How Physical Health Problems Can Trigger Mental Health Problems

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Take care everyone x

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Birthdays And Mental Health Problems

When I was younger and heard adults saying things like “I just want to forget about my birthday this year”, I thought that adults were crazy and needed to seriously reconsider the way in which they were living their lives. Why on earth would anyone ever want to forget about their birthday?

For me, birthdays were something to look forward to and something I couldn’t forget about if I tried. Birthdays were about choosing which soft play area you were going to take all of your friends to for the party, buying rainbow coloured bouncy balls to fill party bags with and deciding whether you wanted a Thomas the tank engine or Spice Girls birthday cake ready to decorate with a flaming beacon of candles. Birthdays were about unwrapping incredibly exciting and complicated plastic contraptions that you would then spend the rest of your day watching your mum struggle to assemble amidst an encyclopedia of instructions in every language but English, before finally making it look like the thing on the box, only to realise that batteries were not included, causing your mother to curse the creators of Toys R Us and howl at the moon until the early hours of the morning, Barbie’s camper van standing motionless and taunting you from the corner. Birthdays were about wearing a badge with your age on it to school so that everyone would know how very mature you were and how much respect they should bestow upon you, and no birthday was complete without a trip to TGI Fridays where you would stand on your chair like a king whilst a chorus of red and white striped waiters belted out “Happy Birthday”, the performance concluding with rapturous applause from all around and, if you were lucky, an extra gummy worm in your Mississippi mud pie. With all that to look forward to, how could anyone dread a birthday?

I was sure that I would always look forward to my birthday and would never be one of these fools who looked upon the occasion with anything other than spine tingling excitement. I was wrong.
For the past few years, despite little Katie’s best intentions, I have become one of those people who wants to forget about their birthday, and I think it is because as you get older, birthdays don’t mean the same things as they used to. They become less about gummy worms and birthday cakes and more about time passing you by, life passing you by, which isn’t something you really care about when you are younger and your main focus is getting the bit of icing on the cake that has your favourite cartoon character on it. On top of that however, when you are mentally ill, I think they are especially hard because for me at least, a birthday can feel like a reminder that you have wasted another year drowning in anxiety and the older you get, the longer you have been stuck with this mental illness bothering you all the time.

That said, I guess you can sort of see birthdays and that marker of time passing as a positive thing. This year for example, I turned 25 (I did it last Thursday as a matter of fact and luckily, despite all the dreading and worrying about it talked about in this post, I really did have a lovely birthday, so if you sent me a birthday message or said hello to me at all on the 22nd June then thank you for being someone who made it special. I really appreciate you all so much). Alas! I must get back to the point!
So, turning 25 means I will have been unwell for 14 years. On the plus side, whilst a depressingly long time, it is an improvement in the sense that I can say the number 14 because it is a safe number, unlike the number I used to have to say, (the one that comes between 12 and 14), which is a somewhat difficult number for me to handle in terms of OCD (YAY SILVER LININGS).
Also there is something rather motivating about birthdays in that they often inspire you to make goals of things you are unhappy about and want to change before the next one.
Indeed, I think that as the number of years I have been ill has gone up, the more motivated I have become to fight my illnesses and push as hard as I can for recovery even when it involves doing something scary.

During the first years of my illness when I had to go back a year in school and take time out of education to go into hospital, I was motivated to fight purely because my illnesses were making me unhappy, but not so much because I realised what I was missing out on whilst stuck in my head. Ok I often couldn’t leave the house and I missed out on a few sleepovers with friends, a couple of school trips and several opportunities to share a pizza and watch a movie on a Saturday night, but to begin with, missing the odd pizza isn’t that big a deal. Obviously I would have liked to have done all the things like going bowling with friends and eating popcorn at the cinema, but for me being safe at home not having to touch or eat anything, felt a lot more comfortable. I would have rather stayed in my little bubble avoiding as much anxiety as I could, even if that meant being a little bit lonely, than go out of my bubble and cause myself a lot of distress trying to wear a pair of bowling shoes or eating a mouthful of popcorn. Staying safe was my priority, and if that meant missing out on a few sleepovers/meant less terror, that was a necessary sacrifice I would take. Why terrify yourself for weeks and weeks just trying to get the courage to see a friend for an hour? Better just to avoid it.

However the longer you live with mental illness, the more those little things add up over the years, and suddenly you find you have not just missed the odd sleepover, you have missed hundreds of sleepovers, hundreds of moments in which people took photos and made memories that they reminisce about and fondly recall with sentences beginning “Oh my goodness do you remember when…”. After several years, you haven’t missed one bucket of popcorn, you have missed an entire swimming pool worth of popcorn (not that I advise you put popcorn into a swimming pool…just trying to get the image of how much popcorn we are talking about across), and that amount of popcorn can’t be caught up on as easily as the one bucket you missed in the first place. As the days become months and the months become years, you realise just how much of your life you have missed out on because you were too scared to take part in it, and suddenly the motivation to work even harder to stop the years passing by without you noticing increases, because you finally understand how rubbish it feels to be left so far behind everyone else.

However at the same time, whilst the longer you live with a mental illness the more anger and frustration you have at it to motivate your recovery, the further entrenched you are in that illness and thus the harder it feels to get better. It is a catch 22 situation, the most vicious of all the vicious circles.

Time passes, you get angrier at all the time wasted, you become more motivated to fight but then find it is harder to fight than the first day you tried to challenge yourself because the illness has used the time wasted to dig its claws into you even further. Odd things that started out as little quirks to keep yourself safe become engrained habits and habits are a lot harder to break than things you only did a few times. I have smoked only one cigarette in my life and I will be honest, I hated it. It was like swallowing a smelly smokey fire. Therefore deciding to “give up” on the idea of smoking after that cigarette was not a challenge at all. I had spent longer as someone who didn’t smoke than I had spent as someone who did, it wasn’t a habit and I was not addicted or used to the comfort or feeling of a cigarette in my hand. Now however, I have officially been mentally ill for longer than I have ever been not mentally ill and I have dug myself into a hole so deep that it is far harder to get out of. Years ago I didn’t go to a meal out with friends because it made me uncomfortable, but that uncomfortable feeling has built over the years, and now I don’t go because I am terrified. Eating out doesn’t make me anxious, it makes me feel like I am dying on the inside. The longer you are ill, the more set in your ways you are and the harder it is to get better.

This year then, as always, though I dreaded my birthday as it scares me to think how long I have been trapped in my own mind, I am trying to see it as a positive motivation for change, an opportunity to say “this past 14 years has been hell and I am determined to fight as hard as I can to make sure that number doesn’t go up by one every time my age does”. I am fed up, truly angry every year as I see the growing list of all the opportunities I have missed out on and I really do want things to be different. It is just difficult, ageing with mental illness. As the years pass you may feel more motivated, but at the same time, you just feel more trapped.

Take care everyone x

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