The Difficulties Of Communal Life In An Inpatient Setting

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

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

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

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

The Difficulty Of Trusting Psychologists When You Have Mental Health Problems

Trigger warning: This post mentions the eating disorder behaviour of distorting your weight from professionals, so if that would trigger you then flee! Flee I say!

When I was younger, I was always taught not to trust someone who promises to give me sweets if I climb into the back of their van (unless of course those sweets involve any kind of combination of chocolate and peanut butter in which case who cares about potential kidnap, get in the damn van and don’t let those beauties drive away).
Unfortunately, somewhere in my brain as I have got older, “don’t trust strangers with sweets in a van” has morphed into “don’t trust psychologists” (regardless of whether or not they drive a van containing a portable candy heaven). Turns out however that when psychologists say they are going to do something and give you ultimatums, you should believe them.

Since coming out of hospital post “appendix explosion gate”, every week in my eating disorder appointments my psychologist has been telling me that I need to increase my intake in order to regain the weight I lost. To be fair, I have been trying, but a problem I have is that unless someone gives me specific deadlines for things I am scared to do, I will procrastinate until my arms fall off and tentacles grow in their place (not eight tentacles like an octopus though…that seems a little excessive…four is enough for me thanks.)

Every time my psychologist would tell me to increase I would hear her, try, but ultimately think “it is fine, she will just say the same next week and I will do it then”. Two Tuesdays ago though, my psychologist gave me a proper ultimatum with proper dates and deadlines by which I had to carry out her instructions. I was given one week to gain a certain amount of weight with the alternative being that I would be recalled back into hospital under the Mental Health Act. Seeing as how my brain works, you would think that this fairly clear statement would be easier to adhere to than the alternative casual “you need to eat more”, but still my head found ways to procrastinate, not because I wasn’t listening, but because I didn’t believe her. This was a mistake.

As much as I know I am mentally not very well at the moment in some aspects, physically I am finding it hard to see that there is a problem at all. Hearing threats and statements about my health that are designed to scare me, therefore make little sense. It is like telling someone over and over again that they are going to die of alcohol poisoning and that their liver is failing because of alcohol when they know that this can’t be the case because they haven’t touched a drop of liquor in their lives.

Back home I tried to increase but I was so scared of gaining weight that it didn’t go well, partly because I didn’t believe the “consequence” I was told about were I to fail to do so. Still, I didn’t want my psychologist to be disappointed or angry with me for failing her, so on the morning of weigh in I drank the weight I had needed to gain in water so that the scales would show the increase required and keep everyone happy. I hate “water-loading” before weigh in (aka the behaviour some people with eating disorders do whereby they drink a lot of water prior to weigh in to manipulate their weight on the scales and prevent therapists from knowing their true weight). It always freaks me out because even though I can know that I have just drunk water, whenever I see the number go up on the scales, my head will convince me that it is real weight and not just excess fluid swishing about in my bladder.

Thus I stepped on the scales prepared to be triggered, but somehow, it didn’t work, and I saw that I had not reached the goal set for me at all. Initially I didn’t really panic because I thought as always that my psychologist had been lying and that I could get out of it. I thought I could easily insist that I would just “meet the target” next week, but she hadn’t been lying and to my utter shock and horror, I couldn’t get out of it. What happened next? Well, considering I am writing this at a hospital desk in an inpatient eating disorder unit, I think you can guess. That’s right, that is the update this week, Born Without Marbles is back in the loony bin, and to be blunt, it sucks.

People keep saying things like “at least you know the place” and “you have done it before” but that doesn’t serve as much comfort because even though I know that, this time it feels different, so unnecessary and therefore scary. If you believe there is a physical problem it is easier to understand the need to take the medicine needed to cure it (in my case that medicine being “Food/general nosh”), but this all feels like one terrible mistake. I don’t need to be here and thus I do not need the medicine.

I am almost waiting for ward round on Tuesday where everyone discusses how things are going and for them all to turn around, apologise for the inconvenience and send me on my way.

The scales may say that I am under my CTO weight (a full explanation of the Mental Health Act and CTO’s can be found here: Demystifying The Mental Health Act…With Penguins, but basically a CTO is a legal document under which you are sectioned but allowed to live in the community as long as you adhere to certain conditions aka in my case, stay above a certain weight), but I don’t think I have actually lost any weight. I can read the scales and everything so I know that the number is lower but I am 100% sure that this is purely because I had my appendix removed and thus the weight of a whole organ has gone. If you chop someone’s arm off their weight is obviously going to go down but it doesn’t mean they have lost “weight” all over, it just means that there is some rude reckless person running around cutting people’s arms off.

I am so scared in here and I don’t know what to do. I am trying my very best to work with people and “listen to the professionals” but it is harder than I thought. Trusting them feels the same as trusting all those terrifying people with vans and sweets when I was a child (especially that particularly frightening lollipop obsessed child catcher in Chitty Chitty Bang Bang…seriously if you ever need to teach kids that “don’t get into vans with sweets lesson” just show them that film and you will be sorted…of course they will also learn that cars can fly and that dressing up as a Jack in the box will get you through security at a royal palace, but I think the worth of the sweets lesson trumps the potential misinformation spread by the latter).

So yeah…Mental health awareness lesson of the week: trusting professionals with medical degrees and things who should technically know more than you is hard when you have mental health problems. Very hard.

Other than that, I don’t really know what to say today. I just want to go home. I feel I should write an extra good, extra long blog today considering I am in hospital and certainly have free time to write but the words won’t come. Maybe I should offer them some sweets as encouragement.
I am also struggling to keep this update upbeat rather than explode all over you, so I think I will sign off for now and hope that I am a little bit more coherent in the next post. Sorry.

