Wednesday 6 January 2016

Treatment Part Two

In January 2015 I entered a private residential facility for treatment of my eating disorder. After a lengthy assessment with the consultant, I was diagnosed with EDNOS - eating disorder not otherwise specified. Another ridiculous sounding disorder, bloody psychiatrists. Basically, I engaged in behaviours attributed to bulimia and anorexia nervosa, but didn't tick enough boxes on either side to fit neatly into one box. Boxes are very important to most mental health professionals; once they can give someone a definitive diagnosis they can use the 'one size fits all' treatment plan that has been recommended for that disorder. I have found this to be particularly true of private psychiatrists; you stop being an individual and are completely defined by your diagnosis. You are no longer Lisa, a 30 year old woman with unique life experiences, beliefs or feelings; you are Borderline Personality Disorder and everything you say or do is because of it. You don't hate the taste of mushrooms, you are anorexic(I'm not exaggerating, I had to have 3 meetings in hospital in order to have 'no mushrooms' written on my chart).

When I entered the facility in January I was terrified, but I also knew that I needed help. For me, there is always a conflict between what I want and what the eating disorder wants. It is not as simple as asking for help and embracing it; my eating disorder had become the one thing I could depend on in my life. When everything around me, and inside me, was spiraling out of control, I would use food and weight to anchor myself to the world. So while I voluntarily agreed to treatment, a part of me wanted to cling to my ED, because I was afraid of what would happen if I gave it up. Better the devil you know...

The first priority in any ED programme is to feed the patient, a starved body and mind is not able to engage in the therapies used to treat the psychological side of the disorder. That first day, it took me an hour and a half to eat my half portion of dinner. With every morsel that passed my lips the ED voice grew louder and louder. The rage, disgust and shame were all consuming; I remember nothing else of my first week there. During the day we would have group sessions - Art therapy, craft groups, CBT based groups, nutritional therapy, interpersonal therapy etc; and in the evenings we had weekly individual therapy sessions. Any free time between groups and meals was spent in a communal living room, hiding away in your room was not permitted. Bathrooms were locked for an hour after meals, condiments and spices were restricted, as was liquid intake. We were weighed twice a week, had our bloods checked daily at first and then twice weekly, and we were not allowed to leave unsupervised until the consultant was satisfied that we were committed to the programme.

My referral to the programme had included a detailed history and description of my diagnoses, and I had discussed my BPD during my initial consultation. However after about two weeks the consultant began to question, and eventually dismiss, the BPD diagnosis. The characteristics and behaviours I exhibit that are attributed to my BPD did not fit into the ED mold. So it was simply ignored, and I was now EDNOS. Unsurprisingly, I repeatedly stepped over this new line; and while my actions and thoughts were ignored in terms of my treatment, they had to be dealt with on a practical level. So for the 40 days I was in the facility, I never left the house unaccompanied or ate so much as a biscuit without a nurse present.

Some of the therapies proved quite beneficial to me and none more so than my individual sessions with a CAT therapist, whom I still work with. I met wonderful people, staff and patients alike. I gained some weight and my health improved. I self-harmed and attempted suicide, and on one occasion absconded. I learned about portion sizes, healthy diet and how to make banana bread. But when I was discharged, I returned home and immediately began to restrict again. Suddenly alone for most of the day, I found I didn't have the willpower, and if I'm honest, the desire, to eat without supervision. We had been taught to weigh everything we ate; on my first day home I dutifully weighed out 40g of porridge and cooked it with water. On my second day, I weighed out 35g. My third, I decided the bowl looked too full and threw several spoonfulls into the bin. And so on and so forth until there was no porridge.

My relapse occurred so quickly, and totally, that my depression worsened. I had let my family and friends down, I was a failure and I was weak. Worse, now I was a fat failure. There was nothing I could do, or was willing to do, to make amends with my family but I could do something about my weight.

Just like that, I was back at the beginning. Within a few weeks my weight was back to where it was before treatment, food and numbers were the sole focus of my life, and my depression pulled me lower and lower. I had been discharged at the end of February, and on the 31st of March I turned 30 and tried(poorly) to cut my wrists in a pub toilet. I had given up on myself and given in to the hunger and darkness.

2 comments:

  1. Thanks for your description of this unit, I am going there soon and I'm extremely anxious, but it was good to read your experience to get an idea from a patients side of things. X

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  2. Thank you for sharing such a personal, difficult experience. Sometimes just knowing that there are others who have gone through what you are going through makes it much easier to get help yourself. This post inspires me to gather the courage to get that help that I know I so desperately need.

    Margaretta Cloutier @ Aspire Wellness Center

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