How To Know When It’s Time To Talk With Your Doctor About Medication To Treat Anxiety And Depression

A photo of a window and box, with clouds outside, representing imagery accompanying the question of when it is time to speak with your doctor about medication for anxiety and depression

How do you know when it’s time to talk with your doctor about medication to treat anxiety and depression?

First things first. To treat something, it’s helpful to know what the “something” is and if it has a name.

So let’s first define anxiety and depression. After that we’ll address talking with your doctor about medication to treat anxiety and depression.

Anxiety

Occasional anxiety is normal. It’s natural, for example, to have anxiety preparing for an exam, meeting, or other important event. Generally, feeling anxious at times is not in and of itself problematic. In fact, anxiety can actually help you stay energized, motivated, and well prepared – depending on its intensity.

Anxiety is a problem when it happens a lot, regardless of what’s going on in life, and/or it causes distress. Especially when anxiety affects other areas of your life, including school, work, and family.

There are different types of anxiety. Often they include negative thinking and ‘what if’ scenarios.

What are common signs of anxiety that indicate it is time to seek help?

  1. Concentration difficulties
  2. Restlessness
  3. Irritability
  4. Sleep problems
  5. Muscle tension and other physical symptoms such as a pounding heart or headaches.

Often the first place to seek help is with a psychotherapist. Together, you and the therapist can discuss when it is time to talk with your doctor about medication to treat anxiety (and depression). This especially makes sense if you know of a therapist you feel comfortable talking with.

Another resource is your primary care doctor (PCP). This option may make more sense than finding a therapist on your own, especially if you have a relationship with your PCP. Meeting with your PCP is also a good idea so you can have lab work done to rule out physical causes, such as hyperthyroidism.

Depression

All of us at times feel sad or discouraged. Depression is more than that, and it can last days, weeks, months, or years. Especially if left untreated.

To have clinical depression means you are either uninterested in things you used to enjoy, and/or have had a depressed mood – for at least two weeks.

Common symptoms in addition to lack of interest and/or feeling down include:

  1. Sleep or appetite changes
  2. Loss of energy
  3. Poor concentration
  4. Indecision
  5. Feeling worthless

It’s important to seek help for these symptoms since they can cause significant distress and affect your relationships at home, school, work, and in other important areas.

The treatment options discussed above for anxiety are the same for depression.

Whether or not medication is the best treatment for you depends on a lot of factors. Some considerations include the severity of depression and its history, your age, and personal preferences for treatment.

Most people do best with a combination of antidepressants and psychotherapy.

It is possible to have depression without anxiety, anxiety without depression, or both at the same time.

How Antidepressants Work

Most antidepressants slow down the removal of certain chemicals in the brain. The chemicals are called neurotransmitters. We need neurotransmitters for normal brain function. Serotonin is an example of a neurotransmitter. Selective serotonin reuptake inhibitors (SSRIs) is a common group of antidepressant medication. Another is serotonin-norepinephrine reuptake inhibitors (SNRIs).

Antidepressants are often used to treat anxiety, especially when depression and anxiety occur together.

How Anti-anxiety Medications Work

The symptoms of anxiety vary depending on the type of anxiety a person has. Proper diagnosis is useful so the medication with the best chance of being helpful is the first medication to try.

Many SSRIs and SNRIs are also used to treat anxiety. This is because these medications to treat depression can also help with anxiety. Both groups of medications target mood and stress.  

Medication to Treat Anxiety and Depression

Anti-anxiety and anti-depressants are legitimate prescription drugs and not simply “happy pills.” The medications have risks and benefits, and are taken under a doctor’s supervision.

People of all ages vary in their comfort level with taking medication. Side effects are often a concern. So is the belief that taking medication indicates weakness or defeat.

Some people are uncomfortable talking candidly with their doctor about mental health. Acknowledging out loud the pain of depression or crippling effects of anxiety can be a lot more difficult than acknowledging the pain of a broken limb.

Here are the most common reasons people give for why they do not want to discuss medication:

  1. “I shouldn’t need medication. I should be able to manage without it.”
  2. “What if I take it and become numb, and lose touch with who I really am?”
  3. “Medication will cause me to gain weight.”
  4. “Medication causes suicide.”
  5. “I don’t want to become dependent on medication.”

There is no shame in taking medication for anxiety and/or depression.

Medication is definitely NOT a magic bullet to feeling better, but it can help. Especially when it is part of a comprehensive plan that includes psychotherapy.

Regarding the notion that you ‘should’ be able to manage without medication: Says whom? Where did you hear that? Is the same thing true for other people, or does it just apply to you?

Taking medication is not a sign of weakness. It is treating a disorder. Or helping to reduce symptoms.

The idea that you could lose touch with who you are is ironic. When depressed and anxious, people are prevented from being who they are. Their true selves are held hostage by depression and anxiety.

Concerns about weight gain are common. Some medications for depression and anxiety are associated with weight loss, some with weight gain, and some with weight neutrality (meaning no effect on weight).

Medication does not cause suicide.

The medications for depression are NOT from a family of medications that are associated with addiction/dependence. Certain anti anxiety medications are, however, which is why it is important to take these medications under the supervision of a prescriber, and to also meet regularly with a therapist.

When To Seek Treatment for Anxiety/or Depression

Overall, the sooner you recognize you have depression or anxiety and get treatment, the better the chances for recovery.

The first thing to do is to acknowledge how negatively depression and/or anxiety affect your life, and that you really could benefit from getting help.

Examples of signs that it is time to consider medication for treating depression and/or anxiety include:

  • Length of time suffering

    Has it been for two weeks or more? The longer you wait, the worse your symptoms can get, and the longer it will take to feel better.
  • Effect on your work

    If you start to miss work, or continue to arrive late it is time to get help. Another sign is if you fall behind and can’t catch up.
  • Affecting physical health

    The mind and body are connected. Changes in physical health are common and understandable. Depression or anxiety can cause changes in weight, problems sleeping, and lowered immune system.
  • Self-medicating with drugs or alcohol

    Using alcohol to ‘take the edge off’ depression and/or anxiety leads to more problems.

While treatment of any kind can be scary, people are usually relieved after starting on a treatment plan. They are typically happier and more hopeful. To treat anxiety and/or depression, many options are available. Medication can be one approach, utilized either alone or in combination with psychotherapy. There are many types of medication and of psychotherapy. What you try first may not be effective. Many people have to try several medications for example before they find the one that works well for them.

I am a clinical psychologist in MA who specializes in providing treatment for people with mood or anxiety disorders, body image concerns, and eating disorders. I have a particular interest in supporting people who are Highly Sensitive.

88 Healthy Body Image Role Models You Need To Meet

Healthy body image role models are hard to find, let alone meet. Especially in Diet Culture.

Diet culture is a system of beliefs we’re taught. The beliefs aren’t factually true, yet they’re nearly universally endorsed in Western culture. So much so that we often don’t even realize the beliefs aren’t actually true.

Diet Culture is dangerous. It harms people of all sizes.

Identifying Diet culture when we are immersed in it is difficult. It’s the lens we through which we see (and automatically judge) bodies, beauty, food, weight, and worth.

The belief system of Diet culture is based on the premise that weight and worth are connected. And that to be worthy, attractive, successful, likable, and “good”, you must be thin.

Thinness is idealized. It is the end all, be all. The pinnacle.

The beliefs of Diet culture are so embedded that we tend not to blink an eye when someone says she was “naughty” for eating dessert. Or that he was “bad” because he skipped the gym yesterday.

Dieting is put on a pedestal, and food is moralized. Worth as a human being is defined by body size and food choice in Diet culture.

The truth is though whether you order fries or a fruit cup your worth is the same. Whether or not you exercised yesterday, today, or anyday doesn’t determine your value as a human.

Fries and fruit have no moral value, even though Diet culture wants you to believe that fries are bad and fruit is good. And that you’re bad if you eat fries, and you’re good if you eat fruit.

(Bad fries would more accurately mean they were made from rotten potatoes. What if the fruit were also rotten? Would it still be “good”? Nutritional merit is not the same as the moral judgments of good or bad.)

