One day in June last year, anorexia nervosa sufferer Hannah White decided to try something different.
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The 24-year-old of Ballarat, who has been struggling with the psychological illness since she was 16, decided to start her recovery from home with the support of treating medical professionals and her family.
Opposed to the hospital setting like Ms White had experienced for a long time, she was in unknown territory.
"I worked closely with my professional treating team, which consisted of a psychiatrist, dietitian, GP and psychologist," Ms White said.
"I had to start from the basics with food, learning to eat again. As the weeks went by I could make changes and set the next goal as directed by my dietician. I can't stress enough how important it was to have this guidance and support by my dietician to support you through this journey."
Ms White said she went through a lot of emotions after starting her recovery from home.
"I had been obsessed about calories and numbers. I also had to hand over the reins of cooking for myself, as my eating disorder ruled it with rules and the obsession with the calories and food groups.
"It basically become impossible for me to make a meal anymore. So for a period of time, I was no longer cooking for myself. I ate what everyone in my family ate whether I wanted it or not."
Ms White said she learned through her ongoing recovery that people heard about the 'rock bottom' and the recovery stories of eating disorder survivors and sufferers, but not the 'middle part'.
She speaks about this on her blog, which she published on Monday to coincide with Body Image and Eating Disorder Awareness Week, held from September 6 to 12.
"One of the biggest things I have found that is so difficult and traumatic is no one talks about the middle part: the panic attacks, the hysterical crying, the trauma, feeling like you're on one side of the door and the other side of the door is being bashed down by your eating disorder, and the stages and steps you have to go through to work towards being a bit freer from your eating disorder," she said.
"I don't claim I am recovered by any means and I am still actively in recovery. Even though I still struggle and some days it is a day-by-day thing for me, and with the support of my professional treatment team external to Ballarat and the support of my family, we do the best we can.
"I could revert back to restriction or obsessive exercise, especially when life gets stressful or maybe I'm not coping so well.
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"One of the things I look at now is you don't choose to get an eating disorder or any illness but recovery is a choice I make every single day. Every day is not always the same and you do just want to give up and throw the towel in.
"But for me that's just a part of the journey. I think that these challenges are going to be there, especially when you've had your eating disorder as your security blanket and as a coping mechanism for however long or short it's affected you.
"But I guess I am proof that you can see some of the sunshine shine again even though you are in the darkness a lot of time during this journey."
- Hannah White
Ms White said working in recovery could feel like a full-time job, but it was a job worth working for.
She she had not been in an eating disorder clinic since January and it was her goal to make that one year.
Like for many people, the COVID-19 pandemic has been challenging for Ms White, especially when lockdown restrictions meant people were confined to their homes.
"This gives us a lot more time to think and that can be quite overwhelming. I know last year, that set my eating disorder off when I felt out of control and we didn't know what to expect and what was going to change. I threw myself back into excessive exercising and restriction because I thought that's how I would cope," Ms White said.
"Now, as I am actively in recovery, I have to make those choices of how I would cope with the changes in circumstances every single day. We got thrown into this last lockdown within two hours and I have to think about how I am going to cope with that, and now it's finding things to do and structure to occupy my day with different things to help manage my anxiety.
"I think the uncertainty really does give you a lot of anxiety. That's a big challenge."
Ms White said re-entering society after a lockdown created a whole other element of anxiety and uncertainty.
"Often, for a lot of us, it's hard enough to leave the house without a lockdown and interact with other people, do a class somewhere. That's already hard, so when we are withdrawn from society, you are more scared to enter the world than what you already were."
Ms White said because the medical system was overloaded due to COVID-19, it made it hard for people to get the support they needed, especially if they had just developed an eating disorder
She said a telehealth consultation did not always work for everyone as they could not always find privacy in their homes and feel secure.
Body Image and Eating Disorder Awareness Week started on Monday and ends on Sunday. This year, eating disorder organisations unite to warn against harmful diet culture messaging, particularly during the COVID-19 pandemic.
Presentations of eating disorders have increased and a record number of people have sought support and treatment.
The Butterfly Foundation has reported a 20 per cent increase in demand to its national helpline across July and August, compared to June, with the organisation attributing the surge to the impact of COVID-19 lockdowns and restrictions.
Butterfly Foundation national helpline manager Joyce Tam said the helpline was currently receiving a lot more distressing and complex contacts from people experiencing an array of different eating disorders and body image concerns.
"We know that isolation, changes to food and exercise routines, uncertainty around changing restrictions, and a lack of social connection has placed immense pressure and added stress on those living with eating disorders and body image issues," Ms Tam said.
"This can often exacerbate symptoms, or even trigger disordered eating thinking and behaviours. This is compounded by the increased challenges to accessing treatment, with both the public and private sectors struggling to meet demand."
Last year, contacts to Butterfly's webchat support service increased by 116 per cent. School services have saw a 150 per cent increase in demand since the beginning of 2021, compared with 2020, reflecting the spike in students' eating disorder and body image issues that schools are identifying.
Eating Disorders Victoria CEO Belinda Caldwell said EDV had seen a significant increase in calls and contacts reaching out for help.
Since the beginning of 2020, EDV's helpline service, the EDV Hub, has experienced a 300 per cent increase in contacts from the community.
"Diet culture is currently prolific, with unhelpful terms such as 'COVID-kilos' being coined, and we must begin to dismantle its harmful beliefs, messages and practices. Health, success and self-worth are not found through altering physical appearance, and the pursuit of a certain body shape or size can have detrimental consequences for a person," Ms Caldwell said.
"Being bombarded by this type of messaging is not helping anyone mentally, emotionally or physically right now."
Help and Support
Anyone needing support with eating disorders or body image issues is encouraged to contact:
- Butterfly National Helpline on 1800 33 4673 (1800 ED HOPE) or support@butterfly.org.au
- Eating Disorders Victoria Helpline on 1300 550 236
- For urgent support call Lifeline 13 11 14