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

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