Diet culture is so all-encompassing that we typically don’t even see it for what it is. Sort of like fish not knowing they’re wet.

So imagine meeting others who’ve discovered Diet culture alternatives to being in their body. Is it possible to be freed from Diet culture messages? Are there people whose relationship with their body is either neutral or positive?

Yes. Even in the world of social media. How ironic! Social media, has been a prime way Diet culture messages are spread. The very same platforms can be utilized to spread messages of body neutrality, and decoupling weight and worth, and food choice and virtue.

What is body image and why should you care?

Everyone with a body has a body image.

Body image fluctuates, based on lots of things. Factors like mood, hormones, age, health, cultural and family messages, media ideals, and personality traits such as perfectionism affect a person’s relationship with her body.

Historical roots are an important part of body image. Both in terms of your own personal family tree and systemically (sexism, classism, racism, and other ism’s).

There is only one place you’ll live your entire life, and that is in your body. So finding peace within the body you inhabit is important.

How you feel and think about your body is something to care about.

If you have a positive body image, you’re more likely to have physical and psychological well-being. You’re also more likely to have interests, purpose, and meaning in your life.

In contrast, negative body image is associated with depression, social anxiety and self-consciousness, as well as eating disorders. And not so much fulfillment.

Magic happens when you stop judging your body harshly and learn to appreciate your inner being, soul, and spirit.

You weren’t born hating your body. Diet culture taught you, starting at an early age.

Take back your birthright; live unapologetically in the body you were born in and with.

What are role models?

When you’re looking for guidance, who do you go to?

You probably go to people you know and who seem qualified. Maybe people you consider to be role models.

Role models are people you look up to and whom you might want to be like, now or in the future.

People you know but haven’t met personally could be role models, as is often the case when social media is involved. Or they may be people in authority. Parents can be role models. So can teachers, peers, and coaches.

In real life, people are just as likely, or more so, to spend equal time with social media influencers as with peers and parents.

Social media influencers have a lot of followers who consider them to be a role model.

Think about whom you have designated as role models.

Have you chosen role models whose values align with yours? Are the role models you have chosen celebrities or influencers who spread Diet culture messages (and who also may not even realize it)?

Consider that media influencers have lots of platforms to send their message. These include television., YouTube, video games, Twitter, and music. All of these platforms are available 24/7.

Not all celebrities, stars, or influencers have positive messages. Influencers’ messages can be powerful. And their messages affect all of us.

On some social media sites, the best body image role models have four legs.

Neither dog in the photo below is likely lamenting the shape of its ears or the way its stomach hangs down.

two corgi's are body image role models

Social media

Social media influencers and celebrities get the most attention. They also have the most impact.

The way media works has naturally led to worsening body image country-wide (and in some cases internationally).

Instagram allows users to post images easily, and to view and follow other people. From the comfort of any room, you can easily access hundreds of images of women and men with “perfect” bodies. These images are “liked”, and praised for their appearance.

Many of the images are not even real! They’re filtered, airbrushed, or otherwise altered.

For teenage and young adult women, who may be consuming most of Diet culture’s media messages, unrealistic goals for weight and shape are reinforced.

Viral body image posts and even challenges are common. For example, there’s the trend of teenage girls balancing coins on their collarbones. How about all the ruckus about a thigh gap.

There may be no malicious intent. Regardless, the impact on body image is detrimental.

The increase in social media outlets has strengthened Diet culture. The system of beliefs spreads quickly, powerfully, and widely on the internet.

What then happens is we internalize what we consume and take them as ‘just the way things are’.

But there is good news here.

The intention and impact of social media influencers can be positive. Even with body image.

For example, Lorde posted two photos of herself on social media, one without makeup or Photoshop. “Remember, flaws are ok” she reminds followers.

There actually are positive body image role models who are human (not canine) and really do exist (and not just in social media).

We discussed that social media is a major transmitter of unhealthy body image messages.

An important step in a healthier body image is to think about the social media accounts you follow.

How do you feel about your body when you scroll through the posts on those accounts?

Why bombard your inbox with people who look a certain way and/or cause you to feel bad about yourself? How about if instead you include role models with a range of body sizes and shapes? While you are at it, include people of color, of different abilities, and gender identity.

To widen definitions of beauty and body size, diversify your accounts. Move away from unhealthy body image messages social media presents as healthy and normal. Those are the ones that keep you stuck in Diet culture and self-criticism.

So what to do?

The first step is a social media cleanout.

The second step is to follow healthier body image role models,

To find healthier body image role models, check out these accounts, many of which are borrowed from Alissa Rumsey’s list. Let me know if you have any accounts to add.

Body image accounts – Role models

Websites and Quotes from Body Image Role Models:

1. Virgie Tovar (https://www.virgietovar.com/): She’s an author and expert on weight discrimination and body image. She’s also relatable and fun.

“When we reconnect with our body, it doesn’t just mean we may have more confidence or a better relationship to the mirror. It means we reconnect to the information superhighway that is our body. It means we reconnect to what our bodies are telling us – not just about food or hunger – about everything.”

2. Christy Harrison (https://christyharrison.com) is an anti-diet, Health At Every Size informed, Registered Dietician, podcaster, and author.

In her own words, “My mission is to help you recognize Diet culture for the life thief that it is, and tune back into your body’s inner wisdom about how to truly nourish yourself—so that you can free up space in your life for bigger and better things.”


3. Alissa Rumsey, RD (https://alissarumsey.com/) helps people “free themselves of the shame and pain of chronic dieting so they can live their most unapologetic, liberated lives.”

As she says, “the more you trust your body with food, the more you start to trust yourself in other areas of your life.” 

4. The Body Positive (https://thebodypositive.org)

They “help people develop balanced, joyful self-care and a relationship with their bodies that is guided by love, forgiveness, and humor.”

5. Sonya Renee Taylor (https://sonyareneetaylor.com)

She’s the founder of “The Body is Not An Apology, a digital media and education company promoting radical self-love and body empowerment as the foundational tool for social justice and global transformation.” 

6. Lindo Bacon, PhD (https://lindobacon.com)

Lindo is an author, professor, speaker, social activist, and outspoken proponent for global body positivity.

Read their Body Manifesto.

Registered Dietician Body Image Role Models:

These body image role models provide anti diet, Health at Every Size/Intuitive Eating informed nutrition.

  1. @Evelyntribole Evelyn Tribole (Co-creator of Intuitive Eating_
  2. @ElyseResch Elyse Resch (co-creator of Intuitive Eating)
  3. @haes_studentdoctor Jess Campbell
  4. @thethicknutritionist Tash (Non-diet nutritionisht)
  5. @kristamurias Krista Murias (“Your worth doesn’t change with the shape of your belly…”)
  6. @mollybcounseling Molly Bahr
  7. @haescoach Kerry Beake (Coach who specializes in social justice, weight stigma, body image)
  8. @thewellful Brenna O’Malley (“Friends don’t let friends talk sh*t about their bodies”)
  9. @body_peace_liberation Kathleen Bishop
  10. @bodypositiveyoga Sarah Harry
  11. @fionawiller Fiona Willer Author, podcaster, speaker from Australia
  12. @kaley_rd Kaley Sechman (“Hunger is a normal body sensation.”)
  13. @rachaelhartleyrdRachael Hartley
  14. @thereallife_rd Robyn Nohling (She is a non-diet nutritionist and Nurse Practitioner, specializing in women’s health.)
  15. @laurathomasphd Laura Thomas
  16. @themindfuldietitian Fiona Sutherland
  17. @hgoodrichrd Haley Goodrich
  18. @immaeatthat Kylie Mitchell
  19. @jessihaggertyrd Jessi Haggerty (Registered Dietician, Personal Trainer)
  20. @intuitiveeatingrd Sumner Brooks (“My body is not for your viewing pleasure, or displeasure…”)
  21. @lindsaystenovec_rd Lindsay Stenovec (“How do I unlearn diet culture?”)
     
