3 Basic Recovery Tips for Moms & Moms-to-be with Eating Disorders

Pregnancy and motherhood can be extremely daunting. The “what-ifs?”, “can I manage it all?” and “what will my body do?” internal dialogue often begins quite early in the process of parenthood, even among women without eating disorders.  When a woman struggles with body dissatisfaction and disordered eating, normal concerns throughout pregnancy and parenting can escalate into major anxiety. They may also fuel a new or renewed focus on weight and shape that can lead to harmful behaviors like restriction, purging, bingeing or obsessive exercise. Co-occurring depression – or postpartum depression – can also be risk factors for disordered eating.

According to data from the CDC, the average age at which women have their first child is 28 and this has been steadily rising for decades. As of 2016 however, the demographic with the highest birth rates are actually women in their early thirties (ages 30-34).1 This holds true across all fifty states as well as all racial and ethnic groups.

Interestingly, women between the ages of 30 and 40 are also increasingly seeking treatment for eating disorders. Eating disorders affect about 10% of women during their reproductive years and this number may be growing.  With this in mind, it has become exceedingly apparent that there is a need to tailor treatment to mothers and mothers-to-be in order to effectively assist women during this stage of life.

Pregnancy-related body image concerns combined with the extra stressors of parenting – and feeding – young children can complicate eating disorder recovery efforts. But there are also opportunities and strengths in this new role and certain things moms-to-be can do to stay recovery-focused during the adventures of pregnancy and parenthood. Below are three very basic tips to help provide a starting point for a healthy transition.

 

1. BE HONEST.

If you’re currently pregnant, tell your OB or midwife that you have a history of an eating disorder and about your current or past symptoms.

Some women say they feel shame or guilt in expressing feelings of body-dissatisfaction or disclosing ED symptoms to their medical providers, especially during pregnancy and post-partum. If you find yourself battling these thoughts, it’s helpful to remember that eating disorders thrive on silence and secrecy. Keeping symptoms a secret usually means things get worse, not better. Being open with your OB or midwife allows them to better care for you and more accurately monitor the health of your baby. When your providers know about the eating disorder they can also do more to support your recovery efforts; this could include connecting you with a local support group or tailoring discussions about food and exercise appropriately. Remember, eating disorders are serious illnesses – not simply a choice or lifestyle. It’s okay to let go of the guilt and shame so you can move forward with help.

 

2. EMBRACE IMPERFECTIONS.

You can’t do it all perfectly—nobody can (even if it looks like they do on social media).

More mothers than ever are raising their children while managing full-time careers outside of the home and trying to keep up with ever-increasing expectations for the always perfect outfit, an exquisitely clean house and an expertly planned family vacation.On top of it all, posting finely tuned photos on social media to prove it all happened can almost feel mandatory.Moms who internalize this pressure are understandably overwhelmed because perfection is a race that no one wins. Remember, even the people who look like they have it all together online, are only sharing what they want people to see. It’s essentially a person’s curated highlight reel; the behind-the-scenes shots may not be so picture perfect.

Given that the trait of perfectionism is an established genetic risk factor for the development of eating disorders, it’s easy to see how these increasing expectations and media pressures can create extra challenges for pregnant and parenting moms working on eating disorder recovery. If you find yourself constantly comparing your house, your body, your parenting or your life in general to people you see on TV or friends on social media it’s important to discuss these influences with a therapist or treatment team. You can also do a self-audit of your feed and make some changes to ensure you are cultivating a body positive presence across your social media platforms.

 

3. PRIORITIZE RECOVERY

Self-care isn’t selfish.

There’s a reason why the flight crew on every plane instructs parents flying with children to put on their own oxygen masks in an emergency before putting one on their child.  It might feel counterintuitive or even selfish to do so but we know it’s not. Why? Because it’s much harder to take care of other people – especially infants and toddlers – if you’re not caring for yourself.  When it comes to mental health and eating disorders, you may need to prioritize your recovery efforts now so that you have the physical ability and mental clarity to prioritize your family in the long-term. Seeking therapy, keeping up with appointments and staying connected to other moms who talk openly and authentically about the challenges of motherhood are integral to recovery.

 


At The Center for Eating Disorders, we recently launched an outpatient therapy group to help pregnant and parenting moms with eating disorders do the hard Kristen Norris, LCPCwork of prioritizing recovery while caring for their families. The group, which meets weekly, focuses on skills for balancing recovery and motherhood, addressing body image concerns and strategies for feeding the family. In addition to building recovery skills, this group can also be a way to help moms recharge and gain support. It is open to pregnant women and parenting moms of any age and stage.

The Moms’ group is held on Thursdays at 10 a.m. at outpatient department in Physician’s Pavilion North, Suite 300. Please contact Kristen Norris for additional information or to enroll in the group. She can also be reached by phone at 410-427-3904.


References:

  1. Mathews TJ, Hamilton BE. (2016). Mean age of mothers is on the rise: United States, 2000–2014. NCHS data brief, no 232. Hyattsville, MD: National Center for Health Statistics.

12 Tried and True Ways People Upheld a Recovery-Focused Holiday


Looking back on this holiday season, it’s safe to say that social gatherings and celebratory feasts posed some significant challenges for anyone trying to develop a more peaceful relationship with food – including those in recovery from an eating disorder. That’s why The Center for Eating Disorders at Sheppard Pratt launched a social media campaign called the “12 Days of Eating Disorder Recovery.” The initiative shared tips on how to maintain healthy relationships with food through the holiday season and beyond. These are summarized below – one for each day of the 12 days – so you can use them to navigate future holiday seasons and get a little help finding the joy and peace within the hustle and bustle.


#12DaysofEDRecovery

Day 1: Keep expectations realistic and set manageable goals that will help you stick to your plan.

Regardless of where you’re at in recovery, celebrations, holiday feasts and schedule changes can pose challenges. Planning ahead and setting realistic expectations can help you stay focused on what truly matters.


Day 2: Grab a notebook or journal and write down all the reasons why recovery is important to you.

While you’re at it, make another list of support people. Figure out in advance who you will call if things get overwhelming or if you simply need to get out of your own head. Things that help you cope daily are still needed during the holidays.

If you’re headed out of town, pack your suitcase with your notebook along with other recovery tools. This could be tangible things like a fidget cube, fun book, art supplies or a favorite essential oil.


Day 3: Connect in safe and meaningful ways with others in recovery.

Recovery from an eating disorder is a journey that requires support, encouragement and ongoing motivation. Individuals with eating disorders and their loved ones can find hope and help in others who understand what they’re going through. Support groups and therapy groups can be a great way to strengthen recovery skills and help remind you that you are not alone.


Day 4: Set a goal today that has nothing to do with food, weight or your eating disorder.

