Most people have heard of “the baby blues.” But did you know there is a difference between the baby blues, postpartum depression, and postpartum anxiety? PPD and PPA are medical conditions that need treatment to improve, and although anyone in the postpartum period can be at risk, you don’t need to worry – there is help available! This topic was requested by one of our readers, and in this post we’ll be discussing the differences between the three conditions and how they are treated, including things you can do at home in addition to seeking medical attention.
The Baby Blues
According to the American Pregnancy Association (2021), “approximately 70-80% of all new mothers experience some negative feelings or mood swings after the birth of their child”. Because of hormones during pregnancy and after childbirth, chemical changes in the brain can occur resulting in this milder form of postpartum depression. The symptoms of the baby blues tend to disappear by a few weeks after childbirth, and include mood swings, feeling overwhelmed, irritability, and reduced concentration just to name a few.
The baby blues will usually go away after a few weeks, but in the meantime, work on getting as much rest as possible, accept any help you may be given, don’t be afraid to ask for help when needed, try to find time to take care of yourself, and connect with other new moms when possible.
Postpartum Depression
Unlike the “baby blues,” postpartum depression doesn’t just go away on its own. Although postpartum depression can seem scary, it is 100% treatable and fairly common. In fact, research shows that up to 1 in 7 moms will experience postpartum depression (Wisner et al., 2013). There are several factors that put you at risk for postpartum depression: low socioeconomic status, history of depression, history of stressful conditions, lack of familial support, and unwanted pregnancy are just a few (Ahmed et al., 2021). The difference between the baby blues and postpartum depression can look like the inability to bond with your baby, restlessness, hopelessness, feeling inadequate, excessive crying, and recurring thoughts of death and/or suicide. The media has shared many stories of women suffering from postpartum depression without being treated that harm their children, but postpartum depression can also look like a desire to harm yourself.
Postpartum depression is usually treated with therapy, medication, or a combination of both. With appropriate treatment, symptoms usually improve, but it is important to stay the course and continue treatment even after you initially feel better.
Postpartum Anxiety
Postpartum depression gets a lot of press, but what about postpartum anxiety? Some of the symptoms overlap (like sleep disruption, even when the baby sleeps), but what sets postpartum anxiety apart from postpartum depression is a constant or near-constant worry that won’t go away. You may feel dread or have racing or intrusive thoughts, have heart palpitations, or hyperventilate. The anxiety can even result in panic attacks. It’s a lot to deal with when you’re already dealing with a newborn, but don’t worry: just like postpartum depression, postpartum anxiety is 100% treatable.
Postpartum anxiety is also usually treated with therapy, medication, or a combination of both.
Your prenatal care provider should monitor you throughout pregnancy for signs of depression. If you notice something is off, do not hesitate to let them know. After your child is born, you will typically have a 6-week postpartum check with your provider and they will assess you for postpartum anxiety and depression at that time. Again, do not hesitate to let them know of your concerns, and be sure to attend your 6-week appointment. Often, pediatricians’ offices will have a mother fill out a questionnaire the first few visits to assess you for postpartum anxiety and depression as well. If symptoms develop after that time (which is possible), be sure to reach out for more professional help.
You may be reluctant or even embarrassed to admit that you need help, but if you are feeling depressed or anxious after the birth of your baby, call your doctor as soon as possible.
It’s important to be aware that you can develop PPD or PPA with a second, third, fourth, etc. pregnancy even if you have not had it with previous pregnancies. If at any point you have thoughts of harming yourself or your baby, seek assistance from loved ones to take immediate care of your child and call 9-1-1 for help.
Helping a friend
People with postpartum depression or anxiety may not even realize what is going on and that they need help. Don’t wait and hope that things will improve; if you suspect a loved one is suffering, help them get help immediately
Although fathers may not experience the hormone changes in pregnancy, that doesn’t mean they are immune to postpartum stress. When a mother is depressed, chances are that the father may feel similar stress. Again, in this situation, seeking help is a necessary step.
“Home remedies”
These are things that can help in addition to professional help. They should not be a substitution for professional help such as therapy and medication, but rather, a supplement to that assistance.
