Anorexia Nervosa - Understanding the Signs, Symptoms, Causes, and Treatment

For people with anorexia, it really is true that one can never be too thin. Despite being dangerously underweight, anorexics see a fat person when they look in the mirror. What they don’t see is the tremendous physical and emotional damage that self-starvation inflicts, so they continue to diet, fast, purge, and over-exercise.

While people with anorexia often deny having a problem, the truth is that anorexia is a serious and potentially deadly eating disorder. Fortunately, recovery is possible. With proper treatment and support, you or someone you care about can break anorexia’s self-destructive pattern and regain your health and happiness.

What is anorexia nervosa?

Anorexia nervosa is characterized by an irrational dread of becoming fat coupled with a relentless pursuit of thinness. People with anorexia go to extremes­ to reach and maintain a dangerously low body weight. But no matter how much weight is lost, no matter how emaciated they become, it’s never enough. The more the scale dips, the more obsessed they become with food, dieting, and weight loss.

The key features of anorexia nervosa are:

• Refusal to sustain a minimally normal body weight
• Intense fear of gaining weight, despite being underweight
• Distorted view of one’s body or weight, or denial of the dangers of one’s low weight

There are two types of anorexia. In the restricting type, weight loss is achieved by restricting calories. Restricting anorexics follow drastic diets, go on fasts, and exercise to excess. In the purging type, people get rid of calories they’ve consumed by vomiting or using laxatives and diuretics.

Anorexia is most common in adolescent girls and young women, with a typical age of onset between the ages of 13 and 20. But people of all ages­—including men and children—can suffer from anorexia.

Effects of drug abuse and addiction

What makes drug addiction problems so challenging to face, as opposed to other mental or physical problems? Drug abuse affects the person’s life in many ways, including health, finances and stability. But it also affects the entire family, friends, colleagues-- and even the community. What’s more, the strong denial and rationalization of the person using drugs makes it extremely difficult to get help, and can make concerned family members feel like they are the problem.

Health, employment and crime

Those who abuse drugs have a greater risk for health problems down the road, from neglecting their own health to risk of infectious disease like hepatitis or HIV from sharing needles. Heavy drug use directly affects health as well, including lung disease, arthritis, heart problems, brain damage and death from overdose. Productivity at work often suffers, and eventually trouble keeping a job or even homelessness can occur. The urge to use is so powerful that criminal activity for money or more drugs can be a strong temptation.

Staying addicted: Denial and rationalization

One of the most powerful effects of drug abuse and addiction is denial. The urge to use is so strong that the mind finds many ways to rationalize drug use. Someone abusing drugs may drastically underestimate the quantity of drugs they are taking, how much it is costing them, and how much time it takes away from their family and work. They may lash out at concerned family members, making the family feel like they are exaggerating and overstating the problem. What makes this so frustrating for family members is the person abusing drugs often sincerely believes they do not have a problem, and can make the family member feel like the dysfunctional one.

This denial and rationalization can lead to increased problems with work, finances and relationships. The person abusing drugs may blame an “unfair boss’ for losing her job, or a ‘nagging wife’ for why he is increasingly going out with friends to get high. While work and relationship stresses happen to everyone, an overall pattern of deterioration and blaming others may be a sign of trouble.

Drug abuse and the family

Sadly, drug abuse and addiction doesn’t only affect the person abusing drugs. It affects friends, family and the entire society. Child abuse and neglect is much more common when there is drug abuse in the family. The abuser may neglect a child’s basic needs in the quest for more drugs, or lack of impulse control can lead to increased physical and emotional abuse. Drug abuse by a pregnant woman affects the developing baby’s health. Domestic violence also happens more frequently. Abusing drugs leads to higher risk of injuries and death to self and others in car accidents.

