Teen Eating Disorders Thread 7

[Lottsbiffandsmudge]

We have managed to fill the previous Thread here https://www.mumsnet.com/talk/eating_disorders/4471980-Teen-Eating-Disorders-Thread-6?page=40

So I thought I would start a new one.

Everyone supporting a young person with and ED is welcome here for advice (non professional but lived experience) and support.

Hoping everyone can find us...

I have also applied for CAHMS and counselling and am also seeking a private counsellor.

Helpneeded Welcome and I'm sorry you're in tgis journey. Yes it's about taking control of food by doing the 3+3 and stopping physical activities and asking the school for support with eating in school, making teachers aware, a safe space etc. Camhs generally have their own counselling so it might be worth waiting to see how long it will take to get help before looking at private help.

Me moaning again, sorry. I'm very low at the moment, 100% due to dds illness, and think I may need to ask for help. Will the gp be able to offer me anything, considering I'm not actually depressed? I'm just in a situation thats making me depressed, if that makes sense?

I do look after myself, I read and watch movies and buy myself lovely chocolate. I walk as much as I can, get my hair done. These things lift me up and make me remember that life isn't all doom and gloom. However, after a battle with dd (which is every mealtime now) I go into quite a dark place. Last night was particularly bad and I had some awful thoughts.

Hi @HelpNeeded7 has your DD lost weight? What is her calorie in take at the moment? Did you self refer? Or see GP. Has she had obs done?
Sorry for all the questions. If you suspect an eating disorder it's quite likely it is. How does she react if you make her eat say lunch?
As a first step we would say GP to have tests done. Or if eating fewer than 500 cals a day for a few days or if weight loss very dramatic A and E.
She needs to be checked out physically. So full blood tests, BP, pulse on sitting and then standing (to check if the heart has to work too hard when going from sitting to standing), an ECG

It's also an opportunity to rule out any other reason for the appetite loss. (Thyroid etc)
Whilst you get these booked and the results and wait for a CAMHS appointment start the meal plan. Not eating is not an option she doesn't have to enjoy it but she does have to do it.
You need to take full control. It may mean her being supervised at lunch and breaks at school or coming home for lunch. Or stopping school entirely.
Use incentive, leverage whatever it takes.
Even if its not an ED she should still be eating this way. At 12 she has growing, brain development and puberty to fuel.

@Whyisthishappeningtous I am so sorry things are so tough. I remember it well.
I would go to the GP for a chat and poss anti depressants

I cannot recommend the Beat support groups enough they were a lifeline for me esp as we were all in lockdown. There can be a wait list but it's worth signing up. They are on line and speaking face to face (sort of) with people going through the same was very helpful.
Do you have good family and friend support?

Why it's not moaning, it's normal to feel like shit when you're trying to manage this. I think I cried every day for about 3 months at one point. Definitely talk to your GP, lots of parents of kids with ED need antidepressants to help them cope. Also some counselling might be useful.

Need have you taken her to the GP to get medically checked out? As lots said she needs a thorough medical once over and needs referring to the Eating Disorder service not general Camhs. If her intake is less than 500 cals a day a trip to a&e will be needed. Yes to starting 3 meals and 3 snacks a day, non negotiable and you have to stay calm, compassionate but determined they have to eat.

@Whyisthishappeningtous You might also want to see if there are any talking therapies available local to you. I have found Talk Liverpool's (NHS) sessions really helpful. I'm also not depressed (I've been depressed - it's different), but am anxious and tearful a lot of the time. I do find the Talk sessions helpful.

@Whyisthishappeningtous I echo everyone’s comments, in my case GP prescribed antidepressants and they did help. I don’t take them now but they helped me to sleep as well which is what I was struggling with.

What helped me was routine, I think @myrtleWilson referred to it as battle rhythm, and it helped me, ready for the day ahead with a plan but knowing the plan may need to change. It’s so bloody hard but it does get better - and those dark thoughts are common. I felt like I was mourning the loss of the daughter that I had raised - now we see glimmers of that girl more often.

Sometimes I would stand outside at the back door just to take in the fresh air for ten minutes, my ME time!

