Why Does Getting Better Feel So Bad?

Living with an eating disorder is akin to living in a constant state of trauma and fear. The individual is in perpetual survival mode. Every. Single. Day. When they embark on their recovery journey, especially during the early stages, it can be confusing (for the person as well as their support network) to understand why they may actually appear WORSE (for a period of time), even though they are treating their body better. 

In this blog, we will explore in detail WHY this happens, and the effects on the nervous system during chronic fight or flight (such as living with an eating disorder). I describe eating disorder as trauma, due to the pervasive and relentless nature of the condition, affecting both the mind and body.

Here’s why:

1. Physical Toll

• Malnutrition and Health Issues: Constantly restricting food intake or engaging in cycles of binge eating and purging leads to severe malnutrition, digestive problems, heart issues, and more. The physical pain and discomfort become a constant reminder of the disorder.

• Body Image Distortion: The ongoing dissatisfaction with one’s body can lead to obsessive behaviors, avoiding mirrors, or excessive exercising, creating a state of perpetual stress and self-criticism.

2. Mental and Emotional Strain

• Intrusive Thoughts: Eating disorders often come with obsessive thoughts about food, weight, and body image. These thoughts are intrusive and can dominate a person’s mind, making it difficult to focus on anything else.

• Emotional Turmoil: Guilt, shame, and anxiety are common emotions. The cycle of engaging in disordered eating behaviors and then feeling remorseful creates an emotional rollercoaster, contributing to a constant state of mental unrest.

• Isolation and Loneliness: The secrecy and shame associated with eating disorders often lead to social withdrawal. The person may isolate themselves to hide their behaviors, leading to profound loneliness and a lack of support.

3. Psychological Impact

• Low Self-Esteem and Self-Worth: The relentless pursuit of an often unattainable body ideal can erode self-esteem. The person may constantly feel inadequate or unworthy, impacting all areas of their life.

• Trauma Response: The behaviors and mental states associated with eating disorders can be seen as a response to deeper psychological traumas or stressors. The disorder becomes a coping mechanism, albeit a harmful one, to deal with underlying issues.

4. Chronic Stress

• Fight or Flight Response: The constant anxiety about food, body image, and weight can keep the body in a heightened state of stress, similar to the fight or flight response. This chronic stress can have long-term effects on physical and mental health.

• Uncertainty and Fear: The unpredictability of an eating disorder—whether it's worrying about the next meal, the next binge, or the next time someone might comment on their appearance—creates a constant state of fear and instability.

5. Interpersonal Relationships

• Strain on Relationships: Eating disorders can create significant strain in personal relationships. The secrecy, mood swings, and isolation can alienate loved ones, leading to a lack of support and understanding.

• Conflict and Misunderstanding: Friends and family may not understand the complexity of an eating disorder, leading to conflicts, misunderstandings, and further isolation.

Understanding that life with ED is TRAUMATIC helps us understand the effect is has on our nervous system as well as belief system. When a person is recovering from survival mode, they often experience profound fatigue due to the prolonged state of hyper-arousal their body has been in.

WHAT IS THE NERVOUS SYSTEM?

The body’s response to perceived threats is managed by the autonomic nervous system (ANS), specifically through the activation of the sympathetic nervous system (SNS), which is responsible for the fight-or-flight response. Essentially, when the body feels threatened, it will respond by activating “fight or flight” in order to move away from danger into safety. Once the perceived danger is removed, the body will turn off this system and return to homeostasis.

If you have an eating disorder, however, the perceived danger is always present - meaning, the nervous system is indefinitely activated, without an opportunity to regulate and rest. This is survival mode.

WHAT HAPPENS DURING SURVIVAL MODE?

1. Sympathetic Nervous System Activation: The SNS triggers the release of stress hormones like adrenaline and cortisol. This prepares the body to either confront or flee from the threat, leading to increased heart rate, heightened senses, rapid breathing, and a surge of energy.

2. Chronic Hyper-arousal: When this state is prolonged, the body remains on high alert continuously. This is common in individuals experiencing chronic stress, trauma, or anxiety.

3. Hormonal Imbalance: Constant SNS activation disrupts the balance of stress hormones. Elevated cortisol levels, in particular, can impair immune function, digestion, sleep, and cognitive processes.

