Last day of IOP?

I’m really scared going into today. As I sit here typing, the IOP team is deciding my fate. I learned yesterday that this would be the case. It’s been a long time of (in their eyes) me needing a higher level of care but avoiding it. I am 95% sure they’re going to recommend PHP and I have little fight against that. I could technically refuse, but I also just can’t. What choice do I really have when they’re not going to let me continue IOP?

I’m guessing that either today or Monday will be my last day, and then I’ll be forced to start partial. I’m so scared for a million reasons. It may be the least disruptive option for treatment right now, but this is going to be terrible all around. My parents are going to freak and yell and scream and try to refuse. I truly can’t afford it at all. Not only is it expensive (though at least covered by insurance), but I would have to quit working or cut back by a lot.  I don’t know how Im going to continue paying for treatmdent in general but that’s an added stress.

I’ve been trying my hardest to avoid answering the main question on everyone’s mind: can I make this on my own or do I need a higher level of care? I think the answer may be no, but only because of time constraints. I have 5.5 weeks until school and I guess it might not be possible to get to a good enough place by then. I haven’t told anyone this and can’t even accept it myself.

I want to shut down or skip treatment or not ever show up again. Part of me still hangs on to the hope that things will get better, so I am going to try. I am at least making myself stay for lunch. If I can’t handle everything after that I won’t push myself. There’s a lot of stress and hard decisions coming and maybe a break for the rest of the day would be okay.

My only hope is that somehow things work out and that it won’t be as bad as I think.

“The day”

The funny thing is, I asked for this. I presented a more in depth take on my treatment history, specifically the summer of 2015, to my team some weeks ago. I skated by that entire summer. Did I need a higher level of care week 1, maybe not. But then NTS camp came and went. My level of struggle at that point, early-mid July, was enough for treatment. I fought hard. Legally, my therapist could do nothing except coax me into telling my parents since she didn’t have a release to talk to them. I used this position to run my own treatment until I hit a major crisis point. By mid-August, I no longer had the luxury of over a month to cushion between then and moving in to college. I had maybe 12 days by the time I told my parents that I was struggling hard and needed inpatient. I spent a week at the hospital then went to orientation a couple days later. That wasn’t truly enough since I ended up in residential a few months later. I’ll never know for sure; however, there’s a chance that it could have been prevented if I had gotten help when I was knee deep in the hole instead of consumed by Ed.

I know how bad that summer was. Ending my last week with a psych hospital stay really stunk, but everything that came before was miserable too. I looked like a normal person, acted like I was perfectly wonderfully fine, but really felt dead on the inside. I honestly can’t remember much of that time other than NTS camp (mainly from pictures). Someone was asking me at work how different things were the first summer v now and I couldn’t think of a whole ton. That makes sense considering I was passing out while cleaning showers and not at all fueling my body. The only other memories are from inpatient. I never would expect every day to be some amazing adventure, but I longed for a summer to look back on fondly.

Another huge goal from the very beginning was to get back on track and into a healthy place for fall. I always struggle at the start of semesters or other areas of big change, so I need some higher ground to fall back on. I took the recovery focused step to tell my team that I wanted an end date, a time where we would seriously evaluate my progress and see what should happen. Monday July 9 worked great, since it was after we returned from Ludington and about halfway through the summer. I basically promised to consider whatever recommendation they might have. Part of me now really regrets asking this of them at all.

For probably a month now my team has had parameters where, if met, I would have to be honest about my struggle. I never hit that but it had no effect on the number of times this was brought up. There has been a lot more serious talk lately, so many “if, then’s” and possible outcomes. I’m not sure why I still expected different today.

We didn’t take the hour therapy appointment to talk through my vacation and other ups/downs of the past two weeks. It was briefly touched on and then R started on the part I didn’t want to hear: she and K both think I would benefit from a couple weeks in partial. It isn’t a set in stone, this is happening for sure thing yet. I’ll have a week still to figure this all out. The first step would be talking to my parents about how I’m struggling. Ideally, I apparently should have done this weeks ago at least. The second step is PHP (partial hospitalization program – around 7 hrs a day). I offered an alternative of C. none of the above. I have a million and one reasons (excuses?) about why neither work. They don’t buy it at all. I saw that coming, of course.

