Eating disorders are highly complex psychological illnesses that can develop for myriad reasons. They can arise from a complex interaction of biological, psychological and social factors and what triggers an eating disorder in one person can be very different to the trigger for another, according to everyBODY Project Worker Deborah McCready.

Few people who develop eating disorders will experience the same symptoms. Similarly, different treatments work for different people and recovery lengths vary. Eating disorders can be seen as a way of coping with emotional distress, or as a symptom of underlying issues.

• Eating disorders are not primarily about food.
• Eating disorders can affect anyone.
• People can and do recover.

Eating disorders are characterised by varied disordered eating behaviours such as:

• Self-starvation – by fasting and/or food restriction.
• Purging – by self-induced vomiting, over-exercising, or laxative abuse.
• Bingeing – by consuming quantities of food beyond what the body needs to satisfy hunger.

An eating disorder can be very destructive, both physically and emotionally, and people can get trapped into the destructive cycle of the eating disorder without knowing how to cope with it. An eating disorder is not just about food and weight, but also about a person’s sense of who they are.

Although the term ‘eating disorder’ is applied to a wide range of disordered eating behaviours, there are four main classifications: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and Other Specified Feeding or Eating Disorder (OSFED). Just because somebody doesn’t fit in absolutely with one particular category doesn’t mean they don’t have an eating disorder. A large number of people with eating disorders don’t fit strictly into one category but fluctuate between the three and may be diagnosed with OSFED.

ANOREXIA NERVOSA

• A person will make determined efforts to attain and maintain a body weight lower than the normal body weight for their age, sex and height
• They will be preoccupied with thoughts of food and the need to lose weight
• They may exercise excessively and may engage in purging behaviours

BULIMIA NERVOSA

• A person will make determined efforts to purge themselves of any food eaten, sometimes following a binge, and often following ‘normal’ food intake
• They will engage in high-risk behaviours that can include fasting, excessive exercising, self-induced vomiting, and/or the misuse of laxatives, diuretics or other medications
• They may maintain a body weight within the normal range of their age, sex and height. As a result, bulimia is often less obvious than anorexia and can go unnoticed for longer

BINGE EATING DISORDER

• A person will engage in repeated episodes of bingeing without purging
• They will likely gain considerable amounts of weight over time
• They find themselves trapped in a cycle of dieting, bingeing, self-recrimination and self-loathing

PEOPLE EXPERIENCING AN EATING DISORDER MAY

• Have dieted
• Have low self-esteem– though this may not be obvious, as people who develop eating disorders are often ‘high achievers’
• Show a marked over-concern with body shape, weight and size, and an obsession with food
• See thinness as a magical solution to problems, while weight gain is feared
• Have difficulty identifying and expressing their real needs
• View their body as larger than it actually is (distorted body image)
• Have problems around control
• Find it hard to talk about their feelings and to deal with conflict
• Be depressed and may become isolated
• Experience mood swings
• Find change difficult and spontaneity challenging
• May eat alone or in secret
• Have sensitivity to cold
• Have absent mensturation
• Engage in compulsive exercise
• Have excessive fine hair on body and face
• Suffer dehydration

ADVICE ON HOW TO HELP A LOVED ONE SUFFERING FROM AN EATING DISORDER

If you are worried about someone’s eating behaviors or attitudes, it is important to express your concerns in a loving and supportive way. It is also necessary to discuss your worries early on, rather than waiting until they have endured many of the damaging physical and emotional effects of eating disorders.

Approaching the subject of an eating disorder can be a daunting prospect.  Remember that recovery is so much more difficult in an atmosphere of secrecy and denial, and the disorder will not go away by itself. Talking about it can be an essential first step

What to Say – Step by Step

Set a time to talk. Set aside a time for a private, respectful meeting with them to discuss your concerns openly and honestly in a caring, supportive way. Make sure you will be some place away from other distractions.

Talk to them one to one. If other people are around it people feel like you’re ganging up on them.

Communicate your concerns. Share your memories of specific times when you felt concerned about their eating or exercise behaviors. Explain that you think these things may indicate that there could be a problem that needs professional attention.

Ask them to explore these concerns with a GP, counsellor, doctor, nutritionist, or other health professional that is knowledgeable about eating issues. If you feel comfortable doing so, offer to help them to make an appointment or accompany them on their first visit.

Avoid conflicts or a battle of the wills with them. If they refuse to acknowledge that there is a problem, or give any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener.

Have some information about eating disorders to hand. They may not feel ready to talk or share with you yet but if they can go away with information to read that helps them to recognise they may need help, they are more likely to come forward when they’re ready to ask for support.

