Coping with the exam and assessment period

The exam and assessment period at GCSE, A Level, or during university is often a time of high anxiety. Pressure to revise and to ‘do well’ can exacerbate symptoms of an eating disorder as we attempt to cope with overwhelming emotions and uncertainty.

In this blog, we’re sharing our thoughts about approaching this often intense period. We’re not going to minimise exams – they can be a means of opening doors to further education or a career – however, your wellbeing is just as, if not more, important. Particularly if you are in recovery from an eating disorder.

It’s normal to feel stress – it’s our response to it that matters

Feeling stressed is a normal response to a situation that feels out of our control. If we boil it down, stress is merely a state of high alert that serves to prime us for a situation that feels uncertain or possibly threatening.

People with eating disorders can struggle to tolerate the emotional experience of stress – along with other perceived ‘negative’ or overwhelming emotions, such as anger or deep sadness. There can be a fear that the emotion will become all-consuming and that we’ll never be able to come through and out of that emotional state. Because of this, there can be a resistance towards connecting with those difficult feelings and allowing them to help us understand our lived experience.

Instead, we may try to silence our emotional experience or repress certain emotions that could potentially disturb the “peace”. Here, eating disorders serve a purpose to ‘block out’ or numb threateningly intense emotions.

Remember, recovery isn’t a linear process; there will be ups and downs as normal life challenges arise and we take steps to overcome and build resilience against them for the future.

Bring awareness to eating disorder compulsions

You might notice during exam and assessment periods that your eating disorder feels amplified. Some refer to it as a ‘voice’ that gets louder during times of challenge.

When we’re in a situation that feels out of control, we might look outside of ourselves to cope. For an eating disorder diagnosis, this coping mechanism is often related to food.

Some individuals may find that their bingeing gets worse during this period as they turn to food as an attempt to self-soothe. Others may exercise more in an effort to relieve stress. Some may restrict and tightly control their food and caloric intake as a means of creating a false sense of control over an otherwise uncontrollable situation. Others may lose their appetite due to worry or forget to eat / decide to skip meals in order to prioritise studying.

This list is not exhaustive, but it is important to bring compassionate awareness to how we may be coping during moments of overwhelm. Notice any urges to behave in a certain way and, without judgement, compassionately respond to the underlying trigger – which is often related to stress or fear.

Know that you can always reach out for help – from loved ones or treatment teams.

Challenge the pull towards perfectionism

People with eating disorders are often high-functioning and can have perfectionist tendencies. Exams and assessments may exacerbate the pull towards perfectionism – why?

Our ‘locus of evaluation’ is what we refer to in order to make judgments about ourselves, other people and our place in the world. Having an internal locus of evaluation means that we trust our own instincts – that we can look internally to know that we are safe and trust that we are going to be ok. An external locus of evaluation is where we judge ourselves according to what other people might find acceptable (or what we perceive other people to find acceptable).

People with eating disorders can struggle with their sense of self-worth and may therefore look to external things or achievements in the hope of finding a sense of security and worth. For some, this may include performing well in exams and assessments. Here, self-worth is conditional, i.e. dependent upon something.

What’s more, it may be that you have a very ‘black and white’ mindset – e.g. you must do well or else you have failed. Many people with eating disorders think in this binary or dichotomous way and therefore feel compelled to push themselves to the limit in terms of performance. With this mindset, there is no room for nuance, understanding, and forgiveness.

Know that your exams do not define you. There is so much more to you than your performance at school, college or university. In treatment for eating disorder recovery, you’ll uncover this unconditional self-worth and self-trust.

As much as possible, be compassionate with yourself

We’ve got to be kind to ourselves.

If things are really tough right now, it doesn’t mean that you are failing, it simply means you’re being really, really challenged right now (and if you’re reading this blog post it’s highly likely you’re searching for ways to keep on track, which is really positive). Recovery is a journey with different chapters, just as this exam period is a journey with different chapters.

Let’s not forget to recognise the incredible work you’ve already done – a challenging time doesn’t undo any of that work. As humans, we’re built to adapt and resilience is borne from challenge. This is merely another opportunity to show our dedication to our recovery, and work with ourselves (and our treatment teams) to make this chapter as gentle and kind as possible.

Our tips for tolerating stress:

  • Breathing – this is the one part of the autonomic nervous system responses that we can control. So if your heart is racing and your palms are sweating, take deep, slow breaths with a focus on your belly rising and falling
  • Mindfulness – through things like journalling and meditation we can learn to be present in the here and now, and not “stuck” experiencing the past in the present
  • Compassion – similar to the above, learning to be compassionately curious about our emotional experience. If possible, inviting feelings in and recognising that we don’t need to over-identify with our emotional experience

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