Monday, 30 December 2013

12 Days of Mental Health : Day 5 - EDNOS

Evening all, I hope everyone is well and still enjoying 12 Days of Mental Health. I must admit, I have learnt a heck of a lot in a very short space of time, and have been amazed at the stories people have written for me. Seeing the amount of courage in this world motivates me to keep going - if you do one thing tonight, give yourself a back on the back. You deserve it.

Today's guest blogger is Esther talking about her experience of EDNOS. First up, information.

Please note today's blog post may be triggering for some. Always look after yourself first. 

What is EDNOS?

EDNOS stands for Eating Disorder Not Otherwise Specified, and is normally given to those who meet some but not all diagnostic criteria of an eating disorder, for example anorexia or bulimia. Differences between EDNOS and other eating disorders may be that a woman still has menstrual cycles (these tend to stop or become irregular) or maybe chews but then spits out food.

Here is a "text book" definition of how EDNOS may be diagnosed. Note this does not necessarily take into consideration how someone may be feeling.

Examples Include:

  • All of the criteria for Anorexia Nervosa are met except the individual has regular menses.
  • All of the criteria for Anorexia Nervosa are met except that, despite substantial weight loss, the individual's current weight is in the normal range.
  • All of the criteria for Bulimia Nervosa are met except binges occur at a frequency of less than twice a week or for a duration of less than 3 months.
  • An individual of normal body weight who regularly engages in inappropriate compensatory behavior after eating small amounts of food (eg, self-induced vomiting after the consumption of two cookies).
  • An individual who repeatedly chews and spits out, but does not swallow, large amounts of food.
  • Binge eating disorder; recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of bulimia nervosa.

EDNOS is more common that you may realise - it is estimated that between 40 - 60% of those seeking treatment to an eating disorder have EDNOS, according to the National Eating Disorders Collaboration. It can affect anyone regardless of age or gender, though there does seem to be some research to suggest it tends to develop more frequently in adolescence and early adulthood.

What are the signs/symptoms of EDNOS?

Potential symptoms of EDNOS are quite similar to that of other eating disorders. Here's just a handful of them:

  • Being preoccupied or obsessive over food, such as calories, cooking, and nutrition
  • Frequently weighing yourself 
  • Avoiding meals and denying hunger
  • Exercising obsessively
  • Feeling a sense of guilt, shame or embarrassment when you eat
  • Purging
  • Periods become irregular
  • Withdrawal from social situations 
  • Physical change in appearance
  • Feeling more sensitive to the cold, dizzy or tired
  • You may also experience symptoms related to depression and anxiety
There are lots of studies that look into how an eating disorder might have originated, but these are different for everyone. Just because someone has had a particular life experience, it does not mean they will get a diagnosis of an eating disorder, and vice versa. Many say that society of today is some of the reason due to its focus on body image, but other suggestions are that it could be due to bullying, family issues, genetics, and other environmental factors. 

What treatments are available?

Eating disorders can be extremely complex and there is no one-size-fits-all treatment. People vary in the length of treatment they require, and how long their recovery may take. Some individuals may have a different eating disorder at another stage in their life, but this won't necessarily happen for everyone. 

If you suspect a loved one has an eating disorder, try and support them as much as you can, and don't get frustrated. It is better to accept and help fight it than to try and pin the blame. 

In the first instance, always visit your GP. Many find writing down what they want to say before they go really helps. Referrals may be towards a mental health team, a counselor, or a dietician. CBT might be offered as a talking therapy as well. Medication may be considered if you are also experience symptoms of depression and/or anxiety. 

Some people find that support groups are the path for them to take on their route to recovery, and there are also some good books and online resources.

In some circumstances, it may be necessary for hospital treatment so that the right support, advice and guidance can be given to aid recovery. 

Remember- everyone is an individual, and what works for one person may not work for another. 

Esther's Story


I’m Esther, a very-nearly 20 year old Politics student from a sleepy little town in Suffolk. I am happy to live in a world where everyone is different and where – for the most part – those differences can be appreciated and embraced. I can’t hop, click my fingers, whistle or wink but I am taller than average and I make a pretty good Thai curry so I guess that’s just the hand I was dealt. I also have Depression, Anxiety Disorder and an Eating Disorder Not Otherwise Specified (EDNOS) rolled up into a neat little package. It’s EDNOS I’m going to talk about here because it’s what I feel needs greater understanding. 

EDNOS is, in my experience, a pretty bizarre thing to be diagnosed with in that no one knows what it flipping well is. Obviously the doctors do, but generally speaking the majority of the population have not heard of the condition despite its prevalence.  

My ‘problems’ - for want of a better word – reared their ugly heads in sixth form, though everything had been bubbling away for a while prior to that. A combination of stress, perfectionism and insecurity gradually started to take hold of the way I saw food and my ability to eat it. Without going into too much detail I found myself progressively restricting my intake as I felt more and more pressure around me. Although I still wanted to eat food, and didn’t necessarily want to be thinner, eating around other people became nigh-on impossible as I was so fixated on what they might think of me if they saw me eating. 

Many counselling sessions, food diaries, courses of CBT and packets of medication later I’m in a far better position. I like to see myself as a ‘work in progress.’ I do have frustrating days where I find it hard to eat and there are still some foods and situations which are really difficult to succeed with but I’m slowly making my way through the list and ticking them off as I gain confidence in myself.  

Since being diagnosed I’ve managed to get my weight up and get to university, where I’ve made some amazing friends and am now living in my own house and responsible for my own eating. I made the effort to get involved with as much mental health charity work as possible and am also a welfare officer at uni. As scary and overwhelming as it can seem to be sat in a GP’s room or a CAMHS office and suddenly have labels sewn into your very being, I’ve found that on the whole people are lovely and want to understand, help and encourage you in any way they can. 

What my experience and speaking to other people in similar positions has demonstrated to me is the incredible resilience of human spirit. It’s dreadfully clich├ęd to say that everything has made me stronger but it kinda has, actually. I’ve been shown that even in the darkest of moments there are always people around you who will fight to understand and to care, and that mountains can slowly be turned into molehills if you can accept yourself and apply enough determination. 

In the words of Albus Dumbledore:  ‘Happiness can be found, even in the darkest of times, if one only remembers to turn on the light.’ 
 
You can follow Esther on Twitter by clicking here.

Esther also writes a blog - you can read it by clicking here.

Further Information

beat: EDNOS (They also have a helpline and a specific youth line for advice and support)