Especially for c-section mamas, physical activity may be difficult in the initial days or weeks. Once you are able, try to introduce some physical activity back into your daily routine, such as going on a walk with your baby. The endorphins that accompany exercise can help improve your mood and you can bond with your baby during this time.
Avoid isolation as much as possible. The postpartum period may feel lonely, but there are many others who have been through it and are willing to help you. If they don’t offer help, please do not be afraid to ask for it yourself. If someone offers to watch the baby so you can sleep or shower, take them up on it. It’s important to take time for yourself, and even time with your partner.
Try to set realistic expectations for yourself. You can’t do it all and you shouldn’t be expected to, so don’t be too hard on yourself. Do what you are able and leave the rest.
Help is available to you. More information on postpartum anxiety and depression can be found here.
If you are pregnant or in the postpartum period, make a list of individuals you can reach out to when you need help – whether it be a meal, watching your baby, or more.
If you are looking to help someone who you think may be suffering, reach out, now. Do not ask what you can do to help, find what you can do to help.
References
Ahmed, G. K., Elbeh, K., Shams, R. M., Malek, M. A. A., & Ibrahim, A. K. (2021). Prevalence and predictors of postpartum depression in Upper Egypt: A multicenter primary health care study. Journal of Affective Disorders, 290, 211–218. https://doi-org.erl.lib.byu.edu/10.1016/j.jad.2021.04.046
Baby Blues. American Pregnancy Association. (2021, July 16). Retrieved October 4, 2021, from https://americanpregnancy.org/healthy-pregnancy/first-year-of-life/baby-blues/.
Gueron, S. N., Shahar, G., Volkovich, E., & Tikotzky, L. (2021). Prenatal maternal sleep and trajectories of postpartum depression and anxiety symptoms. Journal of Sleep Research, 30(4). https://doi-org.erl.lib.byu.edu/10.1111/jsr.13258
Shulman, B., Dueck, R., Ryan, D., Breau, G., Sadowski, I., & Misri, S. (2018). Feasibility of a mindfulness-based cognitive therapy group intervention as an adjunctive treatment for postpartum depression and anxiety. Journal of Affective Disorders, 235, 61–67. https://doi-org.erl.lib.byu.edu/10.1016/j.jad.2017.12.065
Shorey, S., Chee, C. Y. I., Ng, E. D., Chan, Y. H., Tam, W. W. S., & Chong, Y. S. (2018). Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. Journal of Psychiatric Research, 104, 235–248. https://doi-org.erl.lib.byu.edu/10.1016/j.jpsychires.2018.08.001
Wisner KL, Sit DKY, McShea MC, et al. Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women With Screen-Positive Depression Findings. JAMA Psychiatry. 2013;70(5):490–498. doi:10.1001/jamapsychiatry.2013.87
McKay Strongis a Texas native. She graduated from Brigham Young University with a Bachelor of Science in Family Life. McKay works full-time at a local nonprofit, has been married for three years, and recently gave birth to her daughter. She is a proud Ravenclaw and an even prouder cat mom. McKay is passionate about self-love, body positivity, healthy sexuality, and breaking the stigma against mental illnesses. Also, Harry Potter.
They say that the only two certainties in life are death and taxes. If I may be so bold, I’d like to add stress to that list. Regardless of wealth, gender, or race you will experience stress in life. Moving, losing a job, starting a new job, the birth of a baby, the death of a family member are just a few of the major family stressors experienced by most families. These stressors have also been compounded in the last year with the major stressor of a global pandemic as recorded in the Harris Poll conducted in February of 2021.
A representative sample of the US population reports that their stress has increased in a variety of categories in relation to the pandemic. Not only are people dealing with the expected stressors of life as mentioned previously, but they are more anxious to seek out health care, stressed about potential job loss and financial troubles, and experiencing weight gain (Harris Poll, 2021). People are struggling to cope with their stress in healthy ways. I know I have been, and it manifests in our relationships.