Avoid placing shame, blame, or guilt on them regarding their actions or attitudes. Do not use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements. For example: “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”

Be aware that they’re likely to be feeling embarrassed, shamed and scared. Acknowledge that this must be difficult for them and reassure them that you aren’t there to judge, but to support.

Avoid giving simple solutions. For example, “If you’d just stop, then everything would be fine!”

Express your continued support. Remind them that you care and want them to be healthy and happy.

As the global spotlight shines on eating disorders, one client of AMH everyBODY reveals what life with an eating disorder is really like…

“AMH everyBODY provided a relaxed setting, which made me automatically feel less ashamed- something I had been feeling for a long time. One of the first things that really helped me was that it also helped my family, for the first time, to gain an understanding of how things were affecting me. Through everyBODY’s one-to-one support, and by coming to the Carer Support group, I could see they were starting to have an understanding of how difficult things were for me, that it wasn’t just all about food or weight.  It gave them a different perspective and they were able to communicate in a better way with me.

The service has taught me that it’s OK to be different, that uniqueness is a good thing that should be celebrated. Through AMH everyBODY I was able to find my identity again. With an eating disorder you are constantly comparing yourself to others, and not feeling good enough. I was able to discover MY voice. I learnt it was OK to put myself and my needs first. The creative photography course offered during this journey helped me to challenge myself especially in a social environment.

Stigma

One of the hardest parts of my journey was being able to open up and be honest. It took about a year to admit to myself and my family that there was a problem. The main reason was because of the stigma – the fear of what other people would think, that they would judge me and think it was about being vain, which it wasn’t!

For me, speaking out about my eating disorder led to people understanding.  I was surprised by the support from both genders amongst my peers. Male friends were genuinely interested and hadn’t realised that is was about so much more than just food. It really helped letting people know that it was more about what is going on in your head.

Impact

 Living with an eating disorder took EVERYTHING away from me. It was a very sneaky, secretive thing to live with and it surrounded me with a cloak of shame. It deprived me of my enjoyment of things I used to love and was interested in; the things you enjoyed doing become unthinkable. Your thoughts are taken over by eating disorder thoughts and it’s all consuming: I couldn’t concentrate or think about anything else. I remember feeling numb, trapped – like there was no way out.”

Recovery

 The support from everyBODY has meant EVERYTHING to me. Through the service, I was able to discover who I was again, to be able to be truthful to myself. I’ve been able to start to find beauty in life again, and start to enjoy new things.  Recently, I was able to go on a trip, and for the first time, feel a sense of freedom – to not be controlled by my eating disorder. Within my family, we were always close but now we are a lot more open and check in on each other more.

Advice

 My advice to others would be to remember that recovery is a journey – it can take time and you may  have ups and downs but it’s worth it. Be honest with yourself and don’t be afraid to ask for help. You don’t have to change everything overnight – just take things at your own pace. Try to find what matters to you and don’t be afraid to distance yourself from negative influences.”

 

This week is Eating Disorders Awareness Week – an international event devised to fight the myths and misunderstanding that surround anorexia, bulimia, binge eating disorder and EDNOS – disorders that are similar to but not exclusively characteristic of anorexia or bulimia.

The theme of this year’s focus is ‘Why Wait?’ – due to the alarming fact that on average, 149 weeks pass before those experiencing eating disorder symptoms seek help.

That’s almost three years or 1,043 days. That’s too long to wait for anyone, especially in light of statistics which show that eating disorders claim more lives than any other mental illness, with one in five of the most seriously affected dying prematurely from the physical consequences or by suicide. That’s why Action Mental Health’s eating disorder service everyBODY was launched. Operating in the Southern health trust area since 2000, it was formerly known as ADAPT but was relaunched in September 2018 as AMH everyBODY.

EveryBODY employs a preventative, interventionist and postvention approach, targeting the general public with awareness-raising sessions to equip people with the knowledge and skills necessary to self-support or seek help.

It also supports people affected by eating disorders, including family members and friends, to support recovery, and develops effective partnerships to ensure comprehensive, progressive support.

In light of the alarming suicide rate linked to eating disorders, AMH everyBODY promotes a greater understanding and awareness of these conditions. It promotes positive lifestyle choices, about eating to develop preventative and self-supporting skills. It also exists to help break the associated stigma – including unhelpful assumptions that it is attention-seeking behaviour or fad dieting that stops people seeking the support they need: in short, having an eating disorder is a serious mental health condition.

