How can I help my sister - possible pnd/anorexia?

[kando]

I'm not sure where to post this to get the maximum response, so thought I'd put it in here. Apologies if I ramble and go off tangent, but I'm really worried about my sister and it may well all come out in a jumble! Here goes ...

Sis is 25, had a gorgeous dd 10 months ago and went back to full time work when her dd was 4 months old. My parents look after her dd whilst she's at work. [I live the other end of the country to my sis and parents so only see her a couple of times a year, if that, so I don't feel we have a really close relationship. Parents live 5 mins away from sis.] Anyway, we visited her recently and got the shock of my life when I saw her - she is just skin and bones, her stomach is getting to the "concave" shape and her hips stick out like sticks. My mum mentioned it to me (I was completely shocked that mum had never mentioned how skinny she was before as we talk on the phone most weeks - sis is unhealthily skinny) and said she doesn't eat proper meals. Cue everyone watching her like a hawk whenever we had dinner together. I only saw her eating one decent-sized portion of food whilst we were there (admittedly, we didn't spend every meal time together, but mum says she hardly ever cooks). Dad also mentioned that she seemed to disappear to the toilet very soon after eating, which I (hopefully discreetly) kept an eye on, and yes, she did disappear to the toilet on most occasions. Whether she was being sick I don't know.

As I don't have a very close relationship with her, I didn't feel I could press her too hard about it - all I said was that if there was anything which was bothering her or stressing her out - about the baby, motherhood or work - she could talk to me and I would listen. All she said was that she was fine, everything was fine and not to worry. My dad had a word with bil about it and he said he would ask dsis about it and also take her to the doctor. dsis said to bil that everything was fine, she wasn't making herself sick after eating and that she wasn't going to the doctor. She said that her appetite was "just a bit smaller" than before she had her dd. (she used to eat like a HORSE pre-dd). I suggested to my mum that it could be pnd but she dismissed it completely.

I'm at a loss as to how to help her, or even if I can help her given the distance between us. My mum, dad, bil, (other) sister and myself are all really worried about her, but don't want to wade in there guns blazing for fear of her making a swift retreat or making things worse. Can anyone offer me any advice on how to handle this, or advice which I can then pass on to parents/bil to help them deal with this? Sorry if this is rambling and all over the place - thanks for bearing with me if you've got this far!

sorry, no advice, but bump!

Thanks berolina!

Can anyone at all offer me any advice, please? ... Think I might have to change my nickname, no-one ever seems to reply to any of my threads.

No direct advice I'm afraid, but try googling 'eating disorders' or better still eating disorders family support' and you will find loads of sites with hopefully some useful info.

Kando, I do sympathise, and I do think that your sister has a problem - poss PND which she is 'controlling' with her eating. Drastic weighloss that is 'hidden' and not celebrated in my experience is usually a sign of a problem somewhere.

My sister has suffered from anorexia and bulemia (sp?) on and off for over 17 years now, and it has been very hard for the family to understand and therefore offer any help. What I have discovered is the more we push her into talking about it and the more we 'pay attention' to it the more unconstructive that is in terms of achieving a positive result, i.e. her eating again normally. Also I think that being family (and possibly therefore intwined with the root of her problems) she finds it easier to talk to strangers (professional or not) about what's troubling her.

As your sister has not long had a child maybe her husband (or you) could contact her health visitor or dr about your concerns - maybe they could then come out to see her or get her to go to them under the guise of a developmental checkup for her dd?? That would help them access PND - which is sometimes so hard for us to recognise in ourselves.

Apart from that I'm afraid I have no practical advice I can offer...we're still working with my sister to help her, and have good periods and bad. But I have found that if we 'back off' slightly we get a better response than if we go in guns blazing and laying the law down...I'm sure that actually goes for all of us

On a positive side for your sister maybe you could see if she'd come away with you on a girls only trip for a weekend, be it a spa break or a trip to another city/capital...maybe a break would do her the world of good too

Hi Kando, I will try and help best i can. I had severe PND with ds. Now recovered and 2nd year mental health student nurse so hopefully i can try and help from both sides.

1. With the query regarding sisters weight and possible eating disorders - if you are worried that she is throwing up food have a look at the condition of her knuckles as there are often tale tell signs of abrasion from teeth. Also her teeth would be suffering due to acidity of sick. Is she excercing alot more than is 'normal' for her, especially after eating? Could it be that she is just not making the time to eat and look after herself, working and being a mum is a tough combination for anyone.

2. Re possible PND, is possible she could be suffering but not aware that she is if that makes any kind of sense. I wasnt diagnosed till ds was around 10 months. She may feel that she is trying to live to others expectations etc. YOu said when you mentioned to your mum she dismissed it, I dont know your mum but does she have high expectiations of her own children and perhaps passing them on? It is important if your sis is suffering she gets some help and time that is suitable for her needs.

What can you do? One of my sisters lives a reasonable distant away, she is the one i am especially close too. I couldnt have got through pnd without her. She would just listen, never judge and gentily guide me as best she could. I would also visit her and spend time with her as me, not as ds mum but as me who has a ds. Hope that makes sense.

It is important to get some time with your sister away from everyone, more 1 - 1 so that she wont feel 'overwhelmed'.

On the other sde, my sister is skinny as a rake and my mum and elder sister were worried she was poorly too. She is fine but her body has kicked back in and she regularly excercies eats well and runs around (when not working) after her 3 dd's.

Hope this helped, you sound like a lovely sister

Hi Kando
this sounds really hard to deal with.
I used to work for EDA (website is edauk.com) so will pass on some general thoughts.
First thing I would suggest is for you to call their helpline and talk things through with them. Your BIL and parents may also be able to get some benefit from this, particularly if they are not sure that there is a problem. As you have shown, it can be quite hard to spot a problem with food if you are seeing the person very frequently, and it is possible to hide rapid weight loss for quite a long time if you are determined.

In general, if people with EDs feel that they are 'being watched' this is more likely to make them feel defensive, under attack and scared: it's OK to monitor what's going on but you need to be VERY discreet about this as your sister may well be feeling very tense and scared already.

I think it's a really good idea to try and whisk your sister away for a trip out so you can talk in a more relaxed way: she may well not 'spill the beans' immediately, but let her know you care about how she FEELS rather than how she LOOKS, and you never know, she may open up. If she does have a problem with eating, you can take it for granted that she will be thinking about food the whole time anyway, but if you manage to focus on how she feels, that she looks sad (rather than thin), that you haven't seen her smile for ages, then that might be a way in.

I think the best thing you can try to do is to inform yourself about EDs, try and get info about what she may be experiencing, and try to provide a source of non-judgemental support for when she IS ready to address the issue. Nobody starts to get help for an ED before they are ready to face up to it, but if she feels you are on her side that will really help. (and being on her side does not include covering up for her about what she is/isn't eating, or keeping secrets by the way...)

I need to admit to a vested interest as I wrote the thing, but it might be useful to get a copy of EDA's Carer's Guide for yourself - I tried to put in quotes from people with EDS as well as from their families and partners so maybe that will give you a bit of support.

As everyone has said, it sounds as if your sister is really lucky to have you, so good luck.
Vic