Treatment

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

/ bornwithoutmarbles / 30 Comments

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

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

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

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

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

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

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

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

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

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

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

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

Take care everyone x

RecoveryCar

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Mental Health New Year’s Resolutions

/ bornwithoutmarbles / 2 Comments

Quick everyone! Get your noses out…Do you smell that? Just there?
That whiff of hope, new goals, exciting plans and new calendar pages all waiting for you like fresh, crisp bed sheets from the washing machine with just a slight undertone of possible regret for your behaviour last night and the sharp tang of cheap gin? That my friend is the smell of New Year’s Day, aka a day that is only a few hours later in time than the previous one, but a day in which we are supposed to be reborn and regenerated like Doctor Who (yes I am also thrilled that the next Doctor Who is going to be a woman but I have to admit that I’m still disappointed that the BBC didn’t go with casting a penguin in the role…Admittedly it would be hard for a penguin to hold a sonic screwdriver or operate a Tardis with flippy flappy wings but the waddling away from Daleks chase scenes would have been unbeatable).

As lovely as this whole “New year new me” idea is however, like I said in last year’s “new year” post (Oh my goodness, look a handy link to that very post:Why Baby Steps Are More Important Than New Year’s Resolutions In Mental Health Recovery), it does put rather a weight of pressure onto one’s back to make sudden drastic changes, which is why I said last year about the fact that I am very much in favour of setting smalls goals and making small gradual changes over a long period, especially when it comes to goals relating to recovery from mental health problems.
Indeed, last year I made a big point of talking about making small mental health New Year’s Resolutions, but this year I realised that as helpful as that is as a piece of advice, I did not provide any examples or suggestions to help figure out what these goals could be…Shame on you Born Without Marbles of 2017!
Thankfully though, it is, as of today, 2018 and therefore, now being a completely new and different person since midnight (please note the use of extreme sarcasm), I am here to solve that mistake from last year with this post where I am going to try and sprinkle a few ideas out there for you on the internet as to mental health New Year’s resolutions should you so wish to make any this January.

I think that coming up with mental health goals is often a tricky one because mental health is such a broad spectrum that cannot be pinned down or confined (much like a cloud, a wave upon the sand or a certain curtain sewing, puppet operating, singing nun called Maria) so to help make this whole thing a bit easier, I have divided my set of suggestions into four main categories of ways that you can make small and manageable changes over the course of 2018. Let’s go!

1. Goals about treatment – This is probably the easiest category to make mental health goals for because these are basically just goals relating to whatever mental health treatment plan you have going on. Say for example you take medication but struggle to do so, one idea could be to set yourself the goal of taking your medication every time a dose is required, with a calendar or chart to help you keep track and aid as an extra reminder or motivator. Maybe you have an eating disorder and have a meal plan set by a dietician or are working towards building a meal plan up, maybe make a goal to follow what that dietician has said or to gradually keep up with increases in your meal plan until you reach the amount that is right for you and is going to help you best in your recovery. Hate turning up to appointments with your therapist either because you find them awkward or because your local psychologist’s waiting room smells like cauliflower cheese? Make a resolution to attend all appointments or at least increase attendance over a period of time (and maybe invest in an air freshener for your nearby surgery…I recommend something with a hint of lemon if like me you are partial to a citrus tang).
If you already turn up to appointments regularly, then there are still loads of appointment related goals that are possible like doing any therapy homework on time (I think I might need to make that one of my resolutions for 2018…the ”my penguin ate my homework” excuse has not been going down well for some time now), making more use of therapy sessions by being more honest or maybe taking notes of important things that are said to take away so that they don’t get lost in the “post appointment mental blank abyss”.
Even if you have a mental health problem and are not in specific mental health treatment you can still make goals in this category especially if for example pursuing professional support is something you are interested in. Booking yourself an appointment at your local GP surgery to discuss possible treatment options, filling a form in to get your name down on one of those pesky waiting lists, making a phone call about a first appointment or setting up an assessment or perhaps doing some research into nearby therapy groups you could attend, are all awesome mental health treatment related New Year’s resolutions to get 2018 started off with a bang (and by bang I mean therapeutically supportive environment…ahem…Kapow!)

