Inpatient / Recovery

TRANSITION WEEK

Day 52

I am home 🙂

It’s been a wild ride. My last two days at the clinic were focused on discussing healthy ways of managing my out of control anxiety issues. I had one day of leave cancelled altogether (Sunday) as I couldn’t be trusted not to harm myself. I didn’t even trust myself. The next day was escorted leave and Tuesday – my final day as it turned out – back to full unescorted pre-discharge phase.

I decided (with doctor approval) to discharge late Tuesday afternoon rather than early Wednesday. It meant I could attend all Tuesday groups then get all the discharge paperwork and packing done in the afternoon. I spent my last night in a beautiful hotel with my husband – a lovely king size bed and a double spa. Wednesday morning we were able to sleep in, pack, late check out, then Uber straight to the airport. It was very relaxing and non-stressful and nice for my husband and me to spend some quality time together before heading back to real life.

He has two weeks’ carer’s leave to try and help me maintain my recovery menu planning. We were provided with lots of menu planning info for discharge, with the plan specifically adapted to me. I need to be strict with it though, and for that, I need support from my husband and my friends. I’ve typed up a one-page summary to make it nice and easy. Tomorrow I’ll finish the shopping and get the pantry well-stocked so I can be as successful as possible.

I’m still concerned about my management of anxiety.

I am very drawn to self-harm at the moment but haven’t succumbed since Saturday. The clonazepam helps and I’ve been sent home with a week’s supply – of either 0.5mg morning and night, or 1mg each morning. I was on 1mg morning and night at the clinic so have decided to stick with 1mg in the morning and go without at night. I’ll see how that goes until I can get to my GP next Tuesday. I am also waiting for the referral to get an appointment with the psychiatrist who can manage medication on a longer-term basis, but I have to be prepared to wait a month or two for an appointment.

I feel good to be home – proper ceramic cups, real glasses, unlimited internet and computer and phone usage. My own individual meal plan rather than the generic EDP plan. I’m also really looking forward to returning to the gym tomorrow night and to be able to establish a regular daily writing routine. I have so much reading and writing to catch up on.

And the last thing is to invest lots of time and energy into seeing if my online business idea is going to work. I’m almost ready to do my practice clients – hoping to complete each biography in one week. Once I’ve fine-tuned and practised the process, I can launch it and fingers crossed, earn some money. While recovery is my number one priority, I fully believe I need other things to focus on, or I’ll become stuck in a world of mental health issues forever. I know they’ll always be a part of me, but I don’t want mental health to define me.

Day 55

This is the last week I will continue the detailed recovery journaling. I had planned to keep daily journals for the rest of the week, but alas, my plans went awry. Mostly they went to sleep – I am so fricking tired.

Anyway, it’s just after 5 pm on my third full day at home and I’m having an overwhelming desire to binge. And as we all know, binge leads to purge leads to restricting leads to another stint in a psychiatric hospital. So let’s just try and nip this in the bud.

When urges to do anything maladaptive crop up (eating disorder, self-harm, candy crush, online shopping – name your problem) I’m often told to journal. My writing mentor – whom I adore – would say, Write into it. So here I am, writing into it.

I have no recognition of why I have this sudden desire to binge. Mostly I’ve desired to starve since I returned home. I haven’t. I’ve been extremely compliant and followed my meal plan. I keep eating when I’m full – because apparently it will take a lot longer for my body to recognise natural hunger signals. I can’t trust my body. I can’t trust my head.

I have to trust the professionals who worked with me to develop an eating plan specific to my needs upon returning home.

This afternoon I spent four hours with my hairdresser – a most delightful way to spend a Saturday afternoon. It has been many moons since my hair has had the full loving care of my expert hairdresser. I had a cup of tea and a biscuit while I was there. Then came home and had two more biscuits. I don’t know if I’ve had two afternoon teas or two halves of afternoon tea. But the confusion is messing with my head. Or perhaps it’s the taste of Tim Tams – they’re very delicious. One is too many and a hundred is never enough. Yet I’ve been cautioned not to avoid trigger foods as I will remain in a permanent eating disorder mindset. So I have a large snack box filled to the brim with every type of snack from my menu plan, all carefully portioned out into a snack-size serving. And twice a day I choose a snack and have a piece of fruit with it.

I’m hoping these very early days will just feel uncomfortable and I can retrain my brain to accept all food – not good food versus bad food. But just food. And with a daily diet of regularly feeding my body and a balance of nutrients. And no such thing as bad or off-limits. Or foods that require punishment after eating. Apparently this is how people with a healthy relationship with food behave. It is clear I have never, ever had a healthy relationship with food. But after almost eight weeks of intensive recovery, I have been told on so many occasions it is possible for this to happen. It takes time, courage and persistence. But most of all, hope and belief.

