Often, when people around us are struggling with their mental health, we can feel at a loss as to what to do. This can be particularly true if somebody is struggling with an eating disorder as it seems to make so little to sense to people on the outside and can be so physically damaging as well as mentally.

There have been a lot of people around me who have come and gone over the last 18 years throughout my struggles with anorexia, some more helpful than others. I thought it might be useful to put a little guide together of things that have helped me over the years, and this is something a few of you have asked for.

Don’t blame them – or yourself
Nobody has an eating disorder by choice – they are potentially deadly illnesses that are absolutely torturous to live with. Equally, eating disorders come about for a variety of different reasons including genetics, environmental factors, a predisposition to the illness and certain personality types, all of which can make us more vulnerable to developing one. It is rarely as simple as being down to one person or one event (although everybody is different). Sufferers often feel immense levels of guilt, and blame in either direction is only likely to intensify that even further.

Avoid diet/food/weight talk
All conversations around this topic can be incredibly difficult for people with eating disorders and can potentially be a trigger for certain behaviours. Try not to talk about your weight (or theirs where possible), how much or little you or somebody else eats or any diets that you are on. Also try to avoid labelling food, eg referring to things as ‘good’ or ‘bad’, ‘guilt free’ or ‘naughty’. It’s likely we are already attaching moral value to food and thereby transferring that to ourselves – hearing it from others makes it all the more challenging.

Do some research
Eating disorders are incredibly complex illnesses and not everybody experiences the same symptoms, thoughts or feelings. Do some reading about what it is like to live with an eating disorder, the different types, and how you can be helpful as part of their support network. A bit of education can go a very long way in helping you to understand what they are going through and making them feel as though you care.

Ask questions
I don’t mean bombard them constantly about what they are/aren’t eating, their weight or about any other behaviours. But a really important question is just asking them directly what you could do that would be helpful. Chances are that they already have some ideas about what they do and don’t need, and it takes some of the pressure off you by relieving the anxiety of guesswork and constantly worrying that you’re saying or doing the wrong thing.

Encourage them to seek help
Recovery from an eating disorder is incredibly difficult and outcomes are significantly improved by receiving professional help. Unfortunately services are incredibly stretched and a lot of people won’t be able to access support, but it’s always worth trying. If support through the NHS can’t be accessed, charities such as Beat can offer support through groups, chat rooms and 1:1 messaging.

Offer practical support
It might be that the person doesn’t want any emotional support from you, and that’s okay. Not everybody wants to open up about their feelings, and everybody in life plays a different role. They might not want to share their thoughts with you, but they might need somebody around to help with food shopping, meal planning, cooking or meal time support. They might need reminders or prompts to eat, or distraction to stop them from engaging in other behaviours. They might need somebody to plan future goals with. It’s okay not to always be the listening ear, because there might be other useful ways you can help. Many people act as both.

Keep including them
Eating disorders can be very isolating, especially because so much of how we socialise revolves around food and drink. Don’t stop inviting them out even if they do say no often, and if you can, try and arrange activities outside of eating and drinking. It may require a bit of creativity but they will appreciate that you’ve thought of them. We often don’t want to be spending lots of time alone, it just feels like the easier way out sometimes.

Try not to change plans
Sometimes it is inevitable that plans are going to change, but try to keep them in the loop at the earliest opportunity. Eating disorders can make people rigid and fixed on routine – often our entire lives revolve around it – and it can provoke huge anxiety if anything interferes with that. Even if those plans have nothing to do with food, don’t underestimate the impact that changes could have on somebody.

Let them vent
There might not be anything you can say to make them feel better. They might reject all attempts you make at reassurance or comfort. Sometimes, there just isn’t anything anybody can say to make us feel better, we just need to get it all out in the open and off our chests. It doesn’t mean there’s any failure on your part to be a good emotional support, it might just be that things feel so hopeless that there’s no right thing to say.

Get some space if you need to
Eating disorders can make us behave in ways that are out of character and at times can make us not very nice to be around. We are often aware of this in hindsight but it can be very difficult to control at the time. If you find that you’re getting into conflict, try and walk away. It’s unlikely you’re going to resolve the disagreement at the time when emotions are running high. Try to stay calm and avoid showing your frustrations if you can.

Support them to appointments
They might want to go to appointments alone – I often did. But it’s also possible that they’d like somebody to support them to and from, or even during appointments with professionals. If this is the case, try to be available for moral support where you can.

Expect lapses
A lapse does not always equal a full relapse, but recovery is a very complicated journey and is likely to have many ups and downs. Try to be there for them through lapses and don’t give up on them – there will be many fluctuations in progress over time but hopefully the general projection will be upwards. It may also be the case for others that they have full relapses several times before being able to commit to recovery or to sustain that progress – everyone’s path is different and some of us need a few run ups before we manage to take more forward strides.

Look after yourself
It can be incredibly draining trying to support someone with complex needs, and the additional worry on top of trying to offer practical and emotional support can lead to burn out. This can result in more conflict and less capacity to support the sufferer. Make sure you are taking time out for yourself to do things you enjoy, talking to people when you need to and accessing support from professionals if you need to – either from charities like Beat or potentially through the NHS.

This list is by no means comprehensive – eating disorders are complex illnesses and there are going to be many things that are helpful for some people and not for others. I hope that this post may go some way to helping generate some ideas about useful, practical and emotional support.

I would love to hear if any of you have anything you would add to this let – let me know in the comments.