I have a week to figure this out, or as I say get my shit together. There are a couple options here: accept their plan(s) and my inability to handle this, come up with an alternative that will actually be approved, or make some major progress. I felt about .03% hopeful until K squashed that with my goals for the week. They seem really lofty and not something quite possible. I’m not sure if she thinks I can do it or wants to show that I do need help. Regardless, I know this is going to require a lot more effort than I’ve been giving.

I don’t have a clue where things will stand in 7 days. I could be heading into a fun picnic lunch (super excited about this actually) and then a less painful dietitian appointment with therapy the next day. On the other hand, it could be devastating and hard and result in a call with the place I swore I would never be back to.

Yes, I can technically refuse any and all recommendations, but I don’t know that I have a ton of power in what happens from here. Even my best effort may not be enough of a push. I could be kicked out of outpatient.

I want nothing more than to keep outpatient, working 4-5 days a week, enjoying some freedom, and taking time to relax. This may be the best possible time to go through treatment and big change. Maybe, maybe, I might benefit from telling my parents or doing PHP. But it could blow up in my face and be terrible. I guess I won’t really know until something happens.

For now, I will be scared and stressed and unsure. It’s all I’ve been thinking of for nearly 14 hours. I need some sleep, and maybe motivation in the morning. I’ll have a nice full day of work to check out a bit and then star figuring this out later. I can’t promise myself that I can fight, but I can make sure to at least consider all of my choices and not just the one I like.

More than just a bad choice

*this was written almost entirely last week but I’m just getting around to posting it

It has been a day, and I am just now coming up for air at nearly 2 am. There was a lot of good, and I’ve been overly focusing on absolutely everything BUT what I should be. I’m ready to do the work and unpack a little.

Exactly what happened doesn’t matter. I don’t want the specific behaviors/overall situation as the focus. Sure, that matters to an extent. I can discuss that part with my team or not at all. Right now, though, I want to look at what this all says about my recovery.

This morning started off well. I got to sleep in and I was really excited about seeing my friend (now coworker!) and then suffering together through an orientation thing. I started thinking about the day which of course included meal planning. That’s when the ED voice started to grow. By the time I had to leave and grab food, i was in a constant battle over what to do: choose Ed or recovery. Ed won. A flood of different emotions came. It’s always like that with behaviors. The ED side is prideful and euphoric, when deep down I know it’s only hurting me. I have a hard time knowing how to feel with so many conflicting thoughts.

Once I returned to my home, I could have completed a behavior chain, dusted myself off, and kept going. Instead I continued to be pulled in Ed’s direction. It wasnt about one bad decision anymore, but all of the consequences that piggybacked off of it.

The entire day has involved at minimum background noise from the ED. Many points brought overbearing thoughts, like around dinner and towards the end of tonight.

Ed promises that he will shut up for a while if you only do xyz. That’s not the truth for me. Restriction and behaviors only leads to more of the same. I have to get out of this cycle before it ends with me going back to treatment. What happened today cannot repeat again and again. Tomorrow, I will fight this more and be stronger. I will feel the fear and do it anyways, as one of my favorite therapists always says.

“That person”

Before I start this post, I wanted to give a little clarification (that will make more sense as you read). I in no way, at all, feel that those who are “that person” struggling are bad people, weak, or anything else negative. I have compassion and empathy for them, and I get how hard it can be. When I’m talking about how I feel being “that person” is a negative thing, this is solely my perception of MYSELF. I’ll explain that more, but I just want to clarify how these thoughts/feelings/judgments I’ll be sharing don’t apply to others. It’s a very personal fear.

“Emily, it’s time to get your Ensure”

“All of my clients are kicking butt, but it doesn’t sound like you have been”

“I’m doing pretty well.” “Me too!” “How about you Emily?”

“Are you sure you wouldn’t like to eat with the group and have more support?”

These are some of many blurbs I wish I never had to hear.

I have had 7 supplements in the past 4 weeks at IOP. Four of those have been in group because I couldn’t manage an entire lunch plus supplement at one time. I hate it.

