When you’ve been in ‘the system’, the mental health system for years, friends begin to take on another meaning. It’s hard at first, to suss out who are the helpful ones in your life and who are not. You become drawn away from the people, before your mental illness that haven’t had similar mental health experiences that you now feel detached from, and you find yourself becoming friendly with people during your time in hospital, or in the community that get what you’re going through. But is it always helpful? This doesn’t have a black or white answer, just as anything with a healthy balance in this world – it depends on a lot of factors. But I’ve also experienced some stigma from mental health professionals about it.
Social anxiety has always been a thing for me anyway, which has been a blockage in a drainpipe to me flourishing amongst any friendship group. But I suppose in the big intimidating world, before my mental health struggles became recognised and confirmed to me, I felt even more confused about why I didn’t fit in, why my personality didn’t seem quite right – why I never felt good enough. I was a puzzle piece that was faulty in the box. I tried my best to adapt, and some friends had a positive influence. But at the same time I also found it exhausting battling the shyness that became an enemy in myself and constantly comparing my looks, my less-than-bubbly personality, my keenness to work hard at the jeopardy of my social life… and my weight. Regardless of how much I tried, I still felt inferior to anyone who was more talkative than me. I felt less.
And suddenly I stumbled across people who had a struggle so real and so similar to my own with my eating disorder. Slowly, there formed connections that made me feel like a working puzzle piece. I wasn’t the odd one out. When you’re in hospital, making friends (well, to me) is far from your mind at first. I had to put 10x the amount of energy in hospital being treated for Anorexia, than I had to out in the real world to have a reasonable social interaction, as I fought internally all of the things that were out of my control and absolutely terrifying. Firstly and majorly – having no control over what I ate. I had a choice to some extent between different food choices at each meal-time, but not over the amount, and all of the choices that were offered were almost equally terrifying as each other, to me at that time anyway. Of course I was on a refeeding plan, and gradually over time the amount would increase – it had to for my physical health… but the one thing that had helped me get from A to B during the day, was counting my calories and planning the small amounts I was eating that eventually felt too much that I couldn’t possibly eat any more than. Even the social anxiety had become numbed by the Anorexia, so the potential threat now of that protective shield being taken away from me, was a pain too hard to bare. So how could I even begin to think about making friends?
Before going into hospital for my first admission, I had made a couple of connections in the community before I deteriorated a lot with my physical health, having heard their similar experiences to me. It was when I was doing quite well and ticking along. But it wasn’t just for this reason I was meeting this girl, the first time I would actively meet up with anyone who had an eating disorder; she had a warm energy that had nothing to do with her mental illness, a spark of character there that wasn’t hijacked by it. I remember feeling a tummy full of energetic butterflies and the temptation to flea the shopping centre, when I approached the coffee shop I was meeting her at for the first time. All of those automatic tormenting social anxieties about whether I was good enough to meet her, whether I would bore her, whether I would make a fool of myself, whether I would freeze up in the middle of talking, whether I’d speak too quietly and make it awkward if she didn’t hear me or asked me to speak up.
And… because of the Anorexia still existing in my brain, “what if I order a drink that is more calorific than hers?” (I recognised this was an irrational thought because I was strong enough at the time, and rode the discomfort and slight awkwardness on my behalf, that came from ordering the drinks… and once we sat down it was a forgotten thought)
Yes it was a comfort to talk about our shared experiences, but in the friendships stemming from mental health that I found worked and were helpful to me, it was important to have a laugh, to talk about other things going on in our lives outside of our problems. And she made this enjoyable. I think because I was actively in recovery at this early stage, I was drawn to the fact that she was too. So it worked. We spoke about our aspirations for the future, and although I knew this girl for a short amount of time, I couldn’t help but feel proud of her for setting goals and being ambitious. But realistically ambitious. The best part is, although we don’t speak much now because we have our own lives going on, years later she has achieved much of what she shared with me back in the day. She’s living in another country, is a healthy weight, and has (hopefully) filled that void an eating disorder leaves behind in recovery, with things that make her feel alive.
