Depression – a way out

From a colleague

My name is Rachel, I work in the medical field. I enjoy writing and sharing my experiences with others. Over the last 25 years I have experienced periods of deep sadness, anger and thoughts of not wanting to be alive anymore. Thankfully they do not last long – perhaps a few days.

As a doctor, It’s very tempting to “diagnose” myself. Is this depression? Having that sort of label can be very comforting when in pain. It appears to make the whole experience understandable. It places it in a container and it feels easier to understand something tangible. It’s also easier when talking to others, “I’m struggling with depression.” Most people have heard of “depression” before. They know the Royals talk about it and there are various campaigns out there designed to raise awareness. I applaud this work. It’s important to talk about how we feel.

I started writing articles around 20 years ago. I was probably experiencing similar feelings then, although back then it felt normal and it lasted longer. I found writing down my thoughts helped. These days, I am more interested in finding out what I can do to get myself out of this head space. This helps me to help others to do the same. I find this very rewarding.

At the moment, I am struggling myself. This article is hard to write. In actual fact, its much easier to write about the “difficult stuff” than the “positive stuff”. There is a critical voice screaming at me and It feels as though my head has become stuck and the usual fluidity of my thoughts has stalled. But I know it will change and that gives me hope.

So what helps? These things help me and perhaps they will help you too. I should say that if you are experiencing thoughts of wanting to harm yourself and you feel unsafe, please do seek help immediately and talk to someone. This may be your GP, or the Samaritans or someone who you trust. This article is very helpful

1. Sitting and thinking about how bad things are doesn’t help. It actually seems to make things feel much much worse. This is a habit for me and I can kid myself into thinking that I am doing something productive. It increases the feelings of stuck-ness and inertia. Doing something, anything other than this is going to be helpful. This might mean getting out of the house, walking briskly or a change of scenery.
2. Taking the pressure off is helpful. I have a tendency to be self-critical at times and I drive myself extremely hard to perform and succeed. This is another habit and these habits can feel normal and comfortable. A few months back, I started to see the price of this behaviour and now painful it could be. So I started to give myself permission to rest. To do nothing at times. To accept that a “good enough” piece of work was ok. To tune into myself and pay attention to what it was that was needed at this moment in time. To be kind. Interestingly I also found that when I was kinder to myself, it was easier to be kinder to others and that helps to make the world a better place. Self-compassion for our humanity is really important. Kristin Neff’s work on compassion is really worth looking at. Here’s one of her TED talks
3. Get out of bed, shower and dress. It helps.
4. About social media. I think social media has many positives. I think it can also be a miserable place at times. The key I find is to cultivate an awareness of how we are feeling and asking the question – Is our social media experience making things better or worse for us at this moment? If the answer is that it is making things worse, stop for the moment. I think a key for understanding and getting out of these head spaces is noticing the supposed cause / effect nature of things. The things that make the situation worse (and better) are usually pretty predictable. Do less of things that make things worse and more of the things that make things better. It’s about getting to know yourself better. This takes practice and is not an overnight job. Be kind to yourself.
5. Spending time with people. Spending time with people who accept where we are at the moment can be very helpful. There is also a human need to be understood and accepted. I’ve certainly noticed a real need to communicate how I am feeling to others. If I sense that they accept me as a person despite how I’m feeling, this is deeply helpful. People may not understand and I think it’s important not to take this personally because they may not have a frame of reference for the experience. They may not be able to cope with strong feelings in others. There could be something else going on – who knows? I tend to choose the people I spend time with when I am feeling like this. I have many good relationships but some people don’t really know what to say or do and that is ok. It is what it is. The only person who can change me is me but being with others sometimes helps to facilitate this.
6. Do something for someone else. This is helpful. I know many people who volunteer or help the homeless in their spare time.
7. The comparison habit. This is a common one. I think I heard the TV presenter Fearne Cotton describing it as to “compare and despair” If you think about it though, you are not really comparing “like with like” as people are so individual. I think it is more helpful to compare “oneself with oneself” over time. To see progress and to celebrate progress.
8. “This too shall pass” This is a slogan from the 12-Step program of Alcoholics Anonymous. I’ve found it best applied after the event. Once we have experience of knowing it passes, we can apply that experience the next time. I think Winston Churchill described it well when he said “If you’re going through hell, keep going.” It does and it will pass.
9. Damage limitation. For me, getting through these episodes is akin to preparing a boat to ride through a storm. It’s generally a good idea to batten down the hatches, reef the sails and make things as straightforward and simple as possible. Put off large decisions that can be put off, protect close relationships by avoiding arguments and allow people to be supportive. Sleep, eat sensibly and make time for rest.
10. Remember these experiences are not you. They are things that the brain and the mind do and the totality of what makes “you” “you” is so much more than this. It like confusing the trombone with the entire orchestra.


