I’m going crazy
, I thought as I grabbed a cookie out of the trashcan during an out-of-control binge at 22-years-old.
Who does that?
I wondered, absolutely disgusted with myself.
Unfortunately, my solution to end the confusing and chaotic relationship that I had with food turned into: just don’t eat. Of course, this misguided tactic failed miserably and set me up for more intense and prolonged binges, and then, ultimately, for purging.
Fast-forward 15 years, and I’m on the phone with my therapist, curled up in a ball crying, saying those words again, I’m going crazy
. I was describing — not a binge — but an uncontrollable exaggerated startle response that seemed to activate without warning. Who does that?
I asked myself. My whole body would jump as if someone had walked up from behind and scared me — only no one was there.
Our struggles change our brains
In the scenarios described above, I felt like my body was being taken over by an outside force. I thought I was losing my mind. Today, I know the truth: neurobiologically, my brain was hijacked.
I eventually learned in therapy that I jumped because a part of me was still afraid — very afraid — of a memory of a trauma that I had experienced in my late twenties.
It took a long time for me to break through my denial — and it sure didn’t help when so-called experts missed and dismissed both of my problems — but I now know that I was struggling, first with an eating disorder, and later, with PTSD.
No one should have to suffer with any mental illness for as long as I did without help.
Today, as we acknowledge World Mental Health Day, my hope is that our global advocacy efforts will lead to earlier detection and treatment of these mental health conditions and others.
The link between PTSD and an eating disorder
Did you know that eating disorders and PTSD, two very debilitating conditions, often co-occur? Some experts refer to an eating disorder as a brain disorder; many refer to posttraumatic stress disorder (PTSD) as a brain injury. Here are some facts about these disorders in the US:
- For adults with bulimia nervosa, 37 to 45 percent will experience PTSD at some point in their lifetime.
- For adults with binge eating disorder, 21 to 26 percent will battle PTSD during their lifetime.
- When it comes to anorexia nervosa, the odds of having PTSD are higher in individuals who engage in bulimic behaviors like binge eating and/or purging.
- PTSD affects 5 to 12 percent of individuals without an eating disorder.
According to studies, it seems that PTSD, not the actual trauma itself, is what contributes to the development of an eating disorder.
For some people, PTSD symptoms are so devastating that eating disordered behaviors become a way to cope, particularly binging and purging
. As an example, in an effort to alleviate the hyperarousal symptoms that occur with PTSD (e.g., feeling keyed up, irritable, and/or startling), some might binge. In an attempt to decrease the intense emotions associated with flashbacks (another symptom of PTSD), others might purge. Some do both.
Having said this, not all people with PTSD will engage in eating disordered behaviors. And, importantly, not everyone who experiences a trauma will develop PTSD.
Recovery from both conditions is possible
Since I was well into my eating disorder recovery work when my trauma occurred, there was only a short time when the two disorders collided. Looking back, I can clearly see that there were instances when I used my eating disorder as an attempt to deal with the emerging symptoms of PTSD.
Here’s what I want you to know: both eating disorders and PTSD are real, life-threatening illnesses; they are not choices.
I couldn’t “just eat” to get over my ED any more than I could “just get over” my trauma and the debilitating PTSD symptoms I experienced.
I hope that you join me in spreading the word to those who are suffering: help is available, and recovery from both eating disorders and PTSD is possible!
Treatments for eating disorders and PTSD
There are a variety of evidence-based treatments for both PTSD and eating disorders
. Here is a list of some things that I’ve personally found to be helpful in my own recovery:
- Cognitive behavioral therapy (CBT), which was particularly helpful for my own eating disorder recovery
- Prolonged exposure therapy and eye movement desensitization reprocessing (EMDR), which were particularly helpful for me in dealing with PTSD
- Alternative therapies like yoga, acupuncture, massage and somatic therapy can help us reconnect and make peace with our bodies
Some who battle both PTSD and an eating disorder find it best to tackle both simultaneously while others find it more helpful to approach the illnesses one at a time.
If you (or your loved one) struggle, professional help that is individualized by experts with experience in treating both disorders is often recommended.
We must seek full recovery
Today, I am happier and healthier than ever before. While I still experience many challenges in this thing called life, I am grateful to say that I can now live without the chronic negativity that was fiercely attached to both my eating disorder and PTSD. I view each day as a gift. I’ve reconnected with self-compassion and self-forgiveness. I love myself. When I thought I was going crazy, I chose to take a step toward recovery, which eventually made me stronger.
If you, too, believe that you might be losing your mind, consider this: through your struggles, you just might be stumbling upon your strengths. Believe it, and, on this World Mental Health Day, reach out for help
. Healing is possible.
Jenni Schaefer is a bestselling author and popular speaker on eating disorders and related disorders, including PTSD.
References: Brewerton, T. D. (2007). Eating disorders, trauma, and comorbidity: focus on PTSD. Eating Disorders, 15(4), 285-304.
Dansky, B. S., Brewerton, T. D., Kilpatrick, D. G., & O'Neil, P. M. (1997). The National Women's Study: relationship of victimization and posttraumatic stress disorder to bulimia nervosa. International Journal of Eating Disorders, 21(3), 213-228.
Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348-358.
Reyes-Rodriguez, M. L., Von Holle, A., Ulman, T. F., Thornton, L. M., Klump, K. L., Brandt, H. A., . . . Bulik, C. M. (2011). Posttraumatic stress disorder in anorexia nervosa. Psychosomatic Medicine, 73(6), 491-497.