10 Lessons I Learned in Eating Disorder Treatment that are Helping Me Cope with COVID-19 Isolation

Waking up on March 13, 2020 my chest immediately tightened. I knew it was coming for a few weeks as I watched COVID-19 spread across the world, witnessing from afar as different countries responded to it. I knew it would come here but I wasn’t prepared for how I would feel. I didn’t know exactly how things would unfold or when the moment would come to go into isolation. The place where I work confirmed the night before that it was closing for at least 2 weeks along with many other places in the city. The day before I had my last in-person therapy session for awhile. I had to get some supplies in. An isolation period was just beginning and I was scared and overwhelmed. All the news reports were highly activating but I couldn’t stop reading. I don’t handle uncertainty well. I’m not great at regulating my emotions when I’m alone.

I have Dissociative Identity Disorder and Complex PTSD, caused by early childhood trauma, and exacerbated by traumas in adulthood that still haunt me. Add to that a history of a severe eating disorder and several autoimmune illnesses (Crohn’s and Rheumatoid Arthritis to name a couple) and you might understand my panic about both the COVID-19 virus and the period of isolation. I chastised myself for being so distressed and feeling unable to function in these moments. There have been worse times I told myself, listing off wars, disasters and specific periods in history. There are people who are in situations more unstable then your own, I berated myself. I acknowledged the privilege I currently had in life, the ability to work from home, a roof over my head, food to eat and a support system in place. At some points in my life I didn’t have those things and I realize I am fortunate to be where I am now. Instead of just being grateful to be okay enough I used all of this information to tell myself that I didn’t deserve to be scared and distressed. Everyone’s feelings are valid but it’s always hard for me to validate my own and comparing is generally not helpful. In case you need to hear it, your feelings are valid!

From the start I knew I was having trauma responses to the current situation. Some of it was obvious like the fear of getting sick and being unable to breathe. I had severe asthma as child which felt very isolating since I was frequently bedridden and fighting to breathe. My lungs hurt, days and nights spent coughing up mucus. Vaporizers, oxygen tents, eucalyptus, inhalers, hot packs, piles of pillows to keep me propped up all provided some relief but didn’t take it away. Whenever I get a cold now my lungs are affected and I struggle to breathe. It takes me back to that time. But there were other things too, not as obvious but just as triggering, if not more so. Feelings of helplessness, uncertainty, terror and loneliness that I felt as a child living in a volatile environment and which frequently leave me feeling unsafe and alone as an adult even when I’m not. But probably hardest was not seeing my therapist in person and worrying about her getting sick. What if I died without seeing her again? What if she died? Why has she abandoned me? I may logically know that this response is Disorganized Attachment and can even look back and understand why I react this way now but it doesn’t make it easier.

My mom had me when she was 21, about a year after she was married. My father worked on the ships and was away for months at a time. Although I know my mom felt overwhelmed and alone, having my father away was better because already early into the marriage he was abusive. My mom has her own trauma history so it’s not surprising that she often dissociated. Of course at the time I didn’t know or couldn’t understand any of this, I just knew my mother felt unreachable at times. I couldn’t seem to connect to her in the way I needed. My mother also had a lot of health issues which sent her to the hospital for weeks at a time. I never knew what was happening. I would need to stay at different relatives homes while she was away, frequently my grandparents place. Relatives told me different information when I asked them what was going on. If my father happened to be home he would say “She’s gone shopping.” I don’t remember if I ever got to visit her in the hospital. I think my mom didn’t want me to visit because she was worried it would be too much for me or I would catch something. I never knew if I would see her again. I realize all of this and more plays into how I respond to present day things, in particular how I’m reacting to the uncertainty of coronavirus.

And here it is St. Patrick’s Day and I’m eating Lucky Charms cereal (which by the way, has nothing to do with having Irish roots and everything to do with trying to cheer up one of my younger parts) wondering how I will get through this. I have to self regulate. There’s always the option of being hospitalized but I want to be able to get through this safely and I know I have the skills to do that I just need to access them, which is easier said than done when I switch to other parts caught in trauma time. “How am I going to tackle this?” I wondered. I need a plan.

When was the last time I felt so much crushing panic, uncertainty and isolation from the outside world and how did I get through it then? And then I remembered that every time I was in residential or inpatient for anorexia I felt a lot of what I’m experiencing now. Every time I went away for treatment I struggled with the uncertainty of the experience and panicked about when I would be able to go home. But I got through it which means I can get through this.

