I do not actually know if my friend has bipolar or has anorexia, but she won’t talk to anyone and denies she has a problem.
She has been somewhat stressed recently (identity crisis, landlord selling house), and back in January I noticed a slight change in behavior and she wasn’t as joyful. She took a planned 2 week trip to India at the end of January and when she had returned, she had lost a ton of weight, refused detailed conversations, and her mood was off and on until it just went completely down. She reasons that food is not a priority, or she doesn’t want tight fitting clothes, etc. She’s been given several resources but refuses to get help. She stands by her computer at work and has actually fallen over. Her skin has become blotchy.
How do you help someone who doesn’t think they need help, but is starving themselves to the point of fainting, assuming she won’t answer the phone, text, or doorbell.
First, and most important, I think your friend is very lucky to have someone who is concerned about their health and seeking out ways to help. Many have family and friends that either ignore changes like these, downplay them, or run away as fast as they can when things like this appear.
Eating disorders are very tricky illnesses. They creep up on you and can spiral out of control before you even realize what is happening to you. Others may see you withering away, but you can only see your own distorted perception staring back at you in the mirror that shows the complete opposite of withering. How can you help someone with an eating disorder or even with bipolar disorder if they do not think they need help? The blunt answer? You can’t. Sort of like the saying “You can lead a dog to water, but you can’t make them drink.” The only way your friend will get help is when they are ready to admit there is a problem and are willing to make changes and get help. Does that mean that you sit back and do nothing? Absolutely not!
You can express your concerns to your friend, however, be advised, it is very common that people with eating disorders will deny, deny, deny. They may get angry, agitated, and frustrated if you repeatedly force the issue and might even end up causing them to pull away from you, leaving you feeling even more helpless than you already do. When approaching your friend, it is best to not come at them in an accusatory manner. If you do, your friend may become very defensive.
Start off by mentioning that you have noticed she’s been a bit different since her return from the trip and you wanted to make sure she was ok. Let her know that you are concerned because her health seems to be affecting her at work and offer to be there for her if she needs to talk. Eating disorders are not as simple as someone just deciding that they do not want to eat or that they aren’t hungry. There is usually something much deeper going on. Telling her how terrible she is looking or trying to force feed her will most likely make the situation worse. While she has been given many resources and has declined to use them, offering to be there for her as a friend and allowing her to confide in you and trust in you, she may feel more comfortable talking things out with you as a friend one on one and not jumping right into something as big as going to a therapist. If you can get her to feel safe with you and open up to you, there is a greater chance that you can get her the bigger help she needs by going about it in a “baby steps” type method. Just like an eating disorder doesn’t become a disorder overnight, neither will the realization that there actually is a disorder. It will take some time and patience in order to get her to see what really is happening. You all might see it plain as day, but for her, it slowly became a way of life for her and a way to cope and the only way she will get better is when she realizes that things have gotten out of control and she could do some very serious damage to her heart, or bones, or various other internal issues may arise because of this behavior. She will not see this overnight though, and she will definitely continue to push away all efforts that are thrust at her because she is in denial.
I wish there was more that could be done, but aside from offering to be there as her friend, you can’t force her to eat and you can’t force her to get help when she can’t even recognize there is a problem. In extreme cases, parents and caregivers can intervene and if it is serious enough, there are ways to get your friend involuntarily hospitalized to get the help that is needed, but that is something that is a worst case scenario type of option.
I hope this helps a little bit! Feel free to contact us again if you have more questions!