Tracking food:
I still track food exchanges (well, sometimes), and originally I could only find one app that was appropriate for this in the app store: EatRight.  After that I discovered Foobi, and most recently have converted to FoodTrackerPro.  Note: none of these apps use calories — just servings/exchanges — and I’ve been pretty pleased with all of them, but FoodTrackerPro is definitely the coolest.  PLUS, it works on the iPad, so bonus points for that.  You can customize your meal plan and make charts and set goals and all of that… but it also has a great food servings cheat-sheet — for all those times that you’re trying to remember how much hummus equals a protein exchange (for example).  iPhone/iPad, $1.99.

Tracking mood:
I started doing this on paper awhile ago and found that it was actually a good exercise for me (not only to see the patterns in mood but also just to check in with myself).  I’ve seen several apps for this, but currently my favorite is MyMoodTracker (same company as FoodTrackerPro, actually).  It’s only for iPhone (no iPad yet, bummer), but it tracks mood using a 1-10 scale and little emoticons.  You can track sleep on here, too, and see how that influences mood.  iPhone, $1.99.

Meds:
You know those times when you’re at the drug store trying to purchase something to help with your nasty cold, and you can’t remember if it’s okay to take Sudafed with the Wellbutrin you’re on?  That’s when you need Epocrates.  Or… when you have a headache and have already taken Tylenol twice and are not sure if it’s okay to take another dose yet?  Okay, maybe it’s just me, but I run into situations like this all the time and would be lost without this app! Plus, when you’re on more than one med at a time (which is pretty common these days), things get complicated (drug interactions, dosing, side effects, etc), and it’s just good to have it for reference.  iPhone, free.

Countdown:
By now you’re probably thinking, “okay, you track way too many things”–and it’s probably true.  BUT, do you know what’s even better than personally tracking something?  An app that does it for you!  That’s Countdown.  I have countdowns for everything — how long I’ve been married, how long it’s been since I last acted on symptoms, how many days until my next therapy appointment, how long until my birthday (hey, why not….), etc.  Random countdowns aside, there’s something really motivating for me about knowing that I haven’t skipped a meal in three months, or drank coffee since…. err, yesterday (okay, really bad example), or that I have therapy in 1 hour, 42 minutes and 18 seconds (and really need to do my therapy homework).  I just love seeing that.

Coping Skills:
Remember my series on coping skills?   Well, for each of those items, there is of course an app for that:

1. card stores – it’s not a card store, but someecards can entertain me for an embarrassingly long period of time (both the app and the website).
2. bulletin boards – Corkulous would probably by my favorite app-equivalent of a regular cork bulletin board.  However, the real purpose of bulletin boards for me are to serve as reminders, so that the “out of sight, out of mind” thing doesn’t kick in.  For that, I’d probably actually use a todo app or custom background/wallpaper (not going to link these because there are a million and I don’t have a favorite!)
3. kudos chart – again, this is something you could probably find in a todo app, but if you’re looking for something a little more…. sticker-chartish… try GoalTracker (ipad).
4. crafting — there are a million apps for: coloring, collaging, drawing, photo-editing… really, a million. You might start looking in Apps for Kids.
5. dvds — you can download just about anything from tv/dvd onto your iPhone/iPad from the app store.  Additionally, ABC has an awesome media player that lets you stream shows for free.

Okay, that’s the end of my list for today.  If anyone has any other app suggestions, I would love to hear them!

“A relationship doesn’t have to be romantic to fall into the “toxic” category, of course. Many friendships, mother-daughter, boss-employee, and waiter-eater relationships qualify. If someone is bringing you down consistently, chances are that your relationship with him is toxic.”

Hmm, sounds like something that I can connect to eating disorders! (Imagine!). I’ve heard that “the eating disorder is like a bad boyfriend.” I guess that in this context, referring to the eating disorder as “Ed” makes a lot of sense. The boyfriend analogy aside, the eating disorder does fall under the category of “toxic relationship.” Just look at how relevant the 10 steps are…

1. Step out of denial - I just wrote a whole post about eating disorders and denial. The article suggest asking yourself questions like, “Does the ED leave you feeling energized or drained? Do I want to spend time on the ED or do I feel like I have to? Do I look to the ED for a response that I never get?”
2. Keep a log of emotions – I’ve had a hundred food journal variations, but I think they all had a section for thoughts and feelings.
3. Identify the perks - The eating disorder is doing something for you… it serves a purpose (maladaptive as it may be). Maybe it’s something you’re good at, or it’s a distraction from everything else in your life, or maybe it numbs overwhelming feelings. There are pros of the eating disorder.
4. Fill the hole - EDs are coping skills. If you take it away, you have to find some other coping skill to rely on. (See my whole series on coping skills). Recovery might leave you with other holes… like free time that you previously spent obsessing over food/weight or that sense of accomplishment that you got when the number on the scale went down.
5. Surround yourself with positive friends - the article is right on with this one:
   

   “Lots of support and friends isn’t going to cut it. You need the right kind of friends – i.e. those working on their boundaries as hard as you are, who aren’t enmeshed in their fair share of toxic relationships and therefore become somewhat toxic themselves. The stuff is contagious.”

   Eating disorders are competitive. Dieting and disordered eating are prevalent in society. It’s easy to be triggered and important to be surrounded with “normal” eaters.