Sometimes I wish things were like when I was in PHP the first time around. For whatever reason, I felt very comfortable in my struggle then. I wasn’t concerned with being this perfect person. I allowed others to see my struggle. I didn’t finish meals because I couldn’t always handle that at this point. I didn’t for nearly two weeks of lunches. Despite all of this, I never felt embarrassed or wrong because of it. There were others doing way better than me, some around the same, and a few having a really hard time. I didn’t pay attention to that, though. The only way I judged my progress (somewhat) was when it came time to meet with the psychiatrist, and that’s only because he held my fate. If I didn’t improve I would be forced inpatient. Luckily, I kept making progress and that never came up again. I felt proud of myself at the end and that was it.

I don’t know if I was naive or truly didn’t care or something else, but the next time I found myself in treatment yielded different results. I was inpatient the last week of summer before I moved in to Calvin. I knew I had basically zero time and I wanted to make the best of it, since I figured a week IP would be a cure-all. I decided I absolutely was not allowed to refuse any Ensure, which quickly became never be offered one. My reasoning for this was valid: there was a serious threat to my schooling if the doctor felt I wasn’t making progress. It was a mix between the motivation for school and drive to just get out of there that helped me that week. I don’t think I fully realized what changes my decisions then made.

Fast forward to residential round 1, November 2015. I went in with a completely different attitude. I (falsely, oh so falsely) believed that being “good” was going to get me moved up levels/further into my recovery. It was then that I decided I would never do anything that could come with a consequence: not finish a meal, get caught using a behavior, failing to complete a snack pass, etc. Again, some of this came from a valid and reasonable place. I did want recovery and I was putting in the hard work. I even earned the nickname “Challenge Queen.” My drive for perfection mostly helped my recovery to a point, and I never did get offered a supplement or forced to do a chain analysis.

A year went by and then I began coming to groups then IOP at my current treatment center. I’m not sure why, but this only increased the shame when I showed I was struggling in any capacity. There were countless meals/snacks where I was having a really hard time but looked fine to everyone. Everyone assumed I was doing okay because I never said otherwise. One time that stands out is when we had a random food challenge. It wasn’t a snack or anything, but we were each given a bowl with peanut butter, a couple of apple slices, and some pieces of chocolate. I was terrified. I hadn’t eaten peanut butter in a long time. Instead of reaching out for support, I choked it down. I finished a little before everyone else. One person was particularly outwardly struggling. I remember her saying something like “I’m the only one having a hard time.” This was far from the truth, but I couldn’t own up to that.

This summer I tried to let go. I challenged myself to be more open about how I’m really doing. I knew that my recovery depends on it. No one will know what’s going on unless I tell them. It took a lot of work and vulnerability, but I slowly began to speak up. Much of the time this was with staff and not the other girls, but that’s still a huge step for me. By the end of the summer I was no longer afraid to be “that person,” and I truly wasn’t. I found strength in recovery. I didn’t struggle like before, so I had no reason to be dishonest. I felt safe to share. I am truly proud of myself for how much I faced my fears of being imperfect.

I have been terrified of being “that person” again for a few months now. I think it stems from how much I’ve slipped backwards when I *should* be far into recovery. I don’t want to show that I’m struggling. I avoid the topic if at all possible and I’ve flat-out lied to so many people. I find it hard to share the truth in a group setting (although I can with my treatment team). Often times what I’ll talk about in group one hour after therapy is a completely watered-down version of the truth. That way, I don’t bring attention to myself. I can pretend and fit in with how others are doing.

Drinking my supplement in art the past 4 weeks has cracked open my facade. No one is given these just because. It’s an obvious clue that someone isn’t doing the best in recovery. I’m embarrassed, ashamed, disgusted with myself. I’ve wanted to cry every single time, but that would draw attention to me, too. So I sit there and pretend that it’s all fine, hoping no one else will notice.

I have been terrified of what consequences would come if I dare spoke my truth. Wouldn’t that just expose my brokenness and lead to judgments? While some EDs desire to be the sickest in the room, I am the exact opposite. I would rather no one know anything and keep the disordered parts all to myself. I hold in a lot of guilt and shame this way.

In order to put off this image of doing well, I am ignoring some of my core values: namely honesty, connection, and authenticity. Without exposing some of my truth, I am choosing to hide behind my fears of being “that person.” This is only harming me. I don’t need to share every intimate detail of how I’m doing, but I think it would help to at least  open up a tiny bit.

First, I need to let go of my belief that perfection is necessary in recovery. I don’t need to have it all together. Why else would I come to these groups? I’m not there for ~6-8 hours a week for fun, but to grow and get help. I can only receive as much as I decide to.

