Why Boundaries Are Important When Living With Mental Health Problems

A few weeks ago when I was talking about the fact that I am getting discharged from an inpatient setting on the 20th of February/tomorrow if you are reading this on the day of upload, (handy link to that blog post here: The Pressure To “Get Better” When You Are Struggling With Mental Health Problems), I mentioned that there were going to be a lot of rules and boundaries in place regarding my mental illness that I would have to follow back home.
Seeing as these boundaries were set by my parents you might think I live in a particularly strict household with rules and regulations more often seen in a school rather than a home setting, but actually, I am starting to think that when you are living with mental health problems, it is vital for everyone to set some boundaries.

Thing is, when you have a mental illness bobbing along with you through life, you can guarantee that it is going to do all it can to interfere with any plans you had prepared. Thought you were going out for a night with friends? Surprise! Depression has crossed that out of the calendar and scheduled you in for a good old evening of crying into a pillow and thinking about what a terrible person you are. Decided to spend several hours working on that novel and actually being productive with your life? Nope! Instead OCD would like you to waste those hours antibacterialising various objects in the house that were already clean to begin with. No matter what illness you have, it is obviously going to impact your daily routine, and if left with total freedom, it is likely that it will impact your daily routine more and more as time goes on until you find yourself looking back and wondering how on earth things managed to get so out of control. Now when you are in an inpatient setting this aspect of mental health problems is managed somewhat by the rigid structure of your day to day life on the ward, but on the outside it is a hell of a lot easier to get carried away with your own rigid routines.

The reason for this is that I have started to realise that mental illnesses are much like dinosaurs, and living with them is analogous to being that professor that Richard Attenborough plays in Jurassic Park and it is that analogy (to be fair it has been a while since we settled in for a good old traditional Born without Marbles analogy) that I want to talk about today.

Maybe some of you out there haven’t actually seen Jurassic Park (and if you haven’t you really should, it is fabulous), but basically in Jurassic Park there is this guy called Professor Hammond (that’s the person with mental health problems in this analogy), and he owns this safari park of dinosaurs he created out of some blood that has been hiding inside of a mosquito for several thousand years (in the analogy the park is your brain and the dinosaurs are your mental illnesses, except obviously in the mental health version you did not create your dinosaurs/illnesses, rather they appeared one day and as a result you found yourself as keeper of this prehistoric zoo of insanity).

Having the dinosaurs there is obviously dangerous, so Professor Hammond does all he can to keep that danger to a minimum. In order to keep the visitors safe, he has a whole team of keepers helping him to keep an eye on his dinosaurs (aka psychologists and other mental health professionals), and there are physical boundaries/electrified fences set up all over the island around the dinosaurs to keep them in check. They are still dangerous dinosaurs, but when confined by their boundaries, their level of threat is somewhat controlled.

However in the film, before long, this idiotic man with absolutely no common sense turns off all the electric fences and cages that were housing the dinosaurs, and utter chaos ensues.
Without the fences, the dinosaurs do not remain in their neat little pens, they run amok and cause a hell of a lot of destruction and noise when doing so. That image (aka that of dinosaurs running madly all over the place eating people and crashing into everything), pretty much illustrates the importance of boundaries when living with mental health problems and why I have so many regulations in coming home.

For example, whilst I have been in hospital at my local eating disorder unit, there have been very definite rules set out to govern my behaviour. These rules are numerous and I cannot list them all for fear of boring you all to floods of uncontrollable tears, but as an example they have been things like the fact that if I do not eat my meal, there will be a replacement issued which if not completed will lead to consequences in ward round, or the rule that meal times take place at set points throughout the day with no option to delay that peanut butter sandwich for another five minutes. Meal times are meal times, you eat your meals in meal times, end of discussion.

Similarly there are rules to govern my OCD such as time limits for showers because without this kind of rule, my OCD tends to grab hold of all control over how long I take to shower and run with it a lot faster than I can chase after it (I was never one for athletics in school.)
When I have a time limit however, I have something to aim for, and though my OCD will still be present in my behaviours for the duration of the shower, it is my attempt at controlling it as best I can. If in hospital I weren’t to shower within the allocated time, I would be removed from the shower, so I sort of had to reason with my little OCD dinosaur to get through it. My dinosaur wanted to spend the next three years washing yet the rules meant this was impossible, so we had to work together and compromise. I would shower and do all the rituals I was told to, but only for a certain length of time. Having a time limit obviously didn’t always work and there are times where I still couldn’t stick to it, but like I said, it gave something to aim for and consequently I will still have that shower time limit now that I am heading back home again. Again it is unlikely that I will always be able to keep myself in check, but I know that without any rules in the shower things would be a lot worse than they often are and if I didn’t have a boundary set in place, then I doubt I would ever be able to get out of the shower at all.
I can of course tell my OCD that I have finished washing but OCD will always come back with “just another five minutes”, a request that, when given into, will be repeated every five minutes leaving me stuck in a ritual with no way out. With my rule, I at least have an argument against that. In the shower the OCD still dictates behaviours, but when it is time to leave the shower, I at least have the statement of “time is up and we must leave now to avoid consequences” to come back at any “five more minute” suggestions that should arise.

If you are living with mental health problems then, it is important to have your own rules in place to try and keep track of the interference it causes. You can’t control whether or not you have a disorder, but there are some things you do have control of that can help lessen the impact. Say you have an eating disorder and, as I will be attempting when I get home, you are trying to give yourself enough nutrition.
If you say to your eating disorder “I am going to eat better today”, then it is unlikely that you will achieve much, as “better” is a negotiable, subjective term that you will find yourself debating. Instead, hard and fast rules like “I am going to eat three meals and three snacks today” are more likely to merit results. They won’t necessarily mean you achieve what you want, yet again, like the shower time limit, it gives you something to aim for rather than a wishy washy “I will eat something” or “I will shower quicker” which without specifics don’t really mean anything and give too much control to your illness. I know that especially with eating disorders, giving into little things are a sure fire way of letting them spiral completely.
Whenever I have a bowl of cereal for example, I weigh out exactly the same number of grams each day without question. This is disordered of course, and one day I would like to pour cereal with all the gay abandon of a cereal pouring professional, but I know that if I don’t have a weight from my dietician to stick to, aka a boundary, then my portions will just get smaller and smaller. My eating disorder won’t ask for anything dramatic at first, just little requests like “just one flake less today” or “one gram less”, which doesn’t sound much but if you keep listening to that you will end up a few weeks down the line staring at a solitary rice crispy in the bottom of a bowl wondering where all the others went (and possibly hearing a very quiet pitiful sobbing from the rice crispy as they are very social creatures who, when portioned out individually, often get rather lonely. Rice has feelings too kids.)

You don’t have to make loads of rules and they can be small rules to start off, but no matter what the size it is vital that the rules are there. If you have depression, that sucks and you cannot control the effect depression will have on your mood. What you can control however, is things like taking any medication you have been prescribed or attending any appointments to try and keep it in check. If you have an eating disorder and a meal plan you have been told to stick to, make that meal plan your rule, your boundary that cannot be negotiated. Ok the eating disorder will still be there screaming and it may interfere with your behaviours, but having that meal plan there is a non negotiable that is not up for debate. With OCD rituals put time limits on how long they can take so that a quick five minute tidy doesn’t descend into a five hour mass organisation mission or at least put a limit in place as to how many times you are allowed to do something simply to give you something to aim for.
Like I said, this is not going to cure you of any mental health problems nor is it going to stop them interfering/being dangerous beasts much like the dinosaurs in Jurassic Park. In or out of a cage, a T-rex is a T-rex (unless it is a bunny in disguise), and you cannot control the existence of that T-rex or its nature/behaviour as a stomping, roaring, chomping scaly thing. What you can do however, is put boundaries in place to try and limit the destruction that dinosaur can cause, to do the best you can to take control of something that otherwise will take lack of rules as a chance to run amok to see what it can get away with, and that is why, as I go home tomorrow, I go with a set of rules and boundaries in place.

