This sounded fun, and a nice way to tell about the little things that happened this month 🙂
Month: April 2017
I know EXACTLY what’s coming
*please note, there will be some cursing due to the emotions/thoughts coming through in this subject
Psychiatrist, May 2014: “I want to talk to you about this place called Forest View..” –> Began PHP at FV July 31, 2014
Therapist, almost all Summer 2015: “We need to consider returning to FV so you can get into a better place by the time you go to Calvin.” –> IP at FV end of August 2015
Therapist, November 2015: “You need to really consider a higher level of care. I cannot let you continue in this semester if things don’t change very soon.” –> residential November 19, 2015
Same therapist, Novemeber 2016: “You’ve gotten to a point where I am no longer able to see you. It’s time for a specialist in EDs.” –> new therapist, then groups, then IOP
Dietitian, April 2017: “You aren’t there yet, but if things keep going the way they have been we might want to consider some other treatment options over this summer.”
The very first time a higher level of care was mentioned, I was not expecting it whatsoever. For one, I didn’t see him often and had only had him as my psych for around 3 months at the time. I had little ability to judge his level of concern. It didn’t help at all that my therapist (in the same office, mind you) was basically the opposite of concerned. Side note, she didn’t know I started PHP until afterwards when my mom called (pissed aha) to cancel all future appointments. Anyways, I’m sure that there were some subtle signs I simply missed back then. That first time became a learning experience.
I had been seeing J for nearly a year before FV was brought up. I had numerous “scares” where I could sense that I was slipping into the too-sick-for-outpatient zone. Each time, I would convince myself, and ultimately her, that I was able to do this on my own. If anyone has read my posts from my year as a youth leader, you would have seen this in action. I could barely take care of myself for long stretches of the year, let alone my 4 main girls. It was a mess that should have been taken care of much earlier. By the time youth camp was over, so was any grace for falling more into the eating disorder. It was crunch time, just a month before college. Every visit, I would deteriorate while J’s face filled with more and more concern. I knew something was very wrong, but couldn’t see it clearly. I wasn’t in much shock once FV was mentioned. It made sense, given all of the concerns she had voiced. Realizing what was coming ahead of time led to compliance and a readiness for what was to come (although this was also met with crazy amounts of anxiety/fear).
I didn’t get very far into the semester before my new therapist at school showed the signs. Even though I hadn’t known her long, it was easy to tell when she was either shocked or significantly concerned with what I was saying. Don’t get me wrong, I was still surprised to a degree, but that wore off almost immediately. Things moved quickly after that, and I was off to California in (what seemed like) no time at all.
Round two of my therapist at school recommending higher treatment was less of a shock than the fall before. First of all, she had very limited availability. It was obvious that therapy every other week for maybe 45 mins wasn’t cutting it. Once the topic came up, I actually thought that I would be sent straight to PHP. Thankfully that didn’t happen. I called the very next day to get things set up, and began my journey from groups to IOP and back again.
When “more treatment” was brought up a few weeks ago, I almost laughed. I only somewhat noticed that our sessions were heading in that direction. R does a damn good job at hiding when she sees things going downhill. I sat there just staring. How the hell was I there yet? Honestly, I mostly pushed it off. This wasn’t anywhere near as severe as the other times. Her words were so vague, and I believed that “more treatment” just meant IOP, aka not a big deal.
Expecting these conversations ahead of time did little to reduce the denial that comes when anyone tells me how deep I am into my ED. Acceptance is the last component that comes before I finally am able to make a change. Sometimes this comes shortly, like before residential. I was at CFD just two weeks after I had the first conversation with S. The first and second time, however, denial led to avoidance of treatment for weeks/months. Unless there is a way for me to be forced into treatment, I don’t believe I’ll ever be able to enter it until I start to see how much of a relapse I am in.
The above was written earlier this week, but Tuesday my suspicion became more true.
Dietitian, April 26 2017: “You are declining fast. If you continue this way for the last 4 weeks of school, you will end up in residential. You may not be “underweight” BMI-wise by then but that won’t change the fact that you need help. We could end up petitioning you, if necessary.”
Immediately my thoughts began to race:
- Shock. What the fuck??? How did I get here? There’s no way this is true. R is wrong; everyone is wrong. She’s just overreacting. This is insane. Anyone could look at me and think I’m fine. My weight has NOT gone down, no fucking way.
- Anger. How could she do this to me? How could I do this to me? Why am I so stupid? Why didn’t I fudge my logs and [insert other behaviors here that would increase weight on scales]?
- Disbelief. She’s just lying to me so I’ll eat and get scared. There’s no way she is right. I don’t believe anything she’s saying right now. I didn’t lose weight; the scale at home proves so. Maybe I should get a new scale just to prove her wrong.
- Fear. What if they can actually force me into residential? Is that really a thing? I mean I know I can be kicked out of treatment I suppose or placed into inpatient if it ever got that bad.. If everything is really crashing down on me, I am screwed. What if she contacts my parents? Dr. C? Oh God no. What if this jeopardizes my summer or nursing school?