If I may, I would like to share a bit of my recent experience on the topic of relationship stress and what my husband and I have done to resolve it. In the past few months, my husband and I both quit our jobs, packed up our life, and moved to Texas for his graduate school. We were lucky enough to buy a home in Texas but as we know all too well, home ownership comes at a great price. In a matter of weeks, we found ourselves with a significantly reduced savings account and I found myself jobless and co-owner of a home in serious need of cleaning and repairs. We were stressed.
For a while, I ran full-tilt into DIY home renovating with my excess of spare time. My projects were incredibly rewarding and I was really enjoying myself. That was until we ran out of our allotted project money. No project money, no more projects. That was about two weeks ago and I started to sweat. The stress of my continued joblessness despite my countless applications was taking its toll on me and on my marriage.
A Different Way of Looking at Stress
Enter, the ABC-X model developed by Reuben Hill (Hill, 1949; Hill 1971; Peterson et al., 2013). While grasping for something to help myself personally and my marriage as a whole, I remembered the ABC-X model for family stress and decided to use the model to help me in my stressful situation. Let’s walk through it.
A represents the event or situation causing the stress, the stressor (Boss et al., 2002; Peterson et al., 2013; Paragamet et al., 2013). In my case, my whole situation of joblessness and no more projects to distract me from my predicament are my A. B represents the resources available to the family experiencing the stress (Peterson et al., 2013). For many, resources can include family, friends, education, or coping strategies. Really anything that helps and acts as a buffer to the stressor (A) is a resource (B).
This is where I began to apply the model; I took a step back and asked myself, “What resources do I have?” I took more time applying for even more jobs and, because I am religious, I began praying daily for help to find a job that would hire me. I also reached out to my husband and told him about some of the feelings of inadequacy and frustration that I was feeling because of my perceived lack of contribution. Viewing my husband as a resource rather than a person I was actively disappointing helped lessen the stress on our marriage because I became less avoidant and fearful of judgement around him.
C represents the family’s perception of the stressor (Peterson et al., 2013). If the family’s perception of the stressor is that it is insurmountable or unmanageable, then the family will likely crack under the pressure. If the family views the stressor as a growth opportunity or a short period of trial, then the family will ultimately strengthen. It was at that moment that I also realized that I had been viewing this period of joblessness and never ending and I had been catastrophizing the whole situation in my own head. If I remain jobless, we will never financially recover from buying this home and we will never have savings again and so on. I needed to change my perspective (C) in order to reduce my stress and change the outcome of it all on my relationship.
That brings us to X, which represents the level of stress (Peterson et al., 2013). The stressor (A), the available resources (B), and the perception of the situation (C) all affect the level or severity of stress (X) felt by the family. In my situation, I was feeling very stressed and like my husband was judging or blaming me for my joblessness despite my efforts. However, when I drew upon my resources, including my husband, and changed my perspective, my level of stress and the stress on our relationship decreased substantially.
Though not guaranteed to work in every situation, this simplistic view of the ABC-X model could help you or your family cope with stress as it did mine. Start by identifying the stressor (A) and your available resources (B) both within and outside of the relationship. Then examine your perspective (C) of the situation; is it accurate or realistic? From there, draw upon your available resources and work to change faulty or pessimistic perspectives. As you do so, you should feel a lowered level of stress in your life and relationship.
We cannot always remove stressors in our lives, but we can learn how to cope effectively and positively. Stressors do not have to crush us, they can instead strengthen us. It is a fact that fire burns wood but tempers, or hardens, steel. In a world of fire, are you made of wood or steel?
Practice using the ABC-X model in one of your relationships this week! Where are you currently experiencing stress? Identify the stressor, your resources for dealing with it, and your perception of the situation, and then evaluate how that impacts your stress level.
References
Boss, P., Bryant, C. M., & Mancini, J. A. (2002). Family Stress Management: A contextual approach (2nd ed.). SAGE.
Hill, R. (1949). Families under stress. Harper.
Hill, R. (1971). Families under stress; adjustment to the crises of war separation and reunion. Greenwood Press.
