Setback *Triggers* *SU SH triggers*

[Paula]

"Occasionally, someone with anorexia may refuse treatment even though they're severely ill and their life is at risk.
In these cases, as a last resort doctors may decide to admit the person to hospital for compulsory treatment under the Mental Health Act. This is sometimes known as sectioning or being sectioned."

That's a quote from the NHS website http://www.nhs.uk/Conditions/Anorexi...Treatment.aspx

It seems clear section would be a last resort. The trouble is, hunni, is that it doesn't matter what the reason for you not eating is, unless you start eating you're going to become severely ill so they have to prioritise that regardless of whether it's anorexia or depression. If you don't want to go to hospital, you have to eat and keep sustaining a gradual weight gain.

[JustEM]

Thanks for sharing the link, Paula. I know that sectioning is definitely a last resort. I feel less anxious about it today because I've been left to my own devices. I know I will feel more wound up tomorrow when I have to meet with the ED services. I guess I'm just afraid of having all control taken away from me. I'm afraid of the ED services because they have the authority to section people.

The reason for hospital admission would be for tube feeding, but surely if it did come to that and I said I would drink the calories with supplement drinks (I could not eat that amount of calories. That would overwhelm me totally) then they wouldn't tube feed me. Surely the doctors would only tube feed someone who was refusing to take in calories by any other means. Obviously to avoid tube feeding, I would have to comply with the drinks which I am sure I would!

I feel I really need to talk to the nurse who runs this gastric ward about this. I will also ask the GP on Friday when I increase my medication. I need to know where I stand. I don't trust these ED services.

There are options to explore before hospitalisation, too. I could be a day patient somewhere or ask the ED services and CMHT to provide meal support not to support me with eating but to make sure I actually eat. Not a route I want to go down but better than a tube all the same.

I've said I've started on the supplement drinks again. Chucked it down the sink this morning and I know I will do the same tomorrow. If lying will prolong admission, then I will simply have to lie.

Also the sertraline is making it hard to eat. I feel nauseous to the point of wanting to vomit. Last week I was so full of energy but the last few days (and even more so today) I feel totally drugged and sedated. All I want to do is sleep. In a way, it's a real comfort because sleep can be an escape but excessive sleeping as an escape was a long-time symptom I thought I had overcome.

Job interview tomorrow though just for a few hours on the weekends part time. The gardening project have also arranged for me to go there and meet them. Going to call to check availability for the reflexology course just now, too. So hopefully having little things in my life will help me and I really hope these pills work too.

[Paula]

Hunni, you need to stop lying about what you're eating. You can't fake it if you're losing, or not gaining, weight so it's pointless lying anyway. And all the ED staff want is to help you and protect you from this illness - they're not your enemies. Please, please tell them what's going on.

And I really think you should think carefully about the reflexology. I know how gruelling the training is and, right now, it seems to me you're not well enough to cope with it. That's not to say you couldn't do it in the future, but now might not be the right time. Please think about it

[JustEM]

I know they'll find out about the lying eventually. I just can't help it though. It's like it's out of my control. Even today, I became so overwhelmed by my depression that I just stood staring at the sink, unable to get washed or dressed. I'm currently staying at my brother's because my parents are away and I cant bare being alone right now but it's like I'm paralysed with anxiety and depression... I can't get up and I've been hiding in bed all day.

When my anxiety and depression are worse, my eating is worse too. I haven't eaten all day. I feel sick and nervous. Don't know what the hell is up with me. Could it be the pills or just my mental health getting worse...? I was honestly great at the weekend.

The course is only one evening a week. My brother lives close by to the college and would be able to pick me up and drop me off there. They have an open day on Monday next week so I will go for a look but I will definitely keep what you've said in mind. Thanks. I don't want to set myself up to fail.

I think the gardening project is a good thing because my therapist recommended it and it is specifically for people suffering with MH issues. The part time job might be a bit much but I could try it at least. It gets me out for a few hours and I'm not great physically but it's not an exhausting job and I'm not on deaths door like! Little goals.

I've held off from big future plans. I just want to be happy because if I'm happy it won't really matter what I'm doing.

[JustEM]

I've also contacted the eating disorder charity Beat to ask advice on how to discuss certain concerns with the OT tomorrow. This charity have always previously helped me greatly so hopefully I'll feel more reassured about seeing her tomorrow. I'm currently DREADING it.

[Suzi]

Sweetheart if you aren't being honest with them then that is enough to make them think that you aren't coping. If you aren't eating you won't be getting any better physically or mentally. You know all this.
Really lovely, do talk to someone about how you are honestly doing...

[JustEM]

I know. It's like I can't stop it. It's like an addiction in a way. It's not even about weight or being 'thin' now. It's about wanting to diminish. I just want to shut off and sleep all day. Again.

I can't tell the ED services. I just can't. They'll put me in hospital. I want to be at home with my family, not on some ward somewhere. I honestly think that would make things worse. But the anxiety about going to hospital is actually making me eat less. But they're not stupid and I cant hide everything from them. I'll be glad when the appointment is over today and I'm left to my own devices and can just sleep.

My family know I'm struggling so I'm not completely alone or anything. I'm scared though and I feel really uneasy. I don't know how my MH has got to this point. I honestly don't want to feel like this.

[magie06]

If you don't want to feel like this any more, then I think you know where to start. You really need to tell them everything and even ifit's recommended that you return to hospital, what's the worst thing that can happen? You get the nutritional help you need. You get to off load things that are on your mind. Both your body and mind get a chance to become healthy again. Please take that first step.

[JustEM]

You're right, Magie. Thank you.

I met the OT today. She said when she told the ED Team Leader my BMI today, she wanted to admit me today. They even called me this morning to get into the clinic to check I was stable. It was the OT (the one I felt was against me!) who pushed to give me the benefit of the doubt and just one last chance. So tomorrow, I'm getting weighed. If I lose any more weight, I will be admitted for tube feeding. When I asked about the option to drink the calories rather than have them through the tube, she explained that wouldn't be an option because they wouldn't admit me to drink!

So, YES! I was finally honest. I told my mother and father AND the OT afterwards the truth that I had severely restricted these last few days and that I had been abusing laxatives. I drank a supplement drink for the first time tonight and didn't share it with the sink! My bloods were good last week. I'm having more done Friday so if all is well and the weight is stable then I won't have a tube! You're right, I know where to start.

The CMHT can also provide me with CBT therapy once the bmi pops up a bit more and I'm increasing the sertraline to 100mg tomorrow. I missed my job interview today due to all this anxiety but called them to say it was a 'family emergency' so hopefully another interview will be scheduled pronto!

I'm meeting with the gardening project Monday and going to a college open evening next week about a part time course so I'm choosing to live.

Everyone seems to think the medication and eating better will help beat this depression. It's the least I can do to TRY.

Thanks everyone for your ongoing support. You're an awesome bunch xxx

[Jaquaia]

That's awesome! I am so proud of you for being honest!