It’s common for social gatherings to revolve around food in our culture, especially during the holidays. These celebrations often lead to an intensified emphasis on meals and eating for those working on recovery from an eating disorder. Keep doing what you need to do to fuel your body in recovery, but try also setting a goal for yourself that has nothing to do with food or your eating disorder.


Day 5: Don’t let your eating disorder make decisions for you in the grocery store. Use price or brand to inform decisions instead of reading nutrition labels.

Whether we like it or not, grocery shopping is part of adulthood. But for the millions of individuals living with an eating disorder, this everyday task feels overwhelming and becomes a significant barrier to recovery. If you are worried about buying items for upcoming gatherings or celebrations, this tip can help make grocery shopping more manageable.


Day 6: Defuse grocery shopping stress by bringing a friend, avoiding crowds and shopping at smaller stores in off-peak hours.

If you’ve had negative experiences with grocery shopping, you can start developing more positive associations. A Registered Dietitian may provide some easy steps for managing your grocery list.

Ask your dietitian for support, or consider adding one to your treatment team if you haven’t done so. You can also go with a friend or support person the first few times to help distract from any eating disorder thoughts and avoid being triggered by diet products.


Day 7: Infuse your New Year with body positivity and gratitude.

Be prepared to see your newsfeed flooded with New Year’s resolutions, gym memberships and diet plans in the coming weeks. To balance triggering and unhealthy messages, remember to reality check all the bogus weight-loss ads and surround yourself online and IRL with body-positive people and organizations.

Pay attention to which images and messages contribute to your feeling badly about yourself or your body and do what you can to remove them from your daily life. When you notice them, remove them (unsubscribe, throw them away, etc.) or challenge them.

Focus on gratitude for the functionality of the breath in your body, the ability to move, see, hear, taste or touch. Try to elevate those in your mind as you go through your day.

Create your own New Year’s goals with body positive thoughts. Work to set aside unhealthy ideals and embrace your body.


Day 8: Tackle eating disorder stigma by dispelling myths among friends and family.

Major misconceptions about eating disorders are widespread, even among those closest to us. Family can be a key component to recovery success. Unfortunately, some family and friends may still subscribe to ED myths that lead to stigma and might make it harder to ask for help or to seek treatment. Help educate and increase awareness about eating disorders among your loved ones.


Day 9: Friends and family can be a great support network. Be open with the people closest to you about how they can best support you.

Holiday conversations often revolve around what people are eating or not eating, who’s eating too much or too little and even criticism or praise about body weight and size.  Did this happen for you during Chanukah or Christmas this year?

The start of a new year can be a great time to enlist family members as allies by being open about your needs and boundaries. Set the stage for healthier gatherings in the new year by having a post-holiday conversation with them about how their words impacted you and what they can do instead to support you at the table and in other stressful situations.


Day 10: Meditate or listen to soothing music to start your day in a positive place.

It’s not just about food and body image. Incorporating mindfulness in the new year can be a way to care for your overall mental health. If you’re heading back to work or school after winter break, find a way to change up your routine to build in mindfulness practices.  Even just three minutes of meditation can help you set a positive intention for the day.

You can be mindful in your social connections too. Cultivate awareness about the different support each generation of your family can offer. Hanging out with cousins can be a nice way to connect and get support on specific life stage issues like being away at college, parenting stress, job hunting, etc. On the other hand, reaching out to older generations, like grandparents, is an opportunity to see how priorities can shift throughout life. Even the youngest generations have something to offer you in your recovery-focused festivities.


Day 11: Aim for balance and flexibility rather than perfection.

Individuals who are perfectionists often struggle with the urge to compare themselves to people around them. Research has shown perfectionism to be a significant risk factor for the development of eating disorders.

Constantly striving to be perfect with food or appearance during the holidays can lead to tension and stress. Even those holiday photo cards hanging around your house can trigger negative social comparisons. Try making some small changes to help ease perfectionist tendencies this time of year.


Day 12: Support is essential to your wellbeing. Recovery is possible with treatment and support.

Whether you are an individual working on recovery, or a loved one who is close to someone in recovery during this time of year, it’s important to remember that support is essential to wellbeing.

Remember, you don’t have to go through this alone.

Ask for help.

 

If you are experiencing symptoms of an eating disorder and you’re not connected to a therapist or receiving treatment, don’t wait any longer.  There is no reason to go through this alone. Call (410) 938-5252 for a free phone assessment today.


This holiday season, and year-round, carry these tips with you. Recovery is possible and recovery is worth it.

Spring Blog Round-Up


“Where flowers bloom, so does hope.”
~Lady Bird Johnson
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Our CED Staff has been busy guest blogging for Eating Disorder Hope on a variety of topics from nutrition and meal plans to body image and relapse prevention. We hope you’ll take a look and share with friends, colleagues or clients who might benefit from the following information.

If you have questions about eating disorder treatment or a topic you’d like to see us write more about, please send your suggestions and requests to our Community Outreach Coordinator, Kate Clemmer at  kclemmer@sheppardpratt.org


The Importance of Incorporating Fear & Challenge Foods in Recovery

Written by Caitlyn Royster, R.D. & Rebecca Hart, R.D., Registered Dietitians

While you may technically be following your meal plan, without incorporating fear foods you are still giving the eating disorder a major foothold by preserving fear and anxiety. It might seem like choosing safe foods is better than acting on symptoms. However, over time this restriction can snowball and lead to relapse. READ MORE…


Mother’s Day Makeover: Boosting Body Image for Ourselves and Future Generations

Written by Irene Rovira, Ph.D.
Psychology Coordinator

Most of us appreciate all the mother figures and mom-types in our lives – including aunts, sisters, mentors and best friends – for the love they give or how they make us feel. We do not value them based on their weight or size. Yet we often hold a double standard when it comes to how we view ourselves…READ MORE to find 7 Tips to help boost body image for yourself and future generations



4 Changes You Can Make in Your Home to Support Eating Disorder Recovery & Reduce Relapse

Written by Kate Clemmer, LCSW-C
Community Outreach & Education Coordinator

It’s safe to say no one who has been through recovery from an eating disorder would downplay the difficulty or complexity of it. And while recovery is never simple or easy, there are some simple and straightforward changes you can make to reinforce recovery efforts and help prevent relapse. These specific modifications are not changes in thinking (cognition) or even changes in behavior but rather, changes to your physical living space – your home environment.  READ MORE…


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Simple solutions for holiday (and everyday) conversations about food and weight


dining room
As we head into the holidays, it can be helpful to have a very simple plan for responding to family and friends drawn to the very topics that may be most troubling during recovery from an eating disorder.  Depending on how you spend your holiday this year, one or all of these suggestions may come in handy when the conversation takes a turn toward triggering language regarding bodies, food or weight.


Step 1:
Obstruct or change the conversation if you notice someone is heading into a discussion that makes you uncomfortable.

