Navigating the Intersection between Anxiety and my Eating Disorder
Feeling anxious or stressed is something we all experience. In the typical person, anxiety is a normal and often beneficial response to a stressful situation, like sitting a test or needing to meet a deadline, as it increases your breathing and heart rate, and concentrates blood flow to your brain – where you need it. Basically, it is a physiological response designed to help prepare you to handle an imminent threatening situation.
But for some, the feeling of anxiety is relentless – occurring without logical reason or cause – and actually hinders how they experience the world. It can reach unbearable levels, affecting their ability to maintain relationships, do well in school, hold a job and can completely take over their capacity to lead a normal life.
If I think back to any single memory from my childhood, it was riddled with anxiety. From a very young age, I was experiencing intrusive and distressing thoughts about bad things happening to my family. Because of this, I had attachment issues; too scared to ever leave my mother’s side. It held me back from experiencing many of, what were supposed to be, fun and enjoyable experiences of being a kid.
Not knowing how to express myself, I would often say I felt nauseous, which I genuinely felt, but reporting this so often meant people soon questioned my honesty. People just thought I was really shy, a bit soft or a wuss, but no one ever questioned my mental health.
In my teenage years, my anxiety transformed into fears about self-image.
I was hyper-aware of my changing body and how I was considered by other people, both physically and emotionally. I never felt good enough, but still felt a need to prove that I was, and soon found that working hard and doing well at school made me feel I like I was on top of things.
But as the pressure of school increased with later years, paired with my low self-esteem and body image, my anxiety morphed into an eating disorder.
I consider my eating disorder was, at the time, the most appropriate form for my anxiety to take to claim an ongoing role in my life. Fixating on my eating and weight provided an avenue for me to channel my anxious thoughts in a “productive” way, such that I could do something and receive a sense of control over my life, and by so doing, temporarily alleviate my symptoms. Hence why it was so difficult to overcome my eating disorder – it had become an important part of how I knew to cope with an underlying condition.
There is significant intersect between anxiety disorders and eating disorders. Two-thirds of people with eating disorders suffer from an anxiety disorder at some point in their lives, with around 42% having developed an anxiety disorder during childhood, before the onset of their eating disorder (Kaye et al., 2004).
In fact, the word “nervosa”, part of anorexia nervosa and bulimia nervosa, literally comes from the Latin word for “nervous”.
Anxiety disorders include Generalised Anxiety Disorder (GAD), Obsessive Compulsive Disorder (OCD), Social Anxiety Disorder (SAD), panic disorders and certain phobias. OCD is the most common to co-occur with an eating disorder, however there is often a large crossover between eating disorders and obsessive-compulsive tendencies, regardless of an OCD diagnosis. This is often observed through obsessive thoughts about food and body shape, food rituals such as cutting food symmetrically and hoarding of food items, as well as compulsions to engage in compensatory behaviours.
This means that for many, myself included, treatment for an eating disorder includes an overlap with treatment for an anxiety disorder. It was with my psychiatrist at the time that we determined anxiety was the driver of my disorder and then explored methods to first help manage my anxiety. This involved various medications, one of which I am still on today and continue to benefit from.
It also involved receiving Transcranial Magnetic Stimulation (TMS), a relatively new, non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of anxiety and depression. Both helped reduce my anxiety baseline to a manageable level and opened up avenues in my life I’d never once had.
For example, answering a phone call, ordering food out, talking to strangers, driving to new destinations – all relatively small things that might be considered easy to most, but were nearly impossible for me before. It was at this stage that I also started building confidence in myself and who I was as a person, which was when I really started to make progress in my eating disorder recovery.
Through recovery from my eating disorder, I learnt a lot of new skills and techniques that helped me manage my anxiety, some of which I still use today.
If you are someone who experiences anxiety alongside an eating disorder, here are some of my recommendations:
Know your triggers:
This is often a bit of a journey in itself. However, it is beneficial for both eating disorder recovery and coping with an anxiety disorder, as anxiety triggers are also often triggers for disordered eating. If you don’t know where to start, keep a diary of when your anxiety is at its best and worst.
It can help reveal patterns that you may not have been conscious of. Remember, that what triggers you is very individual and might not be the same as what triggers someone else. Be sure to approach yourself with curiosity and compassion, rather than judgement because whatever your triggers are, they are valid.
Mindfulness is a practice that has helped me in many ways throughout my healing, but still in my everyday life. Mindfulness is the practice of bringing your awareness to the present and not being overly reactive or overwhelmed by what is going on around you.
Anxiety loves to make you ruminate on the past or live in a hypothetical future that hasn’t happened yet. By bringing yourself back to where you are in the current moment, you soon realise that no matter what might be going on for you in your head, stillness can always be found at your core.
Have an outlet:
It is important to find activities that either calm, divert or channel your anxiety in a positive way. For many people, their eating disorder serves a purpose beyond food, weight and shape – whether it is to deal with emotions, provide distraction, or a sense of accomplishment or control. Thankfully, there are other ways we can cope that aren’t self-destructive.
Everyone finds different types of activities beneficial. For some, doing something adventurous like rock-climbing or hiking enables them to harness and use their heightened energy to feel physically good. Whilst others, like myself, find engaging in something more grounding like gentle yoga, drawing, cooking, or reading a book helps settle their anxious mind and body. Explore new avenues and see what makes you personally feel more at ease. It also presents opportunity for gaining new hobbies.
If you’re like me and spent majority of your life with anxiety, but it was never really talked or known about, taking the first step to share this with others can seem scary. Whilst I don’t believe in mental illnesses as labels, I do believe that diagnoses can help people, including you, understand the issue at hand. It allows someone to educate themselves about what you’re experiencing and then more likely come from a place of compassion and understanding, than judgment and confusion.
It is also an opportunity to express that phrases like “just relax”, “calm down” or “get over it” are therefore never helpful. I’m a big believer in speaking your truth, and truly think that anyone who doesn’t respect you, your needs or wishes isn’t worth having around.
In honour of OCD and Anxiety Disorders Awareness Week (4th-10th August), please know that you are never alone in your struggle. If you have an eating disorder and experience extreme fear or worry, anxiety disorder or not, you aren’t just overreacting. Your stressors are very real and valid.
Kaye, W. H., Bulik, C. M., Thornton, L., Barbarich, N., & Masters, K. (2004). Comorbidity of anxiety disorders with anorexia and bulimia nervosa. The American journal of psychiatry, 161(12), 2215–2221. https://doi.org/10.1176/appi.ajp.161.12.2215
Korey Baruta is an Accredited Practising Dietitian (APD). Through her lived experience of Anorexia Nervosa, she was inspired to help others overcome the pressures of diet culture, develop compassion for themselves and rediscover a healthy relationship with food. She launched her business Nutrition for Every Body at the start of 2021, where she utilises Health At Every Size (HAES®), the Non-Diet Approach and Intuitive Eating to help people of all shapes, sizes and abilities overcome disordered eating and eating disorders.