Stepping into a doctors' surgery, unsure of what to expect. Trying to explain the panic in your head surrounding food to a medical professional at school, yet being met with nothing but a quizzical gaze. That first appointment at the hospital, sitting there and thinking, "how did it come to this?". These feelings are summed for me perfectly by the image above, taken from Katie Green's graphic novel "Lighter than my Shadow", written about her own journey through Anorexia Nervosa.
This year, the UK's eating disorder charity, Beat, is asking people to focus on the importance of early intervention in ED treatment , for Eating Disorder Awareness Week. Whilst in the UK the NHS is a wonderful thing, it still remains a fact that roughly 50% of GPs are under-trained on mental health issues, and will not know how to help a patient presenting the early signs of an Eating Disorder (source: BBC News-beat).
In this post, I am going to share some of my experiences of early treatment for my eating disorders, along with some facts, figures, and early intervention advice.
I remember the first time that I admitted to someone other than myself or my Mother that something was wrong. I was probably 14 years old, and had what I now recognize to be my first panic attack. Sitting in a textiles class at school, I had started to feel faint and uneasy, I didn't know what was wrong with me, but excused myself to visit the nurse's office. Once there, I broke down in a cloud of anxiety, supposedly about the mock maths exam I was supposed to be facing in an hour or so. Trying to calm me down and find out what was wrong, both the School Nurse and my head of year barraged me with questions - what was I so upset and worried about? I was a good student, it wasn't a real exam, and I was usually very calm in situations such as these. Eventually, through my tears and shock, I was able to stammer out that my Mum was concerned about my eating.
"Are you not eating?", they asked. I replied that I was. I ate breakfast, lunch, and dinner. They looked at me and each other, not seeing a problem. "What do you eat?" they asked. I told them that I ate porridge made with water and a banana for breakfast, a lettuce sandwich and an apple for lunch, and a small meal for dinner, that I always cooked myself. No snacks. They still saw no problem.
A few weeks down the line, I found myself sitting in my family GP's office with my Mum, whilst I sat quietly and she tried to explain how preoccupied with food I was, how me crying after dinner was almost a nightly occurrence, and how I generally wasn't myself. He implied that she was paranoid and neurotic, her own state of mind being the problem, and looking past me completely proceeded to suggest that she herself was the one in need of psychiatric help. She was enraged, helpless, and distraught at how she seemed to be the only one capable of seeing the dangerous path her only daughter was on.
I don't remember how, my memories of this time of my life often being extremely hazy due to impaired cognitive function as a symptom of my illness, but I was eventually referred to the Child and Adolescent Mental Health Service (CAMHS) at my local hospital. I admitted that I had a problem, albeit that I was unaware of its seriousness, and was able to skip the 8 week waiting list for treatment due to supposedly being an "easy case". How wrong they were. My eating disorder only thrived in treatment, my diagnosis changing from EDNOS (Eating Disorder Not Otherwise Specified - now referred to as OSFED - Other Specified Feeding or Eating Disorder) to Anorexia Nervosa over a period of months. I was an outpatient between the ages of 14 and 18, narrowly avoiding inpatient treatment when it was decided that this would only serve to make me worse.
I do not personally know what it is like to seek Eating Disorder treatment as an adult, or treatment for other eating disorders such a binge eating disorder, since I never strayed into this group of symptoms, but i do know that far too many other people have had similarly hard experiences in early intervention to mine, regardless of age. It scares me, and makes me feel guilty, to think of the other teens who I skipped past on that waiting list just because lack of funding made the service look for easy (I was not at all easy) cases to "fix" and quickly end on their way before treating the further progressed cases. It angers me when I hear storied from people suffering with overeating disorders, who are just told by their doctors to simply eat less and exercise more, as if it is a purely physical health problem.
So, how are things going to change? Well, here's my little list.
- Education on the early signs for EVERYONE. Not just medical professionals - you yourself can help by looking out for changes of behavior in your friends and family.
- More mental health funding so that ALL cases get the help they deserve, in a much more timely manner.
- SELF LOVE, openness, and The Body Confidence Revolution!
And here's some more information from Beat, the UK's eating disorders charity.
- Lips - even a seemingly positive interest in food can be a warning sign. My family were delighted when I became interested in cooking, helping with the food shopping and preparing family meals. Little did we know that this would become the trademark of my very own specific brand of Anorexia. I became possessive, not letting anyone touch or prepare my food unless they were a trained restaurant chef, and would often shake with anxiety as I cooked complicated meals that I had spent hours, often 2 per night, researching recipes for in books and online. A passion for food is wonderful, something that I am happy to have again now, but obsessions are always dangerous.
- Flips - eating too much or too little has a serious affect on your moods and emotions. For myself and many others, depression, OCD, and anxiety were a co-morbid with having an eating disorder. I hate to think about how many times I snapped, shouted, and screamed at the people I love during this period of my life.
- Hips - distorted beliefs about weight and body size are things that should always be taken seriously. These should not be dismissed as "girls being girls", or as boys feeding their egos.
- Kips - being tired, sluggish, and unable to concentrate can be signs of a myriad of health problems, both mental and physical. My brain fog in class, my forgetfulness, my wooziness on the netball court, an my short breaths after climbing the stairs, were all signs that this metal illness was taking a dangerous toll upon my physical self.
- Nips - bulimia and bulimic tendencies are not a disease of the glamorous. I never had bulimia, but had a bulimic phrase for a month around my 16th birthday as I panicked at the weight gain I was experiencing was I started to slightly recover and was no longer at risk of inpatient treatment. Eating disorders can also damage, sometimes permanently, your digestive system, and I would occasionally have to take day off school because I was extremely constipated, and had to take diuretics to offer myself some relief. This being said, taking diuretics can be a dangerous substance that some ED sufferers resort to using as a way of purging and losing weight without appearing bulimic.
- Skips - exercise should above all be fun. If someone you know is exercising to the point of exhaustion and not replenishing what their body needs for survival, they are in trouble. I myself went through a phase of obsessively jogging on the spot while I watched TV every night, becoming extremely anxious if or some reason I was unable to do this. Exercise is good for you, but please find a way to do it that you enjoy. As with drinking and gambling; when the fun stops, stop.
As always with the things I post about, please don't hesitate to contact me with any questions. Also, I would really recommend taking a look at www.b-eat.co.uk or searching the #EDAW17 tag on social media to take a look at what others have had to say this week.