Coincidentally, that is also why mental health problems are like dinosaurs and why it is vital to have boundaries when living with them in your head/prehistoric safari park. Rules may be broken, but having certain rules in place at home does often help me to manage typically unmanageable situations a little better. If you have been in hospital, take hospital rules back home when you are discharged so that the illness doesn’t have the total freedom to reinvade, and if you haven’t been in hospital then maybe come up with some rules with friends and family who are willing to support you in your battle for sanity. Remember, a dinosaur is always going to be a wild destructive interference, but with boundaries, that destruction can at least be controlled as much as possible…I hope…

Take care everyone x

BoundariesDinosaur

Advertisement

The Difficulty Of Eating In Public When You Have An Eating Disorder

To the average person the idea of going out to eat is a pleasant one, and when someone suggests going out for a coffee and a piece of cake in a local cafe or out to dinner at a fancy Italian restaurant, the usual reaction would be “Why yes what a lovely idea”, or “of course! I think I shall order the lasagne”.
To someone with an eating disorder however, it is likely that the idea of eating food out will be a terrifying one, reserved to the realms of nightmares rather than sweet dreams, and if you are anything like me when it comes to life with my eating disorder, it is likely you would rather dance a tango with a giant hairy spider than go out to “grab a bite to eat”. It is for this very reason that when I was in ward round this week and I was told that I had to go out to a local coffee shop for a snack with a member of staff, I started to wish there was a chance to whip out my dancing shoes and go to a ballroom with an enormous arachnid instead.

It is silly really because like I said, as a rule people generally enjoy going out for food (even if, like my mum, that is simply because you don’t have to wash up at the end of the meal), but for me there are so many things to be scared of and I don’t think people realise just how many things there are to worry about when it comes to going out for something to eat when you have an eating disorder rampaging in your frontal lobes.

First off there is the difficult task of looking at a menu and choosing what you are going to eat. Alright you may have to make some food choices in the home or out at the supermarket, so choosing food shouldn’t be a sudden and new experience, but at least with that kind of thing you can plan far in advance and prepare what you are having yourself so you know exactly what the meal comprises of. When you are eating out however, the ability to plan everything and control each stage of the process is whipped out from under you quicker than a slippery yoga mat on a vaseline coated floor. Ok, nowadays most restaurants and cafes tend to have menus online so in a sense you can prepare for what you are going to attempt and do not have to make a choice on the spot, but even if you make a choice from an online menu you can never guarantee that what you decide on will be available in the branch of the restaurant that you visit in particular. What if you have your heart set on the roasted aubergine spaghetti and then get to the table only to be confronted by a waiter breaking the news to you that they are all out of pasta and severely lacking in terms of aubergine supplies? What if you get your head all psyched up to tackle a chocolate muffin with multicoloured sugar strands and then find that the muffin man got caught in a traffic jam on the way to deliver his cocoa rich rainbow sprinkled delights? HOW CAN ONE RELAX AND MAKE A DECISION WHEN THE WHEREABOUTS OF THE MUFFIN MAN AND AUBERGINES ARE ALL UNKNOWN?

Then again, what if the aubergine harvest has been plentiful and the chef can prepare your chosen dish? How are they going to prepare it? How much pasta will they use? Will there be oil? Will there be butter? How will it be arranged? Will the sauce be served on top of or mixed into the spaghetti? Exactly what kind of concoction should you expect? Also what if you can’t even get that far and can’t make a decision as to what to have in the first place, either because there are too many options or not enough safe ones? When it comes to people going to restaurants a little bird told me (a very little bird. about half the size of Tweety Pie to be exact) that people chose what they “fancy,” but again when you have an eating disorder and find most of your decisions controlled by calories and grams of fat, what exactly does it mean to “fancy” something?

Even when food is chosen and aubergines can be found in abundance, the worries don’t end because then you have what I would say is the hardest thing about going out for food and the thing that I worried about most after this news about a snack out had been broken to me: eating in public. Indeed the choosing from a menu worry wasn’t even what made me anxious about the excursion as when I went out for snack with my nurse I actually took the food with me to the coffee shop from the hospital (not that that is technically allowed in terms of coffee shop table taking up without making a purchase regulations, but when you are terrified and have an eating disorder you don’t give a damn about the rules!), so it wasn’t the menu issue but the eating in public part that was troubling me.

Truth is, when I eat I prefer to do it in private because even though I am well aware that other people have too many things on their minds and in their lives to have space to think about what is on my plate, I am always paranoid that everyone around is looking and judging me for every mouthful that I consume. Why do I care what random strangers have to say about my choice of snack of an afternoon? I have no idea. Why do I think that a business woman on her lunch break or a student cramming for an exam over an espresso and a laptop, care about whether or not I eat a hobnob? Who knows, but regardless of the reason, I do care and I care a lot. For other people I do not see the act of eating as something to be ashamed of at all but when it comes to me there is something so guilt and shame filled about it that the idea of eating in public is sort of how I imagine the idea of showering in public would feel to most people, aka self conscious and like you want to throw a sponge and curl up in a ball so nobody can see you.

No matter what you do or what you eat, it feels like everyone is staring at and judging you, even if you can see for a fact that others around you may even be eating more than what you have on your plate and are not actually looking anywhere near your direction. When I was out for snack there were plenty of people busy reading papers over plates far fuller than mine, yet still I thought that they were somehow looking at me with some kind of laser vision and thinking that I was greedy for attempting what I had before me. It was so bad that just to get through the snack I had to close my eyes and play that childhood game where you imagine that because you can’t see other people ,they can’t see you either (side note: it is surprisingly hard to eat a snack when you can’t actually see it…).
Somehow I got through it using my head down, eyes closed, just keep munching method but still it was a horrendous experience and one that I am not planning to repeat in the near future or ever if I can help it.

Overall then, though it would seem that the idea of eating out in public, either for a snack or a meal, is some kind of treat to be looked forward to, when you have an eating disorder, it really isn’t that simple a task nor is it a particularly enjoyable one either. Like I said, I know I for one am not going to be attempting such a thing again voluntarily simply because even without the ordering stress and malarky it is the actual act of eating in public and being judged (however irrational that thought may be), that causes all of the anxiety. A snack out in a coffee shop may be a piece of cake physically, but in practice I can assure you that it certainly isn’t! PLEASE DON’T EVER MAKE ME DO IT AGAIN!

Take care everyone x

EatingPublic

5 Ways To Deal With Weight Gain When You Are In Recovery From An Eating Disorder

If I had a penguin for every time I have heard someone say or have said myself “I want to recover from anorexia but I don’t want to gain weight”, I would have more penguins than exist on this planet and would therefore have to get the existing penguins to rapidly reproduce in order to make up numbers (which is why all the penguins of the world are probably grateful to hear that I don’t have to have a penguin for every time I have heard that sentence or else they would have a lot of egg hatching to do).
Admittedly, there are many sides to the Rubix cube confusing madness that is recovery from anorexia, both mental and physical, and there are a lot of fears revolving around all of them, but I think when it comes to recovery, probably one of the top three things most people worry about is the weight gain side of it all. Personally at least, I know that the fear of weight gain is certainly a big thing for me and is particularly relevant right now as in my current admission to hospital it is the forced and rapid weight gain that has ended up distressing me most of all to the point that I haven’t even been able to focus on any of the more long term mental health sides of the illness as I am too focused on the scales.
I know that to other people, my weight does not define me as a person and that the number that flashes up when I step on a little machine should not dictate the way I live my life but when you have an eating disorder, those thoughts are often automatic and knowing they are irrational doesn’t take them away.

