Relapse

Luckily, I have not relapsed since starting my recovery but I know that even now, it is still a possibility. The important thing to remember if we do relapse is that we shouldnt ever be angry or dissapointed in ourselves. All that matters is that we recognise the relapse and move on from it healthily. I found the folowing information on th NEDC Website and though it was quite interesting so decided to share it with you all.

Relapse and recurrence

Relapse can be a common part of the recovery process.

Many people with eating disorders experience a relapse or recurrence as they recover from their disorder and learn to manage their eating habits.

It should be kept in mind that a relapse or recurrence does not signify a failure to recover; instead, it should simply be seen as a normal part of recovery. Many people with eating disorders view relapses as an opportunity to learn from the experience and to improve their skills so they can cope with the relapse next time.

How likely is a relapse?

While many people with eating disorders will encounter a relapse or recurrence as they recover, those who display certain risk factors may be more likely to relapse during the process of recovery.

When considering how likely relapse and recurrence will be, the below should be taken into account:

• The amount of time the person has been living with the eating disorder; the longer the duration of the illness, the higher the chances of relapse
• The age of the person at the onset of their eating disorder; the older the person is at the time of onset, the more likely they are to relapse
• Whether the person has been treated in a general hospital/clinic or a specialised eating disorder clinic; patients who are treated in an eating disorder clinic are much less likely to relapse
• Whether the person carries out excessive exercise, even after recovery is complete
• Whether an increased focus or recurring concern with body shape and weight is present, even after recovery
• Low self-esteem or poor ability to interact with others
• The occurrence of negative and stressful life events

Specific risk factors for relapse

In addition to the above risk factors, there is also evidence that relates to people suffering from Anorexia Nervosa. The following risk factors have been associated with relapse for a person with Anorexia Nervosa:

• Lower per cent body-fat in recently weight-restored women
• Lower desired weight (when a person wishes to be a lower weight even after recovery, there is an increased chance of relapse)
• Consuming an overall diet of lower energy density or a limited variety of foods

If you have relapsed

It is valuable to still maintain hope even when relapse/recurrence has occurred. Remember that relapse is common.

While relapsing may feel like a step backwards, you can still learn much from a relapse or recurrence. For instance, you may be able to identify the triggers that caused the relapse or you may learn new coping techniques, which can help you recover more quickly or easily next time.

If you have relapsed, these tips may help you:

• Remind yourself that relapse is a normal part of recovery
• Try not to focus on the fact that you have relapsed; instead focus on finding your way back to recovery
• Seek help from your clinicians or support network and don’t be afraid to tell them you have relapsed
• Try to identify the triggers that have caused the relapse and consider how you could deal with these triggers next time
• Employ the coping skills and techniques you have learned throughout the recovery process
• Boost your self-esteem by spending time with your support network and/or engaging in activities that you enjoy

For more information on relapse and recurrence, find professional help in your local area or phone the national support line on 1800 ED HOPE.
 

Falling into anorexia's trap

It scares the absolute hell out of me, just how easy it is to fall back into anorexia's trap, without even realising it. The thing is, no matter how hard you try not to, relapsing or even just moving backwards a little in your recovery can happen to anyone, without you even realising it.

Over the last few days, I have come to the realisation that in a way, this has in fact appened to me. Fortunately I have realised that my anorexia was starting to control me a little more again before it actually caused me to lose any weight or hurt myself in any other way but iit has still been a huge eye opener to me, to see how easily relapse can actually happen.

I never thought that I was at risk of relapsing. I felt as though I was too aware of the warning signs and would never let my anorexia get any worse again but that is exacttly what has happened, ever since I cut my intake down a little and decided to stop trying to gain weight.

All of the things were only tiny, almost unnoticable to most but I can now see how doing those things meant listening to my aorexia, which was giving it strength. I can also see how this could quite easily have gotten out of hand and lead to me relapsing. I am just so grateful that I have realised what was happening, before this happened. Afterall, I have worked way too hard and come too far to throw it all away now.

I think that the reason anorexia started to creep back in is because I decided that I no longer had to gain any more weight, which made me start fearing weight gain once again, just as much as before. This lead to me using my kitchen scals to check the weights of things like muesli bars and fruit and a few times I even weighed out portions of nut butter for my toast.