2. Goals about physical self care –  In any toothpaste or shower gel advert they always make acts of self care like brushing your teeth or showering, look like such an easy, pleasant task (to be honest some toothpaste adverts I have seen go way past pleasant to the point where someone will look so eager and thrilled about brushing their teeth in the morning that they have the deranged look of a serial killer in a horror film with minty fresh breath), but in real life those things aren’t as simple as they seem. Sometimes when you have mental health problems just getting out of bed is a task to be proud of, let alone things like brushing your hair, showering, cleaning your teeth, eating or putting something on that isn’t pyjamas…However, as hard as all of those things are to do, they are important and taking care of your physical health and physical needs, though exhausting, often helps take care of the mental side of things too. Trust me I know, I have the days where I stay under a duvet and refuse to move but as hard as it is to drag myself out of my cocoon and into the shower, I have to admit I always feel a bit better when it is done.

Similarly getting fresh air is important for your physical health as is eating which, even if you don’t have an eating disorder, can be difficult when you can barely muster the motivation to blow your nose. That said, it is bad enough being mentally ill without your body becoming physically ill and deprived of care, which will only make you feel more hopeless, so goals around self care physically are also important. Again they don’t have to be big and can start out as small as you like from “get out of bed for at least X amount of time every day” or every other day if that is too big a step. Setting yourself a goal to shower a certain number of times a week, brush your teeth every day, spend five minutes outside for a short walk and fresh air, or maybe make goals regarding eating enough proper food meals to take care of yourself properly. Whatever it is, in this category just make goals that are about taking care of your outer physical needs and hopefully they will have some effect on making your internal mental health nonsense a little better too.

3. Goals about socialising – scientific Studies show that humans are social animals and that we feel better when we aren’t lonely. My brain studies however, show that socialising with humans is nevertheless very difficult sometimes, often terrifying and mentally exhausting. Again though, like showering and all that fresh air our lungs crave, it is important so some New Year’s resolutions for your mental health could be to do with your social life and, dare I say it, talking to other people and actually going out to make friends and have “fun” (Oh God I shudder at the thought!). I know that a lot of years my goals in this category include things like “Text a friend at least once a day”, or “meet up with so and so (trusty friend so and so, she really is good to me), X times a month.” When you are getting ready to actually carry out the action part to those goals and are getting ready to see good old so and so, you might be so anxious that the meeting doesn’t feel like it will be of any benefit to your mental health, but at the same time, doing what I usually want to do and isolating myself doesn’t benefit much either. Of course alone time is important but a bit of conversation can be a nice distraction and it can be a great motivator to see and hang around with the people you care about and who care about you. Who knows, despite all the anxieties, maybe you will end up having a bit of a laugh by accident and what a happy accident that would be!

4. Goals about interests – I think this category is the hardest category to make goals up for as in this one to help your mental health it is about investing time in things that are nothing to do with mental health. That may sound like trying to improve your swimming without going anywhere near water, but mental health problems tend to be all consuming and it is important to make goals to try and get a bit of space away. I know that for me, days when I have multiple therapy appointments and spend the entire time talking about all the madness in my brain are exhausting and as important as it is to pay attention to the mental health things, it is also important to take space away from them too. Again this is incredibly difficult because i know that for me it can feel like you can’t take space away from your mental health problems because they are not a separate thing to you, they simply are you, glued into your internal brain make up but the key thing to remember is that though you might have mental health problems, you are not entirely your mental health problems (even if they try to convince you that you are). Whether you see it or not, you are a person too and a person who deserves to be treated like one. You would never tell someone with a broken leg that they were their broken leg so don’t let anxiety convince you that you are just one bundle of neuroses either. The best way to make goals here is to think about your interests which once again is difficult because when you are consumed by mental health problems, you don’t really have interests and might not get pleasure or enjoyment from doing anything. In that case I set goals to do things like “try a new hobby” or “try something that I used to enjoy” to at least make an attempt at getting in contact with even the tiniest bit of you that isn’t broken. Like I said you may not feel it, but trust me it is there and making goals that pay that little part attention might make it stronger in the long run.