Unfortunately, despite the fact that the weight gain side is incredibly hard, if you really want to recover from your eating disorder, the fear of weight gain is an unavoidable thing that will need to be tackled and that, if neglected, will never truly allow you to get back to a healthy mind and body again.
So how do you manage it? If you want to recover from your eating disorder (or even if you don’t and are in forced treatment at the moment…ahem), how are you supposed to deal with one of the most frightening challenges to face someone struggling with anorexia: weight gain. Well, if that question has been on your mind at all then welcome to a blog post containing some possible answers, because today I am here (wearing a bow tie no less because I am fancy and have dressed smartly for you on this occasion), with 5 thoughts to help you deal with weight gain when you are in recovery from anorexia. So without further ado, lets get into it *straightens bow tie and gets down to serious business*…

1. Weight redistributes – When you start the re-feeding process after depriving yourself of adequate nutrition for a long period of time, your body will have no idea what the hell is going on or what the hell to do (something I explain a little more in this post here: Five Things You Need To know About Re-feeding During Eating Disorder Recovery). Because of this confusion and deprivation, when your body first starts gaining weight, it will want to prioritise on life saving things first (handy that) and for this reason a lot of people find that weight gain in the early days primarily goes to the tummy area so that the body can focus on repairing things like a dodgy liver or an out of whack kidney. This has happened to me multiple times (including right now) and understandably it can be quite distressing as your body can start feeling out of proportion, but what I want to emphasise with this point is that even though weight may initially go to life saving organ places, it WILL redistribute and spread out eventually as long as you hang in there and give it time. Restricting your intake to lose the weight again will only make this process more dramatic, so the key is to stick with it and always remember that redistribution will happen!

2. You are gaining weight you shouldn’t have lost in the first place – Whenever you see or hear an advert for a weight loss diet club, the people will emphasise how good it is to have lost the weight they did with whatever weird low carb eat upside down with a pineapple up your nose (difficult task, would not recommend) diet they have been following and therefore the idea of gaining any weight back is automatically “bad”. Culturally this has then created this false idea that the act of gaining weight is a bad thing in itself however this is not always the case, especially when it comes to recovery. Thing is, when you are regaining weight you have lost through an eating disorder, you are actually not gaining weight but are regaining parts of your body that you should not have lost in the first place, so whenever you see that number go up on the scale remember, it is not weight gain in the negative way that the diet clubs claim it to be, it is just re-finding a little puzzle piece of the wonderful you that may have been lost to this terrible illness.

3. The alternative is worse – I will hold my hands up and admit it: weight gain is scary. Then again, if you think about it, isn’t the alternative, aka death (for anorexia is the mental illness with the highest mortality rate of all), even scarier? “I am not that bad” I hear you cry, “I am not going to die of anorexia”, but hey, that’s what they all say and in a lot of cases, it turns out not to be true. Anyway, even if you are one of the fortunate souls whose body somehow manages to survive the abusive nature of an eating disorder and live, what kind of a “life” is it to spend your days tortured and tormented by a beast in your head? Weighing things up then (no pun intended…actually screw it…with me the pun is ALWAYS intended), although weight gain is scary, when you are going through the process it is important to think of the alternative, and remember that that alternative is a hell of a lot worse.

4. Weight gain is not as visible as you think – If you are like me, when you stand on the scales and see that the number has gone up, you can immediately see where that extra weight has gone to. This however, in the nicest possible way, is utter nonsense because in actual fact changes in body weight are no where near as visible as we might think. I remember one week when I gained one pound and instantly I saw my physical appearance change into something unrecognisable to the person I had been before that pound. Know what everyone else saw? Nothing. I would be lying to say that no weight gain is ever visible (as someone who has just spent 5 months in hospital I can guarantee I do look very different now), but my point here is that weight that you gain every week at weigh ins is not as visible as you might think and if you think you can see that pound or two of extra weight then it is simply proof that your eating disorder is distorting your vision. Don’t listen to its lies I say!

5. Getting bigger doesn’t mean you are big – If I ran a banana farm and after the harvest found that I had 1000 bananas, that would be a lot of bananas (and I would clearly be one hell of a good banana farmer). In that circumstance then, 1000 banana would be the definition of a lot of bananas. If the next year I then had 100 bananas would I think that I had hardly any bananas (trust me I do have a point here and am not just trying to send subliminal messages to you all about my secret dream to become a banana farmer). If however I had 0 bananas one year and then the next had 100, 100 bananas would be my definition of “loads of bananas” and that is what it is like with weight: aka all relative. Just because you are gaining weight and getting “bigger” it does not mean that you are big. You might think “I am huge” because the number on the scales has gone up but what I am saying is that just because the number has got higher it doesn’t mean that number is big. 100 bananas only looks like a lot of bananas if you previously had no bananas, just as a certain number of kilos only seems “huge” because it is bigger than the nothing you had previously and every “high” number you fear only seems high because you are looking at a lower one first. Getting bigger does not mean getting big therefore and if it was the other way round (aka the 1000 banana situation first) then your “high” number would be someone else’s low in a different situation. Whenever you see you have gained weight and feel like your weight is high, remember the bananas and the fact that a high number only seems big because it is bigger than the previous number and it is not that the number is big in itself.

SO there you have it! 5 thoughts to help you manage the fear and stress that is the weight gain side to recovery from an eating disorder! As always I am not saying that this blog post is going to solve the problem, nor will it probably make gaining weight any easier, but these thoughts are at least important and sometimes helpful/comforting things to bear in mind when the voices are getting a bit too loud for comfort and you have no arguments to fight against them. These thoughts are therefore your arguments against all of those bad thoughts, your weapons for the recovery battle, so take them brave soldier and use them wisely to outwit that cunning eating disorder who is trying to fool you into making weight gain seem like a bad thing.
In the meantime, if you are someone struggling with the anxiety ridden process that is gaining weight, please know that I really do feel for you as someone who has gone through the process multiple times myself (and is still going through it today), and I hope that this blog post has perhaps helped a little bit. Remember, recovery and weight gain is hard but losing your life to a cruel demon in your mind is far worse.

Take care everyone x

WeightGainFear

The Difficulty When Mental And Physical Progress Move At Different Speeds In Eating Disorder Recovery

In a few days time, I will have been in hospital for 16 weeks aka a grand total of 4 months, and because of this, I am often being asked questions like “How are you getting on?” or “are you feeling better?” which are both very complicated and difficult questions to answer when you are in treatment for an eating disorder. You see, on one set of paper work, things are going rather swimmingly and I am indeed doing much better, yet on the other set of paper work in my opinion, I am actually feeling and am “doing” worse than I ever have done in my life.

Oddly enough, this discrepancy between paper works is not because I have two very different doctors with opposing ideas writing sets of notes about my progress, but because when it comes to recovery from an eating disorder, there are two very distinct and different sides to it, the mental and the physical, and unfortunately these two sides do not work as sleeping otters do (aka hand in hand – yes, fun otter fact for you, otters hold hands when they sleep to make sure that they don’t drift away from each other. Apparently they also make waterslides and play with pebbles. Conclusion: Otters are cool).

Indeed the two sides to eating disorder recovery are so separate that I think that asking someone in treatment for an eating disorder how they are, is a question that needs to be asked twice, once for each side of recovery, because otherwise getting one coherent answer is impossible.