I can see now how dangerous behaviours like these are whilst in recovery frm an eating disorder however at the time, it didn't feel dangerous. When I asked myself whether  I should weigh the food or not, I ad a voice reply and say that it was completely fine to weigh the food, afterall it was only a one off thing. Now I can see, plain as fday that it was my aorexias voice telling me that and not my own.

Before I cut my intake down and I was trying tto gain weight, I was not as compelled to know exactely how many calories I was eating as I knew that if i did by ny chance eat a little extra, this would only lead to the tiniest bit of weight gain, if any at all and that it was ok as that is what I was trying to achieve anyway. But once I stopped trying to gain weight, I started fearing eating too much again and I also stared fearing weight gain.

Also, I have found that since I have started exercising more most days, I am feeling more compelled to exercise more naad more. I feel guilty if I dont get for a long walk and I have also started taking more notice if my 'daily steps' counter on my phone. I never actually put this counter on my phone, it was just there when I got it but in the last few days, I have decided that I need to turn it off.

At first I actually found this little app quite interesting and it wasn't harmful as I didn't actually really care how many steps I took each day. But since I stopped restricting my exercise as much, I have started to feel guilty if I do not reach my usual amount of steps on any one day. This lead to me going for longer walks then I necessarily felt like some afteroons, just so tthat I could reach that articular number of steps.

Once again, at the time I didn't actually rrecognise the fact that this was actually me listening to my anorexia but now Ican see it. Yesterday morning as I was planning out my day, I realised that I would only havee enough time to take Tess for one big walk. Thoughts started to appear in my mind about whether or not I should compensate for this by eating less, or whether I should go for an extra long walk that morning.

I am so glad that I recognised that it was my anorexia making me think those things and that I therefore needed to take action and fight it. I decided to take Tess only for a very short walk yesterday morning and reiminded myself that there is absolutely nothing wrong with exercising less, or even not at all some days. Healthy exercise is not about reaching any silly goals like calories burned or steps taken, it is about exercising as much as you enjoy on any partcular occasion.

In a way, I am actually glad that this has happened as it is the exact wake up call that I needed. Even though I thought I already knew it, this has actually shown me that recovery does not stop once you reach a healthy weight. In order to make a full recovery, you need to keep fighting your thoughts and challenging yourself, even after you have reached a healthy weight.

My goal always has been to reach my natural setpoint weight so I should not stop myself from gaining any more weight if that is what my body wants to do. This just indicates that I have not yet quite reached my natural set point weight. I think I have made myself an easy target for over the last few weeks as I made the mistake of letting my guard down when I thought I had reached a healthy weight.

Now I know how easily letting your anorexia back in can be I am not going to make the same mistakes again. I have decided that my intake is going to be a daily bare minimum and that if I ever feel like extra food, I am going to eat it as that is exactly what my anorexia doesn't want me to do. I also feel as though this is a good step to take to prepare myself for eating intuitively in the future and for reaching my natural set point weight, if I have not already reached it.

I have also taken it upon myself to turn off my step counter on my phone and to take a step back when it comes to exercise. It is not healthy to feel guilty for not exercising as much which is exactly why I need to face this fear and not exercise as much, if at all some days. f I ever feel as though I am not motivated to exercise or am not enjoying it, I will simply stop and I will refuse to listen to that voice in my head, telling me to go further or faster.

I think it is really important to remember that relapsing is a part of recovery that many people experince. I just wanted to remind everyone that if you do start to relapse, this does not mean you have to give into your anorexia. As long as you start fighting again, as soon as you realise things are getting bad, all of your hard work will not be wasted. Just because your anorexia starts to take back control does not mean you should let it. 

Think of it like this. If you looked in your wallet and saw that one of your $50 notes was missing, would you throw all of your remaining notes away? Or would you do everything you could to make sure you didn't lose your remaining notes? Of course you would not throw your remaining money away and recovery is exactly the same. 

Just because something goes wrong in your recovery does not mean you should give up on it all together. It just means that you need to pick yourself up again and continue moving forward in your recovery. Even though you may have taken a few steps back, this does not mean that you will have to go right back to the very start of your recovery. I thought that the following article described relapse and how to deal with it fairly well; 

Eating Disorder Relapse

Article Contributed by Debra Cooper, BS, Staff of Timberline Knolls Residential Treatment Center

In our society, we rely on expressions such as “Rome wasn’t build in a day,” to serve as reminders of the truth. Obviously this city wasn’t built in a day or even a year- it took a significant amount of time. The truth is…most things of great value or import do take time and effort. Building tools and maintaining recovery from an eating disorder is no different. An occasional slip back into the behavior or total relapsecan occur.