  22. @emilyfonnesbeck_rd Emily Fonnesbeck (“My body is my home and I won’t burn it down.”)
  23. @chr1styharrison Christy Harrison
  24. @rebeccascritchfield Rebecca Scritchfield (“Never diet again.”)
  25. @bodyimagewithbri Brianna M. Campos (Body image educator)
  26. @heytiffanyroe Tiffany Roe (“Body bashing is not bonding.”)
  27. @bravespacenutrition Katherine Metzelaar (“You don’t need to love your body to improve your body image.”)
  28. @livedexperiencecounsellor Sonny Jane
  29. @alissarumseyrd Alissa Rumsey

Fitness Body Image Role Models

  1. meisjessamyn Jessamyn Stanley
  2. @bodypositiveyoga Sarah Harry 
  3. @bodypositivefitnes trainers (“Removing barriers to fitness with a safe, inclusive space for all.”)
  4. @bodypositivehf Shelley Lask
  5. @curvyyoga Anna Guest Jolley also includes free yoga and meditation for people in bodies of all sizes.
  6. @deadlifts_and_redlipss Karen Preene (Non diet personal trainer)
  7. @positiveforcemovement coaches
  8. @amberkarnesofficial Amber Karnes
  9. @the.intuitive.trainer Julie Newbry (non diet, Intuitive Eating oriented personal trainer)
  10. @fatgirlshiking community
  11. @louisegreen_bigfitgirl Louise Green (Author of Big Fat Girl; “size inclusive fitness expert”.)
  12. @bloomfittraining trainers (“I was not put on this earth to count almonds.”)
  13. @practicewithdana Dana Falsetti
  14. @thephitcoach Jake Gifford 
  15. @emmafitnessphd Emma Green (“Why you don’t need to do 10,000 steps/day.”)
  16. @letsjoyn – Free body neutral classes for all bodies
  17. @themirnavator Mirna Valerio
  18. @sarahsapora sarah sapora
  19. @bloomfittraining coaches
  20. @iamlshauntay Latoya Shauntay Snell (“Chef, journalist, speaker, advocate.”)
  21. @fitragamuffin Jamie (“We’re prioritizing the wrong things when it comes to fitness.”)
  22. @tallyrye Tally Rye (“Your body is not your art. It is your paintbrush.”)
  23. @dearbodybymeg Meg Boggs (“Be your body’s protector, not its predator.”)

Activist & Educator Body Image Role Models

  1. @Madeonagenerousplan Meredith Noble (Fat liberation coach)
  2. @Sundaymorningview (“celebrating the beauty in women”; Self Love magazine)
  3. @Historicalfatpeople (“Vintage photos featuring nice to not-so-nice fat people of yore. Occasional diet ephemera.”)
  4. @Ownitbabe Rini Frey
  5. @Bodyimagemovementt Taryn Brumfitt
  6. @yrfatfriend Aubrey Gordon (“What we don’t talk about when we talk about fat.’)
  7. @iamivyfelicia Ivy Felicia( “Body peace is your birthright. You just have to claim it.”)
  8. @fierce.fatty Victoria Welsby (Author, speaker who “helps fat people ditch shame and unlearn fatphobia.”)
  9. @themilitantbaker Jes Baker (“Pay attention to who you are with when you feel your best.”)
  10. @sonyareneetaylor Sonya Renee Taylor
  11. @meghantonje MeghanTonjes is a singer/songwriter. (“Fat, blessed, and thriving.”)
  12. @betteringbecca Becca Ferry (Postpartum body image; “Your weight might fluctuate but your worth does not.”)
  13. @shesallfatpod (“The podcast for FAT POSITIVITY, radical self love, and chill vibes ONLY.”)
  14. @shanboody Shan Boodram (“Dr Ruth meets Rhianna”)
  15. @fyeahmfabello Melissa Fabello is a digital media educator with a PhD in Human Sexuality studies.
  16. @iamchrissyking Chrissy King (Writer, speaker who talks about equity for wellness community)
  17. @beauty_redefined (Lexie & Lindsay Kite) (“To improve your body image, prioritize the way you experience the world, not the way the world experiences you.”)
  18. @DanaSuchow Dana Suchow
  19. @bodypositivememes Michelle Elman (“You are a walking miracle. Struct accordingly.”)
  20. @chubstr (“Style for big men”)
  21. @lizzobeeating Lizzo
  22. @jameelajamilofficial Jameela Jamil (“The only diet advice you should take from celebrities is ‘don’t take diet advice from celebrities”)
  23. @i_weigh Jameela Jamil
  24. @iamivyfelicia Ivy Felicia

Body Image Role Models

  1. @Ellanabryan Ellana Bryan (“Self love and Body Positive Advocate”)
  2. @sassyredlipstick Sarah Tripp (“Curvy, confident body positive mama”)
  3. @lolo_russell Logan Russell (“Empowering you to embrace your body”)
  4. @tessholiday Tess Holiday
  5. @ashleygraham Ashley Graham
  6. @Madeonagenerousplan Meredith Noble (“Fat liberation coach”)

Now what?

Consider all the options available for choosing body image role models. There are 88 examples provided here, and this is not an exhaustive list.

Check out these accounts. However many of them you want to. . Then, decide in a more deliberate way whose accounts to follow and whose not to follow.

And whose to delete.

Together, we can ditch Diet Culture and create radical changes to improve body image.

YOU have agency. You can choose.

Once you recognize Diet culture’s impact, you’re in a stronger position to choose body image role models who aren’t drinking the (diet) Kool-aid.

I am Dr Elayne Daniels, a Massachusetts based psychologist with a passion for helping people feel more comfortable in and accepting of their body. Contact me here for more information.

4 Things To Know About How Stress Can Cause Eating Disorders And Depression

The hands of a woman through the horizontal slats of a blind, representing the stress of someone with depression and or eating disorders

One reason stress gets a bad rap is because it can trigger physical and mental health problems, including eating disorders and depression. Knowing how stress can “cause” eating disorders and depression may help prevent you or someone you love from suffering.

To be clear, stress is not always a bad thing. Especially in the short term, when it may help you feel energized to meet challenges.

In and of itself, then, stress doesn’t mean you’re destined to develop an eating disorder or depression.

But, when demands in life are greater than your coping skills, mind and body are impacted. And usually in a negative way. As in possibly leading to eating disorders and/or depression.

Stress can trigger psychological or physical problems, or both. Makes sense. After all, the mind and body are connected.

Many factors are involved in how stress impacts mind and body. Some of these factors are family history, genetics, emotional support, race, peer relations, education, social constructs, trauma history, temperament, coping skills, finances, among others.

Some factors are a buffer, and others worsen stress’ impact.

Can stress cause eating disorders ?

National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives. That’s a lot of people. We don’t need a national survey to tell us that 100% of people experience stress in their life.

If stress caused eating disorders, the rate of eating disorders would be 100%, or somewhere close to it.

So the next time you hear people wonder if stress causes eating disorders (and depression), you’ll know what to say: “Not exactly.”

But stress can be and often is the straw that breaks the camel’s back.

Stress does not CAUSE eating disorders (or depression) but is a variable in the equation.

a camel representing a straw that breaks a camel's back

There’s a handful of ways stress and eating disorders are linked.

1. Stress can trigger — and seem to cause — eating disorders (and depression).

Worrying about food and weight is central to all eating disorders, regardless of the type of eating disorder. The clear message from social media, peers, and diet culture is that thinner is better, and that what you eat defines your worth as a human. Being a part of diet culture and adopting its belief system create stress (and a $70 billion/year industry).

So, in people with other risk factors, stress can easily lead to problematic coping. Coping by dieting is socially suggested, approved, and even sanctioned.

Staying on a calorically restricted diet is stressful. Even, or especially, when the diet is camouflaged as wellness, clean eating, or a lifestyle change.

Weight loss compliments and admiration from others is a source of stress as well. In 95% of cases, weight loss will be replaced by weight gain. And no more compliments or admiration.

Dieting is one of the main risk factors for eating disorders.