To be fair, towards the beginning of my admission, the physical and mental sides of how I was doing were fairly in sync. Mentally things were a bit all over the place and physically things were too. This then continued as I struggled to work with the program at the eating disorder hospital, until the introduction of my NG tube and since that most unwelcome introduction, everything has changed, in my eyes, for the worse.

Before, when I was mentally struggling and didn’t feel able to manage food, I was able to avoid it which obviously didn’t help my body very much but it prevented my anxiety levels from getting worse. Now though, since the NG tube, I have a constant and unavoidable source of nutrition and it doesn’t matter how I feel, food cannot be avoided. If I don’t eat, the food still goes in, and consequently my mind is in utter turmoil. My body on the other hand is as they say “loving life” and ironically, it is killing me.

Seeing as food is unavoidable now, I have been following my meal plan in one way or another for weeks and the affect this has had on my body is dramatic. I am gaining weight faster than I have ever gained weight before (perhaps because I have never had such an unavoidable source of nutrition stuck up my nostril before), so health wise, I am “improving”. I am no longer at a weight where I require a wheel chair, I am now able to stand in the shower for long periods of time, even on one leg (I am a fantastic flamingo impersonator these days), and when I get out of bed in the morning, the world doesn’t swim before my eyes and go black. Objectively these all sound like good things and for the medical professionals and my friends and family, these are good things but to me, these are terrible things.

I really don’t know how to explain this idea to people who may not have eating disorders as I know that to most people it sounds absolutely ludicrous. Physical health, the ability to stand in the shower and walk down the corridor are abilities to be appreciated not feared, but when you have an eating disorder, these abilities mean entirely different things.
To me, not being able to stand up without things all going fuzzy was a sign that I was “behaving” myself, a sign that I was doing a good job at punishing myself so the guilt I felt at being alive was lessened. Now though, I am unable to “behave myself” by not eating because even if I don’t eat the food will go in without my permission, so with things not going fuzzy, it is like a sign that I am doing something “bad” (even if it isn’t always me who is doing the eating), and I guess I am feeling all the guilt and shame as anyone else would were they to do something they thought was bad, like stealing or punching someone in the face.

Now I take up too much space in the world and with the weight going on as it is I take up more and more space each day, which is something I have always struggled with. When you hate something you want to make it as small as possible (or you want it to disappear altogether), you want it to take up as little of the world’s space as possible so as there is more room for the good things. In gaining weight I feel like a weed taking up too much space in the flower bed and stealing all the sunlight from the marigolds.

It is incredibly hard to watch this body you hate, morph in front of your eyes into this thing that is getting bigger everyday, getting “better” everyday whilst inside you are all the more depressed and tormented.
I don’t have any idea if I am making sense here because to be honest I am on so many medications right now that my brain is not functioning but if I had to resort to the good old Born Without Marbles way of explaining things, aka an analogy, it feels like my body and brain are one of those cars people drive off in after a wedding with tin cans on the back and “just married” scrawled across the rear windscreen.

My body is the car and as it gains weight it is zooming off full speed. Meanwhile my brain is the collection of tin cans tied to the back, being dragged along and through all of this road that it is not ready for, each can bouncing and denting, bruising and breaking a little more with every mile that passes. My body gains weight, my brain cracks a little more, I feel more broken, depressed and bruised and the faster my body goes the further it is from my brain which is actually all the way back at the starting line. I guess this analogy isn’t perfect because you could say “but your brain is moving in the right direction like your body if it is tied to the car” but that is where the analogy fails because that is not happening at all, like I said, as the car moves the brain just gets battered and even staff have admitted that in the past few weeks things have mentally become worse and worse as time has passed and weight has gone on.
Christmas day is a perfect example of this. When I woke up on Christmas day I was weighed (NOT something I asked Santa for and if I ever wake up to a set of scales in my stocking on Christmas morning again I swear to God I am marching to Santa’s grotto to give that beardy man a piece of my mind…and his scales back), and I had gained a lot of weight. On paper then and to the doctors, my body had got “better” but mentally the shock of it all had such a strain on my mind that I totally lost it. Within minutes I was having to take medication to calm down from the anxiety and agony and when my family came to see me for our two hour visit, the visit wasn’t better for the weight gain, it was worse. It should have been better logically, my body was healthier than the last time they had seen it but in becoming that way I became so upset, distressed and anxious that I had what we shall simply call “ a little incident” and I had to ask my family to leave early.

It is that which I think illustrates my point best as to how impossible it is to answer the question as to “how are things going” when you are in recovery for an eating disorder. Am I better? In a way, yes and I am getting “better everyday”, but in the other more important mental side am I better? Am I progressing? Not at all. I hate myself more than ever, I am more unhappy than ever and I feel more trapped than ever in a body that I no longer relate to. The distance between my body and mind is so great now that I have asked staff if there is any chance we can slow down on the weight gain so that my mind has got a chance to catch up but they are refusing and it all feels like I am being dragged and pushed too far out of my comfort zone. I am in hospital being treated for an eating disorder and the physical problem is being taken care of by a tube, but the mental aspect is being torn apart and I really don’t know how much longer I can handle it.

It is so frustrating trying to explain all of this and I guess in the end the main thing I want to do at the end of this blog post is apologise because I feel like I haven’t made any sense and that I have wasted your time with my incoherent waffle. Like I said though, I am on all sorts of crazy meds at the moment (to calm me down because I am in so much distress due to this whole struggling mentally with the physical progress my body is making right now when I am not ready for it), so please blame those meds and not my inabilities as a writer. I don’t understand half the things that are going on at the moment so explaining them coherently is somewhat difficult. I really am sorry. I am just so battered. I hope this makes some sense at least or that I have got the point across in some way that physical recovery and mental recovery for an eating disorder do not go hand in hand and can sometimes be literally travelling in opposite directions. “How are you doing?” is such a simple question but good lord when you have mental health problems is it a difficult one to answer.

Take care everyone x

RecoveryCar

Is It Ok To Give Food Related Christmas Presents To People With Eating Disorders?

As soon as winter rolls around, there are certain questions that suddenly pop up every time you interact with another human. These questions vary but include things like:
“Are you doing anything nice for Christmas?”
“What do you want for Christmas?”
“Do you really need to buy more penguin themed decorations this year?” (Yes. Yes I do)…
And of course the ever sigh inducing “Have you started your Christmas shopping yet?”

Due to the birth of commercialisation and consumerism (two things that, although very much involved in Christmas, were not actually born in Bethlehem and laid in a manger), Christmas shopping is a big stress over the festive season both for money reasons and of course wondering what the hell to buy for everyone. Mental health wise however, there are further complications because sometimes there is a question not just to what you should buy a friend or relative, but whether there is anything that you should definitely not be buying…

As you may know, I have a lot of friends with eating disorders and several of these friends have come to me in the past exasperated and fed up, poised with a story to tell me about a distant relative who sent them food as a birthday or Christmas present. I know a lot of people with eating disorders might get frustrated, find the gift insensitive, rude, or even cruel, like taunting an alcoholic with a bottle of gin, and the majority of people I know have stated that “people should not give food related presents to people with eating disorders”.