Pargament, K. I., Exline, J. J., Jones, J. W., Shafranske, E. P., & Walsh, F. (2013). In Apa Handbook of Psychology, Religion, and spirituality. essay, American Psychological Association.
Peterson, G. W., Bush, K. R., & Lavee, Y. (2013). In Handbook of marriage and the family. essay, Springer.
Emma Smith is from San Diego, California. Emma recently graduated from Brigham Young University with a degree in Family Life and an emphasis in social work. She met her best friend and husband Dallin at BYU her first semester home from her mission for The Church of Jesus Christ of Latter-day Saints. She enjoys horseback riding, swimming, reading, painting, and anything outdoors. In everything she does, she has one goal: to help others.
Written by Natalie Burgess, Brigham Young University
My memories of growing up with my mom are marked with happiness mingled with unforgettable pain. Due to her struggles with Borderline Personality Disorder, my mom seemed to operate on a revolving door—she was the kindest person one day, and the scariest the next. I often felt as if I was walking on eggshells, fearing her next outburst of anger, manipulation, and screaming. This wild mix of highs and lows felt like whiplash and largely shaped my childhood (Rizvi & Najam, 2017).
Eventually, I discovered that her actions were partially due to a mental illness and not just her unique personality. However, I found that many of my peers with similar experiences diagnosed their parents as “toxic” (Oyler, 2018)—or contaminating others by their destructive behaviors—rather than mentally ill.
While our society is becoming increasingly aware of mental health issues, other voices support a new trend that encourages individuals to make greater efforts to “self-protect” their happiness. Some individuals do this by recognizing (Morgan, 2020) which of their relationships are unhealthy and dumping them in hopes of something or someone better—or at least putting off investing (LeFebvre & Carmack, 2020) in close relationships once they have determined that a relationship may not be what they want it to be.
However, “You can divorce an abusive spouse. You can call it quits if your lover mistreats you. But what can you do if the source of your misery is your own parent?” (Friedman, 2009)
After consulting my therapist, he told me, “There is another option. If you want to keep your relationship with your mom, you need to set boundaries with her. You set the rules as well as the consequences for not keeping them—and you must stick to them.”
He introduced me to some communication methods, one of which is known by the acronym DEAR MAN (Richard et al., 2013):
D: Describe what you want
E: Express your feelings about the situation
A: Assert yourself by asking for what you want
R: Reinforce or reward the person by explaining the potential rewards of complying *this is also a good place to list consequences for not following your request
M: Stay Mindful—do not get distracted by their arguments or defensiveness
A: Appear confident and try to take yourself seriously, avoid stammering, and staring at the floor
N: Negotiate and compromise what you can without ignoring your needs
As I practiced this skill with my therapist, I realized that this type of conversation would require some bravery and may not initially elicit a positive response from my mother. I decided to call her on the phone, so I could leave the situation if I needed to, as well as have the ability to have notes with me that I could reference and that could keep me focused and give me something to say. Here is an example of how I used DEAR MAN:
Application
“I want to be spoken to respectfully. I feel hurt and angry when you yell at me and call me names. I need you to not yell at me or call me names. If you do this, our relationship can improve, and we can spend more time together like you have said you would like to. If you do not do this, I will not speak with you until you can speak respectfully. (If at this point the other person begins to argue or place blame on you, do not argue or defend yourself, but calmly redirect the conversation back to what you were saying.) Can you do that? What can I do to help with this?”
My therapist also recommended having my husband on the phone call with me in order to support me, back me up, and refocus me as needed. For others, this may look like discussing the situation with a roommate or friend to receive encouragement and validation for your experience afterwards.
In the following weeks, I began to incorporate DEAR MAN into interactions with my mom. At first, she was upset and offended, but I firmly stood my ground. I realized that without the support of my husband, it would have been easy to doubt if what I was choosing to do was the right move.
As I practiced this new skill with my mom, I began to recognize that much of her behavior was due to her fear of abandonment and loneliness—not out of a pure desire to make my life difficult. Understanding the depth of pain behind her own actions helped me to develop more empathy for her. Eventually, I started to see positive changes in my relationship with my mother.
