How could elements of our ‘New Normal’ way of life be feeding the growth in eating disorders and other forms of addictive behaviour?

The reality in numbers:

“UK Hospital admissions relating to eating disorders in under 20’s increase over 50% in 2020”

“Alcohol abuse has increased during the coronavirus pandemic, according to the British Liver Trust, which has reported a 500% rise in calls to its helpline in 2020”

(bbc.co.uk)

Written by Colin Day, an Anorexia Nervosa eating disorder survivor

I’ll start this blog with a statement that by no means is any of the content politically motivated.  Also, I’m not a qualified psychiatrist.  In fact, I’m a qualified accountant, but like to think I’m a ‘numbers man’ with a high degree of empathy.

So, why should you consider listening to what I’ve got to say?  The answer is simple, my experience living life as a father, husband, and leader (in a professional sense) whilst fighting a daily, hourly battle against an eating disorder gives me a unrecognised PHD on this subject.  Like most others who’ve had encountered addiction in their life I never saw it coming and even when my life and the lives of my loved ones were consumed by my internal ‘intruder’ I didn’t recognise that I had a problem. Years of therapy and an awful lot of inner thinking have given me with a deep-rooted understanding of the triggers that can easily result in addictive forms of mental illness which all too often lead to harmful consequences.

Society has come a long way in recent years to reduce the stigma associated with mental illness, notably a better understanding and empathy with those suffering with general anxiety and depression.  In many respects the pandemic accelerated our levels of empathy with everyone feeling the internal pressures from living in an unpredictable world.  However, society still has a long way to go in its understanding and willingness to talk about forms of mental ill health that manifest in addictive forms of self-harm…. alcoholism, drug and gambling addiction, eating disorders and physical self-harm…the secretive areas of mental illness.

As someone who’s one of a disproportionately low number of men to publicise the fact that they have suffered at the debilitating hands of Anorexia Nervosa, I could see the eating disorder crisis that many parts of the western world are currently facing, a mile off shortly after the first lockdown. What we’ve seen since then is a progressive move to cement a new way of life that I believe will see what was thought to be a lockdown driven mental health crisis snowball into something much bigger.

My concerns with referencing life now as the post Covid ‘new normal’

As human beings we been through thousands of years of gradual evolution to get to where we we’re at the start of the pandemic.  We’re highly adaptable creatures with an intellect that has seen the tools we use to live our lives rapidly develop in the last couple of decades….my kids still don’t believe that I lived until the age of 21 without a mobile phone, and even then, it was only capable of calling or texting! Putting the advancement in technological capability to one side, my challenge lies with the impact from what are increasingly looking like radical and most importantly, permanent changes to some fundamental basics of our human DNA in less than two years.  It’s hardly surprising that this has proved to be an insurmountable challenge for many.

The truth is that for a variety of reasons, no one will ever know the degree to which eating disorders and other forms of addiction have grown as an unhealthy life coping mechanism during and after the peak of the pandemic. However, experience show that a small number of long-standing reasons people are far less likely to seek help in the early stages of addiction, with cases all too often reported when at crisis point.  Using my own experience I think following are the core reasons why the true number of people suffering from eating disorders is likely to be significantly higher than reported:

(1) Fear of being stigmatised as an outcast personally and professionally. This is especially the case with men.

(2) Long standing failures in the health system to diagnose, intervene and treat eating disorders as an addictive mental condition rather than a physical illness in which BMI remain the blunt indicator of risk.

(3) During the initial stages of the onset of addiction it’s often described a euphoric experience. The addictive internal voice makes you feel all powerful and in control of life, which conflicts with an underlying need to seek help.

(4) The secretive nature of eating disorders means sufferers often carry on with life without anyone noticing. In the case of Anorexia Nervosa, which I suffered with, it’s more visible, but society often fails to make the connection.  I’m 6’3” tall and at my lowest I weighed 64kg.  It couldn’t have been more obvious, but no one outside of my close family suspected that I might have an eating disorder…. because men don’t get eating disorders do they?

Whilst the pre pandemic eating disorder crisis was a hugely understated societal problem, I fear that elements of our ‘new normal’ way of life will see the problem grow exponentially, despite the increasing signs that Covid is now becoming endemic.   Should elements of recent and emerging changes become rigidly cemented as a way of I believe life, these could well see the risk of eating disorders and other forms of addictive mental health move from a pre pandemic crisis point a post pandemic epidemic.

No one single element of the ‘new normal’ way of living is to blame.  It’s the compound impact of smaller changes!

Mandated Remote Working

No one can deny the fact that there are many benefits from working at home…. more time with the family, less time travelling etc.  I believe that employers that have moved to a hybrid model with a mix of time at work and home are the good guys and girls…. if it isn’t mandated!.  Not everyone has kids to ferry to and from school and various clubs. A sizable proportion of the working population live alone, often using their work environment as a way of serving their day to day social needs.  Instead, my concern lies more with the employees often of large corporates and in cases, areas of the public sector that see a full remote working model as the answer to deliver significant savings across their commercial property footprint.

Humans are ‘pack animals.  Whether recognised or not even introverts need human interaction in person to feel human.  Whether we recognise within ourselves or not it’s been proven through a variety of medical studies that social interaction is critical for both mental and physical health.  A well-known case study of 7000 participants spanning nine years in 1960’s USA found that “people who were disconnected from others were roughly three times more likely to die than people with strong social ties”.  Technology has given the world the capability to have a face-to-face discussion with someone at any time and in any part of the world.  However, the barrier of the laptop / Ipad screen simply does not provide the same human experience as a discussion in person

I know from experience that the feeling of insular isolation battling the trauma of my father’s death, led me down the path of addictive behaviours (restricted eating and over exercising) as a way of coping.  I’ve no doubt that we are likely to see a disproportionate trend in addictive behaviours in employees, especially those living alone, who are being starved of the social interaction that gets them out of bed in the morning.  Addictive behaviours formed in an attempt to feel in control of one’s life (alcohol, excessive exercise, starvation, purging) thrive in secrecy…. the main reason why an isolated home working environment is likely to be the perfect breeding ground.