Impact on the Body and Mind

The ongoing activation of the fight-or-flight response takes a significant toll on the body and mind, leading to several consequences:

1. Energy Depletion: The body’s resources are directed towards maintaining a state of readiness for danger, which is energy-intensive. Over time, this depletes the body’s energy reserves, leading to chronic fatigue.

2. Nervous System Exhaustion: The continuous demand on the SNS without adequate recovery phases exhausts the nervous system. This can lead to a state where even minor stressors trigger a disproportionate response, further exhausting the individual.

3. Immune System Suppression: High cortisol levels suppress immune function, making the body more susceptible to illness and infection, which can contribute to feelings of fatigue.

4. Sleep Disruption: Chronic stress often leads to difficulties with sleep, including problems falling asleep, staying asleep, or experiencing restorative sleep. Poor sleep quality exacerbates fatigue and impairs overall functioning.

5. Mental and Emotional Strain: The psychological burden of being in survival mode can lead to anxiety, depression, and emotional exhaustion. This mental fatigue compounds physical tiredness, creating a cycle of depletion.

So, if it feels so bad, and has so many negative effects and implications, why is choosing recovery so hard? Or, in some cases, how can the individual be in denial about the circumstances? 

Because, we have the adaptive ability to “get used to anything”.

Living in chronic trauma can fundamentally alter a person's perception and experience of what feels right or normal. This process involves complex psychological and physiological adaptations, often as a survival mechanism. Here’s how it happens:

Psychological Adaptation

1. Desensitization: Continuous exposure to trauma can lead to desensitization, where a person becomes less sensitive to stressors. This means that what might initially feel wrong or harmful starts to feel normal because the brain is trying to protect itself from constant distress.

2. Cognitive Dissonance: To cope with the constant conflict between their traumatic experiences and their understanding of what is right or normal, individuals might rationalize or justify the trauma. This cognitive dissonance can lead them to accept bad situations as normal.

3. Altered Beliefs and Values: Chronic trauma can reshape a person’s beliefs and values. They might start to see harmful behaviours or situations as acceptable or even necessary, especially if these experiences are reinforced by their environment.

Physiological Adaptation

1. Neurobiological Changes: Chronic trauma can change brain chemistry and structure. The brain regions responsible for fear, stress, and emotions (like the amygdala and prefrontal cortex) can become overactive or under active, affecting how a person perceives and responds to danger and stress.

2. Hormonal Adjustments: Prolonged exposure to stress hormones like cortisol can affect a person’s physical and emotional state, leading to a state of hyper-vigilance or numbness. This hormonal imbalance can make unhealthy situations feel normal.

Behavioural Adaptation

1. Survival Mechanisms: In an effort to survive, individuals might develop coping mechanisms that are effective in the short term but harmful in the long run, such as dissociation, substance abuse, or self-harm. These behaviours can start to feel like the right way to cope with their reality.

2. Learned Helplessness: Chronic trauma can lead to learned helplessness, where a person feels powerless to change their situation. This can make them more likely to accept bad things as a fixed part of their life.

Social and Environmental Factors

1. Normalizing Dysfunction: If a person’s social environment consistently reinforces harmful behaviors or situations as normal, they are more likely to accept them. This is particularly true if the trauma is intergenerational or culturally embedded.

2. Lack of Positive Role Models: Without exposure to healthy relationships and environments, a person may not recognize what a good situation looks like, making it difficult to distinguish between right and wrong.

So how does a person get better?

Recovery and Rebalancing

When a person begins to recover from survival mode, several processes occur:

1. Parasympathetic Nervous System Activation: Recovery involves the activation of the parasympathetic nervous system (PNS), which promotes rest and relaxation. This shift allows the body to begin healing and replenishing its resources.

2. Hormonal Rebalancing: As the body exits the state of chronic stress, cortisol levels start to normalize, reducing their detrimental effects on the body.

3. Rest and Restoration: The body needs time to repair the damage caused by prolonged stress. This includes restoring energy levels, improving immune function, and re-establishing healthy sleep patterns.

4. Psychological Healing: Emotional and mental recovery are crucial. This may involve therapy, mindfulness practices, and other strategies to process trauma, reduce anxiety, and promote emotional well-being.

