Can Some Treatment For Mental Health Problems Make Issues Worse?

Peanuts are a great source of protein, anti oxidants, and have been shown to be beneficial to heart health. When I eat a peanut, my heart throws a little fiesta in celebration and uses every ounce of peanut to make itself extra awesome. When my imaginary friend Jimmy eats a peanut however, he explodes and turns into a bucket of water (Jimmy has a very severe imaginary peanut allergy. Don’t worry though, I gave him an imaginary unicorn to ride on as compensation for his unfortunate condition). 

Clearly then, sometimes, things that are supposed to be good for us and that are supposed to be beneficial to our health don’t work for some people, and the same can be said of mental health treatment. 

Now before I get carried away I would like to express that I am VERY grateful for all of the mental health treatment I have received over the years, even the things that haven’t worked out, because they have taught me what kind of things do and don’t work for me. I know I am very fortunate to have had so much and such a variety of support, as there are all too many people out there who don’t get any treatment at all and that is heartbreaking. Anyone suffering with a mental health condition should be able to access treatment, end of discussion, so I am not saying “screw all of you people who have never had any help, I have had some unhelpful help so pity me”. 

Instead, I think it is important to look at some aspects of mental health treatment that can maybe cause more problems than they solve so that we can improve that treatment and make it better in the future. It is all well and good to say “all treatment is good treatment and you should just take it no matter what” but if we did that we would never move further in the ways people with mental health problems are supported and increase the benefits that support can bring.

Hundreds of years ago, people with what we might potentially diagnose with mental health problems, were seen to have evil spirits lurking inside of them and were treated by having a drill shoved through their skull to let the spirits out. If nobody had ever stopped to think “hey, maybe this bashing people about the head isn’t very helpful after all”, we might still be doing that today (which would make my weekly trip to my psychologist even more terrifying), so although I don’t think anything around today is as detrimental as head drilling, I have personally found some treatments to be quite problematic. In this post I therefore I want to be seen as looking at the peanuts and trying to keep all the goodness in whilst getting rid of all that stuff that turns imaginary people like poor Jimmy into imaginary buckets, rather than as throwing all the peanuts into the bin and declaring them all to be useless. 

I am sure there are a lot of people out there who can attest to treatments that have been more detrimental than helpful in the sense that a lot of times, group treatments and inpatient settings can be rather triggering. I have known many people who have picked up behaviours from other people they have met in hospital, but I think this is less a problem of the style of treatment and more a problem with the competitive/comparative nature of certain illnesses themselves. It would be unrealistic to say that everyone who is ever hospitalised should be kept in a separate room away from other potentially triggering patients because that isn’t real life, there are always going to be people who trigger you no matter where you are, and the key is to learn to deal with and manage that. 

When it comes to problems with treatment however, an important example for me in terms of an actual treatment style that made things worse for me, was a certain inpatient unit I was in for my eating disorder, and their extreme “this is the most important thing ever” focus on weight. 

Before I went to that unit, I did not weigh myself, nor did I care about the number of kilos on the scale or what my BMI was. 

My eating disorder was all about how I saw myself in the mirror and how I felt inside. Some days I would struggle more because I “felt” and saw myself as extra disgusting, whereas other days I would do better because I maybe didn’t feel as terrible about myself. 

If I had been weighing myself during those times, there probably wouldn’t have been much difference between the numbers shown on the scales on the days that I “felt massive” compared to the days I “felt not as bad”, like I said, it was all subjective and all internally measured by my emotions as apposed to any little plastic square I could stand on that would then flash numbers at me. Ok, I counted calories obsessively, but when it came to weights, numbers were irrelevant to me, and if you had told me what I weighed it wouldn’t have had any meaning to me. 

During my first inpatient admission for my eating disorder however, all of that changed, and it is since that admission that my eating disorder has progressed to the point where my it is still concerned with how I feel but also obsessed with the number on the scales and the great significance “what that means” (spoiler alert: it means very little nothing at all in terms of a person’s self worth or value on this planet. That kind of thing is instead measured by how lovely you are to people and whether or not you are one of those cheeky people who puts an empty carton of milk back in the fridge just to destroy someone’s morning hopes of a bowl of Coco Pops. THE MILK CANNOT TURN CHOCOLATEY IF YOU DON’T LEAVE ME ANY MILK).

I understand that in eating disorder treatment it is important to be aware of weight to a certain degree for various reasons (not that the weight of someone with an eating disorder will tell you how ill they are or how physically at risk they are of serious complications), but in this unit, weight meant EVERYTHING and every number on the BMI scale had a significant consequence to it. It would have been one thing if there was a rough weight band stage thing to use as a guide, but instead of that each number specifically told you what you were allowed or not allowed to do. 

Some I could vaguely understand. There was a weight at which you were allowed to do yoga for example, a weight at which you could go bowling, and a weight at which you were given permission to walk around the grounds. It is the more arbitrary number obsessions that I think should have been focused more on the individual and their struggles/progress, rather than simply basing it on silly numbers. For example there was a weight under which you were not allowed to pick your own food at lunch and instead had to keep your fingers crossed that the nurse wouldn’t pick the one option that you genuinely hated for reasons outside of your eating disorder, a weight at which you were allowed to pour your own milk into your cereal, even a weight you had to reach to earn the right to spread butter and jam on your own toast. 

Again I get the importance of this, very early on in treatment people may be unable to spread an acceptable amount of toppings on their toast or decide what option to chose at lunch so that extra support may be warranted, but who is at what stage should not have been decided by weight alone. 

For example what if someone who was severely unwell came onto the unit above the weight of toast spreading privilege. Was it fair to leave them wrestling with the marmalade on day one just because their weight was a few digits out? And what about people who mentally progressed very quickly and although they came in at low weights were able to manage marmalade responsibility before their weight reached acceptable levels. I knew of several people whose bodies struggled to gain weight no matter what they ate and they got frustrated in feeling mentally held back by not being allowed to spread their own toast or pick from the options at lunch themselves, skills that would have been beneficial for them to practice to carry out responsibly. 

Obviously if they had started demanding dry toast and a celery stick for meals it might not have been the best idea, but neither is holding people back or pushing them forward simply because of a number that doesn’t measure the mental part of the mental illness. 

Like I said, before that admission, weight was not a concern, but ever since then, what I weigh has always been significant, and I still think of my personal weight as a measure of how well I am to some degree, regardless of the mental struggle. Even now I still see those weights as the “well enough to spread jam” weight which allows my head to use these opportunities when I am at these weights to convince me that I am “ok now” (clearly when one has the ability to spread jam on one’s own toast it means that a person is fully recovered and needs no other progress to enable a healthy life…YAY EATING DISORDER LOGIC.) It just seems a bit confusing to me how so many therapists and eating disorder services over the years will tell you to “ignore the number” and tell you that “it doesn’t matter”…yet then go on to measure your level of wellness by that number and dictate your rights accordingly, showing that it actually matters and means a lot…contradictory much? 