Family stress

If you have someone you love abusing drugs, it is an enormous emotional strain. You might feel obligated to cover for the abuser, cutting back from work to deal with the abuser’s problems— or working more to make financial ends meet. You might not be able to see friends and engage in hobbies, as coping with the abuse takes more and more time. The shame of drug abuse in the family stops many family members from asking for help, instead pretending nothing is wrong. The emotional toll can be overwhelming. Children are especially sensitive.

When someone you love has a drug abuse or addiction problem

You may not immediately realize that someone you love has a drug problem. It may have started slowly, and your loved one might also have tried to hide the extent of the drug use from you. You might have gotten so used to the drug abuse that coping with it seems almost normal. Or the realization that there is something seriously wrong is almost too painful to admit. Don’t be ashamed, and you are not alone. Drug abuse affects millions of families, from every socioeconomic status, race and culture. There is help and support available.

Does drug treatment work?

Addiction is a challenging disorder. Relapses often will happen, which can be frustrating and disheartening for the person using drugs and their family. But does treatment for addiction really work? It can- and does- for many people. Treatment varies from attending peer support meetings to staying in a residential treatment facility. Some people might use medications to help them reduce cravings for the drug.

Treatment is more than getting sober

While getting sober from drugs is an important first step, it is only the beginning of the recovery process. Once sober, the brain needs time to recover and rebuild connections that have changed while addicted. In this period, depression and cravings to use can be intense and very hard to fight. Without support, relapse is very likely. Good treatment helps you develop new coping skills to deal with stressful situations and triggers for relapse. Without these skills, stressful situations frequently trigger relapse.

Getting started

Realizing that you have a problem and that you need help is a tremendous first step. The following resources are a good place to start:

Peer support (AA, NA). A good place to reach out for support is a peer support group like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These peer support groups provide a place to share struggles with addiction and what others have done to stay sober. More information about these groups is below.

Therapy. If you are seeing a therapist, share your intentions with him or her. A therapist can be a good resource and support for addiction treatment.

Medical professional. Some drugs create withdrawal symptoms that require medical intervention. There are also medications that may help make withdrawal symptoms more comfortable. Your primary care doctor can be a good starting reference, and you may want to consider working with an addiction medicine specialist.

Maintaining alcohol recovery

Life without alcohol

The road to recovery is not easy. It takes time to readjust. Drinking might have been your way of coping with the many challenges of life, such as social, emotional or financial problems. When you first become sober, those problems come sharply into focus- and can feel overwhelming. Maintaining alcohol recovery includes identifying triggers to drinking, learning more adaptive coping skills, and making better decisions when dealing with life’s challenges.

Stay involved in a support group. Your chances of staying sober improve if you are participating in a social support group like Alcoholics Anonymous, have a sponsor, or are involved in an Intensive Outpatient Program or individual therapy.

Start or maintain healthy lifestyle practices. Basic self care practices are essential to good mental and physical health. Eating right gives you plenty of energy and helps prevent mood swings. Make sure you are getting enough sleep- 7½ to 8 hours a night for most. Exercise releases endorphins and improves your mood.

Continue to work on healthy coping skills. When life stresses occur, having healthy coping skills helps prevent turning to alcohol. Stress management skills go a long way towards preventing relapse. Skills to build healthier emotional awareness help keep you in balance and cope with adversity.

Identify people, places or things that are triggers for you. Building healthier associations is critical in the long run. Surround yourself with positive influences and people who make you feel good about yourself. A good support network can help you in this as well.

Practice how you will handle alcohol in social situations. Although you can avoid some situations, social situations involving alcohol will inevitably come up. You might want to role play with your sponsor or trusted friend or family as to how you will respond.

Choosing an alcohol treatment program

What should I look for in an alcohol treatment program?

When you start looking for alcohol treatment, you may see advertisements for programs in tranquil settings with gorgeous views. While amenities like that are nice to have, they also will probably come with a big price tag. Focus on what is truly important; appropriate licensing, quality of care during the program and follow up, and staff credentials. Things to check include:

Program accreditation and licensing. Several national accreditation agencies evaluate detox and aftercare facilities, checking whether they offer effective elements of treatment and a well-documented patient complaint process.