- Acceptance? Okay, so what if she is telling the truth? That means I really am falling fast. It would mean Ed is lying to me, nothing is as it seems, I’m not really in control. Could this actually be the start of a relapse?
I am currently living in a world full of denial, rationalizations, disbelief, mistrust, etc. None of this could possibly be true. I just don’t see it. The eating disorder is not as big as she made it seem, even Dr. C agrees! My therapist hasn’t mentioned much. My behaviors are not that bad. I am not losing weight, not even a possibility. The supposed “facts” have no real weight right now. Maybe it’s the ED talking, maybe I am worse off than I believe (and that very small concerned voice is right). Either way, I am where I am. I have choices right now, and my end goal is to never hear the suggestion of residential again. Ultimately, the conflicted and confusing thoughts/feelings need to be sorted somehow to make that happen.
I am proud of myself this week.
Honestly that feels pretty odd to say/think, but at this moment I believe it. I deserve a freaking gold star for getting through. I want to give myself that kind of recognition. I may wake up tomorrow and have a completely different view, so I am relishing in this moment to explain the “why” behind this amazing feeling.
Way back in residential/afterwards for a little while, I made a list of “weekly accomplishments” to showcase the progress I had made. Sometimes it was painful to come up with two examples, and others I had over a page. No matter what, seeing the positives laid out in front of me gave me a different, perhaps more realistic, view. One of the most common cognitive distortions I engage in is discounting the positives. This is a way to completely turn that around and add up the good rather than all the ways I’ve “failed.”
As R and I were talking through the distortions I frequent, she stressed how much of a concern this is for her and everyone at IOP/my treatment team. I could do something that seems so amazing to them, get a compliment or “wow, that’s progress” but shrug it off and come up with a counter. It is hard to see much progress from when I entered IOP in December to now. That is a long freaking time and too many hours in treatment to count.
As we were coming up with goals on how to change this, I mentioned my accomplishment lists I used during and shortly after residential. She immediately loved the idea and so it became my goal. I got out a beautiful new journal I had been saving for something worthy enough to use it for. Each week (Sun-Sat), I will jot down anything and everything I’ve done that brings me towards the person I hope to become. The hope is that this will slowly chip away at my negative views of my progress/self/recovery/hope/etc.
Just now, I read over everything I wrote down this week. This is why I feel some confidence and pride in how it has gone. Was I perfect? Did I follow my meal plan 100%? Did I complete every single assignment, attend every class? Was it a week free from struggle? Absolutely not! It would be completely wrong to say that I’ve done so outstanding and I am quickly pulling myself out of my struggles. The difference here is how I am looking at all that’s happened. I have spent so much time focusing on the wrong I’ve done, the “should’s,” comparisons, on and on and on. It is beyond time to try something different.
It’s pretty obvious that this is not going to be some easy fix where I suddenly will acknowledge everything they say as true. Even if I come in with the best intentions it is going to take time. These are thought patterns that are automatic, and pulling myself out of them is a challenge. In this moment, however, I will drink in my accomplishments from the past week. I will acknowledge the strength despite some really hard times. I’m going to keep moving forward, with my new journal to (hopefully) help grow confidence in myself and my recovery. This will be a process, one that I am finally ready to embrace.
I haven’t quite decided whether I will make a page on my blog like I did before, or perhaps just share bits and pieces of my journal. For this week, I’ll show everything written down, though.
- ate dinner Sunday when I didn’t have to/want to
- honesty in therapy
- took time to collage and just enjoy
- tried whipped Greek yogurt and kashi bars
- bravely did not cancel my dietitian appt
- attended support group without my two friends
- made goals for the weekend and took in (although reluctantly) what my dietitian said
- got housing set up for next year
- back into blogging again ❤ 🙂
- spent 2 hours “mocking” and not anything else
- survived the car accident without allowing negative thoughts to fester, took care of myself, and gave myself GRACE (more on this soon)
- spent time outside doing yoga
- no skipped meds all week
- stayed patient with my mom even though she has been difficult to deal with
- SURVIVED – it was a rough one!
Songs I am loving
I tend to get completely obsessed with certain songs and then play them at least
twenty times once a day. I really love how many of the one I’m listening to now are really positive/recovery/encouraging (for the most part), so I thought I would share them here! I have plenty of random ones as well, ha.
- This is my absolute favorite song right now. K from IOP always plays it and I love the way it sounds/the words and all of it basically.
Scars to Your Beautiful – Alessia Cara
- So this one can be depressing in a way, but I think that the message of coming through something hard is still hopeful and very raw.
Be Kind to Yourself – Andrew Peterson
- okay, kinda cheesy, but I really do like the message
- I always imagine saying this to a friend ❤ (but should also realize I deserve the same)
Crushed and Created – Caitlyn Smith
Long-standing Demi Lovato faves
- Funny story I first heard this one at FV round 2 and we always sang it during art.
Also I may have linked the 1 hr loop because I still listen to that one oops.
Elementary nostalgia (all songs on my 5th grade graduation video)
- Good Riddance (Time of Your Life) – Greenday
- 100 years – Five for Fighting
- You and Me – Lifehouse
- Daughters – John Mayor
Grey’s Anatomy songs – these don’t have much meaning other than the fact that they come from the best TV show ever.
