Posts Tagged eating disorders

Wedding Fever, me? but I am MAD!

(I just wrote a long post & it deleted itself. Not in Drafts. Unhappy Blooger. Yes.)

Weddings + Me = Bad Idea.

That is what I always thought.

I was never the sort of child who daydreamed about a fairy-tale wedding. I drew pictures of fairys, yes, but I was more concered about lauching my career as a Full Time Fairy who would promote Green Peace (which confused with World Peace for years) than thinking about yucky Boys or a big poofy dress.

As I grew up I pretty much denounced anything girly. I was a Goth (or a Goff judging by many numerous clothing mistakes) I was also mad. As a child anxiety follwed me around like a hated imaginary enemy. It got worse. By 12 I was depressed and worried. By 14 I was in intensive therapy for my Eating Disorder, my self harming, depression & anxiety. I rattled with medication. I was sad, bad, mad.

I thought that –

Mad plus fat plus scarred = never ever married. Ever.

I did not consider it a possibility. During my teenage years, and, to be honest, even very recently, the idea of any future at all was a shady ideal and overshadowed by my numerous suicide attempts.

What has changed? I am still mad, bad, sad. I am still scarred. I still self harm. I still have a rampant eating disorder that rules my life. My anxiety is isolating. My OCD rocks even my strongest relationships. The Great Depression II just ruins everything. My psychosis puts me in hospital.

But I have The Boy. We got engaged to cement the fact we were solid in our relationship that we know will last forever. We got engaged because December and the months before it were hard and horrible, the engagement was the light at the end of a very, very dark and scary tunnel. We were not expecting to plan a wedding until maybe five years into the future….

Then The Boy’s Army ambitions really kicked off…and we talked, and talked, and talked.

We decided (well, maybe I decided) there was no way I was letting him go to a war zone without him being my Husband. We wanted something for me to work towards and in both situations a Wedding seemed like a brilliant soloution. The obvious choice.

I thought it would all take a while to get off the ground..I thought we’d both go off the idea, be put off by the money and the planning.

Like with so many other things, I was so very wrong.

We have both jumped into wedding planning feet first. We love it. I love it. It is making me excited & happy, I wake up with a smile, feeling like Chrsitmas is coming as I count the days until we can go view the first two possible venues. We both have made lists, and counted pennies and started savings.

I am mad – but contray to what I always thought this does not means I can not get married.

I really, really did not think I’d ever cathch Wedding Fever, it is so un-me…but so is the fact I have a First Class degree and am going to start a Masters..but so is my newfound love of pink, my striving to get better, my shakey communication skills that are improving every-time me and Boy sit down with a cup of tea and talk into the night, I am trying in therapy. All of these things one felt like things i’d never ever do.

I would not care, really, if Boy and I had to be wed in a in-use cow barn while wearing bin bags. I’d just want us to be Husband and Wife. But, because we are able to plan a wedding, we are.

It is going to be a pinky, vintage, crafty themed wedding. Boy will be wearing Army Gear. It will be very ‘us’ Controversial and a little bit mad. I am so happy.

I think my fable-esque message at the heart of this post is:

I am mentally ill and physically disabled. I may well be that way forever. But that does not have to stop be persuing my career (as an author not a fairy, sadly) and my life (marrying the Boy and sobbing as he leaves for War). It does not have to stop anything. I can weave it into the fabric of my days….

and If I can do that I really think anyone can.

 

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Meet Simon, a prize tosser..(Fighting back against Eating Disorders)

Do you remeber playing Simon says as a child?

I didn’t win many friends when playing  because I can’t follow instructions. Or I won’t.

If a school- mate said ‘Simon says stand on one foot’ I’d immediately begin doing frenzied star jumps because I so desperation wanted to be different and stand out from the crowd. I was a annoying child.

In school reports I was often described as having ‘a great deal of willpower’ and ‘knowing my own mind’ which I think is politically correct teacher speak for ‘irritating shitty child’. (I now have this confirmed by my Sister who is a primary teacher in a inner city school).

At some point I changed. I begun listening too and following one voice that told me what to do. I did everything it siad and bowed to its will.

In my life Simon now says a lot of things..

Simon says I shouldn’t take 4 sugars in my tea.

Simon says I shouldn’t replace said sugar with sweetener because may make me grow seven limbs and ten eyes.

Simon says I shouldn’t eat fats or salt or..food

Simon says I should be a slave to calories

Simon says I should worry constantly about the scale, and use a number to define

Simon says I should be miserable and have no social life.

Simon says I should inflict harm to myself and try to extinguish my life.

At some point a childhood abilty to NOT do what was asked of me altered to an utter dedication to the eating disroder voice in my mind.

Simon is my eating disorder and Simon is a tosser.

I miss the child in me that was free, that was able to break away from the rules and regulations, that had an opinion and had people make opinions about her. No-one forms many opinions about me anymore, I have become defined by boxes, tick boxes, diagnostic labels. I do not know many people outside of Therapists anymore and they do not see me as anything more than a personified label.

I miss childhood games..

 

I know lots of people have a Simon in thier life.

