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Managing Step-Down Care Within Your Regular Routine

A residential eating disorder treatment program is an important step towards long-term recovery. But unfortunately, taking time away from work and family responsibility can be difficult. This leads many adults with eating disorders to put residential eating disorder treatment on the back burner because it could interfere with other important commitments in their lives. Even more so, it seems an insurmountable task to keep that recovery going when they return to the “normal” routines.

Early intervention is often seen as a key factor for eating disorder recovery, making it important to speak with a trusted medical professional at the first sign of symptoms. They’ll help you identify the symptoms of an eating disorder and possibly recommend treatment at a residential eating disorder program. From there, you can receive specialized treatment in a residential program. The lessons learned in residential treatment are invaluable – they’re designed to make short-term improvement possible, but even more importantly, they are essential to maintain recovery in the months and years after treatment ends.

Directly after residential treatment is over, many people choose to further their recovery by attending a step-down program. Normally meeting with their therapy and nutrition team a few times a week, these programs are not nearly as time-intensive as residential programs, but they can still cause scheduling difficulties with other commitments. Nevertheless, keeping your recovery going during the delicate period after residential ends is paramount.

It’s hard to overstate the importance of making the recovery process a top priority while also finding a balance in their lives. Keep reading to learn more about finding a balance between eating disorder treatment step-down programs and keeping your other priorities satisfied.

How Can Adults Balance Ongoing Eating Disorder Treatment with Other Commitments?

Coming home from residential eating disorder treatment can seem overwhelming; in addition to all the exercises and stress from recovery, you’ve got all the demands of daily life to handle. Work and school, caring for your kids or other family members, and managing relationships – they all add up as stressors. SO how can you manage that and keep your recovery going strong?

Get Enough Sleep

It’s easy to forget that mental exertion is just as taxing as physical exertion. After a long day of physical labor, it’s natural to feel deeply exhausted and fall into a comfortable sleep. Why should it be any different for a long day of mental exertion? Getting an appropriate amount of deep, REM sleep is a great way to prepare for the challenges of maintaining recovery and restore your mental strength for the next day.

Sleeping enough also improves your general attitude; it’s easier to shake off negative thoughts and emotions when you are well-rested. To make sure you’re getting enough sleep, you can take a few actions that make it easier. First, make sure you don’t have any caffeine or sugar after a certain time in the afternoon or the evening (whichever works best for you). Secondly, set a standard bedtime that you stick to every day – over time, your body will naturally begin to feel sleepy at that time. Thirdly, make sure you turn off all screens – TV, tablet, computer, and phone. We all have a tendency to stare at screens longer than we want to, especially late at night. Finally, it’s important not to lay in bed unless you plan to sleep. Spending time in bed reading or scrolling social media trains your body to stay awake even while in bed.

Take Care of Yourself

Finding the time to practice self-care is necessary for virtually everyone. But as life throws more responsibilities our way, taking a step back for a time can become increasingly more difficult. What’s often forgotten is that stress, whether from work, family, or any other source, is a major cause of relapses into disordered eating behaviors.  This means that taking time for self-care should always be towards the top of every to-do list. Self-care can help prevent breakdowns, reduce many of the negative effects of stress and help recovered individuals be more open to objective self-evaluation.

What is self-care? It varies from person to person. Most often, it’s taking a few moments out of a busy day to recoup and relax. Doing things that relieve stress is the best way to practice self-care. You might try taking a “mental health day” off work or even take 10 minutes to go outside and just feel the breeze. People in recovery from an eating disorder are usually encouraged to indulge in a treat like chocolate, although that can be stressful if a person is on edge. Any activity you enjoy can be self-care. This could mean something as simple as going for a walk, taking an art class, or going to an afternoon matinee at a favorite movie theater. The important thing is to take time for yourself.

Don’t Be Afraid to Ask for Help When You Need It

Life gets busy for everyone and that makes it super important to take the time to tend to one’s own needs now and then. This is especially true when experiencing eating disorder symptoms and other co-occurring mental health conditions like anxiety, depression, and panic disorder. Many people have a solid support system around them already – even if they don’t realize it. Reaching out to family, friends, co-workers and even neighbors for help is an easy way to lessen a heavy load of responsibilities. Adults with eating disorders need to work hard to remember that treatment should become a major focus in their lives so that in the long-term they can enjoy all the other great things that life has to offer.

People in recovery should also, if they feel comfortable with it, let their employer or school administration know that they are in recovery. Of course, this is not a requirement. However, most employers and every school will make an effort to be understanding of the recovered person’s needs in treatment. If the person has gone to residential treatment, the organization is likely to know it was for eating disorder treatment and is compelled by human resources law to provide support. The knowledge that you won’t lose your job or fall behind in school due to your recovery is also a great stress reducer.

Set Boundaries Outside of Treatment

Even with the relatively forgiving scheduling associated with eating disorder day treatment, many adults start to feel like the recovery process has completely taken over their lives. That’s why it’s important to find areas where the mind can focus outside of treatment to find enjoyment and calm. In fact, it can be helpful for individuals to limit talk about treatment when at home or in other more personal situations. This is one way to prevent treatment fatigue for those who are in both eating disorder residential and day treatment programs.

While establishing a support system at home can be extremely helpful, some conversations are best left for medical and psychiatric care professionals. There is even a built-in process to explore family and relationship difficulties in the form of group and family therapy, which is included as part of most residential and step-down programs. However, if adults find that the topic can’t be avoided when spending time with loved ones, it can be helpful to schedule some positive alone time whenever possible.

Understand That a Relapse Is Not a Failure

Stress gets to the best of us. Sometimes, even when you’re doing everything right – remembering your exercises, asking for help, getting lots of sleep, practicing self-care – something just becomes too stressful to bear. That something might be a work crunch, a breakup, dealing with writer’s block when you have a project due for school. It could be the sum of a million little things. Unfortunately, for people with eating disorders, these stressors might lead to the return of disordered eating behaviors. Many eating disorders begin as dysfunctional coping mechanisms for stress, after all.

Many eating disorder treatment therapists tell their clients that relapses are a part of recovery, in fact. Virtually no one who’s gone through treatment will never have a relapse. The important thing is to keep in mind that relapses are temporary. With the established support system of the family, the step-down program, and various alumni services (which can be provided by the residential treatment facility in most cases), a relapse can be stopped. If they need to re-enter a residential facility, or more common, increase the level of care in their day treatment. The important thing is to not punish yourself by feeling like a failure because of a relapse. Recovery is a long and winding road.

Learn More About Treatment and Aftercare

Interested in learning more about the many benefits of eating disorder residential and day treatment programs? If you or a loved one has been diagnosed with an eating disorder, it’s important to speak with a medical professional about treatment options as soon as possible. With the help of a strong support system and advanced aftercare, it is possible to find a balance between eating disorder treatment and other priorities in life.

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.