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What to do? Is this really anorexia or another serious mental health problem

(23 Posts)
Sistermoondance Tue 26-Jul-11 19:07:37

hi there,

My teenage step daughter (who is 14) told us she had anorexia and said she'd started stopping eating to get her dad's attention about 3 months ago. She seemed surprised and disappointed that we were not cross and just said that we'd help anyway we could and keep in whatever food she fancied to pick at. The thing is she has never eaten breakfast andhas always seemed to be poorly with one thing or another so we hadnt noticed (she had eaten a big bar of chocolate in front of me the week before (she said she was not making herself sick).

I do not want to trivialise this matter and hope people don't think I am vein flippant but I am not sure it is anorexia and think it could be more about getting attention by being ill. I am wary about making her feel worse or feel she has to stop eating and clearly the fact she is attention seeking at all means I am very worried.

She came on holiday and eat normally (in fact more than me) and chilled out and said she felt fine. But she told her mum that she'd thrown up all the sweets etc and exercised madly the whole time. I can't say for sure she didn't throw up but there was no sign an we didnt hear her. And I know she wasn't exercising much at all, so that at least is a lie.

She was referred to a cams person at school, who did not think it was an eaten disorder, but dsd said she was crap. Now her mum has taken her to th doctor who has referred her to an eating disorder clinic and she is happy. I am confused... She seems disappointed we are not angry, she discusses her disorder openly, but lies about doing more exercise rather than less and wants to go to a clinic? She worries me as she always has to have an illness worse than anyone and something always has to be wrong with her, and when that thing stops getting her attention it fades away and is replaced with something else. I am worried that her going to the clinic will encourage her to continue to not eat properly to get attention, when in fact the problem may be far more deep set and may no be addressed.
I really don't know what I can do

Any ideas of websites etc or anything I can do other than be there?

madwomanintheattic Tue 26-Jul-11 19:25:09

given that she is apparently doing this to get her dad's attention, what does her dad think? family therapy for the two of them? interesting that it's her mum and stepmum who are the ones concerned and you don't mention anything about her relationship with your dp?

tbh i'd be looking to that relationship and exploring why she feels the need to make such dramatic attempts to be noticed? (whether or not she is/ isn't anorexic or have an eating disorder)

swallowedAfly Tue 26-Jul-11 19:30:29

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swallowedAfly Tue 26-Jul-11 19:31:18

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Sistermoondance Tue 26-Jul-11 22:08:26

Thanks, she has a good relationship with dp- although it has been difficult for both of them for a while in that if he hugs her she rolls her eyes and pushes him away- so he still does it but prob not quite as much as he used to as he is not sure she wants the same affection as she did when she was a child. He tries to get her to do things with him, but nine times out of ten she'd rather be on Facebook and if he forces the issue about her coming along she is stroppy and horrid company then says she feels I'll and makes us come home again. He tries so hard to find things they can do together but she throws it back in his face. She doesn't do any chores and if he tells her off for attitude she refuses to see him. I guess a typical teenage relationship btw dad and daughter! He tells her he loves her all the time and she just pulls faces and never says it back.... He feels very hurt, but does loads for her and would do anything. She is welcome here any time and frequently drops in.

Although we didn't react in a big way to her revelations about anorexia that was because it was the next in line of a number of medical problems and we don't feel that we should go overboard in attention because of illnesses. We are sympathetic, give her hugs etc and tell her we are worried but then try to give positive attention by going shopping etc

Sistermoondance Tue 26-Jul-11 22:26:52

In fairness we do know that she tells her mum that her dad is grumpy with her and that she thinks he doesnt spend enough time with her... But we are not sure what else he can do. In fact he asked her and she said she didn't know. He picks her up and gives her lifts during the week even if she isn't staying with us. However she has got a typical teenager attitude and it is usually after he has told her off for being rude that she complains he is grumpy so we put that down to her not liking being told off! She had a lot if childhood illness which put her in hospital a lot but she has recently grown out of it and part of me wonders whether she misses that attention?

swallowedAfly Wed 27-Jul-11 00:32:07

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DioneTheDiabolist Wed 27-Jul-11 00:54:44

I agree with the others who say that she is seeking attention. You say that her dad asks her what she wants to do and her responses are non-commital. This is not unusual in teen life (ask parents of teens who are together). What she is seeking is attention to her.

