How do I help my anorexic daughter till professional intervention starts?

[Jobob66]

My 14 yo daughter is being referred to CAMHS, after being assessed by GP and school. Nurse as needing urgent help to deal with Eating Disorder. She is severely underweight, lethargic and depressed. She still refuses to eat most of the time and when she does eat, makes herself sick.

I am out of my mind with worry, but trying to keep a brave face. I talk to her about it, she tells me how she feels. We are really close and she often cries about how she feels but tells me she is too scared to get better.

I just don't know if I should be stricter about making her eat and risk alienating her trust as well as risking her making herself sick. I genuinely fear I may lose her as she is so thin. I am also struggling to hide how I feel from her, because I know she needs me to be strong.

Is it worth finding her some private help before CAMHS intervention? How long does it take, if a doctor believes it is urgent?

Oh gosh, how awful for you both I don't have any experience with this in the parent side, but I had an ED when I was a teenager that was a cross between anorexia and food phobia.

My mum encouraged me to think of food as medicine and to have small frequent nibbles of foods I felt least threatened by. She would st and chat with me about non-related subjects for an hour or two while I ate tiny portions of something I found acceptable. She never got angry or passed any judgement on the quality/type of food I was eatin, even when I survived for about six months eating almost exclusively plain crisps, pate, cheddar, lettuce and tomato.

I started off with tiny tiny portions (eg a teaspoon of pate, a tomato and a couple of crisps) and gradually increased the amount I was eating over quite a long period. My mum must have been beside herself with worry (I was under 6 stone at one point), but that never came across to me, she was just cheerful and apparaently unconcerned. Amazing really as in all other areas of her life she is a terrible worrier

I'm not sure whether this is brilliant advice for 'straight' anorexia though so please don't take it as gospel. I am fine now by the way and have been for over 15 years

From what others in your situation have told me:
Explain the role of food as per Pushmepullyou.
Ask her to come out to find food (give yourselves a lot of time).
Let her choose.
Do not pass judgement.
Let her decide what she wants to eat (let her take her time).
Then sit with her while she eats.
This again will take time. See every morsel as a triumph, but do not comment.

Phone CAMHS and ask them how long it will be until she is seen. If you feel that is too long then ask for an urgent appointment.
I would say do t go private, work with CAMHS and decide with them on ways to deal with the problem.
In the meantime take your daughter to your GP and get her weight and BMI done (along with the necessary blood tests) as this will speed up the process and also will allow the GP to keep an eye on her weight while the CAMHS appt comes through (and the GP can speed up the CAMHS appt if needed).
Do those things..... And dont panic, it won't help. Sure it's upsetting and worrying but try to carry on life as normal - that's important for your DS.

And if you are REALLY worried about your daughter health to the point that you think her life could be at risk you can take her to A&E or call an ambulance.

Thanks everyone, that's really helpful. Am so worried am just not thinking straight

Hi Jobob

Really feel for you as DD1 (11) just started seeing CAMHS re ED linked to phobia/anxiety/OCD. Couldn't not answer your post, in case any of our experience is helpful/relevant:

Speeding things up - DD had an initial assessment w. CAMHS team in December but we were told she was on a fairly long waiting list. In January when DD's eating got worse v. quickly, I went back to GP and CAMHS contact, we then got referred to specialist ED CAMHS team (had to wait a few weeks to hear if they would accept her). As said by another poster, having DD's BMI done by GP was key to us being seen more quickly. Do CAMHS know how little she is eating? I would definitely call them and speak to GP re BMI, blood tests etc.

Being strict about food - has only ever backfired on me. I try to maintain air of kind firmness otherwise DD's 'rules' about eating get the better of us - ie new 'rules' get introduced if I don't try to head them off. All v. tricky.

Going private - DD sees consultant psychiatrist, community nurse (her main contact - offers therapeutic intervention), dietician and paediatrician. Not sure we would have got the benefit of all these if had gone private. They all work together. Also, I worried about taking DD to private psych who would make things worse.