He takes on many forms..Eating disorders,OCD, self harm, depression, pain, illness – any life event at all that drags you down and whispers things you do not want to hear in your ear.

I hope you can break free of Simon, kick him down and become a contrary child who star jumps when they are told to sit down and write sums.

[The caption that came into my head when I saw this was ‘don’t be a muttet, you are not his puppet! *snorts* maybe I should write for Hallmark..]

For me, part of loosing Simon, of kicking him down and shrugging him off, is to let myself do things I fear. Which is difficult, because I am scared of nearly everything..even dumb stuff like the remote possibility of the kettle exploding when I put it on to boil (it sounds as if it is in pain..) and the washing machine blowing up the house (boyfriend has done all my washing for the past four years, my phobia has actually paid off in that respect..)

One massive thing is my fear of succeeding.

During my Undergrad degree I was a mess. A massive mess. So much of a mess i ended up having a huge breakdown at the end of the year and notched up more stays in the emergency Psych ward than I care to recall. I would cry, publicly and snottily everytime I had to hand in an essay due to the fear it would be lost in the system or that there was last minute mistakes they would lose me a grade. Usually, I would do well..and usually the relief of getting a good mark would once more cause me to burst into inconsolable tears in the department corridor..oh, the tutors were confused (‘but you did well! who on earth are you sobbing!!??’)

Before I even begun my GSCEs I have wanted to take my academia to the next level and do not just a BA but an MA..

Simon said no.

Today I am saying

Screw You Simon 

You utter tool!

 

*snort* > screw, nail, tool…sex jokes *snorts*

But yes. Today I have begun to fill out my application to begin an MA in September.

My eating disorder wants me to stay rooted in this place, this place where going backwards is seductive because it is known, because there is comfort in suffering. Because I am scared.

I kept on thinking ‘when I am better I will continue learning’ ‘when I am better I will do what I want to do’ ‘when I am better I will have a life’

A realization came and slapped me in the face today, and it left a mark.

It was the knowladge that I need to work to get better. I need to move forwards..as a horribly humliating motivational work confrence once told me way back when I worked in retail

‘I need to be the change’

This sort of thing makes me want to vom in protest, but it is true

Me going back to learn stuff isn’t going to change the world, it isn’t going to have a profund effect on human suffering..but hopefully it will set things in motion so that I can be who I want to be and do what I want to in life..

I am firing my Simon.

Because he is boring, and eating disorders, self harm, depression..all this shit, it is all the same. I read so much stuff online from other people with the same, or similar, issues and they may as well be me typing..becuase eating disorder thoughts are not special or orginal. It is boring. It is misguided. It only leads to pain.

An Eating Disorder does not make you special

 

Please kick me if I try to give up.

And let me know if you have any Simon’s and how you are going to kick him in the face.

 

 

 

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My confession..Knitting dreams.

No, not knitting my dreams, that would be fucking freaking, I have been dreaming about Tamagotchi’s and that dream where you are driving-a-car-but-can’t-reach-the-wheel..(odd, as I eleced to give up on driving lessons after two instructors that attempted to get me to reverse around the corner had heart attacks. Not joking).

Anyway..I really really want to make one of these;

a lovely homemade blanket

I am going to – once again, embark on the possibly dangerous adventure of teaching myself to knit pretty stuff.

Way back when I was IP in Oxford the ‘inmates’..sorry, patients..all clacked their needles together in a, frankly scary, war beat and resolved to make a blanket. The challenge was set. Everyone knitted..all the time. All. The. Time. As one inmate/patient left another took thier place and picked up the needles. I am pretty sure everyone aside from me were handed an extra information leaflet about their stay which read; ‘knitting needles are as integral to your recovery as willingness to attend group therapy and eat meals’. 

I have heard many times that people with eating disorders or ‘problem’ personalities, such as BPDers are unusually creative. In my experience that seems to mean they all came from the womb armed with knitting needles and were making wonky socks by the age of 11 months. Even the boys could knit!! Everyone…but not me.

Maybe if I had not been so premature I would not have missed the ‘knitting gene’. Maybe I too would have the inbuilt ability to know that a ’round’ is not always a scone..and ‘peal one’ is not a reference to a posh necklace. I blame the fact I made my entrance into this world at 24 weeks on many things..like the fact I will never be able to stand on one leg..or use a skipping rope with out ending up in an ambulance, bounce a ball or not fall over in the dark.  Lots of things but these upsetting instances seem no where near as disabling as my inability to hold knitting needles.

When I was IP they went flying out the window. At university when my cool,geeky-chic housemates tried to teach me how to knit the needles very nearly went into various orifices..(theirs, not mine.)

I am a grumpy learner.

However….today, that may just change.

My desire from a blanket that is..possible a lot like the one ‘they’ all made when I was in IP..is strong enough to conteract my huge lack of ability. I have ordered wool and knitting needles, I have ordered a book and I have made my mother swear on BigDog that she will help me.