So there you have it! Four categories in which you can make possible mental health New Year’s resolutions and goals to try and improve your mental health and wellbeing in 2018! Maybe you will love this idea and pick several goals for each category, maybe you will just make one tiny goal in one category or maybe you just want me to shut up so that you can go and put the kettle on to make a coffee (if that third one is the case please make me a tea whilst you are at it). Either way I hope this post has been of some use or benefit to you on this fresh, January New Year’s day or has at least given you something to ponder over whilst you enjoy that coffee you are going to make now (AND A TEA DON’T FORGET THE TEA.)
Maybe if you do make mental health goals, write them down to serve as a daily reminder/keep yourself accountable but unless you know tick boxes are helpful for you to see progress, try to avoid them in the interests of the days when you don’t manage to tick any of the boxes and feel like you have failed. Mental health New Year’s resolutions are NOT something you can fail at, they are just casual things you are trying to do as best you can when you can and any progress is so flipping awesome that if you achieve so much as part of one of your goals once this year I highly encourage you to run to the nearest person and insist they reward you with a well earned pat on the back (unless that nearest person is that serial killer like actor in the toothpaste advert…avoid her at all costs).

Overall, do whatever you can to try and maybe end 2018 in a slightly better place than you were at the end of 2017, even if that slightly better place is only a little to the left or just around the corner from where you were. Any mental health progress is progress and whatever happens, I will be forever proud of you (yes even you person who isn’t making goals and just wants coffee. You just read a whole blog! That is very pride worthy…now go and make that tea!).

Take care everyone x

New Year Marbles

50 Ways To Celebrate Christmas When You Are In A Psychiatric Unit

/ bornwithoutmarbles / 13 Comments

Christmas is like Global warming. Whether you believe in it or not, it exists as a concept/event that people talk about. Maybe you have already written your letter to Santa (or to use the Global warming analogy, separated out your recycling for the week), or maybe you hate Christmas trees and are a real life embodiment of Scrooge (I guess in the global warming analogy, equivalent to this would be burying hundreds of plastic carrier bags in the back garden under a fire of perfectly recyclable paper, that you then dance around whilst spraying aerosol cans and cackling manically), either way, no matter what you do, whether you celebrate it or live by it or not, it is a thing and it is not going away.

Christmas is also something that is happening in the very near future, and is a festive period that a portion of the world’s population will be celebrating/experiencing in psychiatric hospitals. Maybe the idea of missing out on properly taking part in the holiday season doesn’t bother you because you are our embodiment of Scrooge (in which case hello, here is a friendly reminder that December does not last forever…also I have a sweetie for you…it is a humbug), but what if you are our Santa Claus worshipping/Christmas loving wannabe elf? What do you do then? How can you get through the Christmas period and celebrate what you consider to be the most wonderful time of the year when all the mince pies and fairy lights are in the outside world, whilst you are stuck on a corridor of mental health nurses, health care assistants and locked doors at every turn? Well my friends, if that is you then what you do is come to this blog (as you have done already, so thanks for that…I would give you a sweetie but I don’t think I have any that you will like…I do have some tinsel though…go wild!), because today I am here to solve that problem and provide you with 50 ways to celebrate this festive season if you are, like I am, spending all or part of it stuck in hospital…