The second example of treatment that I personally think caused more problems than it solved was my first admission to hospital when I was about 11. Admittedly I needed to be there, my OCD behaviours were controlling my life, everything was completely out of hand and someone needed to step in, but remember I was a scared 11 year old suddenly waking up in this mental hospital and  living away from home for the first time. I needed treatment yes, but primarily, I needed mental support, and that wasn’t what I got.  

My shower and soap rituals were instead physically controlled by means such as locking me out of the bathroom and stealing my soap. Now, exposure therapy for things like OCD is a very valid method of treatment, you are scared of something, you expose yourself to it, people help you through that exposure with support and you keep practicing until it isn’t scary anymore. 

Problem was, I had nobody to help me work through that exposure, all treatment was physical and ironically there was no mental support whatsoever despite the fact it was a mental hospital. 

Therefore, instead of working through my problems, I was just traumatised for weeks and left to struggle alone in absolute terror, so naturally, when I went home, I was not a fan of psychologists and would refuse further treatment. Had they worked with rather than “on” me, I would have trusted them and would have seen them as people I could work with to get through my problems, but in my 11 year old brain that experience taught me that therapists were nasty people who take you away from your parents, lock your bathroom, leave you to suffer alone and then send you home with all the mental pain you had before plus a little bit of bonus anxiety. Consequently, there were several years where I refused to see therapists and would lock myself in our home bathroom when they came to visit, refuse to go to clinics, or “forget” to leave lessons when they came to visit at school for sessions (that’s right…I hated therapy so much I voluntarily stayed in Maths lessons that I was allowed to get out of…MATHS!)

It has taken a long time for me to get to the point where I can trust therapists again, actually talk to them, see them as humans rather than soap stealing villains, and still every mention of exposure therapy sends me bananas because my first bad experience of it has not left me excited to give it another go… 

So, can certain kinds of mental health treatments actually make a person worse? Well, yes, and though I think it is important to try new things and approaches, it is equally important not to label all treatment as helpful and to be able to critique the bits that maybe aren’t as helpful and could use a bit of a rethink so that we can improve them, keep the good and edit out the bad, or else we would still be in the time of drilling people in the head, and nobody wants that. By all means use a drill to put up a nice painting or build a table, but when it comes to my noggin, I would rather you kept all power tools at a safe distance. 

Take care everyone x 

Bucket

Advertisements

Should NG Tubes Be Used In The Treatment Of People With Eating Disorders?

When it comes to treatment for people with eating disorders there are many different options and interventions to be explored, various therapies, meal plans, pieces of group work and even hypnotism. However, alongside all the perhaps more psychological treatments, there are other more invasive practical treatments that can be used such as the NG tube (a tube that is inserted through the nose and into the stomach to feed a patient who is unable to consume food orally themselves), and this is something I never had much of an opinion on before it happened to me recently for several weeks of my admission to hospital. It may seem silly or odd to be bringing this up now as my tube came out over 8 weeks ago so surely I should be over it and not thinking about it anymore, but I have to say that even though it has been a while since its removal, the method of being NG fed still affects me to this day, is a fairly traumatic thing for people to go through, and it has made me wonder whether or not NG feeding should actually be used in eating disorder treatment full stop. 

Obviously if I am going to open up a debate in this blog about whether or not NG tubes should ever be used I am going to have to say that aside from all the ethical, psychological, long term effect complicated sides to the issue, bluntly yes NG tubes should be available as a way to treat people with eating disorders. Despite their perhaps negative side effects down the line, it makes no sense to rule them out completely (unfortunately…I really hate admitting this…excuse me whilst I go away and grumble). 

Sometimes, whether we like it or not, NG tubes are life saving necessary pieces of treatment and there are people out there who arguably would have died without them. If a person is unable to nourish themselves adequately and becomes seriously medically compromised, sometimes the only option is to NG feed them as a matter of saving a life and I know that, as much as I disagree with the methods used on me and wish more than anything it hadn’t happened, that that is the argument doctors and nurses have had with me in defending that method of treatment. 

Aside from life saving serious stuff, NG tubes can also be positively used not just for getting nutrition into people but for providing a motivation to eat orally despite the screaming eating disorder wailing in their head like a banshee who just stubbed her toe on a particularly sharp piece of lego. 

When someone is struggling to eat because of an eating disorder it is often made harder by the fact that eating always feels like a choice, an option you actively choose to partake in, and who would choose to torture themselves by forcing themselves to eat when they knew their brain would go off screaming at 90 miles per hour? With an NG tube in place however, the act of getting nutrition is no longer an option or a choice, it is going to happen one way or another and with this choice of whether or not the food will go in eventually being taken away, sometimes eating becomes easier. 

Personally I can at least admit and testify to the fact that I found the NG tube helpful in the sense that it did motivate me to eat because the choice was taken away. No longer did I have the raging debate of “do I eat or don’t I”, it was just a matter of how it was going to go in/happen (“up the nose or down the throat” as I used to think). It also gave me encouragement to eat in a way because there were times when I knew that if I didn’t consume what was in front of me orally, I would get an increased number of calories down the tube and that certainly served as some motivation! 

Indeed at my unit there was a rule that I was presented with a meal and if I were not to complete it, the entire meal would be started again via the feed. Therefore if halfway through a meal I was struggling and really wanted to give up, having the tube there motivated me to carry on as I knew that were I to stop, we would have to start all over again and I would essentially end up having to go through the same meal twice. NG tubes can also be helpful in the sense that they offer a way for medication to go into a patient when a patient is unable to take a medication themselves (another thing which I hated and disagreed with personally but can understand is necessary in some circumstances.) 

As I said at the beginning of this debate however, alongside these positives there are a lot of negatives and it is the effect of these long lasting negatives that I am still feeling today. You see, when you have an NG tube, it takes responsibility for eating away, and whilst this is a good thing when a person is unable to eat by themselves, it is a bad thing because in learning to eat again or going through the re-feeding process they are not actually learning how to do it for themselves. Indeed, people go from needing the tube in an emergency situation to becoming dependant on it and that is what happened to me. For the first few months of re-feeding I was going through the motions but psychologically was making no progress and then when it came out I didn’t know how to eat. Without the tube, suddenly the guilt became much worse because eating went from being the lesser of two evils with the tube in to simply “evil”. 

Another negative from using an NG tube and perhaps the one I am struggling the most with today is that of rapid weight gain. When you are on the tube it is possible to gain a lot of weight very quickly that mentally you are not ready or prepared for and although it can again be life saving and good treatment medically, it can be an incredibly traumatic experience. Similarly, now I have been left at a weight far higher than I am comfortable with because of the tube and because I reached this stage far quicker than I would have done without it, I am still struggling with the repercussions and am feeling overwhelmed. 