But here’s another handy phrase: an ounce of prevention is worth a pound of cure. In eating disorder recovery, relapse prevention is critical. This comes in many forms, such as identifying triggers. A trigger is something in the environment, an individual, a thought, or a situation that prompts a person to return to an eating disorder behavior. By preparing a response in advance, the recovering person will know what to do when faced with a dangerous trigger.

Always keep in mind that recovery from anorexia, bulimia, binge eating disorder and compulsive overeating is extremely difficult. Even the most committed person can experience periods of relapse. Don’t panic, and especially, don’t give up. There is no shame in simply being human.

Remember… Recovery does not happen overnight. If relapse occurs, take a moment to regroup, then return to your recovery plan. Never lose sight of how very far you have come.

http://www.eatingdisorderhope.com/recovery/self-help-tools-skills-tips/relapse

My completed Relapse prevention plan

Relapse Prevention Plan

Remember; Relapse is never planned, but prevention of a relapse can be. 

Begin by making a list of the behaviors and strategies that have been useful to you in your recovery so far. Some things you might include in this list are: eating regular meals, planning meals and snacks, regular food shopping, keeping a food log, self-care activities, etc. It will be important to keep using these strategies for the near future and to return to them at the first signs of trouble.

My List of Recovery Behaviors and Strategies

1. Eating 6 meals everyday 

2. Follow my meal plan religiously

3. Taking packed lunch with me when I go anywhere

4. write down my thoughts and feelings on my blog

5. Monitor my weight gain and increase my inake when neccessary

6. Sticking to approximate meal times

7. Not to worry about what anyone else is eating

8. Avoiding all unneccessary exercise

9. Remember that through recovering I am helping myself as well as those who read my blog

10. To believe in recovery and in myself

2. Next make a list of high risk situations which may increase the risk for slips and relapses. Below are some things you may want to include on your list:

• Stress and/or a busy schedule which makes planning meals difficult
• Becoming overwhelmed by feelings and emotions
• Loss of a family member, friend, etc.
• Marital, social or family problems
• Change in schedule (such as going on summer break) or a move (going away to school, etc.)
• Weight gain
• Dieting or any form or food restriction
• Missing a meal or snack
• Juice cleanses and detox efforts
• Being under the influence of a diet guru or overly health conscious person
• Having friends or family who diet
• Following any form or restrictive eating plan
• Being in unfamiliar food environments and/or having unrestricted access to food (at a buffet, holiday, or potluck for example)
• Getting weighed at the doctor
• Shopping for clothes
• Pregnancy
• Dating
• Others commenting on your weight
• Health problems

You may use suggestions from the list above or create your own list of high risk situations that you feel may increase your risk for a slip or relapse

When my mum makes me angry
Feeling stressed
Feeling anxious
When old clothes get too tight
When people comment on my weight gain
Hearing people talk about their diets/weight loss
Feeling insecure and self conscious
When I eat something wih an unknowwn number of calories in it
Someone close to me dying
Having an argument with someone I care about very much

3. Become familiar with some of the early warning signs of a relapse.

Choose at least 5 of those warning signs that are relevant to you, and for each, write down at least one strategy that would help you cope with that warning sign and get you back on track:

 (You may list more than one way to cope for each situation.)

If I start skipping any meals: I will need to  remind myself how important it is for me to keep eating regularly and that skipping meals will only make my Anorexia stronger or allow my anorexia to take over my mind again.

If I start obsessively exercising: If I do not have the time or energy to exercise I should not feel guilty or restrict what I eat. I need to exercise because I enjoy it, not because I feel like I have too. If I feel as though I need to exercise for the wrond reasons, this means I should not be exercising at all.

If I am too frightened to eat a particular food: The only way to overcome these types of fears is by facing them. If I am too scared to eat a particular food this means that my anorexia is still present (a part of my mind) and I therefore need to fight it n order to try and get rid of it once and for all.

If I start freaking out after a meal: Remind myself that it is only food and that it cannot hurt me. It is very important to remember that compensating is never the answer as through compensating you are giving into your anorexia and giving it strength. If I feel guilty after a meal, I just need to remember that this feeling will soon pass and perhaps try and distract myself from these thoughts.