The wool

 

 I am mentally training. I am watching Youtube clips and tutorials and practicing breathing techniques. I am counting to ten when frustration hits and I am ‘visualizing the end product’. I am making SMART goals centered around knitting. I am reading the advice of others, I am encouraged, inspired and calm. Who says all these years of therapy were wasted?!

The wool and all that should arrive soon…

I will keep you updated, just Watch This Space..

 

(Good luck messages appreciated)

 

 

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Eating disorders, Lol cats and North Wales

I can’t believe how sneaky eating disorders can be..and so utterly stupid, 

so much so I dictated a Google image search to it; 

For my ED

Recently I have been gravitating to Inspriational Recovery Blogs such as Nicole and Gwedolyn, the ex bulimic and Recovery Inspirings Blog. I have been trying to think more positively – I had the pain enough under control today to walk BigDog. I live in a beautiful place and I attempted to actually see my surroundings, soaking up the gorgeous countryside rather than attend to my usual mantra of ‘fat,fat,fat,fat’ and soley using walking as a way to burn calories…this is what my ED makes me ignore – 

To be perfectly and utterly honest I couldn’t quite shake the numbers, weights and calcuations that were spinnig around my head, but I really did enjoy the surrounding area much more than normal. I did walk a little too far and have spent most of the day feeling sorry for myself attempting to push the pain level down from a horrible 8 to a more breathable 7. It hasn’t worked too well and my Ed has taken full opportunity of my mood and neatly tied it in with my attempt to claw my way from it’s grip…

Ed: Hi! Idrawlikenick..you are useless you know that? You didn’t even manage to be productive after that slow, pathetic walk this afternoon…you have just been sitting around on the sofa like a fat slug..

the thing about Ed’s is they manage to turn anything around into hard, pointy, painful spikey words…

Ed: ‘and you have been looking at recovery stories?! Ha! You’ll never be as good as those other people who have sorted out thier life, you are fat, stupid, lazy and boring..pain? ha, pain!? It is just a stupid excuse not to go out inot the world and do something meaningful..

Then the really, really smart bit..(please note the sarcasm) 

Ed: You are not even thin enough to have an eating disorder, why do you not just BINGE? You might as welll, you are not good for anything else. 

Er, yeah…because eating the kitchen of leftovers and Nutella is REALLY going to make me feel better. I am such an all or nothing person. I read about recovery and in my head I decide it is logical to just go binge, because I want to be able to eat normally so I may as well eat everything.

Reality check to idrawlikenick..binges are not part of normal eating..nor is restriction. I am not going to change overnight. I am not oging to wake up better. I am going to have to work for this and it is going to be a long, hard process. 

This inside of my head is ‘Fat, fat,fat, binge, pathetic, useless, binge, binge, binge, binge binnnnnnnnge BINGE’ 

Well, I am not giving in. Peanut butter, nutella and cold lasange, while tasty…do not go together and are not 10 o clock in the evening foods. It is not going to happen. 

Instead I am going to make myself a cup of tea and smoke (the one addiction I am not trying to fight, because If I am fighting everything else I think I should allow myself one socially unacceptable habit). I am going to find something to watch on the tellybox that does not involve weight or clothes sizes. 

I will recover..but I am not going to let my Ed tell me that binge eating is the way to conquer anorexia.

On a similar note (and please take this into account if you think eating disorders are ‘cool’ or ‘sexy’ or just a way to ‘drop 10lbs fast’)I was reading a crime thriller on my Kinsdle last night and It happened to mention the weight and height of the protaginist. This had no real bearing on the plot..which was about serial killers and stalkers and overal a very poorly written peice of crime fiction..but my thoughts got hooked on the damn weight of the fictional character and I spent the entire book feeling bad because I ‘wasn’t as thin as her’. A new low from my life with an eating disorder. Maybe it sounds like a small thing – but when you cannot even use fiction books to escape it is a fairly low moment. 

Eating Disorders are funny sad, not funny ha ha..but I still like things that make me smile..

 

Tomorrow I am going to attempt three things: 

1) Walk BigDog and look at pretty trees & hills, not think about calories. 
2) Take knitting needles, wool and all mindpower I can muster and attempt to do more than just throw them out the window…
3) Spend time looking at Lolcats and happy things not just porning on Come Dine With Me recipes website….

and  this evening I vow I shall not binge. No, no, no, no,no.  

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Labels are for telling peas from beans.

I have never mistook a tin of peas for baked beans, and that is a good thing – because I hate baked beans with a passion that is likely far too feirce. There is no orgin to this hate, I..sadly do not have a witty tale of childhood bean-related trauma (unlike Smarties, but I’ll save that for a different day) I just hate the orange little bastards. Canned peas, I love em..frozen ones I can take or leave, but give me a tin of peas and I’ll be a happy camper.

My point is, in this case, labels are important because there is no other way of knowing what is inside until It is far too late…and pea/bean mix up’s are very sad. In Eating disorders however (and yes, I also think it is amusing that I chose to use a food analagy) labels do not matter….we just think they do.

When someone is diagnosed with an ED (that shorthand for eating disorder which I shall use for the rest of this post)..they think that thier ‘label’ matters very much, at times in thier illness alot of people are defined by thier illness and find it very hard to find a difference between self & ED..

