Month: October 2017

Psychiatric Unit Themed Halloween Parties And Why They Are Always A Bad Idea

/ bornwithoutmarbles / 16 Comments

So tomorrow is Halloween, and though not exactly my favourite holiday as I may have mentioned in my Halloween themed post last year (…ahem…Why Halloween Can Be Difficult For People With Mental Health Problems…) it is a time that a lot of people celebrate and get rather excited about. Some even have Halloween parties with houses decorated to fit in with some Halloween style theme from haunted mansions to circus tents and unfortunately, insane asylums.
Being actually in an insane asylum for Halloween this year then, you would think I would be in the ideal position. Why decorate a place to look like a mental ward when you are on a real mental ward? My job is done. I don’t have to worry about a costume this year either as simply getting out of bed and putting my normal clothes on will qualify me as an accurate representation of a patient in a psychiatric unit. I don’t even have to bother with face paints or drawing spider webs on my face with black eyeliner which then doesn’t wash off for three months, meaning I have to go to my best friend’s wedding with an arachnid adorning my cheek. Think of the time I will save…I can use it instead to have a nice cup of tea with my feet up. Bargain!

Rather appropriately, Halloween this year falls on the same day as ward round on our unit, aka the scariest event of the week (because you have to sit in a room with a lot of intimidating professional people staring at you making scary decisions, not because there is always a ghoul wailing in the corner…he is there all year round and we are all pretty used to him by now…his name is Derrick.) Other than that spooky coincidence however, there is, rather disappointingly, nothing very Halloween like about Halloween in a real life psychiatric unit which might disappoint some people, but it is important to note if you are planning a party with the “asylum” theme, because trust me when I say this is not the ideal setting for your festive frivolities.

From that opening, you may very well assume that from here I am going to send this post in the direction of a serious “why you shouldn’t set a Halloween party in a psychiatric unit theme” rant, highlighting and raising the awareness of the fact that these parties promote stigmatising ideas of mental health problems that are already far too prominent in society. You may think I am about to get all up in your faces about people needing to be politically correct, plead for you to see us patients as mere troubled folk rather than fodder for a costume idea, but you know what, today I am not even touching any of the politically correct important serious issues with mental hospital themed parties this year. Nope, instead I am going to raise awareness of the far more important fact that, aside from being insensitive and offensive in a million different ways which I should probably talk about but won’t because others have no doubt done it before me, celebrating Halloween with a “mental hospital theme” is simply impractical and will not involve any of the fun games and activities people associate with Halloween.

Think about it, what are the common things people do to celebrate this time of year? Number one on the agenda: pumpkin carving.
Pumpkin carving? I am supposedly in the ideal setting… but how the hell am I supposed to do that? Do you really think I would be allowed a knife in here? I don’t even have the wrap around belt for my dressing gown! Do people have any idea about things that are and are not allowed in a psychiatric unit? You can’t go carving root vegetables with machetes when you are in hospital and if you can’t do that then a Happy Halloween party is pretty much impossible. I mean you can try but a Happy Halloween without a pumpkin? Forget it.
Anyway, where am I and all of these “crazed deranged loons” supposed to be getting these pumpkins? In the supermarket? In my homegrown special organic vegetable patch at the local allotments? I can’t leave the ward!
Unless Cinderella’s fairy Godmother is planning on turning up any time soon, pumpkins are another no go item (although admittedly pumpkins are not specifically mentioned on the list of things staff search your bags for upon admission…they are more focused on things like knives and razor blades…shiny silver things mostly…I have a theory that all of the staff are secretly magpies…).

Aside from pumpkin carving then, what else do people do at Halloween to celebrate the holiday at parties and create merriment? Ah, apple bobbing!
Surely that is possible in a mental health hospital? Surely a party in a real or with a mental hospital theme could celebrate via that classic game? NOPE.
Again party planners, think about the impracticalities! I am on an Eating Disorder ward for goodness sake! Food is scary and hard enough as it is without adding the obstacles of a black eye due to a violently bobbing Granny Smith and the potentially fatal risk of drowning mid meal time. Do people think staff allow patients to go submerging their heads underwater like that? OF COURSE NOT (that is unless the staff have a chance of patients retrieving something shiny for them from the bottom of the pool of water…Magpies the lot of them I tell you.)

How about a Halloween party ghost walk? Sorry. No ghosts.
What ghost would decide to haunt a mental hospital? If you get the opportunity to spend eternity in the location of your choice are you really going to settle on “psych ward” as your idea of a forever home? Of course not! If you ask me it is far more likely there will be ghosts haunting more enjoyable places like a beach in the Bahamas or the local pub. Me? Well, keep it on the down low because I don’t want to give everyone else ideas and end up with my chosen location being overcrowded with the wandering souls of the deceased, but personally if I get a chance to come back to hang around earth for a bit longer, I have my eye on Disneyland. No queuing for Thunder mountain and a chance of bumping into Mickey Mouse every day? Sign me up good Sir! Ok, when it comes to the specific mental ward I am on, we do have Derrick in ward round so I guess I could try celebrating with some kind of ghost walk but like I said…he isn’t really that scary (or clever to be honest. Like I said nobody with any sense would decide to spend eternity in a mental institution. Why is Derrick here you ask? Yeah, turns out he is lost. Broken sat nav. Was aiming for a Broadway Theatre so that he could watch all the musicals he wanted for free every night. It is pitiful really. Sometimes I try to cheer him up by singing Cabaret and doing a bit of a tap dance but alas it just isn’t the same.)