Remember people generally like to talk about themselves and their interests. If Aunt Marie is pressuring everyone to eat more pie or is gushing over a family member’s weight loss, use that as an opportunity to reflect the attention back to her. So who taught you how to bake? What are you up to at work Aunt Marie? How was that vacation you went on?

If you’re comfortable staying on the topic but exerting your power into the conversation you could try something like this: I’ve actually been learning a lot about how weight is not a good determinant of overall health. I’m focusing on my work-life balance and healthier ways to deal with stress. I’m thinking about meditation…have you ever tried it?


Step 2: Set boundaries
if someone continues to target you with questions or comments about your body or what you’re eating.

Here are some simple examples with varying levels of intensity.  You can choose which ones you think would work well for you, or create your own.

  • I try not to get involved in discussions about dieting and weight loss.
  • I’d prefer not to talk about my weight today.
  • I am so happy to be here with everyone, I don’t want to waste our time together talking about food/weight.
  • Please don’t comment on my body.
  • Let’s find something else to do or talk about.
  • I’d much rather tell you about school / work / hobby
  • It’s really stressful to me when people make comments about what I’m eating.
  • It’s actually not helpful for me to talk about calories or exercise.
  • I’m choosing to focus on other things this year.
  • It is not beneficial for me to feel badly about my body or guilty about what I ate.

The great thing about practicing these responses with other people is that you’ll be more likely to use them when struggling with negative self-talk or eating disorder thoughts in your own head too.


Step 3:
Step away & seek support.

If stressors persist or you find you just need a break from the crowd, locate your holiday ally or text a friend. Take some time to vent about what’s bothering you, take 3 very deep breaths, and then re-focus on the positive parts of the day.  Sounds simple but it can make a big difference.

You are deserving of a happy and healthy holiday. How you choose to create that is up to you.  Just remember that one insensitive comment from one person does not have to ruin your entire holiday. At anytime, you can choose to re-engage in both the celebration and your recovery.

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Read more about healthy holiday coping…


 Concerned that you or a loved one may have an eating disorder?  Call us at (410) 938-5252 for a free and confidential phone assessment or visit www.eatingdisorder.org for more information about treatment options.

 

Photo credit: freedigitalphotos.net / digidreamgrafix

 

 

 

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8 ways to take the focus off of food this Thanksgiving


Who’s bringing a dessert?  Can someone help with appetizers?  Here, have some more!  Are you really taking another helping?  I wish I could eat like you.  Ugh, my diet must start tomorrow!

guitarSound familiar? It’s not unusual for pre-Thanksgiving talk between family members to focus on food and food-related tasks. It’s also not uncommon for holiday conversation to revolve around what people are eating or not eating, who’s eating too much or too little and, in some cases, criticism or praise regarding weight and size. To be clear, making sure there’s enough food to feed everyone at a gathering is important, but it doesn’t need to be the center of everyone’s day.

When an individual is struggling with an eating disorder, or working hard to maintain recovery from one, these topics can activate disordered thoughts about food, trigger negative body image and impact a person’s ability to be emotionally or physically present at the gathering. Intentionally steering the day towards gratitude and connection instead of food and weight can take a bit of work in our diet-obsessed culture but it stands to benefit many, not just those with eating disorders.


Where to start?
These are just a few suggestions from our therapists and dietitians. Feel free to share your ideas and recommendations on our Facebook page.


1. Offer roles for family and friends who want to contribute something but may not want to bring food.
Not everyone enjoys cooking and some people, especially those with eating disorders, might feel incredibly anxious around food. There are definitely other ways to help and have a meaningful connection to the day that don’t involve preparing food. For example:

  • Planning activities or bringing a craft for the kids (or adults!) to work on.
  • Pet duty. Someone might really love to take the dogs out for a walk while everyone else is distracted in the kitchen or watching the football game.
  • Helping with clean-up and dish-washing (Yes, some people enjoy washing dishes!)
  • Ask the musicians of the family to bring their instruments.
  • See if anyone would be willing to put together a slideshow of past Thanksgiving photos for after-dinner viewing.

Quick Tip: Tap into everyone’s strengths. If your brother has taken up a recent interest in photography ask if he’d be willing to document the day and capture different positive interactions. How great would it be to have a beautiful photograph of a grandparent rocking a new baby or all the cousins playing football outside? These are, after all, the moments you’d choose to remember about a holiday, not how many calories you ate or an offhanded remark someone made about your weight gain/loss.


2. Give in to the gratitude trend.
Gratitude might seem like a big social media gimmick right now but the truth is it does have the power to shift your attitudes and perceptions. The moment dinner is served and everyone sits down to eat can be a moment of peak anxiety if you have an eating disorder. In anticipation of this, Google “gratitude quotes”, pick your favorites and write them on small cards to place at each table setting. Depending on how willing your family is, you could also give everyone a chance to go around and verbally share something for which they are grateful.


3. If you’re hosting, do a quick assessment of reading material around your house.
Put away (or better yet, recycle) any magazines that are overly focused on appearance, diet or beauty. Studies show even just 3 minutes of looking at fashion or “fitness” magazines can negatively impact self-esteem and trigger feelings of sadness and guilt. Do you really want your 7 year-old nephew to practice his reading skills with a fitness magazine full of photoshopped bodies? Do yourself and your guests a favor by instead stocking your coffee table with photo albums, short stories written by your kids, or some photography books by a favorite artist. (If you really want to make a body positive impact, you could leave a copy of Intuitive Eating or Health At Every Size laying around as well.)


4. Identify an ally (or two).
Many of us look forward to holidays with great anticipation because we get to spend time with family members we don’t often see. Some of us experience dread and stress for the very same reason. It’s no secret that family dynamics can be complicated. Instead of focusing on family members who are particularly difficult to handle, focus on the ones who can help. If you have a grandparent, cousin or significant other who knows you’re struggling with recovery, have a conversation with them in advance about the ways in which they can support you at the gathering, at the table, and in specific situations throughout the day.


5. Step away from the bathroom scale.
If you’re hosting and you have a scale in your house, move it out of sight temporarily, or permanently. If you are a guest in someone else’s house, consider asking them if they can stash it in a closet for the day. As a parent, spouse or support person of someone in recovery, this would be a great thing to take care of in advance as a way to advocate for your loved one.


6. Whatever you spend time focusing on will be what you spend time focusing on.
If you’re in recovery you likely going to need to think about meal plans and meeting nutritional needs and that’s okay, but make sure you also have holiday intentions that don’t involve food, eating or weight. Why? Because if all your goals that day revolve around what you’re eating you will be hyper-focused on food just like you were with the eating disorder. Prioritize your nutritional goals, talk them over with your dietitian and then consider adding some non-food goals like these:

  • I will record an interview with a grandparent. (Check out The Great Thanksgiving Listen)
  • I would love to cuddle with a relative’s new baby.
  • I’d like to sneak off to do a 3-minute mindful meditation before dinner
  • I’m going to talk with each family member about their favorite songs, then compile a playlist to share after the holiday.
  • I will give at least 3 non-appearance related compliments to other people on Thanksgiving day.