Me on non-recovered days when ED is incharge: Hello, HiiiiiiiiYA! I am anorexic…and my name is alexishereidrawlikenick

Me on ‘good’ recovery – battle days: Hello, HiiiiiiiYa! My name is alexishereidrawlikenick, oh, and I am anorexic..

The future me: Hello, HiiiiiiiiiiiYA! How are you? My name is alexishereidrawlikenick and I really like dogs, I like to write, I am a bad poet, I am not very tidy, I like exciting coloured pjamas and recently brought a really cute tortiose shaped lamp with i have name Stuart..(//rambles rambles..point being that identifying self with ED doesn’t happen..)

I spend a lot of my time thinking of myself as ‘anorexic’ first and as a person second. For a long time I have had a big problem with binge eating, this problem pre-dated the arrival of my anorexia in my early teens..in all probability if I look at it according to the DSM citetria (for a link to the DSMs on my blog > therapy woes and personality disorders) then I have a touch of EDNOS/Bulimic behaviors too, for a long while this was a huge source of shame that I denied the existence of.

It doesn’t take a genius to realize that if you try and treat an illness while ignoring some of the biggest symptoms you are not going to get very far, and I think that this is one of the reasons why all my earlier attempts at recovery and the time spent in inpatient wards did nothing to really help me. From talking to other people that have fought/are fighting an ED though I have come to a few realizations;

1) ED thoughts are similar. It makes us feel isolated and alone. It promises us that we will be special and hiss in our ear that we are not deserving of food because we are ‘different’. Yet, if you read a testimony/real life story/blog from anyone with an ED, be in Anorexia, Bulimia, EDNOS, binge eating disorder, compulsive over eating..you will find that we are very sheep-like..the thought patterns (the ‘I am bad/underserving/disgusting/pathetic/need to try harder/be thinner/change this/be in control) all repeat themselves over and over again. It is as if there is a massive ED cloud, just talking into a transmitter that is heard by all sufferers..we are all dancing the same dance but behind big, thick screens so we think we are alone.

2) Part of the hold of the ‘ED’ is the idea that you are ‘not sick enough’. For me – I ‘need’ to be anorexic, as stated in the DSM because otherwise I am ‘failing’ and do not desrve treatment. I force/starve myself unitl my BMI is ‘less than 85% of my ideal body weight’ because the ED has put it into my head that if I am not of this BMI I do not have a problem, do not deserve help and ..(yes,it goes to this extreme) that I do not deserve to live. However, my unhealthly behaviours/thoughts and the subsequent feeling festival that causes is no different to, again, people with any other ED Label.

This is all the same hell, the sign posts are just a tad different.

Clinicians uses these labels because it dictates the medical producures that are intitisataed. At least, it used to. Now, however, even that is bollocks.

It is widely understood (thanfully) in the medical/psychological professions that binge eating disorder, eating diosrder not otherwise specified, anorexia and bulimia ALL carry a huge amount of potential for major health complications.

In anorexia weight is often very low, if it is under a certian number the patient is often hospitalised for forced re-feeding. This is the ‘old skool’ way of looking at it, and the view that..unfortunately does not seem to have yet penetrated the bubble of the medical professions to reach the media/the public. (I am generalizing here, I know some people still suffer from chronically mis-informed GP’s/doctors/psychs who think eating disorders are for ‘thin people’ but on the whole it has improved). Psychologists and ED specialists now realize that people with EDNOS/Bulimia/any-other ED can have the same nutritional deficits and overall health risks are suffers with an extremely low BMI.

Bulimics or those who invole in any kind of purge type behavior are often in -more- medical danger than those that follow a restrictive diet…there can be electrolyte imblances which can lead to a much increased risk of a heart attack. It can also cause  tearing and rupture of the oesophagus, malnutrition, dehydration, and lung problems (including pneumonia), Hyponatremia (not enough sodium in the blood), and even paralysis. for more, click here (from somethingfishy)

Now that it is know that all ED’s are as medically dangerous as each other more people -need- to lacth onto the idea that they are all as emotionally damaging as each other. Seriously, people with ED’s play like broken records, we all have the same concerns that loop over and over, the only difference seems to be the social stigma.

ED’s are not actually about weight, but about emotions. (No shit sherlock)..despite that fact the labels themselves seem to be very important even to the individual sufferer.

I will admit that I did used to be proud of being anorexic. My therapist-at-the-time ‘gave’ me the diagnoses as if she was handing me a fragile gift, I nournish and ‘fed’ it accordingly..until it nearly killed me. Also..ED’s are deadly, but very few people die looking like an emaciated bone bag..my ED -did- and had nearly killed me, but not while I was at my lowest weight. Whem my BMI was 13 I had no energy to do anything, especially not kill myself but I have had sevral serious suicide attempts. The ‘worst’ in terms of me nearly being dead was probably when my BMI was a more-socially-acceptable (although still unhealthy) 17. At that BMI I did not ‘look’ like a anorexic..you could not tell by looking at me that I had an ED..but it still came very, very damn close to killing me. Weight does not dictate the amount of emotional distress a person with an ED is going through.