Help and support for UK doctors, dentists and medical students concerned about their use of alcohol and drugs

I spoke to a group of consultants yesterday about the work of the Sick Doctors’ Trust, a charity that exists to support addicted doctors and dentists. Following the talk, a number of my colleagues welcomed the information given, as apparently, it’s not always clear what sources of help are out there for this group of professionals. Here’s a quick synopsis:

For doctors and dentists

If you are concerned about your drinking or drug use, talk to somebody. Addiction is a great isolator and the denial is usually very strong. Ask yourself “Is this problem costing me more than money?” If the answer is yes, then please seek help. You can obviously see your GP who can refer you into NHS or private addiction treatment services. Some other resources are listed below.

The Sick Doctors’ Trust

The Sick Doctors’ Trust  is a charity that was set up in 1996 by a group of doctors recovering from addiction. They operate an 24/7 phone line which will be answered by one of their trustees and they are happy to take anonymous enquiries.  All of their trustees have personal experience of addiction. They can put you in touch with other recovered professionals in your area and help you to find sources of face to face help and treatment.

The Practitioner Health Programme

PHP is a specialised NHS service for doctors and dentists. They will see and provide treatment for those with addiction issues. There is currently funding for London residents. Those outside London can access PHP as a self-funding patient or through local CCG funding (if approved). If you are a GP or GP trainee in England, you can also self-refer to the GP Health Service.

Narcotics and Alcoholics Anonymous

These are countrywide mutual support groups that are based on the principle of the 12 Steps. It’s a spiritual, not a religious programme and all are welcome. Meetings are plentiful in the larger cities with many daytime and evening options. There are also online meetings. Cost is by donation at the end of the meeting. To find a local meeting, put your postcode into the meetings finder box on the website and turn up.

Alternatively, you can ring the helpline listed on the website and the coordinator should be able to arrange for a local member to meet you at the meeting.

SMART Recovery

This is another style of mutual-aid recovery meeting which is countrywide. There are quite a few meetings in the larger cities and environs. There are also online meetings for those who prefer this format

Action on Addiction

A national charity providing residential and community based addiction treatment

For family members

Addiction affects the whole family and typically, family members and friends will constellate around the individual who is drinking or using and try to help them stop. This is completely understandable behaviour and usually ineffective because, try as we might, we cannot make someone else change.  The decision has to come from them and helping a friend or relative into recovery requires a “tough love” approach which appears counterintuitive. If you are a family member or friend, get some help and support for yourself first. There are a number of groups out there specifically for you.

Families Anonymous for the families and friends of those using drugs

Al-Anon for those concerned about another’s drinking

SMART Recovery also run family groups and details of these can be found on their website

The British Doctors and Dentists Group

A country-wide recovery group for doctors and dentists wishing to recover from addiction. There are currently 17 groups in the UK and Ireland – mainly in the big cities. They meet monthly and provide a useful source of support for those in recovery. Please contact the Secretary Andrew M for specific times and locations of the meetings

So, what’s the difference between colds and flu?

This time of year, we tend to see a lot of people experiencing symptoms of (mainly) colds but sometimes flu. More confusingly, people will sometimes think they have the flu when really they have a heavy cold. Sometimes it can be difficult for medical professionals to tell. More confusingly, heavy colds that are not flu are sometimes referred to as “flu-like” illnesses. So what is what? And are there any helpful pointers that help us to decide what it is what and more importantly what we can do to help ourselves?

So what is the difference?

This information is taken from NHS Choices with a little bit of my own observation thrown in.

