Firstly, and this is really really sad news. On Friday – Jelly was put down. I’ve had that dog since I was 7 and I love her very much. She was incredibly old now though and it was definitely the right thing to do. She could barely walk, was blind and deaf, couldn’t keep her food down and had almost stopped eating entirely, was quite unresponsive and generally really very sick. She had liver cancer which was slowly killing her and she became so completely frail and skinny. Although it’s so sad, it’s actually less upsetting that she died in a peaceful way than it was to watch how much she was suffering. Very sad though.
I saw the psychiatrist yesterday. Although she was positive about my physical progress, when she asked about how I was doing emotionally and I told her it wasn’t too good, she sprung into action as if this was not expected. I tried to explain all this disconnected stuff to her and I guess it went worse than I’d hoped. She told me I was “losing touch with reality”, which is a possible psychosis with potential to lead to a full-blown psychotic episode that will land me in hospital. This is actually what she said to me, so now I’m entirely terrified. Way to make me more anxious. So she’s prescribed me orlanzapine which is an anti-psychotic medication and is also used as a mood stabilizer. I haven’t taken it yet because it has some pretty dark side effects that are really really common (one being an average of 40lb weight gain and increase in appetite, which is entirely scary, another being excessive sleepiness. One side effect is lactating which I really don’t want). Anyway, anti-psychotics are pretty hardcore medications and not to be taken lightly. Unlike anti-depressants, they start to take effect almost immediately and start to make you really lethargic within a few days. They might stop these symptoms, but at the same time I don’t really think this is psychosis so am really reluctant to take something with a listed side effect of sudden, unexplained death. On the flip side though, I am now terrified of falling into a psychotic episode. Both options seem entirely frightening.
For the past few week or so I’ve been having some pretty severe PTSD symptoms, which have also been really frightening. The psychiatrist is going to sort me out a referral to specific PTSD therapy though, so at least that might clear up at some point in the future, but it’s probably a ways off right now. One-sensory flashbacks from terrifying experiences is really not fun. It’s like invading thoughts. This has all been triggered by a stupid guy on a stupid bike on the way to therapy last week who really shook me up (pathetic of me I know) and now sometimes I end up on the floor crying due to fear of being powerless and hurt. Plus it made me incredibly disconnected during therapy last week and I struggled to talk about anything constructive at all and didn’t want to mention why. I think PTSD therapy might be the best way forward. Although it’s entirely debilitating, anorexia creates a really easy and comforting escape strategy from anything remotely anxiety producing or emotionally difficult. Doesn’t fix them, but it hides them so well you forget that they were even there. Same goes with the depression and panic attacks and social anxieties. You forget they are there because you’re too busy counting calories, looking at food and losing weight to focus on them. Anorexia gives you something else to focus all your energy on – it doesn’t help you cope at all though. I do think I was functionally more capable at a lower weight though, but if I can work through these things now they aren’t being ignored, I will be the most functional I can possibly be when I hit my goal weight.
I gained a lot of weight this week, which hasn’t helped things. Much more than usual. I ended up crying in front of the dietician this week, calling myself disgusting and fat and crying about how my body doesn’t work like everyone else’s and I’m just especially biologically rubbish. This gain did push me into the very bottom of the healthy b.m.i. range but it doesn’t feel good to me. I feel absolutely huge. This hasn’t been helped by the fact that the dietician has lower the calories on my meal plan now to slow things down for me, whilst at the same time encouraging me to make steps to not count calories. I really need to keep myself in check and make sure I hit her new minimum. I already feel like I’m not going to unless I count calories because the exchanges meal plan she gave me could easily not add up. I’m really confused about what to do right now. And absolutely hating my incredibly fat self. I literally can’t look in the mirror due to the layer of new-found fat on my face. This appointment led me to writing all over both my arms with a sharpie marker so now I’m covered in reminders of how awful I am. And I look like a freak. This is something I’ve always done in times of distress but it’s been getting worse over the past few months. I have fading sharpie marker all over my body. Still, it’s not as bad as it could be. Once I circled every part of me that was too fat, including on my face. I had to scrub myself raw before I could leave my room. Luckily the boy helped by going to the shop for me and trying to gently clean me up. This was four years ago – before exhibiting many eating disorder behaviours (though I was already purging occasionally at this point, but I don’t know whether to count that as the beginning of my eating disorder as that started back in secondary school, didn’t involve heavy restriction or binging behaviours and was never a regular thing). Apparently I’ve been a disaster for a long time. Much longer than I care to imagine.
But finally, some good news. I absolutely love the therapist. At the beginning of each session he always asks me how I am, to which I always reply “I’m ok thank you. How are you?” He always goes “I’m fine” then asks how my week has been and I always mumble “Fine. Good bits bad bits y’know?” or something like that. This week though, although I did impulsively give that answer – I managed to stop myself and just said “That’s a complete lie” and then went over my entire week, starting with the guy on the bike on the way to my last session and ending with crying in front of the dietician. And you know what? He really helped. I still feel entirely rubbish and I get waves of feeling so low I’m scared of what I’m capable of, but he helped me think about some of the things I’m dealing with right now and tried to clear them up a bit. A little bit on my PTSD symptoms, some stuff on my weight, a lot on my feelings of not really being present in my own life and thinking that everything about me is just lies because it doesn’t really feel like me, and a little bit on the meds issue. Basically, he doesn’t think this is necessarily psychosis and thinks that although the meds might help, they are not critical right now so it’s entirely up to me. He said it was “derealisation” which apparently a lot of people experience in response to stressful situations. It’s like your mind saying “I don’t want to be here anymore” then cutting off from whatever is causing the high levels of anxiety, and in doing so also cutting off from everything else. It is really distressing in itself, but doesn’t mean I’m psychotic. Even if I’m not, orlanzapine might still help, especially as I have some not so pleasant reactions to SSRIs. But anyway – basically the therapist has really helped to settle my intense emotional reaction to the dietetics appointment, and though I still feel pretty dark and distressed, it’s not spiralling into a scary place anymore. It was the opposite of a good time but I think it was good because it helped ground me a little (which it has never done before). But now he wants to see me twice a week for a bit, so more therapy on Thursday. Not something I look forward to but at least it might help me deal with some of my difficulties right now.
The orlanzapine, the cut down meal plan and the extra therapy all seem like maybe things aren’t really going to plan with my treatment right now though. That in itself is scary. My team seems to think that something not so good or expected is happening and that I need to be medicated, slow my weight gain and have double the therapeutic support and refer me to an entirely separate therapy course on top of this – all in the space of a week. This wasn’t part of the agenda. Now I’m scared things might be really wrong with me. It doesn’t help that the psychiatrist told me that most patients feel a whole load better emotionally by this point in recovery. Something is not how it should be. I’m not fixing the way I should. Yet another reason to freak out.
Jeez what a dark and stormy post. Sorry. Doesn’t seem to be much good news right now. I will try to locate some optimism.