- Wrecking Ball – Scars on 45 (SO much better that the original)
- Where Does the Good Go – Tegan and Sara – the very last Mertina dance it out 😥
- Breathe (2 am) – Anna Nalick
- Most of “Song Beneath the Song” by the cast
- Love on the Brain – Rihanna
- I’m Gonna Be (500 miles) – Sleeping at Last
Oh how I love my psychiatrist
Hopefully you can sense the sarcasm in that title because my God has he been progressively worse this year v. last. I’ll give a quick rundown of what I’m talking about before I share on yesterday’s appointment.
In October he oh so kindly told me my BMI, which was significantly higher than the last time I had seen him in the spring. That’s bad enough in itself, but then he added on that I could lose 5-10 pounds. I see now that this was definitely a catalyst in my relapse; not the main cause, but still…
- was basically convinced I had OCD when I was talking about using DBT skills (???) and wouldn’t believe me at first that I have never been anywhere close to diagnosed
- asked why I am not eating and if it’s *just* that I’ve decided I’m too fat
- insisted on upping my one medication even though my blood showed I have above therapeutic levels (which after that point doesn’t have increased effects)
- in general a complete lack of understanding of EDs and how to approach them in an appropriate way
I went into the appointment yesterday automatically assuming I would get some sort of ill-advised advice or comments. I was right, but didn’t expect the absolute disregard for my struggles. At first it was just remarks on my sleeping patterns (1-3 am and wake at 7:30-8:30). His advice: go to bed earlier. I then talked about the major lack of motivation I’ve had. We are trying a new medication to possibly replace another one. That I am fine with. He made more comments about me choosing not to eat and how that isn’t helping blah, blah. The last part, however, is the worst advice I have ever heard from a medical professional regarding my eating disorder, right up there with my old therapist asking for diet tips.
His suggestion for being tired all of the time: give me either Ritalin or Adderall. What the hell?!!? Does he not realize that one of the main side effects is weight loss? Does he not know I am diagnosed with anorexia nervosa, a disorder that already has a huge focus on weight and thinness? In addition, it is highly addictive/causes dependency/can easily be abused. I have had a history of addictive type behaviors (eg SH). I really don’t need another opportunity for that to happen. I can see this causing so many issues. If I won’t be addicted from the actual effects of amphetamines, I would probably be hooked on the weight loss it causes. On a less serious note, it can affect my heart as well.
I left in disbelief and very distraught over the entire appointment yesterday. I just don’t think I can handle having a doctor who doesn’t get this anymore. Hell, I would almost settle for Dr. VH. Almost. I think it’s time to consider switching to a different doctor. I hate doing it. I hate change, but maybe this is worth it? I’ll definitely be talking to my mom, support people, and treatment team about this. Maybe one of them can talk to him for me, ha.
Has anyone experienced something like this? Advice? Am I overreacting?
What this backsliding has brought
- The words “we may need to think about higher treatment if..”
- Crying during or after more meals than not.
- Hating the person in the mirror. She is too much, too large, yet not enough in every other way.
- Doubting my treatment team all over again.
- Temptations leading to urges leading to actions leading to guilt.
- More and more of each day being consumed with ED thoughts.
- Not even having to think before using behaviors; being somewhat scared over how automatic it’s become.
- Every dietary suggestion feeling impossible.
- Excuses, excuses, excuses.
- Avoiding church when I once attended 1-3 times a week.
- The immense pain a forced smile or “I’m good” can bring.
- Basic self-care as an afterthought, if at all.
- Near absent motivation for school, to the point of some failing grades and flat out skipping assignments, classes, etc.
- From “stuck” between ED and recovery to dipping another toe into the ED world.
- Isolating – coming out of my room for treatment, classes, and not much else.
- Another semester of missing out on all things that scream “normal college experience.”
- Cutting corners in all aspects of life because there’s no energy to do otherwise.
- Not remembering the last time I talked to a [school] friend outside of class.
- The numbers obsession multiplying every moment.
- Seeing “that face” on the ones who hear the truth.
- Ever-consuming numbness.
- Giving in to cognitive distortions and irrational thought.
- “In my head” most of the time.
- So many wasted hours – spent on nothing of substance whatsoever.
- Guilt for how I’m really doing then lying/hiding it from others.
- Emotional, physical, mental exhaustion that nothing will fix.
- Spiraling out of control faster than I realize.
Nearing the end of my time at IOP, I began slipping back into the ED some. I never truly 100% completed my meal plan, not ever since before I even started treatment. I was doing much better and then shit happened. I’ve been overwhelmed by ED thoughts, anxiety, and depression which has led to more behaviors than I even anticipated. This is going to be a reminder, the reasons that full-blown relapse will not serve me. I can still come out of this. I need to.
Well, it’s been over a month. Plenty has happened, and a myriad of things have kept me from blogging (school, finishing up IOP, stress of all lovely sorts, depression/anxiety, and not much energy or motivation for anything. I’ve hated the break but it was probably necessary. I hope to be back now. I won’t promise any schedule, but I have over 30 drafts sooo there shouldn’t be a lack of topics to write on.