Content note: descriptions of suicide and suicidal ideation.
September is National Suicide Prevention Month, and for anyone who has been impacted by an eating disorder, the awareness and prevention of suicide is necessary and essential. If you have been struggling with the overwhelmingly devastating thoughts that rob you of freedom and of presence in your life, you aren’t alone. Eating disorders have the highest mortality rate of any psychiatric illness for women and suicide makes up an elevated percentage of those deaths. Understanding what leads to suicidal ideation—thinking about and considering carrying out suicide—is necessary in order to prevent its occurrence.
Because living with an eating disorder causes so much isolation, disconnection, guilt, and shame, those suffering are often plagued by thoughts that the only way to end this tremendous pain is to end one’s life. Strong negative emotions, which stem from thinking that one is a burden on others, is misunderstood, alone, and to blame, serve to catalyze thoughts that recovery is impossible and that life is not worth living. I’ve heard patients tell me that their families would be relieved if they were to die because of all the pain that they recognize they are causing them, that no one would miss them because of how isolated and withdrawn they’d become from their friends, and that they would rather be dead than have to gain weight because of how thwarted their capacity to think had become.
Those struggling can often feel that they no longer belong to their own bodies, separate and disconnected from not only those around them, but also from their own physical self. I believe it is this sense of isolation and disconnection, from self and from others, that strongly influences one’s thoughts to become suicidal. Eating disorders are ruthless in their pursuit of the sufferer’s happiness. The mental agony that results from the disorder is like a vice grip on thinking rational, positive, and especially hopeful thoughts. This seduction into irrational beliefs that one is a burden, alone, and unworthy, is slow. It doesn’t start out that way, and that is why this line of thinking can become so toxic.
When one first dabbles in an eating disorder, thoughts tend to be that one is more powerful, more capable, and more connected to themselves than before. It is only after some time that the effects of the disease itself cause the sufferer to feel isolated, burdensome, and caught in the never-ending cycle of not enough-ness. But when this grip finally takes hold, it is brutal and fierce. The thoughts that the eating disorder create are irrational and illogical and will inevitably lead to suicidal thinking because the idea of overcoming the eating disorder becomes an impossibility, too far out of one’s reach.
Even if recovery may be far out of your own reach, it is not impossible. It simply will require that you ask for and receive support.
If you are struggling or if you are part of a team caring for someone who is, it is vital to get them necessary support from trained professionals if these thoughts begin to emerge. Any thoughts that you would be better off dead, that those around you would be relieved by your not being a burden on them, that you will never get better (hopelessness), that you would rather be dead than have to gain weight, or any other thoughts that leaving you feeling overwhelmed or in consideration of dying are three fire alarms to get into treatment now, and to develop a plan for how to keep yourself safe and alive until these thoughts dissipate.
Thoughts are not reality. They seem that way, especially when they are attacking our sense of truth: that we belong, that our lives matter, that we have inherent value, that we are purposeful. One way to begin to cope with irrational thoughts is to consider that your mind is, in fact, separate from the thoughts it thinks. An eating disorder causes thought fusion, where as soon as a thought emerges, it is accepted by mind as valid, and as truthful, and given considerable power. The truth, however, is not in every thought that pops to mind, especially when distorted thinking and irrational beliefs pop into mind. It is not a quick fix but the development of a meditation practice can be a helpful tool in discriminating real, rational thoughts from the lies and distorted thoughts offered up through the lens of the disorder itself.
Therapists can help you with reality testing your thinking by having you express your thoughts to them, and by helping you to weigh the evidence in support of or against the rationality of your thoughts. It’s important to understand that your eating disorder does not only distort the way that you perceive your physical body, but also the way that you perceive your psychological, emotional, spiritual bodies as well. It is ruthless in its pursuit of every single layer of who you are. Therefore, it becomes vital to launch a full force counter-attack, which includes the minds of rational others, to wage a winnable war against the machine of the eating disorder’s deception and despair.
If you are currently struggling, please reach out to your support team, friends, family, and treatment professionals for help. Your negative thoughts may be too powerful for you to disrupt alone because it’s too difficult to see the entire picture when you are in the frame itself. It is likely isolation and disconnection that are fueling the fire of these thoughts, and your ability to connect to someone else may be the missing link between your being able to save the life you may not realize now is still within you and potentially available for you.
There is hope to fully recover from an eating disorder. It is possible to feel differently about yourself, and to feel the freedom from this disorder. It’s just so overwhelming to try to find solutions alone. Please reach out to anyone who might be able to help you, or connect you to someone who can. You are worth being here, you are worth recovery, and you are worth inhabiting your life.
For recovery resources and treatment options, call the National Eating Disorders Association Helpline at 800-931-2237. In crisis situations, text "NEDA" to 741741 to be connected with a trained volunteer from Crisis Text Line.
If you are thinking about suicide, call the National Suicide Prevention Lifeline at 800-273-TALK (8255).
Dr. Melody Moore is a clinical psychologist, yoga instructor and the founder of the Embody Love Movement Foundation. Her foundation is a non-profit whose mission is to empower girls and women to celebrate their inner beauty, commit to kindness and contribute to meaningful change in the world. Dr. Moore is a social entrepreneur who trains facilitators on how to teach programs to prevent negative body image and remind girls and women of their inherent worth.
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