Flu or to give it its full name – Influenza, is a viral infection spread by coughs and sneezes. It predominately occurs in the winter.

People often ask me how you get it and the simple answer is that you get close enough to someone to take the virus into your own respiratory passages via droplets of their cough or sneeze. You can also catch flu from touching a surface or a tissue which has the flu virus on it.

The flu strains may change every year and there is a vaccine available which contains the most common flu viruses thought to be circulating that season. The vaccine is thought to take a couple of weeks to work and this is why the recommendation is to have it as early in the season as possible (around September – October). You can find out more about the flu vaccine here

Flu generally comes on very quickly (within hours) and people tend to feel a lot more unwell that they would with a cold. It also tends to affect more than just the nose and the throat. Typically cold symptoms involve a snotty nose, a mild temperature between 37-38 degrees, sore throat and general aches and pains. Interestingly, although the NHS choices website says that colds tend to come on more gradually, I think they can actually come on quite suddenly as well. However, flu tends to have wider reaching effects on the body and people feel more unwell.

With flu, there will be a sudden high fever (>38 degrees) with a myriad of other symptoms. These may include:

  • Generalised body aches
  • Feeling very tired with a loss of appetite
  • A dry cough
  • Sore throat
  • Headache
  • Loose stools
  • Nausea

The key for me in distinguishing between colds and flu is the degree of functional impairment. With flu, people are wanting to stay in bed, wanting to rest and getting up and going to work is generally not an option. There is a standing joke amongst doctors and patients that if you have managed to get into the surgery, you have probably not got flu! Thankfully flu in most people will get better on its own within seven days. So why do we vaccinate against it? Well the simple answer is that it can kill or cause complications such as pneumonia or a worsening of asthma.

Certain groups namely the elderly, children, pregnant women and those with chronic disease are thought to be most at risk. This is why the flu vaccine is offered free on the NHS to these groups.

Here’s some more NHS Choices advice on flu: and colds

How to treat yourself

Rest is key here and rest means rest. It means switching off emails and distractions and focussing on getting better. Sleep is also helpful to allow the body to heal. It does seem that increasingly people find it very challenging to stop doing things. Recently I’ve come across a number of workers who are unwell but have chosen not to go into the office but “work from home”. This means that they unlikely to pass the illness on to their fellow colleagues but they are hardly resting and I suspect this will delay their recovery. It’s ok and essential to put the recovery first.

Treat fevers and aches with paracetamol or ibuprofen. I’d suggest checking with your pharmacist if you have a history of liver disease, stomach ulcers or asthma or kidney problems as these medications may not be the most appropriate ones for you. Drink plenty of water (so that the urine runs a light yellow colour). The advice above is also applicable to colds which are generally less disruptive than flu.

When to seek medical advice

This advice is taken directly from the NHS choices website. It’s recommended that you contact NHS 111 or your GP if:

  • You are worried about a baby or a child’s symptoms
  • You are 65 or over or pregnant
  • You have a long-term medical condition – for example heart, kidney or lung disease
  • You have a weakened immune system – for example someone receiving chemotherapy or taking long-term steroids
  • Your symptoms don’t improve after 7 days

To close

This article is designed for educational purposes only and is not intended to replace professional, personalised advice from your doctor. Please, if you feel ill and are unsure or concerned, seek advice from a qualified health professional which could be your GP or Accident or Emergency if you have a life threatening medical problem. If you unsure, NHS 111 – can help you decide.

Some cool apps for 2018

As promised, here are some great paid apps for the new year. I’ve tried them out and written a short description of each.

Blinkist. For those that like reading and ingesting facts, but are short on time. The “Blinks” are short synopses of current and trending books condensed into written overviews that take around 15 mins to read. There’s around 2000 nonfiction books in the database. The Blinks, as a stand-alone, are high quality with good information. They’re never going to be a substitute for reading the actual book, but it’s a start and a good one at that. They work best, it seems, when you need to assimilate information quickly about a wide range of topics. Great to nose and then you can buy whatever “whole books” you fancy.
Cost – from $49.99 to $79.99 per year depending on which package you go for. They also have a free version where you get to read one selected Blink per day.

