Relapse of bulimia

Relapses will occur, and it can be frustrating when they relapse. However, they do not mean that you have failed or that you will never fully recover. These setbacks are actually a normal part of the recovery process and provide opportunities to learn and strengthen recovery.

Let us first define these terms: Mistakes or slips are the appearance of mild symptoms, and relapses are the recurrences of frequent overeating or clearance.Because the error is a single event, it does not necessarily lead to recurrence. In addition, a person’s response to a mistake plays an important role in whether it will recur.

Look at statistics

If you have experienced a relapse, then you are in good shape.

In the first two years of recovery, the relapse rate of clients who successfully treated bulimia nervosa ranged from 31% to 44%.

Some studies have tried to determine the characteristics of clients that predict recurrence (such as calorie restriction, discharge symptoms, and body image disturbance); however, based on my clinical experience, I began to believe that a more useful research direction might be to focus on the impact of stressful life events on the body. And psychological symptoms (and recurrence).

A study by Grilo and colleagues (2012) examined the relationship between stressful life events and relapses in patients with bulimia nervosa and other unspecified eating disorders (AKA EDNOS, now called other categories of specific eating disorders). relation.

In this study, researchers conducted life event assessment, which is a tool to evaluate 59 negative events and 23 positive events. These events are divided into work, school, social/friendship, love, family, health and finance And other pressure areas. The results show that:

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Negative stressful life events, especially higher work pressure (for example, serious difficulties at work; being fired or dismissed) and higher social stress (for example, breaking up with friends or losing friends) increase the likelihood of relapse.

Measuring pressure

In my clinical work with clients dealing with errors and recurrences, I found it helpful to look at similar instruments. Social adjustment rating scale, A list of 43 stressful life events. This metric was published in 1967 by Holmes and Rahe. The purpose of this checklist is to catalog environmental events that often occur before the onset of mental illness in the patient chart.

A panel of judges assigned a life change unit (LCU) rating to these events. The scale includes such things as spouse death (the highest LCU score is 100), death of close family members (63), pregnancy (40), changes in financial status (38), and children leaving home (29). Even events that are generally considered positive, such as marriage (50), are included because each event is usually related to stress.

When they released the scale, Holmes and Rahe reported that the incident was additive. Therefore, if your spouse dies and leaves you without income, and your child runs away from home, your LCU score will be 100+40+29 = 169. Researchers say that a score of more than 300 puts someone at risk of illness. A score of 150 to 299 indicates a moderate risk of disease (30% lower than the high category). A score below 150 is only associated with mild disease risk.

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The Holmes-Rahe model has been criticized mainly for its failure to consider individual differences. The scale assumes that each stressor affects people in the same way, which is not necessarily true; for example, some people may feel that divorce is stressful, while for others, it may be a relief.

Talk to the doctor

Although it may not be a reliable tool in psychometrics, I find it useful clinically to help clients understand when and why a relapse may occur. The quantification of life events helps customers see stressors that they may rarely pay attention to.

It is important to discuss specific stressors in your life with your doctor or health care professional so that you can better determine the moment when binge eating is easiest to resume.

Bulimia discussion guide

Get our printable guide to make an appointment for your next doctor to help you ask the right questions.

If you have a recent relapse, it is worth checking this measure. It can be self-managed and consider whether you can identify the stressors in your recent life.

Usually, when a client experiences recurrence of symptoms, it is because of stressful life events and/or transitions, such as going to college or starting a new job. This is not surprising-when a person feels overloaded or faced with an unfamiliar environment, deep-rooted maladaptive behaviors will come back, and newer and healthier coping skills have not yet been entrenched.

If you have recently relapsed, it is important to review what happened and make a plan to get back on track. How you deal with the error or recurrence is actually more important than the occurrence of the error. Resolving it early and working hard can prevent a mistake from becoming a relapse or truly derailing your recovery.

What to do after relapse

  1. Acknowledge and acknowledge that the mistake or recurrence has occurred
  2. Don’t give up on yourself; practice self-compassion
  3. Determined to get back on track.
  4. Ask your support network and/or treatment team for help.
  5. Try to determine what caused the failure/recurrence and how you will deal with similar triggers in the future.
  6. Determine which techniques and coping strategies can help you recover from the past and you can use it again (for example, completing food records, a more diligent meal plan, etc.).
  7. Consider resuming treatment, perhaps even one or two intensive treatments.

In most cases, the treatment time after a mistake or recurrence is shorter than the initial treatment time, and soon you are likely to be back on the road to recovery.