The focus of AMH everyBODY’s approach is recovery through partnership; a partnership between the person, their family and the Southern Health and Social Care Trust, who all work collectively to provide comprehensive support towards recovery.  AMH everyBODY provides much needed support not only to the person affected but also to their families and friends at the Carers’ Group monthly meeting.

Eating disorders affect over 700,000 women and men in the UK at any one time, with research suggesting that this figure is vastly underestimated. It is thought some 80% of individuals who screen positively for having an eating disorder have never accessed help or support.  One of the most harmful symptoms of an eating disorder is silence – AMH everyBODY encourages people affected to speak out for support and know that a listening, understanding and confidential ear will be there to provide support towards recovery.

As a community, part of spreading this awareness is by reducing some of the myths and misconceptions around eating disorder.

It is clear from our experience with clients how damaging misunderstanding, stigma and ignorance can be for both the person affected and their families. Indeed, there is no doubt that this stigma and ignorance can act as a major barrier to identification, early intervention and ultimately recovery from the illness.

Action Mental Health’s Deborah McCready, everyBODY Project Worker said: “AMH everyBODY exists to bridge the gap on the clients’ journey from the moment they seek help until they get to speak to a medical expert, as with existing waiting lists this can be some time.

“When people have taken that important step and are willing to engage and seek help AMH everyBODY offers a recovery approach in sessions when people will receive information and support to develop skills, stay focused and healthy until they see a therapist.”  Prior to appointments people can feel unsupported and alone, contact with AMH everyBODY at this time will help people support themselves and get the best from their therapist when they meet.

Some of the myths and misunderstandings heard by AMH everyBODY project workers include:

“Eating disorders are a choice” 

Eating disorders are serious psychological illnesses which NO-ONE can CHOOSE to develop. Eating disorders develop as a result of a complex interaction between psychological, social and biological factors. Each person’s experience of an eating disorder will be unique to them. No-one can choose to develop an eating disorder;

“Only females develop eating disorders”

Anyone can develop an eating disorder, regardless of gender. Men can and do develop eating disorder. Eating disorders do not discriminate along any lines whether that is gender, race, socio-economic status or age;

“You must be really thin to have an eating disorder”

Eating disorders are serious psychological illnesses which cannot be fully assessed on objective measures such as weight and shape.  Eating disorders come in all shapes and sizes and you cannot tell by looking at someone whether or not they have an eating disorder. Many people who may appear to be within a normal weight range can actually be seriously struggling with a very serious eating disorder;

“Eating disorders are just a phase”

Eating disorders are serious psychological illnesses and must be treated as such. Early intervention and support is vital and greatly improves prognosis of the illness. If you suspect you have an eating disorder or you suspect a loved one has an eating disorder, please seek help now. Eating disorders do not just go away;

“Eating Disorders are a diet”

Eating disorders are serious psychological illnesses they are most definitely not a diet;

“Eating Disorders are a teenage illness”

While evidence indicates that adolescence is an extremely vulnerable stage for the development of an eating disorder, eating disorders can and do develop at any age. Eating disorders do not discriminate and anyone at any age can develop an eating disorder;

“Recovery is rare”

People can and do recover from eating disorders. Recovery is always possible. Recovery can take time and it can be extremely challenging but recovery is always possible.  As a community we can improve awareness of Eating Disorders by being aware of these misconceptions and changing the conversation. Ensuring that there is an open conversation on the subject and removing any shame attached. Eating Disorders do not have a shape or size, they can affect anyone, anywhere, and everyBODY is deserving of help and support.

 

 

The reasons for volunteering for a good cause are manifold. Volunteering provides vital help to people and groups in need right across your community.

But the benefits don’t stop there.

Not only will your time, offered freely, help raise funds for charities, like us at Action Mental Health, it can actually improve your own mental health and well-being.

Studies have shown that volunteering is beneficial at combatting stress, depression and anxiety and also serves to keep you mentally stimulated, improve your self-confidence and provide you with a sense of purpose.

