What does a hard week look like in post-(lots of)treatment recovery?

This has been an extremely difficult two weeks or so for me. It has brought back old thought patterns, urges, and behaviors. I think a huge part of the “why” is stress. My first two nursing exams were this past week. I also have worked more than normal, so studying kind of took a backseat. Adding to this, I’ve had some pretty terrible body image, little to no hunger, and general frustration with food. These things are not an excuse to return to Ed, but it certainly is a factor.

While it can be disheartening that I am back in this space, I am (attempting to) treat myself the way I would treat my best friend. Recovery isn’t perfect and I need to accept that. I deserve grace. If I sit here and go “woe is me,” I will be stuck and feel more hopeless/helpless than ever.

Before, I had zero tools for effective coping. I turned to the eating disorder again and again and again. It was never “I can do this and it will take care of these urges in a healthy way.” Now, I do have a variety of coping skills to use when I need them, everything from mindfulness to journaling to using my kinetic sand. The problem currently resides in the fact that I’m not using them. While I am past the learning phase, application can be difficult too. It comes down to motivation at this point, which has obviously been lacking some.

One thing that I didn’t necessarily expect is how scary this all is. I am on the cusp of choosing recovery and getting back on track or continuing this downward spiral. It’s only a slip right now, leading towards a lapse. While neither of those are great, I’m not in a huge danger zone. I am leaps and bounds above where I was last fall or before residential. This doesn’t need to become a relapse, but it does remind me of the beginning of each one I’ve had.

For me, the main and most important thing now vs. pre-treatment is that I have a strong desire to turn it around. I don’t want to sit here and continue fading away. I have reasons to recover that truly matter (and aren’t all extrinsic). I have hope. I know my strengths. I may not have constant support like in treatment, but I can do this. I am not alone. I don’t need to recovery alone. That’s a beautiful thing.

To come out of this, I must apply what’s worked before. I haven’t had to really use these things in a long while, but now is time to bring them back out. Some pro-recovery things I will do from here on out:

  • Utilize my DBT corner when I’m having urges or very strong emotions
  • Phone a friend – the support I receive is invaluable
  • Journal, journal, and more journaling. It is something I need to do every day, whether I’m in a rough patch or not
  • Eat.the.food. Mechanical eating may be the only way I can go about this and that’s okay short-term. I can’t expect to continue recovery if I’m slowly starving myself. Also, that just fuels the eating disorder even more
  • Listen to and be honest with my treatment team and myself. This is huge. My team are not mind readers. It’s impossible for them to help me if I’m not telling the truth. I won’t get anywhere this way. What starts out as little lies quickly become complete denial. I start to convince myself of the “truth” as well.
  • Practice self-care. This is the last thing I want to do when I am in the ED/anxiety/depression, but it also has helped to bring me out of negative periods as well. Just 5-10 minutes of treating myself like I am worthy it will make a difference.

It isn’t easy just because I’ve been here before, but being here before means that I know how to break free. I am ready to do so.

World Mental Health Day 2017

I am so incredibly thankful for awareness days like today. They are an opportunity to change minds on what mental illness and mental health entail. It can erase stigma and prevent biases. People who are undiagnosed can recognize their symptoms and reach out for help. It is everyone around the world coming together for a cause that affects 1 in 4 people globally.

I have a ton I could say today, but I want to go with this: talking about my mental health has saved my life. Without therapy, psych meds, outpatient programming, partial hospitalization, inpatient, and residential treatment, I don’t think I would be alive right now. It took bravery to speak out and say that something was wrong. Even more strength was necessary to head into my first day of therapy. No matter how scary, treatment has been the best thing for me. The support I have received from family and friends is also invaluable.

If you are struggling, please reach out.

If your friend, family member, or loved one seems to be or is struggling, reach out.

Silence is not the answer.

No matter who you are, please take some time to learn more about mental health and mental illness. You DO know someone with a mental illness. Maybe that could be your significant other, classmate, child, sibling, coworker, relative, or friend. They need your support and they need you to be knowledgeable about what they’re going through. If you think that you don’t need any information on it, look at all the people you care for. Would you be willing to ignore them if they have a cry for help? Would you do the same if they had a physical diagnosis? Even for those without any mental illness, caring for our mental health is important. Everyone gets stressed, sad, angry, etc. Learning a few self-care techniques and coping skills can really go a long way.

Today may not mean a whole ton to you, but I promise it means the world to anyone who does struggle or will struggle with mental illness in their lifetime.