Take care everyone x

ChildCatcher

The Mental Health “Spot The Good Things” Challenge

This week, when I sat down to write my blog post, I was determined to try and make it about something positive. Over the past few weeks I have gone on about drowning kidneys, an exploding appendix and suicide, and there is nothing fun to read about there. Admittedly, this is a blog about mental health so things aren’t going to be all fun and games (except for on Wednesdays when we play snakes and ladders…I say we…it is just me…talking to the green snake on the board…nobody else ever wants to play…not that I mind…*Sobs in a corner whilst rolling dice pathetically*).
Still, I have lovely people reading my blog, and as much as I want to talk about all that deep important stuff, I would like to think that people enjoy reading it a little bit, and enjoyment is seldom found when one is talking about exploding organs.

Therefore, determined to write a chirpier post, I sat down today, opened my laptop, placed my fingers upon the keyboard…and wrote nothing. I so desperately wanted to say something happy, but when you have depression that is quite the challenge, and suddenly, as the word challenge arose in my marbleless brain, I became even more determined to succeed. If there is one thing I love nearly as much as penguins and Helena Bonham Carter, it is a challenge (as long as I win of course), and so it was that an idea came to me for a challenge that I would like to invite you all to join me in today (it is a team challenge so we can all win don’t worry.)

I think one of the most frustrating things about living with depression isn’t just the suffocating sadness and inability to feel positive emotions, it is the fact that those things feel so infinite and you cannot imagine an alternative.
If we knew our suffering was temporary, depression would be an easier ride, get through the storm to reach the nice happy place kind of thing, but depression doesn’t let you think that, it tells you that it is here forever and that because you cannot feel or appreciate good things, those good things do not exist. This, as recently proved by an intense and vigorous lie detector test on the embodiment of depression itself, is a lie.
Just because you have no apples left in the fruit bowl, it does not mean that all the apple trees in the world have perished, and even if those apples are incredibly difficult to find and maybe you can’t even taste them when you find them, they are growing somewhere.

In Harry Potter, the Dementors that guard Azkaban/suck people’s souls out/generally float around in shapeless black sheets that Gok Wan would surely improve by accessorising with a nice belt, make you feel like you will never be happy again, much like depression, and the only way to get them to go away is to whip your wand out and throw animals at them made of good things (J.K.Rowling explains it better but that is the gist). It was this that gave me the idea for this challenge, the challenge being to write a list every day of at least three good things to look at as a reminder that good things do exist when depression is sucking the life out of you.

Now you may be thinking “Katie, this is not an original idea, I have seen people make lists of things that they are grateful for or things that make them happy and it doesn’t work.” Well no, in my opinion those lists often don’t work, but this is not one of those lists.

I myself used to keep a list of three things I was grateful for every day and it has been an activity suggested to me many times over the years in my battle with depression. However, as great as it is to feel grateful about things (and believe me when I say I really am), I found that writing those things down sometimes made me feel worse. For example if you are having a really bad day and then you write that you are grateful to live in a house with running water, you can be pleased about that yet then become frustrated and angry at yourself for being so lucky as to live in such conditions yet STILL not be happy. It is like when people say things like “I know you are sad but just be grateful that you don’t live in North Korea”, and of course I am grateful that I don’t live in North Korea (I hear the weather is terrible), but reminding someone of another person’s pain doesn’t take their pain away and is more likely to make their pain worse by making them feel guilty about complaining.

Similarly, I have struggled with the “three things that made me happy today lists” because when you have depression, a lot of the time you simply CANNOT feel happy, even if you know you should. Someone can give you a hug and you can mentally register that that person is a lovely person who is showing you kindness and that it should make you happy, but the logical identification of “this is good” never reaches the emotional sensors that are being held captive by depression, so you never FEEL that good. You could watch a film that you know is your favourite and feel totally numb, hear a joke that is funny yet be unable to laugh, and writing down things you should feel happy about but don’t is yet another miserable and fairly disheartening activity.

This list involved in this challenge however, is not a list of things that you should be grateful for or that you should feel happy or any other emotion about. It is not subjective or about feelings at all, so you can do it even when you are as numb as an anaesthetised turnip, because you are writing down the things that are objectively good, not to make you feel better, but just to remind you that they can exist.

After my post about suicide, I received such lovely comments reaching out to me with hope and kindness, and though it didn’t cure my depression, it served as a reassuring and helpful reminder that that hope and kindness is there. People told me how they or friends and family had been in similar situations but had made it through and though I may not be able to see or believe that possibility for myself right now, it shows that that possibility DOES exist, and for me, that was a very good thing. When I went to sleep that night I still had no apples in my tummy, but I knew that somewhere there was an apple tree growing, and right now, knowing that is enough.

Now, as someone who has been doing this challenge for a week now, I will admit that it is incredibly hard (hence the word challenge) because depression is so good at the whole black and white worldview that “EVERYTHING IS TERRIBLE”, and finding good things on some days has taken me hours. Some days I have even written my list and thought screw it I don’t even care about those good things, and a lot of the time you won’t, but again it doesn’t matter if you care or not or even if you hate all those good things, this is not a list about how you feel, this is simply a reminder to the objective factual part of you devoid of any emotions.

Things on this list don’t have to be big at all, you don’t have to win the lottery or suddenly gain the ability to fly, it can be ANYTHING that is objectively good even if it doesn’t affect you.
For example one day I was out shopping and saw that a popular shower gel was half price. I do not buy that shower gel so the half price offer was going to have no impact on my life, but I knew that objectively that offer was good for someone and I liked to think that someone who used that shower gel would come into the shop later, appreciate that good thing and maybe even make more good things by spending the money they saved on a hot chocolate to take home.

Maybe you were so depressed that you weren’t able to leave the house that day, or week or month, maybe you couldn’t even leave your bed, but still the key is to force yourself to think of something good even if you have to kind of make it up or get really creative. Even if you were under a duvet and didn’t see the outside world, you can be pretty sure that the sun rose that day and objectively that is good because somewhere a nice hedgerow enjoyed an afternoon of photosynthesis (unless it rained and was cloudy…which is also good because then the hedge had a drink…).