I think that one of the difficulties in this issue, is trying to decide whose responsibility it is for someone to manage the whole gift giving/receiving situation. Is it the responsibility of the person who is choosing the gift to give (maybe an unfair burden considering not everyone will know every personal detail of whoever they are buying for this December and surely if it is “the thought that counts” any present is incredibly kind and generous), or is it the responsibility of the person receiving the gift, to manage what it is appropriately for them?
If you give a Dolly Parton hater (for-shame! Come on now, you have to at least like Jolene? 9-5? IT IS A SONG ABOUT THE MONOTONY OF WORK LIFE! DOLLY GETS US!), a copy of Dolly Parton’s Greatest hits, whose responsibility is it to deal with the CD? The gift giver for not knowing about a person’s hatred of the world’s greatest country singer and for not being too careful, or is it the responsibility of the gift receiver to simply donate the generous present to a charity shop where it can be enjoyed by someone else who is able to appreciate a bit of “I will always love you” blasting from the speakers? However, what if a gift is medically inappropriate? Whose responsibility is it to manage then?

For example what about Horris who is deathly allergic to peanuts? Maybe Horris didn’t write a Christmas list this year (always a risky move), and maybe his third cousin twice removed’s husband’s goldfish wants to send Horris a gift (for he is a very generous goldfish), but is unaware of Horris’ unfortunate peanut condition.
If this lovely Christmas loving goldfish sends Horris three tonnes of peanut butter, a t-shirt made from knitted peanuts and a trip to the “World of Peanut” theme park with the “Ultimate Peanut Experience Peanut roller coaster” (you ride around the track within the shell of a giant genetically modified peanut and then at the end enter a flume tube filled with peanut butter that will leave you utterly soaked upon plunging into it). If Horris uses this ticket to the theme park, surely it is partly his fault for not taking proper care of his health requirements (aka the requirement to not plunge into a pool of peanut butter at 100mph in the shell of a giant peanut). Then again, what if Horris is so allergic that the mere sight of the ticket and the tonne of peanut butter sends him off in an allergic reaction without him having any warning of the deadly gift? Who do we blame? Goldfish or Horris? Surely this is a very different kettle of ethics than the previous Dolly Parton debate? So what about people with eating disorders?

On one hand, as a person with an Eating disorder myself, I can see the point of those who say that giving food as a present to someone with an eating disorder is inappropriate or something they don’t like happening. It can indeed be frustrating to be given food presents that you fear every year and are possibly unable to enjoy due to your illness. I have heard people with anorexia say that it makes them feel more isolated from the rest of the Christmas festivities because being given, say a Christmas present that is a box of merry smiling gingerbread men with chocolate buttons, a freshly cut yule log or a batch of homemade mince pies is like being shown something “normal” about Christmas that others can enjoy and that they may want to take part in like other people, but due to their illness, feel they can’t. Some could say that getting food presents makes them feel misunderstood or like their problems/disorders have not been taken seriously, belittled and assumed to be “a mild difficulty with food” that can easily be solved if you put a nice bow on a box of chocolate penguins, rather than a fully fledged eating disorder ruining their lives no matter how many bows you stick on top of that box of rich 70% cocoa waddlers.
As well as food presents for disordered eaters being problematic in the sense the present receiver may be too scared to enjoy them, there is also the risk that food presents could trigger someone in other ways, for example someone who feels the compulsion to binge and maybe purge afterwards. Some sufferers keep certain foods that they are likely to binge on out of the house to make them feel more in control, so when that food is suddenly handed to them wrapped in glittery ribbon tied paper, they struggle to deal with it in the way they might like to when fighting their disorder.

That said, though what I am about to say is something most Eating Disorder sufferers would disagree with, I don’t think that people should put a full-on ban on food presents for people with eating disorders and I think that getting a food present once in a while is more likely to help rather than hinder your recovery.
What if one Christmas as the countdown to the 25th was underway, you went into some form of new treatment that you started to find more beneficial than any you had tried before. What if an image of what life could be like without your eating disorder started to give you hope in a positive future and what if, like a Christmas miracle, your eating disorder backed off a bit and you felt strong and determined enough to kick some ass. What if in this Christmas miracle you became so inspired to fight your demons that you made a promise to join in on all the scary Christmas food things this year, finally buy that advent calendar, make that gingerbread house with the candy cane decorations, try one of Aunt Enid’s famous mince pies and join in on all the party canapé platters at the work Christmas buffet (I hear the brie and cranberry filo tarts and chocolate penguin profiteroles are a delight). What if all of these goals arise, all this determination to fight and join in with everyone else…and then nobody gives you the opportunity to do any of it because they are all too scared to offer you that filo tart or wrap up that tub of Celebrations. To me, that would be incredibly triggering, if I were to be there ready to fight, ready to eat and join in and everyone just left me out anyway because they assumed I wouldn’t do it. This year, considering i am in hospital and not particularly well right now, that assumption might be right but in my head, never being given food presents at Christmas or any other time of year like Easter or a birthday, is simply a way of other people confirming the idea you already have in your head that you don’t deserve or need food and therefore shouldn’t eat it. People treat you like an eating disorder and you will find it hard to see another identity for yourself. Furthermore, when would the food ban stop and would it ever? How would that be decided and wouldn’t that be more triggering in itself to have food presents suddenly reintroduced? If you have an eating disorder at one point, are families to avoid food gifts even if you are recovered “just incase” which again isolates you from certain celebrations. Yes food can be triggering as a gift but wouldn’t it be more triggering to be very unwell for years and then one year to be maybe doing a little better mentally and physically, so much so that people notice, give you food and then you freak out thinking that they are insinuating that you “aren’t ill anymore” or that they think you have put on weight so are clearly fine with eating again.
Personally to avoid all of these issues, when it comes to food presents, I would rather be treated as normal, like everyone else, receiving the odd box of Quality Street and being offered the iced mince pies. Even if I can’t accept the mince pies or have to give the Quality Street to my mum, I would rather they were there to make other people treat me “normally” until I am in a place to play that role of “normal person who eats food presents at Christmas and gets two candy canes stuck in their gums by getting a bit too enthusiastic when impersonating a walrus”.

Overall though, I guess that with this topic, it is impossible to make any conclusion because whether or not you give food to someone with an eating disorder is going to be a tricky thing to gauge and will vary from person to person. As I said, even I and my group of friends who share the diagnosis feel very differently about the topic so to be on the safe side, if you are wondering whether or not to give someone with an eating disorder a food related gift, you might want to check with the individual or maybe a relative of that individual first to see how they might react to it. There are many types of eating disorder and even people with the same one will experience them differently at different times, such as when they are going through periods of relapse or recovery, so as much as I would like to have given you a black and white simple answer (and we all know how much I love things that are black and white ahem penguins ahem), I am afraid I will have to conclude in a rather hazy grey as the answer will vary from person to person.
All I would say is, if you are the gift giver, try not to get too anxious or caught up in overthinking it because ultimately you have a 50/50 shot of getting it right and if you get it wrong, it isn’t your fault, nor does it make you a bad person. Similarly, if you are the receiver I am sorry if food present wise, things don’t go your way this year, but equally remember that other people may not be thinking as deeply into the meaning or significance of a box of chocolates as you might be and maybe it is just their way of trying to show they think you are pretty awesome. A Christmas present is a Christmas present, it isn’t a holy significant statement laden with meaning as to how someone views you or your body, it is a sign of appreciation, a sign someone cares, and at the end of the day, it is always the thought that counts.

Take care everyone x

Pudding blog

Is It Possible To Be Too Open About Your Mental Health?

TRIGGER WARNING: This blog post contains reference to certain medical treatments that can be used with people with eating disorders, so if that is something you would find unhelpful then please do not read it for your own safety. If you are like the witch in the Wizard of Oz who melts when coming in contact to water, THIS is your warning to STEP AWAY FROM THE FLUME.