Quick Tip: Whatever you choose, make sure your goals are easy, achievable and positively worded. Think about adding good things into your experience, instead of avoiding a negative. For example, instead of saying “I won’t go on Facebook during our Thanksgiving get together” say “I look forward to taking a break from social media so I can catch up with my loved ones.” Remember, whatever you focus on will be what you’re focused on.


7. Remember that you cannot control everyone else.
We live in a food and weight-obsessed society, so it’s likely some of this conversation will make it’s way into your holiday despite your best efforts. If and when it does, be prepared with ways you can change the conversation, set boundaries and seek support.


8. Give Back –
Identify a local charity and ask all the Thanksgiving guests to bring a donation for the cause. Even if the day is hard for you and your recovery you will be left with a visual reminder of everyone’s generosity, (even if they couldn’t stop mentioning how many calories were in the appetizer all day).


Thanksgiving can be a truly beautiful holiday that reminds us all to give thanks and reflect upon the positives in life. Taking the focus off food might not only benefit those with an eating disorder but anyone struggling with negative thoughts, low self-esteem or loneliness this holiday season.

When we lift the food frenzy and body angst we are better able to focus on gratitude and authentic connection with others and ourselves.

Happy Thanksgiving.

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You may also be interested in reading:

Simple solutions for holiday (and everyday) conversations about food and weight

 


 

Questions about treatment for an eating disorder? Call us at (410) 427-3886 or visit eatingdisorder.org

 Photo Credit: freedigitalphotos.net / bugtiger

It’s Diet Season: Are You Prepared?

girl with unbrella

Diet season is officially upon us.
Weight loss companies are well aware that millions of Americans are actively making New Year’s resolutions. Armed with teams of marketers and millions of dollars, they’ve spent the last twelve months crafting their year-end advertising.  And year after year they are wildly successful, at least in terms of revenue. According to this report, global weight loss markets were expected to be worth $586.3 billion in 2014. The U.S. is the largest contributor to that figure and was projected to reach $310 billion last year.

Yes, the weight loss industry has been preparing for an entire year. But, you can be prepared too. The first step is anticipating the messages that you will be bombarded with so you’re not caught off guard. Here are just a few of the diet industry’s strategies you are sure to encounter in the new year:

  • They will make a lot of promises for a “better” you, a “more successful” you, a “happier” you, but most emphatically, a “thinner” you. They will use those terms interchangeably to try to convince you that you cannot be better, happier or more successful without weight loss. You can.
  • They will pay celebrities enormous amounts of money to endorse what they are selling. Average salaries for celebrity weight-loss endorsers range from $500,000 to $3 million via ABC News.
  • They will tell you this time will be different.
  • They will make faulty connections between weight and health.
  • They will use scare tactics and personal stories to appeal to your emotions.
  • They will use before and after pictures that may or may not be the same person, are often retouched and photoshopped, or might just be stock images of someone who never used their product.
  • They will try to convince you that your body cannot be trusted to do one of it’s most basic jobs.  They will insist you need to pay them money to rely on external rules or charts for when and how much to eat.
  • They will ignore the natural and healthy diversity of bodies by telling you everyone can be thin if they work hard enough. This also happens to be one of the four toxic myths that promote most body image and weight concerns. This cycle works very well for diet companies because the more concerned people are with their bodies, the more likely they are to engage in weight control behaviors. In other words, it is in their best interest to keep you dissatisfied with your body so that you keep buying their product and it keeps being ineffective.
  • They will share short-term statistics from studies funded by their own investors to show how well their diet plan works for the first 3-6 months. They will not respond to requests for independent, long-term outcome studies.
  • They may tell you their product is “not a diet but a lifestyle”.
  • They will tell you your health is at risk. They will not tell you about studies like this which found the risk of mortality was higher among people in the underweight category than it was for those in the overweight category OR like this one which showed increased health behaviors led to improved health markers even in the absence of weight loss.
  • They may even include the phrase “results not typical” in fine print at the very bottom of their full page ad or in speedy verbal disclaimers at the end of a commercial.
  • It is only January yet still, they will tell you that summer is just around the corner and then attempt to make the case that your body is not “ready” for the beach. Spoiler Alert: If you have a body and you have the chance to go to a beach, then you are ready.
  • Are we missing anything? Can you think of other trends or predictable marketing slogans used by the diet industry to try to sell their products? You can add to the list on our Facebook page.

Why is it important to be prepared?
The National Eating Disorder Association reports that 35% of “normal dieters” progress to pathological dieting, and 20-25% of those individuals will develop eating disorders. This is not because eating disorders are simply “diets gone too far” but because diets trigger biological, emotional and mental shifts in the way you process food and information about that food. It is well established that diets can…

  • Dysregulate and weaken your body’s natural cues for hunger and fullness.
  • Trigger obsessive thoughts about food and weight
  • Cause intense cravings for off-limit foods
  • Create anxiety about certain types of food and in response to specific situations involving food such as eating with other people or in public places when the diet-safe food is unavailable.
  • Establish a pattern of failure, low self-esteem and distrust of one’s body
  • Assign moral judgment to foods
  • Develop a system in which exercise is used as a form of punishment instead of a fun or social activity

Clinging to the diet mentality or getting caught up in weight cycling is futile, not to mention potentially harmful to your health and your wallet. For individuals at risk for eating disorders, or for those in recovery, these dieting side effects can be even more dangerous and may create risk for relapse. This year, don’t let the diet season bring you down. Be prepared to stand up against diet pressures by knowing exactly what to expect.  If you find yourself getting overwhelmed or tempted by the ads this season, print out the list above and try checking off all of the marketing tactics you notice.  Then choose to move towards nourishment, self-care and non-judgment by inviting a body-positive friend to lunch, scheduling a massage, setting the table for a mindful eating experience or reaching out for extra support from a treatment provider.

Other Helpful Resources:

  1. Mindful Eating on Campus: Parts 1 & 2
  2. The Resolution Solution
  3. A Message for People Considering Their Next Diet (pdf) from Linda Bacon, PhD
  4. Ringing in the New Year in a New Way
  5. What is Intuitive Eating?
  6. www.eatingdisorder.org

Join CED on Facebook for body image inspiration and recovery support.

*Above image courtesy of freedigitalphotos.net and a454

Seasonal Depression: Fall-ing into Winter

Fall on the SP Campus...
Does the idea of darkness during your 5pm commute home from work get you down? You’re not alone if you’ve noticed that it’s not just the flowers in your garden but also your mood that has “wilted” with the cooler temperatures. During the fall and winter months, people may experience a shift in their mood as we collectively adjust to less sunshine and more cold weather. But it might be more than just “the blues” if it is a persistent sadness that feels present most days and is interfering with your ability to function or engage in day-to-day life. If this is a pattern that’s occurred for at least two years in a row and impacts you at the same time each year, it might be Seasonal Affective Disorder.