6. Drop a note to yourself – I was glad to see this on the list, just because it makes me feel a little less crazy. I write notes to myself all the time.
7. Bribe yourself - I knew a girl who did this. When she was tempted to binge, she’d take the money that she wanted to spend on that and purchase something else for herself (nothing big – like $10 to $15).
8. Heal the shame - I think that shame is HUGE in maintaining eating disorders. The article references “inner-child work,” which I know is helpful for a lot of people.
9. Repeat affirmations - I am not an affirmation person, but I may be the only one. However, I am a QUOTE person… and while not really the same as an affirmation, I think that they can kind of serve the same purpose – to cheer you up, keep you motivated, remind you of something important, etc.
10. Allow some rest - need I really elaborate?

So, while I don’t think I’ll be telling my friend that my eating disorder is just like his relationship with his girlfriend… it’s an interesting idea.

The introduction contains the best definition for “coping” that I’ve seen to date:

Coping refers to the thoughts and behaviors that people engage in so as to manage, tolerate, or reduce internal or external demands that are appraised as exceeding an individual’s resources and is typically thought of as a factor that mediates the relation between stress and the onset of psychiatrist illness.  Coping is often depicted as a multi-dimensional construct, including task-, emotion-, and avoidance-oriented skills.

The whole article is definitely worth the read (and you can download the whole text for free), but there were two things in particular that I found interesting:

1. The healthy controls had the highest level of avoidance-oriented coping skills
2. Partially-recovered individuals were closer to those with active eating disorders, while fully-recovered individuals coped more similarly to the healthy controls.

The avoidance finding was a pleasant surprise (for me).  I’ve always believed that avoidance is a healthy coping skill to some extent… but have had therapists who insist that it is maladaptive.  The article makes a good point about this:

[Avoidant] strategies can be effective in the short-term for reducing pain, stress, or anxiety, and can include some adaptive strategies (e.g., spending time with a special person or going for a walk…)

The second finding about partially-recovered vs. fully-recovered was also validating to see.  The only distinguishing criteria between fully and partially-recovered individuals was the presence of psychological recovery.  I think that sometimes in treatment, individuals can be deemed “recovered” even when they are still struggling with a lot of the old, destructive thoughts.  Personally, I have found this partially-recovered stage to possibly be the toughest.  You’re not using your eating disorder to cope and you don’t have the level of care and/or support as you did at the height of your disorder, but you’re still struggling psychologically.

There are lots of other great points made in the article, so I highly suggest that you take a look!

On the 12th day of Christmas,
my therapist gave to me…

12 new feeling words
11 prying questions
10 goals for eating
9 self-affirmations
8 ways to be mindful
7 coping skills
6 restructured thoughts
5 empathetic statements
4 problem solutions
3 anti-depressants
2 more diagnoses, and
a reminder she won’t be here next week

Dr. Meredith Grey: In the hospital, we see addiction every day. It’s shocking, how many kinds of addiction exist. It would be too easy if it was just drugs and booze and cigarettes. I think the hardest part of kicking a habit is wanting to kick it. I mean, we get addicted for a reason, right? Often, too often, things that start out as just a normal part of your life at some point cross the line to obsessive, compulsive, out of control. It’s the high we’re chasing, the high that makes everything else fade away.

Dr. Meredith Grey: The thing about addiction is, it never ends well. Because eventually, whatever it is that was getting us high, stops feeling good, and starts to hurt. Still, they say you don’t kick the habit until you hit rock bottom. But how do you know when you are there? Because no matter how badly a thing is hurting us, sometimes, letting it go hurts even worse.

I’ve talked about this before, but I think that wanting to want to recover is a big roadblock in eating disorder treatment. Meredith explains it very well — we get addicted for a reason. The ED plays a role in our lives. You don’t go seeking an eating disorder… but for whatever reason (I’m sure largely biological), coping via food / exercise works for you. Restricting did give me some kind of a high, but more importantly it did make “everything else fade away.” Of course it didn’t SOLVE any issues… but it did somehow mask them and make them less important to me.

The eating disorder doesn’t “work” for me like it used to. It doesn’t give me that relief that I’m looking for. It doesn’t make stressors go away. 10 years ago, I felt some kind of sick accomplishment from restricting. Like somehow not eating made everything better. These days, maybe it deadens things a little bit, but largely it throws off my blood sugar and makes me feel like crap.

I’ll admit that for whatever reason, in many situations it’s still my first instinct to use the ED to cope. All the coping mechanisms I mentioned are attempts to replace the disorderedness with something healthier. But really, it takes three “healthy” coping mechanisms to offset one unhealthy one. The kudos chart is an everyday thing and a bad day might require coloring AND card shops.

I think a lot of people struggle with feeling like they still need their ED. Even if it is kinda ruining their lives and not working like it did in the past, they still feel like they won’t be able to deal without it. If you’re trying to replace that disorderedness with bubble baths and crafts — well, that’s a tough sell.

I’m not saying it’s not worth it or that EDs are just unhealthy coping skills… I’m just saying that recovery takes a lot of coping skills.  You burn some of them out (for instance, reading does not help me like it used to) and have to be creative and come up with new ones.  And sometimes they feel ridiculous.  Heck, I’m in my mid-20s and googling “print complicated coloring pages.”  My kudos chart is remarkably similar to the sticker chore chart that I had when I was seven.  I’m not sure any of this is “normal,” but hey, it helps.  Ridiculous or not — just go with it.

Five of the most underrated coping skills:

1. card stores
2. bulletin boards
3. kudos charts
4. crafting
5. dvds

I have a lot to say about each one of these, so I’m going to break them up into different posts.  However, I’d love to hear you feedback and any alternative or underrated coping skills that you might use.