• It doesn’t matter whether you volunteer for a single event, or whether you want to make a more long-term commitment and volunteer on a regular basis, you’ll be a valued member of team AMH – and it will be worth it. Any time you can give on a volunteer basis can make a meaningful difference to people with mental health needs throughout Northern Ireland.
• You will meet like-minded people who are passionate about making a positive difference to people’s mental health and well-being.
• It’s an excellent opportunity to boost your career prospects by enhancing your CV or UCAS application and help you stand out from the crowd.
• Volunteering helps boost your own well-being. According to the Public Health Agency the act of giving is one of five evidence-based steps – and one of the Five Ways to Well-Being – that we can take to improve our mental well-being. Giving to others stimulates the reward areas in the brain, creating positive feelings. Read for yourself how it can benefit you: https://www.nhs.uk/conditions/stress-anxiety-depression/give-for-mental-wellbeing/
• It will help teach your children about the impact of giving back to the community. Children watch everything you do, so, by following your example, it will give them first-hand experience of the benefits of volunteering, both to those on the receiving end, and to themselves.
• You’ll have lots of fun! We have plenty of fun opportunities such as volun-cheering to support our runners at the Belfast City Marathon.
• You’ll meet new people and make new friends! Volunteering is a great way to meet new people, especially if you are new to an area.
• It will provide you with an opportunity to gain valuable new skills, knowledge and experience – such as communication, problem solving and teamwork.
• Volunteering is a great opportunity to give back to a charity that you believe in or that has impacted you either directly or indirectly.
• It will help boost your confidence and self-esteem, by gaining personally from new experiences and meeting new people.
• It will also help you log volunteering hours for Gold Duke of Edinburgh – for those over 18.
• Even if you have limited mobility there are still ways you can help us here at Action Mental Health. You can volunteer to man one of our cheer stations at the upcoming Deep River Rock Belfast City Marathon, on Sunday, May 5; host your own Great Big Purple Picnic, an annual event which takes place in spring; or devise your own fundraising effort to suit your personal requirements.

What’s Involved?

Join us cheering on our fantastic runners and cyclists across Northern Ireland, promoting AMH at glamorous wedding fairs or join the team on collection days.

You will be notified of our exciting volunteering opportunities and then it’s up to you to pick and choose which events you would like to participate in.

Who can Volunteer?

No experience is necessary to volunteer for Action Mental Health, however, you must be at least 18 years of age unless accompanied by a parent or guardian.

What Volunteering Means to Us?

By volunteering with us you’ll be helping to raise money and awareness to help change the lives of those living with mental ill-health and promoting resilience and well-being to future generations.

To find out more about volunteering with Action Mental Health or to register your interest please email [email protected]

 

 

 

 

 

Action Mental Health’s Inspirational Young Person of the Year 2018 Katie Graden Spence has been selected as a finalist in a prestigious category of the Pramerica Spirt of Community Awards.

The awards programme recognises and rewards secondary school age children for volunteering work in their communities and this year Katie, from Newtownards is among 20 finalists in the list of Ireland’s Top Youth Volunteers.

The Glenlola Collegiate School pupil last year came to prominence after walking 297 miles for suicide awareness – a mile for every person lost to suicide in 2017, raising £1000 for Action Mental Health in the process.

She also devised plans to establish student led mental health and well-being committee for every school in Northern Ireland.

The 18 year old even outlined her proposals before to the Department of Education and the All Party Group on Mental Health.

Katie said her short-listing for the award ‘raises awareness on how young people have the power to change the world’.

Katie will attend the awards ceremony next month, which will take place at the Aviva Stadium in Dublin.

Last Wednesday (6^th February) our Business Development manager Gavin McConvey was in Brussels for the launch of the H2020-MSCA-RISE “MENHIR” project.

MENHIR, led by the Universidad de Granada, Granada, Spain will research and develop conversational technologies to promote positive mental health.  The technology hopes to assist people with mild depression and/or anxiety manage their symptoms and prevent relapse via mental health monitoring through interactive conversations.

Action Mental Health is one of the project members of MENHIR, a partnership of academia, private and voluntary sector organisations.

 

The other members are –

• Ulster University, Belfast, N. Ireland
• Universidad del País Vasco, Bilbao, Spain
• Intelligent Voice Limited, London, UK
• Universität Ulm, Ulm, Germany
• Universitá degli Studi della Campania Luigi Vanvitelli, Caserta, Italy
• GLOBIT-Globale Informationstechnik Gmbh, Barsbuttel, Germany
• Universidad de Granada (UGR), Granada, Spain

MENHIR will use co-creation to develop a technology Chatbot to provide symptom and mood management, identification of patterns indicative of relapse and recurrence, personalised support, coping strategies, mental health education and signposting to online resources and local services.

Action Mental Health has teamed up with local experts like Dr Tracey Murray who today – during Children’s Mental Health Week – shares her expertise on helping young people negotiate the world of the Internet, Social Media and Gaming.

Tracey is an art therapist with New Life Counselling’s OKAY team, working with children and young people under 18 years of age.