I did think more than once about actually putting the BMI I ‘reached’ in here in numbers…because I am all too aware of the  negative comparisions that ED’s cause. I also know that a blog post on the topic of ED’s is much, muxh more likey to be read than a sufferer or some one who has suffered than average-joe public. However, I felt it necessary in order to give the sheep-like ED thoughts an extra kick. If I read weights I immediatly compare, but irregardless of what my weight is now or has been in the past, the feelings still equal emotional distress and dysfunction.

My current book is a murder thriller, a rubbish 89pence on i downloaded on my Kindle, my ED managed to ruin the whole book for me because the author noted the weight and height of the protaginist..my ED thoughts jumped all over this as if it was a day old kitten in a bastket and refused to give me any thought space for the plot. It turned a fictional novel about a ‘heart in the mouth’ serial murderer into something to feel bad about myself for…now, I realize how damn stupid that is, yet I bet any other person with an ED rerading that will nod along, knowing all too well the situation I am talking about..

whatever your weight is/ your label is…it is the emotions that matter. The fact that you feel so low is not okay, the fact you have a screwed relationship with food is not okay, the fact that your day to day activities focus on this fact is not okay…

weight is a causuatly of the disease, but it does not define anyone as a person…the label of your ED only matter to the ED. I have seen people that are fully recovered and they do not think that anorexia is ‘a better diagnoses’ than any other ED label..whereas people currently fighting an ED actively want to be anorexic, or even more anoreix. No -one is ever ‘sick enough’ if you have an eating disorder.

Labels, diagnoses, and weight all seems to have become ‘part’ of the eating disorder itself. In an ideal world all Dr’s/GP’s/medical experts/lay person will realize that all eating disorders are pretty much identical in terms of thoughts and feelings and only differ a tad in behavior..the medical stuff seems to be fairly individual and should only concern the medical professions, it shouldn’t be another tick on the list that feeds the greedy eating disorder that’ll not want to cease, ever.

I do often wonder if it is helpful for me to talk about ‘my anorexia’ instead of ‘my eating disorder’ because of the connotations I am hammering home to a) my own consciousness and b) other people who may read this – I do think that labels should be left on tinned goods but quite possibly it would be helpful to remove them from eating disorders.

I hope that one day I will become a person with a wide range of interests who does not identify themselves by a mental illness.. someday I am ‘anorexic’ other days I am ‘agoraphobic’ and some days I am a ‘self harmer’ if I can only view myself in these terms it is no wonder I have stayed unemployed as a graduate..

If anyone has read this, and has any views on the ‘label’ debate, I’d love to hear from you.

an ED thought scanner?

 

 

 

 

 

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Therapy woes and Personality Disorders

Not a happy bunny

I am not a happy bunny at the moment, although possibly less grumpy and more melancholic than the bunny in the picture. I do not know how to draw melancholy.

Some links that may help make this post make more sense – DSM for BPD (Borderline Personality Disorder) DSM for Anorexia DSM for Bulimia DSM for EDNOS

The Eating Woman was not very helpful, although I am pretty sure it is a) my mindset toward treatment in general and b) the personality clash that seems to be going on, rather than any major wrong doing on her part. Nonetheless I have been sulking since I saw her and licking my (metaphorical) wounds..

Therapy is not easy, as I said in a previous post I saw my first therapist when I was 14 and have not really been ‘out of the system’ since then. Someone from an online forum today said to me it was hard when you have been in therapy since a young age as you are forced to take on a persona of a ‘miniature adult’ both in terms of responding to your immediate chaotic environment and in terms of beginning of the path to understanding yourself. I agree with this statement wholeheartedly, although I do feel I apply it too liberally to my own situation in an attempt to dampen down the more difficult parts of therapy…

Tips of Therapy (and BPD) from about.com

Why is it hard? Isn’t it just moaning about how you feel?

Yes, and no. I think that therapy is very much individual, even if you are under a specific ‘treatment programme’..therapists, also, be they psychologists, clinical nurses, psychiatrists or any other -ist, do seem to have their own expectations that they bring to the room. Even in behavioural therapies, such as cognitive (CBT) or dialectal (DBT) seem to vary from clinician to clinician and I think this is appropaite but slightly confusing. I spent nearly 24 months in a DBT treatment group while I was studying for my BA and the group would change significantly depending on which group leader was in charge. It always surprised me that this used to alter the atmosphere of the room more than the emotions of the ‘service users’..(other mad people in the group)..I suppose I adopted an ‘us against them’ mentality and thought our emotional distress would sway the agenda much more than the planning of a trained therapist.

I think that therapists often know a lot more than the ‘client’ thinks they do..and also has a much greater role in a grop context. It has always surprised me when I have had an opportunity to see my notes (not a very nice experience)…I think when you have been in therapy for a long time you (well, me) tends to think they already know what the shrink/doctor/whatever is going to think..this is wrong, contray to my understanding therapists are not robots, but actual people with minds of there own.

