Waiting

Waiting for a phone call that hopefully won’t come.

Waiting for the next appointment with my GP (Monday).

Waiting to see my psychiatrist (Monday).

Waiting, and quietly wishing, that my electrolytes will end up out of whack, I’ll have a heart attack, and that I’ll just drop dead. Over. Gone.

My GP was blunt. Kind, caring, and supportive, but blunt. The ED is entirely out of control. Obs, blind weighing, bloods, and ECG to be done every week until I can increase my food and fluid intake.

I’d be falling over and fainting if I weren’t already on meds to increase my blood pressure. The call that hopefully won’t come is from my GP. An after hours call telling me that my blood work is badly off and I need to go to the local hospital emergency department. It’s happened once before, and hopefully never again.

I’m to use Recovery Record and log every single item I consume. I dread it. I don’t want a list of everything I’ve eaten and drunk in front of me. My GP is insistent. I think she’ll be woefully disappointed.

I don’t even feel like trying. I just want to curl up, fall asleep, and not wake up again. That’d be lucky though. My body, thus far, has been incredibly resilient, and I’m still alive despite nearly two decades of abuse in the form of eating disorder behaviours, self-harm, and overdoses.

 

“Was there any reason you haven’t placed an order?”

I had someone from the online grocery retailer I use call me this afternoon. This man wanted to check that I was happy with the service, and wanted to offer me 10% off my order for six weeks, as well as asking why I hadn’t placed an order.

I told this man that I’d been away. Apparently that’s a plausible excuse for not placing an order in quite a while. He offered me another promotion. Some kind of membership that would entitle me to a percentage off my weekly shop if I bought it.

Why haven’t I placed an order? We all know that. Fruit and vegetables were either eaten, or thrown out some time ago. Any binge food has already been eaten. The only food remaining is generally unappetising or off limits because it belongs to my housemate.

I haven’t done a proper grocery shop in a while. My latest order consisted of a carton of soft-drink, alcohol, other soft drink, and toilet paper. Oh, and ingredients for making fruit mince pies for my family.

I’m in the middle of an eating disorder (ED) relapse and can’t remember the last time I bought proper food. “I’ve been away” is a) much more appropriate to tell a stranger and b) easier to explain.

The Eating Disorder Voice

If you have, or have had, an Eating Disorder (ED) you’ll be familiar with this ‘voice’. That part of you that screams internally at you to binge, purge, starve, exercise, punish yourself.

Very early on in therapy I was taught to separate the ED voice from myself, to name it, and to fight it. I filled journal after journal with a written war on the ED.

You don’t deserve to eat. You don’t need food. Skip that meal. No one will know if you skip it. You’ll feel so much better if you skip it. If you eat it you’ll have to make up for it later. You’ll have to be punished.

Everyone deserves to eat. I’m not different to any other person that deserves to eat. I need to eat just like every other person on the planet. If I skip the meal I’ll feel guilty, and will confess it to [therapist] anyway. I won’t feel better if I skip  it. I’ll begin to feel physically unwell. I don’t have to make up for eating it. I need this meal. No one deserves or needs punishment for eating, me included. Eating is necessary for life.

That kind of journalling helped me fight the ED and move towards recovery.

For the family, friends, and loved ones of someone with an ED it can be very hard to know what’s going on inside for the sufferer. The ED silences me. I sit and watch quietly, or avoid people all together. There’s a very loud argument going on in my head.

Imagine having a conversation with your loved one with an ED. You’re standing facing each other and chatting about what you did over the weekend. Your loved one is quiet, withdrawn, and responding with single words or short sentences.

What you can’t see is the ED voice. Imagine a person standing directly behind your loved one. They’re shouting responses at your loved one.

You: What did you get up to over the weekend? Did you see that new movie?

Loved One: Oh, no-

ED: Nothing! See, you did nothing! You’re useless and boring and everyone hates you.

You: Huh?

Loved One: Oh, I didn’t do much.

ED: See! You’re hopeless and pathetic. If you lost weight it’d be better. People would like you. You’re useless, hopeless, and pathetic! Everyone hates you!

Every single time I interact with someone this is what happens. I’m trying to pay attention to the conversation with a friend, but the ED voice is louder, and more persistent. It’s hard to focus on the conversation. Every social interaction ends with me feeling defeated, trapped, and hopeless.

