I’m Going Crazy, Again? —
Healing From an Eating Disorder and Posttraumatic Stress Disorder
By Jenni Schaefer
I’m going crazy, I thought as I grabbed a cookie out of the trash can during an out-of-control binge at 22 years old. Who does that? I wondered, absolutely disgusted with myself. But what felt even worse was when I stole the binge food. Among all possible jobs, I became employed at a restaurant as the manager in charge of inventorying food every single Sunday night. Let’s just say that sometimes my original count of 10 cookies became a big zero by the end of the evening. Stealing from the restaurant by bingeing like this made me hate food—and myself. Then again, I loved food, yet I was terrified of gaining weight. My solution to end the confusion and chaos became: Just don’t eat. Of course, this misguided tactic failed miserably and set me up for more intense and prolonged binges, and, ultimately, for purging. I couldn’t figure out how someone who had maintained excellent grades in college and was accepted to medical school couldn’t master something as basic as feeding myself.
Fast-forward 15 years, and I’m on the phone with my therapist, curled up in a ball crying, saying those words again: I’m going crazy. I was describing not a binge, but an uncontrollable exaggerated startle response that seemed to activate without warning. Who does that? I asked myself. My whole body would jump as if someone had walked up from behind and scared me—only no one was there. In fact, nothing actually existed anywhere that was dangerous in any way. I had learned in therapy that I jumped because my body was afraid of a memory, a trauma that I had experienced in my late 20s. This happened to be about five years after I had finally sought help for bingeing, purging, and restricting. My startle response frequently occurred when I saw, heard, smelled, touched, or even thought about anything remotely related to the trauma. While the startle, as I began to simply call it, bothered me, what made me feel worse—the I’m a horrible person version of worse—was a fierce rage that would well up inside and come out in the most unflattering ways. (That’s an understatement.) Never in my life had I been overtaken by a deep-seated, vicious anger. I am fairly sure this scared me more than anyone who encountered it.
In the scenarios described above, I felt like my body was being taken over by an outside force. I thought I was losing my mind. I’m not just saying that as a cliché; I believed it. The girl I once knew seemed to be gone. Today, I know the truth, that neurobiologically, my brain was hijacked. Some leaders in the mental-health field refer to an eating disorder as a brain disorder; many call posttraumatic stress disorder (PTSD) a brain injury. It took a long time for me to break through the denial—and it sure didn’t help when so-called experts missed and dismissed both of my problems—but I now know that I struggled with an eating disorder and, years later, with full-blown PTSD.
Eating disorders and PTSD are debilitating conditions that co-occur frequently. The lifetime prevalence of PTSD in the United States is 37 to 45 percent in adults with bulimia nervosa and 21 to 26 percent in those with binge eating disorder—compared with 5 to 12 percent in individuals without an eating disorder.1,2 When it comes to anorexia nervosa, the odds of having PTSD are higher in individuals who engage in bulimic behaviors like bingeing or purging.3
Research suggests that it is PTSD, not the trauma itself, that can contribute to the development of an eating disorder. Yet, not all people who suffer from PTSD will engage in eating-disordered behaviors. And, importantly, not all of those who experience trauma will develop PTSD. But for those who do, the hyperarousal (e.g., feeling keyed-up, irritable, and/or startled), flashbacks, and depression associated with PTSD can be so devastating that eating-disordered behaviors become a way to cope, particularly bingeing and purging. In my case, there was a short time when the two disorders collided. As I mentioned previously, my trauma occurred when I was well into my eating disorder recovery work. Looking back, I can see clearly that there were instances when I used my eating disorder as an attempt to deal with the emerging symptoms of PTSD. Yet, in my life, the two full-fledged disorders—at their heights of horrible—occurred well over a decade apart (essentially, I battled delayed-onset PTSD.) Regardless of the timing, both eating disorders and PTSD are real, life-threatening illnesses, not choices. I couldn’t “just eat” any more than I could “just get over” my trauma and the debilitating PTSD symptoms I experienced. But the good news is that help is available, and recovery from both eating disorders and PTSD is possible.
Today, I am fully recovered from my eating disorder. During my much-later recovery from PTSD, not once was I even tempted to binge, purge, or restrict. And when I started losing weight from the stress of PTSD and the havoc it caused on my thyroid disorder, I was truly upset about the drop in pounds. On my own, I even bought nutritional supplements and began “boosting” myself between meals. That 22-year-old young woman afraid of gaining even an ounce would never have set foot near a supplement like Boost®. But there I was, in my 30s, thrilled to watch the number on the scale increase. Yes, you read that right.
What about PTSD? This healing journey, in my life, is a much newer experience—something I have just begun talking about compared with my long-term eating disorder recovery. In fact, by the time I received help for PTSD, I had already written three books about overcoming my eating disorder (aka “Ed”). When it comes to PTSD, although not fully recovered, I am light-years ahead of where I used to be. In fact, I rarely startle; the rage is gone. I consider myself significantly recovered. (That, by the way, is how I described my eating disorder recovery when I wrote my first book, Life Without Ed.) From time to time, I still get triggered, but not anywhere near the same intensity. And what matters now is that I have tools to deal with what comes my way. A therapist once told me that the memory of the trauma never goes away but that PTSD absolutely can. I have made a choice to believe that. What will you choose? Across mental illnesses, hope has been shown to be both a trigger for recovery, as well as a maintaining factor. We must find a way to connect with hope—even in our darkest moments. If we can’t find a way to do that for ourselves, we must let our loved ones and treatment teams hold on to hope for us.