My experience leading teams in a professional setting for over 20 years has left me in no doubt that giving employees the opportunity to work together in person translates into superior outcomes for customers and from there admirable top and bottom-line business performance.  The danger of a short-sighted approach, introducing mandated full remote working to deliver shareholder value through expense savings carries a very real risk of harm to businesses in the longer term as customers feel the impact restricted innovation / poorer service and business expenses increase in other areas because of increasing levels of process inefficiency.

I also want to mention, but not labour on the issue associated with employees who tend to lean towards behaviours aiming to please their colleagues, largely to feel a degree of self-worth.  I would openly admit to having displayed these tendencies in the past and found at times over the last couple of years reverting to unhealthy working patterns.  Was this simply because I had a lot on my plate at work or was it subconsciously an attempt to seek virtual recognition to fill the void left by an inability to regularly interact with people outside of my family?  If I’m honest, probably more the former, but the degree of professional isolation has been really hard to deal with at times.

Societal Division

Society has made some huge strides forward in recent years to create a greater degree of equality.  But what we’ve seen emerge since the start of the pandemic are increasing barriers to our freedom of expression.  One of the key pillars that makes the UK stand out has been our ability to express our views and opinions without fear of retribution.  However, what we’ve seen in the last couple of years is a growing fear of being “cancelled” which has prevented many from feeling able to form and express their own opinions without fear of consequences.

As a case in point, let’s look at the topical subject matter of our covid vaccination status.  My overwhelming instinct, which helps articulate my underlying point, is that I feel a need to say that I have chosen to take the vaccine.  Right or wrong, it’s possibly through fear of a potential backlash.  But what are the consequences for those who’ve decided not to accept the vaccine?  Facing dismissal, restricted sick pay and if you’re open about it, the risk of some vile online “hate”.  Most of us will have seen first hand the kind of response people can face on social media should they reveal they’ve exercised what is a fundamental human right to decide whether they will or will not accept medical intervention.  Those who’ve exercised the right to decline the offer of a vaccine are feeling increasingly marginalised, seen by many as lepers.  On the flipside, we’ve all seen the online punishment that anti vaxers have dished out to those like me who’ve made the decision to accept the vaccine.

Whether it’s because of someone’s vaccination status, opinion on mask wearing or even if they believe that erasing our history by tearing down statues is not the right way of creating a great degree of equality, the suppression of our ability to express ourselves openly through fear is creating a more insular society.

You’re probably asking the obvious question “how can this translate into addictive behaviours?”  Again, it comes down to the overwhelming feeling of internal isolation that restricted free speech creates.  People become internally frustrated with themselves and their thoughts.   The frustration this comes with can be the major trigger for many to explore all forms of unhealthy coping mechanisms.

What is solution what is a highly complex problem?

As an accountant my natural tendency is to try to find a logical solution to a problem.  Sadly, and hugely frustrating on my part, despite a lot of deep inner thinking using my own experience of addiction to find a solution, the “magic bullet” answer simply doesn’t exist.  I’ve often described my experience of mental ill-health as a Venn diagram of complexity which had multiple, often inter-related causes that took years to even start attempting to understand.

The fact is we’ve all got a role to play in helping to reset elements of society to a more normalised and stable position, which I believe is the fundamental requirement to stem the increasing challenge we face in keeping our mental health in a stable state:

(1) Employers have a duty of care to provide employees with a degree of balance between a remote and in-person working environment.Ultimately businesses will reap the rewards from a motivated and enriched workforce.

(2)Those in management roles are often selected based on their expertise rather than their ability lead people. Businesses need to suitably equip people leaders with the tools and knowledge to spot the signs of addiction which are often extremely hard to notice.  We cannot expect leaders to have a full understanding and know what to do just because they are of a higher pay grade.

(3) We need to move towards proactive model to help stem the development of mental ill health in the early stages versus reacting only when people have been in crisis point, often for an extended period.A proactive model doesn’t stop at encouraging people to try mindfulness, take an online CBT course, or use a mobile app to provide a daily status of.  These are great tools for the mainstream of society, but often have a limited benefit for those on the more extreme ends of the spectrum.  Proactive means faster access to GPs (in person) and initial diagnosis, effective triage into the right areas of the system and in the case of employers, arming leaders with the right tools (above) and investment in creating a culture of organisational openness versus playing lip-service to it.

(4) As individuals we must start moving towards a place where there is far greater acceptance of different opinions, even if these may challenge the status quo. What we’ve seen recent years is an real effort to repair many long-standing areas of society division, including race, gender, and sex, only to create segregation in other areas during the last two years.  Whether you’re right or wrong as long as your views aren’t discriminatory towards others and can be supported with reasoning you should be allowed a voice.

(5) Lastly, and possibly the most important point, we need to look out for each other. If you notice a friend, colleague or family member becoming more reclusive, reach out to them.  Given the secretive nature of addiction it is likely to take perseverance, so please stay strong and probe with empathy!

In summary, just like my interpretation of how elements of the ‘new normal’ may be inadvertently driving and increase in addictive forms of mental illness, I believe the compound impact of several small changes are needed to guard society from a further deterioration in its mental health.

Written by Colin Day

https://fallibleman.co.uk/2022/01/30/how-could-elements-of-our-new-normal-way-of-life-be-feeding-the-growth-in-eating-disorders-other-forms-of-addictive-behaviour/