Take care of yourself.

@LittlePickleHead Hi - sorry to hear about the self harm. As others have said, I've shared our approach to managing self harm.

DD's had a variety of CAMHS workers - some focused on the ED and some focused on the anxiety and self harm. The latter group worked with her on a "keep me safe" plan.

The plan described how she felt, and behaved at different traffic lights of green, amber, red. It also set out what she could do to de-escalate and what she needed us to do.

DD have certain physical 'ticks' that we knew meant anxiety was escalating - she would scrunch up her shoulders in a particular way and have her hands near her collar bone - this was a sign of her moving to amber. The move from amber to red take place in a nano second so we had to try to de-escalate promptly at amber as once she hit red it was a long time of self harming.

As she moved from green to amber we'd do grounding things like "Name five things you can see that are blue, name four things you can see that are yellow etc" It would try to create something new in her brain to focus in on.

DD route to harm would often be initially scratching/gouging on skin, hitting herself and then on to head banging off walls. So our amber activity tried to give her hands something to do - she'd use a tangle toy to give her fingers something to concentrate on, or we'd throw a bean bag or toy around. If things still escalated we would then get ice cubes and she'd hold them in her hands for the longest time.

Because we knew her hands were an important part of her trigger process, even at green we'd try to do distraction exercises that kept her hands busy so playing bananagram, we took up macrame, she made jewellery.

The keep me safe plan also detailed when she was wanting us to physically touch her and when not.

Obviously, we had support in writing it but as a starting point I'd think about what you notice when she's moving from her version of green to amber to red - what do you notice about the way she's holding her body, or does her tonal speech pattern change, are 'hands' an issue for her etc. See if you can draw out a sense of how she's passing along that spectrum and think about what could help as distraction - the plan should be led by your DD but it is helpful for you to do some observation and thinking in advance.

As ever, good luck and this won't always be as intensive and disturbing - recovery will come

Thanks so much @myrtleWilson for spending the time to write that out. So many really helpful tips particularly around keeping her hands busy, I can identify with that. She already has some kinetic sand on the table that she can play with during meals which seems to help.

Todays psychiatrist assessment was tough. DD didn't like him, was sullen and actually quite rude, non communicative. I felt embarrassed really but I'm sure they are used to this behaviour! But I liked him and we have some practical steps - referral to therapist and dietician, and more of a clear plan for me. Plus linking it in with the GP and making sure once the CAHMS referral does come through treatment is aligned.

It's daunting but I feel better and whilst he was compassionate, he was also quite blunt with her at points - eg she doesn't comply she'll end up admitted. She doesn't work with me and I'll buckle. I think some of it sunk in but she's adamant she's not going to speak to him next time at all and he's 'rude and patronising'. Not sure how much to take this into account but he's very experienced, and was saying exactly what any other professional would say in the situation (I assume)

That appointment sounds good little don't worry about the rudeness my dd was exactly the same. She wouldn't speak or look at any of the Camhs team and she pretty much told the dietitian to fuck off 🤦‍♀️

It is a normal part of the illness (unfortunately) to be in denial there's anything wrong with them coupled with a deep reluctance to accept help.

That's what makes getting them better such an uphill battle.

Sadly I think the staff are quite used to rude stroppy teens! I've certainly seen quite a few having been in and out of CAMHS for a few years with my children.

I do think though that the stern 'headteacherly' manner can be a good place to start but doesn't necessarily end up producing any type of co-operative working relationship that might be needed later on. Being told off and threatened might work on some teens, but not on others, it doesn't on my daughter and after 6 months of threats, serious faces and hospital admissions (not for refeeding, but for other consequences of her bulimia) the family therapy team are taking a more positive approach which I'm glad about. I do think my dd does get scared, but adults/threats don't scare her (you'll be sectioned, you'll be hospitalized), I don't know why, I would be terrified! She shuts down in the fact of this or removes herself, and unless they are prepared to go the whole way and actually section/refeed on a court order, then it turns out to be quite empty threats and she realised that early on. I think that there can be both stick and carrot in these situations.