Studies measuring the effectiveness of the program's treatment methods. Treatment effectiveness is a new field of study, but treatment centers should at least have some statistics on their success rates, preferably from an objective external agency.

Type of aftercare program to prevent relapse. Intensive treatment requires follow-up. Programs should offer a well-run aftercare program, with referrals to appropriate self-help groups. It’s important that a staff member collaborate with you to create a discharge plan before you leave the program.

Beginning alcohol recovery: getting sober

The start to alcohol recovery is getting sober, also called alcohol detox. Alcohol abuse and alcoholism lead to a physical dependence on alcohol.

The more you drink, the more you need for the same effect. For example, if you need a drink in the morning to steady your nerves, you’ve built up a dependence on alcohol. During alcohol detox, which lasts roughly 1 to 5 days depending on how much you drink, you may experience withdrawal symptoms as your body adjusts to no alcohol. These symptoms can range from mild to severe depending on your level of drinking and your general health. They include:

Agitation, insomnia, irritability
Headache, nausea, vomiting, loss of appetite
Hand tremors
Increased blood pressure, low grade fever, rapid pulse, heart palpitations
In severe cases, seizures, hallucinations and delusions

Contact your doctor about an initial plan for alcohol detox. You may be prescribed medication to make you more comfortable during the withdrawal process.

The plan might include outpatient monitoring, or, depending on the severity of drinking and other health concerns, an inpatient stay at the hospital. If you are considering residential treatment, some facilities allow alcohol detox on site, while others request that you complete the detox process before beginning residential treatment. More information about alcohol treatment programs is below.

The Road To Recovery – Alcohol Rehab and Treatment Options

Alcohol abuse and alcoholism happens in all types of families from all walks of life. If you are realizing you have a problem with alcohol, don’t try to go it alone or feel that you are weak. On the contrary, it takes enormous courage and strength to admit that you have an alcohol problem.

While it might feel overwhelming, millions of people and their families have gone through the recovery process and are leading successful lives. Recovery is possible with the right medical help and social support. Help and support is available to help you and your family through this process.

Does alcohol treatment work?

There are no easy solutions to alcohol abuse and alcoholism. Relapses often happen, which can be frustrating and discouraging. But does alcohol treatment really work? It can- and does- for many people. There are many types of alcohol treatment for all levels of alcohol use, from attending peer support meetings to staying in a residential treatment facility.

Treatment is more than getting sober

While getting sober from alcohol is an important first step, it is only the beginning of alcohol recovery. Both your body and mind need some time to recover. In this period, depression and cravings to use can be intense and very hard to fight. Without support, relapse is very likely. Like it or not, you will most likely face alcohol again since alcohol use is so common in our society. Good treatment helps you develop new coping skills to deal with stressful situations and pressure to drink socially. Without these skills, stressful situations frequently trigger relapse.

Getting started

Realizing that you have a problem and that you need help is a tremendous first step. You might realize that you are an alcoholic, physically dependent on alcohol. Declining health, a job loss, a lost relationship, or trouble with the law over alcohol might also be a wake up call. Maybe you are concerned about binge drinking, or seem to be turning to alcohol more and more to manage your problems.

The following resources are a good place to start. Remember, the earlier you seek help if you have a drinking problem, the better. It is not a sign of weakness or an inability to “handle your liquor”.

Trusted friend or family. Trusted friends or family might be a good sounding board for concerns about alcohol abuse. Alcohol might be affecting you more than you think, since denial is a key part of alcoholism.

Peer support. Peer support groups like Alcoholics Anonymous (AA) provide a place to share experiences with alcohol abuse and others experiences in alcohol recovery. More information about these groups is below.

Therapy. If you are seeing a therapist, share your intentions with him or her. A therapist can be a good resource and support for alcohol treatment.

Medical professional. If you are an alcoholic, getting sober may cause withdrawal symptoms that require medical intervention. Your primary care doctor can be a good starting reference, and you may want to consider working with an addiction medicine specialist.