Yoga Nidra App. Yoga Nidra is a deep relaxation practice that helps to relax and reset the entire body system. I’d been practicing for some time, using some of the excellent videos on YouTube, when I came across this app by Madhav West. He’s a trained Yoga and Mindfulness teacher from Australia and the app is simply brilliant. This program contains three guided meditations of varying lengths, incorporating traditional aspects of yoga nidra — visualisation, body awareness and breathing. I’ve noticed greatly improved sleep with my daily practice.
Cost £3.99. There’s also a Lite version which is free.

Heart Rate Variability Training. Heart Rate Variability (HRV) is the beat to beat variation between successive heartbeats. The greater the time variation between each beat, the greater the HRV. High HRV is associated with many health benefits and you can find out more here: You used to have to buy a fairly costly telemetry lead to measure HRV on your phone but now the technology has advanced sufficiently to allow the smartphone camera to function as a measurement device. It’s perhaps not as accurate, but a lot more convenient. This app computes your daily HRV and tracks it alongside exercise, sleep and lifestyle data.
Cost £9.99

Curable app for chronic pain. This is a bit of a cheat as I covered Curable in my last blog. Here’s a little bit more about the app. The three founders of Curable had experienced persistent pain themselves and wanted to develop low-cost tech method of helping those without access to mind-body physicians. The methods it delivers are supported by medical research and pain science. The actual site has a lot of free content and blogs explaining the links between persistent pain and the mental, social and physical aspects of the person. It features Clara – a virtual pain relief coach who guides you through the online program. The paid program incorporates aspects of education, brain training, journalling and meditation. There are many positive reviews to be found on the internet, in particular one guy who experienced an 80% reduction in his migraines within weeks. Good stuff.
Cost monthly subscription $12.99
Yearly $95.88

Yin Yoga with Simon Low
Yin yoga is a gentle yoga practice that focuses on balance and restoration. It works into the connective tissue, fascia and bones and provides an alternative to the faster paced, muscular “yang” practices. Yin is great to do after the more vigorous Ashtanga sequences. There are three different tracks on the app.
(I couldn’t copy the exact link. If you google Yin Yoga, Simon Low, it will come up)
Cost £1.99

Universe of Emotions by Complete Coherence
I came across this app following a recommendation. It’s actually rather fun. Designed to improve the recognition of emotions, users are invited to journey through a metaphorical universe peppered with 2000 emotional “planets”. Some of the planets have orbiting stars which break the emotional state into different facades. The idea is that once you can identify roughly what you are feeling, you can journey to the respective planet, examine its stars and fit the emotion into its linguistic box. There’s even a diary to track your emotions and share them with your friends. I haven’t used this function as I want to keep my friends and in fairness they are probably not all that bothered. Off to the miserable planet…
Cost £1.99


Interesting websites for 2018

2018 is now upon us and here are some interesting websites for you. I’ve included sites I’ve found interesting on my travels through health, psychology and the mind-body connection. It’s a mishmash of themes loosely based around humanity, our health and recovery and our connections to one another.

The Stress Illness Recovery and Practitioners Association
SIRPA was established in 2010 by physiotherapist Georgie Oldfield. Her network of practitioners work with those experiencing chronic pain. The approach helps people to recover from pain and get on with their lives. There are no pharmaceuticals or suppression of symptoms here. Rather, people are helped to feel and process unconscious emotions. The SIRPA website contains loads of material relating to the SIRPA programme as well as free content.

Curable Health
Curable is an app, launched in the US last year (from what I can gather). It’s designed to be an affordable way of helping those experiencing chronic pain. It’s based on the premise that the experience of pain, over time, tends to rewire the brain to become more sensitive to pain. The directions in the app help the user “de-wire and rewire” the brain, changing the pain signals so that over time the pain diminishes. As humans, we have the ability to change and rewire our brains through a process known as neuroplasticity. We can do this at any age and so it’s never too late to start doing something new with your body and mind. The podcasts on the site are well worth a listen.

Sustainable Human
This website popped up on my Facebook feed one day and when I realised that some of my colleagues had liked it, I did too. Yes, Facebook has power. The aims of Sustainable Human are to highlight the roots of our current sustainability crisis and to examine and promote ways of improving the connections with have with ourselves, others and the planet at large.