Seriously, throw any Halloween party activity idea or game at me and I will be able to prove my point that realistically, trying to play that game in one of the top rated theme setting type places of a mental hospital is simply not a good idea. Playing with a spooky pet rat or a creepy horror movie style jump scare of a black cat leaping around every doorway? Yeah, good luck getting that around infection control. Pin the bone on the skeleton? WHAT DID I JUST SAY ABOUT SHARP OBJECTS AND STAFF LIKING TO CONFISCATE SHINY THINGS. Huddling up to tell scary stories at midnight? Cancelled. Your anti psychotics will have you asleep by 9pm before you have even had a chance to say “Once upon a time on a dark and stormy night”.

See what I mean? Aside from all that serious nonsense about being politically incorrect and damn well offensive, setting your Halloween party in an insane asylum is simply not a good idea because it is impractical when it comes to celebrating with any of the usual activities. Of course don’t let that stop you, if you feel ultra compelled to promote the stigmatising stereotype that people with mental health problems are terrifying lunatics to be feared, then be my guest. Just thought I should warn you that if you do that you really aren’t going to have a very happy time if you are doing the setting/theme accurately, aka without the obligatory activities pumpkin carving, apple bobbing and other Halloween classics. My advice for your Halloween party theme this year? Go with the haunted mansion plan or vampire lair. Trust me, as well as being less offensive, those ideas will provide a lot more fun…I hear some vampire lairs even come with their own poisonous bats, with no infection control getting in the way and neat vegetable patches supplied with organic, perfectly round pumpkins, ripe for the carving…Hoorah! Happy Halloween!

Take care everyone x

HalloweenInvite

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Things You Will Need When You Are Admitted Into A Psychiatric Hospital

/ bornwithoutmarbles / 16 Comments

Before you move house, you need to pack your life into a van. Before you go on holiday, you need to pack suncream and the inflatable dolphin into a suitcase, and before you go out rambling in the wilderness, you need to pack a picnic in a picnic basket (preferably one of those wicker ones with a gingham tablecloth and lots of little boxes inside…one must never go out rambling unless one is accompanied by a picnic).
There are however some things that are a little less fun to pack for, those being admissions to a hospital or inpatient psychiatric unit, which is nowhere near as much fun as a picnic (and involves 100% fewer wicker baskets…By God I love a wicker basket).

When I decided to write a blog about this topic I was therefore going to call it “Things you will need to pack for an inpatient admission” but as I have started writing I realised that sometimes when it comes to mental health hospital admissions, they are not planned like a two week cruise around the Mediterranean, and there is seldom time to “pack”. Even when an admission to a unit has been planned, you are going to be so nervous about it the night before that you forget to pack anyway, so instead here I thought I would offer a little help to all those who find themselves in that situation by providing a list of things that you will need during an admission to a mental health hospital.
It doesn’t matter if you are making a list of things to pack the night before or simply things you now need to start begging family/friends/online delivery people to bring to you because you were not prepared and only came onto the ward with a one way train ticket to Exeter (trust me, it happens…). Whatever the situation, this blog post is here for you, so lets get on and start this fabulous list of things you will need during an inpatient admission to a mental health hospital (things you will need if you have fabulous taste like me that is…)

BASIC LIFE THINGS: You may think that this is a rather obvious logical point to make but remember, mental health admissions are stressful times where “obvious logical things” turn into “I like ducks”, and you would be surprised by the number of people who turn up to hospital without a toothbrush (warning, this may make teeth angry and cause them to phone the tooth fairy emergency helpline for immediate assistance. Don’t say I didn’t warn you.) So yeah…I am not going to list all the miscellaneous nonsense you may use every day, but as a general note to start off with, when you are in hospital, you are probably going to need a lot of the general nonsense you use everyday (toothbrush/toothpaste/underwear etc.)

MOTIVATION: Of course I mean this point in the emotional sense of the word, but when you are isolated in hospital it can be easy to forget why you are there and what you are doing in this inpatient bubble, so practical pieces of motivation to get you through are also essential. Things in this category can include photos of friends or family, motivational books about people who have been through recovery for your disorder, quotes or even little prompts to give you a little boost when your brain refuses to do the boosting for you (e.g taking something like a list of things you want out of life to have at your place at the table on an eating disorder ward to help at meal times). I have known a lot of people to go all out with motivation and to bring enough cards/quotes/photos to decorate their entire room into a cave of inspiration (if that is allowed on your unit and you are not in a stripped room that is), so if that would help you, do that. Personally though, I prefer not to put up too many decorations because I am always so hopeful about leaving that I refuse to accept the idea that I should settle because I may be there a while…