If I don’t judge others when they’re experiencing what I am so afraid of, why am I holding myself to these standards? Why am I so convinced that the truth is going to prove I’m a terrible person? It’s time for me to challenge this. I can leave space to struggle. It’s okay to be “that person” sometimes.

Is this relapse? Plus treatment lately and a new plan of action

*I will do my best, as always, to keep anything I believe is triggering out of this post; however, I want to put a warning for the general behaviors and thought patterns that will be mentioned. There are no numbers or specifics ahead*

So.. I don’t want to be writing this post, but then again does anyone? Is it everyone’s dream to slip back into something that’s nearly taken everything from them multiple times?

I don’t see this as so bad.. but I have been in denial before. The signs are there, but I haven’t been able to admit it yet. Instead I’ll write about it here.

  • The number of exchanges I’ve had is making K and R concerned. It’s below a percentage of my CFD mealplan that’s just not okay with them.
  • It’s scarier to eat the amount of food I normally do and the maximum has been lowered. This goes along with the above.
  • Other than when I’m at home (and even then, truly) I eat the same things over and over. I actually at the same protein for 4 meals in a row this weekend/yesterday… so that’s a pretty good explanation of where I’m at.
  • The possibility of a higher level of care has been mentioned more than once. I hate that. Bring on the guilt/shame…
  • I am hungry. I know this sounds weird to determine how well I’m doing, but I haven’t had hunger unless I’ve restricted since this summer.
  • Going along with the hunger, I feel full much faster than before. This has to do with the amount of food my body is used to which is much smaller than before.
  • Some physical symptoms have returned or worsened: feeling cold, hair falling out, dry skin, dizziness, headaches, weakness. I also have a hard time with concentration and thinking in general.
  • I’ve always loved yoga, BUT it may be getting out of hand at this point. The intensity has increased as well as the amount. My team isn’t happy about it and I see Dr. C this week so I’ll know of any changes then.
  • My weight is down. This is not an indication for everyone. For me, it is. Once my weight gets to a certain range, I end up in treatment. Note: this weight range is well above underweight, just proof that you don’t need to be a low BMI to be sick enough for a higher level of care. If it continues I know somehow I won’t make it outpatient. Still, I have a certain “healthy” goal for myself, so I’m stuck and Ed is enjoying this decline.
  • Many (most?) of my waking hours are controlled by ED thoughts. They’re in the background always. R once told me you can have close to 12 hours of disordered thoughts per day and I would say I’m getting there.
  • Rigidity is getting worse. I have to do things exactly the same to feel in control. This extends to everything from specific exchanges per day to amount of exercise.
  • The last time I ate out was on Thanksgiving and I felt like I was going to die just by going there. I was intent on skipping church 2 weeks ago because my parents wanted to do lunch out. I faked sick until they finally decided against going.
  • Once again, I am staying in my room more and more, I haven’t even gone to the library to study or something just to be somewhere else. I also have skipped all floor dinners and eat alone too. I was already pretty isolated before but it just gets worse when I’m more into the ED.
  • Rationalizing is my current superpower. It’s okay I skipped X because it’s close to X meal. This was just one bad day. A little weight loss is fine. I can find an excuse for anything and everything.
  • Spending time at home brings lying, manipulation, and lots of sneaking around. I don’t want my parents to know what’s going on. The idea of having to eat more there is terrifying, so instead I find ways around that.

I don’t know exactly what to do right now, but something does need to change. My future is on the line now. It isn’t like Fall 2015 where I could take off a semester for treatment. I’ve not yet come to terms with all of this. What I do know (and don’t want to admit) is that this is relapse. It isn’t just “not doing well” or “struggling some.” It’s time for me to get back to a stable point where I can start spring semester in the best health possible.


 

I’ve had 2 very hard days of treatment. Thursday was a little bit of a wake up call. R had some no BS words for me. On my red, yellow, green, and in between scale, she believes I am now firmly planted in the red. This means full relapse. I do have one category after red, which is when treatment becomes necessary and nonnegotiable. She also said I cannot stay here, especially with the real semester starting so soon. After this we talked about what my options are currently. I ended up deciding to step up groups on the two days each week I am already there. I don’t fully want this or believe I fully need it, but I’m agreeing because waiting will only make things worse. Spring semester is coming fast. I have to be stable. The only real goal she gave was to increase by 1 exchange until Monday and then add another exchange. That didn’t really happen..