In both the mental and physical health worlds, confidentiality is a BIG thing. When it comes to your wellbeing, there are a lot of rules between professionals, your medical notes and what can or can’t be said in front of friends and family.
Want to keep that random extra hand sprouting from your lower back a secret from Aunt Enid so that she doesn’t start knitting you an extra mitten every winter? No problem, medical confidentiality has got you covered (unlike your third hand which is now not going to have a mitten for Christmas).
Don’t want people at work to know that you have a condition that causes you to temporarily morph into a teapot whenever stressed? That’s fine. Tell the doctor and they will keep that tidily hidden away on a computer protected with lots of codes and National Health numbers that would make your deepest medical secrets hard to find, even if people were looking for them.
You see, when you are dealing with hospitals, everything is kind of like some kind of James Bond spy film, it is all very hush hush, very top secret, very “who can we talk about your bunions in front of” (which, coincidentally was the alternative title for the 1964 classic “Goldfinger” but Shirley Bassey didn’t want to sing about Bunions).
Not only is medical confidentiality important though, it is also fragile, and like all fragile things, this unfortunately means that it can very easily, even accidentally, get broken.

My question however, is if it is YOUR personal medical confidentiality, is it ok/are you allowed, to break it yourself? Are you allowed to be “too open” about matters that other people would usually keep private, in the interests of raising awareness of those issues?
Not to talk about any single person or specific situation in particular or anything (THIS ENTIRE BLOG IS ABOUT ME AND MY VERY CURRENT AND SPECIFIC SITUATION), but is it possible I ponder, for one to be too open say, about a mental health condition and the treatment that may be involved as a consequence?

Like I said, we are not talking about anyone in particular (THIS IS ALL ABOUT ME), but as a very rough, vague and unspecific example, lets go back to Monday the 27th of November 2017 at 10:01am when a link to a post on this fabulous mental health blog you might have heard of, was uploaded to try and give a rough update to readers of said blog regarding the situation (or rather, the colossal mess of a situation) of the writer.
Oh screw it, I cant keep the secret anymore. Ok yes! You are right! I am talking about my blog aka this blog and my situation last Monday when I tried to write a post to tell everyone the latest news and was incredibly vague about everything, which is unusual for someone who usually speaks honestly and openly about everything personal and mental health related. Why was I incredibly vague? Well, because I was scared after staff had raised concerns about me sharing certain things on my blog, which really freaked me out and had me very worried and confused.

Thing is, when it comes to medical confidentiality, I kind of see it like you see a piggy bank, it belongs to you, you can look after and protect it, but at the same time, you and you alone are allowed to break it.
Were you to go over to someone else’s house, find and destroy their piggy bank and run off with all the money inside (or say medical details), that would be wrong on many levels. It would be theft, it would be a breach of someone’s privacy, destruction of their property and the murder of a perfectly good ceramic piggy. If however you have your own piggy bank and, after several years of amassing various coins of experience, decide that you don’t mind sharing those experiences and spending those coins out in the world in the hopes of making a difference, and consequently smash your own ceramic oinker to smithereens with a mallet…I think that is ok, because it is your property, your information to share, your little piggy to destroy (and then mourn over appropriately of course).

It is still important to be responsible for your information of course, and I don’t believe people should, as it were, shove their information coins into other peoples faces whether they like it or not.
There should always be warnings to alert people when someone is talking about a sensitive issue that could be triggering or harmful to others, so that they as a reader can use their own personal responsibility to choose to remove themselves from potential harm. Nobody should be forced on a flume and plunged into a bath of emotions without the opportunity to get their rubber duck out but similarly, if you know you melt when you come in contact with water, maybe don’t go on a flume.

Admittedly this is more complicated with things like mental health problems which can sometimes cause you to do things, read things and get involved in things you might know deep down are harmful, but we can’t all be silent about everything, and if Donald Trump is allowed his own twitter account then I like to think I can spout my nonsense freely and use my free speech on my blog in my little corner of the internet.
That is how I see all this, all the drama that I have been caught up in over the past week about what it is and what it is not ok to share, whether there are some things that should be kept confidential and whether you can or can’t be “too honest” about personal matters, and it is that opinion that has led me to just throw caution to the wind and write this post being honest about things anyway.
This is of course merely my opinion, and I am sure there are many people out there who will disagree, but there we go, we can’t all like mashed potatoes made by the same recipe, opinions vary, some people don’t like lumps, some people don’t like pepper and others don’t like to read blogs about people who talk about mental health (weirdos). End of.

So what is going on? What has been happening? What have I been skirting oh so daintily around for the past fortnight? Well I will tell you because like I said, this is my piggy bank and if I want to take a mallet to it then I damn well will.
Basically, as you know, I have been in a psychiatric unit being treated for my eating disorder for the past 10/11 weeks, but things were not going well and I was not managing mentally or physically with any of this recovery business. It was then decided that we had reached a point where it wasn’t safe to keep me where I was anymore (which feels so weird and confusing to write as I still adamantly believe that I am perfectly fine and do not need any of the things going on around me, but that is a topic for another time). Anyway, as a consequence of various decisions regarding my mental and physical health last week, I had a week or so away over to a medical ward, and, if this post is going up in time and all the professionals stick to the current plan, I will hopefully have been transferred back to the mental health place on the Friday before you are reading this.

When you have an eating disorder there are a lot of physical complications that can happen as a result and there are sometimes a lot of things that may need to be medically treated as well as mentally, but the main reason for this transfer was so that I could be fitted with an Nasogastric tube (aka a tube that goes up your nose and then down into your tummy so that you can be given nutrition without having to eat it yourself if needed).
Some eating disorder units can do this procedure on site themselves and many do, but the one I am in has been unable to until now (hence why a few weeks ago I was talking about maybe being sent to Glasgow or somewhere else across the country). With no beds becoming available in time though, I had to just pop off to get it done on the medical ward and have some treatment over there. Like I said though, if all goes to plan, by the time you are reading this, I will be back on the mental health ward, still with my tube for a bit now it is safely up and running, but working to have it out as soon as possible which would be nice, as I am not thrilled about this new accessory (I would have preferred a bowtie but alas you cannot give someone nutrition through a bow tie. Not even a sparkly one). It was this whole tube thing that caused the staff to get a bit over excited with the “shushing” (picture a librarian after several hundred cups of espresso).

If I am trying to see from their point of view, I guess I can kind of sort of understand on some level. For example, I know there are some people who might find talk of NG tubes triggering, and unfortunately there are occasions and certain sufferers/people who see them as something to take pride in, something that proves they are “really ill”. This is of course ridiculous as every eating disorder is equally severe and serious and everyone is “really ill” regardless of whether they have been through certain treatment options or not. Even if you have never received any treatment for an eating disorder you are as ill as someone who may have been in therapy for years, and the last thing I would ever want is to give a message on my blog contradicting that.
However at the same time, whilst a tube is something I do not think one should be proud of, I do not think it is something to be ashamed of either and that was what stressed me out so much last week. I was all there ready to go ahead and write as per usual, and suddenly everyone was telling me that what I wanted to talk about was inappropriate, which had me paranoid that I should be ashamed of what was going on or that this happening meant that I had let everybody down by “failing” to get better, and thus not say anything at all just to be on the safe side. To be honest I don’t think a tube is anything to feel particularly anything about. It just is. Sometimes they just happen to get fitted to people who have eating disorders to help them try and get out of being rather stuck in a highly sticky syrup/velcro/superglue bound/sellotape/plaster situation.

If you are reading this and think that me admitting any of this is to be too open about mental health/confidentiality breaching then I am honestly sorry, but like I said, talking about mental health and my experiences within the realm of mental health treatment is something I am passionate about both in terms of reaching out to others, raising awareness, breaking stigma and misunderstandings about various illnesses and overall making people feel less alone and not as weird and isolated as I did when I kept all of my problems bottled up and never had anyone to relate to. Maybe I am breaking a piggy bank, but it is my piggy bank to break and it has been my decision to be honest about it.