The profound fatigue experienced during recovery from survival mode is a natural response to the body’s prolonged state of hyper-arousal and energy depletion. Understanding this helps individuals be patient with their healing process, recognizing the need for rest, proper care, and gradual rebalancing of their nervous system. At The Holistic ED Recovery Center, we emphasize the importance of a comprehensive approach to recovery, addressing both the physiological and psychological aspects to support full and sustainable healing. (Learn more about our customized recovery plans here).

Thats from a physiological perspective. Healing from trauma and the belief systems prolonged exposure creates, we also need to explore how to break the cycle of “what’s wrong feels right, what is healthy feels bad”.

Breaking the Cycle of Trauma and Embracing Healing

Breaking the cycle of trauma and engaging in healthy behaviors is a challenging but essential process. For those who have lived in chronic trauma, adopting positive changes can feel incredibly difficult and even wrong due to several deep-seated psychological and physiological reasons. Here’s an expanded look at how to break the cycle and why the process can feel uncomfortable:

Why Healthy Behaviors Feel Wrong During Healing

1. Comfort in Familiarity: Trauma survivors often find a sense of comfort in the familiar, even if it’s harmful. The predictability of their traumatic environment can feel safer than the uncertainty of positive changes.

2. Distrust and Suspicion: Chronic trauma can lead to a deep-seated distrust of others and new experiences. Positive behaviors and healthy relationships might be met with suspicion, as the survivor is conditioned to expect harm or betrayal.

3. Fear of Vulnerability: Healing requires vulnerability and openness, which can be terrifying for trauma survivors who have learned to protect themselves by being guarded and self-reliant.

4. Identity and Self-Worth Issues: Long-term trauma can erode self-esteem and create a negative self-identity. Positive changes can clash with this internalized view, making the individual feel undeserving of good things.

5. Physiological Responses: The body and brain can become accustomed to high levels of stress hormones. Engaging in calming activities or positive experiences might feel uncomfortable because the body is used to operating in a state of hyper-arousal.

Steps to Break the Cycle

Therapeutic Intervention:

• Trauma-Informed Therapy: Working with a therapist who understands trauma can help individuals process their experiences and develop healthier coping mechanisms.

• Cognitive Behavioral Therapy (CBT): This therapy helps reframe negative thought patterns and behaviors associated with trauma.

Building a Support Network:

• Safe Relationships: Forming connections with trustworthy and supportive individuals can provide a sense of safety and belonging.

• Support Groups: Joining groups with others who have similar experiences can reduce feelings of isolation and provide mutual support.

Mindfulness and Self-Care:

• Mindfulness Practices: Techniques such as meditation, deep breathing, and yoga can help individuals reconnect with their bodies and calm their nervous system.

• Self-Care Routines: Establishing regular self-care practices, like adequate sleep, nutritious eating, and physical activity, can promote overall well-being.

Gradual Exposure to Positive Experiences:

• Small Steps: Gradually introducing positive changes can make them feel less overwhelming. Starting with small, manageable goals can build confidence over time.

• Celebrating Progress: Recognizing and celebrating even small achievements can reinforce positive behaviors and build momentum.

Reframing Negative Beliefs:

• Positive Affirmations: Using affirmations can help challenge and change negative self-beliefs.

• Journaling: Writing about experiences and emotions can provide insight and help reframe traumatic narratives.

Creating a Safe Environment:

• Physical Safety: Ensuring that the physical environment is safe and free from triggers can support healing.

• Emotional Safety: Cultivating an environment where emotions can be expressed without judgment is crucial for healing.

This process is extremely foreign and uncomfortable. 

Let’s explore how to Overcome the Discomfort:

1. Acknowledging the Discomfort: Recognizing that feeling uncomfortable is a natural part of the healing process can help individuals be more patient with themselves.

2. Seeking Professional Guidance: Therapists can provide strategies to cope with discomfort and navigate the healing journey effectively.

3. Building Resilience: Developing resilience through positive experiences, learning new skills, and facing challenges can empower individuals and reduce the discomfort associated with change.

Breaking the cycle of trauma is a complex and multifaceted process. It involves not only external changes but also profound internal shifts. Understanding why healthy behaviors might initially feel wrong and taking gradual, supportive steps towards positive change can help trauma survivors reclaim their lives and develop a new sense of normalcy. Healing is possible with the right support, patience, and persistence.