If I start weighing food or counting calories after I recover: Even if I feel tempted to do this I know that I should not allow myself to do it as once I start doing these things again, I can see it getting out of hand very fast. I will get rid of my scale, my calorie counting apps and books so that I smply cannot count calories or weigh food.

If I feel as though being thinner will make me happy: I will remiind myself of how unhappy Iwas when I was underweight and that being thin does not equal happpiness or beauty. No matter what size I am I can be beautiful and happy, I just need to believe in myself and develop a sence of self respect.

If I find myself looking in the mirror and hating what I see: Simple, I will get rid of the mirror. Ionly need a little mirror so that Ican see my face in and if a mirror is going to make me have negative thoughts about my body then I refuse to have a mirror. 

In times of crisis, it can be difficult to remember healthy ways of coping. Many people in crisis do resort to familiar ways of coping. Making a plan ahead of time can be helpful. Make a list of 10 things you can do instead of reverting to eating disordered behaviors as a way to cope. After the list is completed, keep it in a place where it can be accessed when needed. (i.e. refrigerator, cupboard, etc.)

1. Email one of the girls who I have met through my blog

2. Take Tess for a walk

3. Call my sister Amy

4. Visit my dad and give him a hug

5. Just remember to breathe and it will pass

6. Remember not to give into my anorexia, no matter what 

7. Read other peoples recovery blogs

8. Try and fix the actual problem, instead of avoiding it

9. Go for a shower

10. Do something else to distract myself

11. If I need to, have a good cry

It is also important to reach out during times of crisis, when you are feeling scared, alone, out of control, etc. Talking about your feelings can help to relieve some of the anxiety that you may be having and can help to prevent a slip or relapse. Reaching out also helps to remind you that you are not alone. Below write down names of people you can reach out to. You may find it difficult to reach out, but the more you do it, the easier it will become. The person that you call will be glad that you did, will welcome the call, and be there for you the best way that they can.

                    NAME                                             

Dad

Nan

Amy

Readers

Anna ( the other Tasmanian blogger)

Lyn, my boss

Realising that skinny doesnt equal happiness

Thinking back, I can see that my breakthrough moment was the moment I realised that being skinny did not make me happy. While my anorexia was developing, I was convinced that all I needed to do to make myself happy was to lose weight and be skinny. The more awful I felt, the more I would listen to my anorexia. My anorexia promised me that I would feel so much better if I listened to it and did exactly what is told me to do, so that is wat I did.

Before I got sick, I was very unhappy with many different aspects of my life and I felt as though I had no control over any of these things. I didn't feel like I could fix these things that were wrong with my life but I didn't want to keep feeling the way I was either. So I tried to find a way to make myself feel better, which is where my anorexia began. As I lost weight but still did not feel any better, I just kept thinking that I neeed to lose more and more weight, in order to find the hapiness I was so desperately wanting to feel.

After being severely underweight for 18 months or so, I realised that losing weight had not solved any of my problems, in fact it had made most of them worse. I finally decided to committ to my recovery because my anorexia was no longer what I wanted. Before that moment (although I would never had admitted to it) I didn't truly want to recover as I believed that gaining weight would make me even unhappier then I already was feeling. It was not until I realised that this was not the case that Ifelt as though I actually wanted to get better.

Since committing to my recovery, my anorexia still tries to convince me to restrict and lose weight but fortunately I know better then to do this. I know that losing weight will not solve any of my problems, it will only cause me and the people I love a lot of pain, so what is the point? My best chance at hapiness to is to amk a ffull recovey from Anorexia, too get competely healthy and to learn to love my body the way it is naturally supposed to be.

I cant expect to always be happy, even after I recover because no one is compltely happy all the time. I am confident however that I will never make the same mistake again and try and make myself feel better through controlling my food and weight because I know that this will not work. Unfortunately I learnt this lesson the hard way but the important thing is that I have learnt it. Once I get rid of my anorexia once and for all (and I know I will), I will never fall back into Anorexias trap as I now know that listening to my anorexia will never make anything better.

