National Eating Disorders Association

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When things get bad?

I'm in a bit of a moral pickle and looking for some advice.

My GF struggles with bulimia. We've been on and off for almost 4 years now. On the most recent stretch things got bad. She took on a new job with a ton of stress. ED got much worse, and she started saying things she's never said before. She was having suicidal thoughts, heart issues, was very scared, and had reached a point where she openly admitted she couldn't fight ED on her own.

This was pretty scary, but I tried not to overreact. I tried to sit down with her and talk about options for recovery, but she got mad saying she just needed support not a 'list'. I tried to take a more active role, out of fear, but that just made it worse.

Most recently she pushed away saying she needed to do it herself because it's the only way she knows how. I'm used to this by now, and I understand where she's coming from and support her in recovery, whatever that looks like.

But I'm scared. In the 4 years I've known her I've never seen her this bad. She has never mentioned suicide, ever. What can or should I do?

I sent her a text asking how I could support her? She never responded. I understand that could be an impossible question given what she's going through. Thank you.

When things get bad.

Dear Benberk,

Yes, it sounds like you pretty much know the drill by now, and are familiar with the sorts of limitations on what a partner can do. Sometimes I think it makes it even worse in situations like that, than it was in the beginning when we understood less.

The suicide thing - those really are thoughts that can come up, that's for sure. I tend to think they relate to the control issue. In the beginning EDs served to provide the person with a feeling of control. But later they transform themselves into a thing that controls the person instead. The old associations with control still remain, but now drive them to engage in behaviors that feel totally beyond their control. The irony of that can drive a person to despair, and cause them to feel like there's no way out. Add that to the fact that these relapses generally show up in response to situations that are extra stressful to begin with, and things really can start getting emotionally chaotic for the person.

So yeah, what now ?

This is going to sound harsh, but she's going to have to man-up and take some responsibility in all this. I suspect that she knows this already, but may also feel like there are limits on what she is willing to do to get better. Get some therapy ? Gosh, that's even more of the "surrendering control" thing. Best to really bear down on herself instead, and see if she can exert…control. Maybe you are starting to see a theme here ?

"I sent her a text asking how I could support her? She never responded."

Yeah, well she needs to. She may be in a place where accepting help from you may feel (again) like she is surrendering control, but she's going to need to get past that. Rather than just going with her knee-jerk response, she'll need calm down and think of some ways that you can help. "Oh, no one can help me !" may be how she's feeling right now, but in a practical sense that's probably not true. So I would not let her off the hook with that.

From a broader standpoint, recovery from EDs generally means being willing to take some risks. A willingness to get outside help; something which on it's surface may seem to fly in the face of the personal control thing.

I know things must be rough now, but keep the "willingness to take risks" thing in mind. It may not be something that feels safe to confront her with right now, but at the same time, she probably knows that at some point it may come down to that.

Anyhow, just some thoughts. Keep writing ?

Bob J.

She's not sure

She eventually responded and said she honestly didn't know how anyone could help her, and she felt like the help she needs only she can provide herself... which is good I guess? Maybe she's taking action?

What was really strange this time around is I felt like I couldn't make progress with her. If I sat back and listened and tried to support I was being too passive. If I presented her with a list of alternative options for help, she didn't want a list of options she just wanted support. At one point she even felt that me suggesting other options meant I didn't feel she was doing anything, which is not at all what I said. If I gave her affirmation I was "cheer leading". If I suggested therapy I was "passing her on to a 3rd party". It's like anytime I tried to help in the various ways I know how she pivoted and it was never enough. Is this normal? It was really confusing for me, so I could only imagine how confusing it is for her.

She's not sure.


I'm glad you heard back from her - That's a good sign.

"... and said she honestly didn't know how anyone could help her, and she felt like the help she needs only she can provide herself... which is good I guess? Maybe she's taking action?"

It's probably wrong for me to second guess this, but if we go with the "EDs are about control" assumption, then you can see where she might not want to accept help from others, and feel like she needs to handle the situation herself. But when someone is trying to use the same brain that's getting them in trouble, to get themselves out of that same kind of trouble, it can be a difficult matter for them. As I'm sure it's being for her. Which can result in her feeling a lot of frustration.

Sort of like you are seeing reflected in the ways she responds when you try to help her. Because they sound like the responses of a frustrated person, you know ?

"It's like anytime I tried to help in the various ways I know how, she pivoted and it was never enough. Is this normal?"

I guess you'll need to ask yourself what she feels might be helpful ? Or better yet, ask her what she thinks might feel helpful to her?

In my experience people with EDs don't want a list of solutions; they'd rather feel like people understand what they are going through instead. Like right now she must be feeling a lot of frustration. So…"I know this must all feel pretty frustrating" is the sort of thing you might say? It's likely she has doubts about if she can recover, so…."I know you must worry about if you can recover or not" might be another thing you could say.