For more information:

TFHR – 10/03/17

It’s been forever and a half, so here’s a current TFHR!

Thoughts

  • I love blogging. I missed blogging. It has been beyond amazing to be back here again. This is a huge coping skill for mirror. Not much beats opening up a blank post and watching it come to life, especially when I can either tell my story or spread awareness.
  • I can acknowledge my progress, finally. It has been difficult in the past to do so, but my self-talk and perception of events is so much better give
  • I am so dang lucky to live in West Michigan. I cannot get enough of the beach, state park, sunsets, etc. It seriously is one of the most beautiful places.
  • I need to get back on track ASAP before it ends up like last fall or spring. I can’t afford that and I really don’t want it for myself regardless.
  • I am noticing some of the same old distorted thinking come back again. I’m glad I can recognize it, but now the hafrd part will be challenging the thoughts as they come.

Feelings

  • Everything.  I just feel like this overwhelmed, confused ball of emotions. I have found it hard to even connect this to anything or recognize where it’s all coming from,.
  • Nostalgic. I just miss treatment so damn much. I keep thinking of all the memories I have. A lot of me wants to go back there, or at least bring back the girls and support.
  • Down (Depressed?). I should be used to this by now, but every time I go from normalish to not is still a shock. I’m hoping it can be temporary.
  • Connection. I am not that surprised with the amount of empathy and compassion I feel towards the patients. I know plenty of what they’re feeling. I had one tell me how crazy they felt up until they were in treatment. I feared that as well. I had another talking about how hard it is going outside only once a day. I completely get that. It feels claustrophobic to be stuck inside a cold hospital all day. Even if it is difficult being back at the hospital, I know my experience there has helped shape me into a better nurse for my patients.
  • Proud (of myself). I already am seeing a huge difference each day I work with patients. Today, I was cool and collected. I shook off the nerves and communicated really well. I feared the therapeutic communication portion of nursing at first. It hasn’t come easily, but I am so proud of myself that I’m growing in that area.

Happenings

  • Work is weird. I don’t know what exactly I expected when coming back to work, but I didn’t think things would have changed the way they have. I am not a crew leader, there are a ton of new people, and I just feel weird. I guess it’s hard to pinpoint? Being back to retreat season is definitely different than before. We have full crew turns that mirror summer and even more new people. I feel like I barely even know what work will bring anymore.
  • Rewatching Grey’s Anatomy. I feel super accomplished because I finished the entirety of Grey’s last week. I only started at the end of July and was at work/IOP plenty of that time period.
  • EDS pain. Unfortunately, work means working my joints in ways they haven’t been for months. I feel exhausted each time. I can always count on pain, namely from my right shoulder and elbow, and more recently left knee. I have to find a balance and take care of myself. Ehlers-Danlos is not a joke.
  • Tons of groups/appointments. I feel like I am constantly talking about my emotions, triggers, mealplan, etc. I kind of am, truthfully. Mondays and Thursdays both include multiple forms of treatment. It almost feels like I am living between these appointments, at least when I’m not doing well. I am trying not to let that happen this time around.
  • Shared MY story for an assignment in my nursing class. I still can’t believe this happened. I didn’t even use pseudonyms like I planned. Granted, literally anyone who has me on Facebook or Insta could easily find out about my eating disorder. I don’t try to hide it really. I want for it to be something others connect to, learn from, and understand eating disorder more because of it.
  • Seeing all the people at FV. Today I counted at least 5 people I knew. Some were from ED, like the amazing dietitian, and others just randomly from my inpatient stay. I wanted nothing more than to say hi and thank them, especially my old dietitian. I didn’t do these things but I hope to find an opportunity to say hello soon.
  • First test(s). Yesterday I had my first exam in our theory class and Friday will be one in the strategies class. I’m not feeling the most confident about them and my stress level is pretty high. I know it’s only the first test, but I’m so worried about the future. What if I actually cannot do this?
  • Validation. I know someone who is a charge nurse at the other psych hospital my professor works at. She messaged me on Saturday night asking about who my instructor is. It turns out she was sitting right next to her at work! She told my prof that she knew me, and she had some good feedback. My prof was impressed by how I handled last week, since I had little time to catch my patient before discharge. She also said my nursing process was great. I wasn’t feeling the most confident about these things, so hearing about it was uplifting. My hard work is paying off.

