’t surprised I suddenly felt I was wading upstream and the “HH” voice became louder. But I was better equipped to deal with the bullshit.

The old voices of “walk the long way, count your steps, you don’t need to eat, are you seriously gonna eat that?, that’s disgusting” played like a broken record.

I made myself a contingency plan: I took in lots and lots of snacks meaning I could not be in a place without food.

I ate between walking to cases.

I knew the days after nights would be a bit trickier because of the old neural pathways. Therefore I enlisted support early. I told my husband. We planned out our meals, my snacks. I think this is helpful because in the midst of my ED, I wouldn’t have shared, I would have struggled on and likely engaged in the behaviors ending up deeper.

Therefore identifying potential triggers is a big thing in recovery. Something that deserves a post in itself. It’s unsurprising old memories, situations activate entrenched pathways. We are creatures of habit. Most of recovery is unlearning old habits. Exposure to old situations, places that are tied to unhealthy behaviours has been an integral part of my recovery.

My nights finished yesterday and last night we had takeout. I felt full, uncomfortably full. This caused a few moments of turmoil. However I know having eaten “a lot” of food in the early stages of recovery, fullness settles on its own. You do not need to do anything, it passes. It is normal. My fullness last night was just because I had eaten a little extra. Big deal. Don’t judge your fullness. In the early phases of recovery, fullness can be excruciating because of the gastroparesis. Gastroparesis is basically where your gut is so out of practice at digesting and undernourished the emptying is really slow. Often your gut can’t keep up with your mouth and brain, but like all things in recovery it gets better. Eating is the medicine.

You eat, repeat and move on.

Normal eating is sometimes over eating, sometimes eating slightly less. Fullness is not something to fear or avoid.