05/11/2025
Appetite and safety
One of my psychology friends sat in an intake interview with me for the admission of a patient with a possible ED diagnosis. At some point in the interview, she got teary and said: I just don't have any appetite.
He then reflected back to her: "it sounds like your appetite for life is also low."
It hit me like a ton of bricks: if you have no appetite for life, why would you have any appetite/interest in food?
What I find interesting, though, is how the control found in ED (low appetite) from a subjective experience helps to regulate mood/OCD levels to tolerable levels (increase appetite for life). As soon as we start making some progress with the ED and increase intake (increase appetite), depression and anxiety can present itself with new intensity that feels unbearable for the patient. Of course, cases differ, but this observation is quite common, especially if progress feels rushed unsafe.
A patient needs a safe environment to eat.
Recently, there has been a change where I am feeling unsettled/unsafe in my own home (sectional title living for the win). I am acutely aware of my shallow breathing, increased heartrate and struggle to keep food down. This just reminded me that it is impossible to consume food in an environment that does not support your nervous system.
Are we paying enough attention to this?