10 Things that helped me get through treatment for anorexia that will help me get through COVID-19 isolation:

Structure and routines

Having a structure for each day and some routine you can count on is so important, otherwise the days can melt together and time can feel like it has stopped. For me it helps to visualize each day, using a day planner to outline what I need to do each day or what I want accomplish each week. Not only does this create a purpose for getting out of bed it also helps me stay aware of what day of the week it is. One of the simplest ways to add some structure to the day, but which can also feel the hardest when you’re depressed, is to make your bed every morning, shower and get dressed. In residential we all had weekly house chores to do such as setting the table, doing dishes, putting together a flower arrangement etc. All of those things added some normalcy to an otherwise unfamiliar situation. And while it was perfectly acceptable to wear sweatpants and leggings everyday in treatment, I needed to feel as much myself as possible so I wore some of my favorite dresses just as I would if I was going to work or out with friends. Whatever makes you feel ready for the day and even a little a bit better is worth doing.

Sleep

Staying home it’s easy to slip into a pattern of staying up too late or sleeping away the day especially as anxiety can really disturb sleep patterns. Right now it’s even more important to go to sleep at the same time every night and get up at the same time each day. In treatment it was lights out at 10pm and we were woken every morning at 6am for vitals (unless you’re like me up by 5am, dressed and ready by the time the nurse came in). If you don’t already have one, try establishing a routine at night that helps you wind down. At night I have a relaxing cup of Yogi lavender and honey tea, take some melatonin, turn off most lights, watch or read something lighthearted, and turn on the white noise machine in my bedroom.

Eating consistently and staying hydrated

Being stuck inside by yourself it’s easy for food patterns to shift. Maybe you feel extra emotional so you find yourself eating more throughout the day or maybe you have lost your appetite all together and are struggling to eat. Perhaps you even think that if you aren’t as active as were prior to isolation that you don’t need to eat as much. What’s true is that everyone still needs to eat. If you’re not eating consistently your emotions will likely become more unsteady and unmanageable, and you could run yourself down physically. Try to plan what you will eat each day and eat on time. Don’t skip meals or snacks. In residential, meals and snacks were one thing you couldn’t get away from and the times when we ate were regimented, even to the point of hearing a gong to call us to the table. It might sound silly but the consistency worked. If you are forgetting to eat, try setting a timer. If you have a favorite meal that brings you some comfort now is the time to make that. On days when it feels too hard my go-to is a pb&j because it’s easy to make, it offers some good nutrients and it never upsets my stomach. And stay hydrated. Being indoors can make you even more dehydrated and you might not feel thirsty but you need to take in fluids. With Crohn's and some of my medications I tend to get even more dehydrated so I find it helpful to keep some some stuff on hand to make sure my electrolytes are in-check, such as Drip Drops which can be added to water.

Connecting and reaching out

Staying in my apartment by myself is lonely. I’m someone who tends to feel lonely a lot even when around people (another response to past trauma) so right now this feeling is even more intense. I feel lost and afraid, cut off from the outside world even with technology because I value and need in person human connection. In residential there were lots of people around but every time I arrived, especially the very first time, I felt so fearful. I felt removed from everything and everyone that brought me comfort. I had to adapt. I had to adjust to a new routine, connect to new people, reach out to the people in my life who I was away from in new ways, focus on the day-to-day and hang onto the fact that the outside world was still out there but for now I had to take a break from it. I wrote cards and letters a lot, both to people inside and outside of treatment. Importantly, I had to learn to ask for help and let people know what was going on. I got to be there for other people when they needed support by allowing people in. And now I find myself connecting with others using FaceTime, Google Hangouts and Zoom, texting more frequently, checking in on people more often and allowing others to check on me. None of this replaces being with someone in person but it’s so important to connect in all the ways we are able to.

Time to be creative

In treatment I often found myself measuring time by coloring and drawing. I started to know how long it would take me to color in one of those intricate meditative images or draw or write something I wanted to express. This helped me manage time without fixating on it. I felt free from the pressure to create something specific only the desire and need to create something. If things inside treatment felt too chaotic or I was in too much pain or distress I could ease some of it by focusing on the paper in front of me. It felt safe and nourishing. I think during this period of social distancing making time to create will be very important to my wellbeing. One of my younger parts noticed that the wall behind us when we are on a video call is bare and they want to create a series of small paintings to make that space more colorful and hopefully bring some joy to the person we are talking to.

Sitting with feelings and self soothing

This one is hard. Tolerating painful emotions and not reacting to them or getting swept up by them takes a lot of work. Some parts of me are better at this than others. While I may be able to talk myself through something another part might spiral into crisis. Using grounding skills and keeping myself in adult brain is crucial right now. I frequently check-in with myself to try and determine what emotions I’m feeling and what part is struggling. Awareness can help me find a solution before I get completely flooded. Taking time to notice my surroundings and name what’s okay in this moment is a necessity. My therapist once told me to ask myself “What information do I need right now that I’m missing?” rather than asking “Is this real?” as a way to help me stay connected to the present moment and not got swept away by pain from the past, uncertainty about the future or entangled by emotions. I’ve learned the hard way, and I’m still working on this, that the more I fight my emotions or react to parts the worse things feel. If I let myself feel and accept parts of myself the faster I will move through something and the more relief I’ll get. If I bury emotions or force parts into hiding the more likely I am to be overtaken by them. I sometimes get angry that I’m feeling a certain way or I shut down and dissociate, both of which make it hard to self soothe. Self soothing can go a long way towards calming your nervous system. Self soothing is so personal to each individual and can be anything from wrapping yourself in a blanket, using an essential oil that makes you feel more present or talking to yourself in a kind and loving way.