In terms of trauma it can also be a traumatic experience to be restrained for feeds and when this happens it can damage the patient vs treatment team relationship. For example I used to trust my treatment team and even get along with a lot of them, but if I am honest, now I resent them all and want to be discharged from the entire service because the act of having something so traumatic being done to me has led me to dislike and mistrust them all. Having something like an NG feed physically done to you whilst you are held down means being treated as an object not a person, there is no therapeutic benefit, you are just a thing being pumped full of stuff you are terrified of with no chance to work through it or figure out a long term solution at home. It is a temporary fix and though you can force feed someone food, you cannot force feed them long term recovery, so in a sense the NG tube method is unhelpful long term. Then again that is just my experience and I know that for other people actually starting with an NG as a temporary measure can help long term as it gets enough nutrition for their brain to work and allow recovery long term afterwards so it really is all down to personal experience. 

Overall then, should NG tubes be used to treat people with eating disorders? Well, I don’t know is the honest answer, it is a tricky one because I think the answer will be different for different people. For some people using the NG tube is not a matter of something to be debated but a necessary life saving act of treatment and sometimes it can even help long term recovery by motivating someone to eat orally by taking away the choice. Also the more nutrition someone gets the more likely it is that their brain will be receptive to treatment but then again there are the negatives of cases like mine where I have been fed up to an unbearable weight via physical methods without going through the proper therapeutic work, meaning that I am now stuck unable to deal with it and thus struggling with relapse. I don’t think when it comes to this question there will ever be an answer for everyone but it is certainly a controversial topic that I think we need to keep working on and talking about. 

Take care everyone x 

NGdebate

6 Tips For Managing Your Self Esteem On Social Media

Recently, because I am struggling a lot with my mental health, I have not been posting much on social media, and the other week I went a full fortnight without posting on everyone’s favourite photo sharing app: Instagram. In the grand scheme of things, this is not a big deal at all, but in my head, after fourteen days still with no photo to post, I was in a right panic and felt like the apocalypse was bound to begin.
As much as I hate to admit it, my self esteem rests a lot on what people think of me in real life and online, and therefore a large portion of what I think about myself comes from things like social media. I know it is unhealthy, unhelpful and perhaps a little bit silly and I am ironically the kind of person to shake my fist at the sky when people get upset about the number of “likes” on their selfie and cry in dramatic anguish “The number of likes doesn’t matter and doesn’t dictate your value as a person”, but in the end I cannot help it.
After two weeks of not posting a photo I managed to convince myself that everybody hated me, was furious at my inability to post a reasonable selfie or a witty hashtag and so I resigned myself to the fact that this was the end. Solemnly I sat in my lounge and listened for the sound of an approaching mob, preparing myself for the hoards of villagers to arrive with their flaming torches and their pitchforks. After four hours of anxious worrying however, no angry villagers, no flaming torches and no pitchforks had arrived which was both a nice surprise and quite a shame as I had bought a nice bag of marshmallows to toast on those terrifying torches for a little snack before the riot started and I had a lot of hay and straw that needed tidying (according to Wikipedia: “clearing hay and straw” is what a pitchfork is used for…handy little farming fact for you right there…ooh and in other farming fact news, chickens lay eggs and sheep say “Baa”).

Turns out I may have got a bit carried away with the catastrophising (which is odd and so unlike me…), and I would imagine that there are some other people out there with buckets of anxiety and no buckets of self esteem who have been in similar situations. Therefore today I thought I would try and help my fellow pitch fork, flaming torch fearing, mentally ill pals out there which is why I am here to offer a few tips as to how to manage the anxieties that can be caused by this 21st century obsession with social media accounts and how to help keep your self esteem and the way you think about yourself away from that..

Tip 1: Know that trolls exist – Twenty years ago, the word “Troll” was used to denote a creature that likes to live under bridges tormenting billy goats. Nowadays though, if someone speaks of “trolls” they are more likely to be referring to those hate filled creatures on the internet (otherwise known as humans who have nothing better to do), who spend their time locked away in computer filled rooms spouting as much hate as they can to torment all the innocent people they can find (like the original troll definition they also are known to torment billy goats if they come across them, although billy goats are slightly harder to come across using the internet due to their lack of opposable thumbs, laptops, Wi-Fi and their preference of crossing bridges to googling cat videos.) Basically, these are people who are going to potentially post negative or offensive comments on your uploads regardless of what they are and the key here to remember is that it is NOT your fault nor is it personal. If you find yourself getting hate online do not simply accept that it is hate you deserve and be aware that as well as cool things and nice people, some real idiots exist on the web, but whatever they say is no reflection on reality. Seriously, if people want to be nasty they will say anything just to get a reaction and that reaction is all they are looking for rather than a desire to state the truth about you as a person. I once saw a troll commenting on a video of a penguin saying that “penguins suck” which I think perfectly illustrates my “some people are idiots,” as clearly penguins do not suck and I think we can all agree are waddling miracles of nature who deserve much love and respect. If you ever get hate remember that penguin hating troll and with that remember that some people just want to be mean for the sake of it, so don’t take any negative comments you might get to heart.

Tip 2: Remember that interactions are open to interpretation – One day years ago, my mum and I were buying a new microwave and in asking for my opinion of which one I preferred, my mother asked me “if you were buying for your own house which one would you pick”. By this she meant “I know nothing about microwaves. Do you have a preference or opinion you would like to share to help me?” What I heard however was “how long are you going to live in our house for? Please start thinking about buying microwaves and other appliances for your own place and start the process of moving out of the family home immediately.” I guess the point I am making here is that I can often read too much into comments made by other people, or indeed read them as meaning entirely different things to what the speaker intended, and I think people often do this online in social media where comments and likes are flying all over the place without the correct tone or specification of the meaning perfectly portrayed. Therefore whenever reading a comment or interpreting the meaning of a “like” online, always remind yourself to not get carried away with interpretations and that it is unlikely that a simple statement such as “I do not like penguins” on a photo of you and a penguin means something dramatic like “The entire foundation on which you base your life is wrong, please jump off a cliff”…

Tip 3: Be aware that people do things – There are periods of time when people use social media. Logically then, this means that there are some periods of time when people don’t use social media and it is vital to be aware of this fact if you, like me, often find yourself relying a little too heavily on social media as a source of self esteem. Every time I post a tweet, photo on Instagram or a blog on this delightful website you are currently visiting (cheers for that), unless it is well received within the first five minutes I am in despair about the fact that everybody hates me/nobody likes me anymore and that I am a terrible human, without realising that there are multiple reasons for silence on one of your posts, one of these reasons being that people haven’t seen it because they are not on social media. It isn’t as if people sit 24 hours a day, 7 days a week staring at your account in anticipation of your next post, ready to react seconds after it is uploaded, they do stuff and live their lives. If you ever find yourself panicking about the lack of likes on a post a few minutes after you have submitted it, try not to assume this is because you are hated and get carried away thinking all of the negative thoughts you can about yourself. Maybe some people won’t see your post at all but that is fine and the lack of interaction is more likely to be down to that than some flaw in your character. Whenever you get no likes just remember, people need to leave social media to do things like pee (an activity they are hopefully not doing whilst using their phones…)

Tip 4: Think about the long term – Life is unpredictable and none of us can be sure where we will be in ten years time even if we make very organised plans for our lives over the next decade. One thing I can predict however, is that any interaction you have on social media today (yes…even commenting on this blog…feel free to do that by the way…as long as it is nice and doesn’t make me cry), will not matter to you or mean as much to you in ten years time as it does right now. When you find that social media scores and numbers are getting you down and are comparing yourself to other people with a million retweets on that picture of a tortoise (people love a tortoise), imagine yourself living in a nursing home at 100 years old reminiscing about your life and adventures. I cannot guarantee that you will have achieved all you wanted nor that you won’t have some regrets over time, but what I can guarantee is the fact that if someone were to ask you at 100 years old what the highlight of your life was, it is not going to be “that time my Instagram picture got over 1000 likes”, and is more likely to be something along the lines of “that time I swam with penguins”, “that time I hugged a penguin” or something else people see as important…like marriage and the birth of your kids…that stuff. Of all the nursing homes I have ever visited people in, I have never heard of anyone reminiscing about the time they got retweeted by that guy from that band (and not just because twitter wasn’t invented in the time period being discussed). In the long term, likes and comments don’t matter, it is experiences, people and penguins that do.