Stated in another way, eating disorders begin with an “innocent” diet.

Stress is part of the perfect storm.

2. Eating disorders create (more) stress.

Having a poor relationship with your body and an unhealthy relationship with food is stressful. (Thank you, diet culture, said no one ever.) Worrying constantly about food and weight causes anxiety. It’s like a 24/7 internal battle that affects everything – your relationships, mental health, physical well being, and self worth. Your fundamental sense of who are you is at stake.

Another way eating disorders create more stress is physically. Put simply: Having an eating disorder is exhausting.

Eating disorders involve harmful behaviors in the name of achieving a cultural aesthetic. Restriction, poor nutrition, purging methods, and other eating disorder behaviors place stress on your body, including your organs. (That includes your heart.)

Eating disorders create a stress fest. But festive it is not.

3. People who develop eating disorders are often prone to stress.

The impact of stress on eating disorders is likely mediated by temperament (e.g. overly controlled; perfectionistic in the case of anorexia; impulsive, outgoing in the case of bulimia).

And certainly mediated by diet culture. Social media has intensified diet culture’s harmful impact. Even Instagram acknowledges the harmful effects of filtered selfies on body image. (“Compare and despair”)

For an eating disorder and depression to develop takes more than stress alone. When other risk factors are in place, and a stressful event occurs, an eating disorder can become activated. Without the stressful event, the eating disorder may not be triggered.

The ‘why now’ question of the timing of an eating disorder usually involves a triggering event. Examples of the kinds of triggering events include a loss of a pet or other loved one, a divorce, an injury or other medical event, or teasing. In other words, some form of stress.

4. The relationship between stress and eating disorders is a vicious cycle.

Stress does not cause eating disorders, but the two combine to create a vicious cycle.

Here is how that happens.

In general, two main eating disorder symptoms are negative body image and a problematic relationship with food.

Having a poor body image and relationship with food is stressful! And that stress in and of itself worsens body image and triggers eating disorder thinking and behaviors.

Hello, vicious cycle.

Stress occurs, and you feel overwhelmed. To cope, you turn to eating disorder behaviors. Then, ongoing negative body image and self talk associated with eating disorders increase stress.

It is a hard trap to get out of. Once you see it, though, you are in a position to make some changes to stop the cycle from continuing.

Stress and Binge Eating Disorder

The most common eating disorder is called Binge Eating Disorder (BED).

BED is characterized by eating large quantities of food (binges) and feeling a loss of control during the binge episodes. Eating is often rapid, and to the point of discomfort. Often the person feels a sense of shame or guilt afterwards. The person does not have compensatory behavior, such as purging, to offset the binge eating. The person will often deliberately restrict intake between binges.

In their lifetime, 3.5% of women and 2.0% of men will have BED.

To put this in perspective: BED is more than three times more common than anorexia and bulimia combined. BED is also more common than breast cancer or HIV.

The good news is that BED is treatable. (And preventable.)

The stress of following diets or other rules contributes to the stress that fuels BED. (Hello again, diet culture.) People with BED in larger bodies face additional stress from weight stigma and discrimination.

To cope with stress, binge eating becomes the relied upon method to manage feelings that would otherwise be overwhelming. Bingeing can provide immediate comfort. The bingeing itself, though, then causes more stress and overwhelm and causes you to feel bad about yourself.

Then, there is the stress associated with fearing weight gain. And of actual weight gain. There is also the stress associated with replacing the food you’ve binged on so no one knows about the binge.

Even physicians are guilty of shaming people with diagnosed or undiagnosed BED. Especially when people are in larger bodies. If that isn’t stressful, what is?

Stress and Bulimia nervosa

Bulimia nervosa is a serious, potentially life-threatening eating disorder. It is characterized by cycles of bingeing, and self-induced purging to undo the effects of bingeing.

Three in 100 American women suffers from bulimia.

It’s common for people with bulimia nervosa to use food and purging to manage feelings they’d rather not feel — including sadness, shame, anger, stress and boredom.

So the person with bulimia feels stressed, binges (for comfort) and purges (for relief) to alleviate the stress. What then replaces the original stress is the stress of being secretive, of cleaning up the ‘evidence’ of the binge or the purge, and of shame.

The physical impact of bingeing and of purging is another form of stress caused by the eating disorder. The list of short term and long term physical effects of bulimia is extensive.

Stress and Anorexia nervosa

Anorexia nervosa is an eating disorder characterized by weight loss, refusal to maintain a medically appropriate body weight, and distorted body image.

People with anorexia tend to restrict calories and good tasting food. Some people with anorexia also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.

Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities. One in 200 American women suffers from anorexia. 

Although anorexia nervosa most often begins during adolescence, an increasing number of children and older adults are being diagnosed.

You cannot tell if a person is struggling with anorexia by looking at her. A person does not need to be emaciated or underweight to be struggling. Studies have found that larger-bodied individuals can also have anorexia, although they may be less likely to be diagnosed due to cultural prejudice against fat and obesity (yep, diet culture’s effects again).

Anorexia nervosa numbs emotion and creates preoccupation with food, weight, calories, and exercise. The preoccupation is the body’s response to restriction and starvation (both of which are stressful to mind and body).

Simply put, the preoccupation is stressful. It is all the person with anorexia can think of. It is the last thing she thinks of before bed, and the first thing that comes to mind upon awakening. Even dreams are often about food and body size.

Sleep is usually poor, which creates stress in and of itself.

Anorexia is an attempt to feel more of a sense of control in life, and therefore less stress.

However, a ton of stress is created by the symptoms of anorexia. The stress anorexia creates affects both the mind and body. In fact, anorexia has a higher mortality rate of any psych illness. That is stressful.

Can stress cause depression?

Does stress cause depression? Yes and no.

Depression is a mood disorder. Its symptoms include sadness, and/or a lack of interest or motivation in things you used to enjoy. Additional symptoms include lethargy, fatigue, low motivation, poor concentration, sleep problems, or changes in appetite. Depression may include physical symptoms that don’t respond to treatment, such as headaches or gastrointestinal problems. Having any of these symptoms is stressful.

Depression affects about one in 15 adults (6.7%) per year. One in six adults (16.6%) experience depression at some time in their life. Depression can occur at any time. Typically it first appears during the late teens to mid-20s.

Stress affects 100% of adults, yet 100% of adults do not develop depression.

1. Stress can trigger depression

Stress can (seem to) cause depression in a few different ways.

When people don’t cope effectively with stress, they may become depressed. They may feel defeated, ill-equipped, or overwhelmed by the stress. A “why bother” attitude could develop, which is a depression response to stress called learned helplessness.

What happens in learned helplessness is people eventually stop trying to manage the stress because nothing has worked in the past. Not trying leads apathy. All-or-nothing thinking comes next. The person’s self talk is based in distorted thinking. It may be something like, “Nothing I do matters. I suck”. 

Chronic stress is especially problematic. It can derail your natural physiological stress response, which means you are not able to manage stress as well. Depression sets in.

Generally, when people feel stressed, their problem solving skills aren’t optimal. Without the stress, the person’s coping and problem solving skills may be effective enough.

Stress can also lead to people neglecting self-care. Or to engaging in behaviors that harm their health, such as smoking or drinking alcohol.

2. Depression creates more stress

The effects of depression can create or intensify stress.

Being depressed is stressful for a bunch of reasons..

Depression disrupts life. It’s often associated with withdrawing from people and instead isolating yourself. And not doing things you usually enjoy doing.

Depression and stress can lead to a vicious cycle

The relationship between depression and stress is bidirectional. Depression can cause stress, and stress can cause depression. Stress makes depression worse, and depression makes stress worse.

3. So how does stress cause eating disorders and depression?

Stress in and of itself does not CAUSE eating disorders or depression.

Rather, stress triggers or intensifies eating disorders or depression. Stress is bidirectional in the case of eating disorders and depression.

At their core, eating disorders and depression are disorders of disconnection.

Feeling disconnected from others or from yourself is stressful.

One way to address disconnection and social isolation is to connect with someone you trust. Let that person (or those people) support you.

