I am 20 years old (junior in college) and struggle with overeating. I have been overeating a lot lately and I don’t know how to get myself to stop. It’s controlling me and taking over. I am so depressed and really just want to die. I cut myself on occasion….but only when things build up to more than I can handle…which is usually once every month or two. I just started going to counseling at my college…but it’s SO hard for me to be honest with her. I have a lot of trouble saying things/feelings verbally that I am going through. I don’t know what to do. I’m so lonely and it hurts so bad inside. I need to know how to make the pain go away!!!!!!!!!! Can you help me at all? Thanks. – Christa
Thanks for writing this letter; seeking help is an important step in moving towards the changes you desire. College can be a very difficult time, especially if you don’t have a strong support group at school. I want to strongly encourage you that things can change. The problem is that the steps in making changes involve multiple areas, but we often try to simply “stop” whatever it is we are doing (e.g., overeating). When that does not work – it leads to discouragement and hopelessness. Please be encouraged – but know that there are several areas you will need to address.
Let me first talk to you about the depression and wanting to die. Most people who develop feelings of wanting to die have lost hope and come to believe that nothing will ever change. The depression isn’t just about what’s happening right now – it is the feeling that it will never stop. The problem is depression tends to make many of us shortsighted. It is hard enough to think about today and tomorrow, let alone down the line. The Bible says without a vision people perish. Depression robs us of that vision. I have met a great many people who once believed things would never change or work out, who are living good and fulfilling lives today. That can be you – even if you cannot see it right now.
Your seeking therapy is great. I hope by now you have been able to open up to your therapist, but if not, I would like to help you with that. (If you have stopped therapy – please start again, ASAP). If you have become suicidal it is important to tell someone in a responsible position (therapist, parents) immediately.
Don’t hesitate to get help due to shame about being suicidal (if you are); it doesn’t say anything bad about you, nor does it mean that you will not or cannot move to a very healthy place and put the suicidal issues in the past. Right now, nothing is more important than dealing with suicidal issues – if that has become a struggle for you – even if it means leaving school for a time to heal. School will always be there.
In terms of not being able to verbally tell your therapist what’s going on and how you feel – I have two suggestions. These suggestions are ones that I, as a therapist, would welcome a client to use. First, you can write out your thoughts and feelings. Once you have given this paper to your therapist (or read it out loud), it will likely make it easier for you to open up and talk directly, and also give your therapist a place to start in asking questions.
If the self-harm is hard for you to talk about – let me state that a lot of patients have used self-harm to cope. I would not be surprised if your therapist not only has had clients in the past who self-harm, but has other clients right now who self-harm. People self-harm for a variety of reasons, usually to bring relief to overwhelming painful emotions. It means they are desperate – not “crazy.”
I would strongly suggest an assessment with a psychiatric provider to consider medications if you are not already taking antidepressants. If you are on antidepressants, however, communicate to the prescribing provider that they are not helping as much as you’d like. S/he may need to adjust the dose or change the medication. Since self-harm and eating can release chemicals in your brain that make you feel better, medication can help replace the biochemical changes in your brain so you no longer have to resort to those practices.
What also happens with overeating, however, is that the brain learns to associate food cues (not just food) with pleasure and/or with a decrease in emotional pain. That means parts of your environment where you are overeating can start to trigger reactions that create a drive to eat. Your room or parts of your room (if that is where you overeat) can become a trigger to eat – even if you don’t feel one way or the other (good or bad) about your room. If you overeat while watching a certain TV show or while online, etc., those activities can trigger urges to eat, especially if you are hungry and/or feeling bored, depressed, etc. An activity such as studying can also be a trigger to eat; if so, try to study in the library or someplace other than where you eat.
As a temporary measure, don’t overeat in places where you spend a lot of time (e.g., your room). If you are in an apartment – eat normal meals in the eating area, but if you have an urge to overeat that is just too strong – go outside and eat – assuming it is a safe area.
Children base almost all of their reality on emotions; we develop some cognitive controls over those emotions as we grow and mature. However, the stronger an emotion becomes the more likely it is to gain control over what we think and do. The higher the emotion is in intensity the weaker our cognitive and rational coping skills become. There comes a point when certain emotions (e.g., anger, sadness, anxiety, etc.) gain control and can become dangerous.
If you have thoughts such as “I am worthless,” “Things will never change,” “I will never stop overeating,” etc., remind yourself that you are overwhelmed emotionally and therefore not in a good place to evaluate these issues. Emotion-based thoughts are accurate in telling you something is very wrong – e.g. “I am very depressed and hurt and I need help” – but they don’t mean anything about your future, your worth, etc.
The goal is to lower the depression and other emotional pain to manageable levels. This can involve supportive therapy, support groups, faith-based activities, reasonable exercise, and medication. Once the emotions are stabilized, you will be in a better position to examine your life with the help of a therapist or trusted spiritual leaders, to develop plans to move forward, etc.
I have no idea what is behind your depression — but I would wager — that the overeating is a way of coping with your depression and then becomes a cause of your depression. To deal with the overeating, you need to deal with the depression, but you don’t have to wait until you are feeling great to begin to make behavioral changes to decrease your depression.
First, recognize that the overeating is a coping strategy. Change how you look at the overeating. Start with:
- My overeating is not healthy for me – but it is not a “BAD” shameful behavior.
- My overeating is a coping strategy I use to deal with painful emotions. It works to some degree to help me feel better in the moment, which is why I use it. It is not irrational, because it is very rational to want to stop feeling bad.
- My overeating is the best way I know – at this point in time – to offer me some relief from the emotional pain.
What my overeating does NOT say about me:
- I am lazy, I can never change, I am undisciplined, I am a loser, I am weak, I am hopeless, I am worthless, I am doomed, etc.
What my overeating does say about me:
- I am in emotional pain.
- I have learned over time to eat in order to deal with pain.
- Right now, I don’t know how to use other coping methods well enough to deal with the pain.
- Although it helps with my feelings in the moment, overeating is not something I choose/want to continue because it is not healthy for me, and only temporarily deals with my emotions. Behaviors that help us deal with emotions cannot just be stopped – they must be replaced with something else that works as well or better.
- I may not have an alternative right now – but I can develop other ways to cope and deal with the pain with the help of God and others.
The purpose in changing your outlook – apart from it being the truth – is that it decreases the shame. It may not immediately do so, but begins to chip away at it. Shame is a major reason why many people overeat – but overeating only adds more shame because of the way some in society perceive overeating. I would recommend the book Shame and Grace: Healing the Shame We Don’t Deserve by Lewis B. Smedes.
Finally, none of the suggestions I made will work if you do it on your own, without help. You need therapy, likely a psychiatrist to work with medications (would not have to be weekly), a dietitian (if possible), spiritual interactions with others (e.g., religious group at school) and God.
Love is patient, kind, gentle and does not keep track of wrongs. Talk to yourself the way you would talk to a loved one who had problems. May God be with you and hold you steady; giving you a hope for a good future.
David Wall, PhD