One day, one of my positives was the fact that after taking one of my medications that is absolutely vile, I only wretched uncontrollably over a bowl four times. Why is that good? Because the previous day I had wretched at least five times, and today I already know that one of my positives is that I did a big sneeze (I flipping love sneezing).
Admittedly a lot of the time during this challenge you are going to feel like you are sieving for gold and only finding dirt which you are then painting to fool yourself is gold and maybe that is true, but I still think it is important because even little bits of dirt painted like gold are somewhat of an argument and challenge to the overriding emotion that EVERYTHING is dirt.

So that is my challenge to you if you struggle with depression or indeed if you are reading this blog at all. If you can think of three things that actually made you feel happy then do that, but if that is a bit of a stretch right now as it is for me, just write three things that are scientifically objectively good, even if you feel absolutely nothing positive about them whatsoever. Then at the end of the week when you are feeling useless and like you have just wasted another seven days staring into the abyss, you will have 21 tiny examples that things DO exist outside of that abyss. It doesn’t matter if you don’t believe them now, the main thing is that you see them, acknowledge them and simply know that they are out there. Seeing good things isn’t as good as feeling them, but if seeing is believing, then my dears, we are at least a step along the way.

Thank you so much to everyone who has been sending me endless and wonderful support at this really rough time. You are all of my good things and I hope that this week, this hopefully less morbid post/challenge can partly repay you for all of that kindness and be a little support and help for you too.

Take care everyone x

GoodThings

Is Suicide Selfish?

Whenever the topic of suicide is discussed, several adjectives will magically appear depending on the speaker’s opinion on the issue. Over the years I have heard it described as “tragic”, an act of “desperation”, something “incomprehensible” to those surrounding the victim, something “unexpected”, and all of these are valid words to use. One of the adjectives that I hear come up that I strongly disagree with however, is the idea that suicide, and thus the people who “commit” suicide, are selfish.

Obviously I cannot speak for everyone who has ever struggled with suicidal thoughts, attempted or committed suicide, but for me, when I am feeling suicidal, it is actually the idea of continuing to live that feels like the selfish option (I am not saying that this idea is right and that therefore people should start killing themselves all over the place…DON’T DO THAT…I am just being honest and saying how it feels.)

Depending on how well you know me, whether you are a casual blog peruser, an online pal or friend/family member in real life, you may or may not be aware that I am currently in what all the professional psychology people around me may call, “in crisis”, although I personally prefer the term “in one hell of a pickle”. “In crisis” might be more professional and accurate a term, but if I am going to be in the state I am currently in, I would at least like the silver lining of naming it something a little less frightening than “in crisis”, and a little more related to the process of preserving some kind of food by anaerobic fermentation in brine or vinegar. As you can see I am all about finding the fun where I can/describing myself in ways that make people think of cheese sandwiches.

I don’t want to freak anyone out or make anyone panic by what I am going to say in this post and I want to reassure everyone that I have a hell of a lot of people on my pickle like case at the moment. Professional people keep phoning me (not that I answer because I am terrified of phones but they try anyway), I am having appointments all over the place, meetings are being held, I am never left alone and my mum has even been sleeping in my bed a lot to keep me safe on the really bad nights where I am really out of control. Therefore whatever I say in this post, please REMAIN CALM AND KEEP YOUR ARMS AND LEGS INSIDE THE VEHICLE AT ALL TIMES.

So, I don’t really know what exactly has sparked off my predicament and has caused things to get worse than they already were (it isn’t just the recent appendix thing…I actually wrote this blog post before all that and am editing this bit in now…hello!), but truth be told, a lot of the time I have been feeling like an outsider watching my own life and my actions in it.

You know when you have been reading a book for a really long time, flicking through the pages without really noticing until you suddenly stop and realise that you only have one chapter left. When you read that last chapter it sort of feels different to all the chapters that came before it because you know that this is the end. It doesn’t matter how many cliffhangers or revelations are being whipped out by the author, you are holding the book and you can see there are only a few pages left. It doesn’t matter if there are still mysteries to solve, if the monster hasn’t been vanquished yet, you know it is the end because you can FEEL it and see it just as you can see the handful of pages that is left.

That is how I feel when I look at my life. I feel like a reader on the outside of my story knowing that of all the mental health crises I have had before, this is the last one, the one the story is going to end on. No matter how hard I look, I cannot see any pages past this, any way around it, this time it is all too much, the pain is just too intense. Sometimes when I have been in difficult situations and have been extremely suicidal in the past I have been able to see it as something that I will eventually get through, I might know that it is impossible to feel that any emotion is forever, yet somehow this time it feels different. I feel different.

I am having a dramatic breakdown practically every day and rely on medication most nights just to keep me safe. Being conscious is currently so unbearable and overwhelming that I have been napping for hours each day just to get through them, the small tasks I set myself for the day have mainly been reduced to “just try to keep breathing” rather than anything productive on top of a task that most people take as fairly mandatory. Even that task however is getting harder by the day, and to be blunt, I physically cannot do “this” much longer.

I am putting all of my effort in and trying so hard, but there is only so much effort, only so much that one person can physically take before they crumble. Every time you drive over a bridge there will be a road sign telling you how much weight that bridge can take to warn you that if your vehicle is over that limit you might want to find an alternative route. It isn’t because the bridge gives up or isn’t trying when something that heavy passes over it, it is because it physically can only withstand so much.
Due to all of this, my family, friends and professionals are putting a LOT of effort in to try and help me through it and I appreciate it more than I can say. I can hand on heart say that I would not be here if it weren’t for the insane amount of support I am getting from the people around me, yet that is what is prompting me to think that actually the unselfish thing would be to just get on with it, end things and stop them having to put in so much of their time.

Even if they love me, even if they want to help, in concrete, factual and unemotional terms, it would be a lot easier for everyone if I wasn’t here anymore, and rather than suicide feeling like the selfish option, it is forcing people to carry on putting all their efforts in to keep me alive that feels selfish. When I am struggling with suicidal thoughts and the feeling that that is the only option as I am now, I am not thinking “screw everyone else I am in pain and I am going to end it whether they like it or not”, I am thinking “I really think this is the only option. The best thing to do for ALL of us.”