  1. Get a reed diffuser with a Christmas scent like “Winter Spice” or “Gingerbread” to give your room a more Christmassy ambience/make it smell less like industrial strength cleaner, and the pile of tear soaked tissues in the corner.
  2. Buy a pair of antlers and put them on the pet therapy dog.
  3. Impersonate crackers by wandering the corridors shouting “BANG” at random intervals, then proceeding to tell a joke and throw a paper hat and tiny pack of cards at anyone nearby (real crackers are unfortunately NOT allowed in most units because apparently they count as “explosives”…)
  4. Have a Christmas movie night with the other patients (if choosing a film is difficult maybe write down a list of suggestions and pull one from a hat…a Santa hat…obviously.)
  5. Spray fake snow on the windows which are likely to be misted over so that people can’t see in anyway and therefore will not interfere with the ability to see daylight/the clouds if you live in the UK.
  6. Do Christmas shopping online or send everyone a message saying that you can’t buy them a present this year because you are in hospital where shopping opportunities are severely limited.
  7. If allowed foliage, get a Christmas tree for the ward or at least a plastic one.
  8. Again, if allowed, decorate your room excessively to the point that Doctors and nurses comment on it in your notes.
  9. March the corridors with a CD player booming out all of the Christmas songs that the people around you will surely not be sick of hearing quite yet.
  10. Tie string around one of the staff members and then shout “On Donner on Blitzen! Now Prancer and Vixen!”
  11. Run around/walk glacially if on an Eating Disorder ward, asking “Has he been yet?” with frantic excitement.
  12. Set up a fancy dress competition and judge the therapeutic abilities of every staff member by how much effort they put in.
  13. Jingle bells outside everyone’s room each morning to add a festive wake up call to their morning routine.
  14. If you are allowed to cook or have a supported cooking group with an Occupational Therapist, bake mince pies and gingerbread men.
  15. Gather cotton wool balls for blood tests from the clinic and make your very own Santa beard.
  16. Knock on the staff room door and when they open it start carol singing.
  17. Insist that all wheelchairs be referred to as “sleighs”
  18. Insist your bedroom be referred to as “The Grotto”
  19. When visitors message you and ask if you need them to bring anything in for you, phone them back and sing out “BRING US SOME FIGGY PUDDING OH BRING US SOME FIGGY PUDDING”. Put a bit of gusto into it.
  20. Leave mistletoe above all of the doors that only staff are allowed to use in order to create awkward situations between the pharmacist and ward manager.
  21. Write a letter to Santa asking for leave over Christmas or maybe a discharge date if you have been VERY well behaved this year.
  22. Whenever a decision is made or treatment option that you do not agree with is suggested shout “Humbug”.
  23. Play Charades (a really good Christmas game for the days you are too depressed to talk but are physically capable of using mime to portray the literary classic “Little Women”.)
  24. Put glitter on your therapy homework
  25. Make a “gingerbread house” out of care plans.
  26. When you feel a panic attack coming on, get that CD player out and start playing “The Carol Of the Bells” aka the most intense and dramatically stressful song of all time (they use it in Home Alone when things are getting really dangerous and the burglars are on the way).
  27. Yell at the night staff for staying awake through the night and making noise, because at Christmas it is supposed to be that “not a creature was stirring, not even a mouse” let alone a mental health nurse doing checks.
  28. Write to the catering department and request sprouts.
  29. Create a tombola to raise money for the ward and leave posters around so that visitors can enter.
  30. Name one member of staff “Rudolph” and then do not let that member of staff play any of your reindeer games.
  31. Gather the patients together and perform your very own nativity
  32. If the ward is full (and let’s face it, with the shortage of inpatient beds across the country it is going to be), make a sign and hang it on the door to let people know there is “no room at the inn”
  33. Make Christmas cards for everyone on the ward.
  34. When you see the cleaner, steal their broom (sounds weird but apparently in Norway it is traditional to hide the brooms to keep all the bad spirits out at Christmas time…seriously google it…and steal those brooms!)
  35. Make your own Christmas drink stall with decorated mugs so that patients don’t miss out on the vital Christmas activity of taking a photo of their gingerbread latte in a Christmas cup to post on Facebook and Instagram.
  36. If a nurse asks to do a heart tracing/ECG refuse because last Christmas you gave someone your heart and “the very next day they gave it away” meaning that this year to save you from tears you have given it “to someone special”.
  37. Set up a secret Santa situation so that everyone gets a little present in December.
  38. Bring three wise men to your ward round. Or some shepherds (sheep optional).
  39. If you need the toilet in the night, pull the emergency alarm and ask staff to escort you through the dark to the bathroom with their star (aka the torch they keep shining through your window).
  40. Tie carrots to every door handle incase one of Santa’s reindeer comes past and gets peckish. EVERY door. Reindeers are unpredictable in terms of location especially at this time of year.
  41. Tamper with the emergency response alarms so that every time staff pull them they play Good King Wenceslas instead of that infuriating beeping noise
  42. Make balls of coal out of papermache and give them to all the staff who have been annoying you recently. Also tell them that they are on the naughty list.
  43. Flood the wet room, freeze it and go ice skating.
  44. If you are on 1:1, take a little drum to the toilet with you and bang it furiously in impersonation of “the little drummer boy” so that staff cannot hear you urinating.
  45. Wrap all objects available in wrapping paper and put bows on everything. It will be incredibly inconvenient and will likely destroy the rainforest but damn will things look lovely.
  46. When you knock on the clinic door for medication every morning have the staff announce the date as they open the door prior to the giving of the meds in order to be a real life mental health version of an advent calendar.
  47. Knock a hole in the wall, wear orange, sit in the hole and flail around a bit next to a sign inviting passers by to roast chestnuts over the “open fire”. Technically you should get planning permission for this one but my advice is to not bother because it will probably be denied and you do not want this opportunity for festive activity ruined…
  48. Ask to be treated for “Low Elf Esteem”
  49. In art therapy make some puppets and re-enact The Muppet’s Christmas Carol.
  50. Rewrite the lyrics to the 12 days of Christmas (Examples of ideas include “four HCAs three bank staff two stress balls and Lorazepam in a pear treeeeeeeeee”.)

