Don't read this post about suicide and eating disorders

You don't want to read this. This topic freaks you out, brings up your worst fears, and you just can't face it.

You know eating disorders can kill. You've heard that anorexia is the deadliest of psychiatric illnesses. And don't forget: bulimia is under-counted because coroners prefer to write: "cardiac arrest" or "electrolyte abnormality" instead.

But suicide is a leading cause of death for people with eating disorders, and ignoring that fact doesn't help.

And this is gonna hurt - I'll warn you in advance - these suicides do not happen just at the "dangerously low" weights we all titter and point at. In fact, suicide in eating disorders often happens when recovery is under way.

Suicide kills more people in the US than homicide does: 30,000 a year. But I think we tend to have a compassion deficit on the topic because it appears to be self-imposed. Eating disorders and suicidality are not choices; they are symptoms of disease.

Our firm and loving support needs to extend beyond the initial weight gain and the brave initial efforts the patient makes to recover. The hell for them isn't just when they are starving or purging - those activities numb the pain - their hell is reaching and then maintaining a healthy body and active brain. That takes many months of brain-rending work, and may have to be done more than once.

Yet the supports that get a person to "look better" are often withdrawn when they do.

I don't mean worrying, suspecting, snooping, and despairing: I mean maintaining generous and appropriate levels of support. College can wait. Independence can wait. Cutting back on therapy bills can wait. Our normal lives can wait.

If you read this far, you deserve some good news now: research is uncovering clues to who among us is the most vulnerable to suicidality. This may lead to better monitoring in future, and a better understanding of what mechanisms underlying the thoughts and behaviors.

Although anti-depressants have been largely ineffective for underweight ED patients, they may have a role in individual cases. Yes, antidepressants are believed to cause more suicidal thoughts at the beginning of treatment, but did you know that the same effect is found with psychotherapy? Recovery is hard.

Not recovering is harder, though. We can't let our fears of suicide cloud that truth: staying ill isn't an option. Negotiating and giving in to the illness won't prevent suicide: they make it more likely. Early and firm intervention, full recovery, and long term supports are what we CAN do. And must.


  1. Laura,

    As someone who has attempted suicide (within the past year), I absolutely applaud you for staring this issue in the face. I lost hope- for a while- that recovery was real, that things would ever get easier. My AN rituals relieved anxiety and allowed me enough umph to get up in the morning and see what the scale said. When they were gone...well, all hell broke loose. Much of the guilt I was feeling at the time was due to the fact that treatment had cost me and my family so much (money, time, effort, heartache) and I still wasn't better.

    The irony is that my complete split, my realization that there is no such thing as half-recovery, that I had to throw in the towel and just hold on- that's when things began to turn around. And ultimately why I am where I am today.

    Thank you Laura, for saying what so many of us are afraid to say: suicide is real. And scary. And it doesn't have to happen.

  2. What strikes me as the most frustrating aspect of all this is that Kristi shared her pain and plans with all the WRONG people, not someone who could reach out and hold her through her darkest period. And now it's too late. And now some foolish follower might think it's okay to give up.I've known others who've taken this journey, one leaving 2 young boys, and the truth is that the pain never goes away with them, it's left for others who love them to bear and it sucks!
    I am so glad that you survived yourself Carrie! Life will be hard at times, no doubt about it. You were fortunate that you got another chance. Please take care of yourself and honor yourself. If you ever feel like you're sinking again you know you have people who WILL believe in you even if you don't. Don't ever be too proud to ask for help. As Laura said, we know this is hard for you and others.
    My mom used to tell me that suicide was against the law! In a way it is.
    Thanks for addressing this in your blog Laura.

  3. Mary,

    How right you are about how this poor young woman shared her pain with those who let her wallow in it, rather than dragging her out.

    I am glad I survived, and I think it basically took looking death in the face and realizing that face wasn't as comforting as I thought it would be. I was lucky- I chose the right person to talk to- my mom. :)

  4. Dear Laura and Carrie,

    Laura, Thank you so much for opening the conversation about the most emotionally painful but infrequently discussed outcome of eating disorders - suicide. As the mother of a 15 year old daughter struggling to recover from anorexia, the daughter of an extraordinary mother whose life ended by sucide, the granddaughter of a beloved grandfather whose life ended in suicide, and a mental health professional, the topic is one that is so personally meangingful and needs to be openly discussed and acknowledged. Carrie, you are so courageous to disclose about your own very painful road to recovery. I am looking forward to your upcoming book for teenagers about eating disorders and have already pre-ordered a copy from Amazon.

  5. Hi Laura: I am the author of the post you refer to titled "Internet Suicide."

    I wanted to clarify that my site is not a proana site, my mission, as a mother and recovered ED sufferer is to EXPOSE the proana web trend.

    My goal is to educate parents on ED and the proana movement.

    Take care,

  6. MV,

    Thank you for writing - I really apologize for my wording (now fixed) which was just plain sloppy. I didn't mean that your blog was pro-ana. I am an admirer of your blog and your work to discuss and confront the pro-ana sites!

  7. This is a really good thing to set up on the internet.
    I have attempted suicide once around a year ago when i was recovering from self harm, thank god i managed to stop that, it was taking over my life.
    And today my brother and mum have been calling me anorexic just because i haven't been eating much recently, an apple for breakfast then salad for lunch, then a proper 'normal' dinner at night with pudding and stuff :) Just because i don't feel very hungry in the day, also i will usually buy a cake of something from school, (im 14)
    I hate my mum at the moment.

  8. Your mother loves you. Trust her.


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