I won’t go on about it any more now because writing this much is scary enough as it is, but I hope in the future I will be able to write about how this experience and tube feeding in general has affected me and how it can be used in treating people with eating disorders. It isn’t a nice topic, nor is it a nice experience, but it happens.
Now if you don’t mind, I am off to hide under my bed as I do when I post all scary blog posts that could potentially make someone angry with me/get me into trouble (I also need to hide from the cleaner…that is one thing nobody warns you about when you get a tube…when you have one in there is a genuine risk of being mistaken for a Henry hoover and dragged across a carpet snorting crumbs for three hours…) I hope this has been ok, I hope having this tube doesn’t mean you feel that I have let you down and if not I really am very sorry. I promise I am still trying.

Take care everyone x

PiggyConfidentiality

The Latest Mental Health News – When Mental Health Treatment Gets Rather Complicated

*Blog opens on a black screen, dramatic music plays, lights flash up to show the bespectacled author of Born Without Marbles sitting in front of a giant spinning globe, wearing a suit and looking very dapper* (Please note that it is the author wearing the suit and not the globe who has instead chosen an inflatable rubber ring as a wardrobe choice, for he is a globe with serious Saturn envy). Author holds up large piles of paper, shuffles unnecessarily, lays them on desk and then begins to speak*

Happy Monday everyone and welcome to the news. Not just any news though, for this is strictly the Born Without Marbles News.

*Globe with inflatable rubber ring spins for dramatic effect…more shuffling of paper*

Whenever you turn on the news these days to see what is going on in the world, the stories you see are usually incredibly depressing tales of natural disasters and various wars between countries who decide it is a better idea to settle their differences by blowing each other up rather than sitting down for a nice cup of tea and talking through their issues. If I were head of a country I know that would be how I would want to resolve any conflicts between nations (I would even have a special teapot for such occasions and there would always be biscuits rather than nuclear bombs or machine guns involved, which is nice because biscuits are far less toxic, noisy, and overall they are much tastier.) Today though I am coming to you with an update in news that is far more jolly, far more positive and exciting than anything you might have heard from some suited person on the television sitting behind a desk shuffling papers about, for I have GOOD news. What news? I AM OUT OF THE MENTAL HOSPITAL.

*Globe spins very excitedly and a party popper is released from an unknown location*

That is right folks, after 9 weeks I am off that psychiatric corridor and into the wonderful world of freedom and…hang on…wait…news just in through the ear piece…ah…yeah…Ok so good news we are out of the mental hospital…bad news is scrap the freedom bit as it is only because I have been transferred to a medical bed for more intensive treatment until I am stable enough to return to the psychiatric unit…hmm…that kind of puts a downer on things…this is awkward…but still yay to no guns or nuclear bombs in this broadcast!…And I do have biscuits!… *Holds up a pitiful broken packet of National Health Service own brand digestives, smiling desperately as a waterfall of dusty crumbs cascade into a pile on the floor*. Clearly it is a lot more difficult to be a cheerful news reader than I thought…

*Globe stops spinning…awkward silence…very awkward…like really awkward*

But back to the news update! As you know, last week I was talking about how unpredictable life is when you have a mental health problem and how currently things to do with my personal care and situation have been rather up in the air. On the positive side this last week has brought about decisions and actions that mean I am no longer up in the air, but have been brought back to earth out of the floaty confusion with a bit of a bump.
I think I mentioned the chance of me being transferred to another eating disorder unit last time because I really haven’t been managing where I am, but over the past week, no beds became available in time (SIDE SHOUT OUT TO THE GOVERNMENT STOP USING MONEY TO BOMB THINGS AND PAY THE POLITICIANS’ COFFEE BILLS AND MAKE MORE HOSPITAL BEDS FOR MENTAL AND PHYSICAL HEALTH FOR GOODNESS SAKE), and it reached the point where we had run out of time and I couldn’t really wait any longer. Thus another transfer had to be made, hence the update that I have now been moved to a medical bed to treat the immediate physical health issues that now need a bit of prioritising over the mental health side to having an eating disorder…

…And unfortunately, as brief as that update is…that is, frustratingly, all I can tell you this week. You see, a lot more has happened that I want to talk about because I am always one to be honest about mental health and do all that awesome awareness raising…

*Waves “I like to raise mental health awareness” flag*

…but recent discussions have taken place over the last week that mean that for now…that really is all I can say about what is happening, where I am and what medical treatment I am currently undergoing. To be honest it is all very “red tape” and “confidentiality” based stuff that I don’t quite understand but would rather clarify with official people first rather than getting myself into any trouble, which is really not needed in the Born Without Marbles world right now, as figures show that levels of troubles are already high above acceptable levels.

*Shows graph with a big red line going up. Arrow points to line labelled “Things that have gone wrong in 2017”…Cue a bit more paper shuffling and a random act of origami in which the aforementioned graph is folded into a lotus flower perfect for adorning a dinner table…It is passed to a member of the sound crew who lays it on a table at which 10 very important people then dine whilst commenting on the beauty of the lotus flower. They eat Salmon en croute*

Hopefully next week or at least sometime in the future I will be able to explain a bit more about what is going on but for now I just wanted to write a brief blog this week to update everyone on the fact that in terms of my mental health and mental health in general, I am personally in one of those “when mental health problems cause physical health problems” situations. Just wanted to at least say that because I also wanted to reassure people out there who may have been lovely enough as to send me concerned messages recently, that I am somewhat ok/being very well looked after and, though I may be hating it with every penguin loving grain in my body, I am in what other people would argue is “the best and safest place/situation right now”.

So yeah, I am afraid that is the blog post for this week. I really am sorry it was not the best/most exciting/most awareness raising but I guess it has raised an interesting discussion about confidentiality when it comes to talking openly about mental health, which I will be writing about a bit more when I am up to it, even if I am still not allowed to go into my current form of medical treatment sometimes used on people with eating disorders.

*Random party popper is released because this is the the Born Without Marbles news update and thus random party poppers and things that do not make sense are required at all times*

Anyway, I hope you are all well and know that I appreciate you all very much, especially if you read/watched this news broadcast to basically let everyone know that normal blogging activities will resume but I am currently somewhat out of order right now…kind of…although now I look at all I have said that is actually quite a lot of words for someone who thought that due to “circumstances” a BRIEF apology update blog was all that was possible this week…Note to self…learn to shut up…like seriously…for example right now…TAKE CARE EVERYONE X”

*Blog cuts to a giant map covered in rain clouds and lightening bolts where Gerry was supposed to be presenting the weather but isn’t because he got bored with the main part of the blog news for not being specific or interesting enough and went to the local bakery to get a sausage roll. Ironically he got rained on having forgotten his umbrella because he had not predicted a high chance of showers…Switch to spinning globe that aspires to be Saturn…fade to black*

NewsUpdate

The Difficulty Of Knowing What Counts As “A Behaviour” When You Have An Eating Disorder

How do you tell the difference between an elephant and a letterbox? You check to see which one has a trunk and which one is filled with neatly addressed handwritten letters that will soon be lost in the abyss that is “the postal service”.
How can you tell the difference between a brand new slipper and a boomerang? You throw it to see which one comes back and smacks you in the face.
So far so good (apart from the fact you may have just been smacked in the face with a boomerang or lost a perfectly good slipper), but now for the third question:
How do you tell the difference between the genuine preferences of someone with an eating disorder and the disordered behaviours of someone with an eating disorder? The answer? With extreme difficulty…if at all.

