Eating Disorders, Substance Use, & Trauma
February 24, 2025 | Dana Harron
This is a repost of our blog originally posted in 2024.
Eating Disorders, Substance Use, & Trauma: How Each Effects the Other and How to Get Help
Trauma, eating disorders, and substance use are deeply connected, often creating a complex cycle that can be challenging to break. Many individuals turn to disordered eating or substance use as a way to manage overwhelming emotions rooted in past traumatic experiences. While these coping mechanisms may provide temporary relief, they often lead to further distress and reinforce harmful patterns. Understanding how these issues interact is the first step toward healing and recovery.
Understanding The Terms
Understanding Trauma
Let’s begin by defining our terms. Trauma is a negative experience or series of negative experiences that have overwhelmed your ability to cope. A trauma reaction is defined as the body’s survival systems- fight, flight, freeze, collapse, fawn- become chronically dysregulated in response to trauma. Trauma isn’t about what happened, it’s about the body’s response to what happened.
Trauma also alters your perception and ways of thinking about yourself and the world. Many people develop deep-seated beliefs and conceptions that they are worthless, hopeless, or inherently wrong. Additionally, it is also common for trauma to lead to internalized ideas about the world as dangerous or unpredictable.
Understanding Substance Use & Abuse
The definition of problematic substance use is, simply, “continued use despite negative consequences.” I’m not talking about a glass of wine at New Year’s Eve but this doesn’t necessarily mean extreme cases like multiple DUIs or legal intervention—it can also include more subtle warning signs.
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Negative consequences could include increased tolerance, persistent hangovers like a headache the next day, or a mild feeling of discomfort when you know that you are using substances to deal with your feelings. Drinking to avoid conflict with your spouse, popping a cannabis edible to numb anxiety about your kids, or relying on pills to handle stress and take the edge off of dealing with your parents. These are all examples that qualify as using substances in order to deal with your feelings. These help you get through the moment, but they often come with long-term costs.
Understanding Eating Disorders
Disordered eating is quite common in our thin-centric society. However, an eating disorder is typically diagnosed when food and body image concerns dominate a person’s life. Spending more than an hour a day obsessing over eating, not eating, or how you eat may indicate a problem. Additionally, feeling extreme guilt about food choices is a strong sign of disordered eating.
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Trauma Sets the Stage for Eating Disorders & Substance Use
So in this commonly seen trifecta, trauma initially sets the stage. Trauma often makes a person experience seemingly intolerable emotions that they would do almost anything to escape. Eating disorders and substance use are both ways to deal with overwhelming feelings. They get a person out of their body and out of their head.
Eating Disorders & Substance Use are Reciprocal
Substances affect you differently when you are malnourished. Substances also aid and abet in eating disorder behaviors and many people with eating disorders use substances in order to lose weight, suppress appetite, vomit, or exercise beyond the point of exhaustion.
Eating Disorders & Substance Use Set the Stage for Further Trauma
Please do not take this as victim blaming. We are not looking at the initial trauma here, but the ways in which behaviors that people do in order to deal with the effects of the trauma can themselves be re-traumatizing. Some people can have traumatic reactions to eating disorders, or substance use, the same way one would a car accident or combat situation. This makes sense because these illnesses represent real threats to a person. Additionally, substance use in particular often puts people in risky situations. Obtaining illicit substances, hanging around in settings where people are likely to be unpredictable, and other problems can come up.
Healing from Eating Disorders, Trauma and Substance Use
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Because these issues are overlapping and intertwined, they can seem overwhelming to address. However, a skilled and trained therapist can help you to address these issues by leveraging your strengths and figuring out the need that you are trying to fill with all of these different behaviors. Likely, it has to do with a felt sense of security and connection to self and others. Many people find this feeling for the very first time when they are working with a really good therapist, and it sets the stage for finally finding freedom from these destructive patterns and peace of mind within yourself.
Reach Out
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You can also call or text us at 202-656-3681, or email us directly. Give yourself the opportunity for the support you deserve.