So there you have it! 50 ways to celebrate Christmas when you are stuck in a psychiatric unit and are feeling all too far away from the fairy lights, Christmas markets and winter wonderland set ups across the country. As I said last year, when it comes to Christmas there is nothing I or any of us can do to make sure it is definitely a “Merry” occasion, but I do hope at least, that however you feel about Christmas and wherever you are spending it, you get through the festive season in the best possible way with the best possible and safest outcomes for all. If you have a merry time then that is fabulous, but remember, if you are struggling with it, that is ok too. Christmas is a hard time for a lot of us but I will be thinking of you all.

Take care everyone x

HospitalChristmas

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

/ bornwithoutmarbles / 7 Comments

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

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

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

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

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

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

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

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

Take care everyone x

Pudding blog

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

/ bornwithoutmarbles / 11 Comments

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

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

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

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

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

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

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

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

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

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

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

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

Take care everyone x

PiggyConfidentiality

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

/ bornwithoutmarbles / 5 Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

NewsUpdate

The Unpredictability Of Life With Mental Health Problems

/ bornwithoutmarbles / 14 Comments

Nobody can predict the future (except for Raven Baxter of classic Disney Channel hit “That’s so Raven”…anyone else miss that show? SOMEONE REMINISCE WITH ME).
Predicting the future is, however, a hell of a lot harder when you are living with mental health problems, aka almighty inconveniences that could pop up and smack you right in the nostril at any time. Of course everyone has the risk of things popping up unexpectedly in life and smacking them in the nostril, regardless as to whether they have mental health problems or not (which is why I always keep mine protected and am currently running interviews to employ my own personal nostril body guard…applications are still open for any hopefuls out there), but I think when you are mentally ill, the chances are increased and you are far more aware of them.
It is like leaving the house and wondering whether or not to take an umbrella. Some people may look out of their windows and see a blue sky with no sign of anything to suggest that an umbrella will be needed in the near future. Maybe a storm will randomly come along out of nowhere and surprise them, but they are not thinking about, nor are they aware of that storm before it has arrived. With mental health problems though, you always know that the chance of rain is there, you can always see the black clouds looming and can’t risk planning a picnic too far in advance or leaving the house unprepared without your wellingtons, just incase.