Obesity is a very tricky topic. My dd is very driven in her ED by the fact she was an overweight child (which she was) and she is adamant she will never be that bullied 'fat' child again. I think it's a mistake for health professionals to comment on body shape, size or weight at all. That said, we have an obese dietician and that initially did affect how my dd received her advice ('she's trying to make me like her!') We now try to talk, if we do talk about bodies which most of the time we do not, about being body neutral, which is about what your body can do- so can it go to college, can it go out with friends, are your legs working fine for walking rather than about how it looks. Or just not talk about it at all.

So freaking hard!

I never know if we are doing the right thing, but I do know that after 6 months of dire warnings by HP and in and out of the health system, my dd was worse, not better, so I'm glad they have been open to trying a slightly different approach. That said, she is not a classic AN patient and her BMI is low but not life-threateningly so, it's the bulimia that is where most of the risk lies and that's really tricky to tackle, any tips on that, beyond watching her for an hour after food (which is fine, but doesn't take account of her getting up in the night!) would be greatly appreciated.

Thanks so much everyone for replying to my moany post and your amazing advice - as usual. It helps me so much. I will check out the sites recommended.

Dd has spent most of today following me around complaining. Her whole life is shit apparently. I get that it's difficult at the moment, but she was criticising our house, our car, our area, the fact our family is small and she has no cousins (not sure what I can do about that!), even the poor cat was called 'boring' as she's elderly and sleeps all the time, poor thing. It was basically just a constant stream of complaints. It's hard to tell if it's an entitled teen talking or if it's to do with her illness. It's all a bit irrational and quite bizarre to hear so I'm leaning towards her mental state. Of course she then starts about her looks and then it's downhill very fast.

I'm hoping to learn some distraction techniques for when she gets like that. Usually we go for drives but in the laws have borrowed my car and dh was out. Movies and games etc don't work.

She's just gone in her room after hanging around me since 7.30am this morning. Dh came home and she scooted off. I love her but it's like having a toddler hanging off me sometimes, sucking the life out of me. At least she draws the line at wanting to come in the bathroom.. 😆

@Whyisthishappeningtous I’m sorry it is all consuming isn’t I find it’s sort of harder than a toddler because even when she is not with me I am worried about her and I can’t just drop her at nursery or at my mums !

does anyone have any advice on calories my D will not stop going on about them.

Also I wondered does anyone have a child with autism and anorexia as some behaviours I am struggling to separate from anorexia and autism so could I pick all your guys brains ? These are just a few

• she has to have her pasta weighed out at the correct amount of grams in a separate pan so she knows she is getting the right amount ( should add it’s 75 grams so not a small amount ) if I say put 150 in a pot then split it after cooking evenly she will leave loads of it as she says she has been given more than half.
• she has to have her sauce separte to her main plate in a side dish ( we do make her eat it all this has sometimes meant she is having to just have spoons of curry sauce etc as she has eaten her chciken and rice ) same with custard and creams although oddly will eat a risotto and a paella although eats those weirdly picking out the meat or fish or cheese then the veg then having the rice
• very sensitive to change in any sense for example we had scampi the other night and she had one extra from last time which was a disaster but equally the other day she had one less meatball and that was also a disaster so it is not always about having less. She is also very sensitive to change in the product she will kick up a massive fuss if we get a different brand of ketchup or crumpets for example. Also she eats things in the same way so if she was having a quiche she will cut it up into 1/4s then cut these in half and will eat one half of the 1st quarter as a normal person would then the other she would eat the filling then the pastry and so on

sorry for the length of the post I am just curious and wanted to share in case anyone can offer some insight

Why my dd is similar, I try and ignore but it is very wearing hearing how shit her life is and how she wishes she'd never been born. This definitely intensifies around her period and I can tell now when she's due on as the moaning is more persistent. Distracting helps a bit as does love bombing her a bit, I'll offer to massage her feet or do face masks together.