Yesterday was rough. I knew it would be going in. I had no doubt that there would be difficult conversations and possible ultimatums. I wanted to tell myself this wouldn’t happen, though. I wanted to prove to my team that I didn’t need the extra support. That didn’t work one bit.

First, I met with R for lunch and therapy. I barely had the right amount of exchanges for the meal and had to many Ed thoughts to finish. In IOP I would have been given a supplement. Here, she couldn’t force me but reminded me of that fact anyways. She was concerned with my exercise. Her emphasis on weight is that it’s not the only thing they are considering. I know this logically, I just don’t believe it. Unfortunately, she will also be contacting Dr. C so she’s in the loop about my treatment plan and struggles. The message she tried to instill in me was needing to trust my treatment team. I absolutely agree here, especially with K. Why would I ever listen to someone if all I see if them lying? I’ve got to work through these Ed thoughts that tell me otherwise.

K and I met right after. I really liked a metaphor she used. If you imagine a raft in a river, it will continue floating down the river unless you do something about it. You can paddle slowly and stay in place, or work really hard to swim up the river. Recovery is like that. Without the hard work, you aren’t going to make it. She was not happy with my weight or the way that I keep rationalizing/arguing that it’s okay. I was pretty surprised to hear that, in her opinion, if I drop much more I could be put inpatient (or residential). My immediate reaction was huge disbelief. I still don’t get that at all, especially if it were inpatient. Like I’ve heard (and hated) before, my healthy weight for my body probably doesn’t fall here. It’s a bad sign if the only way I can maintain it is by doing what I am now. Another interesting point she made about weight is that she would never want me to continue gaining. Sometimes that’s all I have believed about dietitian’s goals for me. I need to bring up my exchanges, and even though it isn’t much I feel hopeless/fearful/disgusted about the increase. Like I’ve heard a lot lately, she ended with reminding me that I cannot survive here, at least not for long.

After both appointments I joined back into the group one of my favorite activity therapists I have ever met was running.  I’ll call her K-AT here to distinguish between her and my dietitian. She’s known me for even longer than R, ever since my first FV days. The other two girls left the room for about five minutes, and she took that opportunity to have a little heart-to-heart. The first thing she did was ask me what I am doing here. I knew exactly what she meant. Honestly, I don’t really know. It seems like It’s been getting worse for a long time but also all at once. She fully believes in me and said that I can turn this around, I have it within me, and I need to remember that I am going to be a nurse. She reminded me that I am a child of God and so loved, needed, a masterpiece, and fearfully and wonderfully made.Another thing I really appreciated was that she challenged my thoughts about treatment being a waste if I just ended back here again. Despite all of the encouragement, I felt like she was almost disappointed. It was a look that I saw before, right when I decided to go to residential. I don’t think she truly is judging me or anything. My guess is that’s just her concern shining through. Our conversation started the tears. I haven’t cried in therapy since summer when my grandpa died. It feels raw and vulnerable and a little scary. I’m very thankful I was able to spend that little chunk of time with her. I know that she will also be the best person for me to have lunch with Thursday.


My new plan:

  • Monday and Thursdays will be my treatment days
  • This Thursday I have lunch with K-AT, a group where a girl I was in IOP this summer is coming to talk about her strength in recovery, therapy with R, then group therapy and art.
  • Monday is lunch with K, therapy with R, then joining in for all groups of the day. I told her yesterday to make me supplement if I don’t finish, since that would happen if I did it in group lunch. That was the brave thing to say and I have a feeling it may happen..
  • Next Thursday is my first group lunch (not excited/totally freaked out) and the full day of IOP minus therapy
  • Up until the semester starts, I’ll continue with this schedule. After that, I have Thursday’s free. It may be a full treatment day, but nothing has been talked about yet.
  • Basically I’m doing IOP two days a week without calling it IOP and being pulled out for therapy/dietitian. This means no switching to the IOP dietitian though hallelujah!!

If you made it all the way to here you deserve a medal. It feels really good to write that all out and kinda process it here while doing so. I’ll be sure to update on how everything goes and just overall progress too. This feels different than every time before, so I don’t know what all will happen.

