How to deal with a depressed/anorexic sister

[maximusminimus]

Sister is mid-20s. Married to a lovely guy. She's been battling anorexia for around 7 years now. Never been hospitalised, and she's currently 'well' enough to live normally: if you passed her in the street you'd just notice that she was thin rather than had an ED if that makes sense. She has a very very stressful job which I know that she hates. She goes running every single morning, and she doesn't eat properly at all: fruit and undressed salad for every meal, plus bucketloads of coffee. She's permanently cold, her fingers are always red/purple etc.

She often comments on how unhappy she is, how much she hates herself and how she's permanently tired.

She's had counselling in the past, but it wasn't of any use - there doesn't seem to have been any trigger event. She seems to have given up to be honest: seems to think that she'll always be like this, so why try to get better.

I'm at my wits' end about what I can do. Any advice? I'm thinking that she sounds depressed so maybe encouraging her to go see her GP and get some medication, since I know feeling depressed/undereating/low blood sugar/feeling depressed is a vicious circle...

[Bluestocking]

Does she know she's anorexic, or does she think her approach to food and exercise is perfectly OK?

[maximusminimus]

She knows she has a problem and that what she's doing is destroying her body. But it seems to only be theoretical knowledge: she wouldn't let anyone else exercise that much and eat that little, since she knows intellectually that it's incredibly bad for you, but the 'rules' seem to be different for her if that makes sense.

[Bluestocking]

Poor you, poor her. Would she agree to go and see the GP? Are you in the UK? She might do better requesting a referral to a psychiatrist. She could well be depressed, because as you say the low blood sugar and borderline malnutrition are going to be affecting her mood. Have you discussed the situation with her husband?

[maximusminimus]

I have but he's totally confused and doesn't know what to do. I alternate between wanting to scream at her and wanting to slap her...

[TodaysAGoodDay]

Generally there isn't usually a trigger event, most cases stem from teenage years where the person feels they have no control over their life except for what they eat.

It's called acrocyanosis when the fingertips and lips turn blue, it's caused by a sluggish metabolism and lack of correct nutrition.

It's very sad that it sounds like she has never had in/out patient treatment which is helpful in some cases. Unfortunately, I hate to say this, but there really is nothing much you can do about what's happening. She will begin to resent you if you do try and 'help' (she will see this as interference most likely) and will be resistant to any help offered unless she seeks it herself.

This must be tearing you apart, and I understand how helpless you must feel. I know this is a long shot, but have you thought about getting counselling for yourself if only to help you deal with your feelings regarding what she is like? It really helps to talk about things, and I am sure you will find a sympathetic ear if you ask for help.

I wish I could be more positive, but I used to nurse young women who suffered from anorexia, so I know how both she and you feel. Very good luck with everything, I'd love to wave a magic wand for you.

[maximusminimus]

Thanks. Not what I wanted to hear but appreciate the candour.

Wish I could find the solution but am realizing there's not a simple one step answer.

[jessjessjess]

OP I suggest you have a chat to an organisation that is geared towards helping ED sufferers and their families. Google has just pulled up this list: www.disordered-eating.co.uk/help-for-eating-disorders/eating-disorders-organisations-uk.html

They will be familiar with, and trained to advise on, your situation. Must be so hard - I wish you well and hope you can get some good advice.

[jessjessjess]

And again but with linkage: www.disordered-eating.co.uk/help-for-eating-disorders/eating-disorders-organisations-uk.html

[BovineUddersAkimbo]

I wish I knew what to say to help you and your sister. My sister is 24 and has been bulimic since she was eleven. I myself have done the rounds of anorexia/binge-eating for many years, and it was only having children (daughters specifically) which has given me the motivation to change the way I perceive myself and begin to appreciate my health.

Anorexia is fuelled by fear. Fear of change, fear of losing control, fear of losing grip on what often feels like the only thing that makes you an acceptable human being (thinness and perceived attractiveness). It is very, very much an internal battle, and as such there really is little outsiders can do to help, other than be there, and try to have patience.

For me, the things that helped me most were

Education: learning about biology and how the human body actually functions, and why we need to fuel our bodies correctly. For me, I was always petrified of dietary fat. I had to learn that fat is not evil!

Having something to live for: for me, it was my daughters. You mention your sister hates her job, would it be possible for her to investigate changing careers? Perhaps finding work which she finds truly fulfilling might shift her perception of herself.

Drugs and doctors: confiding in a professional about how I felt was the smartest thing I have ever done. Now I have a working relationship with my shrink and GPs etc, and choosing and changing medications is very much a negotiation process. Finding a good doctor or two is essential.

Probably none of this will be helpful to you, but please know that you are doing the right thing just by posting here; it shows you care. Caring, and continuing to care (even when you're livid with frustration and worry) is the most important thing you can do.

[Bluestocking]

Hi maximus, some great advice here. My youngest sister is a long-term anorexic - we noticed it when she was 15 and she's now 45 - she's been lucky enough to transform her illness into "gymorexia" and while her relationship with food is still not easy, she maintains her extreme skinniness by running/swimming and rather than looking freakish, she just looks like a marathon runner. I completely relate to your wanting to scream at her and slap her - I used to feel like this when we were both in our teens. I think that, like Bovine, having her daughters really made her rethink her relationship with her own body.
I completely agree with TodaysAGoodDay - there really is nothing you can do for her, she has to acknowledge that something is wrong and she has to want to change things for herself. If she really does hate her stressful job, is there any possibility of her being able to change jobs, or take a sabbatical?

[maximusminimus]

Thank you all for your lovely messages and advice - I don't have time to digest them all properly right now (have the family visiting!), but I will do at some point today. xx