and it continues…

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.

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5 Comments

Filed under general, recovery

5 responses to “and it continues…

  1. Woah. I’ve got HUGE respect and admiration for you. I can’t even pretend to know what you’re going through right now but the fact that you’ve managed to get all that down on paper(/internet) is something in itself. Your post is entirely coherent, and certainly not the ramblings of a crazy person.

    Seriously, you’re incredibly brave. And strong. You need to remember that you have the support there for you, and the fact you like your therapist is a massive bonus, along with the fact you gave the truthful answer to the ‘how are you?’ question! Don’t be scared to ask for more help if you need it – and it’s not a case of you ‘not fixing the way you should’, there’s no SHOULD about it. Everyone is different, some people may feel more emotionally stable at this point in recovery, others won’t be anywhere near. Some people will not have had to deal with anything remotely close to the things you have, and are dealing with. The fact is – you ARE dealing with it. So what if it takes longer? You’ve faced up to the fact you need support, and so what if it doesn’t fit the ‘normal’ recovery process? Everyone’s case is different, there’s no formula.

    Not sure what to say about the meds. I have never taken any and would be as wary as you. If you’re not convinced they would be any good for you I’d leave it. Or at least leave it a few days/weeks maybe and see if your symptoms get any worse and if they do, perhaps reconsider and give them a try.

    Your therapist sounds like a good bloke, he seems to have steadied you a bit and helped you rationalise your thoughts maybe?
    Oh, and if you’re not ready to change the format of your meal plan yet, maybe leave it another week until you’re feeling a bit more settled? I don’t know. On the one hand it IS important to stop counting the calories, but similarly it’s important your weight continues to increase (and I assure you, without even seeing you, you’re NOT huge) and if counting calories is the way to do that for now, then so be it. Sometimes too much change too soon is far unsettling.

    Well done for venting your thoughts, I’m sorry my words seem to insignificant compared to how you are feeling but just keep fighting xxx

  2. P.S Sorry that comment was a ridiculously long ramble x

    • Thank you for this. It’s just really scary right now as you can imagine. I don’t like that things haven’t gone as smoothly as expected. It makes me feel like I’m not strong enough because needing more support is a sign of weakness. Ergh. I fucking hate feeling like I’m rubbish and don’t deserve anything and that everyone has it worse than I do and that I’m just being dramatic and deserve nothing. I know they wouldn’t offer if they didn’t think I needed and I know there is no formula but now I feel pathetic.
      I think the therapist has been good recently, or maybe my brain is just more capable of getting more out of it. It was useful today as well. Generally I feel like I failed at it. I still feel a bit like I failed and that I was only lying and that it wasn’t really me, but I can logically see some benefits. The new meal plan is really difficult though… I know right now I still really have to count calories because if I don’t I undereat dramatically. Grr. I hate being like this. I don’t want to be this disaster of a person anymore.
      Still in contemplation of the meds though. Scary decisions.
      Thank you again x.

  3. Eve

    Echoing above!
    Plus I think opening more about how your week has been with your therapist was good – when I see my counsellor I pretty much just talk about my week, and maybe mention plans and things from the past, and it always seems to put me in a more positive mood, just letting someone know how you feel when things happen/don’t happen and just the things you never really talk about in a ‘normal’ conversation.
    Also, I’m sorry about Jelly :( it is good that she isn’t suffering anymore, my dog who I had from about 10 was put down after a year with cancer, it was horrible to see her not herself for the the whole year and in the end it was better that she went peacefully. xx

    • Thank you! Generally when I talk about my week only, I get really upset by it all as I feel I’ve said the wrong things and it doesn’t go anywhere and has no focus. It makes me feel like I’m getting nothing out of it at all. But now I’m trying to focus more on the hard bits of my thoughts, rather than the actions of the week if you get me. Trying to focus more on the actual problems. Today’s session was much more structured. My problem with just talking without a theme is exactly the problem I have with counselling. Don’t get me wrong – I love counselling in theory, it just doesn’t help me much. Talking about myself without actively challenging my thought processes only makes me more stressed because I end up focusing on the bad stuff more if you get me, not how to fix it.
      I know though. I miss her a lot :( Thanks though x.

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