Treading water – recovery update

*Note: this does not mention specific ED behaviors, numbers, etc etc etc. I know how not-helpful that would be to anyone, including myself. It is, however, pretty negative. I think you can tell where my mindset is and that is more in the eating disorder. Proceed with caution if you think this is something that may be triggering, although I’ve tried my best to not make that an issue here

Honesty time: things haven’t been the greatest. I’ve had some slips and am more stuck in eating disorder ways than I was a few months ago.

Right now it feels like I’ve been thrown in the deep end of the pool and can’t swim. I’m able to tread water and stay stable, but I can’t remember how to swim and get myself to safety. It isn’t that I’m sinking or don’t know how to swim at all; it’s a lack of immediate knowledge of how to get from point A to point B. I’m also not really motivated to get to point B anyways, because point A seems like a good place to be. Another important thing to note is that I’m not drowning. I am not in immediate danger, but treading water for too long isn’t good either. I’ll get tired and eventually not be able to keep myself afloat. I may need someone to rescue me and throw in a life preserver.

This metaphor is about as close as you can get to how I’m feeling. I’m not in relapse. I am in the warning stage. On the scale from green to red, I am sitting at around an orange, so about a step above true relapse. The ED is trying to convince me that I can lose a few pounds. I can live off this amount of food. I can continue to use exercise in a negative way. Deep down I don’t believe that as much. K and R always remind me that it’s a slippery slope. What starts as some ED coming into the picture can snowball. It’s not really possible to believe the lie that you can get a little thinner, a little more into Ed’s rules.

My appointments with K and R have gotten.. interesting? Not as tolerable? More serious? Honestly just a mixture of many things. Today I met with both of them and as time goes on they seem more concerned.

K (dietitian)

  • I have a minimum that if I don’t reach I’m *supposed* to drink an Ensure (hahaha yeah not happening), but naturally I haven’t met that and am not forcing myself to drink a nasty bottle of chemicals. Now my maximum has been going down little by little. I stayed relatively stable this week, but it is lower to a point that my new goal doesn’t even include the minimum I’m supposed to follow. Basically it’s not realistic anymore because there’s no way I’ll do that when I haven’t hit it in maybe a month?
  • My other goal is to have more afternoon snacks. As always, my ED means cutting down on eating and morning and afternoon snacks are typically the hardest.
  • As per usual, I’m having a hard time with negativity. I tend to get in a place where I just feel like a complete failure. She had me try to list 2 positives from this week and it was honestly one of the most difficult things I’ve had to do in the past week. (Is that sad? Perhaps.)
  • I’ll admit, I have been using yoga in an unhealthy way more and more. This isn’t new to me and I’ve been here before. Actually, the last few times I’ve relapsed with exercising it has consisted at least half the time of yoga. Anything can become maladaptive with an eating disorder, apparently. Given this, K wants me to spend one day doing completely “normal” and gentle yoga. I may or may not be too happy about this.
  • For the first time in a long while, she told me that weight is not even the most important factor at this point. It’s something I’m pretty heavily focused on, but she has other markers. For example: physical symptoms like dizziness, amount of restriction, amount of exercise, type of exercise, level of Ed thoughts, etc. For some reason this surprised me a bit because I tend to judge myself by weight or size.

R (therapist)