Tip 5: Know that none of it is real – Ok, with this one I am going to hold my hands up and admit that I do not exactly know how the internet works, where it comes from or where it “is”. In my head however, though the internet is a real thing that we all use and experience in day to day life, it is not something like a cliff which would take serious crane action to remove and technically, with one flip of a switch, it could all be gone tomorrow. Of course nothing real is permanent and mountains and rivers can be “deleted” with enough effort, but few things aside from the internet that are so integral to our lives could be gotten rid of so easily. The internet exists but it could just as easily not and sometimes that also helps me when I find myself basing too much of my self worth on things I find on there. Every time you are upset or struggle with a comment or interaction on social media, perhaps it will also help you then to think about the fact that it makes no sense to base your self esteem on something so flimsy, for at any second the internet could just be over (LORD PLEASE DON’T LET THIS HAPPEN) and could all disappear at the flick of a switch…

Tip 6: Don’t forget the “real” world – I suppose this point is quite similar to the previous one but it is still important because as much as I want to encourage remembering that the internet is so fragile in it’s existence, I want to encourage people not to forget that the real world (you know…that stuff outside that you see when you peep out from under the duvet every few weeks) and the “real” life exists outside. Virtual and digital worlds exist for sure and they can be fantastic places to get lost in or even find yourself in, but though our world can be a bit rubbish at times, it is there and you do have a life within it away from social media, so tuning out of social media and into the real world is ok. Again of course, everything in the world is technically very fragile and not even mountains or oceans will exist forever, but in a way it is a lot more permanent and real in my eyes than a thumbs up icon or a few characters typed on a mysterious “mobile telephone” device. I know that shortly after that incident where I didn’t post online for a while, I met up with a friend and it really helped because it reminded me of what is actually important and that there is a life and dare I say it real people around as apposed to digital emojis and Facebook profile pictures, and sometimes those real people are worth spending time with too (unless their name rhymes with Bonald Wump. Never trust anyone whose name sounds like Bonald Wump.) If you are too caught up in social media scores and “friends” and what they all mean, take a step back and maybe glance around at the real world to remind you of the other things out there. Trust me, some of them are quite fabulous and worth keeping an eye on.

So there you have it! 6 ways to manage and look after your self-esteem/general mental health and wellbeing when you find yourself spending too much time on the internet or worrying about social media. I am not saying that these tips are going to make that bizarre side of 21st century life easy, nor am I denying that you will probably still freak out a bit about that comment and that photo with only 2 likes on it (don’t worry…I may have written these tips but I know I shall be doing the same), but I hope these at least help a bit with those stresses and anxieties, even if they are things you only remember once in a while.
Now if you don’t mind me, I am off to upload this blog to that trusty friend the internet and then I am going to spend the next few hours staring at the screen to see exactly how many people read it, how many like or comment on it and how quickly so that I know how much to value myself/hate myself for the rest of the day/generally get an idea of my worth as a human. PLEASE LIKE ME AND MY BLOG OR I AM NOTHING. NOTHING I TELL YOU…ahem…

Take care everyone x

SocialMediaSelfEsteem

Being Institutionalised After An Inpatient Admission

Humans are very much like lions. They have very fluffy manes and they like to stalk antelopes…no wait…that wasn’t my point…what was my point…ah yes, humans are very much like lions: they are not supposed to live in captivity. When you see a lion in a zoo standing behind the glass peering out, longing for freedom, they do not look happy, they do not look free, they look listless and bored and tend to pace around a lot because that is not an environment they are supposed to be in. Similarly, humans are not supposed to live in psychiatric units, it is not their natural environment, it is not where we evolved to be and being in one is an abnormal and temporary experience. Problem is, when you have been staying in a psychiatric unit for almost half a year, you start to get a little bit institutionalised and consequently over these past two weeks I have been struggling with my new found freedom.

Indeed, going back to the lion thing, I feel very much like a lion who has been living in captivity for a long time and then has suddenly been chucked out into the wild without any of the coping skills or natural instincts necessary to survive. I didn’t like living on one small corridor but at the same time it was a contained space that I knew every part of, it was a place I understood, yet now I find myself in this big wide open space of a world and no idea what to do or where to go. Over the past months I spent so much of my time desperate to get out of hospital that I never really thought about what it would be like when I got there and am now finding myself feeling a bizarre sense of “right….now I am out…what the hell do I do now?”. It is like my sense of direction has gone, my goals and my aims were all so focused on getting out and being free that I forgot about what would actually happen and what I would actually do when that freedom was achieved.

What troubles me is that I am not living in a place where I should feel like this, I am not living in an abnormal environment as I was when I was in the hospital, I am living where I am supposed to be, out in the wild, out in the real world, yet it is suddenly a world in which I do not feel I have a place anymore.

To be fair I am quite a homebody, I don’t go out much and the most adventurous trips I have been on since I have been out have been to places like the local supermarket, but every time I go to these places I find myself wandering around watching all these people casually buying food as part of their day, part of their lives that they are living and I wonder how on earth they do it. How do they live in this big scary world? How do they have jobs and families? How do they know what food to buy in a shop and then how do they go back home and make it into something to nourish themselves before maybe going on an evening out to do something similarly alien to me like socialising? I am not a part of that world. I am part of a world where I am used to waking up and being timed to eat a bowl of cereal under the watchful eye of a nurse or other mental health care professional, before gathering in a group room around a box of tissues to talk about my feelings. For five months the biggest deadlines and expectations I have had on my shoulders have been things like making sure I turn up to emotional regulation group with my notebook on time and making sure I am at the clinic to be weighed at 7:30 on a Monday morning. True I didn’t like it, to be honest I hated it, which is why I spent such a long time fighting professionals and trying to get out. I didn’t belong there anymore than a lion belongs in a perspex box, but it feels like so much time has passed and I have become so institutionalised, this admission more than any other even though this has not been my longest, that I don’t belong out here either. I don’t belong anywhere, I am like a ghost wandering around aimlessly haunting old places that I used to know yet now don’t feel a part of.