Love I have similar issues with my dd, I think the general advice is if the behaviour was there pre ED then it's likely to be autism if not then it's ED. That said my dd is very routine based and is exactly the same re amounts of food for example she has 3 items for lunch and it doesn't matter if these are highly calorific items or low calorie items but it has to be 3 items 🤷‍♀️

Re the calorie content and weighing I would completely avoid and ignore any discussions about calories and do not weigh out food. Just portion it out, she may have a melt down about it now but it will save you a battle further down the line. Tbh she shouldn't be in the kitchen anyway so wouldn't know if the pastas been weighed out or not.

@Whyisthishappeningtous I'm feeling like that at the moment - touched out. I crave a day completely on my own in the middle of a bleak moor or something. I'm finding it all so draining - because of the self harming, at the moment I can't leave her alone at all which means the evenings are distraction (mostly tv) then me hanging around whilst she gets ready for bed with the bathroom door open, then me sleeping with her overnight.

I've just been signed off work though and after being be resistant to it initially I've realised trying to do it all was just unsustainable.

DH is also struggling as DD is freezing him out completely and seems so resistant to him in general. She doesn't want him to come to appointments either. He wants to help but can't.

Also DD going on today about how I don't care any more etc etc

I mean I've literally stopped my life, stopped work, spend all my time making sure she's ok. How on earth can she think I don't care?

Littlepicklehead My dd is also completely blanking her dad. It's comforting to hear its not unusual. He's really shocked by it all. A few months ago they were going out and doing hobbies together. Now she texts me to tell him to leave the kitchen because she wants to go in there.

She also says I don't care etc. It's ridiculous. I've all but given up work and spend all my days and nights thinking about how best to help her.

Lovewinter. I do dds pasta/rice in a separate pan and tell her I've weighed it. It actually helps as I can get butter, oil etc in there without having to have it myself. She knows she shouldn't count calories but I know she does. A hard habit to break I guess. The brand thing is difficult and I do pander to it I must admit. Anything to get them to eat, we'll do it won't we? The dietitian said to avoid anything 'low calorie', 'light' etc. It's actually bonkers how much stuff there is, especially in the dairy section, yogurts etc, it's quite difficult to find something that doesn't say low fat or fat free on it. Things like bagel thins are annoying. Dd will spot anything that's slightly smaller/lower. Sainsburys even have some rice cakes that are 'good for you'..they barely have any calories anyway. Bonkers and annoying.

@Whyisthishappeningtous does your DD go shopping with you? We get it delivered which removes any input from DD as I do it on my phone.
Weirdly DD doesn't seem to have clocked onto calories, it's more about foods that she perceives to be healthy (eg won't eat quavers, but will eat Emily sweet potato sticks which are more than double the calories). Obviously I'm not pointing this out at all!

LittlePickleHead I'm slowly phasing out supermarket shopping and trying to only go when she's in college and I get some deliveries as well. It's difficult as she likes shops like Home Bargains and B&M for toiletries, make up, stationery etc but of course they have a lot of food as well which she gravitates towards.

It's really good that your dd hasn't cottoned on to calories. For my dd it was calories in restaurant menus that I think may have partly triggered this whole thing. We used to regularly go to nandos and prezzo and I started realising she was ordering whatever was lowest calorie and asking for the children's menu (at 16). We still eat out occasionally but sadly it has to be somewhere with calories on the menu or she won't want to go 😞

She says she has the calorie amounts in her head for most foods now so even if she's not checking she just knows what it is. It's very hard to fight against that. All I can do is enrich each meal as much as I can and hope and pray her brain starts to restore.

Hi,
I find myself in a place I never thought I'd be.
Worst week of my life. Everything has escalated so quickly since DD's ED came to light just 6 days ago. I'm struggling. An urgent GP referral got us seen and we're on CAMHs meal plan 1 but it's not been well received. I can't bear this. It's like picking a fight/totally destroying DD 6 times a day. How do you get a child who has been starving themselves to suddenly eat 6 times a day? So sad here.

@SwattyPie I'm so so sorry.

I'm still relatively new on the journey myself and so I don't have any words of wisdom (DD hasn't been seen by CAHMS yet) but from everything I've read here there is light at the end of the end of the tunnel. You're aware now and taking action and that's huge.

In the 5 weeks since I discovered DD13s eating disorder this thread has been a huge support.