It isn’t that I particularly want to predict the future, but I cannot stand the swirling uncertainty that being a bit bonkers in the head can cause. Take right now for example. Okay I am in hospital so we have my current location all clear, but other than that I have absolutely no idea as to what on earth is going on.
Being under a section, I can’t exactly decide on discharge dates right now, so I do not know how long it will be before I am home. I don’t even know where I might be in the coming weeks as things are currently not going particularly well and there are talks of me being moved to another unit, one of which could be in Glasgow which is a long way from my hometown of Bristol and is terrifying the life out of me (if you do not live in the UK and do not know how far apart these locations are, all you have to do is get out your Atlas and find a map of the UK. All good? Ok, now put one finger on the very top of the country and the other on the very bottom in the little denty bit. That is how far away they are, aka THE ENTIRE LENGTH OF THIS TEA OBSESSED ISLAND. It is so far that there are airports in both locations so that you can fly between them because nobody has time to sit on a train or in a car for three million hours.) Everything is being done both by me and staff to prevent that from happening, but all in all, it is not my decision and more down to professional people in suits. Then if I were to be transferred to some currently unknown location anywhere across the country, I have no idea when it would be or for how long I would be there.
When it comes to medication I am similarly in the dark as to what will happen because a certain medication I have a problem with and do not want to take, has now been approved by a second opinion doctor, so legally if I refuse to take it orally, I can be injected with it. IN THE REAR. People really should not be stabbing that area with needles. I need it kept bruise free for me to sit on!
I don’t know how long I will have to take it, what will happen with the dose, if it will change, or how I will feel if it does (I am really not a fan of the current side effects).

Then there is my appeal against my section at a tribunal in a few days time, again a place where I can share an opinion but not make a choice. Being in hospital means waiting for a decision to be made and permission to be given on EVERYTHING, even whether or not you can go to the toilet, have a shower, or whether you are allowed to have a cup of tea in your room with your friend, aka things you would generally take for granted. You want to pee? You pee! You want tea with a friend? You tea! In hospital though? We are going to have to “discuss that with the team”. Good lord do they love to discuss things. It isn’t even just short term plans either, because things get even more foggy with a chance of showers and a few tornadoes when looking to the long term, especially when people consider their lives outside of a hospital setting, where things can be even more uncertain.

I love to keep things organised, I love to plan and I have always liked the idea of those huge calendars that big families buy brightly coloured magnets for, to stick to the fridge. In my mind every square and every day is scribbled on in black marker with holidays, social occasions, appointments and of course Great Aunt Enid’s 94th birthday. How can you book a holiday to the Canary Islands though when there is a 50/50 chance as to whether or not you will be well enough to go. Maybe when you book the holiday things are fine, but how can you guarantee they will be the same in a few months time? How can you be certain you will be able to make Little David’s football match on the 12th when depression could strike you down into immovable zombie mode ten minutes before the big game? How can you guarantee your presence at Aunt Enid’s all night rave at 2am? (She may be 94 but nobody can control Aunt Enid. When that woman wants a party, you had better be ready. With glow sticks.)

Obviously the only thing you really can do in these situations is to go ahead and agree to these potential plans and hope for the best, but as ok as that is in theory, it doesn’t take the uncertainty of the future out of the equation, sometimes financially worrying uncertainty if there is a risk that your flights to the Canary Islands and all inclusive hotel resort are going to have to be cancelled.
Aside from long term social activities, there are long term considerations like job courses to consider or places at university. In 2014 I was given a place at a university nearby to study to become a teacher, applications, exams, interviews, all done and ready to go…then I went into hospital. No worries we thought! The children can wait an extra year for my excellent teaching skills. Maybe it will be a good thing, give me more “life experience”, “develop me further as a person”. I asked if I could defer my place to the next year, all was agreed and the plan seemed back in place. I left hospital, I started to prepare for a life in the classroom teaching children all the reasons as to why penguins are awesome (might chuck in some lessons on times tables and ABC’s to keep OFSTED happy…Penguin starts with a P…One penguin plus another penguin equals two penguins…potentially three if dinner and a movie goes well).
Then, unexpectedly and unplanned, I ended up in hospital and my 2015 teacher training once again had to be put on hold. I asked if they would let me defer the place one more time but that request was denied and to be fair that is probably a good thing, because since then my mental health has been even more unstable.