She needs to feel from your DH that she is important. Important enough to be thought about when she is not there. Important enough to have her dad think about her and organise things she would like in advance (even though she may not be appreciative at the time).

At this stage it is not just about acceptance, but about recognition of who she is. Teenage pique for sure, but she deserves to have the adults in her life deal with it properly.

Sistermoondance Wed 27-Jul-11 08:48:30

Thanks, I do know what you mean and appreciate the responses. I know it is hard to get the balance right. In a way I don't think it was ideal for dp to ask her what else he could do, but I think he fel he'd tried everything he could think of. We have both tried asking her to sit with us in the evening to talk/ play games and watch tv. But she rarely wants to do it - she wants to watch videos of dancing or make up tutorials and practice them. He tells her how proud he is of her when she does well at school and he often takes her out without me to visit her grandma etc he sends her frequent texts and buys her little cards etc so she knows he is thinking of her- but I think we had run out of ideas! I mentioned shopping as although I don't buy her loads, just occasional treats this is the one time she seems happy to come out with us and is chatty spending her pocket money and looking at stuff she likes. He has offered to take her to see films or sit down and work out with him how she wants her room decorated and no interest. She clams up if he starts talking to her and gives one words answer. He keeps trying though and has more patience than me as I just have to bite my Tongue at times. We are always telling her how clever she is (she is!)

What do other dad's do with their teenage daughters that they both enjoy?

ragged Wed 27-Jul-11 08:54:57

My dad used to take me to cinema a lot.
Certain sports we both liked to spectate at, too.
Meals out together once a week, just the 2 of us, with movie to follow if time. He was quite a stickler about it after my parents split up.
And video games (arcades); we both had a laugh at that.

I wonder about taking her & a mate ice-skating, where he'd hang out watch a bit & ust be there for her to come back to for money/chat, even if he's just reading the paper half the time, like having a tether string she can keep testing & knows she can tug on whenever needed, at a moment's notice.

fastweb Wed 27-Jul-11 09:01:25

She seems disappointed we are not angry, she discusses her disorder openly, but lies about doing more exercise rather than less and wants to go to a clinic? She worries me as she always has to have an illness worse than anyone and something always has to be wrong with her, and when that thing stops getting her attention it fades away and is replaced with something else. I am worried that her going to the clinic will encourage her to continue to not eat properly to get attention, when in fact the problem may be far more deep set and may no be addressed.

-----------------------

Given her age I'd ask for a consult with psych. Perhaps raising the possibility of Histeronic Personality Disorder or the milder syndrome that is used to quantify people with a few of the red flags who don't qualify for the PD.

I'm not saying she has it. Could just be normal teenage "look at me" stuff. But if she does have deeper rooted tendencies this would be a better age to start keeping an eye out for escalation and for starting a programme to help her overcome the behavioral tenancies than say in her 20s or 30s when it becomes quite hard to treat.

I learned to behave similarly to your daughter and it really came into its own at much the same age, I was mirroring my mother who most likely does have HPD. It was quite a long road to train myself out of the the habit forming thought processes and behaviors. Got there in the end but think it might have been easier and far faster had I had a professional hand in the process.

Please don't panic at the above, the fact that i recognise behaviors is not a diagnosis and I am not a doctor giving a professional opinion. It is something to mull over and may end up being a start point to unraveling nothing more exciting that a teenage girl having a temporary fit of the drama queen. But for peace of mind, cos you do sound very concerned, I would check it out and see if you can have her assessed.

matana Wed 27-Jul-11 11:17:26

I can only go by my own experience. My sister suffered with anorexia for a period after my nan died - she was very close to her and was going through loads of other adolescent feelings at the time too. Anorexics tend to try to do anything they can to hide the fact that they aren't eating food and do not draw attention to it in the way your DSD seems to be doing. My sister used to take longer than everybody to eat her dinner so she could feed the dog under the table when we were all otherwise distracted to hide the fact she wasn't eating. My mum found mouldy sandwiches in the bottom of her wardrobe, which mum had packed her for lunch weeks before. Even when anorexics are 'found out' it's like an addiction - incredibly difficult for them to admit to and discuss openly.

I'm not convinced your DSD is suffering from anorexia. However, the fact that she is acting out to get your attention in itself is something that needs addressing.