This doesn’t happen all the time of course. Having been in an eating disorder unit 3 times, and the acute unit a handful of times, I’ve met a lot of people suffering so my connections have varied. In the eating disorder units, the hardest thing for me was the competitive, threatened nature of the Anorexia. By feeling as small as I could, I felt I had the strongest shield from the hardest parts of the world. So when for example there was a new admission, someone who was very physically unwell, and a lower weight than myself, I instantly wrote off any chance of a friendship – because the Anorexia wouldn’t let me, and the thoughts of feeling fat, and not worthy as much as this new person, were like daggers on my brain cells. So I had to distance myself. Often, this became most people, because even if they seemed a slightly healthier weight, or were actively involved in their recovery, the Anorexia still felt threatened in case there was a situation I would feel exposed, feel more greedy than them or they saw any of the real me.
These irrational thoughts became chipped away during spending so much time living with these other sufferers, that you start to see glimmers of the real person behind the eating disorder; a witty one-liner, talking about a passion for certain types of music before the illness took over, a talent or skill they show and grow confidence to share… and genuine kindness coming from behind the eating disorder mask. I’d say despite not getting close to people inside an eating disorder unit, there was still a golden friendship there, invisible, another member of the recovery army. We didn’t need a night out or an hour laugh on the sofa to confirm friendship. It just took seeing moments of fight in each other, and then the odd arm around someone when they were upset over a snack.
Another extremely valuable person in my life, was a patient that came into my room when I was first admitted to introduce herself and let me know she was there if I needed anything. This took guts. To be fighting that battle inside, and then put that competitive nature of Anorexia on a shelf to show who she really was, took genuine kindness and courage. And to this day, although we don’t see each other a great deal, we do still travel to meet up, and to share our recovery wins and the life we’re building outside the eating disorder is a pleasure better than most things.
Most eating disorder sufferers, as they deteriorate despite having social anxiety or not, become isolated over time because of the nature of the illness. Forming friendships with other service users and people with similar struggles, I feel is so important for making connections again back in the real world. It’s a stepping stone, a transferable skill. It gives you confidence and trust in others again, and faith that people want to talk to you, want to know you, simply because you’re navigating a similar problem together.
The struggle here though, can be when you’ve been under health services for a number of years, it becomes difficult to shuffle away from just the friendships that stem from sharing similar mental illness experiences. I know that I have found it hard to trust people will accept the real me if they don’t understand what my daily battles are. People who don’t have experience of your struggle, it feels like they live on another planet eventually, and that feels threatening. Another reason is, when in recovery but still struggling, it becomes a challenge to explore other activities and social groups outside of anything to do with mental health or connected under that safety net, or people are too ill to get back into work. so by avoiding this because of anxieties about engaging with the bigger world, our friendships do become restricted to people with mental health problems.
And that’s not always helpful. In fact it can make it more difficult long-term to strive for a life without a mental illness dictating your day. Your identity can feel too intertwined with the difficulties you face, instead of realising your potential, as a whole other person away from the illness. There is a big difference though, between hanging onto those friends that are ‘actively’ in recovery (that doesn’t mean they have bad days and bad weeks but they want recovery, and they are trying to make changes to leave the illness behind, as much as it’s daunting), and those that are struggling, have been stuck for a long time and aren’t actively making changes to reduce their life-compromising thoughts and behaviours. It’s not necessarily their fault, sometimes it’s a case of they haven’t got the support they perhaps need to flourish in recovery, and they have faced a lot of complex life situations. But if conversations with friends in this position become majoratively focused on their experiences in services and their struggles, it may not necessarily be triggering, depending where you are at in your own recovery, but this can still sit heavy on your own battles. It could sometimes leave you feeling drained.
Although I have experienced this myself, my empathy for people struggling with things similar to what I have sparks a drive in me for wanting to help them. And sometimes I want to be that friendship they need as a stepping stone to developing other relationships. But I try and recognise when I feel ready for that.
Sometimes too, I may need to open up to someone who ‘gets it’ when I’m struggling too so it’s a 2-way street. You have to be prepared to give and to receive, but as long as the friendship isn’t based purely on mental health difficulties, it can still work and be helpful. If you feel stable within yourself to really help that person, and want to coach them as well as be their friend, then great. That’s what I currently like to do. If you’re in a better place to be able to help someone who is facing the difficulties you have overcome then you have something valuable to offer them – and it can be rewarding for you too. Just maybe make sure you step back if you need to reserve your own energy or are struggling yourself. It can be difficult talking about things that you experienced in the past, some would say triggering, but again it depends where you’re at.