Although our relationship is not perfect and I occasionally still have to remind her of my boundaries, I have been able to work on my own healing and no longer feel that I must walk on eggshells and fear her reactions. I recognize that there are relationships that truly do need to end (Friedman, 2009); however, the decision to cut ties (Carr et al., 2017) should not be taken lightly in families, nor should one do so without searching for outside resources such as therapy for help. Creating a healthier relationship may take repeated efforts to see improvement or there may not be change at all—but at least you will know that you gave it your best effort.
I am grateful that I found a way to purge my relationship of toxicity—not by ending my relationship with my mom—but by learning how to improve it. As a result, I am able to stay in contact with my mother and my daughter is able to know a grandmother she would not have otherwise.
Consider ways you can “self-protect” your happiness, including setting appropriate boundaries in relationships that may be considered “toxic.” Follow Natalie’s example by writing out your feelings, observations, and perhaps a script using the DEAR MAN format noted above. You don’t need to implement those boundaries right away, but processing these thoughts and ideas will lay the foundation for future conversations.
References
Carr, K., Holman, A., Abetz, J., Kellas, J. K., & Vagnoni, E. (2015). Giving voice to the silence of family estrangement: Comparing reasons of estranged parents and adult children in a nonmatched sample. Journal of Family Communication, 15(2), 130–140. https://doi.org/10.1080/15267431.2015.1013106
LeFebvre, L. E., & Carmack, H. J. (2020). Catching feelings: Exploring commitment (un)readiness in emerging adulthood. Journal of Social and Personal Relationships, 37(1), 143–162. https://doi.org/10.1177/0265407519857472
Ricard, R. J., Lerma, E., & Heard, C. C. C. (2013). Piloting a dialectical behavioral therapy (DBT) Infused skills group in a disciplinary alternative education program (DAEP). The Journal for Specialists in Group Work, 38(4), 285-306. https://doi.org/10.1080/01933922.2013.834402
Rizvi, S. F. I., & Najam, N. (2017). Unseen wounds: Understanding the emotional and behavioral correlates of psychological abuse in adolescents. Pakistan Journal of Psychological Research, 32(2), 525–543.
Natalie Burgess grew up in a blended family in Round Rock, TX and served a mission for her church for 18 months in Seattle Washington. Natalie and her husband, Ryan, have been married for two years and enjoy traveling, catching up on sleep, reading books together, annoying their cat, and playing with their daughter, Lindsey. Natalie is currently a senior at Brigham Young University studying human development and will attend graduate school in the coming year to pursue a degree in Marriage, Family, and Human Development.
I was quite certain it was cancer the moment I received the call. Despite the heartrending news I replied, “Come what may and love it.” Over the next few weeks, I learned how rare my tumor was, including the staggering statistic of a 38% recurrence rate after treatment. In an instant, it felt as if my current life was put on hold, and I was traversing completely unknown territory.
A diagnosis of cancer comes to many, but even those who never get cancer will almost certainly have difficult times in their lives. While challenging moments can be extremely tough, they can also teach us valuable lessons when we keep a positive attitude. My journey through cancer, as arduous as it was, became a meaningful chapter in my life as I learned to work through my grief, serve, maintain gratitude, and strive for hope.
Grief Can Be Helpful
During the ensuing months of treatment, I felt a roller coaster of emotions. There were days I felt calm and ready to conquer anything and other days that I wanted to curl up in a ball and cry. This is a normal part of the grieving process we go through when we have a loss due to a severe challenge.
Take the time you need to understand your feelings of grief. Doing so can allow you to deal with the accompanying emotions from the loss your particular challenge brings. When you are ready, allow yourself to begin looking beyond your personal circumstances so emotional healing can begin and you can move forward. Some losses may take a long time to process, which is okay, but try to keep your mind and heart open to eventual healing (Ennis-O’Connor, 2018).
In the process, seek out those who can be helpful—family, friends, professionals or others who have gone through a similar situation. I learned the importance of seeking out those that can help when I did not feel helped by a well-meaning friend. I shared with her my fear about the ways the surgery would alter my face. Expecting empathy and compassion, I was disappointed when I was met with the response, ‘You shouldn’t worry so much about your appearance.’ Seek out those who will listen and allow you to grieve, which gives room for healing.