Seasonal Affective Disorder (SAD)
Many people around the world suffer from SAD, now identified in the DSM-5 as Depressive Disorder with seasonal pattern. It is suspected that seasonal depression is, in part, caused by a reduced exposure to sunlight resulting in disruption to our natural circadian rhythm (the body’s “internal clock”), as well decreased levels of the hormones serotonin and melatonin which help to regulate mood, sleep and appetite. Not surprisingly, populations living farther from the equator experience higher rates of seasonal depression than places closest to it. Thus, this type of depression occurs more frequently in populations throughout the northern rather than southern parts of the United States. In fact, one study found prevalence rates to be 1.4% in Florida and a much higher 9.7% in New Hampshire. (1)  Much of the research also indicates younger people and women tend to be at higher risk for winter depressive episodes.

People who already struggle throughout the year with clinical depression or bipolar disorder may also experience worsening symptoms during specific seasons. For those with seasonal depression, the episodes of depression that occur in the fall/winter are significantly greater than those episodes that occur throughout the remainder of the calendar year. In any case, it’s important to pay attention to seasonal patterns in your mood so that you can prepare and seek appropriate treatment and support as needed.

Common symptoms of seasonal depression
Seasonal depressive episodes generally set in during late fall or early winter. Some of the most common signs and symptoms include:

  • decreased energy, lethargy
  • increased sleep, difficulty waking
  • social withdrawal and loss of interest in activities previously enjoyed
  • increased appetite, unintended weight gain
  • persistent sadness, hopelessness
  • difficulty concentrating or focusing on tasks

(Though less common, some people experience spring/summer depressive episodes and those symptoms can look a little different, more often encompassing sleeplessness, irritability, decreased appetite and weight loss, etc.)

How might seasonal depression affect people with eating disorders?
A depressive episode can impact eating patterns and thus, impact eating disorder recovery efforts.  Individuals suffering from seasonal depression often report increased appetite. Specific studies have indicated that individuals with SAD tend to experience more cravings for foods that are higher in carbohydrates and rich in starch and report increased consumption of carbohydrates when depressed, anxious or lonely. (2)  Combined with decreased energy and declining mood, these cravings can place one at higher risk for binge eating behaviors.

Other research has shown a seasonal component to depression especially for those individuals suffering from Bulimia Nervosa. (3)  The research revealed that patients with Bulimia Nervosa tended to experience seasonal patterns of mood and appetite similar to those described by many with SAD. (4)  Some research has further speculated with regard to a possible genetic link between eating disorders and susceptibility to changes in mood related to the season. (5)

Treatment Options for Individuals affected by seasonal depression
So what can you do when the light outside your window has turned to darkness and, perhaps, this has added fuel to the eating disorder fire as well? The good news is that there are many different treatment approaches that are helpful to those suffering from seasonal depression.

  • Light therapy or Phototherapy is a commonly prescribed treatment for individuals suffering from seasonal depression. In light therapy individuals sit in front of a “light box” for approximately thirty minutes daily or per their doctor’s recommendation. Research has shown that light therapy can relieve the symptoms of seasonal depression in as many as 70% of cases. (6)
  • Anti-depressant medications can also be helpful in treating winter depression and have been shown to improve mood, energy and sleep patterns. One of the ways in which these medications work is by increasing serotonin levels in the brain.
  • Evidence-based therapies for depression such as Cognitive Behavioral Therapy (CBT) can also be helpful for seasonal depression.
  • Behavioral interventions in your daily life can also be helpful in reducing symptoms of seasonal depression. Consider trying to incorporate some or all of these:
    1. Engage in activities with friends and family each day to ward off feelings of lonliness or isolation.
    2. Make a point to get outside in the sunlight for at least a portion of the day if possible. Schedule a walk with your colleague during break or sit outside instead of inside while you do your daily perusing of Facebook, however…
    3. Be mindful about whether online social networks make you feel worse instead of better OR if they take up large amounts of time that could be better spent connecting with people in person (see #1 above).
    4. Plan to get plenty of sleep on a consistent schedule; do your best to go to bed and wake up at the same times each day, and aim for 7-8 hours of sleep/day.
    5. Avoid the use of alcohol or other substances which can worsen depressive symptoms, complicate eating disorder symptoms and disrupt sleep.

Focus on the highlights of the changing season.
If you struggle with seasonal depression, a long autumn and the approaching winter can feel daunting. Holiday stress, can make things even more difficult for individuals who are triggered by tense family dynamics, elaborate meals and social gatherings. This year, Instead of focusing on the doldrums of the season or annual stressors, consider looking for positive seasonal activities in which to get involved. Now is the perfect time to go to a holiday parade, paint a room in your house a new color, volunteer for a new cause, plan a weekend getaway, attend a recovery event, build a snowman or read a winter-themed book. It could also be a great opportunity to finish your summer vacation scrapbook or try a new activity like snow tubing or ice skating. You can even practice guided imagery or meditation – just because there is snow outside it doesn’t mean you can’t imagine yourself relaxing on a warm beach.

Try not wish away the winter season.  Each season comes with its own set of challenges for individuals with eating disorders – just think of the onslaught of diet pressures throughout spring or the bathing suit saga of summer.  So the key is not to just “get through” each season (there will be a new set of stressors on the next calendar page after all) but to learn to live mindfully in each season and find ways you can enjoy what it has to offer.

Above all else remember to ask for help when you need it. Talk to your treatment providers about your seasonal mood changes and they can help to devise an individualized treatment plan that works for you. If you are seeing a Registered Dietitian now is the time to talk with them about the food cravings you might be experiencing and devise an approach to cope and integrate more variety into your meal plan. Remember to open up and involve your support system– let your friends or family be a part of the process by sharing with them what you are going through. With help and support, you’ll be celebrating the Vernal Equinox in no time and reflecting on a well-spent, memorable winter.

For questions about treatment for co-occurring depression and eating disorders, please visit our website at www.eatingdisorder.org

Written by Amy Scott, LCPC

 

References:

  1. Friedman, Richard A. (December 18, 2007) Brought on by Darkness, Disorder Needs Light. New York Times’’.
  2. Krauchi, K., Reich, S.,& Wirz-Justice, A. (1997). Eating style in seasonal affective disorder – who will gain weight in winter? Compr Psychiatry, Mar-April, 38 (2). 80-87.
  3. Lam, R.W, Goldner, E.M., & Grewal, A. Seasonality of symptoms in anorexia and bulimia. International Journal of Eating Disorders. 1996. Jan 19 (1): 34-44.
  4. Fornari, V.M, Braun, D. L., Sunday, S.R., Sandberg, D.E., Matthews, M, Chen, IL, Mandel, F.S., Halmi, KA & Katz, JL (1994) . Seasonal Patterns in Eating Disorder Subtypes.Compr Psychiatry. Nov /Dec; 35 (6): 450-456.
  5. Sher, L. (2001). Possible Genetic Link Between eating disorders and seasonal changes in mood and behavior. Med Hypothesis, Nov 57 (5): 606-608.
  6. Wein, Harrison ed. (2013). Beat the winter blues shedding light on seasonal sadness. NIH News in Health. Retrieved from http://newsinhealth.nih.gov/issue/Jan2013/Feature1.