When a loved one has a problem with alcohol

You may not immediately realize that someone you love has an alcohol problem. It may have started slowly, and your loved one might also have tried to hide the extent of the drinking from you.

You might have gotten so used to the drinking that coping with it seems almost normal. It might actually feel normal if there was an alcoholic in the family growing up.

The realization that there is something seriously wrong might be too painful to admit. Don’t be ashamed, and you are not alone. Alcoholism affects millions of families, from every socioeconomic status, race and culture. There is help and support available.

Understanding what is involved in recovery

You cannot force someone you love to stop abusing alcohol. As much as you may want to, and as hard as it is seeing the effects, you cannot make someone stop drinking. The final choice is up to them. The right support can help you make positive choices for yourself, and balance encouraging your loved one to get help without losing yourself in the process.

Don’t expect your loved one to be able to quit and stay sober without outside help. Your loved one will need help, support and new coping skills so that he or she will be able to resist cravings in a society where drinking is often glamorized. What’s more, if your loved one has crossed the line from alcohol abuse to alcoholism, she or he has built up a tolerance to alcohol. Withdrawal symptoms can be unpleasant, painful, and even deadly.

Recovery will be an ongoing process. Someone who abused alcohol will not magically be a different person once sober. Alcohol use may have been masking painful feelings that will bubble up to the surface. It also takes time for the body and brain to recover from the effects of alcohol. Learning new coping skills and how to apply them in stressful situations is an ongoing process.

Causes of alcohol abuse

Why can one person drink responsibly, while another drinks to the point of losing their health, their family and their job? There is no one simple reason.

Alcohol abuse and addiction is due to many factors. What’s more, since drinking is so common in our society, problem drinking can be hard to identify. Do you drink to share enjoyment or share a connection with others? If drinking is the only way you feel comfortable connecting to others, or you drink to mask depression, grief, anxiety or loneliness, you are at risk for alcohol abuse.

Some other risk factors include:

Family history of alcoholism. While the interplay between genetics and environment is not entirely clear, if you have a family history of addiction, you are at higher risk for abusing alcohol.
History of mental illness.Alcohol abuse can worsen mental illness or even create new symptoms.

Peer pressure. If people around you drink heavily, it’s hard to resist. If you are a teenager, you might feel you won’t be accepted. If drinking is common practice for work celebrations or entertaining clients, you might feel pressure to conform.

Stressful situations or a big life change. If you have a major change or a stressful situation in your life, without other coping skills, you might turn to alcohol to help you get through.

Alcohol Abuse and Alcoholism

Drinking alcohol is woven into the social fabric of our culture, and indeed many people enjoy the social and cultural connection of sharing a drink together. However, because drinking is so common in our society, realizing you or a loved one has a drinking problem can be a challenge.

The consequences of alcohol abuse are serious. Alcohol abuse causes extensive damage to your health, your loved ones, and society. It results in thousands of innocent deaths each year, and exacerbates situations involving violent crimes and domestic violence. Learn about alcoholism signs and symptoms, what you can do, and how you can help a loved one.

What is alcohol abuse?

Social drinking is common and popular is many cultures all over the world. In several cultures, for example, a glass of wine or beer with a meal is common practice. Celebrations are often punctuated with a glass of champagne or other celebratory cocktail. And in many jobs, going out for drinks after work or entertaining clients with alcohol is the norm.

The difference between social drinking and alcohol abuse is when alcohol becomes your focus. You might only want to attend social events that involve alcohol, or you can’t enjoy yourself. Getting to the bar, or making a drink after coming home from work becomes more important than connecting with friends or family.

Alcohol might be your way to avoid painful feelings or troubled relationships. And you might resort to dangerous behavior, like driving while drunk or even increased violent behavior. Increased dependence on alcohol leads to alcoholism, where you are physically dependant on alcohol and have lost control of the amount you drink.