 

The Internet, Social Media and Gaming

With growing developments and accessibility in internet technologies in the past few years there has been an increase regarding issues and negative factors affecting children and young people using social media. Whatsapp, facebook, instagram, snapchat, and musically, to name a few, are common online social platforms used by children and young people. Some of the issues arising and faced by children and young people from online activity include social withdrawal, online bullying, peer pressure,  sexualised communications (sexting), sites promoting eating disorders, self-harm & suicide and sexual grooming.

In 2018, the World Health Organisation named gaming as a mental health disorder under gaming addiction. Gaming in children and young people has become more of an issue over the past few years with an increase in playing inappropriate games which have violent content, like Call of Duty and Grand Theft Auto which are both age 18 rated games. Fortnite (rated age 12) is one of the most common games played by children of primary school age and has associated popular dances (The Floss). Gaming addiction could include a child or young person socially withdrawing from friends and shutting themselves away from family, along with gaming for long periods of time, losing interest in other hobbies and a change in sleep, eating, mood and behaviour.

Some tips for parents on gaming and social media usage:

• Limit days/duration of screen time on gaming device/phone/tablet/computer
• Monitor types of games being used with consideration for content and age appropriateness
• Set parental controls on the gaming/phone/computer devices
• Monitor any online activity with friends and unknown people on games/phone/computer
• Find alternative activities like playing board games and outdoor play/sports
• Monitor changes in mood, behaviour and sleep and contact GP if any changes become concerning
• Check websites for advice on internet safety for different age groups: thinkuknow.co.uk , www.internetmatter.org , www.nspcc.org.uk , www.psni.police.uk

 

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To find out more about New Life Counselling click here.  New Life Counselling is a member of the Action Mental Health Group.

Our AMH MensSana team support all ages in the area of mental health and emotional well-being through a range of activities tailored to suit group needs. To find out more click here.

Thanks to everyone who contributed to our focus on Children’s Mental Health this week – to those who read the articles, commented and shared – thank you also. We are very grateful to all our supporters and fundraisers who make our work with children possible.

Action Mental Health has teamed up with local experts like Dr Tracey Murray who today – during Children’s Mental Health Week – shares her expertise on understanding Anxiety among young people.

Tracey is an art therapist with New Life Counselling’s OKAY team, working with children and young people under 18 years of age.

Anxiety

Anxiety can present in children and young people of any age and it is one of the most common presenting issues in youths (age 12-17yrs). There are different types of anxiety:

• separation anxiety – when a child becomes anxious or distressed when separated from a significant other like a parent or care giver and this can occur when being dropped off at school or if a parent leaves the house, for example. This type of anxiety can be accompanied with other issues such as family difficulties/parental separation and attachment problems.
• situational anxiety -this type of anxiety can manifest in developing fears or obsessive thinking and behaviours, like excessive hand washing. Some situational anxiety can be linked to specific experiences like exam stress or traumatic experiences. Moderate to severe anxiety can manifest in children and young people as panic with symptoms in the body including; rapid heart rate, excessive sweating, tight chest/shortness of breath, nausea, shaking.
• social anxiety -caused by a fear of being in social situations and/or interacting with people. Anxiety is often accompanied by other presenting issues and factors such as social withdrawal, school refusal, low self-esteem and distorted self-image for example.

Helping a young person with anxiety:

Creative therapies and Cognitive Behavioural Therapy (CBT) approaches offer different ways of exploring and managing anxiety in a child/young person. Creative therapies offer a more child-centred approach that encourages the child/young person to express and explore their anxiety and any other related issues creatively using art, music, drama and/or play. A CBT approach is a more directive method which uses particular strategies aiming to change a young persons’ negative thinking and subsequent behaviours.

There seems to be growing understanding and development across primary schools in NI for implementing mindfulness and resilience type programmes into their Personal Development and Mutual Understanding (PDMU) which could help deal with and manage issues like anxiety presenting in children. Some primary schools also provide counselling/creative therapies. There is also an Independent Counselling School Service (ICSS) available in every post-primary school in NI for young people to access. Various community organisations such as New Life Counselling also provide therapeutic support to children and young people from age 4 – 17 years.

 

Dr Tracey Murray is back again tomorrow and shares her expertise on helping young people negotiate the world of the Internet, Social Media and Gaming.

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To find out more about New Life Counselling click here.  New Life Counselling is a member of the Action Mental Health Group.

Our AMH MensSana team support all ages in the area of mental health and emotional well-being through a range of activities tailored to suit group needs. To find out more click here.