When you are already managing a mental health issue, the additional stress of social isolation can be particularly tricky to navigate.
As we launch the new digital version of the Eating Disorders & Other Shadowy Companions, we thought it was worth spending some time finding out how COVID-19 may be affecting the mental health and wellbeing of people managing eating disorders.
How is COVID-19 impacting on people with eating disorders?
The Butterfly Foundation for Eating Disorders says that disruptions to food shopping and food availability, altered exercise routines, reduced contact with support networks and increased exposure to social media messaging, can all be highly stressful for people managing an eating disorder.
As there is still so much shame and guilt around eating disorders, often people already feel isolated and alone. At the moment, these feelings of isolation are likely to be heightened, as are anxieties related to food and weight.
Danni McDougall, lead author of Eating Disorders & Other Shadowy Companions believes that there are a number of things we need to be aware of when supporting people with eating disorders at this time.
‘I have noticed that there have been many conversations about “making the most of lockdown”, with a number of companies and individuals encouraging people to change their bodies through exercise and diets.
‘While reminders to maintain wellbeing can be really helpful, for people with an eating disorder, exercising at home may trigger reminders of times when they were unwell and exercising excessively, possible in secret—this could bring up distressing feelings.
‘When so much feels out-of-control in the world and in our lives, it can be tempting to slip back into old habits. But by adapting resources and focussing on other hobbies, the eating disorder does not have to take more space than it did pre-COVID-19, or erode the progress a person has made towards health and wellbeing.’
So what can people experiencing an eating disorder do to look after themselves at the moment?
Juliette Thomson, clinical psychologist and manager of the Butterfly Foundation Helpline suggests that staying connected and limiting exposure to unhelpful media is key.
‘Eating disorders thrive on isolation so it’s critical to stay connected with family and friends. Social media (when used appropriately), video calls, and phone calls – all play a part in making sure we stay connected.
‘Set a time every day for a video call with a group of friends. Try to limit your exposure to news, and even then only at set times of the day, and only follow reputable sources.
‘Practising mindfulness and engaging in journalling, meditating, chatting with friends, and other activities you enjoy can be extremely helpful during this challenging period.’
How can digital tools like Eating Disorders & Other Shadowy Companions help people stay connected?
At exactly the time people most need to have meaningful conversations about mental health, many of the places they would usually go—friends and family, counsellors and psychologists—are harder to access.
While phone and video call tools are great ways to stay connected, a number of the strategies we usually use to build rapport with people have been curtailed. It may be harder to read body language, for example, or demonstrate empathy by matching and mirroring people as they talk about their experiences, in a virtual space. As a result, it can be easy to miss important cues or skim the surface and not get to the heart of the issue.
That’s where digital tools can be useful. By providing prompts and activities, they can help guide and deepen virtual conversations.
Danni says that the digital version of Eating Disorders & Other Shadowy Companions has a number of features that can help build rapport and connection.
‘The digital cards are interactive which means they can be adapted to the specific circumstances a person is going through. The ability to draw on them, highlight them and record notes on them helps open up conversations.
‘The digital cards can also support conversations about options that might feel too difficult to act on just yet. For example, with the card, Where will it lead? you could write on one part of the card where you think it will lead if things stay the same, and on another part of the card, you could write about what might happen if the direction was changed a bit.
‘If someone is not ready to make a step in a different direction, the cards can create a safe space to consider these ideas, knowing text added to the cards using the text tool can be rubbed out using the eraser tool if it feels too confronting.’
Danni notes that the cards can be used in many creative ways as a ‘canvas’ for prompting and recording conversations.
‘In the booklet that comes with the cards, we talk about many ways people can use this resource. Suggestions tailored especially for the digital environment have been added to the beginning of the digital booklet. The benefit of being able to interact with the cards digitally (for example, by drawing on them) is that people can personalise the cards according to what is happening for them in that moment.
‘In an art therapy session a client could be asked to choose a card that represents how they are feeling now and then asked to add key words to the card, using the text function, to describe what their experience felt like. They could then be asked questions like, What does that feel like in your body?, How would you like it to be different?, How would you know if it was different?, What would it be like if Ed was a bit more in the background?’
‘One of the other benefits of digital interactivity is that the card can be saved with the person’s adaptations, and reviewed in a later session, to see if things are the same or have changed.’
The digital version Eating Disorders & Other Shadowy Companions is available now.