Like I said I am so incredibly grateful for all of the love and support I have been receiving lately, but at the same time I can’t help but feel incredibly guilty. My parents are constantly on tenterhooks (I don’t know what a tenterhook actually is but they are certainly on them), they are scared to ever leave me in a room by myself and they are called into my room increasingly frequently by me screaming in my sleep due to some nightmare. My therapy team are having to make extra appointments, extra meetings to make sure everyone is on the same page, texting me, phoning me, and generally suffering under an increased work load simply because I am unable to manage right now.

I have amazing and wonderful friends taking the time to visit me at my house when I do not feel able to leave it, they read my texts at 4am, tell me they love me when all I can see is hatred, they send me letters in the post, cards, even parcels containing amazingly wonderful things like books about penguins who have a tendency to worry a lot (if you have never heard of the “Worried Arthur” books then good God you need to look into them because they are FABULOUS), cuddly penguins and a myriad of other wonderful things that I am so grateful for and touched by, that saying thank you doesn’t do justice to what I think.

Think of how much effort that is for people to be worrying in the middle of the night, reassuring some lunatic who will only worry about the thing they are being reassured about again in half an hour even after great advice, spending money on presents and letters. DO YOU HAVE ANY IDEA HOW EXPENSIVE POSTAGE IS? A FIRST CLASS STAMP IS 65p…AND THAT IS JUST FOR A LETTER. For a parcel you are talking £5.70 and again, that is only if the parcel comes from within England! If it is from another country it is even more than that! You can’t just whack a crown on your head, snap a selfie, print it and stick it to a letter pretending to be a stamp, (trust me that doesn’t work…not that I have tried it myself…ahem…*removes crown and smiles sheepishly*), you have to pay if you want the postman to carry your parcel to someone, and that is then more effort for the postal service! I AM FORCING THE GOOD HONEST WORKERS OF THE ROYAL MAIL TO CARRY PARCELS OF PENGUINS TO MY HOUSE. They could be at home with their families! And £5.70 for a parcel stamp? You could get six two litre tubs of vanilla ice cream for that price and you would have 18p left! You could get 1120g of chocolate buttons and still have 30p left jangling in your purse! I AM DEPRIVING PEOPLE OF ICE CREAM AND CHOCOLATE BUTTONS. DEAR GOD I AM A MONSTER.

As you can see then, rightly or wrongly, when suicide is the only option I can see, the only way out of this utter hell of a brain situation, it is not because I am selfish and don’t care about how that might affect other people. Indeed it is the benefit my disappearance would be to everyone, that is actually one of the arguments my mind throws at me in the middle of the night when everyone else is asleep and I am too afraid to close my eyes incase I see the things that make me scream.

Like I said, I am not saying in any way that I think it is selfish to not kill yourself and I am NOT ADVOCATING SUICIDE IN ANY WAY AND WOULD ADVISE ANYONE WHO IS IN A SIMILAR SITUATION TO REACH OUT FOR HELP. If you do not have a therapy team and family around you I will put a link below to some of the charities out there who can help you, I am just writing this post to try to explain to the people who may think that people who commit suicide are selfish how it feels for some people who really are struggling with suicidal thoughts.

If you are one of the people who is currently supporting me I thank you from the bottom of my heart and I am really sorry that I am putting you through all of this stress, worry and effort. I promise I am trying. I promise I am looking for pages that could make a next chapter. I really hope that I find them. I wish I could be better for all of you. You deserve so much more.

I love you all so very much.

Take care everyone x

SelfishSuicide

Phone Helplines:

Samaritans – National freephone number: 116 123. They are open 24 hours a day, 365 days a year.

SANEline –  National number is 0300 304 7000. They are open 6pm–11pm, 365 days a year.

The Silver Line – If you are over the age of 55, this service is open 24 hours a day 365 days a year and their number that you can call from anywhere in the UK is 0800 4 70 80 90 (freephone).

CALM – Helpline for men experiencing distressing thoughts and emotions. Their national number is 0800 58 58 58. Open from 5pm–midnight, 365 days a year.

 

How Physical Health Problems Can Trigger Mental Health Problems

Last week I talked about a recent incident where my mental health, more specifically my eating disorder’s obsession with drinking a lot of water, had a detrimental affect on my physical health and in a hilarious twist of fate and example of bizarre symmetry (and by hilarious I mean literally the most unamusing thing to happen ever), this week I am talking about how the opposite can also be true, and how physical health conditions can end up triggering or making a pre existing mental health problem worse.

So when we last left off, I had explained how I had been admitted to hospital for water intoxication and was being treated for this problem via a strict fluid restriction plan to get all of my electrolytes back to acceptable levels (it is at times like this when I wish I had one of those “previously on” video clips that they show before episodes of various TV dramas…I should really look into that…ooh and a theme tune! I do love a good theme tune!)
Now, after a few days, the fluid restriction, whilst being incredibly annoying for me, seemed to be working, and my sodium levels kept improving until they were back to normal. Really, that should be the end of the story, the problem was solved so I should have been packing my bags and making my merry way home, but alas the story did not end there and developed into what I like to think of as an epic novel of utter ridiculousness.

You see whilst my sodium levels were improving, I wasn’t feeling any better which didn’t make much sense. I had been admitted for a problem that was being successfully treated yet bizarrely, as the days went on, I became more unwell with a pain in my stomach. The doctors couldn’t really make sense of this and before long I was in so much pain that I couldn’t stand or lift my head off the pillow and was in need of all the morphine I could get. A few tests were run but no answers were revealed so a surgeon was sent to have a look at me.

