Post Traumatic Stress Disorder

[Warning:  this may be triggering to those on the path to recovery from an eating disorder.]

The National Institutes of Health website includes a document on Post Traumatic Stress Disorder.

As the article notes, PTSD is a type of anxiety disorder.  It can occur at any age.  It can follow a natural disaster.  It can follow traumatic events.  The causes listed include:

• Assault
• Domestic abuse
• Prison stay
• Rape
• Terrorism
• War

I believe that PTSD can occur to those who are witness to the destructive effects on a family member of serious diseases like cancer and an eating disorder.  One study documented that some family members are still feeling the effects of the trauma of cancer in a young family member 10 years after the event.

Wait, you say.  But eating disorders?

Yes.  Eating disorders are biologically based brain disorders that affect the behavior of people who develop them and affect family members who more often than not become distraught by the changes in personality and physical health that occur in their loved ones.

Yes.  It is believed that eating disorders are the deadliest of all brain disorders .  "Anorexia nervosa (AN), in particular, has the highest mortality rate of any psychiatric disorder.  Risk of premature death is 6-12 times higher in women with AN as compared to the general population, adjusting for age."   Work is continuing to reduce that number and, in fact, the number may have been reduced somewhat by the knowledge that has been gained in the past couple of years including the increasing visibility of family based training (FBT) and what is referred to as the Maudsley Method, first developed at Maudsley Hospital in England.

But, still.

So, to those who leap to the conclusion that a family member exhibiting behaviors that seem like PTSD
Quote from the linked article:
PTSD can cause many symptoms. These symptoms can be grouped into three categories:
1. Re-experiencing symptoms:

• Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
• Bad dreams
• Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.
2. Avoidance symptoms:

• Staying away from places, events, or objects that are reminders of the experience
• Feeling emotionally numb
• Feeling strong guilt, depression, or worry
• Losing interest in activities that were enjoyable in the past
• Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.
3. Hyperarousal symptoms:

• Being easily startled
• Feeling tense or “on edge”
• Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.

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 or who appears to have  become or is enmeshed with the loved one with an ED, stop for a moment and think about the trauma that a parent especially often goes through when their child or adolescent or even adult child or spouse [only some behaviors are listed here of the many that occur]

• stops eating
• loses weight dramatically
• exercises compulsively, sometimes late at night or in their room behind a closed door
• becomes violent and abusive day after day after day when presented with food and asked to eat
• gets up after everyone has gone to bed and eats everything edible in the refrigerator or pantry and then either vomits the food into the toilet, into plastic bags they store in their bedroom, or into the garbage bin, or in the shower (while the water is running and running and running)
• turns to cutting, drugs and/or alcohol in an attempt to subdue their anxiety when presented with food that to them increases their anxiety when they eat or that helps them get through the cycle of binging and purging
• tries to separate family members such as the mom and dad so they can continue their ED behaviors because one of the parents may not believe the situation is as serious as a medical emergency, which eating disorders are
• drinks water to the point of hyponatremia or purges food and therefore electrolytes resulting in a visit to the ER only to receive an IV that corrects electrolytes and then sent out the door within 24 hours because they are determined to be "stable" even if they are visibly emaciated
• uses laxatives even though either there's nothing in the intestinal tract to process or because they believe the laxative will interfere with digestion and absorption (doesn't work, actually) and again terribly interfere with their electrolyte balance
• is ejected from a residential facility because their behavior is disruptive to other patients and the facility does not have the staff or the treatment area to help them through the rage phase 
• emerges from a long residential treatment only to return to those behaviors
• or even dies no matter what treatment has been available and/or provided

How helpless and angry a parent can feel  when they are blamed for an eating disorder even though in multiple children households no one else exhibits or exhibited eating disorders at the same age or even if they do; when their family is labeled dysfunctional because when they finally seek help they are all torn apart by watching what has been happening; when they cannot scrape together the funds to pay for treatment that may or may not -- after many attempts -- work; when their insurance policy listed as comprehensive only provides 10 days or a month of treatment when research is showing a person needs a full year at least of complete and steady nourishment in order to even get on the path to recovery; when there is no one for them to talk to/with because a support group is not available or they themselves cannot afford supportive therapy to cope with the horror of what is occurring in front of them.

I have touched upon some of this in my essay here on this site.  I am grateful for the support I have found among friends, at an Al-Anon weekly meeting I attend without fail unless I am out of town, by working with a therapist who "gets it" and who has worked with me so I have the tools to keep going, from the people on supportive websites such as Something Fishy and Around the Dinner Table/F.E.A.S.T., and by working with a team of professionals to address the effects of this horrid, horrid disease on my family member.

PTSD is very real among us parents.  It can disable us when the illness goes on for months or even years (and to some parents even a few weeks can feel like a very long time).  If you are reading this and are a professional who is working with a child or adolescent or adult and often seeing his or her parent or significant other in the waiting room, please remember to ask her or him how they are doing and if they need help.  Recommend that they carve out some time for themselves to do something they enjoy even if it's only a nap or a brief walk with the dog or a date with their significant other.  Recommend that if they can afford to, to see a professional themselves.  If you have time, develop a list of  resources for that parent or significant other.

It can be for some a very long road and sometimes the light just doesn't seem to appear.