THINGS TO DO: When you are in a psychiatric hospital it is likely that there will be things going on. On the week days there may be things like therapy groups, 1:1 sessions and opportunities for visitors, but aside from all of those things and the “spare hours” that will be taken up by things like crying hysterically, you are still going to end up with a fair bit of free time, especially on weekends when it is quieter and a lot of patients may have leave. Keeping yourself occupied therefore is going to make time pass quicker and distract you (a bit) from what is going on. For example on my ward there is a current craze with origami and people are making paper cranes faster than I can count (I tried to get into Origami too and managed to unfold one of these aforementioned cranes into a normal square piece of paper again but apparently that “isn’t the point”). There are also patients who knit and live in giant balls of wool, people who colour with crayons, draw, and there are patients like me who get through the day either by writing or by tossing reality out of the window and reading to get lost into alternative fictional worlds (This week I read “The Secret Garden” a book I highly recommend for times in hospital when you cant go outside and see a real garden yourself.)

COMFY CLOTHES: The first time I ever packed for an inpatient stay, I put all of my nice going out clothes into my suitcase and took them to the hospital ready to co-ordinate my outfits every day so that I would “look nice” for the other patients. I also wore mascara to a place I was highly likely to start crying in upon arrival. I was an idiot.
Listen, I get it, people like to look nice both for themselves and for other people but let’s be real, a psychiatric hospital is not a fashion shoot (cameras are not allowed), and after five minutes neither you nor anybody else is going to care what anyone looks like because you are all too busy being caught up in fighting your head demons and managing general anxiety. Even if you are not worried about what you look like or what people are thinking of your sense of style, “nice clothes” are simply not practical. When you are in hospital you are going to want to be comfy. Imagine you need to curl up on your bed for a good sob or find that you are so anxious that you start having panic attacks and problems breathing. Maybe things have got a little bit out of hand and staff need to carry you somewhere, carry out a quick blood test or give you an injection to calm you down. All of those things are going to be a hell of a lot more pleasant (as fun/pleasant as being injected in the rear can be at least), and a lot easier/more comfortable if you are wearing comfortable clothes rather than a corset and, skinny jeans.
Don’t get me wrong, if you want to dress up because it makes you feel better/more human then feel free to do so. I know a lot of patients who still like to wake up, wear a fancy skirt and put make up on in the mornings because that is what works for them, makes them feel less “mental hospitally”, more normal and lifts their mood (I am not one of those people…) However, even the people with the nicest most fashionable clothes will need a onesie and a lot of baggy trousers for “those days”. I would also add slippers to this both because they are comfy footwear and make a nice slip slop sound as you walk down the corridors. Trust me, stiletto heels are not a good idea (they tear the evacuation slide…or am I getting psychiatric hospital attire confused with ideal footwear for planes…)

TACTILE/FIDGETTY DISTRACTION THINGS: When people get anxious, their bodies get filled with adrenaline, and to calm down, that adrenaline needs to be released. Often this can happen via what the professionals call “unhealthy coping mechanisms” and that is not ideal because…well…it is unhealthy, and therefore you need other practical tools you can use to keep your hands busy releasing adrenaline whilst the rest of you remains safe. These things are different from the “things to do” category because they are not things that require any particular concentration, brain power or coherent thinking, these are for the times when your head is so loud that you cannot remember the alphabet and just need something to cling onto. I personally have what is called a “Tangle” (this weird thing that can be bent into all different kinds of shapes), and a fidget cube. Other things people may use include stress balls, squeezable spikey rubber balls, fidget spinners and putty. Sometimes things like a pebble to hold or little pebbles to pass from one hand to the other can also be helpful, but I will leave that up to you to decide because some people may not find those items to be safe to be around in a stressful situation.

And now to the final category, the most important thing you will need for an inpatient admission to a psychiatric hospital…

SOMETHING TO CUDDLE: Enough said. I don’t care how old or cool you are, everyone needs a cuddle once in a while/all the time so pack a damn teddy bear for the love of God.

So there you go! All the things you could possibly need to survive an inpatient admission in a psychiatric hospital. Obviously feel free to take other things as well, but as a basic guide I would say this list is a good one to start with.
I should point out before I finish here that as well as a list of things you will need to take to an inpatient unit there is usually a list of things that you should not take (like sledge hammers…mallets are ok though), so on the whole as a final tip, when you are packing, stick to things that are softer and squishier than a pick axe. If you are currently in an inpatient admission or are approaching one I hope this list helps, and if you are not then thank you for coming along for the ride anyway! I am thinking of and supporting you all, wherever you are, you are not alone in your fight.

Take care everyone x

InpatientPacking

The Difficulties Of Communal Life In An Inpatient Setting

/ bornwithoutmarbles / 8 Comments

If you put one fish in a fish bowl, that fish will probably be very happy, especially if you give that fish one of those little plastic castles that sit at the bottom of fish tanks in cartoons. Fish love castles. Nothing makes them feel more content than a nice turret.