  • I am convinced that a certain weight I want to get to is healthy, because BMI-wise it definitely is. I feel like that is reasonable and would make body image better than it is currently. R went back through my weight history since I began coming there a year ago and told me that when I get into x range, I have ended up in treatment. I don’t want to accept that my body would be more comfortable at this higher weight. Note: I don’t actually know my weight (minus when I saw it a couple of weeks ago at the Dr) so all I really am aware of is if I’m losing.
  • I have a ton of distrust in my body and it’s somewhat carried over into not trusting my team. I feel like they could be lying to me and how would I ever know that?
  • She has seen quite a bit of downslide in the last month or so. It hasn’t been super severe and is generally slow, but it’s there. If it continues… (fill in the blank with options I am not too fond of)
  • I may not be able to continue EMDR much longer if… I continue restricting and/or lose weight, since it would lead to a state where I cannot concentrate enough or have the mental energy to work through things. As much as I have a love-hate (mostly hate) relationship with EMDR, I know that it needs to happen. I can’t be held back by this any longer. It’s frustrating already to feel pretty stuck on this target, but knowing I could be forced to put it all on hold is scary. It feels like I would be giving up entirely.
  • We talked about my goal once school ends (in 10 days!?!?!), which is to maintain how I’m eating and exercising. I don’t really want to challenge everything too much, even if I will be away from much of my stressors. Stability is safer. She is concerned about this, given how my body is reacting, but I think it’s better than alternatives like just giving up the recovery piece.
  • I may be closer to relapse than I really think. Last week she mentioned I may be in the orange, so this past week I wanted to prove that wrong. I checked off every symptom I have currently from each grouping (green, yellow-green, yellow, orange, red, rusty-red aka needs treatment). I have way less in the green and much more in yellow, orange, and even red. I am a little shocked. I get into the mentality of I’m not that bad and just ignore the signs.
  • Every single time I see her (and K somewhat), I end up convincing her and myself (one of us doesn’t quite buy it) that this isn’t anything to worry about. How do I master this? Comparison! I can look back at 2014, 2015 x2, 2016, and 2017 to compare now and when I’ve previously entered treatment. I am not doing as poorly with my mealplan/eating in general, still managing school, at a healthy weight, and not currently slipping at a fast rate (actually I’m relatively stable for the last week or so). No matter how many times I hear differently from them I just can’t buy it for whatever reason. I think the Ed voice is just so strong and convincing that I have a hard time considering the other side of this.

Although I haven’t done so in this long, jumbled mess, I have been making it a point to separate out the Ed voice vs my voice. I figured it may be a tad confusing for it to happen here. I can recognize the unhealthy side, although that’s getting harder. Once of my assignments I find helpful is putting Ed thoughts or rules and reframing them. That starts to give me a new perspective.

Reading this back now, I can tell that things aren’t all great and unicorny and whatnot. I am struggling; I’ll admit it. Treading water has not been a fun thing. When it goes on for over a month, nearing 2, exhaustion sets it. I have slipped some, with the most change coming in the past month (according to R and K). I’m finding it harder to stay afloat at this point. I think I know what happens if I actually begin to sink. I don’t want that at all. I can’t do that again. My goal, then, is to stay enough afloat and manage everything. I’m not truly aiming to get better, but if I at least maintain we won’t have so much to worry about.


That’s a wrap for now (and a long one, holy cow 1500 words). I wanted to get this all off my chest and continue to practice authenticity here. I can’t just sugar coat things. This is a true experience of my struggles. It would be a disservice to myself and anyone who reads my blog if I pretended recovery is always wonderful and the easy decision. It’s messy and that’s okay. Today my version of recovery isn’t where I or my team may hope, but that can all change. I want to document that no matter which way it goes.

Where I’m at – end of exam week 5/17

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I’m feeling vulnerable and raw, so here goes. This picture is real life right now. No filter, no editing, no posing to make things seem better than they are because it really has been a shitty time.

It’s not quite 6 am. I have been up basically two days straight, minus a few broken hours of sleep Monday night. I have barely eaten with all of the stress I’m under.  I am studying for my exam at 9 and attempting to work on a week overdue essay. I still have one more exam tomorrow and the task of moving out my entire dorm by 4ish.

I question myself constantly: how did I, a once straight-A, hardworking, enthusiastic, and successful student come to this point? The answer (almost solely): my eating disorder.

I always assumed that nothing could possibly get worse than Fall of 2015, before residential. I struggled hard my first semester at Calvin, but I gained so much momentum in recovery through treatment. Things went well up until the end of this past Fall; then enter IOP and groups, improvement, and once again relapse. I have never been so low on motivation, dealt with this amount of stress, had my depression and anxiety affect me quite this way, or relapsed so significantly so fast. This combination naturally compounded into a miserable experience, particularly the last 2 months or so.

I am surviving and that is it. I feel like giving up most of the time. My behaviors, thoughts, lack of following my mealplan, etc have lead to a pretty desperate situation. I had two choices: gain motivation and stay outpatient or enter a higher level of care. Nothing seemed to help where I was headed. Everything only intensified, leading to pretty drastic (to my treatment team) weight loss. Last week we made an agreement that I reluctantly obliged to: lose absolutely no weight through the week/in the future or I would be forced to have a phone session with my mom. Monday that’s exactly what happened.