After thumping me in the abdomen with an iron mallet a few times (she said she was only going to “press gently” but trust me from the pain I am pretty sure that woman had a mallet and a vendetta against my stomach region), it was concluded that I might have a swollen appendix. I was told that normally the surgeons would book me in for an operation to whip it out just incase, however due to my already poor physical health from my eating disorder, they wanted to avoid taking me to theatre (alas the operating one and not the version where you get to watch The Sound of Music on stage whilst eating a little pot of ice cream with a spoon that is basically just a mini plank of wood with no resemblance to a spoon whatsoever), because they weren’t sure I would survive an anaesthetic.

Thus it was decided that they would only operate if they were absolutely certain that such a thing was necessary and therefore some more tests were scheduled to try and clear up what was going on. The problem with this was that by leaving time for tests, we were also leaving time for things to go downhill which they did fairly rapidly. Again the surgeon visited and again an operation was suggested but also feared so I was sent to yet another test in the form of a CT scan where I was basically shoved in and out of a tube a few times whilst doctors took photos of my insides (I really hope that my organs put on their best clothes and posed nicely for the occasion…it isn’t every day someone wants to photograph your intestines).

After the CT scan was complete it was around 1am and I was finally allowed to have some more morphine and attempt a snooze, whilst my sister, who had been sitting beside my bed for the past few days, went home. That was until 4am when another surgeon woke me up, to tell me that the scan had shown that things were rather serious and I was scheduled for emergency surgery immediately, my sister being called back in by the nurses having only just left. The next little bit of time is somewhat of a blur but from what I remember I was pumped with anaesthetic and taken to theatre (again, the operating one. I didn’t get so much as a lick of ice cream and I saw no children dancing in curtains. Livid.)
I was so knocked out that it was about 24 hours before I woke up from the procedure, dazed and confused with a tube coming out of my stomach and leading to a bag of some unidentified liquid.

It was then that I was informed that my appendix, in being left for so long, had ended up exploding. (The surgeon told me that I shouldn’t say that it “exploded” because in technical terms you should say that it “ruptured” but damn it I went through a hell of a lot of pain and nonsense because of what happened so if I want to say that my appendix literally exploded like a firework on the 5th of November then I will jolly well do so!)
Consequently my body had been filled with poison, hence the tube and bag scenario coming out of my stomach after the appendix had been removed, to drain the poison out (the poison being the funny liquid in that bag.)

Since then the job has basically been to free my body of poison, recover from the surgery and try to build my body back up after its internal beating, a job that isn’t going too well at the moment because this whole physical health problem extravaganza has triggered the life out of my mental health problems, more specifically my eating disorder.

Admittedly I haven’t been doing particularly well for a while now, but I have been clinging on to some sense of stability by rigidly carrying out the same routine meal plan via some form of repetitive autopilot action. Unfortunately, this event has utterly destroyed my autopilot “just do what you did yesterday” routine.

I think when you have an eating disorder, eating your meals is kind of like a recovering alcoholic avoiding the pub.
If you force yourself to eat the same meal plan every day, you get into a sort of rhythm, a rather bumpy and unpleasant rhythm that you can’t lead a good conga to, but a rhythm all the same. Missing one meal however is like an alcoholic downing one mouthful of vodka after a few months sober and then suddenly finding it impossible to stop.

Knowing that missing one meal will always make the next one harder is the reason that I fight so hard to complete my meal plan even on the bad days because I know that not doing so will make it harder for me in the long run, but in this whole “my organs are exploding” situation, missing a meal wasn’t something I had any control over.
For the first day of the hospital admission, eating was mentally impossible because I was in a different place with different foods. This problem was somewhat solved when family and friends hauled bags upon bags of my safe foods to my bedside, but by that point I was physically in too much pain to lift my head let alone grab a spoon to chomp down on some cornflakes. During all of these pain days I was also constantly being wheeled in and out of various tests that doctors were telling me I wasn’t allowed to eat before, and incase I was going to need emergency surgery after some of these tests, my stomach also had to be kept empty on the off chance that people would be whipping the scalpels out (apparently it is significantly harder to operate when one has just demolished a peanut butter sandwich…or any kind of sandwich…not that there is any other sandwich worth mentioning).

Post surgery I was finally allowed and encouraged to eat to regain my strength and I genuinely tried, but again there were hurdles. Firstly the combination of anaesthetic/poison/million medications made me extremely nauseas, and I was being sick multiple times a day. My taste buds had also suddenly gone haywire and for some reason I could not tolerate sweet foods which for someone who always picks sweet over savoury and who lives off sweet things like porridge and cereal, this was somewhat of a problem. Even the flavour in toothpaste made me throw up (all over my toothbrush I might add…suffice it to say my breath was not minty fresh), and shock of all shocks, I started to be repulsed by peanut butter. Me. Repulsed by peanut butter aka the food that was previously the holiest substance on earth? Who am I? I think I am going through some kind of identity crisis. You might as well start calling me Malcolm.

Therefore I was trying to find new foods that I could both mentally and physically tolerate, family and friends bringing in new groceries every day (including my parents who had had to cut their holiday short and catch an emergency flight back to the UK with fears that they might not get “back in time”…safe to say their relaxing trip to Malaysia was somewhat of a disaster this year..).

Excitingly, a new safe food that I could physically and mentally tolerate was discovered in the form of mashed potato, but by this point it had been so long since I had eaten properly even that was a struggle. I felt sick at every meal time and I could never be sure why. On one hand it could have been the “genuinely physically ill with poison and anaesthetic” sick that I shouldn’t have forced myself to fight as nothing I ate would be kept down anyway, or it could have been the simply sick with anxiety and fear of food sick that I really should have been challenging to prevent it getting any worse. Sometimes food would arrive and I would feel so ill that I wouldn’t risk a mouthful only for the food to be taken away, the sickness to go and me to realise that all that nausea had been anxiety as apposed to anything related to physical complications.