Hoping someone with more advice will be along soon

SwattyPie

It feels strange to say 'welcome' as this isn't a place you want to find yourself, but welcome to this wonderful thread where people totally understand what you're going through and where support and advice is never far away. I'm quite new as well and have been where you are now just about 3/4 nonths ago. It's a shocking illness to discover and start trying to make sense of.

I'm so glad you've got seen so quickly. We were given a meal plan as well but it's just a guideline and can be stressful for them to see it. For us what worked was building on what she was comfortable eating and we made our own meal plan around those meals.

I would recommend you have a read through this thread and the previous ones. I spent a few hours reading and learned how start the process, phrases to use and tips to make meals as calorie dense as possible without them feeling like they're eating too much. The Eva Musby book is invaluable and she has youtube videos as well.

Thinking of you as you start the journey ❤️

@SwattyPie sorry that you find yourself here. When the eating disorder is outed it kicks back hard - we were naive and thought what is the problem getting DD to eat six times a day, eating is natural. I cried over rice cakes and iced party rings. CAMH gave us the 3 meal 3 snack photocopies - with advice such as 4 weetabix for breakfast, if she could eat that then we wouldn’t be needing the services of the ED unit!

This is what worked for us, strict set times for all meals and snacks - say 8am for breakfast, 11am for snack, 1pm for lunch, 4pm for snack, 6:30 for dinner and 9pm for supper snack. We set time limits, 20 minutes for snack and 30 minutes for meals - using my phone as a timer. And the most effective and important point was that if she didn’t finish then DD would have to drink a fortisip meal supplement shake (fortisip is available on Amazon) - refusal or partially completing a snack - one fortisip, irrespective (no negotiating part snack part fortisip). Total meal refusal two fortisip - eat main but no pudding then one fortisip - partially eats meal or pudding, then a fortisip drink per partial eat. We learnt this from hospital - DD hated liquid calories so ate her food plan. It is sad to see them so distressed, but this worked for us and it is a terrible analogy but it is akin to training a badly behaved pet - you have to take control and have threats if DC doesn’t comply - fortisip was my threat.

I promise it will get better, you are at the lowest point and it will slowly get better - you’re not dealing with your DD but an abusive demon that she relies on, you need to squash the devil and it is like an exorcism whilst you reestablish yourself as the loving force that she can trust and that saves her.

Easier to say than do but take care of yourself - this doesn’t fix overnight so you need to be physically and emotionally prepared and that involves taking some time out in the day which is not about anorexia.

Thank you all for your replies and help this group has already helped me so much thanks

@SwattyPie welcome if that is the right term as others have said I am sorry you are her but if you are in this situation I can assure you from my brief experience it is the best place to be !

Am I allowed a little pitty party I know most on mumsnet will tell me it’s my own fault as I had 4 children but I feel so awful as I am such an awful mum to my other three daughters for example one is incredibly stressed over friendship issues and just in tears earlier and when I walked in she instantly stopped and pretended it was all ok but when I hugged her she lost it again and kept apologising as in her words ‘ her problems are insignificant compared to her sisters’ but they are not to me I just feel like I am letting everyone down as I give up all my time to help eldest who is still very very I’ll mentally and physically and also claims I don’t care or love her so it is sort of like I am sacrificing everything for nothing. I just had enough today and went to support one of my daughters today at a hockey match and then we went shopping and watched a film at the cinema yet I feel terrible as I knew eldest would struggle without me and sure enough I came back at 6:30 and she hasn’t eaten anything since dinner last night and has exercised for over two hours but what was I supposed to do 😭 and on top of that I had promised my other daughter I would help her prepare for a presentation she is doing so I know this sounds horrific but I just ignored eldest first and went to help her, I can’t remember the last time I was able to talk a daughter out without eldest or put them first and I just don’t know how to balance everything. I am sorry for that I know it is much my own fault for having multiple kids but tbh I think I would struggle just giving two attention with this illness. I also am worried I wasn’t present enough with my daughter shopping today as I was constantly on edge about my eldest at home It seems I can never win what ever I do 😭