I think all of these feelings highlight one of the main problems with putting people into hospital for long periods of time, that being the institutionalisation I have mentioned and the fact that people forget how to survive anywhere else. They forget what it is like to be a person with a life and an identity other than a mental patient required to take their medication and have a stab at some therapeutic writing on a Wednesday morning or creative group in the art room on a Tuesday. It probably sounds ridiculous because I wasn’t even in hospital for that long and I have had many admissions before that I survived, some of which were longer than this, but I can’t help it, I just feel so out of place and so confused as to what to do now, A few weeks ago I talked about how living in a psychiatric unit is very much like living in a fish bowl and now I believe in that analogy more than ever. I am a fish out of water, or I suppose to put it more accurately since this is where I am supposed to be, a fish who has been used to a tiny little bowl with a little castle and a turret and is now presented with this great big ocean with giant sharks and other fish busily swimming past as if they are all going some place important and all know a lot of things that I don’t.
If it wasn’t for this blog I wouldn’t know what I was doing at all and to be honest I am even struggling with this. At least my blog gives me structure, my blog gives me a plan to work to, every week I write it, I draw the picture, upload it on the Monday and then pray that people read it and don’t suddenly hate me, but even writing has got harder since I left hospital because I am at a loss as to what to do with myself and my brain doesn’t feel like it is working properly. There is too much stuff out here in the real world, too many people, too much noise, too much responsibility and I am just an unemployed head case living at home (for now). It isn’t as if I am some boss at this high powered company where I am entrusted with the responsibility of managing loads of people and their lives and actions as well as my own.

I guess it is all about what you are used to and that I will settle into the real world and get used to it again eventually, but still I wanted to write today to highlight how institutionalised you can get even if you only stay in a psychiatric unit for a couple of months and how very disorientating it can be once you leave. Don’t get me wrong, I do not want to go back there by any stretch of the imagination and I am doing everything I can every day to keep myself safe enough to stay out. Like I said, it wasn’t that I belonged there at all, I just want to know where the place I belong is now because at the moment I cannot seem to find it. I am supposedly back where I should be right now, yet I am very lost and frightened and really in need of some kind of map to find my way home. I just wish I knew where home was.

Take care everyone x

Lion

Dramatic Life Plan Changes When You Are Living With Mental Health Problems

You know that feeling where you don’t see a friend for a year (maybe they were backpacking around Australia or herding elephants in Africa), and then they come back for a cup of tea asking how things are going and you just sigh because there is so much to catch up on? Yeah. That exact feeling is the one I have today, only in this situation it isn’t that I haven’t written on my blog/spoken to you for a year (heaven forfend!). In actuality it has been a mere week since you last heard from me but what a week it has been and good lord with cheese and chopsticks do I have a lot to catch you up on!

Now, you remember last week when I talked about how I was about to go home after a five and a half month inpatient stay at my local eating disorders unit? Remember how I harped on about all the rules and regulations I had set in place to keep myself and my mental health problems on track and the importance of rules when living with mental health problems? Remember all that stuff I said about how I felt pressured to stick to the rules because if I didn’t there would be consequences including, but not limited, to my parents not being able to cope with me in the family home any more? (If none of this is ringing any bells I suggest you read the two posts that can be found, like aeroplane fire exits, here: The Pressure To “Get Better” When You Are Struggling With Mental Health Problems and here: Why Boundaries Are Important When Living With Mental Health Problems).
Good. We all up to date because you know that situation? Yeah, that situation has kind of sort of exploded all over the place and I have only been out of hospital for a week…

Indeed I can barely believe myself that it has only been such a short amount of time because so many things have changed. Like I said, I was only discharged last Tuesday, armed and determined with my rules and boundaries set my my parents to help keep my mental illnesses in check back home, but in this past week, all of those rules have gone horribly wrong.
From that first day back home my eating disorder looked at all of those neatly written out rules and laughed and I was smacked in the face by how much harder all of this eating malarky was going to be outside of hospital.
To be perfectly honest I do not understand it even myself.
For five and a half months I have been following a meal plan and now a simple change in location has completely thrown me off. I am not saying that I admit defeat already, far from it, but I can acknowledge that there is a serious problem and am well aware that, no matter how positive I try to be or how determined I am, I am currently unable to stick to the rules around eating certain amounts at certain times and not self harming that have been set.

“What is wrong with that?” I hear you ask “So you are breaking a few rules. This isn’t school, what are you worried about, getting detention or something?” I hear you cry!
Well no actually, I am not fearing detention but I have been fearing the consequences of me not being able to stay in the family home and in this past week it has come to my attention that me staying in the family home and living by my parents’ rules is, at this point impossible.

Now before I go on I would like to make it clear that my parents are not evil (well my mum is a little bit and she does cackle over a cauldron occasionally but that is a story for another day) and just because I am struggling with my mental health at the moment they are not kicking me out of the house. Far from it, they want and are doing all they can to support me with my insanity, hence why they set up these rules so that we could all try to live happily together, but to be blunt, they simply cannot cope with my madness any more for the sake of their own mental health (remember self care is important folks) and so me being unable to follow the rules has led to some consequences. What consequences?

Well, watch out because here comes a bombshell: I am not going to be living at home anymore. Yeah…I told you a lot had happened…

Like I said it was mere hours before we realised that I was not going to be able to live by the required rules and so, knowing that my parents could not cope anymore and that I didn’t want to put them through all of this again, I hopped onto google and started looking for a place to live. Mere days later I had impulsively used up my inheritance on a flat…yeah…I guess you could say things have moved pretty fast.

I don’t even know what to say or where to go from here because I am still so shocked and mind blown as to how all of this is happening and to be honest none of it feels real.

I am moving out.

I am in the process of buying a flat.

I have never lived by myself before and soon I will be living alone. WHAT IS HAPPENING?SOMEBODY STOP THE RIDE! I WANT TO GET OFF!

See what I mean about having a lot to update you on? Seriously, I have gone from living in an insane asylum for almost half a year, part of that time on 1:1 with a tube up my nose, to buying and living in a flat all by myself in the blink of an eye, and if I am honest, I have no idea how I am going to deal with it. Because of OCD and my eating disorder there are a million of normal every day things that I cannot do for myself from changing a duvet cover, to taking out a bin or washing a pair of socks and yet suddenly all of this responsibility is on me. Oh and how many Katies does it take to change a light bulb? THERE IS NO NUMBER HIGH ENOUGH BECAUSE THIS KATIE CANNOT CHANGE A LIGHTBULB. I AM GOING TO BE LIVING IN DARKNESS FOR THE REST OF MY LIFE UNLESS I GET SOME CANDLES WHICH I WILL PROBABLY DROP AND END UP BURNING THE WHOLE PLACE DOWN. I WON’T EVEN BE ABLE TO PUT THE FIRE OUT WITH WATER BECAUSE APPARENTLY FOR WATER YOU HAVE TO PAY A WATER BILL AND I HAVE NO IDEA HOW TO DO THAT EITHER. SOMEBODY HELP ME FOR THE LOVE OF GOD.