My sister is now very happy and healthy and has never suffered a relapse, so even if your DSD is anorexic the fact that she's admitting it is good news.

ragged Wed 27-Jul-11 11:34:43

Anorexics are normally highly devious & secretive. It's part of their control-freakery to want to delude selves they can hide the disorder from everybody and yet be perfectly in control (but secretly, smugly, arrogantly even); and if does get revealed, they'd want it revealed in a highly controlled way and very selectively (usually). The control of the information is part of the buzz they get from their behaviour. Am not an expert on Anorexia or all the other conditions mentioned, but you're right OP, your SD really doesn't fit very well.

I have a 7yo who does naughty things deliberately to be angrily told off, it's a type of attention seeking he finds easy and gives him the intense interaction he craves. I'm trying to get my brain around it...

swallowedAfly Wed 27-Jul-11 11:40:39

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fastweb Wed 27-Jul-11 12:11:23

but please no psychiatrists

You wouldn't be a scientologist by any chance ?

OP my mother in law is mentally ill, I have met an awful lot of psychiatrists. Sat through appointments, dealt with consults both in office and on ward, both in public and private health care environments.

They are pretty much like any other specialist, you get your god complexed ones, your can't be arsed ones, your patronizing "couldn't listen if my life depended on it cos I just can't stop talking" ones and then there is the bulk, that range from OK to absolutely fab.

If you do go the route of getting a consult, but don't get a good feeling, or you feel they are rushing into a diagnosis without taking the time to really work out what is going on, ask for a second opinion, even a third.

But please don't feel scared of seeking their professional opinion if you feel it might shed some light, or at least ease your concerns, it's a medical field, not a shortcut to bedlam.

Some people have bad experiences with psychiatrists in the same way some people will have a bad experience with an obstetrician, ENT or cardio specialist. What that points to is the need not to ignore your gut and get alternative opinions if you are unhappy with the level of professionalism offered rather than act like the entire professions is out to get you.

swallowedAfly Wed 27-Jul-11 14:13:54

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fastweb Wed 27-Jul-11 18:09:14

Just checking, via the CCHR, they have done their best to use scare tactics where psychiatry is concerned to further their agenda at grassroots level and they rarely declare their association. Most people don't even know that they have been influenced by materials produced by sicentology because they keep their name off it for the most part.

The mainstream field of psychiatry somewhat adverse to rushing into labeling adolescents with personality disorders. Mainly because their personalities are still developing.

That doesn't mean they aren't able to pick up on anything that is a cause for concern with a view to keeping tabs and offering some kind of therapy to help the adolescent cope.

What they can also do is have a dig around and see if an adolescent is acting in a certain way because they are mirroring somebody else who does have for example an eating disorder. Or perhaps see if the teen is trying to get a more generalized (even negative) attention because they are unable to communicate (or understand) a specific area where they need their parents to know they are unhappy and not coping.

It is not a given that a label of any kind is the automatic outcome of an evaluation. A lack of a label post evaluation doesn't mean that a root cause won't be uncovered and hopefully resolved.

I understand that some people are convinced that a label in of itself causes damage.

This afternoon while in town I watched the product of parents, who point blank refused a label because they were convinced a label in itself was a bad thing, floundering. Again.

He'll be in prison by the time he is twenty and his education didn't happen because he did not get the support in school that he needed. That poor lost boy is still without help because his parents were\are afraid of a diagnosis. His predicament has been breaking my heart since he was just 12 years old. It was one thing when he was getting into trouble with teachers and the like. Now it is the police and the stakes are so much higher. He may not have a mentalhealth label, but he sure as hell has been assigned the lables "bad", "loser", "waste of space", "will come to nothing" and "hooligan". Is that really so much better for his self esteem and identity ?

I personally have watched too many people, of all ages, suffer terribly due to a lack of a (professionally assigned) label, which meant a lack of help\understanding and surfeit of blame. Because family and the world at large cuts them no slack and assumes they are operating on a level playing field. Those people get labled by people instead of a psche, and the lables are not glowing and postive. Nor are they fair assessment.

When left to flounder "offically label free" to adulthood, it doesn't always end well. And if growing numbers of people and actively encouraged to avoid even consider an initial appointment with psych because they are terrified ..........