 

Tried & True Strategies for a Recovery-Focused Holiday, Part III: AFTER Thanksgiving has Come and Gone

GratitudePost-holiday time can be filled with mixed emotions.  Some people experience RELIEF that it wasn’t as difficult as they had predicted, others struggle with post-holiday  FRUSTRATION or GUILT related to eating disorder behaviors or holiday meal challenges.  Still others head out of the holiday week EXCITED to return to the familiar structure and schedule of school or work. There may have been HAPPY times or SAD emotions woven throughout your Thanksgiving holiday as relationships and expectations for the holiday were tested. Maybe you tried some of the tips we suggested in Part I and Part II of our holiday blog series with a lot of success…or perhaps with a lot of struggle.  No matter how things went or how you’re feeling now its important to honor your emotions and continue on from this point in a recovery-focused way. Here are some tips that can help you make the most of your week-after-Thanksgiving (and beyond).

 

1. Change your filter.  So often, the eating disorder voice shines such a powerful spotlight on everything negative that it can be easy to get caught up in what went “wrong” on Thanksgiving day and ignore everything that was positive.  This is an example of a cognitive distortion called filtering.  In the days and weeks that follow, try not to allow your eating disorder to dictate how you will remember this holiday.  Instead, sit down with positive intention and make a point to reflect on what went well, what worked and who was integral to those successes.

2. Don’t skip therapy. (Sound familiar?)  If you had a hard time during the holiday and find yourself feeling frustrated or ashamed that you acted on symptoms, do not cancel appointments with providers.  Right after slip-ups is the ideal time to meet with a therapist or dietitian to process what happened, what the trigger was and how to prevent a holiday-induced downward spiral.  If your first appointment with a provider won’t be for another few days, take some time to jot down your observations and feelings about the holiday and what you want to remember to discuss with your therapist or dietitian.

3. Accept post-holiday compliments gracefully.  Individuals with eating disorders often have a hard time accepting positive feedback, especially when it clashes with their own negative beliefs about themselves or their abilities.  If someone is genuinely telling you that you did a good job with something, before you refute them, consider how your reaction will affect you and them. When Aunt Martha calls you this week and says  “Thanks for hosting us this weekend.  Your house looked beautiful all decorated for the holiday and the meal was just great,”  your instinct might be to say “Oh please, the turkey was dry and the house was a mess! I just didn’t have time to clean it the way I wanted to.”   When you completely reject a compliment it sends a message to the other person that you may be overly critical in general or that their opinion is not valued.  Additionally, if you deflect compliments from the same people repeatedly, they may be conditioned not to give them at all.  Most importantly, when you reject compliments you deny yourself the opportunity to absorb a positive belief which could go a long way in helping to boost your self-esteem and overall self worth.  Even if you’re struggling to believe that a compliment is true, allow yourself to receive it and entertain the idea that it just might have some validity.  Instead of deflecting, consider simple statements, such as “Thank you so much – that means a lot to me” or even, “Thanks” will work just fine.

4. Move On. If this holiday wasn’t what you had hoped for, let it go.  Don’t continue to blame yourself for things that may have been beyond your control.  Assess what can be changed in similar situations in the future and make note of them, then allow your mind to move on. Getting stuck in thoughts about how disastrous/boring/disappointing/etc. your Thanksgiving was is not going to help you make today the best it can be.  Remember that non-holidays are just as important in the long run of recovery.  Make today a good day; do the best thing for you and your recovery in this moment.

5. Keep the gratitude going.  Thanksgiving does a great job in helping to promote gratitude.  Even if you haven’t yet jumped on the #thanksvember bandwagon via Twitter or Facebook, it’s not too late to start. Take some time tonight to be grateful and send a genuine “thank you” to the support people that helped you enjoy the holiday…

  • If your mom changed the subject at dinner when a relative was harping on you for not taking seconds of her casserole, tell your mom later how much you appreciated her speaking up.  (If you live close by, give her a hug while you’re at it.)
  • If your friend answered frantic text messages you were sending on Thanksgiving day, let him know how much that meant to you that he was available for support in the thick of the holiday.
  • If your little nieces and nephews forced you into hysterical laughter with their impromptu Thanksgiving skit, send them little notes in the mail to let them know you can’t wait for their Christmas or Hanukkah performances too.
  • When it comes to gratitude, remember to use your voice.  It’s an  excellent opportunity to nourish the positives and create more of what you need for your recovery.

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Is there someone you relied on this Thanksgiving to help you through?   If you have feedback or comments about positive ways in which your support people helped out this holiday, we’d love to hear.  Share in the comments below or join the conversation on our Facebook page.

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Tried and True Strategies for a Recovery-Focused Holiday – Part I: BEFORE the Holiday

Tried and True Strategies for a Recovery-Focused Holiday – Part II: The Day OF Thanksgiving

Above photo courtesy of psychcentral.com (click on the photo to link to interesting research about the benefits of gratitude on health and wellness)

Tried and True Strategies for a Recovery-Focused Holiday – Part II

Each year we see many individuals with eating disorders, and even those in strong recovery, become increasingly anxious as the holidays approach.  Being on high alert for triggers or signs of relapse can be an effective way of staying recovery-focused and keeping yourself well. However, it’s also important to relax into the holiday and not allow the anxiety to overshadow what could be a very positive experience.

Yesterday in Part I, we shared strategies to help you plan ahead for a recovery-focused holiday.  Today in Part II, our staff share their top tips for making it through the actual day of a holiday with health and recovery intact.

Part II: The Day OF Thanksgiving…

Thanksgiving Mantel

  • RELAX – Focus on your breath, meditate, or listen to soothing music on your way to  he festivities so you start off the celebration in a positive place. If you show up in an anxious or negative mood right off the bat, it’s likely to affect those around you and be intensified.

Try to enjoy the holiday, not just survive it! Focus on what you would like to do and who you would like to do it with. Shift your attention from body image, food, and self-criticism and focus on what you want the meaning of the holiday to be for you.