When you are on an eating disorder unit, the food aspect of things/what you can and cannot do with food, is a lot more regimented and controlled by sets of rules than it is in normal life.
Rules will vary depending on what hospital ward or inpatient unit you have been admitted to, but as a general list of examples these rules will be things like “no eating cereal with tea spoons”, “no breaking food up into tiny pieces”, “no sleeves at the dinner table”, “you must scrape the plate that you are eating from clean to complete the meal”, “only X number of minutes to eat your meal” and “no inserting parsnips into the nostrils of the person sitting next to you” (pretty sure that last one is also relevant in real life actually but I am not quite sure…my mother was never very clear when it came to table manners.)
These rules are often frustrating and can seem a bit harsh but they exist because often an eating disorder controls how a person eats and behaves around food, as well as how much or little of it they eat, so part of treatment during recovery involves tackling those food behaviours as well as things like the amount of food someone might be eating. Like I said it can be annoying, but it makes sense. Take the “you must scrape your plate to complete a meal” thing. It may seem over the top (and is a rule that will destroy the lovely willow pattern adorning all of your best crockery), but were it not for rules like that in hospital, there is the risk of people arguing that they have finished their meal when really all they have done is smear it across the good china.

With behaviours like that, I think it is easy to tell the difference between them and genuine food preferences as I don’t think I know any people without eating disorders who “prefer” trying to mash a lasagne into oblivion rather than consuming it.
There are however, a lot of actions people do where it is far harder to tell if the person is making a genuine choice or following a behaviour, and in these situations it is less like trying to distinguish an elephant from a letter box, and more like trying to tell the difference between an elephant, a tea pot and a vacuum cleaner (if you line all three up together you have to admit they do look rather similar…trunks, nozzles and spouts are easily confused…I learnt that the hard way…and broke a teapot).

For example at the hospital I am in at the moment, there are certain rules regarding condiments such as “only two pepper/ketchup/vinegar/mayonnaise/brown sauce etc sachets per meal”. The logic behind this is that some people with eating disorders tend to totally cover their food with a certain condiment in order to make it all taste the same/spoil the food and make it taste horrible as a punishment etc.
Then again, as well as people who use pepper to burn the roof of their mouths off by using it excessively, there are people who use what looks like an excessive amount of pepper simply because they like it. Every time my Dad eats a meal he uses so much pepper that even people scuba diving at the bottom of the Atlantic start sneezing because he likes the spice, and I have a friend who uses what may look like a lot of salt because she has been brought up using that amount and things taste wrong without it. Neither of these people have eating disorders, but they would still struggle living by the rules that are in place to help someone in recovery from a disorder. I guess you could say that the way you tell the difference is to see which came first, the food preference or the disorder, but that isn’t as easy as it sounds. Eating disorders are sneaky, they slip into your life gradually without you really noticing, so it is rare for someone to be able to pin point the day they officially became unwell.

What if my Dad, who currently does not have an eating disorder, developed one in years to come and had to go into hospital? Or my friend who likes a lot of salt? They might, quite rightly, argue that their preferences existed years before their illnesses began and they may be right but the thing is, in hospital, that doesn’t really matter and this is where it gets frustrating. Once you are tarnished with the Eating Disorder brush, suddenly people assume that EVERYTHING you do around food is because of that disorder and they rarely give in or believe you even when you are expressing a genuine dislike. It can be really annoying when you know that your love of toast that is not particularly well cooked is because you like soft as opposed to crisp bread, yet when you are consistently told that everything you do is disordered, sometimes you can start to doubt and be unable to tell the difference between your own choices yourself (aka the is it an elephant, teapot or a vacuum cleaner situation).

How about timings and things like time limits on eating disorder wards? Admittedly they are necessary to avoid still working on Monday’s bowl of cereal at Sunday dinner time (rather soggy cereal I would imagine), but in addition to timings perhaps being affected by disordered thoughts or behaviours, people naturally have varying eating speeds. I certainly know that in my household my Dad will always finish his dinner a good 10-15 minutes before my mum for the simple reason that he has a bigger mouth and more violent set of gnashers (not abnormally large I might add…like he is still a handsome chap and isn’t frequently being mistaken for a shark who needs to be sent back to the aquarium…just clarifying…love you Dad.)

The main rule/“behaviour” that got me thinking about this topic however, the rule I have seen come up in every single one of my admissions to an eating disorder unit and the rule that is carved in a stone tablet and worshipped on a mountain guarded by holy cherubim:

“Thou shalt not dunk biscuits”.

Some of you reading this, who have never heard of such a rule, may be a little shocked, stunned and perhaps distressed to hear that there are people all over the country being forced to eat rich teas that have never actually taken a dip in a real mug of the beverage after which they are named (I know, it is upsetting but we can get through it).
Again, as with all hospital rules there is a reason behind it, that being that people sometimes submerge and drown their biscuits rather than dabbling in a quick dunk and then smear the soggy remains around the inside of their mugs or leave them in sorrowful abandoned mush mountains at the very bottom.

The issue though, comes when you are someone who wants to safely and appropriately dunk their biscuit, yet are prevented by the rule that may not be relevant to you. Of course rules have to apply to everyone on the ward to make them fair, but that is what is annoying, i.e. having an eating disorder and then having EVERYTHING you do with food put down to your disorder when maybe you have just grown up liking a lot of ketchup on your curly fries, or genuinely prefer the texture of a cookie that has had a quick swim in a mug of hot chocolate. Dunking biscuits CAN be a disordered behaviour, but it isn’t always.

Just imagine if the world had to live by eating disorder ward rules with the act of dunking a biscuit being classed as a disordered/unhealthy behaviour and thus banned for all. How would any of us ever eat an Oreo? The dunking aspect to those delights is even in the damn advert! They literally explain how to eat them on the packet! First you twist it, then you lick it, then YOU DUNK IT. If that bit was deleted from the process the country would grind to a halt and living rooms across the world would be filled with poor distressed people holding opened licked Oreos and crying out in agony “WHERE DO I GO FROM HERE?” Think of the number of teeth that would be broken on undunked ginger nuts!

You could maybe be a generous dictator and say that only people who appropriately dunk their biscuits are permitted to do so (something I have asked for on multiple previous admissions), but how can you tell if someone is dunking appropriately? What if someone is genuinely dunking for the resulting soggy biscuit end goal but is such a poor judge of the strength of their chosen biscuit that they get the timings wrong and remove their Custard cream or Bourbon from their brew not to find a perfectly melted vanilla or chocolate cream centre but instead a blank space, an empty half in which biscuit perfection had existed seconds before it was too late and the perfection turned into a sinking disappointment of heartbreak, sorrow and missed opportunities.
Should biscuit dunking be classed as an eating disorder behaviour just because it can sometimes be used as one or can it just be a preference?

Overall then it is clearly very difficult to tell the difference between an eating disorder behaviour and a genuine food preference, especially when you yourself have the eating disorder. I guess when it comes to people who have no issues with food the answer is obvious…until that person is unfortunate enough to develop the disorder and we are caught in the whole confusing “which came first the soggy biscuit or the mental health problem?” dilemma which has plagued scientists for years (scientists who I feel are doing valuable work but are also perhaps taking advantage of their right to order in free biscuits from the big companies under the guise of “research purposes”….)
Of course there will always be ways to figure out the disordered act from the genuine preference but it isn’t always as clear cut as the elephant and the letter box example and sometimes even knowing your own reasons for doing things can get you into a confused muddle of soggy biscuit yourself.

Take care everyone x

ElephantHoover

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