So yeah…that is my update, THAT is the latest Born Without Marbles news and an example of just one of the dramatic changes of plan that can occur when you are living with mental health problems…
Obviously it will be a while before I actually move out and into my new flat (turns out that buying property is far harder and more complicated than buying cuddly penguins…who knew?), but eventually that is what is going to be happening. In the mean time I will of course be living at home trying to stick by the rules as best I can and trying not to drive my parents completely mad but who knows how that is going to work out? Then again who knows how living by myself is going to work out because the only reason I am leaving home is because I am too insane and the last time I checked insane people weren’t the best at surviving in this world alone. Thankfully, whenever this flat does come through I will only be a five minute walk away from home and obviously my parents are going to support and help me through this more than I am probably giving them credit for, but purple onions and gravy am I terrified and filled with questions. How did this happen? How did my mental illnesses take over my life so much that they have led to me being practically evicted from my family home and forced to live alone where I cannot interfere with other people? How will I cope by myself if I can’t even cope with the support of other people? How on earth is this whole moving out of an intense inpatient setting and into an isolated empty flat going to play out? Well, truth is I have no idea. I guess we will be finding that out over the coming weeks together…

Take care everyone x

LifeChange

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

The Pressure To “Get Better” When You Are Struggling With Mental Health Problems

It is official. After five and a half months of being cooped up in hospital with very little interaction with the outside world, I finally have a discharge date and I will be going back home on February the 20th. Considering this hospital admission has been possibly the hardest and most traumatic of my entire life so far (not that I am planning on having another one to top it), I am thrilled, but at the same time I have to admit I am a little scared because the pressure for me to do well when I go back home is overwhelming. Indeed I have had to make a lot of promises in order to get this discharge date agreed, and every day I am starting to doubt a little more whether these are going to be promises that I can keep.

It may be a surprise for some of you reading this to hear that I have a discharge date, considering my posts of late. After all it is only a few weeks since I was writing about the difficulty of being on 1:1 observations and living with a tube up my nose and I will admit this has all moved ahead fairly quickly. To be honest though, I think staff and I have finally come to realise that we have come as far as it is possible for me to go right now and any more time spent in hospital is simply going to be detrimental from now on. As you will know from my post about the body recovering faster than the mind in recovery from an eating disorder (a post you can handily read here…The Difficulty When Mental And Physical Progress Move At Different Speeds In Eating Disorder Recovery), I have been getting rather overwhelmed with the rapid physical progression of my body and weight gain side of things and I really am at a point where I cannot take it anymore. With every ounce of weight I gain my head is screaming louder and louder and the ability to stay alive and simply keep breathing is becoming more and more unbearable to the point where suicidal thoughts and urges to relapse are at an all time high. (God this isn’t a very jolly blog post is it…don’t worry I will try and fit in a knock knock joke or something soon to brighten things up a bit).

On the day that you read this (if you are one of those extremely wonderful keen beans who read my posts on the very day they are uploaded….high five to you and a chocolate chip cookie if you are one of them), my discharge date will still be two weeks and a day away, but in reality I have already checked out of treatment mentally. Then again I suppose you could argue that for the duration of this admission, I never really checked in (it has been five and a half months and I still haven’t fully unpacked and set up my room because I refuse to accept that I am a patient here even now).
I think inpatient admissions for mental health can only ever really be beneficial when both staff and patient are working together to the same end goal, but this time around I have been in such a dark place that I have been finding co-operating impossible and it has very much been an admission of having things done to me, staff feeding me when I was unable to do it for myself and staff keeping me safe because being left alone was too risky even for five minutes. Admittedly, for the past few weeks I have been eating without the tube and keeping myself safe, but that is only with the end goal in sight of going home, and now I am reaching that goal I am not sure if I can carry this good behaviour on. Unfortunately though, like I said there is a lot of pressure for me to carry on because in actual fact, me going home at the end of this admission was never really the plan.

Indeed with the way things have been lately, my parents have been saying that they do not want me back in the family home for the sake of their own mental health. These illnesses may look from my blog that they are only killing me but they are killing them too, so the plan has been for me to move to a more long term hospital. However, though I have been on the waiting list for places you can stay in for over a year, no beds have been coming up (a shortage of mental health beds being available in the NHS?! How shocking and unheard of!) and as I said, since that blog post I linked to earlier, staff and I have realised that I simply cannot wait anymore and that I need to get out of here now.
It may sound harsh to say that my parents have said that they do not want me living at home at the moment but to be fair to them that isn’t exactly what they have said and is only how I have taken it. In actual fact what my parents have said is that they cannot stand having my illness in the house anymore, and after 15 years of dealing with an utter lunatic in their living room (and other rooms of the house of course…I do move around sometimes … I just specifically mentioned the living room for alliteration purposes…) who can blame them? However, as someone who struggles to distinguish between what is “me” and what is “the illness” in my head, them saying that they do not want my illness in the house is very much the same as saying that they do not want me either, seeing as the two in my eyes are so inextricably linked. I know there will be people commenting to say that there is a Katie aside from the mental health stuff and that is very kind of you but really, in the past five months, Katie hasn’t been around much if at all.

Because I was never supposed to be going home then, in order to get my parents to agree to the plan, I have had to agree to live by certain very strict rules to stay in the family home. There are many of these rules but overall they cover general things like agreeing to maintain my new unbearable weight (I don’t even think I will be able to leave the house even when I am “free” because I simply cannot stand the idea of people seeing me with all of these extra kilos I have gained), agreeing to stick to my medication (a medication I hate with a passion due to the side effects) agreeing not to harm myself and agreeing to keep eating. When I made all these promises that I would be able to do these things I honestly meant every word I was saying, but as time has gone on, the doubts have crept in. When I agreed to these conditions initially I was several kilos lighter than I am now, but at this new weight I really don’t know if I can manage and the harder it is getting.

I think there is so much pressure for me to stick to things this time round though because the consequences if I don’t are extremely dramatic. I will be blunt, in my head right now the only thing I want to do is relapse and lose weight, I cannot stand how I feel now in my head or my body and the urges to give up are so strong I might explode, but at the same time I know that if I do, I will quite literally be homeless and back in hospital, neither of which are particularly appealing options. So what do I do? How do I deal with this overwhelming pressure for me to “be well” mentally when it all feels so out of my control. Physically I know what I have to do to be physically well enough to stay out of hospital but how do I manage that when I have pressure to do the opposite piled right alongside the pressure to stay where I am now? Well, if you were looking for answers, I am afraid I don’t have any (and I am afraid I don’t have any knock knock jokes at this point..sorry for that), all I have is pressure, buckets and buckets of it.

I think that for anyone leaving an inpatient admission it is hard because there are so many expectations to be upheld. Will you be able to uphold the changes you have made/carry on with any good behaviour? How? How long for? How long until the million pairs of eyes watching your every move tell you that you haven’t done it well enough and are going to have to be recalled.