1 - a label is unavoidable because the field is just desperate to slap a word on everybody that passes through their doors
2 - that a label, in its own right, will devastate their child

..............that will result in an awful lot of young people falling through the cracks.

I have a feeling that label rejection is in some part potentially another manifestation of the stigma people place on MH issues. The last bastion of discrimination against people with a disability. Nobody would act like a label of cerebral palsy or spina bifida could in some way incapacitate themselves or their child to function to the best of their ability. But put the possibility of a mental health label on the table and all the disinfected bargepoles come out.

Not helped by the Scientologists who put out this kind of stuff, to encourage them in their fear and rejection of anything to do with being lumped in with "the mentalists".

madwomanintheattic Wed 27-Jul-11 18:09:32

particularly if that's what they are angling for to get attention. she was quite chuffed with the anorexia label i recall. i imagine if that didn't get the desired response from the parents various then a pd label would up the ante a bit. wink

get him to be the driver for concerts. does she actually dance? does he go to watch shows and competitions she's in?

i'm not anti-psychiatrists in any way btw. i had a fair bit of counselling a year or two ago and am toying with a referral for ds1 (he's 9 and seems to have behavioural-ish continence issues that the school counsellor and two paeds have been unable to resolve). it just seems that another professional and another dx might be right up the dd's alley from an attention seeking pov... so i'd be a bit wary.

KoolAidKid Wed 27-Jul-11 18:15:01

Agree 100% with swallowedafly. She doesn't need a psychiatrist. She's obviously trying to tell you all something, but with out telling you IYSWIM.

Maybe she can't even work out exactly what's wrong or why she feels the need for attention, but it's possible she's struggling emotionally and is trying to draw your attention to this.

I assume as she's already been referred to eating disorder clinic she will be getting some counselling, if not a counsellor may help? Agree the adults in her life need to listen to her and give her time and attention for herself also.

ragged Wed 27-Jul-11 18:18:54

I agree with MadWoman, I'd give other approaches a chance, at least, for a limited time period (3-4 months?).

madwomanintheattic Wed 27-Jul-11 18:36:48

oh, re labelling and all that jazz - this is slightly different to a mh stigma argument. i don't think anyone is arguing that a young person who has a condition shouldn't be given a dx and treatment. the jury is still out on whether this is routine attention seeking from a teenager, or whether her claim that she has a mh issue should be validated at this point. <shrug> we know that the child lies to back up or exaggerate one dx, why would she not do the same with another one?

she obviously does have a need for attention that is currently not being met to her expectations. i imagine the eating disorders clinic are exploring that with her. and i expect that a further psych referral would be made through that avenue if necessary.

scientology has cock all to do with it. nor has stigma.

swallowedAfly Wed 27-Jul-11 19:48:28

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fastweb Wed 27-Jul-11 20:17:30

the jury is still out on whether this is routine attention seeking from a teenager

I personally would not be comfortable with waiting to see if she gave up attention seeking via ill health as a bad job, when there is no way of knowing if she is caperble of upping the ante to get the attention she might crave, by turning to more demanding tactics.

It is entirely possible that this girl is suffering from nothing more severe than a temporary attack of the drama queen.

But the OP said something that caught my eye..

She worries me as she always has to have an illness worse than anyone and something always has to be wrong with her

It would appear that the anorexia is possibly not a bolt from the blue, it could be an escalation of a patten of behavior. Feigning or trying to reproduce the behaviors of anorexia is quite an extreme way to go about getting attention. Given that she was disappointed it didn't work, I personally would not be that keen on sitting back and seeing how it pans out, just in case she is inclined to take even more drastic steps to see if they will do the trick.

I'd want to head that possibility off at the pass and try to get to the bottom of her angst, be it a more minor issue of wanting more quality time with a parent, a problem at school, being unduly influenced by the behavior of a peer who does have mental health issues, or something more serious.

To be on the safe side.

I'm seeing it as balancing the potential downside of giving a teen drama queen even more attention, against the potential downside of inadvertently motivating a troubled teen to escalate further and go on to take risks with her health and well being in order to get the attention she craves

The latter risk is of a greater concern to me than the former.

Even if going to a psych does reveal I have just allowed the teen drama queen to revel a little more in the limelight, the upside is I am released from concern that it might be more serious. Which means I can feel confident in useing strategies to shut that behavior down without holding back "just in case it is something worse and I am dealing with it all wrong".

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