Other support:
DD sees school counsellor. No ED speciality but has provided listening ear while we wait.
DD's teacher has been great and helped support DD in school hours.
School nurse at new secondary school offered useful advice and suggested strategies for when DD moves up in Sept.
Local voluntary organisations - we have an ED charity near us that offers counselling to parents. Not called them yet but think will.
National charities - B-eat, Young Minds have some literature on coping on websites. But never quite answered my questions about coping while you wait to see Camhs...

Battery running low so have to go. Sending you best wishes.

Thanks Mumtutu - that was so useful. Have also bought a Janet Treasure book - Skills based learning, caring for a loved one with an Eating Disorder, which has felt like a lifeline

Hi Jobob - glad post was helpful. I always feel I ramble on a bit, not v. experienced poster. I will look at Janet Treasure book on Amazon, I've been thinking about buying a book but holding off for some reason. Hope things are ok with you and your DD.

Sorry to hear about your dd's difficulties, and the delay in accessing services.
This is based on my own experiences:
Well done on recognising that worst-case-scenario thinking on your part is unhelpful (although understandably inevitable). Telling her your fears would only fan the flames; by keeping them to yourself you're being the responsible adult she needs.
There's no way you could make her eat without phsyically forcing her. Your aim could be to create an environment where she feels comfortable eating.
Re. advice about sitting with her while she eats. This implies that she's eating at different times to everyone else, and eating on her own. If she wants company while she eats then she can eat at family mealtimes.
Eat as many of the 21 meals of the week together as a family (even if that means just the two of you). I remember how none of the HCP's who treated me checked if family mealtimes were the norm in our house. They just assumed they were when in fact we only sat down together at the weekends. IMO communal meals are crucial to treating, as well as preventing, eating disorders. If she wants to eat outside mealtimes, that's her choice and I wouldn't try to stop her, but don't prepare or cook food for her.
As pushmepullyou said, a positive and nonjudgemental attitude is really helpful. What I remember about anorexia is that it was a kind of smokescreen that hid my real feelings and anxieties. Ask your dd how she's feeling and how her day went. Then the tightrope-walking begins; there's a fine line between validating some-one's worries and joining them in catastrophising. Be calm and bite your lip at times.
Encourage her by getting her to take some responsbility around the house. Being able to care for herself,and eventually others, will raise her self-esteem better than any verbal praise. Ask her to do chores and say "thank you" but do not comment on how well or badly the job was done. She did it, that's what matters.

Hi, lovetomatoes, we always have had communal meals in the house every evening and breakfast at weekends too. When I ask DD to have a snack, I sit down with her and eat too. And actually she takes a huge amount of responsibility around the house, she helps without being asked. It worries me more how she always wants to look after others but not herself.

As an update, CAMHS are now treating her and have advised that unless she gains weight in first 3/4 weeks of treatment, she should be admitted to hospital, to a specialist unit. She is eating, but no way enough to gain weight and is probably still losing. She is still vomiting back the little food she eats, but only once or twice a week. But this is in spite of the huge risks described to her my the CAMHS Team. I do worry that if she is admitted to hospital, it will reinforce her sense of "being an anorexic".

Hi Jobob - just wanted to send a message of support to you and to say thanks for recommending the Janet Treasure 'Skills based caring..' book which I have found really helpful.

Thanks Mumtutu, I found it really helpful - especially the part about what animal you should be! And today, despite my fears, DD has gained a few pounds. And she hasn't freaked out about it, although I can tell how troubled she still is. Thanks everyone for all your support, we're not out of the woods yet, but this really got me through an incredibly worrying time.

I'm an ex anorexic. I run a blog for those suffering from Eds and their loved ones. Please check it out: www.beatingeatingdisorders.com You can find my step by step guide to recovery on there.

Although this is not direct help you should read "Decoding Anorexia" by Carrie Arnold. It will help you to understand the whole thing better and confirm that it's NOT YOUR FAULT! It really is a good book.

I think Hypnotherapy could help with Anorexia. I'm in the process of having that theory supported further.