Due to this I haven’t really been able to make any future plans because I never know how well my brain will be functioning, so whilst being unsure of the current plan here in hospital, things are even more uncertain when we look to the future. I often see people making “5 year plans” and “10 year plans” involving things like “get married”, “Become manager”, “own first house” or “give birth to child”. 10 year plans? Good lord I don’t know what is happening in the next ten days! Ten hours! Ten minutes (actually that last one is a lie…I am going to finish this blog, make a cup of tea and then mum is coming to visit. YAY).

Like I said, regardless of whether someone has mental health problems or not, we are all going to get unexpected storms that crop up and throw our neatly colour coded calendars from the fridge and into the recycling. It is however made even more complicated when you can already see the clouds forming, have a brain that is known to explode, and you are constantly aware of that ticking time bomb waiting to go off.

Take care everyone x

FortuneTelling

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

/ bornwithoutmarbles / 21 Comments

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

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

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

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

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

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

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

“Thou shalt not dunk biscuits”.

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

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

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

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

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

Take care everyone x

ElephantHoover

The Importance Of Triangles In Times Of A Mental Health Crisis

/ bornwithoutmarbles / 9 Comments

When you are going through what is known as a “mental health crisis”, everything feels like such a mess that you cannot even begin to start tidying it all up. Tiny jobs become momentous tasks, trying to survive an hour feels like trying to survive a millennium and it all feels completely unmanageable. Unhelpfully, being in the 21st century, the general busy non stop, non sleep, 24/7 side to modern life does not help matters (on the other hand there is the positive that, helpfully, we are not in the 16th century where, although it was less busy, you had a higher chance of being murdered by your husband if his name was Henry and he happened to wear a crown).
In simpler times your daily activities may have simply comprised of getting some water from your well, milking a few cows, doing a bit of hoeing out in the fields and then perhaps settling down by the fire with a nice bowl of homemade stew, (it is my understanding that in the olden days people ate nothing but stew). Nowadays however, the list of tasks one must perform to get through the days are endless.

Instead of walking out to a field there are specific buses you have to run to catch for work, computer programs that randomly malfunction and delete all the work you have done for the past week (something that never happened when “work” mainly focused on hoeing), specific coffee orders you have to remember for your boss to avoid being fired over a missed shot of espresso in their large cappuccino, bills to pay, TV shows to catch up on, appointments to make, social events to come up with excuses for, washing machines to fix, ironing to do and earphone wires to untangle (SERIOUSLY WHO IS TANGLING ALL OF THE EARPHONE WIRES WHEN I AM NOT LOOKING AND PLEASE CAN YOU STOP IT). It is exhausting and when in crisis, you need to delete it all and focus on one thing.

Triangles.

I am not talking your equilateral triangles, your scalene, or even your isosceles. I sneer at your Bermuda triangles, love triangles, even your 3D Egyptian pyramid triangles, for no triangle is better in a crisis than the great “Maslow’s Triangle” (toast triangles are a close second for being helpful in time of a crisis though, because you can have peanut butter or marmalade on them).

“What is this mysterious Maslow’s Triangle?” I hear you ask? Well I’ll tell you!

Basically there was once this psychologist named Abraham Maslow (I hear he was quite the dude), and he came up with this list of things needed to fulfil humans and reach “self fulfilment” or “self actualisation”, aka “Maslow’s Hierarchy of Needs” (that is the official term in all the text books but I am calling it Maslow’s triangle because it looks like a triangle, that is a catchier name and it meant that I could sound smart in that first paragraph by talking about other kinds of triangle which are now irrelevant to this post…calling it this also gave me the opportunity to mention toast triangles which are tasty, so I went with it and now here we are).
These needs are pretty much all Maslow thinks you need to become a whole and happy person and who knows, he may be right, but right now it doesn’t matter if he was right or not because to be honest, survival is what we want and aiming for his idea for self actualisation is a bit of a stretch at this moment in time/any moment in time during a mental health crisis. As I always say, we need to learn to waddle before we can fly.