What I want to raise the awareness of however is exactly what I have been talking about , the pressure to be well when you leave hospital after a mental health admission which is supposed to have “helped” you, pressure which causes a lot of stress you really don’t need because you are already stressed enough as it is. It is ridiculous really, with physical illnesses you never get this pressure which is why I struggle with this idea in society that mental illnesses are any more in your control. When I left hospital after my appendix there was no pressure to not have another organ explode (although I am rather glad one didn’t and hopefully such organ fireworks never happen again), yet now, leaving a mental hospital, pressure is all I have. I am not sure what will happen when I get home so I guess we will have to see, all I know is that I am going to have to do my best because I cannot afford to not succeed this time. I wish that felt like a manageable task. It just feels very much like a case of knock knock, who’s there? A very scared and messed up in the head person who really wants to stay home but doesn’t know if they can manage (haha see! I told you we would get a knock knock joke in there somewhere…)

Take care everyone x

Pressure

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

Should The Government Be Teaching Children To Count Calories?

When it comes to the government, they are always coming up with handy suggestions as to how people should live their lives. You know the stuff, “eat at least five portions of fruit and vegetables a day”, “don’t drink more than 14 units of alcohol a week” and “drive on the left hand side of the road” (actually that one might be a rule rather than a suggestion…I wouldn’t know. I failed my driving test and every time I asked my instructor for more driving tips after that, he ran away screaming which really did not help with answering any of my questions…)
Always ready to tell the population what to do then, for 2018, the government in the UK have come up with a new suggestion, complete with its very own catchy advert, where play-dough people morph around the screen and a happy jingle plays advising parents to teach their children to restrict themselves to “100 calorie snacks, two a day max”. Now I am not one to turn down advice from our dear Theresa May who is doing such a wonderful job of running the United Kingdom without any trouble whatsoever (pause for laughter), and even I can admit that it is a catchy slogan with a tune that isn’t bad either, but in my opinion this “handy lifestyle suggestion” is a terrible thing that should cease being taught to children immediately.

Obviously for someone (aka me) who is in hospital trying to recover from anorexia and is following a meal plan where snacks exceed 100 calories and are more frequent than twice a day, this kind of thing is unhelpful and triggering. On one hand I have dieticians and psychiatrists coming out of my ears (I really don’t know how they got in there in the first place), telling me that I need to eat this far higher meal plan than the one Theresa May suggests and on the other hand I have play dough people telling me to restrict my intake, which as I have said is obviously confusing and not particularly useful, but it is not just to people with eating disorders that I think this advert is detrimental, rather it is bad for the entire population (far worse for your health in fact than, dare I say, more than two snacks a day comprised of over 100 calories each).

The problem I think with any lifestyle suggestion or diet tip from any source, is that people hear it and immediately take it as gospel. In the real world however, nutrition isn’t governed by blanket black and white, one size fits all rules like that, and there is no such thing as a “diet expert”, only people who have done a lot of research about food and have opinions about it, a point highlighted to me during my brief stint working in a bookshop.
Unsurprisingly, this job involved various tasks including book shelving, and one day I was in the self help department (insert joke about how I need to spend a lot more of my time in such a section here), which was helpfully next to all the diet books. Therefore whilst shelving, I couldn’t help but get a good look at all the titles and diets being advocated.
Now generally, when it comes to reading about a topic, one would assume the more books you read, the more educated you become. For instance say you read 30 books about penguins, it is then likely that you will be more intelligent on that topic than someone who has only read one and that you would do better on any quiz regarding penguins. Alas, when it comes to nutrition, things are not like that, for as I shelved those diet books (working very hard I might add just incase my former boss is reading this…), I realised something ridiculous. Turned out if I were to read all of the diet books, take all of the information, all the “no carb”, “no protein”, “no fat” nonsense and I were to mush it together to make one overall diet plan (which you would think would be the best and most informed having been the culmination of so many books’ worth of information), I wouldn’t be able to eat anything. All the health advice added up together in the world and the conclusion from it? No food is safe, which I think is fairly unhealthy considering such a thing would lead to death, and, were we all to follow that advice, the extinction of all human life on earth. Marvellous. Therefore when it comes to rules like this “twice daily 100 calorie snacks” thing dolled out by nutritionists, taking them as gospel is never a good idea as they are merely opinions rather than facts.

“But for some people limiting snacks to twice daily amounts of 100 calories might be a good, healthier idea than their current lifestyle choices” I hear you cry and I am not going to disagree with you on that, but another thing I want to point out when it comes to guidelines is that they are not universal and are actually only helpful or beneficial to SOME people, which is why it is not helpful to have them rolled out as rules for the general population. As I have already said, this advert is obviously not applicable to people who are in recovery from eating disorders, but neither is it applicable to a large number of the population who all vary in height, weight, activity levels and nutritional needs. What about athletes for example. Is this rule supposed to apply to them too because I am pretty sure that that Mo Farah and Usain Bolt wouldn’t get very far nor would they get any more gold medals were they to restrict themselves to two 100 calorie snacks a day…
Okay I get it, there does need to be some kind of suggestion out there as to how to live a healthy lifestyle and it is important to teach children about food and nutrition but whatever happened to “general education” and suggestions like “eat your vegetables”, “everything in moderation” and try to have a “balanced diet” as opposed to these rigid rules and guidelines ridden with fixed numbers. Where pray did these numbers come from because last time I checked people don’t eat numbers, they eat food (and for good reason too. I once tried to eat a number nine and it was terrible. Tasted purely of pepper.)

It is just somewhat ironic that the whole focus of this campaign is to encourage health but encouraging children to see food in terms of calories and numbers really is a disordered habit struggled with by many people with eating disorders. If healthy snacking is the priority then advising healthy snack foods and providing possible examples would be a far better way to go about it because this focus on calories isn’t healthy at all. When numbers are brought up things start to get obsessive and this is where I think the problem lies. By specifying 100 calorie snacks they are labelling a strict limit to adhere to, but how ridiculously close are people supposed to stick to it? Is a 101 calorie snack ok? What if it is a really healthy snack that is slightly over? Should an “unhealthier” food be chosen instead simply because it fits the amount? Should we weigh already healthy fruit to check that they are “safe” in this new government scheme? Should children be taught how to count calories from the moment they exit the womb? Is that a normal healthy attitude to food? Seriously, think about it, does all of this sound healthy and worth advocating or more akin to rigid disordered behaviour seen in people with eating disorders aka a mental health condition needing treatment?

Overall then, if I had any say or control in any of this government malarky, I would say the whole “100 calorie snacks” with “two a day max” idea needs to be binned and for calculating numbers to be kept in children’s maths lessons in schools rather than in their lunch boxes or at the dining table at home. If you want to educate and give healthy food guidelines from the government then fine, go ahead, but when this advice is given it should be just that, GUIDELINES like the old “eat more fruit and veg” rather than strict, prescribed, rigid calorie counted rules that must be followed exactly and are carved in stone and sung over the breakfast table like some terrible national anthem.