Often it’s better for a supportive person to ask an open ended question rather than to tell you what to do or not to do.

The disconnection at the core of eating disorders and depression can be from yourself. And that stress has the biggest potential impact of all.

If talking to friends or family is not helpful or comfortable, please speak with a trained professional.

Learning effective methods to cope with stress decreases risk for eating disorders and depression. And makes for a more meaningful life.

There will always be stress. But it need not be harmful to your well being or quality of life.

Dr Elayne Daniels is a Massachusetts based clinical psychologist specializing in the treatment of eating disorders, body image and associated concerns. She also works with people who identify as Highly Sensitive.. Contact her here to get in touch.

8 Body Image Quotes And Sayings That Will Help You Fall In Love With Your Body Again

A photo of a girl with two thumbs up as if she likes or loves her body

Body image is complicated. Rarely is there anyone over age 4 or so who loves her body. That is so sad; none of us is born hating our body. And even through early stages of life, we revel in our fingers and toes. And in our body as a whole. Chubby babies are considered “so adorable”. But all this changes around pre-adolescence and certainly adolescence.

So, how realistic is it to think body image quotes and sayings could help you fall in love — or at least like — with your body?

You tell me. Check in with yourself and let a couple of words come to the surface that describe RIGHT NOW how you feel in your body. No judgment, like good or bad.

Read through the quotes.

Pause.

Reflect on which words come to mind now to describe how you feel a about your body.

Body image quotes and sayings that speak to you can be just what you need to hear, when you need to hear it.

Here are more body image quotes and sayings:

“it was when I stopped searching for home within others and lifted the foundations of home within myself I found there were no roots more intimate than those between a mind and body that have decided to be whole.”

― Rupi Kaur

I am so much more than my appearance.

My body is perfectly imperfect.

Wabi sabi.

I am unique, the only one on earth with this soul or body.

My body carries me.

I am tired of hating my body and myself.

My body is something to honor, to care for, and not take for granted.

The back of 4 women, arm in arm, demonstrating the impact of body image quotes

i like the way the stretch marks
on our thighs look human
and that we’re so soft yet
rough and jungle wild
when we need to be
i love that about us
how capable we are of feeling
how unafraid we are of breaking
and tend to our wounds with grace

It is easy to love the nice things about ourselves. But true self love is embracing the difficult parts that live in all of us.

-Rupi Kaur

a lotus

When you find body image quotes or sayings that speak to you, post them on your bedroom mirror. Use them as your screen saver. Repeat throughout the day.

Your body hears everything you think.

I am Dr Elayne Daniels, a Boston based psychologist with a passion for helping people find freedom and ease in their body. You can contact me here.

Why So Many People Wonder, “Are Highly Sensitive People Psychic?”

If you’re a Highly Sensitive Person (HSP), you’ve probably had the experience of sensing something was about to happen before it did. Or of feeling people’s energy or mood. Maybe even when they themselves were unaware of their own emotions. It’s no surprise people have wondered if you, a Highly Sensitive Person, are psychic.

Whether you know about or utilize your sixth sense, it is there.

The reality is you don’t actually have bionic powers or microchip technology in your brain.

However, you DO have a superpower of exquisite attunement. (And that is just one of your superpowers.) The attunement is because, in part, of three particular sets of genes you have.

What is a Highly Sensitive Person?

The concept of a Highly Sensitive Person has gained traction since Dr Elaine Aron coined the term in the late 1990s.

Highly Sensitive People make up 15-20% of the population. The High Sensitivity trait is present in over 100 species.

HSPs are high in sensory-processing sensitivity, a personality trait. High levels of this trait lead to greater awareness of subtleties and deep processing of information. HSPs are more aware of external (noise, light) and internal (hunger, thoughts) stimuli than people without the trait are. Their inner world is filled with rich images, thoughts, and feelings.

Most HSPs have always felt a bit different, without knowing exactly why. Often it’s because of how strongly they feel things and how intuitive they are.

Highly Sensitive People are born with a unique nervous system. It’s configured differently than the nervous system of 80-85% of the population who aren’t Highly Sensitive. In fact, scientists have identified genes that explain behavior, physical reactions, and brain activation patterns specific to HSPs.

So your Highly Sensitive Person psychic brain IS wired in a way that’s essentially a sixth sense.

Brain regions involved in awareness, empathy, and self-other processing are more easily and deeply activated than the brain regions are of people without the High Sensitivity trait.

HSPs essentially feel and integrate sensory information in a way that leads to a high degree of attunement to others and to the environment. Due to their wiring, HSPs feel, think, love, and process life around them very intensely.

This sixth sense is why so many people perceive you to be psychic. You are operating on a higher frequency. You pick up on way more than do the 80-85% of people who do not have the High Sensitivity trait.

A sixth sense/”being psychic” means different things.

There are lots of misconceptions about being ‘psychic’.

For example, many people think being psychic means you’re able to predict the future. True, “fortune telling” is one example of a psychic ability.

But so are:

  • Being aware of energy
  • Being intuitive
  • Feeling others’ emotions
  • Detecting lies

Highly Sensitive People may seem psychic because they can sense or even at times feel the energy or vibe of others. For instance, HSPs are better than non-HSPs at distinguishing between “good” guys and “bad guys”. In real life and in movies. (That does not mean the accuracy rate is 100%!)

Many HSPs have stories illustrating their awareness of other’s energy.

Often such anecdotes occur when out in public, such as at a restaurant. HSPs feel the energy of others around them. Maybe for example they’re aware of tension between a couple, even though the couple appear chatty and happy. Or they can sense the sad energy behind a smiling face. Or that their server is having a bad night despite her cheery demeanor.

If someone is bad news, you know it. Or, if something doesn’t feel right for you, you probably know that, too.

Intuition is another version of a sixth sense. For instance, Highly Sensitive People have an inner knowing, an intuition, that is hard to explain. They know for example what changes in the environment someone needs to feel comfortable, whether it is dimming the lights or lowering the television volume.

HSPs are particularly intuitive when it comes to social and emotional cues. “Reading” people comes naturally.

HSP wiring is designed for self protection. It’s fine-tuned to notice and interpret what’s going on around you in a detailed and comprehensive way. The hyperawareness (combined with memory) likely contributes to intuition.

A third type of a sixth sense is the ability to feel other people’s emotions. This can make it tricky to know when the feelings are yours, and when they belong to the other person.

Though Highly Sensitive People are not psychic, a lot of rare abilities go along with the trait.

Many of which could be considered (part of) what being psychic means.

For example, HSPs tend to communicate well. They hear the words coming out of other people’s mouths AND are attuned to subtle gestures and tone.

Another example of why people wonder if Highly Sensitive People are psychic is HSPs’ natural ability to identify people’s display –or non-display– of feelings.

HSPs pick up on each sense: sight, hearing, smell, taste, and touch.

Without effort, HSPs also tend to take in new information unconsciously, without being aware of what has been learned. This leads to the experiences of an HSP “just knowing” a solution to a problem. This “sixth sense” isn’t technically psychic, but it’s powerful.

One of the keys to thriving as a Highly Sensitive Person is to access and share the perks of your wiring. Your ability for attunement, aka ‘being psychic’, is one such example.

Being a Highly Sensitive Person has challenges associated with it. Constantly processing so much information (“overthinking”), and feeling emotions intensely (“too sensitive”) can be exhausting, for example.

There are also gifts that accompany your extraordinary brain. Your intuition is one of those gifts.

Whether you call your innate capacities a superpower, or not, they’re part of your nervous system. Why not leverage your natural HSP capacities to enrich your life with meaning and connection?

I am Dr Elayne Daniels, a MA based psychologist specializing in helping Highly Sensitive People access and embrace all of their exquisite wiring.

4 Tips For Managing Depression And Anxiety You Can Use For A Flare Up

A woman sitting on a red couch in front of a lit sign "Feelings", appearing to be someone who could benefit from tips to manage depression and anxiety flareups

Never in the history of managing depression and anxiety has anyone benefitted from being told to ‘just snap out of it.” Or “just relax!”