The Conversation
A great site for good-quality independent journalism, highlighting issues affecting us as humans. The Conversation started in Australia in 2011 and its authors are based globally, reporting to a Central London newsroom.

Greater Good Magazine (produced by UC Berkeley, California)
I do love this website. I can’t fully describe it in a few sentences – it’s a huge site with various different aspects to the content. It’s free and marries scientific research with tools and hacks to create a more meaningful life. There’s a large focus on social relationships, happiness and improved mental wellbeing.

Functional Medicine
Dr Chris Kresser is a world expert in the field of Functional and Evolutionary Medicine. There is a strong emphasis here on paleo-ancestral origins in health and thankfully less focus on drugs and symptom suppression. His work is evidence-based and a useful resource for patients and clinicians seeking a different way to health.

Childhood respiratory tract infections
A downloadable PDF for parents with young kids. The leaflet is produced by the PRIME Centre at Cardiff University. It covers all the common respiratory childhood infections (sore throat, earache and chesty coughs). It helps parents to know when they should seek medical advice and when they can sit tight. It’s one of the most helpful leaflets I’ve seen and I refer to it regularly when I’m seeing children. Download a copy and keep it on your phone.

Next blog – interesting apps for 2018

Five things I learnt from observing my cat

Every Christmas, the British Medical Journal publishes a Christmas article which is slightly amusing and tongue-in-cheek. I thought that it was only fair to produce my own offering of a Christmas article that has nothing to do with Christmas.

Recently we became proud owners of a cat called Monty. Here’s a picture of him.


He’s six years old and used to belong to my sister who works as a vet in Cheshire. Consequently he’s been well looked after and well-trained (if you can train a cat!). They say that you never really own a cat, the cat owns you and this is true to my mind. It’s interesting to observe them interacting with the environment and I think we can learn at lot from them. Here are five things that came to my mind.

1. It’s ok to go back for a second look at something if you are not sure about it. We live in a society of fastness (if that’s a word) and there is often a compulsion to do things quickly so that we can move on to the next task. Cats spend a lot of time visiting and re-visiting parts of their territory to check they are safe. They examine everything carefully, from all angles to fully understand it. Monty will ask to go out into the garden, sit on his butt for 2 minutes and then request to be allowed back in. Once in, he wants to go out again. I did wonder “Why on earth can’t this animal make a firm decision?” The reality is that he’s monitoring his environment to make sure he’s safe. We can learn a lot from this. Allowing ourselves to carefully examine our environment to the right degree keeps us in the present moment. We make better decisions, consider new perspectives and over time feel calmer and more in control.


2. Make time for rest and activity. Monty seems to spend most of the day sleeping. He has moments, interestingly when we are just about to go to bed, when he goes mad and charges around the house. This takes up quite a lot of energy for him and before long he is kipping on the sofa again. As a society, many of us are chronically tired. Some of this can be due to medical issues but more often that not I suspect that part of the issue is that we have lost the ability to relax. We live in a 24/7 society and if we rely on environmental cues to teach us when to switch off, we’ll be sadly lacking. Nothing external turns fully off anymore. We have 24 hour news, shops and screens. We need to learn how to balance our rest and activity internally through listening and knowing our bodies. Regular meditation is a way of doing this. Once we become aware of our internal CPU usage, like Monty seems to be able to do, we can manage our energy more effectively.

3. Ask for what you need directly. If you’ve ever watched the Simon’s Cat videos on YouTube, then you will know that cats will not hesitate to inform you if they are hungry, peed off or simply want to go out for a poop.

Simon’s cat produces this distinctive miaow and points to his mouth with his paw. Monty isn’t quite as sophisticated as Simon’s cat and will stand by his empty bowel, look from you to the bowl and repeat for however long it takes to get food.  A similar routine is performed with “asking to go outside” and indeed with most other human-feline interactions that take place within our home. It’s direct and we know where we stand with him.

Humans are not always this predictable. Often we don’t know what we need. We are so busy that we forget to eat and wonder why we feel cranky. Or we say yes to requests when we really mean a big flat “No”.