After multiple meetings with my eating disorder services who visited me a lot on the medical ward, it was decided that I would be discharged home incase eating became easier there due to familiar surroundings. Armed with a ridiculous amount of mashed potato, I really tried but a few days in found that I was struggling to swallow. Again I assumed this must be that whole “throat closing up with anxiety” thing, so I persevered, but then after finding some weird white nonsense all over my tongue and throat and a trip to the doctor, it was discovered that life had thrown yet another curve ball and in my weakened post surgery state, had given me tonsillitis and oral thrush, conditions that make swallowing rather difficult and would therefore interfere with anyone’s ability to eat…Oral thrush? I didn’t even know that was a thing? WHAT THE HELL IS GOING ON WITH MY BODY.

Now I am three weeks post surgery (happy no appendix anniversary to me!) and in positive news, the nausea from anaesthetic and poison is practically gone. Having started another lot of antibiotics and some weird throat drops I have also regained the ability to swallow but after so many physical preventions to eating, I am now mentally more terrified than ever at the prospect. I have been to my eating disorder unit and the scales say that I have lost weight yet somehow I feel bigger.
Doctors are telling me that I have to get back to my old meal plan immediately so that we can add new things in to regain all that I have lost but it feels impossible. I cannot comprehend how the hell I was managing to eat before, despite the fact I was doing it only a few weeks ago, because now such an ability has become alien and frightening. I am tied up in a bundle of fear over food, throwing up, weight gain, trying to eat whilst being laid up in bed unable to carry out my usual exercise routines and consequently recovery from surgery isn’t going very well because I don’t have the energy to recover. Both the physical affects and mental health problems are feeding off each other like my body is an all you can eat buffet, and ironically the one person not getting fed in this situation is me. I have been on the edge of collapse for months now, clinging to the edge of stability with all the strength I can muster, but this has thrown me. I have fallen off the cliff. I am spiralling.

…And on that jolly note, that is pretty much my explanation of how a physical illness can go on to affect/cause/trigger a relapse in a pre existing mental illness. As with a lot of my blog posts, it hasn’t been a particular barrel of laughs as far as topics go, but it is the honest truth, and as always, that is what I am determined to put out there in terms of raising awareness of mental health problems.
Now after all this typing, I think I am very much in need of a nap and then maybe I will give some more mashed potato another go. Eating food is the last thing I want to do right now and my stomach is already full from terror, but I promise, I really am trying.

Take care everyone x

AppendixExplode

The Dangers Of Drinking Too Much Water When You Have An Eating Disorder

So in last week’s blog, I talked about a recent lesson I had learnt about the importance of familiar surroundings when you struggle with OCD, and funnily enough I have learnt something else in the past week too.
I am learning a lot of things lately. It is like being back in pre-school only Daniel Jones hasn’t stolen my green crayon (if you are reading this Daniel then yes I know it was you and I still want it back), and the topics of these recent lessons have been far more focused on mental health and less on how messy one can get whilst finger painting/what noise a cow makes (hint: it is moo).

In life, we are constantly being told to drink more water. If you have ever sat in a doctors’ waiting room you will have no doubt seen several posters about how drinking a lot of water is very important, how kidneys love the stuff, how dangerous it is to get dehydrated, and from all of these posters and health warnings you may assume that the more water you drink the healthier you are, which…well… isn’t exactly true, especially if you are someone who is struggling with an eating disorder.

Drinking too much fluid is by no means something common to all people with eating disorders however, and in my years of experience getting to know fellow sufferers, there seem to be three camps of people and how their disorders manage fluids.
In one camp we have the people with eating disorders who struggle to drink enough water and end up extremely dehydrated, then there is a second camp of people who could drink a whole swimming pool if they had a big enough straw, and then finally in the third camp there are the people with eating disorders who do not have a problem with maintaining safe fluid levels and would therefore like to leave the camp I have just put them in and go back home to a habitat that is slightly less tent like.

As it happens, I am in the second aforementioned camp (ours has a lovely log fire and on Saturdays we roast marshmallows), and I struggle with drinking too much water even if I am not at all thirsty.
It is odd because I have always known that drinking too much liquid isn’t good for you, but when it comes down to it, me gulping down glass after glass of water is like some uncontrollable compulsion, a kind of outer body experience.
Many a time I have been pouring myself another litre and in my head have been thinking “NO. STOP! THIS IS DANGEROUS NOW” but my body won’t listen and carries on filling up my glass anyway. It doesn’t matter how ill I feel, drinking the water feels like an urgent and necessary task as if I need to dowse a fireball that is burning somewhere in my stomach, no matter how much water it takes.

Even in the camp of people with eating disorders who struggle with drinking too much water, it is likely that everyone will do so for a variety of reasons and it is rare for two sufferers with the same disordered behaviours to have the same reasons for carrying them out.
When it comes to me though, my compulsion to drink a lot of fluid is partly because of posters I used to see at my local gym telling me that if I didn’t drink enough my body would hold onto water (leading me to fear that the number on the scales would go higher), but mainly it is because no matter how many doctors or dieticians talk to me about the science of the intestine, I am convinced that if I do not drink ridiculous amounts, any food I eat will get stuck in me forever.

Technically I know all about stomach acids and the body’s ability to break down solid foods via various muscle contractions and other clever things that go on behind one’s belly button, but in my head, eating anything solid conjures up an image of that solid thing getting stuck in a tube. Say for example I eat an apple, it doesn’t matter how much I chew it, when it is in my stomach I still picture it as a big red cartoon like shiny apple with the stalk attached, a lump that will stay there unless I am able to create enough waves to erode and wash it away.

For this reason, to try and keep my drinking under some form of control, I have been on a fluid chart for years where I write down everything I drink to try and keep an eye on things so that it doesn’t get out of hand. If I don’t write my fluids down my brain tends to trick me and convince me that I haven’t had a mouthful of water in days (even if I am surrounded by empty bottles of Evian and have been peeing every five seconds), so it is safer for me to keep a record of it so that when the compulsion to drink a lot comes, I can remind myself that I have already drunk more than enough and need to distract myself elsewhere. Last week however, this fluid chart thing went a little bit off plan with the disappearance of my parents on holiday.