~Kim Anderson, Ph.D., Therapist and Director of Psychology 

  • Check in with yourself about body comparisons. Believe it or not, we hear a lot about patients not liking family gatherings because they are comparing their bodies to other family members. For many people, these inter-family comparisons can be the most triggering or most intense body comparisons they face. If you find yourself going down that road, hit the pause button. Rewind, reconnect and consider engaging the person in conversation instead. See if you can find out something positive about them you never knew before. Remember that they are more than just their body and you are more than just yours.
  • Get grounded.  If you feel your thoughts drifting to food, body or weight, re-connect to something positive in the moment.  Sometimes wearing a special bracelet or keeping a special item in your pocket that you can reach for and touch/hold can help to ground you.  Connecting physically to an item can help you stay in the moment and tune out the eating disorder voice.
  • Cross generational boundaries.  Be mindful of the different support each generation of your family can offer.  Hanging out with siblings, cousins and others of a similar age to you can be a nice way to connect around common developments and gives you a chance to get support/empathy on specific life stage issues like being away at college, parenting stress, job hunting, retirement, etc. On the other hand, reaching out to older generations, like grandparents, is an opportunity to get outside of your own concerns, to see how priorities can shift throughout life and also to collect some family history. Consider sitting down with an older relative and asking them an open-ended question about their most memorable Thanksgiving.  Even the youngest generations have something to offer you in your recovery-focused holiday…

Spending time with the young children in your family during large family gatherings could be a good distraction from “grownup conversation”. Hang out with the kids, play games with them and ask them about themselves. You might even consider eating with the children and think about being a good role model for them.

~Lisa McCathran, LCPC,  CED Outpatient Therapist

  • Be the family photographer.  Grab your camera and put yourself in charge of documenting the day. Many extended families only have rare opportunities to spend time together.  Catching family memories on film will not only keep you focused on something other than the ED, it will give people around you a reason to smile and be mindful of the special moments throughout the day.
  • Hors d’oeuvres.  Food is often present at holiday gatherings long before the actual holiday meal is set on the table. Be prepared. When eating appetizers/munchies, instead of continually grazing and walking around with food, you may want to put all of your choices on a plate together at once so that you can see a total of what you are eating.  Then allow yourself to sit down and mindfully enjoy eating it.
  • Structure your time before and after the meal by preemptively volunteering to help out in ways you are most comfortable with. For example, ask if you could set the table instead of helping around the food in the kitchen. Instead of packing up the leftovers, consider offering to load the dishwasher or get the kids in their pajamas.
  • Be assertive in making sure you get seated next to your most supportive family member at the dinner table.
  • Use your support. If you took the effort to connect with a “safe person” in advance of the holiday, now you have to be sure to utilize them. It can be hard to ask for help in the moment but it will be worth it.

[Editors note: When we asked our dietitians to chime in on the “eating part” of the holiday and their best piece of advice, they all said the same thing…which means it’s probably pretty important.  That’s why we’ve included all of their input below without consolidating.  Even though it’s repetitive, it’s one of the most important things you can do to have a happy, safe and recovery-focused holiday while recovering from an eating disorder.]

  • Take the time to eat your three meals during the holiday.  Breakfast will be particularly important as it sets the stage for your hunger and fullness cues over the rest of the day.
  • Eat regularly!!! It’s the most important thing to do. This is not the best time to try a new eating schedule.
  • Do not skip meals! Do not plan to compensate for overeating later by skipping meals in advance.
  • Stick to the meal plan especially the day before the holiday and on Thanksgiving Day.

Have an adequate meal at each meal time prior to the Thanksgiving meal so that you’re able to enter the holiday meal hungry, but not ravenous.  When you skip meals or restrict during the day and then enter a meal ravenous, you’re much more likely to eat past fullness.  On the other hand, entering a meal with a natural level of hunger means you will be more likely to stop when you’re properly nourished and comfortably full.

~ Hannah Huguenin, MS, RD, LDN, CED Dietitian

  • Everyone needs a little alone time. Remember to take time by yourself to journal or relax during the day. If you’re staying with relatives and can’t find space inside the house to be alone, grab your coat, a cup of hot tea and step outside for fresh air, or consider volunteering to run an errand for your host
  • Play games. Don’t assume that your host will be prepared with distraction techniques for you – he or she will probably be pretty busy with holiday hosting tasks – so bring your own games to the party.  Grab a holiday-themed puzzle or some of your favorite board games that will encourage interaction. Need something quicker and easier?  Simply bring a deck of cards that you can use to play all sorts of different games with others or even by yourself.

Many people with eating disorders, especially those who’ve experienced trauma, may experience very intense emotions around the holidays. These strong feelings and stressors can be overwhelming but they don’t need to ruin or disrupt your holiday. Consider using a “containment strategy”. Write down the unpleasant thought or feeling on paper and put it “away” inside a designated containment box to be opened later when feeling safer such as in a therapist’s office or when the feeling has decreased in intensity.

~ Irene Rovira, Ph.D., Therapist & CED Psychology Coordinator

  • If you are not attending a family gathering it’s still important to plan a recovery-focused holiday.  In fact, it may be even more important to create structure and social opportunities that will keep you focused on the bigger picture and engaged in positive activities. This could include volunteering your time to other causes like a soup kitchen or a homeless shelter or it might mean finding another friend without plans and going out to a movie together.
  • You made a list, now check it twice. If you took the advice in Part I of this holiday blog series, then you should have a list of the top 3 most useful coping skills for you (this will be different for everyone).  If you’re going through the day and you’re struggling with eating disorder thoughts or urges to act on symptoms, refer back to your list and work through them again, making tweaks if necessary. For example, if you called or texted a friend who never replied, do it again but try someone else this time.  Just because the first person didn’t get back to you, doesn’t mean you have to give up.
  • RELAX and end your day with SELF-CARE.  Just as we suggest starting off the day with relaxation techniques, allow more time for yourself to decompress from the holiday as it comes to a close.  Breathe deeply, put on your favorite music playlist for the ride home, or take a few minutes to journal when you arrive home.  Regardless of how the day went, do something nice for yourself before you go to bed on Thanksgiving night. For some people, that might be taking a nice hot bath, reading a book, writing a supportive email to yourself, watching a favorite movie with your spouse or a best friend, or cuddling with your pet. Whatever it is, allow yourself to enjoy it.  Accept that you are deserving of self-care and able to bring your day to a close in a positive way.

We know this is a long list, and you can’t do every single thing on here ( and we don’t want you to overwhelm yourself by trying).  Just choose the ones that speak to you and that you think will be most helpful on your holiday.  Chat with support people and get their feedback regarding how these tips can fit into your specific family’s traditions and holiday schedules.

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Did you miss Part 1?  You can still go back and read the holiday planning and preparation tips here:  Tried and True Strategies for a Recovery-Focused Holiday, Part I: BEFORE the Holiday…

Find Part III here: Tried & True Strategies for a Recovery-Focused Holiday, Part III: AFTER Thanksgiving has Come and Gone

Have a good tip that we missed? Share your support and feedback on our Facebook page.