Firstly we need to become aware of what we need and this ties in with the points above. Tuning into ourselves and our environment and emotions is a good place to start. Working out what is most important to us in life is also useful. And thirdly, asking ourselves how we can get these needs met helps us to focus on what we need to do (or be) more of.


4. Spend quality time with others. Monty hates devices such as phones. In fact, if one of us is using an iPhone or Kindle, he will sit on the screen so that we are forced to give him attention. Obviously this would be a drastic measure to use on another human but the point is that we spend far too much time on our devices and not enough time making eye contact and talking to real people. I know many people who have built-in phone detoxes for parts of their day.  It can feel difficult at first, but the rewards are well worth it.

5. It’s ok to say “no” and do your own thing. Have you ever heard the expression “It’s like trying to herd cats?” I was reminded of this the other day when we were attempting to introduce him to the cat-flap. We followed the instructions and had one person situated on either side of the flap so that we could “guide” him through. There was a lot of protesting and so we abandoned the idea thinking he needed some time to get used to it. As soon as our heads were turned, he merrily trotted up to the door, used the cat-flap and came promptly back in. The lesson from this is that we don’t have to follow the crowd like sheep. If there is something that you want to achieve in life, then go ahead and do it. It’s far better to take the plunge and do something (regardless of the outcome) that to regret not even trying.

We hope you have a wonderful Christmas!

For amusing animated cat videos, go to the Simon’s Cat channel on YouTube

My Recovery from Bulimia

I was flicking through Facebook the other day and I noticed that a good friend of mine had been teaching yoga to members of the eating disorder charity Beat. It started off a chain of thoughts in my head about eating disorders and in particular bulimia – the focus of this article. I’m not planning on going into great detail in this blog about what bulimia is and its diagnostic features. If you want to find out more, please check out the Beat website –

Now I’m a GP, as you know and I quite frequently see people who are having issues with bingeing and vomiting. Many of the people I see who are experiencing symptoms of bulimia have lost hope that they can get better. This is a real shame as I personally know of many people who have recovered. I wanted to share the story of Elle – a close friend of mine. She struggled with recurrent episodes of overeating and vomiting. The problem began in her teens and finally ended in her 30s. She’s given permission for me to share her story and our hope is that it inspires others to believe that they can recover.

“I starting having problems with food when I was around 15 years old. I remember the first time I overate and made myself sick and I couldn’t really have given you a concrete reason why I did it. Obviously I was a teenager and I was concerned about my appearance. I wanted to look right and looking back, I thought about my weight and what I was eating a lot. If I overate, it was bad day and if I managed to control my eating, it was a good day. It was quite split like that. I loved sweet things and eating was comforting and this behaviour was a way of overeating and not having the consequences. That was how I saw it at the time. I was pretty ashamed of the behaviour and went to great lengths to hide it from my family. I actually think it was a while before they found out. It was a dirty secret and I kind of pretended it wasn’t happening. I went to great lengths to be perfect at everything I did.

I didn’t like myself much. I wasn’t sure of my passions, what interested me or what kind of person I was. I was pretty cut off in the department. I’d realised pretty early on that I was bright academically and this was my saving grace. I put most of my energy into my work and learning and did extremely well. This kind of compensated for the rest of me (which I hated) and and so this split emerged. The more inadequate I felt socially, the more brilliant I became academically.

There had been a few things that had happened in the years running up to my “food symptoms” developing that had been difficult. As a teenager, I’d been on the receiving end of violence from a male relative in the household. He was a bully and I honestly felt that he might kill me on occasions. His outbursts were usually triggered by something trivial (which was blamed on me) when in reality he should have been able to control himself. Following this, I’d lost a parent and was unfortunate enough to be sexually assaulted by a NHS care worker. I didn’t tell anyone about this episode. I kept it to myself and got on with it.

I did really well in my A Levels and went onto university. There my symptoms got worse and I was vomiting 4-5 times a day. I was also diagnosed with depression and was taking tablets for this. I did on occasions open up to health care professionals about my eating issues. If I trusted them that was. The reality was I was hugely ashamed of my behaviour. It was completely at odds to the image that I was trying to portray to the world of this sorted academic who had it all together. The other thing that frustrated me was that the questions that doctors would ask me did not make sense. They would ask me what my “triggers” were and why I did what I did. The truth was that I didn’t know what triggered it. I would be fine one minute and then it was like somebody had flicked a switch and I would find myself with my head down the toilet. I also felt that my childhood had been “fine”. Yes, bad things had happened but I had no real feelings about these episodes one way or another.