I have had several people message me asking what on earth happened after the mass break down described last week, whether my parents ended up cancelling the holiday or whether we gave it a go despite plan A being a rather sizeable fail.

Well, after people had realised that I couldn’t stay at my parents’ friends’ house for the duration of the holiday, the immediate conclusion was that the holiday would be cancelled, but eventually we managed to come up with an alternative plan wherein mum and dad would go off to Malaysia as planned and I would stay at home with my sister and my most legendary friend of all time alternating sleeping over to try and help me stay safe.

It was going rather well for the first few days (or at least better than the disaster that had been plan A), but as time went on I started to get more and more anxious about my parents being away and consequently the urge to drink increased in order to wash all of that anxiety and stress away. I know it sounds pathetic but without my mum there to verify how much I was drinking and suddenly in total control of my fluid intake myself, things started to get out of hand. People who stayed over would be able to support me in the day time but when up late at night I couldn’t help but manically gulp glass after glass of water over the sink. All the people who write those “yay kidneys like water, stay hydrated” posters would probably be thinking that is great but as with most things in life, moderation is key and you can have too much of a “good thing”.
Drinking too much water can cause problems for anyone who has been hitting it hard on the old H20 because your kidneys cannot process it and consequently the water stays in you where it can dilute the salt/sodium level in your blood and cause a condition called hyponatremia, which doesn’t sound particularly exciting but in general language this is known as water intoxication, and I am pretty sure that phrases containing the word “toxic” are never good phrases to hear describe someones physical health.

In healthy adults eating and maintaining a healthy diet, a few extra glasses of water will not cause this kind of thing, but the risks when it comes to people with eating disorders is often greater purely because they may not have been consuming enough salt/sodium in the first place, and essentially there is a risk of drowning your cells on the inside. This then leads to things like heart problems, fainting, water on the brain, seizures, psychotic episodes, death, and basically a lot of things that mean you “aren’t very well” which is exactly what happened to me a few days after my parents flew off to Malaysia and is exactly why my poor sleepy friend had to call an ambulance at 2am on a Saturday morning having been woken by me banging around, generally delirious and spouting nonsense (and a little bit of water. I was like a living water feature. Delightful).

The reason I stayed in hospital for so long however is a slightly more complicated story which I will have to get around to next week, just so that we are all up to date and clear as to why I was so rude as miss a blog post two Mondays ago (Oh the shame. And I was raised in a house with such good manners!), but as an initial explanation, the problem was that I was hospitalised for drinking too much water, and it is now after some severe tellings off from several health professionals that I feel the need to write this post about it so that people realise just how dangerous drinking too much water can be when you have an eating disorder, in case it is something other people struggle with themselves and seriously need to seek support for. If you are one of those people who struggles with drinking too much water I know you are probably doing what I used to do upon hearing these kind of things, the whole “surely it can’t be that bad” and “it would never happen to me” but trust me when I say that water intoxication is extremely dangerous and potentially fatal so if you struggle with it, even if your head tells you “you will be fine”, it is vital you get regular blood tests to check your sodium balance.

Luckily after a few days of being on a water restriction in hospital (good lord was I thirsty), my sodium levels returned to a more acceptable level…it is just that other things started to go wrong after that but again, patience dear friends! All in good time!

Now what I don’t want is for someone who already struggles with drinking enough to read this blog and suddenly panic and start restricting their fluids more than they already were because that is NOT what I am saying you should do and that is dangerous for a different bunch of reasons all on their own. I am just saying it is dangerous to go ridiculously overboard when it comes to fluid consumption even if your eating disorder tries to force you in that direction, and that instead of not drinking anything, just do it all in moderation. Water isn’t dangerous, everyone loves a good paddle or dip in the swimming pool, you just have to keep it at a safe level and be careful not to drown.

Take care everyone x

Kidney

P.s I am sorry if this blog is a little bit all over the place. Physically I am still not in the best place right now and my ability to write is somewhat affected but please bear with me! I am sure recovery will hurry up soon!

Why Familiar Surroundings Are Important When You Suffer With OCD

The original title of the blog I was planning to write today was “Tips on staying away from home when you have mental health problems”. You see, my parents were jetting off to Malaysia and seeing as I am not well enough to manage by myself at the moment, the plan was for me to go and stay with their friends in this lovely little house out in the countryside.
We have been planning it for months, I had visited the house and felt OK about it seeing how nice my bedroom, personal office AND personal bathroom were going to be. There was even a cat called Pingu. A cat. Named after my favourite childhood penguin. Ideal right?

Well I thought so, but was still worried about managing my mental health with new carers who do not know me as well as my parents, so I came up with a list of coping strategies and ways to manage it. Consequently I decided to write a blog sharing my oh so helpful tips incase anyone else out there was in a similar situation, but then…well…I went to the house where I was due to stay for two weeks, lasted approximately four hours and then was driven home in hysterics at midnight with my parents due to fly the next day despite having still not packed so much as a flip flop, because we have been spending weeks packing for me to go away (if you want to imagine how many things and bags it was, think of the average stuffed car that people often drive off to uni in, double it and chuck a penguin on top for good measure. Oh and a Christmas elf. One must never travel without one’s cuddly Christmas elf. Oh there we go! I did give a travel tip! YAY ME.)

Clearly then, I am in no place to be giving tips about staying away from home right now BUT over the course of this traumatic experience, I have been reminded of a valuable lesson about mental health problems, so I thought I would share that with you today instead.

Having been mentally ill and having been in therapy for over a decade, I would say I understand my conditions and myself rather well, which is why I felt that I could make a plan about an approaching situation in advance without running into any unforeseen issues.
Trying to do my same rituals in a different place however, really reminded me of something a lot of people might not realise: that being that sometimes with OCD, it is not just about carrying out a specific behaviour like a shower routine, it is about carrying out a very specific shower routine in a very specific shower.