Depression and anxiety can spiral to the point where they feel unbearable. But to expect a person to be able to “snap out of it” is not realistic. Or helpful. If the person could, she would. Depression and anxiety thoughts and feelings are just too intense.

The good news is there ARE effective ways of managing depression or anxiety if you experience a flare up.

Before we discuss tips for managing depression and anxiety, first let’s define depression and anxiety.

What is depression?

Depression is common. Being depressed is like walking around wearing whatever color is the opposite of rose colored glasses. Life is gloomy.

Depression negatively affects how you feel, the way you think, and how you behave. It causes sadness and/or a loss of interest in things you used to enjoy. You may feel bummed, blue, or irritable. Feeling tired and unmotivated are common too.

What is anxiety?

Anxiety is an emotion that everyone feels, to varying degrees. For some people anxiety can be intense, persistent, and very hard to cope with. Physical symptoms (e.g. sweaty palms, increased heart rate) are often part of anxiety.

There are effective ways to manage anxiety.

The goal is not necessarily to get rid of all anxiety forever. Rather, the goal is to strengthen the ability to cope with anxiety.

Tips for managing depression and anxiety if you have a flare up:

Flare ups happen. They don’t mean you’re back at square one. In fact, a flare up can be an opportunity to practice and strengthen techniques from your coping repertoire.

DO EXPERIMENTS to manage depression and anxiety.

Rather than committing to a definitive resolution or plan, use a different approach. I call it the ‘let me see what happens if’ technique.

Think of what you’re going to do to manage the flare up as if you are conducting an experiment For example, let’s say it’s night time, and you’re planning for the next day. You say to yourself, “let me see what happens if I get up in the morning, shower, and then eat breakfast.” As opposed to saying something like, ” I SHOULD or HAVE TO get up early tomorrow, shower and then eat breakfast. Even though I’ll probably be groggy, in a bad mood, and keep pressing snooze.”

In the first case, there is a sense of hope and opportunity. The latter case sounds like a mixture of a guilt induced mandate and pessimism.

With the ‘let me see what happens if‘ approach, you agree to try the thing. Just once. Just for today, as they say.

What often happens is it goes well, and the experiment continues the next day. And for the next many days.

In psychology talk, the behavior involved (conducting “experiments”) in managing depression and anxiety is reinforced (you feel accomplished) and therefore strengthened (it continues).

CREATE STRUCTURE as a way to manage depression and anxiety.

Depression and anxiety affect mood, energy, and motivation. Focusing can be super difficult. You may be tempted to stay home all day and avoid people. If you don’t know how your day will go, you may feel anxious.

A great suggestion is to find a regular routine. Do not let depression or anxiety be the boss of what you do and when you do it.

If you don’t have much structure, impose some. See what happens if you add structure to your days. (Hello, Tip #1!)

Plan out your day. Try to make your day full-ish, but not overwhelming.

Sticking to a schedule will help you to function in your daily life.

For an added boost: incorporate social connection, fun, and nature/the outdoors. All at once, or not.

ELEVATE SELF-TALK to manage depression and anxiety.

Self-defeating thoughts fuel depression and anxiety. Especially because we tend to believe what we think. Most of us often take our thoughts as fact. Even when the thoughts are not true.

Negative self-talk are thoughts like “I’ suck” or “Nothing will help me”. Or, “I’m going to freak out if ‘x’ happens.”

Your inner critic may also glom onto thoughts associated with depression or anxiety. What then happens is an onslaught of more and more and more depression or anxiety.

Negative, inner critic thoughts make it hard to see that you in fact have choices in your life. The negative self talk may mean you feel stuck.

I call automatic negative thoughts ‘ants’ for short. ‘Ants’ can appear quickly. Noticing them will help you to decrease their impact. Catching them and having a counter thought or affirmation will help you emphasize your strengths.

GENERATE SELF-COMPASSION to manage depression and anxiety.

Self-compassion gets a bad rap by those unfamiliar with the concept. With thousands of studies demonstrating its effectiveness, self compassion is a supremely useful tool. And way of relating to yourself and others. It honors your (and others’) human-ness.

With self-compassion, you’re mindful and accept that the moment is painful. You are kind and caring in response, remembering that part of the shared human experience is to be flawed. Imperfect. This reminder allows you to hold yourself in love and connection, and to give yourself the same kind of support you would provide a loved one. Self compassion creates optimal conditions for growth.

Self-compassion practices are not meant to suppress or fight against depression or anxiety.

Try any of these self-compassion practices, with the purpose of experimenting with the various practices (thank you tip #1). Another idea is incorporating self compassion practices into your day (thank you tip#2) and reassuring yourself (thank you tip #3) that an open mind is all you need.

Having a flare up of depression or anxiety may be inevitable. Flare ups are simply an opportunity to revisit techniques you know are helpful, and to experiment with new ideas.

Dr Elayne Daniels, a private practice psychologist in MA, specializing in the treatment of people with depression, anxiety, and/or eating disorders. Another specialty is working with Highly Sensitive People and people with body image challenges.

5 Things You Need To Know About Treatment Options For Eating Disorders

Two women are seated, one with a stethoscope, appearing as if she may be explaining different treatment options for eating disorders

Looking into treatment options for eating disorders for yourself or someone you love can be overwhelming. Even knowing where to start is challenging. In fact, a recent Google search for “treatment options for eating disorders” yielded 11,800,000 results. You read that correctly – over 11 million results.

As hard as it has been for you to get to this point, there are a few things to know about eating disorders before you start looking into treatment options.

1. Eating disorder treatment should not be delayed.

If you have an eating disorder, chances are you’ve had it for a while. People with eating disorders have symptoms for an average of six years before seeking treatment. That’s six years for your mind and body to be at odds with one another.

2. A correct diagnosis is important for treatment.

A correct diagnosis sounds straightforward. It is not.

In fact, it’s common to downplay, overlook, or even dismiss eating disorder signs. (A huge reason eating disorder signs and symptoms are ignored is Diet Culture.)

Symptoms that are easily overlooked include negative self-talk, which by definition is private and not shared with others. That’s what makes identifying when thoughts, feelings, and behaviors are part of an eating disorder so difficult to recognize for what they are. The same kind of thinking is also a part of our weight-focused culture.

Society’s (diet culture’s) messages are super glue strong. And harmful. A person’s weight does not define worth. Even though diet culture insists it does.

You can see how easily the blurry line between ‘normal’ and ‘disordered’ delays diagnosis and treatment. It makes you believe that everything is fine, when in reality everything is not fine.

So how do you even know if you or someone you love may have an eating disorder?

A great place to start is to fill out an online screening questionnaire.

Eating disorder diagnoses: What are they?

Eating disorders are not about weight, vanity, or attention seeking. They’re a way of coping with emotions that would otherwise feel too overwhelming.

Anxiety and/or depression often exist before eating disorder symptoms begin and can delay getting an accurate etig disorder diagnosis.

The category of eating disorders includes:

3. Have a treatment team

A typical eating disorder treatment team includes a therapist, dietician, and medical doctor.

All providers should have expertise in eating disorder treatment. Treating a person with an eating disorder is complicated.

Treatment with a therapist and dietician specializing in eating disorders makes treatment success much more likely.

Your treatment team helps with goals and guidelines and is there to support you every step of the way.

You may be familiar with referral websites such as Psychology Today. But did you know there are also places online to look for eating disorder experts, such as the National Eating Disorders Association?

The same applies to finding a registered dietician with an eating disorder specialty. Nutrition therapy for eating disorders is different from general nutrition therapy.

A family therapist may be recommended as well if the patient is living at home and/or is a minor.

Family-based treatment, also known as the Maudsley Model, may be helpful for families of teens with an eating disorder.

By the way

Many PCPs and pediatricians lack proper training in and knowledge of eating disorders. They too are a part of diet culture. Without even knowing it, they spread harmful myths and stereotypes about weight and well being. They mean no ill intent, certainly, However, you can not assume a medical provider is eating disorder savvy.