If you then add another fish to this bowl, there is a chance that both fish will be happy and will be able to enjoy their plastic castle together, ruling over their water sphere of a home like aquamarine royalty. Add another fish to the bowl however, and the chance of problems will naturally arise as while all fish love castles, every individual fin flapper has their own specific tastes and preferences. Some fish may like a drawbridge on their castle, some may enjoy a moat, maybe there are even a rare few who, dare I say, like their castles without those lofty turrets.
The more fish you add into the fishbowl then, aka the more individuals you have trapped in a confined space, the harder it will be for those individuals to breathe/swim about without accidentally smacking a passer by with a wayward fin and in this sense, psychiatric units are very much like fish bowls (except with really mentally ill fish and no castles…God I wish I had a turret…some fish don’t realise how good they have it).
Like fish bowls, psychiatric units are small confined spaces where you can often find yourself trapped living amongst a group of people you have never met before and it is unlikely that you will get along with all of them, not because any of them are bad people, but because all people, like fish, are different. I think it is easy to think of going into hospital as a very private, individual experience between the patient and their inner struggles and in essence I suppose it is, but that doesn’t take away the community side to inpatient treatment and how difficult it can be living in close proximity to people who are, like you, working through their own personal hell.

No matter how much you go into hospital focusing on yourself, I think a lot of people forget or don’t know about the community side that is bound to be a part of any inpatient admission. Every inpatient setting and inpatient group will have a certain feel, an ambiance if you will that creates some kind of atmosphere, be that positive or negative, on the ward. Sometimes that atmosphere can be constructive and helpful in advancing recovery but as with the fish in the bowl, eventually there are going to be disagreements about whether you install a drawbridge or start knocking down all the turrets, and that can be really difficult and affect your personal treatment more than you would like to admit.

It is a side of treatment that is really difficult to manage and not often discussed, but over the years I think I have realised that there is only one way to manage the difficulties of life in a fish bowl with your fellow mental mackerel, that way being:

  1. Be friends with everyone
  2. Ignore everyone

On the surface, trying to do both of those things are the same time sounds like kind of conflicting advice to give, but then again a lot of great things in life involve components which at first appear to be conflicting.
Just think of the person who invented sweet and sour sauce or the hero that discovered salted caramel. People said they were crazy, that their ideas involved too much conflict between opposing opposites, and where are those legends now? Living the high life in their very own castles (with turrets). And as for the naysayers? Why, they are all cowering shamefully in their hollow lives devoid of delightfully sticky sauce accompaniments with their egg fried rice and of sweet milk chocolate coated toffees set off by the salty tang of the sea.

Personally, I really struggle with the communal living side to hospital admissions and every time I go into an inpatient unit I privately vow to speak to no-one, close my eyes and hope that because I can’t see anyone else, they can’t see me either…But like I said, this is unrealistic and at the end of the day, it doesn’t matter how social or unsocial you intend to be, you do have to live with these people and if you want to survive a shared space of communal compromise, you are going to have to get along to some degree.

I guess it is very much like any communal office or work place where a group of people are forced to spend long periods of time together, regardless of whether or not you have anything in common. Though I have never worked in an office like you see in the movies with all the rows of desks and dividers, I highly doubt that people who do work in those kinds of places would be willing to give all of their colleagues their last Rolo, but you couldn’t get through the day if you held grudges and took things too personally, and I am pretty sure people would be fired if they weren’t at least civil to each other and forced themselves to be a little extra on the polite side.

Maybe you have an office neighbour called Janet who keeps stealing your stapler, puts empty cartons of milk back in the fridge after making a cup of tea and is well known for dropping those little white paper circles that fall out of hole punches all over your paperwork (if this is you then damn it Janet, pull yourself together and keep your little white paper circles to yourself for the love of God.)
If we all had a Janet and behaved as we wanted to (aka smacked her over the head with that stapler she clearly loves so much and changed all the passwords to “Empty milk cartons go in the bin Janet”), it is unlikely we would keep our jobs for very long and nobody would get anything done in life. To keep the country moving and employment rates up then, people tend to bite their tongue at work around their own personal Janets, to keep the peace. That is sort of what it is like in an inpatient setting. You will be in a close proximity to a variety of people for large portions of the day and basically if you want to survive, you have to treat others with all the kindness and respect that you can muster and get on, as good a group of friends as you can.

Sometimes it isn’t even hard to be friends with everyone in an inpatient setting and it is a thing that comes naturally with no extra effort required. After all you are all stuck in a very similar situation going through similar experiences that not everyone in the outside world can relate to. Whilst in hospital it is easy to feel disconnected and isolated from any friends or family members who come into visits talking about holidays abroad and new umbrella decorated cocktails they have tried, whilst the only trips you have been on have been to a walled garden and the only cocktails a brand new combination of anti-psychotics (little umbrella not included).
Fellow patients will be able to relate to that kind of thing and can certainly make you feel less alone. They can also be a great support system who you share a lot in common with and often the most helpful things you can find in treatment are people you can relate to, who maybe give tips as to what has helped them in the past. I have even had admissions where the whole group of patients have got on so well that it has actually been like one giant sleepover in a boarding school with friends and you build such strong relationships that you won’t know how you would have survived the inpatient experience without them. Dare I say it, on special occasions when the brain devils are not out to play, you may even have a few laughs and leave inpatient with a fondly remembered evening of choreographing dance routines to “Spice up your life” by the Spice girls, after a rebellious water fight to cool off in the summer in the wet room (not that I have any experiences of such things personally you understand).