Ramblings

  • The conversations at IOP/treatment peeps in general are amazing, stimulating, and have nothing to do with ED. It’s wonderful. I especially love how feminism/some politics come up in the weirdest way. Those things are important given the state of our country and all.
  • honestly part of me cannot believe that Dr. VanDouchebag is still around and in charge of kids/ED at FV. A story I heard of his actions today angered me a little bit. It sounds very similar to things he would say about or to ED patients in the past. I know he’s the doctor and everything, but condescending isn’t the answer to helping patients.
  • Gah I want to speak up about my time at FV. I talked a bit about this, but I can’t wrap my head around it. I almost feel like it would be proving how sick I was before. This isn’t healthy. What would be a reasonable and healthy way to share this with my prof? Probably not at all.
  • I don’t have many words about Las Vegas, just prayers. One thing I want to mention is how sick I am of political things coming out when we should be supporting during a tragedy. I don’t feel like now is the right time to debate topics. I do share some of the same views as those who are (in a way) turning it into a debate. There is a time and place for that, but it isn’t in the wake of one of the worst loss of human life I’ve experienced in my lifetime.

And that’s all for now! I haven’t decided how often I would like do these. Maybe it’ll be sporadic instead of scheduled, but I’m not sure yet. I do like how it gives a nice overview of life currently.

I am going to be a nurse.

This statement may seem a little obvious, considering I am currently in nursing school. To me, though, it is very significant. I have never been in a place where I truly believed this. Now, here I am, nearly a month into the semester and that statement couldn’t be truer.

I want to focus a little bit on the times I doubted myself so much, since it tells the story of  where I came from. As is with many areas of my life, mental illness has greatly affected the possibility of me becoming a nurse along with decreasing my confidence that I ever could reach my dream. I have been in that dark place for much of my college career. I wondered if it was even worth trying when I saw little hope for anything, especially myself becoming anything worthwhile. My mind constantly plays tricks on me with the distorted thinking. It may be more difficult to reach my dreams, but that doesn’t mean impossible or that I am wrong for the job. In general being sick has brought low motivation, a lack of caring about what happens to me, isolation, and my life as a whole unraveling. I become a sad shell of a person when I’m far into my illnesses.

Another major contributor to doubting is my academic performance. I’ve had struggles three out of four semesters at Calvin. Fall 2015 ended in me leaving early for residential, spring 2016 was actually pretty good, fall 2016 brought plenty of hard times but ended up better than it could have been, and spring 2017 nearly disqualified me from staying in the nursing program since my GPA was so low. I never ever had a hard time in school until my ED became more severe. I never imagined I would be that person who was okay with C’s because anything was better than actually failing. Sadly, that has been my life the past couple years, especially this past spring. It’s hard to believe I managed to pull this all off.

I’m beyond thankful that I’ve fought so hard to get into nursing. I have persevered through it all. In a way, I think this struggle has made me stronger. There is nothing I want more than being able to say I made it as a nurse. In less than 2 years that will be my reality. I don’t think I have had so much hope for the future as I do now.

I want to end this with evaluating how different aspects of who I am will play into learning how to be the best nurse possible. I have plenty that has to change but also so many traits that will help in nursing. I want to be able to look back at this list and see how much I’ve grown.

 

Strengths

  • my experience as a patient will allow me to better understand what patients are going through
  • I am compassionate and truly care
  • my faith allows me to carry hope and see the good in others
  • I love learning
  • my medical knowledge and interest in all things medical
  • I want to be the person that others can come to and lean on in hard times
  • medical math and terminology knowledge

Things I need to work on

  • my extreme fear and avoidance of vomit at all costs
  • I am still pretty shy
  • I tend to feel awkward in different situations
  • I have to practice therapeutic communication, namely slowing down and taking in what the other person is saying v feeling rushed
  • overall, just a TON to learn, but that’s okay!

I’ll probably continue to update this as I think of new things^^

 

 

A letter to my psychiatrist

I may have shaken your hand yesterday and thanked you for what you’ve done the past 2 years, but I promise that was not genuine. I did not just search for a new psychiatrist because of insurance (although that was part of the problem). I cannot be your patient anymore because you are a threat to my recovery.

The nurse knows to weigh me backwards and turn off the scale right away. It is in my chart, loud and clear (I assume). They won’t even place me in the exam rooms with normal digital scales. The office wants to protect me from the harm seeing my weight can cause. My real doctor doesn’t even mention it. She trusts that my dietitian knows and I don’t need to. You have the exact same information as they do but apparently just don’t care.