I have learned that some of the same genetic traits that made me vulnerable to developing an eating disorder also contributed to my PTSD. High anxiety is clearly one example, which has been reported in several research studies. Data also suggests that the fear circuitry in people with eating disorders seems to be turned up. As if it weren’t challenging enough to be someone who falls into fear so easily, people with eating disorders also seem to have a greater-than-normal resistance to the extinction of fear. And, yes, that innate, already-scared part of myself made me even more vulnerable to developing PTSD. Obsessive-compulsive as well as high-harm-avoidance personality traits surely didn’t help prevent either disorder, but, rather, seemed to fuel both. Not only was I a pro at adhering to rigid food rituals, but also, in my personal experience with PTSD, these traits seemed to make me even more sensitive to triggers. My mind latched on to anything and everything that could possibly, in any way, hurt me the way the trauma had before.
Whether suffering with either disorder separately or concurrently, like I said before, healing can happen. The tough thing is that recovery is hard. Very. Hard. Words on this page cannot possibly describe how difficult. Throughout the recovery process, there were times when I actually prayed to God that I would die in my sleep. I bargained with God to just take my life and give it to someone else—to someone struggling with another life-threatening illness, to someone who wasn’t so tired and worn out, to someone who actually wanted to live. My joy had all but vanished. Each day was a living nightmare. With PTSD, every night was an actual nightmare.
Gratefully, a variety of evidence-based treatments exist for both eating disorders and PTSD. With my eating disorder, much of my work, although I didn’t know it at the time, was based in cognitive behavioral therapy. In PTSD recovery, prolonged exposure therapy was key, and eye movement desensitization reprocessing helped, as well. If you (or your loved one) battle both illnesses at the same time, professional help that is individualized by experts with experience in treating both disorders is often recommended. While some who struggle decide to tackle both their PTSD and eating disorder simultaneously, others approach the illnesses one at a time. To heal the brain, we know one thing for sure: Proper nutrition is a must. Throughout both of my recovery journeys, my treatment was accented with alternative therapies like yoga, acupuncture, and massage. Somatic therapy work was crucial, too. To get better, I had to reconnect and make peace with my body.
I also needed to reconnect with relationships. PTSD and eating disorders thrive in isolation, so, to combat this, I attended group therapy for both. In fact, back in my eating disorder group, we used to sit on the floor in a circle before each session, flipping through the pages of this very catalogue. Life has certainly come full circle. I never would have thought that one day I would be asked to write this article. And, surely, I wouldn’t have believed that I would have books and even a music CD listed within these pages. Among all else, my eating disorder and PTSD stole my passions for writing as well as music. Currently, I am in the process of writing a book about fighting through PTSD. I never believed that could be a reality, either, because, just like with my eating disorder, I once thought I was the only person in the world who couldn’t get better. But, with recovery, all kinds of “impossibilities” become quite possible.
I wasn’t born with an eating disorder, or PTSD. If you relate to my experiences, neither were you. No one comes into this world with these insidious problems. We are born with traits that make us susceptible, especially in the wake of certain environments and life experiences. But the traits that made me—and possibly you—vulnerable to both illnesses are not inherently bad. In recovery, I have learned how to harness the positive aspects out of what once brought me down. My obsessive-compulsive traits have morphed into conscientiousness. As an example, when I turn in this article, Gürze/Salucore editors won’t find an overload of punctuation errors; however, there will surely be some. Typos exist in all of my books. Thanks to recovery, perfectly imperfect is my new goal. And today, I like to think of high anxiety as energetic and even creative. (My brain has the ability to come up with all kinds of not-likely-to-happen scenarios!) I now channel that creative thinking into my work as a writer, speaker, and singer. Not to mention, I have found ways to lessen the painful, unrelenting anxiety that used to plague me moment by moment.
I am happier and healthier than ever before. Yes, I have written that previously, probably in each of my books, but I am saying it again—years later—truthfully. Joy is back, and, to my surprise, there is even more of it. These days, I literally dance and sing around my house. While I still experience many challenges in this thing called life, without the chronic negativity that was fiercely attached to both my eating disorder and PTSD, I now treasure every day—and each nightmare-free evening. When I think back to those desperate moments talking with God or on the phone with my therapist, I feel a deep empathy for myself. I’ve reconnected with self-compassion and self-forgiveness. (I’ve made amends with the restaurant owner, too.) I love myself.
My eating disorder and PTSD have been among the best gifts in my life, albeit in the absolute ugliest of packages. Of course, this is only due to the gifts of recovery. Through our pain, we can find our power and purpose. Think posttraumatic growth. When I thought I was going crazy, by taking a step toward recovery, I was actually getting stronger. If you, too, believe that you might be losing your mind, consider this: Through your struggles, you just might be stumbling upon your strengths.
Make a choice to believe it. Surround yourself with those who will let you borrow this kind of hope. And, above all else, get help. Healing is possible.
About the author:
Jenni Schaefer is a best-selling author and a National Recovery Advocate of the Family Institute at Eating Recovery Center (ERC, 877-957-6575). Partnering with ERC, Insight Behavioral Health Centers (877-737-7391) provides specialized treatment for mood and anxiety disorders, including PTSD, at five Chicago treatment centers and one center near Jenni’s home in Austin, Texas. To learn more, visit jennischaefer.com/seek-help
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- Hudson, J.I., Hiripi, E., Pope Jr., H.G., & Kessler, R.C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348-358.
- Reyes-Rodríguez, M.L., Von Holle, A., Ulman, T.F., Thornton, L.M., Klump, K.L., Brandt, H., . . . Bulik, C.M. (2011). Posttraumatic stress disorder in anorexia nervosa. Psychosomatic Medicine, 73(6), 491-497.