Whilst you may choose to keep friendships in your life you found through mental health, I can’t stress enough how important it is to get involved with life, to take baby steps to where you want to be in the future. To keep going so that mental health will take up 10% of your life instead of 90. Really be curious about the hobbies and interests you take up. Not having things in your life other than mental health appointments, is a breeding ground for deterioration or at the very least staying stuck in the same problems. Then, if you do have friendships with others sharing mental health issues, you have a life outside of that bubble too to keep you grounded in who you are. To start shaping your real identity.
Stigma I’ve faced from mental health professionals, are the assumptions that it’s bad to meet up with other service users, that it will have a negative impact both ways. It almost feels as though they assume you’re going to share tips with each other – like how to lose weight, how to self-harm, how to purge better, compare body weight, and calories counted. It definitely feels like professionals have that assumption sometimes. Whilst I can understand being wary about two people with sometimes quite serious problems being vulnerable together, there needs to be an understanding that actually interactions with other service users can benefit their recovery, in moderation. Assuming all service users influence negative behaviours and can inhibit their recovery is false. It’s not as black and white as that.
Helping someone else through a problem, giving them advice can reaffirm what you need to stay focused on too for recovery (if you feel strong enough to do that). As I said earlier, these connections too can be the stepping stone to confidence and trust in a wider range of people in the bigger world. They can be valuable for growth. Yes, some interactions can be heavy and close-to-home sometimes, but as long as it’s not every day I don’t see the obvious damage on someone’s recovery. I think it’s about controlling your exposure and level of interaction with people in your life, and making sure you’re building opportunities to interact with different kinds of people. Some people I’ve met, find it best to cut ties altogether with friends from their past mental health experiences, which I do understand. They’re trying to form a new life, free of their eating disorder associations, and recognising it’s not helpful to talk about the problems they may still be facing.
Sometimes, I feel that too much personal information too early on in a friendship, can be difficult for the other person to take. It’s the sort of things that maybe they should be discussing with professionals from their care team, but I have found asking if they have support for that problem they’re facing, or asking if they have someone to talk about it to more helpful than trying to take it all on myself.
As a now aspiring eating disorder therapist (and artist) I am personally interested in helping someone navigate a problem. Because it’s driven by passion from my own experiences. Maybe that’s what opens me up to warming to other service users. And I know this might seem contradictory of me now, but to a point I can stay in a connection with people that aren’t ‘actively’ in recovery so to speak, more due to the fact I want to help them see their potential so that they can take that leap. On a friendship basis, I find this difficult to persevere with for too long if they are struggling to make changes for a better life, particularly if I am struggling with my own recovery or I’m watching them deteriorate. But I am happy to coach from a distance in the meantime.
Of course, when I’m fully recovered (or as near to that as can be) and do my therapy training, I will be more equipped and resilient enough to help someone all the way through their recovery. But I guess this is where it’s different to being in a friendship with someone, as opposed to professionally. There is a boundary there, and the connection isn’t intimate. There are certain expectations.
I do realise this blog post is on it’s way to dissertation so a big thank you if you’re made it this far! But there are a couple of more points I wanted to discuss… when I’ve been out of hospital and am ‘actively’ in recovery, but stumbling and picking myself up along the way of course, I’ve become aware of how to protect myself and my recovery through what old friendships I keep up. My values have changed a hell of a lot, through all of my worst times with my eating disorder, particularly around body image and diet mentality, so as a general note it’s important to surround yourself with people who bring out the best in you.
Lastly, I want you to meet my best friend if you haven’t already. I met Gem back at the beginning of 2012 when I was a day-patient. Hidden behind a baggy grey hoodie, she looked so fragile. Roll on 8 years later and we are still best friends, solidly. Our friendship doesn’t revolve around mental problems at all, but we also make sure we do talk openly about our recovery wins and struggles when they arise. It’s part of our friendship. But the fact we are both building our lives despite our problems, and being able to laugh and share interests outside of our mental health history, seems to be what has made our friendship to each other so helpful to both our lives. I don’t have a flicker of a doubt we will be going to Bingo together when we are in our 90’s, cracking a joke and discussing our love of Yorkshire puddings.
This is an example of the BEST kind of friendship that can arise from a mental health struggle.