10 Lessons From Eating Disorder Treatment I Can Use While Self-Isolating

Waking up on March 13, 2020, my chest immediately tightened. I knew it was coming for a few weeks as I watched the coronavirus (COVID-19) spread across the world, witnessing from afar as different countries responded to it. I wasn’t prepared for how I would feel when it was our turn to go into isolation. The day before, I had my last in-person therapy session for a while. 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 (DID) and complex post-traumatic stress disorder (C-PTSD). Add to that a history of a severe eating disorder and several autoimmune illnesses (Crohn’s disease and rheumatoid arthritis, to name a couple) and you might understand my panic about both the COVID-19 virus and the period of isolation.

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 treatment for anorexia nervosa, I felt a lot of what I’m experiencing now. And I got through it, which means I can get through this.

These are 10 things that helped me get through treatment for anorexia, that will also help me get through COVID-19 isolation:

1. Structure and routine.

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 want 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, it was perfectly acceptable to wear sweatpants and leggings every day but I needed to feel as much myself as I could, 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.

2. Sleep.

In residential, it was lights out at 10 p.m. Every morning around 6 a.m., we were woken up for vitals (unless you’re like me, in which case I was up and ready before the nurse came in). 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. 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.

3. 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 altogether and are struggling to eat. Perhaps you even think that if you aren’t as active as you were prior to isolation, 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. Don’t skip meals or snacks.

In treatment, we had a very strict schedule for meals and snacks and a gong was rung at each meal to call everyone to the table. It sounds silly, but the consistency helped a lot for when I went home and needed to carry out my meal plan. 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 disease and some of my medications, I tend to get even more dehydrated, so I find it helpful to keep some stuff on hand to make sure my electrolytes are in check, such as an electrolyte supplement which can be added to water.

4. Connecting and reaching out.

Being stuck 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 intensified. 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 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 possible.

5. 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 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 talking via video with someone is very bare and they want to create some paintings during this time to make the space more colorful.

6. 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 OK 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 get 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 achieve. 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 in 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.

7. Distracting.

Distracting gets a bad rep 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 for a Disney Plus and Hulu Bundle. It seems like now is a good time to sign up for an extra streaming service, especially since many offer a one-month free trial. 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 by the time I make my way through all the episodes.

8. 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 three COVID-19 posts or news articles a day, or no more than 20 minutes. I’m really trying to take this one day at a time no matter how much my parts inside cry and ask how much longer. I’ve definitely been 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 nonstop or in a way that feels triggering to you, it’s OK to let them know. Everyone handles stressful and uncertain times like this differently. We all need to be open with each other and help one another get through this.

9. Getting outside and/or moving your body.

Spring is almost here, the weather is getting warmer and the sun will be out more frequently. It’s a hard time 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. 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.

10. 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. Before selecting one, I always ask internally: “What do I really need right now?” The first one I selected was the Angel of Unity, which felt very appropriate. I was introduced to angel cards in treatment 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 OK to 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 OK. 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.