Faith Murray, a 17-year-old with chronic recurrent multifocal osteomyelitis, learned this lesson. Faithlives with severe pain most days. She said life can be really hard and it is okay to realize that, but at some point, you have to stop “sitting in the sadness” and look outside yourself so you can experience the emotional healing you’re seeking (Strive to Be, 2020).
Faith stops sitting in sadness by serving others, which not only blesses the lives of those she serves but brings great joy to her own life. Giving anything—time, money, energy or even blood—not only benefits those around us, but can make us happier (Brooks, 2021). Serving others improves not only our emotional health but our physicalhealth as well. In addition to lowering blood pressure, stress, pain and depression, individuals who serve tend to have a greater sense of purpose and satisfaction (Wells Fargo Advisors, n.d.).
Before each radiation treatment, I would change into a hospital gown and wait in the women’s locker room until they were ready for me. Most days brought opportunities to visit with other women. These women and I felt a synergy as we served each other, listening to personal stories, giving each other encouragement, and showing compassion. After daily treatments for six weeks, I was thrilled to be finished with radiation, but I also knew I would miss those sweet, understanding friends I met. Serving and being served can be a unique blessing to continue through grieving.
Attitude of Gratitude
Another way to stop sitting in sadness is to look for the good. Simply said, count your blessings. Gratitude brings healing to our hearts by improving our emotional health. Researchers studied theeffect of gratitude on mental health patients, finding that those who wrote a letter of gratitude each week for three weeks had significantly better long-term mental health than other patients, even if they never sent the letters (Brown & Wong, 2017).
Surprisingly, gratitude can also improve our physical health.Studies show that counting blessings decreases stress, boosts immunity, improves sleep, lowers both blood pressure and cholesterol levels, and improves heart health (UC Davis Health, 2015). Gratitude is powerful!
When we have a grateful outlook on life, we see things we wouldn’t otherwise see, even hidden blessings. During my treatment, radiation was especially hard on my face, part of which was covered with sores and one eye was almost swollen shut. One day, after being reminded by my oncologist to keep my eye constantly moist to prevent permanent damage, I realized the swollen eye was actually protecting my eyeball. There it was, a tremendous blessing disguised as a trial that I wouldn’t have noticed had I not counted my blessings.
Hope Brings Peace
In addition to service and gratitude, hope was the foundation to my positive attitude. I used to think hope was a weak virtue. I would hope that it would not rain, or that something good would come my way, but those wishes are different than the hope that brings power and peace. I have learned over the years that hope is something coming from deep inside, and often requires letting go of what you can’t control. It is seeing reality while at the same time having a positive attitude. For me, hope is trusting that God’s plan is better than my own.
Hope depends not on the events in our lives, but on the focus of our lives, and can still be felt by those who don’t have a positive prognosis. There is hope that you can handle problems that come, hope in relationships, and hope that somehow everything is going to be okay. Hope can overcome fear and despair. I have heard people say that a person who died of cancer “lost the battle.” Dying of cancer isn’t losing—rather, we lose the battle when we give up hope. Hope is not sitting still while wishing your problems away—rather, it is knowing that every day, no matter what comes, there are good things in life: people to love, people to serve, people to inspire (Ashley, 2017).
Powerful Indeed
As illogical as it sounds, I look back on my experience with cancer and feel grateful for the wisdom I gained, and the continued hope I feel, even knowing my cancer may return. I have changed in ways that are good, and there are things I never want to forget. No matter the path life puts us on, when we let ourselves grieve, serve, have gratitude, and hope, we can find joy and happiness in ways we least expect—even in extreme trials.
Choose one of the above steps—grief, service, gratitude, or hope—to focus on and practice this week.