That said, when inpatient it is also important to stick to the second “way” of surviving the experience, aka part two “Ignore everyone”. This is not to say that when a fellow patient greets you with “good morning”, you keep your eyes on the floor and pretend that they don’t exist (a nice smile and “morning” is a far nicer option for both parties involved), but you do need to keep yourself to yourself to a certain degree. As helpful as it is having people you can relate to, it can also be triggering in ways detrimental to your mental health and wellbeing.
When you are in the fish bowl, everything is intensified and feels more dramatic than it might do in the outside world. In the outside world for example, like in the workplace, there is one Janet out of a global population of several million billion thousand other humans (that is a rough estimate…I lost count). Thus your Janet/difficult person in life makes up a tiny 0.000004% of the population or something and so it is easy in a way to avoid that person, avoid conflict and take yourself out of a situation. Say however that when inpatient there is one person you don’t get on with and it is a 10 bed ward, that is ten percent of the population, so the actions of that person can feel a lot more dramatic.
It is therefore important not to get too caught up in other people’s business and let them affect you , rather it is safe to keep yourself to yourself with your blinkers on and focus on your recovery and goals for admission.
I know I really struggle with getting caught up in the inpatient bubble, very distracted and involved in the lives and worries of people in the other bedrooms along the corridor and it is only when you start to get things like leave that you realise there was a whole other world still outside of those walls and half of the things that were incredibly dramatic whilst on the ward are totally irrelevant back home. When you are in hospital, those people you see everyday are constantly on your mind because they are constantly in view, but when you are home with family and friends living your life and benefitting from all the hard work you did on the unit, you are unlikely to think of them at all (unless you keep photos of them on your bedside or something…don’t do that…that would be weird.)

As much as an inpatient stay is an individual experience then, there is a lesser discussed fish bowl style communal element and that is going to be difficult. There are however ways to deal with it, and for me, this blog post is how I get through and is the advice I would give to anyone else who is currently stuck in a mental hospital fish bowl or anyone looking to an admission in the near future. Never forget that any unit is really just a small glass orb on a coffee table and there is a flipping massive ocean to swim in when you get back out.

Now if you don’t mind, I am off to the nurses’ office to demand we get an immediate emergency supply of turrets on this ward. Fish get whole castles and damn it. I WANT A TURRET.

Take care everyone x

Fishbowl

Five Things You Need To know About Re-feeding During Eating Disorder Recovery

/ bornwithoutmarbles / 11 Comments

Whenever you enter treatment for any kind of eating disorder, you will often be given about a million worksheets, pamphlets and photocopied passages from text books, about the mysterious topic of “re-feeding”.
Indeed, over the years I myself have been handed many of these scientific attempts to explain the various processes the body goes through during re-introduction of food after periods of starvation, and having been through those various processes multiple times, I thought I knew it all. I thought that when it came to re-feeding a patient with anorexia, I was an expert, an oracle of knowledge when combining my scientific genius (aka facts I memorised in text books) and personal experience. So arrogant and confident was I in my “know it all” attitude, that had I been asked to take part in the UK gameshow Mastermind, I would have chosen “the re-feeding process in treatment from an eating disorder” as my specialist subject and would have had a cabinet built for the trophy in my living room before I had even answered the first question. Luckily, nobody has ever asked me to be a contestant on Mastermind because if that had happened, I would have looked like a fool and would have had a very sad and lonely, empty of trophies, trophy cabinet.

Today then, rather than sit and mope with regard to my lack of trophies (and whopping great useless cabinet in my living room), I thought I would use my current situation as “person attempting re-feeding” to share with you the five things everyone needs to know about the re-feeding process when in recovery from an eating disorder.
This is not just the explanations that you get from the science books, this is the Born Without Marbles, real life, honest guide to get you through all the surprises that can happen during the re-feeding experience, even if you have been through it before and think you already know it all…

1. Taking it slow is important: I think there is often this misconception that the more food you can get into a person who has been starving for a long time the better, when really, that can be quite dangerous. When your body isn’t used to being given food, it sort of turns off and goes into a stand-by mode, so booting it up again is a process that needs to happen gradually. It is like if you had an out of work clown, to get them back into juggling you need to start again with 3 soft balls rather than going straight in with 10 flaming knives and a live alligator riding a chainsaw. When coming into hospital for example, people are often started off on half portions to build up from gradually over the space of a few days, to avoid the body going into too much shock and sending your electrolytes and cardiac functions all berserk. Now, this is not an excuse to let your eating disorder sneak in with “well, if it is dangerous to eat much even though you are in recovery, you should probably just eat a little bit of lettuce” because NO. All I am saying is that when you are getting back into the habit of giving your body food, you need to be gentle and start off slowly, preferably under medical supervision/working with a dietician to keep you both physically safe and to make certain you are gradually building up to the amount of food you need rather than sticking to the initial “half portions” of the first stage.