Granted, statements like these may not seem like they're loaded with positivity, but the fact that they show her that someone else "gets it" about what she is going through…a lot of time that's what's going to feel supportive. If you get what I mean ?

"It was really confusing for me, so I could only imagine how confusing it is for her."

See? You're getting the hang of it already.


We met up to talk about a week ago, and the conversation was a little stressful for both of us I think. I did find out she had 10 days of no purging, which was awesome to hear. So she's clearly working on recovery. I'm proud of her.

But then as we started talking that week, things slipped and she had a bad week. She blamed it on us talking and used it as justification of her needing to be on her own.. which was hard to hear. I know recovery has ups & downs, but I don't want to get in the way of it. Still, it's hard to hear when all you're trying to do is help..

So now it's back to supporting at a distance with little communication.. It's been a long time of on/off and I think I'm starting to hit my edge with it. I don't want to hurt her more, but I don't know how much more I can take. Any advice?

BenBerk -Ups and Downs.

"But then as we started talking that week, things slipped and she had a bad week. She blamed it on us talking and used it as justification of her needing to be on her own.."

It's quite possible that the conversation you had set her back some. But as you said, you are trying to be supportive, which is hardly qualifies as a sin, so I hope you won't find yourself sucking a bunch of blame, or trying to second guess yourself. ED will try and push her around, and will try and push you around too.

So if it were me, and I was trying to keep in touch with her, I'd just talk about day to day things. Maybe a hike you took, a nice sunset you saw, about how you'd watched the moon become full, things like that. Things that show that you are thinking of her, but which don't try and poke ED in the eye. I have a friend who I talk to in Norway, who is the worst self-injury person I know. She's almost died from loss of blood several times and etc. I'll send her some pictures of some moths that I saw, and talk about some flowers I'm growing. Sometimes I'll agree with her that the self-injury must be getting in the way of her life, but otherwise I avoid getting upset about it, and stay with the idea of our friendship.

So basically I stay in touch in ways that show that I think she is someone worth knowing (which she is) but the issues she is having are not the main topic of our conversations. Unless she brings it up herself, that is, and even then I'll mostly stick with the day-to-day parts of life that I think that she might find enjoyable.

This sort of approach, where we don't spend a lot of time challenging ED, can help people stay connected to the world, rather than having their minds taken up 100% of the time by their issues.

The person has to allow us to do that of course, but if it seems like she might accept communication like that, it's something that's worth giving a try.


Hi! We're sorry to hear that you're concerned about your girlfriend. We understand how scary this must be so we wanted to provide you with information and resources to help here. First we are providing you with resources to pass along to her so she can get the support she needs through these suicidal thoughts:

Second, you mentioned she was having issues with her heart. We are providing you with a list of medical emergency signs and symptoms to read over. If you happen to know if she experiences any of these, we recommend seeking medical attention as soon as possible.

The following are just some of the signs of a serious problem that demands immediate medical attention:

  • accidentally or deliberately caused themselves a physical injury
  • become suicidal
  • confused thinking and is not making any sense
  • delusions (false beliefs) or hallucinations (experiencing things that aren’t there)
  • disoriented; doesn’t know what day it is, where they are or who they are
  • vomiting several times a day or has uncontrollable vomiting or diarrhea
  • experiencing dizziness or fainting spells
  • too weak to walk or collapses
  • painful muscle spasms
  • experience pain in the lower legs
  • complaining of chest pain or having trouble breathing
  • blood in their bowel movements, urine or vomit
  • a body mass index (BMI) of less than 16
  • an irregular heartbeat, and fast heartbeat, or very low heart beat (less than 50 beats per minute)
  • cold or clammy skin indicating a low body temperature or has a body temperature of less than 35 degrees Celsius/95 degrees Fahrenheit
  • experience dizziness, nausea, fever
  • wounds/cuts heal slowly
  • feel tingling in the hands or feet
  • blurred vision

Seek medical help soon on an outpatient basis if you:

  • have significant heartburn and/or a burning sensation after eating
  • have other gastrointestinal concerns
  • have high blood pressure
  • struggle with significant joint or muscle pain
  • have difficulty sleeping (falling and/or remaining asleep)
  • struggle with fatigue, sudden weight gain, and/or hair loss
  • have frequent urination or unquenchable thirst
  • have gained and lost significant weight repeatedly
  • have gained significant weight in a short period of time
  • struggle with chronic diarrhea or constipation

Please feel free to contact the Helpline at (800) 931-2237. The Helpline is open Mondays-Thursdays 9AM-9PM EST and Fridays 9AM-5PM EST. During these hours you can chat with us by clicking the chat now option at the top right hand corner! Please take care.