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Many thanks to the following CED providers who’ve contributed to this blog series:

  • Samantha Lewandowski, MS, RD, LDN
  • Hannah Huguenin, MS, RD, LDN
  • Jennifer Moran, Psy.D.
  • Kim Anderson, Ph.D.
  • Laura Sproch, Ph.D.
  • Irene Rovira, Ph.D.
  • Amy Scott, LCPC
  • Lisa McCathran, LCPC
  • Anne Holman, LCSW-C
  • Kate Clemmer, LCSW-C
  • Jennifer Lane, MS, OTR/L

 

 

 

Tried and True Strategies for a Recovery-Focused Holiday – Part I

 

plan-ahead-sunsetHoliday gatherings and celebratory feasts can pose some significant challenges, regardless of where you’re at in treatment or recovery. Being aware of them, planning for them and setting yourself up for an enjoyable holiday is important. That’s why we asked all of our clinical staff at CED to share their best advice for having a safe and successful holiday while maintaining or working towards recovery from an eating disorder. They had so much to share that we couldn’t fit it all in just one post so this is just the first of a 3-part series to help you through the before, during and after of the holidays.  

Through the years, these are some of the strategies and suggestions that our therapists have seen the most success with and we hope you will too.  Happy Thanksgiving from all of us here at the Center for Eating Disorders at Sheppard Pratt.

Part I: BEFORE the Holiday…

  • Plan, Plan, Plan…..with your treatment team and with your primary supports. Develop a very specific, detailed plan for managing all the stressors that come along with the holidays.
  • Challenge predictable thoughts before the holiday. If you notice you have predictable patterns of negative thinking pop up at family gatherings or the same triggering thoughts sneak up on you every Thanksgiving day, take time to identify them in advance. Write them down and work on challenging the thoughts ahead of time (on your own or with a therapist) so you’re better prepared to defend against these specific negative/irrational thoughts on the actual day.  You might even consider keeping a list of your positive affirmations or challenge statements with you on Thanksgiving for easy access.  (If you know you’ll have your phone handy, you could even send a text to yourself the day before).
  • Identify one or two major positives about the holiday. No matter how anxious or depressed you may feel about an approaching holiday, there IS a positive hidden somewhere, even if it’s as simple as getting time off from school or work.
  • Make a list of your top 3 most reliable coping strategies and keep it handy in a notebook or on your phone.

Decrease stress and increase relaxation. Only say “yes” to events that you would like to attend and believe you can attend with success. Keep your daily schedule of activities and gatherings manageable.

~ Kim Anderson, Ph.D., Therapist and CED Psychology Coordinator

  • RSVP with a time limit. For example, “Thanks so much for inviting me. I’ll be able to be there from 3:00 to 5:00.” This provides you with some boundaries and an opportunity to leave the situation if it’s becoming detrimental to your recovery. However, if things are going better than expected (which often happens) and you want to stay longer, then you can.
  • Choose a worry chair.  If the anxiety is overwhelming or interfering with life, set up an appointment for yourself to “worry” about your concern at a specified time, date and place- this allows you to “delay” the worry and frees you up to take care of business at hand until then.

I really try to highlight for my patients that they are not alone in experiencing high stress around the holidays and that other members of their family are likely struggling with similar anxieties and negative thoughts. Some are able to manage extra stressors in healthy ways like talking about how they’re feeling, getting enough sleep, setting limits, or adding in extra self-care. Other family members may turn to unhealthy management strategies like drinking too much, getting into arguments, withdrawing, avoiding, hiding their feelings, or eating too much/too little. I try to use this to help my patients see that the problem isn’t the food itself, it is ultimately the thoughts and feelings, that can lead to intensified eating disorder urges. Being aware of this can free you up to move forward and choose more constructive and beneficial ways to cope.

~Laura Sproch, Ph.D., Individual and Family Therapist and CED Research Coordinator

  • Identify a “safe person” you can go to that is aware of your struggle and will support, distract, and protect you on the day of the holiday gathering. Talk with that person ahead of time so they know exactly how to support you during the meal and in specific situations. These things are not always obvious and support people may need a little “coaching” in advance. Some people even like to arrange a “code word” with their support person that they can say when they’re feeling really triggered and need an opportunity to remove him or herself from the situation.
  • A day ahead, you may want to plan out the timing for your meals, especially if Thanksgiving meal is falling at an atypical meal time. Refuse to use that timing issue as an excuse to skip meals or go off your meal plan. Simply juggle around your mealtimes a bit so that you can still fit in breakfast, lunch, dinner and one or two snacks. If you don’t do this in advance, it probably won’t happen.
  • Create a holiday project that will provide you with some distraction and also give you something positive to look forward to on the day of the holiday. Consider creating a scrapbook of past family holidays or a hand-made gift for your host/hostess.
  • Set realistic expectations. Work on decreasing expectations about decorations, food, family time, and any other areas in which you’re feeling pressure to be perfect.

Real-life holidays, like many things, will not resemble the advertisements and commercials that portray them. Holiday gatherings will not be perfect…someone will spill their drink all over the carpet, your relatives will arrive late (or unexpectedly early!), kids will have tantrums, arguments may occur, and at least some of the food will get overcooked. The great thing is, that’s all okay and normal. If you find yourself expecting a picture perfect Thanksgiving, take time to adjust your vision and agree to embrace the day in all its imperfection. Ultimately, that is exactly what will make it memorable.

~ Kate Clemmer, LCSW-C, CED Community Outreach Coordinator

  • Focus on the bigger picture. Research causes or charities that interest you where you might be able to volunteer during the holiday season; focus on the meaning of the holiday rather than the food specifically.
  • Don’t skip therapy appointments. With all of the preparations and traveling and extra time committments, many people find themselves tempted to cancel pre-holiday meetings with therapists and dietitians or skip regular support groups.  We’ve encountered this many times before and unfortunately, it rarely results in positive outcomes.  This is exactly the time when extra support is crucial.  Instead of cancelling, consider other options like adjusting your appointment time to an earlier slot before you leave town.
  • Begin a daily practice of gratitude. Start each day by reflecting on something you are grateful for. You could write them each down in a journal or even post them on Facebook. This is a great way to head into the holiday with a fresh and positive outlook.

Stay tuned for tomorrow’s post with more insight and suggestions from our therapists and dietitians in Tried and True Strategies for a Recovery-Focused Holiday, Part 2: The Day Of Thanksgiving

[UPDATE]: Part II is now live here

[UPDATE]: Part III is available here: Tried & True Strategies for a Recovery-Focused Holiday, Part III: AFTER Thanksgiving has Come and Gone

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You might also be interested in these posts from past holidays…

 Tips for Overcoming Holiday Stress and Anxiety – Part I: The Food

Tips for Overcoming Holiday Stress & Anxiety – Part II: The Stress

Nutrition Tips for a Healthy and Happy Holiday!

Thanksgiving with an Eating Disorder: 10 Tips to Help You Get Through the Holiday

Photo courtesy of examiner.com