Well, that was a bit of a directionless rant wasn’t it?

I am lost in therapy at the moment because I am considered ‘complex’ with many ‘co-morbid’ psychiatric diagnoses.

The main aim of any therapy I have ever been in is to focus on my Eating Disorder, probably because it has the most physical health issues directly attached to it. I have also been labelled with Emotional Unstable Personality Disorder, more commonly known as Borderline Personality Disorder (EUP or BPD)..

As a population, patients with BPD are more likely than Joe Blogs to develop an ED, with 21.7% developing Anorexia Nervosa and 24% developing Bulimia Nervosa..(I beleive that the percentage of people with EDNOS..eating disorder not otherwise specified…would be even higher, but unfortunately this is still not as well known or respected as a concreated diagnoses as ‘pure’ ED’s) Info and statistics from about.com

It is a commonly debated chicken-or-egg type problem..if someone has BPD and an ED..which do you treat first?

I, personally, would like more of a focus on what, supposedly, translates as my BPD symptoms, as I think if the thoughts, the anxiety and my general lack of abiltiy to be normal is made magically ‘all better’ or at least just..slightly altered for the better..I may then be able to think more openly about letting go of my ED, which is my most prevelant coping mechanism. (I do wonder if this is just me using excuses because I am too scared though.)

Anyway, I think therapy is an interesting topic to input into Google. I am always interested in any changes that are made in treatment or any new articles that are released. I love hearing other peoples experiences of therapy, treatment and what works and what doesn’t.

Dr D, my current ED Psych (Eating disorder psychologist) constantly tells me I am being ‘treatment resistant’ in both talk therapy and because I seem largely unaffected by even gross amounts of medication. I think the medication thing is very common in people with underlying BPD and personality disorders as a whole. I agree with the element about medication but I do think she is wrong, to an extent, about the eating disorder. I am not anti-recovery..I am just scared, and feel like If I launch into good ship ‘meal plan’ and ‘weight restoration’ at the moment all my big-bad feelings that I beat down using my ED will come and bash me and leave me in a heap on the floor unable to move. I do understand that this view point is pretty contrary, there are so many people out there that are so pro-recovery, and I do not dismiss that or think it is a bad thing, I have the greatest respect for anyone who has taken on an Eating Disorder and won, it must be such a hard and unforgiving fight..but, I just do not feel as if I have the inner resources or i suppose, the hope, to embark on that perilous journey yet. I suppose I am a big wuss.

I cannot really imagine myself outside of the realm of mental illness. I have had a lot of therapy and I am sure it is my fault, not the fault of anyone clinician or therapist that I have not yet won this war..like I said, I am not a happy bunny at the moment and I think the overall atmosphere of this post reflects that..what I say now is not necessarily very indicative of my general attitude, I get very frustrated that my viewpoint on things and the amount of hope I harbor differs so very dramatically. Depression and the utter fight it takes to even get out of new newly decorated bed is exhausting, this is not always so.

I very much feel for anyone currently struggling with depression, eating disorders or any other mental-wonkyness…or even just plain old, run of the mill discontent. I am lucky to have a good support team; as I said before I have a very good CPN, an ED Pysch who makes me go and feel miserable (which I think does me good) an Eating Disorder Dietitian, a psychiatrist and a very supportive boyfriend/fiance and family. I know I am one of the lucky ones..but, still, it is difficult.

Sirius Project < if you have not encountered this website before it provides very good, clear information on BPD, self harm, ED’s and other mental health issues, I like it as it is very clearly written, check it out.

I am trying to find other Blog’s that deal with similar issues that I am facing, I know there are many out there so if you read this feel free to plug yours or others that you like.

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Getting on my soapbox, Self harm and Eating Disorders

 

I do not usually get on my high horse and my soap box is generally banished to a dark, spider web infested corner but I feel I have to make a Blog post about this topic;

Doctors and mental illness/self harm/eating disorders.

I belong to a few online communities that deal with self harm and eating disorders. Today i logged on and there were two messages from very good friends, one struggles with self harm and the other with bulimia.

My friend who self harms recently ended up in A&E, needed stitches for her wounds but was told, by a doctor, that ‘people like you don’t need stitches’.

The girl with bulimia is on medication for an allergy. Her mother went behind her back to her GP, concerned about her weight loss and her GP prescribed her a different allergy medication where the most common side effect is weight gain.

I am going to write about these two incidents seperatly but I think they are equally awful and show that, whatever progress that the medical community has made, both frontline medics like A&E doctors and family GP’s need to receive further training. Self harm and eating disorders are both ‘passed off’ as ‘phases’ or ‘fads’. They are both serious symptoms of underlying mental illness and both can and do have very serious medical complications – that is ignoring the suffering of the person dealing with these issues.

Firstly, self harm. It is not ‘trendy’. It is not a teenage ‘phase’. Self harm is a coping skill, a bad one, yes, but a method of coping used, unfortunately, by a very varied demographic. It is not just teenagers, I personally know people in their 40’s. 50’s even 60’s who struggle with self harm. It is not just a ‘cool thing’ that teenagers experiment with, it is a symptom of  an underlying issue.