Tawnya Roth lives in Dixon, California where she and her husband have finally put down roots after 25 years moving around the world with the Air Force. She has three adult children and two adorable grandkids, with two more coming in September. She is a student at Brigham Young University, graduating in August 2021 with her Bachelor of General Studies degree with an emphasis in Family Life. Doctors found a cancerous tumor in her tear duct in 2018. Five surgeries, radiation and several miracles have given her a new lease on life.
Written by Rebecca Zundel, Brigham Young University
I’ll never forget the moment when Brooklyn turned to me and said, “Becca, I have something I’ve been needing to tell you.”
First, I felt relief. Brooklyn was finally opening up to me about her nearly year-long challenge with an eating disorder. Then came hope—maybe this was the beginning of recovery. Next, love and a desire to protect my friend flowed out in the form of tears and hugs; I would do anything for Brooklyn. But finally, fear presented itself. Eating disorders were new territory for me.
Although they were new to me, eating disorders are not uncommon. For every eleven Americans, one will face an eating disorder at some point in their life (Arcelus et al., 2011). That one in eleven may be a friend or family member, and watching them suffer with an eating disorder can be discouraging and frightening. However, you can support your loved one by learning how to approach them, seeking to understand eating disorders, and finding ways to assist in their recovery.
I’ve often wondered what would have happened if Brooklyn had not told me that she was struggling with an eating disorder. I now understand that speaking up may, in a very literal sense, save a life. Brooklyn came to me before I ever built up the courage to talk to her about the changes I had noticed, but your case may differ. The following points may help if you find yourself needing to approach your friend or family member about an eating disorder (National Eating Disorders Association, 2013):
Be prepared. Realize your purpose in approaching your loved one, then set up a private time to speak with them. You may even consider rehearsing what you want to say.
Honestly express your concerns. Explain your concerns in an open and caring way without condemning or judging your loved one. One way to do this is to avoid “you” statements like “You’re not eating enough!” Instead, use “I” phrases like “I’ve noticed you are eating less.”
Refrain from “simple” solutions. Avoid suggesting “simple” solutions to their trial. Telling someone struggling with an eating disorder to “just eat” is rarely, if ever, helpful.
Avoid stigmas and encourage professional help. Help your loved one understand that having an eating disorder and getting necessary help is not shameful. Assist them in getting professional help.
These suggestions can help you lovingly approach your friend or family member. However, they may react negatively at first because mental disorders affect your thinking (Zaitsoff et al., 2020). Brooklyn explained it this way: “While I was in the depths of an eating disorder, I didn’t want help because I knew that ‘help’ would mean potentially giving up everything that my disordered mind considered important in life.” Fear of receiving a negative reaction is understandable. I was afraid. But I now understand that I would rather face my fear than lose my best friend.
After our first conversation, I realized that I had much to learn about eating disorders. While Brooklyn’s health was suffering, she didn’t have what I originally thought of as an eating disorder. Her eating and exercise habits were definitely disordered, but Brooklyn ate. Understanding Brooklyn’s experience with an eating disorder was my first step in supporting her, and the following steps can help you on your path to understanding:
Do your research. Accept that multiple variations of eating disorders exist, and eating disorders are more complex than simply not eating. Eating disorders include any condition involving eating and other behaviors that negatively affect physical, emotional, and functional health (“Eating Disorders,” 2018). While Brooklyn ate, her obsession with healthy eating and exercise was still an eating disorder.
Listen to your loved one. One of your best resources for understanding eating disorders may be the person you know who is actually suffering with an eating disorder. Sometimes, their current mindset may not elicit helpful comments, but when they do open up to you, be ready to listen and learn.
Seek the help of medical professionals. If a medical professional is assisting in your friend’s recovery, then seek the professional’s advice. They likely have insights on how you can personally help your friend.
Apply what you are learning. As you better come to understand your loved one’s trial, be willing to adjust and apply the strategies provided by the medical professionals.
With the help of these steps, I learned that multiple factors affect the formation of eating disorders. Brooklyn’s eating disorder actually stemmed from struggles with perfectionism and anxiety. When I finally understood this, I was better able to support my friend in the ways that she personally needed.
