Today marks a whole year since my last appointment with my eating disorders service.
I have been under them on and off since 2011 and most recently for 18 months in a combination of day patient and therapy. It was a very challenging time but I am so grateful for all the support I had, and I definitely didn’t stop the recovery process since discharge. Here are some of the things I’ve learnt.
A target weight is a minimum, not a maximum
I felt so suffocated by my target weight. I had a bracket of 2kg that I could move between and any time it shifted even slightly above the upper ‘limit’ I completely freaked out. I felt like I wasn’t allowed to go above it, because I interpreted it as being told that was the maximum I could weigh. As time went on, it became clear to me that my target weight is not where my body wanted to sit. I was still having to restrict what I was eating and exercise excessively to keep it there, and I just reached a point where I didn’t want to live my life like that anymore. So gradually I moved away from those behaviours, and inevitably I did gain weight. I held such strong beliefs that I’d continue gaining weight forever, but that just didn’t happen. It did eventually stop. I’m not happy with where it stopped and I have never been this weight before but I have also never been this free, or happy, or settled. And to me, that feels worth the trade off.
Treatment can only get you so far
Any form of treatment is not designed to cure your eating disorder, but to give you knowledge and skills to be able to manage and maintain recovery independently. As hard as it is, you really do have to do the work yourself. You have to say no when your eating disorder tells you to do something. You have to rest when you want to move. You have to eat the same things over and over and over again no matter how distressing it is, because that’s the only way forward. Unfortunately services can’t be there forever, you have to take responsibility for your own recovery.
The end of therapy isn’t the end of the journey
In some ways, it’s the beginning. Recovery is an ongoing process that involves constant learning and growing, and that doesn’t stop just because you are discharged. There are always going to be things in life that feel challenging and might make you want to resort back to the safety of your eating disorder, but part of recovery is learning to navigate life’s ups and downs without returning to unhealthy coping mechanisms.
The only way to truly quieten your eating disorder is to ignore it
Do not engage with it. If you give an eating disorder an inch it will take a mile. Starting to fall back into any rules and rituals is a very slippery slope and the further down it you fall the harder it will be to get yourself back up. You cannot negotiate with an illness that wants to kill you.
You can ultimately only be accountable to yourself
Being accountable to services is sometimes necessary for many of us in the beginning, but they can’t be there forever. It can also be useful for family and friends to hold us accountable too. But and the end of the day you need to be doing what you know you need to do, regardless of whether anyone is checking or not. People will eventually lose interest, you need to be responsible for yourself at some point.
Recovery can be boring
This is especially true the further in you get. The novelty of new experiences and foods wears off in the end, because these things stop being new. That’s a good thing. It’s a sign of progress that things aren’t as interesting to you because it means you’re doing them more often. It’s important to try to set goals and plan exciting things in to keep you on track.
You need to form an identity outside of treatment
When you’ve been a patient, particularly in intensive care services like inpatient or day patient, your whole identity is somebody who is unwell and in recovery. It’s your full time job. To maintain progress, you need to move away from that. There is more to who you are than somebody who is ill, and one of the best parts of recovery is getting to rediscover who you are and what you enjoy again.
It’s really scary
This discharge felt the scariest to me, despite me also feeling the most ready I’ve ever felt compared to previous discharges. Because this time I committed myself to treatment and recovery more than I ever have and I was determined this would be my last time in treatment. That made this ending feel much more permanent than it ever has before. Scary is normal, and scary doesn’t mean impossible.
Use other support
Eating disorder services can be so helpful but it’s important to try to establish a network outside of them, who can offer you longer term support. Use family, friends, support groups, charities, forums. Find some good books or other resources. Build yourself up a package of care that exists outside of eating disorder professionals, because ultimately they are temporary.
Reflect on what you’ve learnt
A huge amount of learning can take place in treatment of various forms. Try to remember strategies you have used, coping thoughts and skills, crisis and relapse prevention plans. A huge amount of my sustained progress has been as a result of frequently looking back at materials from therapy, that I’ve used to remind myself not only of all the growth and learning that took place, but of how I used to think and how much I don’t ever want to be back in that place again.
Here’s to a second year out of services and plenty more lessons to learn along the way!