2. Any weight changes on the scales are not going to make any sense: In life, I think we treat scales a lot like calculators, machines that give us logical results and answers to various calculations of input and output made over the week. Unfortunately this is not the case, especially during the re-feeding process of recovery from an eating disorder, and instead of giant body calculators, I would encourage you to treat scales like a very drunk friend following a night out at the pub. This is not to say I advise taking your set of scales to the local takeaway for some cheesy chips and a lamb kebab (scales prefer pizza with a side of garlic bread), rather it is to say you should take everything they say not as fact, more as a vague approximation of reality/what is going on. I am not going into specific numbers here, but when I was admitted to hospital almost three weeks ago (my how time flies when you are in a mental institution!), I ate less than I had been eating at home, due to anxiety and because everything served to me was different and none of it was what I considered one of my safe foods. After a week of eating less than half I had been previously, I stepped on the scales expecting to lose weight. To my horror, I gained. A lot.
“Oh my goodness” I cried out dramatically fainting on the clinic floor. “What is this? My body is broken! Everyone says that when you eat more food you gain and when you eat less you lose weight but I am defying medical science. Someone send me to a laboratory for experimentation!”
When the doctors increased my meal plan, I was even more terrified than I had been before, figuring that if I was already gaining when I wasn’t eating, were I to eat more, my weight would spiral up and out of control. Therefore I continued to restrict in an attempt to lose the weight I had gained…and I gained again.
Soon enough, I had no choice but to start complying a bit and eating a little more, so on the next weigh day, I braced myself for another increase in kilos. You can imagine my surprise then, when I actually lost all the weight I had gained over the previous week despite having eaten double the calories. Logically, that made no sense to me, but, bodies and weights do not make sense during the re-feeding process. As food is reintroduced, chemical reactions explode like fireworks throughout the body, electrolytes get confused, the fluid levels go all over the place so when you get on the scales, any shifts you see are likely to be “false” weights due to all the internal changes going on. Thus, going back to the drunk friend comparison, when they show you a number aka tell you a story summarising the night before, though they will be able to give you a vague idea of what is going on/what your body weighs, they will not provide a logical accurate explanation of your situation/true body weight that you can gain any real knowledge or conclusions from.

3. Your body is going to do some very weird things: When people talk about the re-feeding process they will often whip out phrases like “nourish to flourish”, as if the second you start eating again, sunlight will start shining from your eyes and you will find yourself skipping gaily in a field of daisies. Admittedly, one does need to nourish in order to “flourish” and become physically well, but again this is a gradual process, and at the beginning it is likely your body will do less flourishing and more random weird things that you never expected or understand.
You will probably get tummy aches and indigestion, feel full one minute and ravenous with hunger the next, your bowels may go to sleep or into overdrive, you may fall asleep all the time or even be unable to sleep at all, night sweats and drastic changes in temperature may occur, blood sugar levels will be unpredictably random (recently mine were highest after a day of very little food and then too low after the biggest meal of my admission so far – another reason why medical supervision in re-feeding is vital), and you may experience abdominal bloating as well as this weird thing called Edema. Edema is basically when your body goes through dynamic fluid shifts and parts of your body (mainly your feet and legs) may puff up.
This Edema thing has been especially bad for me this time and my legs and feet swelled up as if someone had thought I was a bouncy castle and plugged me into one of those air machines (during this time I learnt that life is hard when you are a bouncy castle as children are constantly jumping all over you. On the positive side, if you are business savvy you can charge them a few quid a time and make a tidy profit to buy yourself something nice/ice packs to soothe all the bruises made by violently jumping feet all over you).
I think the Edema one had me especially scared because naturally your mind will convince you that rather than water retention your legs are swelling with actual weight and fat, and as someone who is currently managing Edema I can hand on heart promise that is not true. Like I said, I swelled up like a bouncy castle, but after keeping my feet elevated for the past fortnight my legs and feet have started to deflate a little. It feels as if it is a disaster and going to last forever, but it DOESN’T. Me warning you of all these things is not to put you off the re-feeding process, far from it, as it is far more dangerous to remain undernourished with no chance of flourishing in the near future. Instead what I am trying to do here is let you know what might happen so that if it does, you are prepared and know that this kind of thing is totally normal and it is not an excuse for your eating disorder to convince you that it is your body and yours alone being weird and “rejecting food”.

4. Your mind is also going to do some very weird things: You would think that with your body off galavanting and causing mayhem, your mind might perhaps wait to kick up a fuss until after all the physical stuff is over, but no, your mind is going to go a galavanting as well and will also be doing some very weird things. The re-feeding process is very much like the descriptions of puberty I was given in a lesson by my primary school teacher (good Lord was that a terrifying conversation), in that your emotions are going to go all over the place. Like I said, when you are not eating, your mind and body go into standby mode and occasionally emotions shut down. When you start eating again however, the emotions turn back on at weird and unpredictably inappropriate moments. One minute you will be numb and feeling nothing at all, the next you could be laughing hysterically at your shoe, then you will be filled with rage for no particular reason before being overwhelmed with sadness and crying yourself to sleep…It is a lot more fun than it sounds…actually it is not, but again this is not to put you off the process, rather so that you know what to expect!