If you have or even if you don’t have an eating disorder but are finding these adverts unhelpful, as hard as it is, my advice would be to do your very best to ignore them. Remember, just because it is prescribed by the government it doesn’t mean it is automatically healthy and it doesn’t mean that its obsession with numbers is not disordered. Nobody is the authority on rules regarding food and diet, it is all opinion, and strict rules, hell even general guidelines, are not applicable to everyone.

Take care everyone x

GovernmentFood

The Difficulty Of Talking About Anything Other Than Mental Health When You Are An Inpatient In A Psychiatric Ward

I have an amazing family and, since being in hospital, my mum has visited me nearly every day. During visits there are a variety of activities we try to do to distract me from my current situation, sometimes we watch TV programs mum has downloaded to her tablet, we have been known to dabble in a little scrabble and once a week my mum will help me edit these blog posts that you love so much, to let me know if there are any glaring grammatical errors (that’s right. If you ever see a grammatical error on this blog feel free to blame my mother…only kidding…thanks for the help mum). When it comes to conversation however, there is little to no variety in topic and usually, if not every visit, we will end up talking about something mental health related which understandably can get rather tiresome.
It is therefore no wonder that the other afternoon my mum asked if we could possibly “talk about anything else” and lord knows I can see where she is coming from. Anyone would get fed up talking about depressing brain nonsense all the time and I do not blame her at all for asking for a different topic once in a while but at the same time I don’t think people realise how difficult it is to talk about things other than mental health problems when you have mental health problems, even if you are trying really really hard.

I hate admitting that because it makes me sound incredibly boring and self obsessed to say that I am frequently caught up in conversations regarding my head demons but the thing is, when your head demons are in your head 24/7, it is practically impossible to think about the “anything else” that other people wish to be discussing. Which part of your brain is supposed to be free to think about this supposed “anything else”?
When you are lost in your mental health problems, asking such a question is pretty much the same as asking someone who is being repeatedly smacked on the head with a wooden pumpkin to say anything other than “Oww”, “please stop hitting me with that”, “that hurts” or, if the person is a particularly articulate fellow “My frontal lobes are in a state of great pain so please desist with your actions and then tell me where on earth you were able to find a root vegetable carved out of the finest mahogany”.

I think this is especially the case when someone is in hospital because not only are your mental health problems all you can think about but they are all around you and you are in a location in which forgetting them is impossible, like trying to forget the smell of fresh bread in a bakery. I know people are always telling me that I am “more than” my mental illness and that it isn’t my entire identity which should mean I do have other things to talk about, but I think when in hospital you are often treated as an illness rather than an individual, and psychiatric units, though helpful, can make you start to feel like you are not a person at all.

It is like the problem I am currently facing being on 1:1 Observations.
Now, considering I write a blog on the internet all about how I am a flipping lunatic (or “Marbleless Marvel of mysterious Marblelessness when being addressed formally), you could say that I am perhaps not the world’s most private person. I talk about my mental health problems publicly every week and whenever I go into hospital for treatment I no longer ask friends to make up excuses to explain my disappearance in day to day life (my favourite of which was when I was 16 and to cover up my detainment in a psychiatric unit a rumour was spread at school that I was working on voicing a rat in the Disney Pixar sequel to “Ratatouille”, a rumour that was regrettably untrue in that I have never voiced a rat for Disney, nor has a sequel to Ratatouille ever materialised). However, as open and honest as I am, like any regular person, I still do like a reasonable amount of privacy in my life and unfortunately, for the past few months, privacy is something that I have been severely lacking due to the nightmare that is 1:1 and 2:1 observations.

The terms 1:1/2:1 observations in hospital are probably self explanatory and in explaining it I apologise for offending your intelligence, but basically it means that wherever you go, there will be at least one member of staff staring at you (aka 1 or two staff to your 1 patient ratio). It doesn’t matter whether you are going to the toilet, having a shower or having a snooze, the staff member will be with you (possibly within arm’s reach if that is stated in your care plan), and they will be watching every move, almost like a real life version of that song “Every breath you take” by The Police with those creepy lyrics (seriously if you haven’t heard that song look it up. It is weird and is a perfect summary of the 1:1 inpatient experience.) That song and indeed that experience has been my life for the past two months and to be blunt, it is incredibly humiliating. More than humiliating though, it is dehumanising and that is one of the things that takes me back to the question as to how you can talk about anything else other than mental health problems when you are being treated as a new species of disorder that is able to walk and talk. You are not a person, you are a thing that needs to be watched and observed. I am constantly hearing staff in the corridor ask each other “who is watching Katie?” or “who is with Katie for the next hour?” as if I am a ticking time bomb that people are just waiting to go off.

I suppose in fairness everyone loses a certain level of privacy when they are admitted anywhere. Even if you aren’t on 1:1 obs in hospital, you will be on some kind of observations, just as I was initially on 10 minute observations meaning that every ten minutes a staff member would appear at my door to see what I was up to. Therefore staff knew what I was doing all of the time but still in that ten minutes of unobserved time there was an element of privacy that I am sorely missing today, and I think that having just that ten minutes again would make me feel more human and less like a living issue in need of being managed. In those ten minutes I could hum a jolly ditty if I wanted and nobody would know, but now I can’t even convert oxygen to carbon dioxide without a beady eye watching to make sure I do it appropriately.

It is just so humiliating to be watched all of the time, even in the “private moments” that people take for themselves just to respect their own decency. Take urinating for example. Sure I have learnt over time to manage it and can now pee with staff even if I don’t have music playing on my phone (although in the early days such an activity was practically impossible and it is safe to say that I have publicly urinated to every song in the current top 40 charts…have fun getting that image out of your head when you next listen to Ed Sheeran on the radio), but it is still something that I want to do on my own. Worst of all though is showers and I think that is where my main issue lies with this whole 1:1 thing.

Imagine absolutely hating your body, despising every ounce and seeing it as nothing but a source of shame and then having to parade it around naked in front of a different stranger every day whilst you wash yourself. Surely that would be a challenge for even the most body confident person out there but for the person whose body is a constant source of torment and torture? How can anyone feel human or respected then? How can you feel anything other than dehumanised, humiliated and not respected as a proper person with their right to their own privacy whilst they have a good lather? How can you see yourself as, let alone discuss, “anything else” other than mental health problems?

I suppose I know on paper that if I were to print this blog post out and give it to any of the members of staff looking after me right now they would say that they do 1:1 Observations to look after people and keep them safe rather than humiliate but it is a lot harder to believe that when you are the one standing naked in front of a complete stranger whilst you frantically look for a pair of pants (hypothetically of course…this has never actually happened to me… Trust me, when you are on 1:1 you always have your clean pants prepared for after a shower!)

So, when you have mental health problems how easy is it to talk about “anything else”? Well, not very, when you don’t have the brain space or power to think about these “anything else’s”. Sometimes though, the biggest challenge isn’t thinking about anything else, but, when you are on 1:1 observations and have no say in your treatment, it is about trying to see yourself as anything other than a dehumanised circus freak in a constant humiliating parade.
Take care everyone x

TalkAnythingElse