The person in need of treatment may downplay symptoms and/or refuse help. Partly because of the strong forces of diet culture. And, because an eating disorder always provides some benefit. Or it would not exist in the first place. Doing away with something that has brought relief is scary.

Denial and secrecy often go hand-in-hand with an eating disorder. Sufferers deny they have a problem and are secretive about their symptoms.

Matching treatment intensity to symptom intensity makes for a faster recovery. And, a greater chance of a successful outcome.

Higher levels of care

More intensive treatment is called a higher level of care (HLOC). There are 4 main forms.

Medical stabilization, including refeeding, requires an inpatient level of care. Length of stay is usually a few days to a couple of weeks.

Residential treatment is for people who would benefit from round the clock support and structure but are not medically compromised. Residential programs typically last for up to 3 or so months.

A third level of care is partial hospitalization. Structured group therapy for 6-8 hours/day occurs, and patients then go home to sleep. Meals are included as part of treatment.

The lowest level of care is intensive outpatient. These programs are held for three or so hours, three or so times per week. Length of stay is typically a couple of months. Usually patients have a meal and snack together.

Sometimes people start at the lowest level of care and then return to their outpatient team. Others may need higher levels of care. Sometimes treatment involves cycling through different levels of care. There is no standard sequence of treatment levels.

The recommended level of care is mostly based on severity of symptoms. Within each program, treatment is tailored to the person’s needs. There is no ‘one size fits all’.

Some higher levels of care include additional treatment programming. For example, there may be a trauma specialization track, a substance abuse track, or a specialized program for athletes. The tracks are for people who have an eating disorder along with concerns related to one of the areas of special focus.

It’s best if everyone involved in the treatment communicates with each other as a team. That way, adjustments can be made to treatment as needed. And to minimize the ‘he said she said’ that can happen when direct communication is missing.

4. Treatment planning

A comprehensive approach to treatment is ideal. Eating disorders are complex and require several specialists.

Make a plan for eating disorder treatment. This may include settings goals, providing some education, creating parameters for safety, and coming up with a crisis plan.

Treat physical complications. Health and medical issues need attention. That being said, often the sufferers’ lab results are normal. Normal lab results DO NOT mean everything is fine.

Identify resources. Find out what resources are available. Are there support groups, for example, either online or in person? How about specialized movement classes, such as yoga for eating disorders?

Make sure resources are eating disorder sensitive. For example, taking a rigorous yoga class is not a good idea. However, a gentle class taught by an instructor who’s eating disorder informed could be helpful.

Speak with your insurance company to discuss coverage for treatment, regardless of the level of care needed. The insurance company will pay more over time for someone with an untreated or partially treated eating disorder.

Medications don’t and can’t cure an eating disorder. They work best when combined with therapy.

The most common medications used to treat eating disorders are antidepressants. Especially the eating disorders that involve binge-eating or purging behaviors. Antidepressants may help reduce symptoms of depression or anxiety. These symptoms often co- occur with eating disorders.

Medications for physical health problems caused by the eating disorder may also be required. For example, co-occurring gastrointestinal symptoms (constipation, diarrhea, reflux) are commonly treated with medications.

Therapy is a must to successfully treat an eating disorder. The psychological aspects of an eating disorder can be as difficult or even harder than the physical recovery.

Cognitive behavioral therapy (CBT) is a common and effective treatment for eating disorders. CBT improves attitudes about body shape and weight, replaces dieting with Intuitive Eating, and helps develop coping skills.

5. Have hope

Treatment works! Healing happens!

Generally, treatment is more effective before the disorder becomes chronic. However, even people who have had an eating disorder for many years can and do recover.

Eating disorders rarely, if ever, just go away on their own.

It’s OK if you “slip-up” during treatment. It’s normal. With each relapse comes opportunity to fine tune treatment and re-commit to recovery.

The most important takeaway message: People recover. Fully.

Your loved one (including if it’s you) with an eating disorder can too. The key to healing is being in the right level of treatment as early as possible. And staying hopeful along the way.

I am Dr Elayne Daniels, a MA-based, anti-diet, certified Intuitive Eating psychologist. My passion is helping people conquer eating disorders, feel comfortable in their body, and live a life of meaning. Contact me here for more information.

11 Empowering and Inspirational Quotes for Depression and Anxiety

A painting of a woman in an orange dress who appears to be suffering from depression or anxiety and who could benefit from inspirational quotes

If you have depression and anxiety you’re probably looking for ways to feel less alone. While there is no magic quote that will make depression and anxiety vanish, sometimes quotes can shift your perspective enough that you start to feel better. With that in mind, these empowering and inspirational quotes for depression and anxiety can give you that emotional boost you’re looking for.

Everyone has a different response when they read a quote. Maybe, just maybe there are quotes that help you feel understood. Or that provide hope. Maybe even a shift in perspective. Or how about a smile or chuckle?

Pay attention as you read this collection of 11 empowering and inspirational quotes. Notice which ones make you feel understood or hopeful. Be mindful of any other way your perspective shifts even a smidge.

1.“The way you tell your story to yourself matters.”

– Amy Cuddy

2.”What the caterpillar calls the end, the rest of the world calls a butterfly.”

– Lao Tzu

A photo of a butterfly representing an inspirational quote for anxiety and depression

3.“If you think you are too small to make a difference, try sleeping with a mosquito.”

–Dalai Lama

4.“Mental pain is less dramatic than physical pain, but it is more common and also harder to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say ‘My heart is broken.’”

― C.S. Lewis, “The Problem of Pain”

5.“Slow breathing is like an anchor in the midst of an emotional storm: the anchor won’t make the storm goes away, but it will hold you steady until it passes.”

-Russ Harris

Take a breath. Diaphragmatic breathing is one way to feel better fast. Try it before and after repeating inspirational and empowering quotes for Depression and Anxiety.

6.”Ring the bells that still can ring. Forget your perfect offering. There is a crack, a crack in everything. That’s how the light gets in.” 

—Leonard Cohen

7. “Imagine you’re 90 years old. You’re looking back on your life, as it is today. Finish the following sentences:

–Russ Harris

  • I spent too much time worrying about…
  • I spent too little time doing things such as…
  • If I could go back in time, I would…”

Find inspiration and empowerment in recognizing that in this very moment, even with Depression and Anxiety, you have the power to choose.. to look back, look ahead, and/or be where you are, now.

8.“I will love the light for it shows me the way, yet I will endure the darkness for it shows me the stars.”


Og Mandino

9. “When one door closes, another opens. But we often look so regretfully upon the closed door that we don’t see the one that has opened for us.”

Alexander Graham Bell

Every ending also means a new beginning. The beginning may emerge by navigating Depression or Anxiety.

10. Acceptance doesn’t mean putting up with or resigning yourself to something. It (acceptance) is about embracing life, not merely tolerating it. Acceptance literally means “taking what is offered”. It doesn’t mean giving up or admitting defeat. (Nor does it) mean just gritting your teeth and bearing it.

It means fully opening yourself to your present reality – acknowledging how it is, right here and now, and letting go of of the struggle with life as it is in this moment.”

–Russ Harris

11. “No matter how hard the past, you can always begin again.”

–The Buddha

Experiencing joy and suffering, and everything in between, is what being human means.

Along the way, there may be bumps in the road. When those bumps are in the form of depression or anxiety, remember to pause and become conscious of your breathing.

And, remember Dalai Lama’s words and be sure there is no mosquito in your bed.

I am Dr Elayne Daniels, a licensed psychologist practicing in the Boston, MA area. I integrate eastern and western tradition with traditional forms of psychotherapy to help people live a life they enjoy.

If you need immediate help, consider these resources:

How to Overcome Poor Body Image and Body Dissatisfaction

Tips for how to overcome poor body image and body dissatisfaction tend to be generic. Or at least limited.

Suggestions such as valuing what is inside and not just what you look like on the outside. Focusing on what your body can do instead of how it looks. Or that how you look is not that important.

These ideas can feel oversimplified. Like “just do this and you will feel better.”