5. It is different every time: This is probably the most important lesson I am currently learning as I go through the re-feeding process and I imagine it will also be the most important one for people who, like me, have been through it several times before and may be reading this thinking “this is not new information, I know what to expect” much as I may have two weeks ago. I thought that because I knew how my body had reacted to re-feeding before, I would be able to predict how it would be this time round, but that was not the case. Every time you go through re-feeding it will be a different experience and your body will react differently. The longer you have been ill or the more trauma your body has been through, the weirder the experience may be. Like I said, I have really struggled with Edema this time round, and the reason I mentally struggled with it so much is because it has never happened to me before.
I knew all about it and had seen it happen to other people, but when my legs swelled up I was convinced that it was real weight rather than water retention, because my body hadn’t reacted like that on any previous occasion and therefore I thought that kind of problem could never affect me. Had I had Edema before I think I would have coped better with it, as well as the weird things I have noticed this time round on the scales, but it was the fact that “my body doesn’t do this usually” that had me frightened that something was going on and I was actually gaining and swelling with actual weight. Just because your body hasn’t done something before it doesn’t mean it won’t give it a whirl this time and if there is one thing I would want you to take away from this post it is that for all the preparations you make, this is still going to feel very random and very unpredictable…

…What a great final point to end on! Basically I have just told you a list of things to expect during re-feeding and then told you to go into it with no expectations because you cannot predict what will happen…hmm…Great advice…Good one Katie…

To be perfectly honest with you all, I have no idea what is currently going on with my body, what it will do tomorrow and quite frankly I don’t understand a damn word or second of this re-feeding malarky right now.
All I know is that it is scary, it doesn’t feel necessary to me, and I am still doubting the words of every doctor I come into contact with/struggling to accept or trust any of this.
Regardless of any of the mental rationale behind this admission or eating however, this is an honest account of what is and what can happen physically during the re-feeding process as I am trying to get through it, so if you have ever wanted to know what to expect or are going through similar things and are scared, you know that it is not just “your” body being weird and that there is someone else out there with swollen legs covered in the bruises of toddlers who have mistaken you for a bouncy castle.

Take care everyone x

Refeeding

How It Feels To Be Recalled To Hospital Under A Community Treatment Order

/ bornwithoutmarbles / 16 Comments

If someone had asked me what it feels like to be recalled on a Community Treatment Order (part of the Mental Health Act), before it had ever happened to me, I am not sure what I would have said. Possible guess answers that I might have offered would have probably included things like “scary”, “shocking” or “dramatic”. Probably one of the last answers I would have given, would have been “it feels like having your car stolen by a band of incredibly apologetic thieves who are very sorry for your loss”. However, as it turns out, that is exactly what it feels like…

As you will all know from the fabulous explanation of the Mental Health Act that I posted last year and linked to again last week (hint…it is right here: Demystifying The Mental Health Act…With Penguins), when you have a CTO, you have a list of conditions hovering over your head which must be adhered to if you want to avoid being legally recalled to hospital. Rather than conditions hovering like ominous wasps at a picnic who like a look at your jam sandwiches though, I like to think of them as “things that hold you accountable” or “reasons to do things”.
Every time I was scared to challenge my eating disorder and follow my meal plan I had an argument I could use, that being, “you have to do this because otherwise you will lose weight and go back to hospital”. It was a system that worked but admittedly I felt really trapped by it.
Every day I would wake up and force myself to eat a number of calories that made me feel depressed, knowing that it would keep me at my CTO weight which felt equally depressing.

All I wanted to do was give up, give in and lose weight but I felt I couldn’t because that would only involve being recalled to hospital which was simply not an option. My CTO weight was the border to a war zone and I was not taking a single step into no man’s land.
Then however, the recent hospital surgery medical drama, naturally led me to lose weight and I crossed that barrier without even intending to. Before, that CTO number had held a power over me, every digit had felt significant, like a law from the gods that I would probably find carved into one of those massive rocks at Stonehenge if I visited and looked close enough (a lot of people have theories as to why those mysterious stones are there including “for religious reasons” and “rituals”…My theory is that they were simply put there by some cheeky prankster who wanted to leave a pile of stones lying around so that future generations would ask “why the hell are those stones there?”)

When I went under the weight however, the power of that number and the spell was broken. I had thought that one step over the border would have resulted in guns and tanks sending bullets and bombs flying all over the place…but nothing happened. Of course it would have had the weight loss been “my” fault, but I had an excuse, my appendix did it not me, so it was almost allowed. Obviously the CTO weight still mattered and I had to get back to it, but with this medical “it isn’t my fault” get out of jail free card, I knew that I could take advantage and lose more weight without getting into trouble.