It is very rarely done for attention, most self harmers go to great lengths to hide their activites. Most are ashamed, scared and feel alone, which is why it is a problem of a much larger scale then actually seen in A&E. If a self harmer has the courage to actually go to seek treatment for their wounds then they should be supported and encouraged, not shot down. Even IF it is an attention seeking act (because I would be naive to say this never happens) surely the origins of the need for attention should be looked at? If somebody is hurting so much inside they come to A&E claiming, for example, they have taken an overdose and it turns out they have not, surely doctors should be more concered about the origins of this lie than the fact that their time has been taken up? Nobody craves negative attention over positive attention unless there is something wrong, so even acts that appear to be ‘attention seeking’ signal to some kind of problem on an emotional level.

I do not understand why a self harmer is seen as undeserving of help. If people were to apply this warped and discriminatory logic to all health conditions then there would be a much higher death rate amongst the general population.

Yes, a self harmer picks up a ‘tool’ and afflicts damage to themselves. ( I loathe to use the word ‘cut’ as although that is the most common cause of self harm it is not the only one, there are many, many different methods opf self harming which all points to the same level of emotional turbulence and an inability to cope with stressors and day to day events.) However, a type one diabetic may skip his/her insulin because they are tired of having to constantly monitor what they eat/their activity levels – when they are unconscious in A&E due to a hypoglycaemic episode or having keytones they are not viewed as time wasters. It is a fact (and I can dig out the published study) that most admissions to A&E and subsequent moves to medical wards for type one diabetics is caused by an ignorance or mishandling of their condition…so how are self harmers all that different?

Alcoholism is now, thankfully, widely accepted as a disease and a patient suffering from acute alcohol withdrawal is not as likely to come across judgemental nurses/doctors or to find themselves refused care as self harmers. (This observation has been made by talking to self harmers who also suffer with alcohol misuse issues/ online communities dealing with alcohol misuse and through my own first hand experiences of a working A&E department.)

Everybody has a right to medical treatment and care. A self harmer has as much right to self-present at A&E, or even call for an ambulance if needed, as a patient suffering from psychosis, breathing difficulties or any medical complaint.

If a self harmer who needs stitches/medical care does not go to A&E they pose a serious risk of infection and could then find themselves being in need of more serious and time consuming medical intervention than if they went in the first place. If the doctor in question, who decided my friend was ‘seeking attention’ in needing her wounds looked at did not know she was a self harmer would she have been treated differently? Yes. If she has come by the wound via a ‘real’ accident she would have been given more medical care and attention than she did receive. Even if doctors do not want to pay attention to the emotional needs of a patient than the wound should be viewed in isolation, with the same risk assessment and infection management rules applying as with any patient.

Also, A&E is a ‘first response’ unit for psychological crisis’s. If someone feel like harming themselves or ending their life and are not already in contact with the mental health services then their first port of call in A&E. Even if a patient does already receive input from a local mental health team they will often be referred to A&E because CPN’s/psychologists cannot often make emergency appointments or admit patients to a ward without going through the emergency psych team connected to A&E. Therefore this is a KNOWN part of the job. Doctors/nurses/HCA’s should be more adequately trained in mental illness, ranging from self harm to how to deal with a panic attack or psychosis because they are going to encounter it often, possibly multiple times in a day.

I can recognize how it is easy to become jaded. Self harm is selfish, it doesn’t really help and yes, it does take a long time to give stitches to somebody who may possibly go and make another, similar wound within days or hours or treatment – but that shouldn’t be a reason to deny treatment, ever.

If an idvidiual is repeatedly self harming and repeatedly presenting at A&E and needing time intensive treatment it probably does get irritating. There was a time in my life, and it wasn’t that long ago, where I was on first name terms with the receptionist at my local A&E. I was very ill at that point and I wasn’t trying to put doctors out or annoy them – I simply was trying to stay alive. (I realise that it may seem counterproductive but for most self harmers the act of harming oneself is not a suicide attempt, it is a method used to try and keep alive.)

I was very ashamed of my actions and embarrassed but I could not curtail my behaviour. It was not something I was in control of. When I am ill I do not expect tea, sympathy and fluffy bunnies and neither, i think, do any self harmers. I do not go to A&E looking for a pat on the head or a cuddle or for someone to feel sorry for me, I go because I have a medical issue that needs addressing urgently. A doctor who refuses to treat a patient does not help. It simply puts suffers off seeking aid when they require it which increases the chance of infection, or any progress being made, of sufferers receiving help from the psych team, and can, in cases, heighten the change of fatality from wounds or injuries.

My friend is writing a complaint to the A&E department that was involved in her ‘care’. I strongly advise anyone who experiences anything like this to do the same. The medical population as well as the general population need educating about these issues.

I could write about this for ages – I know professionals often raise other points such as ‘why reduce scarring on someone who already has many scar’ and if anyone is interested I am happy to give my opinions on this matter – but from here on it gets very opinion based and (although I am not good at it) I wanted to keep this post as concise as possible in the hope people will take my points on board.

