Ask The Therapist: I’ve been dealing with an eating disorder for 5 years and it has completely ruined my physical and mental health… I feel hopeless and scared of myself, please help me

In 2016, the number of people estimated to be suffering from mental health issues like depression and anxiety amounted to roughly 1.1 billion. Since then, numbers have likely continued to rise. Moreover, studies have also shown women especially on average are a) more likely to suffer from mental health issues, and b) less likely to talk about them. The taboo in Pakistan surrounding depression and anxiety disorders only serve to aggravate the individuals suffering even more. For the women who cannot seek out full time therapy, we’ve enlisted the help of a trained therapist. You sent us in your questions – here are the answers!

I’ve been dealing with an eating disorder for 5 years and it has completely ruined my physical and mental health. I fractured my feet while running and banged my head against walls because I wanted to eat like a normal person, but my appearance just wouldn’t let me eat properly. I have been to 3 psychiatrists and they only made it worse for me with their rude behaviour. I feel hopeless and scared of myself, please help me.

Shahrukh’s Response:

Dear Anon,

Before I begin, I feel like it’s my professional duty to tell you that while I can give you outlines and points for introspection, eating disorders can be really complex and vary person-to-person, depending on their own history; and the journey towards healing can be a long one. I’m sorry for the previous treatment you got from those psychiatrists and I imagine it must have been really disheartening and frustrating to be treated that way.

It’s important to know that some psychiatrists are not always equipped with a background in counselling, unless they have that training. While they may have basic skills, their primary job is to diagnose disorders and prescribe medication. As a result, they might not have been equipped to provide you with the sense of safety and security  you may have needed during your sessions. That said, I would encourage you to revisit the idea of working with a mental health professional who works specifically with Eating Disorders on a psychotherapeutic level. Reach out to CPPD or Therapy Works and tell them about your preferences and I’m sure they will be able to help you.

With all that out of the way, let’s explore what might be happening for you and, hopefully, help you gain a little more clarity.

Eating Disorders: A History

While Eating Disorders can originate from different parts of a person’s history, one  major contributing factor to it is the messaging around food and appearance. This can come from a great deal of sources – family, social circles, social media, magazines etc. In my experience, there are some that say you need to look a certain way or be a certain weight in order to be worthy, praised and desirable. Looking at Pakistani culture, there’s a lot of fat-shaming, while those who are thin are glorified. This kind of messaging can lead to a very distorted relationship with food, and by extension, one’s own body, which can eventually lead to different forms of eating disorders. Some questions to ask yourself are:

• What is my relationship with food?
• What purpose does it serve for me?
• How do I view my own body?
• How do my body and eating habits tie into my sense of self and my worth?
• What would it mean if my weight changed?

Types of Eating Disorders

According to the DSM-5, there are six types of eating disorders:

• Binge-eating
  • Uncontrollable need to have an excess amount of food in a short period of time
  • This is generally followed by feelings of intense shame and/or guilt
  • Usually occurs at least once a week
• Anorexia nervosa
  • Extreme restriction of food
  • Driven by the fear of gaining weight or becoming fat
  • People with this disorder are generally underweight
• Bulimia nervosa
  • A combination of binge-eating and purging
  • Feelings of guilt and shame from eating, result in purging
  • May use laxatives or self-induced vomiting as a way of getting rid of food
  • Average or above average body weight
• Avoidant/Restrictive Food Intake Disorder
  • Food restriction
  • This is an eating disorder that has less to do with weight and more to do with the sensations of food (smell, taste and texture)
• Pica
  • Rare disorder where a person consumes things that are not considered food (paper, clay, sand etc.
• Rumination
  • A person will continuously regurgitate food after which they either re-chew, re-swallow or spit up

Disordered Eating vs. Eating Disorders

Sometimes eating habits might be extremely unhealthy but may not fall under the current definition of “disorder.” That being said, it’s still considered to fall under the spectrum of eating issues known as “disordered eating.” In this day and age, we might choose to diet in a way that might not harm our bodies and is something we do for the sake of our health. It’s important to note your attitude towards the diet and food itself. Signs of an extreme (and harmful) diet could be:

• Low energy levels
• Obsessively thinking about food
• Interrupted sleep (patterns) due to lack of nutrients
• Eliminating specific food groups
• Mood swings

Anon, struggling with an eating disorder for as long as 5 years can be really difficult. Do reach out and get the help that you need, and in the meantime, I hope that this information helped you gain a little bit more insight as to where you might be in terms of your own relationship with your body and food.

Good luck!

The above article is written by Shahrukh Shahbaz Malik who is trained in humanistic integrative counselling at CPDD in the UK and currently has her own private practice in Karachi. The views expressed in this article are those of one expert. They do not necessarily represent the views of Mashion, nor do they represent the complete picture of the topic at hand. This article is for informational purposes only and is not a substitute for medical diagnosis or treatment.