Except it is not that easy or simple.

What I’ve found helpful to overcome poor body image and body dissatisfaction is to widen the lens.

Widening the lens is about taking a step back to shift perspective. A pivot of this sort can help create more flexibility in how you think and feel about your body.

Let’s talk first about why poor body image and body dissatisfaction are important.

And why overcoming them is actually one of the most powerful, revolutionary declarations of (your) worth.

Even just thinking about these ideas can be helpful in the process of overcoming poor body image and body dissatisfaction.

What is body image?

We all have a body and therefore a body image.

Body image is the relationship you have with your body. It includes thoughts, feelings, perceptions, and behaviors. In other words, body image is how you see, feel, think about and perceive your body. Appearance has a lot to do with body image. Especially in Diet Culture. (Don’t know what Diet Culture is? Check this out.)

Body image ranges from negative to positive.

Body image concerns can affect every one of us – regardless of age, gender, or culture. The concerns often begin at a young age and continue throughout life. Especially in Diet Culture.

Most people’s body image is either positive or negative. Rarely is body image somewhere in the middle, especially for females, and increasingly for people of all genders. Particularly in Diet Culture. (Are you starting to see a trend here with the impact of Diet Culture?)

Positive body image is when you feel comfortable in your body, accept your body and weight, and know that weight and appearance don’t define your worth as a person.

Negative body image includes evaluating your body critically and emphasizing what you consider to be flaws. Depression, shame, sadness, and jealousy often accompany negative body image.

Poor body image is one of the best predictors of anorexia or bulimia.

One of the main causes of poor body image is comparing your body to someone else’s.

Body image can be viewed as a state or trait.

Body image as a state refers to the idea that a person’s relationship with her body changes across contexts. As in depending on the situation. A person may have negative body image, for example, at the beach in a bathing suit. Her body image may be better when she is wearing an oversized sweat shirt and yoga pants.

Body image as a trait refers to body image as a consistent, stable quality across situations. Whether a person is at a beach in a bathing suit or in an oversized sweatshirt and jeans at school, body image is similar.

Most people think of body image as a trait. However, it can be state dependent. Meaning how a person feels about their body may depend on the context. There are even questionnaires that specifically focus on body image in a variety or situations. Examples are the Situational Inventory of Body Image (SIBID) or the Body Exposure during Sexual Activities Questionnaire (BESAQ).

Efforts to improve body image affect mental health and well being

The Body Positive movement (aka BoPo)

BoPo promotes size diversity, body love, and improved body image, regardless of age, form, gender, race, or abilities. Its tagline is “all bodies are good bodies”, while challenging the ways society presents and views the physical body.

A criticism of the BoPo movement is that emphasis remains on appearance. And on the ‘how you look =self worth’ link.

Maybe we do not have to love our bodies in order to improve body satisfaction?

There are other options for navigating poor body image and diet culture without introducing a new standard of beauty.


Say what? Well, how about taking less of a leap. Instead of BoPo, what if the goal were Body Neutrality.

The Body Neutrality movement

Why continue to feed into society’s obsession with beauty?

The concept of body neutrality is that you don’t have to like how you look in order to honor your needs. That there is more to your body and to you than just how your body looks.

What if you weren’t as concerned about your body size or shape?

In a paper published in the 1990s, I asked the same question. There’s no denying that culture has taught us to obsess over our appearance in all ways – whether it’s telling us we need to be photoshopped, that our booty should be more lifted, or that stretch marks and curves are what makes a “real woman.”

Frankly, it can be a relief to duck out of the obsessively body-centric conversation altogether.

Just think – how much more brain power and energy we could devote to other worthy causes. How much more could we just plain relax and find inner peace, if our appearance wasn’t constantly taking up center stage?

When you approach your worth from a different lens you become closer to unconditionally accepting who you are. Inside AND out.

You are more than flesh and bones. See yourself as the entire, soul-filled wonder you are.

Dr Elayne Daniels is a psychologist and coach specializing in helping people transform their relationship with their own body. Please join me – and be a part of this revolution!

What It REALLY Means If You’ve Been Diagnosed With Anxiety or Depression

A woman peering through leaves of a branch appears depressed and anxious, as if looking to better understand what her diagnoses mean.

Have you been diagnosed with Anxiety or Depression? If so, now you know that what you’re feeling has a name. You also know you aren’t alone. It is an actual ‘thing’. And maybe, just maybe, there is a silver lining.

A diagnosis of Anxiety and/or Depression is increasingly common. Especially post global pandemic.

But what does it really mean to be diagnosed with Anxiety or Depression?

One thing it might mean is you recognize you haven’t been feeling ‘yourself’. Or maybe family and friends have commented that you do not seem like your (regular) self.

Perhaps you’ve met with your primary care doctor and/or a mental health professional. Maybe a psychiatrist, or a social worker or psychologist. And that person has diagnosed you with Anxiety or Depression.

A diagnosis puts you one step closer to healing.

How can you ‘fix’ a problem if you don’t know what the problem is? A diagnosis can be clarifying.

Thank goodness you asked for help. That in and of itself is a win!

As the saying goes, you gotta name it to tame it.

Being diagnosed with Anxiety or Depression can be the start of actually feeling better than you have in a long time. (Hello, silver lining.)

A diagnosis helps you know what you need to feel better. Maybe more emotional support? How about therapy? Or medication? Perhaps some combination?

This video clip speaks to the value of treatment.

There are treatments available for Anxiety or Depression. And providers of a variety of disciplines are available to offer you their expertise and recommendations.

We’re definitely not talking about a “one size fits all” approach.

Some interventions target both disorders. For example, many different forms of psychotherapy are available to treat anyone diagnosed with Anxiety and/or Depression. For instance, Cognitive Behavioral Therapy (CBT) is a method of treatment with high success rates for people with both Anxiety and Depression, or with symptoms of one or the other. Certain medications, such as Selective Serotonin Reuptake Inhibitors (SSRIs), have anti depressant and anti anxiety effects.

People diagnosed with Anxiety or Depression are more likely to have first degree relatives with mental health challenges. Whether or not those mental health problems were identified ‘back then’ is a different story. At least in modern day, people are generally more comfortable seeking help than were their predecessors.

Fortunately, stigma surrounding mental health is beginning to lessen, especially post COVID. (You’re part of a stigma reducing force, effecting change in the world.)

Bottom line: Treatment improves prognosis.

That said, sometimes successful treatment is a bit of “trial and error”. For instance, maybe the therapist you meet with is not a good match for you. The chemistry isn’t there. Or, the therapy approach doesn’t jive with your style. Maybe the therapist’s office or mannerisms make it hard for you to feel comfortable.

Medication may be another source of “trial and error”. Neurochemical advances make the selection of medication a bit less daunting. Tests are available in which you send saliva to a lab, and a report comes back indicating which medications are likely a good match for your particular brain chemistry

Regardless of the type of formal treatment, you can try lots of things on your own to help yourself. The hardest part can be to find the wherewithal to try them.

Ironically, the very things you know would help can be just too hard to motivate yourself to do. Perhaps you don’t have the motivation (in the case of depression) or are too stressed out (in the case of anxiety).

Additional suggestions beyond professional help:

  1. Attend to the basics: sleep, nourishment, movement, and emotional support.
  2. Practice doing experiments: Check in with yourself just before and then after an activity (e.g. a 10 minute walk). Chances are you will feel better afterwards than before the activity.
  3. Self validate: Recognize your efforts and give yourself credit. Be on your own side.
  4. Remind yourself you are not alone: Anxiety and Depression are part of shared humanity.

Building blocks of physical and emotional health really do matter. Depression or Anxiety can be a nudge to strengthen your self-care.

Pursuing help for an Anxiety or Depression diagnosis is an empowering form of taking charge of your life. Maybe even a wake-up call to enhance meaning and quality. Take some breaths, and just one step at a time.

I am Dr Elayne Daniels, a psychologist in the Boston area, who helps HSPS, people with an eating disorder, and/or those with Anxiety or Depression to move forward in their life and THRIVE!