I doubt this blog post will be up to my usual high standards, given it is being written on my phone, sat on my bed on the psych ward and its not yet 6am.
I slept well last night, a full 7 hours without moving thanks to becoming “agitated” last night and that being dealt with the only way the psych profession can- I was drugged into submission. Whatever gets you through the night and all that eh?
So what’s this post about and did she mention “a confession?” I’ve read this blog start to finish and can clearly see that Zoe has shared everything but bowel habits since her journey into the world of mental health began. There can’t be anything she hasn’t told us can there?
Well there is. I never wanted to tell the world about it, initially I didn’t want to tell anybody about it. I’m doing this so that all of my lovely friends who live in Twitterland and who did such a good job of showing me love, care and concern last night can understand why I find myself so distressed in my current situation.
As you know I am back on the psych ward, have been since expressing an overwhelming desire to take my own life on Friday. I think an explanation of the why’s for that one deserves its own post so i’ll leave it at that.
My biggest, most severe and pervading mental illness is in fact an eating disorder. I have been eating disordered for as long as I can remember. Symptoms and severity have varied over the years but it was something I “needed” to give me a sense of control (in place of feeling in control of my thoughts and emotions) as is the case with these kinda dodgy “coping mechanisms” they ultimately turn on their heads and grab all the control back. One day you find yourself very very stuck.
I am very very stuck.
I do not meet the diagnostic criteria for either anorexia (too fat) or bulimia (don’t eat enough) so on paper, in spite of having so many other psychiatric diagnoses I do not have an diagnosis of an eating disorder. How I wish this were true.
So far my fictitious eating disorder has caused significant and rapid weight loss, severe cognitive impairment and a host of physical niggles that could be nothing today but cardiac arrest tomorrow. Certain knowledgeable members of my team are very concerned, as they should be.
The problem is that my BMI is simply not low enough to access specialist help. Though we pseudo anorexics do love a challenge and I’m working on it. That was flippant, I’m not trying to starve myself into treatment I just have been consumed by an eating disorder, its winning.
Since I began treatment for my MH problems I have always listed the eating disorder as my main problem. Again since the start of this admission I have openly shared all the gory details with two psychiatrists and several nurses. I had my holistic assessment done for my care plan last night and was open and honest as usual- I stated that my number one problem was my eating disorder. I even provided details (I haven’t eaten a thing since Tuesday, I feel ill and freezing) it is clear to anyone who sees me in real life (well that’s what Twitter phobes like to call it) that something is very very wrong.
NICE guidelines are very specific on what ones BMI needs to be in order to qualify for specialist ED treatment and local care pathways follow the (not so)NICE guidelines. As things stand I am 3 “BMI points” away from qualifying as a real live(!) anorexic. It appears that the health profession are unalarmed by how rapidly I am approaching this benchmark. I won’t even attempt to elaborate on the effects of this illness in my life and family, let alone my body. Early intervention may well be the key in the successful treatment of EDs but in truth nobody is that bothered.
In the community I am blessed with the best team of MH professionals a skinny, mental girl could wish for. The problem is that these lovely people need the back up of specialist ED services in order to allow them to help me. But again, I do not fit criteria.
Anybody who knows anything about eating disorders will know they are nothing at all to do with weight or BMI. Sadly this common sense approach does not apply when accessing specialist help. If I had the energy this would be my main campaigning area. As things stand I barely have the strength and energy to brush my hair.
But Zoe, you’re in a psychiatric hospital, they treat mental illness and eating disorders are a mental illness! Rejoice, you are saved!
Alas no, as I was told last night, same as I was told during my admissions to a similar (though inferior) institution last year “we can’t really help you with that as we’re not a specialist eating disorder unit”.
So I’ve done my bit, been open and honest about behaviours and symptoms, I have even said “I am totally out of control and need help” but the only ones listening (my fabulous team on the outside) are having diagnostic criteria, ED care-pathways and NICE guidelines shoved in their faces at every turn. For almost two years the fantastic CPN has been fighting to get the right help. I do have a very lovely dietitian but she is not a specialist dietitian and though she had shown to be knowledgeable, professional, caring and compassionate, she is well out of her comfort zone in trying to treat me. I have being seeing a fab therapist for months but the truth is i’m always just a bit too malnourished to take much away from sessions. In order to do the work I need to do in therapy I need to learn how to feed myself properly
So there you have it in a nutshell.- I have an eating disorder, its bad and the effects on my fragile mental health are huge.
- my body is eating itself
- I am stuck and I know it. It’s not quite as simple as “just eat something” I wish it were.
- in order to qualify for specialist treatment I could lop off a limb and lose a few kgs that way or I can simply carry on as I am which based on recent information suggests I will meet the diagnostic criteria for anorexic nervosa in approximately 6-8 weeks. I wore size 16 clothing in January (thank you anti-psychotics) I am too ashamed to admit what size my trousers are now. Of course over those 6-8 weeks I will become more and more likely to become seriously physically and mentally impaired. It does seem to me though that this is exactly what will need to happen before anybody steps up to offer appropriate care.
There is so much more I could and probably will say about this now that I have “come out” but for now I must put every bit of diet coke and tea fuelled energy I have into sorting this out or it is going to kill me.
When I was reassessed by the psychiatrist yesterday in an attempt to get the constant observation lifted. I told her everything and also pointed out there was no point in my being here as I couldn’t get the help I needed. She fluffed about for a bit and suggested I spoke to the consultant on Monday and “maybe he’ll be able to do something”. I simply replied “I wouldn’t put money on it”.
I just felt that you all deserved an explanation and I can see that you all really care which is very touching.
If anyone who reads this fancies a bit of specialist MH activism, feel free to get in touch.
And anyone reading this that has the spare tens of thousands of pounds to put me through private treatment, please do get in touch!