Distracting

Distracting gets a bad rap sometimes but it is actually a healthy coping mechanism when used appropriately and can be very effective at giving your body and mind a break from dwelling on the current situation. Books, movies and TV shows are obvious distractions but anything that can help you turn your attention away for a bit of an escape is helpful. In residential we played board games, watched the occasional movie and read books to have a break from the daily grind of treatment. When I first knew that I would be practicing social distancing for an indefinite amount of time I signed up a Disney+ and Hulu Bundle. Signing up for an extra streaming service right now seems like a good idea, especially since so many have special offers or even free trials. I also have some books I’ve been meaning to read, things I want to organize in my apartment and small projects I never got around to doing. I’m still feeling emotionally overwhelmed and don’t have the energy to tackle anything too demanding so I’m choosing to distract with movies and TV that aren’t triggering. I’m currently watching Survivor because it’s oddly comforting to have on and there are 34 seasons so my hope is this will all be over with by the time I make my way though all the episodes.

Limiting time spent on social media and the news

You’ve probably already experienced what it feels like to read or listen to too much about COVID-19. You can’t get away from it. Of course it’s important to know what’s going on but you don’t need to read every story you see and tune in 24/7. Create limits for yourself. I’m trying to stop reading anything related to COVID-19 later in the day because I have difficulty sleeping and have frequent nightmares so I need to calm my nervous system down as best I can. I also think it’s helpful to limit yourself to 3 COVID-19 posts or news articles a day or no more than 20 minutes. In treatment we had a communal phone and computer both of which we could only spend so much time with per day. Many people had trouble with this, myself included, but the adjustment was an important one because it shifted our attention to the work we needed to do. And right now the work is to stay as present as possible, something that too much time on social media or the news can sabotage. I’m really trying to take this one day at a time no matter how much parts inside cry and ask the unanswerable question “How much longer?”. I’ve definitely been very triggered in a few conversations lately and have had to work hard to bring myself back to the present moment. If you’re in a conversation with someone who is talking about all of this non-stop or in a way that feels triggering to you it’s okay to let them know. In treatment we were encouraged to actively speak up if something was triggering. Everyone handles stress and uncertain times like this differently and we all need to be open with each other and help one another get through this.

Getting outside and/or moving your body

Spring is almost here, the weather is getting warmer and the sun will be out more frequently. All of this makes it harder to be cooped up inside. Remember that it is safe to go for a walk. Getting outside is good for you both physically and mentally. Obviously there are more restrictions now but getting outside and walking around your neighborhood will make all of this a little more bearable. If you’re scared remember to check the facts. Try taking a mindful walk, paying attention to your surroundings and using your senses. Name and describe five things that lift your spirits. You can practice social distancing and still go outside. If you’re in a small apartment like me and feeling really restless make time to exercise. It doesn’t need to be vigorous just moving your body and stretching can have a positive impact on your wellbeing.

Setting intentions and having something to look forward to

When I’m faced with a lot of unknowns more than anything I want guidance and anchors to help me keep going. Create a small intention for each day and a bigger intention for the week to help ground you. For example, yesterday my intention was to do laundry and for the week it’s to create something I feel comforted by. It can be anything that feels right to you. I also plan to draw one angel card every Sunday night to help guide my thoughts and give me something to reflect on. Before selecting one I always ask internally what do I really need right now. The first one I selected was the Angel of Human Unity which felt very appropriate. I was introduced to angel cards in residential and have found them to be meaningful. At the dinner table every night we all took turns sharing our intentions for the meal and naming something we were looking forward to the next day. These simple acts create positive shifts in the brain and when done repeatedly the impact can be felt. Today I’m looking forward to having a session via Zoom with my therapist and checking in with colleagues on our daily Google hangout.

Remember this won’t be forever. It might feel like it, especially since there is so much uncertainty, but I promise it won’t be forever. It’s okay to feel sad, angry, confused or anything else you might be feeling. Don’t fight your emotions, accept the reactions you’re having and be gentle with yourself. Breathe. Remind yourself that in this moment you are okay. Reach out to others and allow others to reach out to you. You can do this and so can I. We will all get through this together.

(This story was originally published on The Mighty. You can find it and other writing by me there. If you resonated with this or found it helpful please click the clap icon and/or share. You can clap up to 50 times. Thank you!)