Eating disorders and anxiety

I have struggled with anxiety for as long as I can remember. Growing up, I had a lot of anxiety about schoolwork, worrying about performance and how well I was doing. Of course, perfectionism played into my anxiety, always needing to do the best or better than the best. My anxiety worsened the last couple of years in college when I switched music teachers to a bassoonist from the St. Louis Symphony. She had high expectations. I constantly felt inadequate and would dread going to lessons, crying on the way to and from the sessions, worrying I would be ripped apart for my poor playing. The pressure to achieve and perform in graduate school didn’t help matters and that’s when I started using my newly developed eating disorder to cope. I have struggled socially, I even was diagnosed with social anxiety disorder (which I have now recovered from for the most part), and at work, where over the years I worried I wasn’t good enough or working hard enough and ultimately would be fired.

Anxiety has been crippling. I often would cancel plans or stay in my apartment, so I didn’t have to face what scared me. Anxiety led me to drink my worries away, to escape the intruding thoughts while in a drunken daze. I came home at 5 pm, holding in the stress and anxiety from the day, releasing the tension with the initial drink. I also used the eating disorder to calm my anxieties. Restricting and losing weight made me feel more in control and less like my world was spinning out in chaos.

That said, the more I drank and the more I restricted, the worse the anxiety became. My anxiety was always worse at a low weight. So, while I tried to cope, I only made things worse.

Even now, nearly two years into my eating disorder recovery, I still struggle with anxiety. I have done a lot to challenge my social anxiety, such as doing a lot of public speaking and networking. But the general anxiety is still there. It takes the form of worrying about work and my body. This past year at my new job, I have had impostor syndrome, thinking I was not doing a good enough job. I tend to feel anxiety in my body, so body image distress has been higher. There is a correlation between the two.

I also feel anxiety about my health. In my disorder, I ignored my worsening health condition, thinking it wasn’t real or it wasn’t that bad. In 2021 I was diagnosed with chronic kidney disease and that was a wakeup call to get my life on track. Worrying about my health was a catalyst for my recovery. While that was a positive outcome, I would experience a lot of anxiety waiting for lab results or going to the doctor, worrying things had worsened.

Lately, the worry thoughts have been constant. There is a lot of transition and uncertainty at work right now. But I am sober and in recovery, so I no longer use my eating disorder or alcohol to cope. I have learned healthier means to cope.

In addition to taking medication, I have tried so many therapeutic techniques to cope with my anxiety:

  • worry time

  • thought challenge records

  • distraction

  • DBT distress tolerance skills such as TIPP (temperature, intense exercise, paced breathing, and progressive muscle relation)

They all help for in-the-moment relief. But the relief is often temporary.

Other general ways to reduce anxiety include:

  • I have found that walking is a good way to calm my anxiety. Getting outside in nature and feeling the air on my skin helps. For example, one day recently I found out I did not get a job I wanted. Emotions were high, so I went for a short, brisk walk. Like the “intense exercise” of the TIPP skill, walking got out the nervous energy I was feeling. Of course, I make sure I fuel for my walks.

  • Talking to a friend is also helpful. Even just asking someone how their day was is a good way to get out of my head.

  • Playing with my two kittens reduces stress. They’re good about cuddling, which is calming.

  • Something as simple as being underneath a blanket also helps. I particularly enjoy my heated blanket, even in the summer.

  • Breathing, such as paced breathing or box breathing, is also a good way to calm the nervous system. I don’t find breathing to be particularly helpful as it reminds me too much of playing my instrument. But I know for most people it is a good skill to rely on.

Unfortunately, I have not found one thing that will make my anxiety go away entirely. Wouldn’t that be amazing! However, I have found healthy ways to cope that lessen its impact on my day-to-day functioning.

If you struggle with anxiety and co-occurring disorders, I get it. There is hope that it doesn’t have to take over your life. Of course, seeking professional help is recommended for long-term support. I learned most of these coping skills through working with a team. I wouldn’t be where I am without the support of my team.

Anxiety was at the heart of my eating disorder and alcoholism. They often fed each other. But recovery is possible. My day-to-day now does not revolve around my anxiety. Stress and worry will happen, you cannot control the initial thought, but you can manage how it affects you.

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The relationship between my alcoholism and my eating disorder

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Body image realities