“What does this mysterious Maslow’s Triangle look like?” I hear you cry! Well I’ll tell you that too (and may I say you are asking a lot of questions today…)
So here it is:

YayMaslow

As you can see, all of these “needs” are prioritised in order of importance with the most important on the bottom and the least important/ones that will make you happy but are not essential for purely physical survival, on the top. It is like a pointy version of Jenga, you have to have enough of the blocks to make up the bottom or else it doesn’t matter what is going on at the top, that pyramid is going to fall and there will be sand EVERYWHERE.

In times of crisis, I think people (by which I mean I), try to keep going with all the busy things of modern life that make up the entire triangle and in doing so get overwhelmed, miss out some of the more important things, and consequently make myself/my health worse. For example my magnifying glass and entire life focus is pretty much entirely zoomed in on the second from the top level, “esteem needs”, and because I hate myself oh so very much and thus have very low supplies of the “esteems”, I forage for these like a bear who is late in preparing for hibernation, without caring about anything else because in my eyes it is not as important. In my head, I need to feel worthy of and deserving of life before I can do all the things people need to do to actually survive…and yeah…it doesn’t work like that, hence why my pyramid has fallen, leaving me in hospital, in crisis, and trying to pick sand out of all the crevices (like I said, it gets EVERYWHERE).

In every situation I will sacrifice the bottom sections as I claw for that esteem level. When I am worrying about something like my blog/don’t feel productive/like I have accomplished or achieved “enough”, I ignore all other levels of needs until that achievement feeling has been somewhat reached (I say somewhat because, as I am sure many people can relate, no matter what I do in anything, it is never enough). Need to write a blog post but don’t have any time? Better cross “sleep” off the to-do list. Haven’t drawn that pesky diagram of the triangle you need to insert into this blog yet? No food or drink until that triangle is drawn! Not posted on Instagram and need an “outdoorsy” photo but it is freezing outside? Get out there and Valencia the hell out of some greenery even if you freeze to death in the process!
That is exactly what I do, what I think a lot of people do, and that is why mental health crises often get worse and spiral, because we are focusing on the wrong things when trying to survive and get through the day. Self actualisation is great and all that and we can work on getting to that eventually but if you are in a crisis, the most important thing to do is get your Maslow’s triangle out (and toast triangles if you are feeling peckish), and focus all your energy on the bottom levels. No “I should be doing this” or “I need to be doing that”, no, you are in crisis, it is time to prioritise, remove the stress and simply focus on basic survival. Only when you have got that covered can you start building all the other things on top and if you don’t, even if you work really hard at the achievement stuff, eventually it is going to crumble and remember what happens when pyramids crumble…SAND EVERYWHERE.

When you are in a mental health crisis you need to cut yourself a nice bit of slack. If it is necessary, take a mental health day off work to go to an appointment or get some rest, because without the rest you won’t be able to stay at work very long anyway. It is necessary to focus on keeping yourself hydrated (BUT NOT TOO HYDRATED REMEMBER THE SODIUM) and get yourself a cup of tea before sorting out all the ironing (which in the long run is not necessary at all…I don’t see ironing on the triangle…), and it is necessary, nay fundamental, to nourish yourself and give yourself a good supply of food at meal times before worrying about all the other things on your to-do list (I REALLY need to work on this one). In times of mental health crises it is OK to strip things back and take a step back from the things at the top of the triangle so that you can look after yourself and build your way back up to that self actualisation tip. Focus my friends, on the bare necessities, the simple bare necessities, forget about your worries and your strife, I mean the BARE necessities aka the bottom layers of Maslow’s triangle (I think a bear even sang a song about that whilst dancing around in a jungle with a half naked child in orange pants but that might have been one of those weird hallucinations I have been having lately…they are wherever I wander…wherever I roam!)

So, why is it important to focus on triangles in times of mental health crisis? Because my dear friends, in times of crisis, you need to allow yourself to simply focus on looking after yourself, keeping yourself physically well and safe so that you are strong enough to survive that crisis and work your way back up to the top of your Maslow’s triangle with the fun, self actualisation stuff going on. Forget the other shapes, hold onto your triangles, and if those triangles happen to be made of toast, eat them with some jam and a nice mug of warm tea.

As always, take care everyone. x

CoolTriangles