  

Relapse prevention plan

Although I do not feel as though I am going to relapse, I need to remember that relapse can happen to anyone. I found this Relapse prevention plan online and thought that it could be helpful to complete. If you like I can post my completed relapse prevention plan once I finish it but I also wanted to share the template, as I though you may also like to complete it too. :)

Relapse Prevention Plan

Recovering from an eating disorder takes time. You did not develop your eating disorder over night and it will not go away that quickly either. It is important to remember that no one can recover perfectly and there will be slips and relapses during the recovery process. This is normal and it is to be expected. The Relapse Prevention Plan is something that may be helpful to you in preventing a lapse from becoming a relapse.

Remember; Relapse is never planned, but prevention of a relapse can be. 

Begin by making a list of the behaviors and strategies that have been useful to you in your recovery so far. Some things you might include in this list are: eating regular meals, planning meals and snacks, regular food shopping, keeping a food log, self-care activities, etc. It will be important to keep using these strategies for the near future and to return to them at the first signs of trouble.

My List of Recovery Behaviors and Strategies

1._____________________________________________________________________

2._____________________________________________________________________

3._____________________________________________________________________

4._____________________________________________________________________

5._____________________________________________________________________

6._____________________________________________________________________

7._____________________________________________________________________

8._____________________________________________________________________

9._____________________________________________________________________

10._____________________________________________________________________

2. Next make a list of high risk situations which may increase the risk for slips and relapses. Below are some things you may want to include on your list:

• Stress and/or a busy schedule which makes planning meals difficult
• Becoming overwhelmed by feelings and emotions
• Loss of a family member, friend, etc.
• Marital, social or family problems
• Change in schedule (such as going on summer break) or a move (going away to school, etc.)
• Weight gain
• Dieting or any form or food restriction
• Missing a meal or snack
• Juice cleanses and detox efforts
• Being under the influence of a diet guru or overly health conscious person
• Having friends or family who diet
• Following any form or restrictive eating plan
• Being in unfamiliar food environments and/or having unrestricted access to food (at a buffet, holiday, or potluck for example)
• Getting weighed at the doctor
• Shopping for clothes
• Pregnancy
• Dating
• Others commenting on your weight
• Health problems

You may use suggestions from the list above or create your own list of high risk situations that you feel may increase your risk for a slip or relapse:

__________________________________            ___________________________________

__________________________________            ___________________________________

__________________________________            ___________________________________

__________________________________            ___________________________________

3. Become familiar with some of the early warning signs of a relapse.

Choose at least 5 of those warning signs that are relevant to you, and for each, write down at least one strategy that would help you cope with that warning sign and get you back on track:

 (You may list more than on way to cope for each situation.)

__________________________________            ___________________________________

__________________________________            ___________________________________

__________________________________            ___________________________________

__________________________________            ___________________________________

__________________________________            ___________________________________

__________________________________            ___________________________________

__________________________________            ___________________________________

In times of crisis, it can be difficult to remember healthy ways of coping. Many people in crisis do resort to familiar ways of coping. Making a plan ahead of time can be helpful. Make a list of 10 things you can do instead of reverting to eating disordered behaviors as a way to cope. After the list is completed, keep it in a place where it can be accessed when needed. (i.e. refrigerator, cupboard, etc.)

1._____________________________________________________________________

2._____________________________________________________________________

3._____________________________________________________________________

4._____________________________________________________________________

5._____________________________________________________________________

6._____________________________________________________________________

7._____________________________________________________________________

8._____________________________________________________________________

9._____________________________________________________________________

10._____________________________________________________________________

It is also important to reach out during times of crisis, when you are feeling scared, alone, out of control, etc. Talking about your feelings can help to relieve some of the anxiety that you may be having and can help to prevent a slip or relapse. Reaching out also helps to remind you that you are not alone. Below write down names of people you can reach out to. You may find it difficult to reach out, but the more you do it, the easier it will become. The person that you call will be glad that you did, will welcome the call, and be there for you the best way that they can.

                    NAME                                             

__________________________________

__________________________________

__________________________________

__________________________________

__________________________________

__________________________________

__________________________________

During the recovery process it is not always possible to avoid slips and relapses. Many people tend to be very hard on themselves if they do have a slip or relapse. It’s important to remember that no one can recover perfectly. If you have a bad day, you can forgive yourself, put it behind you, and continue to move forward in your recovery. It is important to look back at the lapse to learn from it and at the same time, be compassionate and not beat yourself up. Lapses are a normal part of recovery and can actually be helpful in making recovery stronger.

It may be helpful to keep the graphic below in mind:

- See more at: http://www.mirror-mirror.org/relplan.htm#.dpuf