Assisting in Recovery
Later in the recovery process, Brooklyn helped me understand that having support in recovery is extremely beneficial, even for someone as strong and determined as she is. The following are a few of the best ways to support loved ones through recovery (Fleming et al., 2020):
Listen. Whenever your loved one talks of their experiences with an eating disorder, listen intently. This is not the time to discuss your own difficulties with body image or dieting. Doing so may actually discount your loved one’s struggles or trigger a relapse (Saxey, 2020). Instead, when they talk, simply listen and love.
Show loving determination for accountability. Some days, the love you show will simply include providing company or understanding. Other days, however, your love may need to consist of firm accountability. Help your friend or family member keep their commitments to steps of recovery, and do not enable self-destructive behaviors.
Remind your loved one of the joys of life. Brooklyn explained that an eating disorder is “completely mind-numbing. Life became bland and full of numbers and checklists, rather than the spontaneity and excitement that should encompass it.” Help your friend or family member enjoy different activities so that they can remember the joy of life.
Remain hopeful. Most individuals recovering from an eating disorder will relapse, face emotional days, and experience other challenges along their road to recovery (“Relapse and Reoccurrence”). This does not mean that hope is lost. Remain hopeful and encourage them to do the same.
Recovery is different for each individual, but having support is actually one of the most consistent helpers (Linville et al., 2012). To support Brooklyn, I became more educated about nutrition and intuitive eating. I accompanied her to joyous activities and helped her navigate her eating disorder triggers. As determined as Brooklyn is, she needed support and so does your loved one.
The day Brooklyn told me about her struggle with an eating disorder was years ago. The Brooklyn I knew then was not the bubbly, care-free, and healthy Brooklyn that I know now. She still has her difficult days, but with the support of friends and family, Brooklyn recovered. Approaching your friend, understanding their experience, and assisting in their recovery can help your loved one as they face their own challenge with an eating disorder.
One of the best ways you can help a loved one with an eating disorder is by getting informed about them. Check out the link from the National Institute of Mental Health to read about different kinds of eating disorders, the signs and symptoms associated with them, and what treatment options might be available for your loved one.
References
Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality Rates in Patients with Anorexia Nervosa and Other Eating Disorders. Archives of General Psychiatry, 68(7), 724. https://doi.org/10.1001/archgenpsychiatry.2011.74
Fleming, C., Le Brocque, R, Healy, K. (2020). How are families included in the treatment of adults affected by eating disorders? A scoping review. International Journal of Eating Disorders. https://doi-org.erl.lib.byu.edu/10.1002/eat.23441
Linville, D., Brown, T., Sturm, K., & McDougal, T. (2012). Eating disorders and social support: Perspectives of recovered individuals. Eating Disorders, 20(3), 216–231. https://doi.org/10.1080/10640266.2012.668480
Zaitsoff, S. L., Pullmer, R., & Coelho, J. S. (2020). A longitudinal examination of body‐checking behaviors and eating disorder pathology in a community sample of adolescent males and females. International Journal of Eating Disorders, 53(11), 1836–1843. https://doi.org/10.1002/eat.23364
Rebecca Zundel was born and raised in a small, Midwestern town with her three older brothers. She now studies human development and editing at Brigham Young University and recently married her best friend. She loves traveling, trying new foods, and is constantly craving a big bowl of ice cream.
If you are pregnant or in the postpartum period, make a list of individuals you can reach out to when you need help – whether it be a meal, watching your baby, or more.
McKay Strong 
Emma Smith
Natalie Burgess grew up in a blended family in Round Rock, TX and served a mission for her church for 18 months in Seattle Washington. Natalie and her husband, Ryan, have been married for two years and enjoy traveling, catching up on sleep, reading books together, annoying their cat, and playing with their daughter, Lindsey. Natalie is currently a senior at Brigham Young University studying human development and will attend graduate school in the coming year to pursue a degree in Marriage, Family, and Human Development.
Rebecca Zundel was born and raised in a small, Midwestern town with her three older brothers. She now studies human development and editing at Brigham Young University and recently married her best friend. She loves traveling, trying new foods, and is constantly craving a big bowl of ice cream.