Thus it was that, as you know, I ventured further into no man’s land, and it was a sudden surprise when after all this “oooh this feels quite safe and allowed” turned into the previously expected “guns and tanks and swords and back to hospital for you”. Unsurprisingly, it was pretty distressing and traumatic, so a lot of people have been very sympathetic which has been lovely. I really appreciated comments from people online who were not directly involved in the situation because they felt genuine, but it is when we get to the words of the people closest to me that we get to this whole “I feel like I have had my car stolen”.

To use another analogy, I suppose you could view my body as a car that the garage have been keeping very strict rules on. I may have owned the car but there were restrictions as to what I could do with it, what colour I could paint it and how far I could drive. Then, when the CTO barrier was broken, I suddenly regained control over that car, so I grabbed that wheel, painted it purple and zoomed off into the distance (I suppose if we are combining this with the other analogy I zoomed it off into former no man’s land…just like people did with BMWs in World War Two…I may need to retake GCSE history).
With the car all to myself I set my speed limit, I pumped the tyres to a level that I wanted and I filled every seat with penguins because that is what I wanted to do. I could chose…until I was ambushed by bandits who seized the car and stole it, meaning that it didn’t belong to me anymore. Suddenly they would decide how much petrol went in, how plump the tyres were and how many miles it could run and my opinion was irrelevant (the bandits in this analogy being all the doctors and psychiatrists who recalled me to hospital).
Naturally, having just had my car stolen, I was not best pleased. Thing is, when you ACTUALLY have your car stolen you never tend to see the thieves who are the new owners enjoying a trip around the block in what used to be your very own automobile, and they are unlikely to be very apologetic.

Being in hospital though, I am not only seeing the “thieves” every day, I am living with them, and watching them abuse my car. The doctors and therapists decide what I eat now, when I sit down, where I can go and it is all very hard so I try to talk and work through it with them. I say how scared I am to eat, how scared I am to gain weight, how scared I am of everything and like many people online said last week, they say things like “I am so sorry you are in this position”, “this must be very hard and scary for you” but unlike when people online say it, it makes me angry, and all I can think is “WELL YOU CAN’T BE THAT DAMN SORRY BECAUSE YOU ARE THE ONE DOING ALL THIS. YOU STOLE MY CAR, I AM UPSET ABOUT IT AND CRYING AND NOW YOU ARE SAYING HOW SORRY YOU ARE ABOUT THE SITUATION BUT YOU ARE THE THIEVING, HYPOCRITICAL VAGABOND! VAGABOND I SAY!”

I don’t believe that they can really be sorry because they have what they want, they have the car and are legally allowed to do whatever the hell they want with it. I feel the same way about professionals as I do about close family members like my mum, which I know is terrible and I know I shouldn’t feel that way, yet still as much as I love our visits and I would not be able to get through this place without her, what I get out of them is entertainment, love, company, kindness and knickers (she brings in my clean washing…thanks mum). What I do not want from my mother, is sympathy because in my eyes she is kind of like a thief. Admittedly she did not do the legal act of stealing the car, but she gets something out of it, she now has a say over the car and the thieves will take her views into account. If my mum insists on yellow wheels and the thieves like that idea, those wheels will be the colour of sunshine within 24 hours. She could not have stopped the legal act from taking place but she has more say in it than I think she has used, I am sure if the next of kin kicked up enough of a fuss someone would have to listen, but no fuss has been kicked. On top of that, by me eating and being forced to stay in this hell hole gaining weight, she has benefitted from the thieving.
Again it sounds AWFUL to describe it like that, to compare my mum to someone who is in cahoots with criminals and joyrides around with lemon wheels, when I know she would argue that all she has actually done is not try to stop the people attempting to save the life of her offspring by their actions. She isn’t joyriding (my mum is not a joyful driver…especially if there is a cyclist nearby), she is finally offloading this nightmare she has been living with to professionals who can look after it instead and she can finally sleep rather than stay up into the early hours arguing about sweetcorn. She is benefitting because she gets a break, because as I gain weight she will feel safer and therefore I assume happier yet again, any “I know this is hard and horrible and I am sorry” inspires that same “WELL MAKE THEM GIVE ME THE DAMN CAR BACK AND WHY DID YOU PAINT THE WHEELS YELLOW” rage.

That is why if you were to ask me “how does it feel to have been recalled on your CTO and sectioned back in hospital” I would tell you that it feels like some very apologetic thieves (some of whom are related me), have stolen my car.
Now I am just watching them all make the changes they want, implementing the modifications they have decided, desperate to run out and stop them but with my hands tied. I am just an observer watching people do things to my car, watching things happen to this body that I have had to disconnect from and pretend isn’t mine anymore for my own sanity. I guess a more accurate explanation/analogy then would be to say it is like having your car stolen and then having the thieves force you to be a mechanic carrying out every wish of theirs or risk being whacked on the head by a spanner, but that isn’t how it feels. It feels like things are being done to me, any movements I make are via the puppet strings that they hold, I have no say. When it comes to living with an eating disorder you don’t have much say or control either, but this feels different, this feels more stripped, more naked. This is not my body, it is just a body that I am trapped in, and I am witnessing it be torn to pieces every day. Every meal. Every bite.

CTORecall