I met my first boyfriend at university. He was controlling, and a bit of a git. I was raped on on a couple of occasions and I tolerated it because I didn’t want to lose him. Eventually the relationship ended and looking back on it now, that was a huge blessing. The eating behaviour escalated at this time and this was the first time I started to notice patterns. It was worse with stress and better when I was more comfortable. I like to see this time as the beginning of my recovery as I started to see the driving forces behind what was going on. This made it far less scary. It’s much easier to change if you can see what’s kind of going on underneath.

So that was the depressing part of my story. I wanted to tell it because it’s part of my journey and it feels more authentic to do so. I did seek help from the NHS and the tablets for depression probably helped a bit.  I had this burning desire to fix it once and for all. I’ve always been a bit of a bugger with getting stuff done. If I was a dog, I would be one of those snappy ones that is always around the ankles. I find it hard to let stuff go and I like a challenge.

The next big insight came around 15 years later. I’d started to drink too much and had finally managed to stop. A couple of days later, the bulimia symptoms came back and I started to get the urge to vomit. The eating problems had been “quiet” for a few years but now the alcohol was off the scene, the habit reasserted itself.

It was then that I had a lightbulb moment. It seemed very likely that the same problem was driving both these behaviour patterns – that of bulimia and the excessive drinking. If I could get to the “root cause” of both these issues, then I could heal myself.

This was a revelation to me. Before then, I had thought of my body as broken. These behaviours just happened to me and I felt I had no control over them. Now I could see patterns, and I could work with patterns. I just didn’t know how to.

My next breakthrough came through practicing mindfulness meditation. We were encouraged to observe thoughts and feelings without judgement. Thoughts I was familiar with but feelings? I realised then that I had quite a bit of difficulty identifying my feelings. I knew if I felt good or bad but that was about it. I remember buying a book from the Wellcome Library in London about emotions and it went on to say that we had a huge number of emotions. There was anger, fear shame, guilt, envy and it went on. I was very intellectual about things. I wrote gratitude lists and I knew intellectually that each item was something to be grateful about but I didn’t yet know how to feel grateful. I became very curious about this and the next time I wanted to act out with food, I started to pay attention to what was happening immediately prior to the urge.  I realised that I felt bad.  With a bit of practice, I realised that it was shame that I felt and each time I got the urge to act out, the feeling was always the same. Bingo!

This didn’t stop the bulimia immediately but I felt far more empowered. I started to feel proud of myself and this feeling built to more positive feelings and with more positive feelings, the less I acted out. With practice, my ability to name and feel my emotions got better and I started to feel more and act less. It took some time and I had some slip-ups along the way. If something was bothering me, identifying the emotion helped me to solve the problem in a more effective way. Perhaps I needed to talk to a friend, go for a walk, take a break. I learnt how to look after myself and I started to almost honour myself and be amazed at the complexity of how my body worked. It no longer made sense to treat it like dirt and so vomiting became less attractive and over time I developed better ways to cope. The tablets were stopped (thank God) and I started to live.

The other thing that happened which was quite painful was that I started to grieve the losses and the shitty things that had happened in the past. There was a lot of anger and for a time I saw potential abusers in everyone. Sometimes my intuition was right and I needed to move away from certain people in my life. Other times I was seeing their behaviour through the lens of the past and at the moment I’m still learning to tell the difference. Its a daily journey this life. Sometimes it’s painful but it’s always an adventure and there is learning in everything. We always have choice and if we choose, we have freedom.”

So if anyone reading this feels that they having a problem with eating, please seek help. Please visit your GP and we can offer help and support. The Beat website is also very informative for anyone whose life is affected by an eating disorder.

This aticle is designed for educational purposes only and is not intended to replace professional, personalised advice from your doctor. Please, if you feel ill and are unsure or concerned, seek advice from a qualified health professional which could be your GP or Accident or Emergency if you have a life threatening medical problem. If you unsure, NHS 111 – can help you decide.