 

Now, my friend whose GP gave her medication that would cause weight gain.

To me this demonstrates a massive lack of understanding about the fact that eating disorders are a mental illness. It is a pathological fear of weight gain and of food that means that individuals engage in behaviours such as self induced vomiting or excessive exercise and calorie restriction.

A GP prescribing medication in this way is not only going against patient confidentiality but also spreading the mindset that if somebody with an eating disorder ‘puts on weight’ or ‘eats normally’ they will be magically cured. I am sorry, but this is bollocks, and it makes me so angry to see evidence of a GP still viewing ED’s (eating disorders) in this manner.

Yes, most people do, at some point, struggle with their weight and diet. Most people have dieted at some point, a lot of people have taken this to an unhealthly level..but, luckily, few people get to rthe point where there life is ruled by food and they are diagnosed with Anorexia, Bulimia or EDNOS. An eating disorder will never be fixed by weight gain alone.

If a patient is underweight then their medical risks increase, I agree with this in theory, but it a ‘normal’ weight will not ever reverse the eating disordered mindset.

In this particular case the mother was concerned about her daughter’s weight loss and spoke about her concerns with her daughters  GP. The GP, on hearing this, should have called in the daughter for an appointment and spoken to her about her eating habits as well as running a physical which included a weight check and blood test as well as blood pressure and an ECG.  None of this was done, which not only demonstrates an utter lack of medical knowledge about the dangers of eating disorders but also reinforces stereotypes.

Again, eating disorders are going to be something that a GP see’s a lot of. It has also long been viewed as a ‘teenage illness’ and a ‘diet gone wrong’. Recently a study (again, I can provide this if wanted) has shown that anorexia is more commonly diagnosed in women in their early twenties and thirties than teenagers..and the population of male eating disorder sufferers is increasing rapidly.

In 2007 when I was in treatment for anorexia I was unusual as I was only 17, most of the inpatients were a lot older than me. I also saw several boys come through treatment with me. Of the ‘older’ population in the inpatient unit most suffers had developed the illness later in life and only one woman, who was in her sixties, had been a lifelong sufferer from a pre-teen age. (This woman went on to make a full recovery after over twenty years of being in and out treatment centres from life –threatening anorexia.)

I feel I am going a little off point here, but ED’s should not have the stigma that continues to be attached to them. It is not a ‘diet gone wrong’ and gaining weight is not a miracle cure..similarly in ALL eating disorders, including binge eating disorder, weight does not dictate health – a patient may appear to be a normal, healthy weight but be medically very unwell, a heart attack can be fatal at any weight, as can many other complications of an ED. For me, I was much more of a medical risk at a higher BMI than a emaciated one. At my highest weight I was abusing laxative, diet pills, water tablets and purging in order to try and get my weight back down, it was at this stage that my heart, blood pressure and electrolytes were the most of a whack. At a very very low weight I was very poorly, yes, but my blood pressure was a lot more closely monitored and a lot more stable than it was when I was at my ‘worst’. There is a preconception that a person with an ED is super-skinny, skeletal, quiet, shy, fragile and a victim – this is not true at all. Any individual that has any signs of an ED or shows ‘faulty thinking’ when it comes to food and weight should be taken seriously, especially by the medical community.

As with A&E Gp’s are on the front line for giving access to mental health professional, dieticians and professional that can aid an individual with any type of eating disorder. Professional help is often crucial to a sufferer. Eating disorders are not born from a desire to be a size 0 but are rooted in psychological issues and fears, also, if depression/ insomnia/ anxiety is not already present in a individual with an ED they are bound to become co-morbid problems. It is never ever just about food. GP’s especially should be better trained in recognising the signs of all ED’s and know where to make referrals.

It makes me so angry that a GP can prescribe weight gaining medication to a patient without even explaining the side effects, this would be true even if my friend did not have an eating disorder – this GP would still be in the wrong, the fact that he was told that this individual was losing vast amount of weight and inducing vomiting should have begun a very different chain of response than prescribing a pill that will make her feel more alone, more scared, angry, misunderstood and overall less likely to seek help.

I would like to end this by saying that I have had many, many run in’s with the medical community in direct regards to my ED and my self harm over the years. I have had some amazing doctors and nurses who have helped me considerably – I have also had doctors and nurses who have obviously had their own opinions about such matters and got on with the job regardless. I think that both responses are fine and appropaite. I am not asking for every Doctor/healthcare professional to put aside their own opinions but just to treat people as equals and following the correct protocol and procedures. There are understanding and wonderful Doctors/professionals out there…similarly there are so called ‘specialists’ who deal with ED’s/self harm on a regular basis who treat individuals badly..I really am glad of all the GOOD  care I have received and I urge ANYONE WHO THINKS THEY NEED MEDICAL ATTENTION TO SEEK IT AS SOON AS POSSIBLE. However, these two events are described above need addressing.

 B-eat website

Self injury site

Do I have an eating disorder questionnaire

NHS direct link (helps work out if wounds need medical attention)

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