You may think that your words don’t hurt, because you follow or precede with something like “oh, I forgot I’m not supposed to talk to your weight.” That doesn’t change the fact that you said I have gained weight since last spring and that I can surely feel it in my waist and how clothes fit.

You probably don’t remember what happened last October, just about a year ago. I do, and it will probably stick with me forever. I came in for a routine, first of the school year med check and left with my BMI (and subsequently my weight, because computers and calculators are a thing). To top it off, you added a little tip: I could lose 5-10 pounds and that would be better. What came after was relapse and eventually IOP. You didn’t directly cause it. That doesn’t mean the seeds you planted were harmless.

I may weigh more than last spring. I may be weight restored. I may look normal. I am not normal. I JUST came out of an entire summer of intensive eating disorder treatment. I fought like hell to make progress there, but my recovery is far from perfect. I’m not to the point where seeing or even speaking about my weight is okay.

I don’t need you to tell me I gained weight. I don’t need you to talk about how I must feel my body is different and how my clothes fit differently. They do and I know. I struggle every day to live with that fact.

Even now, a day and a half later and after talking in group/therapy about it, your words linger. They play over again and again. The eating disorder ate it up and now doesn’t want me to eat. I am struggling. I wish it wasn’t the case and I wish I was stronger, but I was not prepared for this, not fully.

I know I’m not the first, but I want to be the last eating disorder patient that you ever hurt like this. I found out today that you’ve been saying these type of things for years and still haven’t changed. How could you not trust a therapist or dietitian who work exclusively with ED patients?

I’m sorry I didn’t speak up more or sooner, but tomorrow I am. I am going to tell someone who has more pull than you do and maybe that will keep you away from more ED patients. Even if it doesn’t I will have done my part to help prevent this.

I am not going to let your words bother me anymore. They don’t deserve any power. So, here I sit, crying over my night snack. I may be overwhelmed, ashamed, disgusted, anxious, and triggered but I am also angry and fighting like hell.

Emily

3 months.

I’m having a hard time holding it together today. I’ve been on the edge of tears all day long (nearly cried while listening to someone talk at clinical). It could be many things: waking up at 5:45, a pretty long and anxiety-provoking day at the hospital, or the very stressful situation that came up last night. More than anything else though, it is because today marks 3 months since leaving CFD. That’s a quarter of a year (!?!?), 92 days. My feelings today really mirror what I felt back then. I want to insert my journal entries from my last day there. These will be in italics throughout this post to help differentiate.

The CFD journey is officially over. I am so blessed to have 34 days with some of the most amazing people I have ever met. This was and will always be the best decision for me. God knew exactly what I needed. This is it. 100% true to this day. I think I’m able to appreciate my experience even more now that I am removed from it.

I want to believe all everyone said. I want to remember it forever and ever. That I am: a light, the official Michigan guide, kind, RESILIENT, courageous, strong, worthy, that I have changed, I can do this, a fun presence in the house, going to recover, overcome lots of things in my time here, have a bright future, have made so much progress, have to keep opening up. 

I want to believe these things ^ More than anything in the world

I’ll admit, I’ve had a difficult time believing any of this. I think part of it is not making an effort to remind myself. My goal will be to write these down somewhere I will read it often. I want to make encouragement, mantras, and positive attributes part of my daily life as it was in residential.

J (my therapist) – if you give a mouse a cookie… she knocked on the door of all my shame but I am the one who opened up. That shows my growth. She has hope for me to continue this. I am grateful for everything she’s done for me. I wouldn’t be where I am right now. I never could have let the shame out if I hadn’t had her. Maybe I would have just carried it forever. While there will never be anything outpatient like J’s shame train (choochoo!) group, I am continuing to explore my shame. I don’t want to live with it forever. EMDR is the current answer to this. I’m hopeful.

What has changed? A LOT

  • I am using my assertive voice
  • choosing recovery over vacation, my parents, what I want my summer to be like
  • I am letting go of the shame
  • I see that my family has perpetuated the shame
  • I am nourishing my body again
  • I can be trusted to eat on my own accord
  • I am using skills
  • the thoughts don’t fully control my life and I can see beyond them
  • I know how to lean on supports
  • I am closer to who I want to be
  • I am equipped
  • I have 34 days of trials, tears, setbacks, frustration, feeling like a failure, steps backwards, resorting to old ways, giving Ed a loudspeaker and more bu also 34 days of discovery, fighting, using skills, so many successes, backing down from Ed thoughts, opening up, checking in, and getting support
  • I am the Challenge Queen

I want to recreate this. What has changed post-discharge:

  • I’m nearly a month into school and doing very well, all things considered
  • I am putting my recovery first by adding in as much support as possible during each week
  • feeling empowered enough to make strides in my recovery all on my own
  • honesty: some slippage, but this is a normal thing that doesn’t need to continue
  • being BRAVE and making strides I haven’t been able to do for a long time
  • I have been with only outpatient care for exactly 4 weeks and I didn’t start sinking right away like before
  • I am proud of my summer instead of embarrassed
  • slowly getting back into yoga
  • giving myself a break and time to rest
  • overall I have maintained the mood improvements that came in residential
  • I feel stronger than I have in a long time, outside of treatment
  • I have hope
  • I am listening to my dietitian and therapist (sometimes reluctantly)

I don’t think I could reflect on CFD without reminiscing. I miss it. I’ll think of memories and laugh, smile, cry, feel proud of myself or others, and experience pretty much every emotion out there. Residential is this life-changing experience. I get emotional thinking about it because my entire stay was full of finally feeling again. I was in a very vulnerable state while also being pushed and challenged. I haven’t ever been a part of anything like it. Right now, I can’t look back at my journal without crying because of the impact it’s had on me. I will never, ever take this all for granted. Instead, I am forever grateful for the opportunity and everyone who made my experience what it was.

These three months have been nowhere near perfect, and I am okay with it. Recovery is a process that’s led to more ups and downs than any rollercoaster. The difference now is that I am fighting like hell. My worst days still are better than any from last year.  CFD (and subsequently, PHP and IOP) helped me build a strong foundation. Now I am just building on to that and continuing in this process.

I will end this post the same way I ended my journal 3 months ago: This is the beginning of a beautiful, freer life.

Tag teamed by my dietitian and therapist

Monday mornings truly are something. I see my dietitian and therapist back to back, before heading to lectures at 10:30 and 12, then lab at 2. Yesterday marked the third week of this schedule. While I am extremely thankful to be back with my dietitian K, I did not expect how she and R work together each time.

It goes like this:

  • I see K at 9, talk about how I did with the MP, exchanges, challenge thoughts, and make ~3 dietary goals
  • R comes in at the last-minute or two and K tells her what we’ve talked about
  • I have a half hr session with R where we talk in  general sense of what’s going on and then make ~3 goals regarding whatever I need to work on

Today went a bit differently. I have been slipping the tiniest bit when it comes to number of exchanges. It has a lot to do with change and school stress, but it is still considerably higher than where I was last year. We talked about that and she stuck with my same mealplan, despite Ed’s protests. Side note: I was brave enough to tell her how I manipulated my dietitian last fall with exchanges. Our long-standing goal is my exchange values. The second goal is eating in the dining hall 7x, which means I get one meal off. I’ve done better the past week with this, compared to eating there maybe 7 times the first 2+ weeks. Our third goal I protested. After clinicals last week, we stopped at this farm stand/bakery/corn maze place right nearby. They have famous donuts and everyone there bought one, minus me. FV also supposedly has the most wonderful desserts. At lunch, I was the only one who didn’t try them. K and I went back and forth about which of these needed to be a goal. She voted both, but I finally decided on the donut. Neither of them are easy, but it seems more doable. I reluctantly wrote these all down and headed into therapy.

We talked as per usual, mostly about my weekend highs and lows, BB stuff, and then worries towards returning to the hospital. I brought up lunch again because that is one of my big stressors. I ended up mentioning the whole dessert thing, and I swear it was like a lightbulb went off in her head. She didn’t say anything, but the way she smiled led me to guess something was up. The second I got my paper out for goals she told me she has the first one: eat a dessert at FV. Usually her goals don’t deal with food, so I immediately tried to challenge it. I explained that I was already supposed to do the donut (which she already knew, of course) and this was way too much. R didn’t budge, so I finally agreed. She seemed pleased with that and we continued a few more goals involving talking more to a support person and using skills at the hospital if needed for anxiety.

The funniest thing was when I was walking down the hall to leave. K came out to tell me something and R immediately blurted out how I am doing a dessert in addition to my donut. They looked so happy and a little mischievous, ha. I get that I am supposed to be challenged and everything, but I’m definitely not happy like they aer with this week’s goals. I’m still going to try. At the very least I will grab/buy the challenge food.

My two team members having this close relationship in regards to my well-being is something I actually appreciate. I no longer have to be the one to explain what one said to the other. I know I’m receiving the best possible care they can both offer this way. I’m certainly not allowed to slack, though!