The conversation itself didn’t end terribly. She was upset with my lies and hiding everything, but also offered her support. We mentioned a higher level of care, but she did not know I had already contacted CFD and found answers. Through the remainder of therapy and my dietitian appt my concern only grew. It clicked that even with my mom’s support I no longer felt confident in my recovery. I made the decision that afternoon to return to residential. I called her that night and began the truly difficult conversation.

Residential feels like giving up in ways. I hate knowing I need more help.. The one thing that has brought comfort is the support from those at treatment. My therapist and dietitian both are happy with my decision, although they wouldn’t make it for me. Group was also very affirming today. It is the right choice. There will never be a good time to go away for treatment, but this is my time. I am too exhausted, too sick, struggling way too much to function. It’s time to put recovery first and begin to break free once again.

 

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.

 

It’s over (!!) and will be for a while

As of this past Monday, I am officially done with school for the semester. I doubted the entire last 2 months that I would even finish it. I wanted to give up. Sometimes, I wish I would have. No matter what ended up happening, I did make it and I didn’t fail any classes or do bad enough for it impossible for me to make it into the nursing program.

This was my hardest semester. It isn’t easy to complete homework, study, or take tests when your body is malnourished and brain lacking the carbohydrates it needs. No matter how much I know logically, Ed still won a majority of the time. I spent more time taking naps and thinking about food than all of my schoolwork combined.

My whole treatment team has told me the same thing: you have to be stronger in your recovery if you want to successfully complete nursing school. Dr. C talked about how I can’t be so used to lying and cutting corners as I enter into the program. It isn’t okay to hide my struggles and carry it over to my schoolwork then eventually my job.

I will go into this in a future post with my thoughts on everything, but as of Tuesday I will be on a forced medical leave for the interim (J term) semester. I honestly was pretty shocked when Dr. C told me this. She was very close to forcing me inpatient or residential. For now she is agreeing on IOP, assuming I can make progress . This next 5 weeks or so are going to be spent in treatment 3 days a week. I will be able to stay on campus still (which isn’t typically allowed but Dr. C set that up right away).

I have to work my butt off if I want to start classes again for spring semester. It’s scary and hard and I’m not sure I can do it, but I am going to try. Goodbye fun interim class; hello, all of the groups, appointments, challenges, and (hopefully) growth.

 

Not doing so hot.

If “doing cold” were a thing I certainly would be there or very close. This is the worse I’ve been behavior and thought-wise since before I went to treatment. If it continues I could be back there. That’s scary.

Even a few weeks ago I was at a much better place with behaviors, but I can also see that many of my thought patterns began well before my actions changed. My body image has grown worse over time since discharge. That alone is a huge part of my downward slide. My appetite has been wacky and near nonexistent for well over a month now. That’s made me much more prone to guilt and not wanting to eat. Seeing my weight last week really started the behaviors again and multiplied ED thoughts.

I have been restricting heavily. I haven’t met close to what my meal plan is, or even the 75% goal my dietitian gave until my hunger cues normalize. In addition to that I started exercising again in a very compulsive way. Because of these things I feel weak, exhausted, dizzy, and just out of it a good majority of the time.

Its amazing how incredibly addicting my eating disorder is. I feel so high when I’m restricting or exercising, just like before. The ED is enticing. It reminds me of all the reasons I should choose to use behaviors and let thoughts grow. What I see in the mirror is constantly growing closer to something I can be okay with, so long as I continue following the eating disorder’s ways.

I know what happens down this road. It feels great, oh so wonderful, at first. You become delusional and hold on to that feeling while your entire life spirals out of control. I am not going there again but I need help.

I reluctantly emailed my dietitian the truth today. I see her Tuesday but I wanted to hear any suggestions when it comes to food and getting exchanges in somehow. My therapist has been sick. I met with a different one at Broene yesterday briefly. He encouraged me to go back to all of my skills again. I am hoping to meet with S tomorrow. I really need her no-BS push in the right direction. I have been honest with a few people. My last two days at school before the weekend wont be as secretive as it has been.

I have work to do if I’m going to move out of this cold spot. Recovery is never easy in the least bit and its like I’m just now seeing that for the first time.