I always knew that because of OCD and anorexia, I have a LOT of routines, rituals and specific ways of doing things. I eat out of certain bowls with a certain spoon, I drink tea out of a certain mug at certain times of the day and I wash my hands, shower and get dressed in very specific ways. As rigid as these and a number of different actions in my day are, logically you could assume that I could carry them out in a different place so long as I had the correct equipment. There was a shower where I was going to stay so of course I could do my shower routine, there was a sink so of course I could wash my hands and I was taking all of my cutlery/crockery so obviously I would be able to eat all in my usual ways.

Even I can admit that years ago, though still having OCD, I was able to do these fixed ritual things in other places with other sinks and showers. I have been on holiday since my diagnoses, have stayed in a hospital and went to university (kind of…), always carrying out the same actions just in different locations. Therefore I tried to do that this time going to a strange house but, with things how they are at the moment, as hard as I tried and as good as my intentions were at the time I attempted it, it isn’t possible (at least to a manageable realistic degree that doesn’t involve hysterics 24/7 for a fortnight which is less “a good challenge” and more cruel torture. I am all for accepting challenges and trying things out of my comfort zone but sometimes you need to eat a few mini muffins before you are up to demolishing an entire five tier wedding cake by yourself).

I was truly shocked as I sort of hadn’t realised how bad things have got again.
The descent has been a gradual process, little slips that in the end add up to a sky diver height of a fall. It is like what they say about if you put a frog in boiling hot water it will hop out but if you put it in warm water and gradually turn the heat up it will boil to death before it realises (that is what they say isn’t it? Who are these people? Please dear readers, do not go putting frogs in boiling water. If you really want to see some green bubbling in a pan just whack in a bag of frozen peas, far more humane AND one of your five a day).

When we pulled up at the house I fully intended on staying for the next two weeks (obviously I did, I had my penguin and my cuddly Christmas elf, I was committed to this trip). Even though I was anxious, by using multiple packets of anti bacterial wipes and with support from my parents, I got through the unpacking and after two hours my room, bathroom and office all looked really nice, filled with familiar things, a comfortable home from home.

It was when I tried to shower that things went so horribly wrong. First there was the issue that the shower was a stand in shower cubicle with a door. At my house our shower head is hanging above the bath, so when I am getting all lathered I can stand out of the flow of water to reach the required bubbliness (I know that this is not the most environmentally friendly way to live my life and that I could just turn the shower off but just know that I am unable to do that at the moment and to be honest when you are focusing on just keeping yourself alive your carbon footprint is not a top priority. At least I am not flying across the globe in an aeroplane to Malaysia like SOME people…).
With this stand in shower however, I was unable to reach the desired bubbliness needed to get through all of my thought routines because before I had time to count to the required numbers the suds had all been washed away.
Then there was a problem that I had to put my soaps in a basket so my lemon shower gel for feet was too close to my banana shower gel for body and far too close to a wall that I couldn’t touch, and the way you turned on the shower made my usual vitally important life saving way impossible.

I took so long to shower that all the hot water ran out and after a while of forcing myself to stand under the cold ice like hail pelting me in the face, I got out though I still didn’t feel clean. I was in a bit of a state but I didn’t want to give up so I persevered and tried to get on regardless but it was one thing after another. I couldn’t wash my hands in the sink because the tap distance to the back of the sink meant holding my arm at 135 degrees rather than 90, I couldn’t step off the towel I had laid on the floor because my bare feet couldn’t touch the tiles and I couldn’t put on the socks that I had brought into the bathroom with me without direct access to trousers and slippers. “You should have taken slippers in and trousers too” I hear you cry but I had thought of that already and couldn’t because there was nowhere safe in the bathroom to put those things at an acceptable distance away from each other. I found myself standing stranded on this towel shivering and blue with cold, so I naturally did what any other person would do in that situation. I cried uncontrollably and screamed in terror for my mother.

Luckily my parents were still there because the unpacking had taken such a long time that they had ended up staying for dinner whilst I showered.
Seafood rice was cooked and eaten and a homemade rhubarb crumble was just being served when the screaming happened and mum came running. She tried to help by offering solutions, one being the ideal “I can go and get the trousers and not let them touch anything”, but I didn’t want to do that. Yes it would have been safe, but I wanted to solve the problem by myself somehow with support.
Mum could have easily gotten my trousers and I could have left the bathroom but what the hell would I do the next day when she was on a beach somewhere in Malaysia? Around this point my “in a bit of a state” descended into full on “out of control don’t know what I am doing dangerous risky chaotic hysterics and panic” and from there things are a bit of a blur. All I know is that I cried for several hours (I tried to talk too but was at that hiccuping crying point so “I don’t know how to manage I want to disappear” came out more like “Hic gasp gulp hic scream”), and my parents and friends frantically tried to decide what to do.
When I was able to talk and sob at the same time I made it clear that I felt it was a challenge too many and that rather than tackling the “parents away and totally different location for all rituals for two weeks” I wanted to attempt the “parents aka usual carers away, in a familiar place” challenge. Losing both was like losing both of my homes, a tortoise rudely ripped from his semi detached terrace house and his shell in the same day leaving a cold naked slug unable to survive in its place.

There were then more hours of discussion before we realised that this really was not a feasible option and then after two hours of packing all of my things back into the bags we had unpacked them from (we didn’t have to pack my elf. He went and got himself back in the car the second he heard the first bout of screaming. He knows me well), we were back in the car driving home in the dark, leaving the abandoned now cold homemade crumble on the dining table. It is a big shame. My parents love rhubarb crumble.

So it was that I ended up back home after my much shorter than planned and somewhat failed “stay away from home with mental health problems”. On the plus side I did manage to get to the house and unpack…I just left two weeks too early.

Clearly then, I think I have proved my point and raised awareness to all the people who might not understand OCD, that when it comes to OCD and other mental health problems with ritualistic behaviours, it isn’t just the rituals that are important to a sufferer but the specific location and circumstances under which those rituals are carried out.

Take care everyone x

Bubbly