The aim of Maternal Mental Health Awareness Week is to raise awareness of the impact of mental illness both during and after pregnancy. For many, this is a difficult area to approach as it is often surrounded by silence and a reluctance for many reasons. Most often, people feel uncertain about what to say and how to approach it.
Here, we’d like to draw attention to the experience of having an eating disorder whilst being pregnant or having just given birth, and the unique complexities associated with this stage of life.
Eating disorders – whilst often ‘seen’ to be manifesting in physical ways – are mental illnesses and as such require specialist understanding of mental health treatment and support.
Pregnancy is a life-altering change. For every woman (and man) approaching this period in life, it’s fair to say that life will never be the same again. And fundamentally, that’s the point – a pregnancy introduces a new chapter in life that shapes everything that follows.
Both pregnancy, and mothering, require physical, psychological and emotional strength, and for someone experiencing an Eating Disorder or in recovery, it may introduce a number of added complexities.
For someone in recovery, they may have spent a significant time in treatment working to understand the issues that supported the role of the eating disorder in their lives. This may have included exploring a fixation on body image, addressing issues around food intake, use of exercise or a reliance on numbers for safety.
In pregnancy and following the birth of a baby, these issues can resurface as underlying fears or experiences are awoken.
During pregnancy the reality of the 9-month clock ticking and the gradually growing baby and inevitable changes to a woman’s body can often lead to a refocussing on number-tracking, measuring and at times, comparing. Whilst this essential monitoring ensures the pregnancy or baby is progressing healthily, it can awaken familiar eating disordered thoughts and behaviours, and this can become a concerning, sometimes frightening time.
As a team, we have worked with many women facing the unwelcome return of the voice of the eating disorder at this time. It can leave the sufferer feeling deeply ashamed that she is feeling concerned about such things at a time where she feels she ‘should’ be focused on ‘more important’ things.
The conflict between wanting to provide a safe and secure body for the baby to thrive in, is often challenged by thoughts and feelings that can compete with this instinct. This can leave a mother-to-be or a new mother feeling hopeless and uncertain about her potential to care for her baby. Often this compromises the mother’s ability to take care of her own needs during this time, with a gradual shifting towards the eating disorder.
Changes to the body
The very real changes in body shape and size can be extremely hard to deal with as well, and for some become all encompassing.
Messages encouraging a focus on “healthy eating to nourish baby and mother”, or guides to “fast post baby weight loss” coupled with images of ‘successful’ expectant and new mothers with all the latest accessories, can be hard to make sense of, and often leave those struggling feeling like they are the only ones not “getting it”.
For many women during this time, they are left feeling ‘less than’ or ‘not good enough’. Their dreams of how thing “should” be – whether driven by social or personal expectations, feel distant and unachievable, and whilst rarely do women navigating pregnancy and motherhood feel they are getting it all right, this increased sense of not meeting external expectations can reinforce feelings of low self-worth and anxiety, leading to a greater dependency on the eating disorder for refuge and solution.
Coping with change
Change, or the prospect of change, can be very scary and anxiety-provoking for people living with eating disorders. Routines that help someone to feel safe and in control in their recovery may be threatened, and the future, therefore, may feel out of our control.
In response to this, someone may revert to perfectionist or controlling behaviours, they may isolate or distance themselves, and feel extremely anxious and overwhelmed.
If this experience sounds familiar, pause, and take a breath. This is an entirely new situation and “not knowing how to handle it” is a completely understandable and ‘normal’ response.
What is happening is okay. What’s important is recognising that it is happening and getting some support. This is a time where you need compassion and kindness, and importantly help to take care of you and your baby’s needs. This might be a supportive partner or spouse, or a sibling or friend, or a professional that can help you navigate this time in your life.
Eating Disorder or no Eating Disorder, every woman going at this stage of her life this needs someone to talk to.
Invite change with kindness, patience and curiosity
Pregnancy and childbirth does bring change and uncertainty, and at times it can increase the sense of vulnerability. But it is also a time in which something miraculous, momentous – and extraordinary takes place!
For some women who have recognised they are living with or recovering from an eating disorder, the purposefulness of the body in pregnancy and birth leads to a deeper more connected awareness of the body. This can lead to a process of acceptance of the body, providing a relief and release from the eating disorder.
This may not be a constant state, and often it oscillates with the more familiar and controlling feelings of the eating disorder, but there is the possibility of meeting with the body which can lead to a new way of understanding and living within the body.
Recovery is possible
At Orri, we often refer to recovery as a process of rediscovery and creativity; rediscovering the you within the eating disorder, and creating a life and identity for yourself that’s independent from the illness. You can still do this, even whilst pregnant or as a new mother.
The most important thing is that you keep communicating. There is no shame in reaching out for help for an eating disorder at any time in your life, and recovery is always possible.
If you need support during or following your pregnancy, reach out. The team at Orri are experienced in providing psychological and physical support during this important time.
For more information on our in person or online support, reach out to our friendly Admissions Team via the contact form on this blog.