If you can imagine a mean, cruel, vindictive person standing behind your loved one with an ED yelling at, and taunting them you’ll have some idea what it’s like to live with an ED.

What Are Your Warning Signs?

Mondays are therapy days. The one guaranteed day each week that I drag my exhausted, sore body (thanks ME/CFS) out of bed, and out of the house. Today was no exception.

I spent my time in the waiting room chatting to a friend on Facebook. I hadn’t given the upcoming session much thought. Things seemed fairly on track. Stable mood, no suicidal ideation, no self-harm, eating enough, and generally coping. Plus allowing more internal communication and switching.

One hour later, and I had a completely different perspective. My psychologist did a very good job of pointing out the warning signs I hadn’t yet seen, and expressed her concern for the behaviours I’m engaging in.

It’s made me think about the relapse prevention work we did in group whilst in hospital earlier this year. In one group session we had to identify relapse warning signs, and work on strategies to prevent. I dutifully filled in the worksheet and participated in the group discussion. When I came home the worksheet went away, and I haven’t thought about it since.

However, I do know my warning signs. It’s just that this time I’d forgotten to keep an eye out for them. This isn’t a complete list, but these are some of my warning signs.

Eating Disorder
Increased concern and worry about body shape, size, and weight.
Avoiding or restricting specific foods or food groups.
Significantly reducing portion sizes.
Swapping meals for low calorie protein shakes.
Skipping meals.
Ignoring hunger.
Using fibre supplements to avoid eating.
Abusing laxatives.
Bingeing.

Depression
Decrease in social activities.
Decrease in enjoyable activities.
Failing to see the point in engaging in the above activities.
Feeling like there’s no point to life.
Feeling hopeless.
Not seeing a future for myself.
Feeling like a failure.

Hypomania
Increase in enjoyable activities.
Talking more quickly.
Multi-tasking to the extreme.
Starting new creative projects.
Laughing much more than usual.
Swearing a lot more than usual.
The urge to buy things, or actually buying many, many new things.

Dissociation
Increased switching and associated memory loss.
Losing chunks of time (more than several hours).
Increased occurrence of flashbacks and body memories.
Difficulty falling or staying asleep.

Knowing the warning signs isn’t enough to prevent a relapse into unhelpful behaviours. Being aware of them, or having others point them out to you certainly helps, but it’s not enough on it’s own. Awareness is only the first part of preventing a relapse.

My task for the week is to work on tackling some of the symptoms that make up my Eating Disorder warning signs. I haven’t relapsed. This is about staying on track and preventing a relapse. I’ve been warned by my psychologist that a relapse will only lead to another hospital admission. Having already spent 7 weeks in hospital this year, another admission is the last thing I want.

All I Want For Christmas is…

…to be without this eating disorder.

This year my Christmas plans involve a family holiday. Spending a week away with my younger brother from interstate, and an older brother and his family. I’m grateful to be included in their plans, but terrified as well.

Eating Disorders aren’t fun at the best of times, but definitely not at Christmas. The majority of the festivities centre around food which, for most people, is completely okay, even welcomed. For me? I’m filled with dread.

My intake has been less than desirable. “Starvation” according to my psychologist and GP. Small meals not only induce nausea and physical discomfort, but intense anxiety. Eating is not pleasurable right now. So the prospect of going away for a week and having to eat (or otherwise admitting a relapse to my family) is bordering on terrifying.

The other possible option for Christmas is a hospital admission. That doesn’t fill me with joy either. It also involves eating, although with much more support, but means my family find out I’ve relapsed. I know I can’t read minds and can’t 100% accurately predict how my family would take this, but I don’t think it would go down very well.

I don’t know what I’ll be doing yet. I’m waiting for an outpatient appointment with the same psychiatrist who admitted me in July. Until then I’m being closely monitored by my GP, psychologist, and community mental health team. I’m holding on.

So, my wish for Christmas is that the ED will lose a little grip. I wish for the internal chaos, torment, and torture to ease. I wish to be able to provide my body with the nutrients it needs. I wish for the painful emotions to lift and become more bearable. I wish to be able to genuinely smile and say I’m okay. I wish to feel happy and free again.

I know that wishing for positivity, for recovery won’t make it happen. I have a lot of work to do to get myself out of this relapse, but I have hope. It’s buried under a lot of ED bullshit, but it’s still there.