I have an enormous amount of belief and trust in the team of support people around – friends, family, and the professional clinicians at home and in the clinic. I also have a little bunny called Hope, wearing a key necklace with “hope” inscribed on it. And when I go to bed each night, I find the bunny and I say, I have Hope. And the words are becoming believable. My eight weeks of inpatient and the transition to home have been intense – just the tip of the recovery iceberg. But I am now determined to meet and exceed everyone’s hopes and expectations for me, and I am convinced that this is the year I reshape myself into a better version of who I’m meant to be. Binge urge or not, I will not be defeated.

I have a cup of tea. I have a journal. I have my bunny. That is hope. That is enough.

Day 56

This is going to be my final journal entry regarding my clinic and immediately post-clinic inpatient stay.

I ended up staying 52 days in an intensive, militaristic, hard-line, no-messing-about, Eating Disorder Program, in a large psychiatric hospital. There were between 10-18 of us in the EDP at any one time. Most of the girls were 20-ish but there was another lady my age and one or two in their 30s and 40s coming and going. At no point were we ever allowed to discuss our own particular eating disorder diagnosis, but to my non-expert eye, it would appear at least three-quarters of the girls were anorexic. I believe some were bulimic and some had moved backwards and forwards from one to the other. The program didn’t cater for Binge Eating Disorder (there’s a separate program for that), so I’m confident everyone was anorexic and/or bulimic.

When I read back over my journals from the first week (I rarely read back anything I’ve written) I realise how tough it was. It did gradually get easier – familiarity will do that. I learned a lot and I’m so glad I had the opportunity to go. It wasn’t fun… I didn’t enjoy it. It wasn’t the holiday that a lot of people who don’t know me well assumed I was on.

I was apparently quite malnourished on arrival.

They did regular blood tests and I believe I am much better nourished now. Eating six meals per day will do that – especially if they’ve been planned by a team of dietitians to my specific needs. While many of the rules were harsh and unrelenting, the staff were (mostly) amazing. I have now had two (voluntary) stays in psychiatric hospitals and I’ve found for the most part that mental health nurses are awesome. They are great at listening and drawing things out and getting to the heart of the matter, then finding perspective and self-forgiveness. Even my psychiatrist and his registrar were great. And the dietitian of course.

Daily routine involved very structured, specific, timed meals, followed by post-meal supervision. Eating and supervision took 6.25 hours per day… Then we had a one-hour therapy session each morning and afternoon Monday-Friday – psychology and art/music/movement therapy. One day a week we would go on Out and About where we’d go to a cafe and have a hot milk drink and a piece of cake. About once a month there’s a lunch out at somewhere like a burger place – where you have to have a burger and soft drink or juice. The eating out is about overcoming fear of ‘bad’ foods. There was much discussion of the fact that food is food – neither good nor bad. And we were constantly being challenged with snacks that many eating disordered people fear as off-limits. Or as binge foods. In a well-balanced diet, no food is bad. All food is okay. Apparently. So overall in my 52 days (416 meals and snacks in total) I feel I normalised eating patterns, became much better nourished, have started on the road to accepting food is neither good nor bad (have more work to do in this area), was reassured to learn that eating regularly caused me no weight gain (my greatest fear), and discovered the root cause of a lot of my issues is very high anxiety that I have just managed to hide extremely well for 50 years.

Probably one of the biggest gains of my stay was losing the desire to purge.

I now have zero interest in purging, but unfortunately due to the lap band, it still is sometimes an issue. Last night was the first time I purged since I left the clinic – I’d eaten dinner too fast. I hope to learn to manage it to the point it never happens at all. I vacillate between wanting to binge or restrict but have succumbed to neither at this point. When wanting to restrict I remember to follow my meal plan (alarms go off on my phone) and eat anyway. I’ve had very little desire to binge, but when it’s come along I’ve actually chosen to use some of the strategies I’ve learned in the past – and they were successful. Self-harm is still a constant desire but again, so far I’m resisting.

I’m also conscious of the fact that right now I have a lot of support and a lot of eyes on me. And I’ve also come home to a fairly stressless environment. So it is always much easier to do the right thing when things are going right. The strength of my recovery and progress will be best measured when the next life curveball is hurled my way. We all get them and I’d be awfully naive to think my life is going to be a bed of roses from now on. I’m hoping, however, that the more habitual my good habits become, the easier it will be to safely navigate stormy waters when they head my way.

I am still unbelievably exhausted all the time.

You’d think all this nutrition would boost my energy – but not as yet. I’m down to one clonazepam each morning and will drop to 0.5 tomorrow. That definitely contributes a lot to the exhaustion but is also working miracles for my anxiety. It isn’t a long term solution though. I have to wait a couple of weeks to get to a psychiatrist for longer-term management of anxiety. I also have extremely low mood today – not sure why, there’s been no trigger – so I think I need a complete review of my mental health medications.

Aside from that, I think I’m doing okay. I feel compliant with the plan and optimistic for the future. I know my energy levels will come back – I just have to give it time. I’m now starting to pour what energy I have into my writing and preparing my business idea. And I have an awful lot of planning to do for our three months in Europe – which is now only three months away.

Life is full and busy and I’m tentatively hopeful that my intensive stay at the clinic will be a major turning point in my life. I will make it so 🙂