Inpatient / Recovery

WEEK TWO

Day Eight

Same old, same old. Neither better nor worse. I feel my depression has sunk pretty low and I spent a lot of today mapping out “exit” strategies. But I also communicated this with the registrar and have requested to have my dose of pristiq increased. She’s also modified my leave to “escorted” which is fine by me. I feel significantly unsafe at the moment. I’m so far from home and friends and support networks and it takes precious little time for it all to seem like history – forgetting that those same friends and support networks and home will still be there on the other side of this. The clonazepam most certainly helps with anxiety and relaxation, which aids in eating meals more easily, but it is also zombieing me out. I just sleep all day. Sleep and eat. I also wonder if it’s contributing to this rapid depression cycle – I don’t know. I wish I could at some stage see the actual psychiatrist one on one, rather than the registrar. She’s lovely but she reports everything back to the interim psychiatrist for him to make a decision and I’d prefer to communicate with him directly. I stare at every meal in horror, wondering how to manage it. Whatever I do I need to learn to do forever. I’m not here to pass a test, leave, then forget all abut it. I need forever changes. Food is bringing me so much overwhelming fear. Still pig-headedly determined to never purge again – even if that means lots of supplements. But of course that’s not sustainable in the real world. I am bone numbingly tired. Thanks drugs… No epiphanies today. No progress. It’s a long, tedious process. This too shall pass.

Days Nine & Ten

It pains me to say this, but I’m in a rapid downhill spiral.

Perhaps this is a normal part of the process. Perhaps it is failing to meet unrealistic expectations in a relatively short period of time. Perhaps it simply just is.

My depression has escalated rapidly and I feel highly suicidal. I’ve been making perfectly logical plans. But I’ve also mentioned this to the registrars who have agreed that I can stay in phase one – meaning I can go out twice a week – but I need to be escorted. There is a certain amount of relief in this as I can abdicate responsibility for myself when out and about. I feel so far away and so distant from friends and family it is just too easy to lose that sense of connection.

I had a beautiful visit from a friend today. She stayed for a couple of hours and we talked about absolutely every ting. As she’s been through such similar situations it is easy to discuss the burning desire to self harm or to end it all – she understands. But she’s also worked through strategies that keep her here and grounded. She also brought me a beautiful soap that just smells divine.

Today they’ve moved me to yet another room and this has plunged me into a really sorrowful pity party. This room is tiny and dark and has no view and no bathroom. I feel like I’m being punished but I don’t know why. I know they’re moving patients from other wards around as there was a sewage leak into the roof of ward five. Apparently my lovely room was nice and close to ward one which is who’ll be looking after the new patients. But it wasn’t the only room close to ward one …

I’ve asked the nurse to give me more information regarding the self harm contract. She said she’ll draw it up then come and chat to me about it. If I don’t follow the rules I can be discharged.

I am terrified I’ll be kicked out of this program before I’ve even made any progress – and then I’ll be a complete failure with zero hope.

When she comes with the contract I’ll hand over my paperclip. My desire to tear my hands to shreds is escalating and I don’t know how to deal with it. “Talk to people” I’m told. I have no words. The pain is speechless and inexplicable. I couldn’t eat dinner tonight – just stared at it with tears streaming down my face then had the supplement later on. This endless circle of failure. I have made one step – feels positive to me  – I’ve made a pact with myself to never, ever purge again. If food does get stuck in the band for whatever reason, I’ll suffer through the pain and misery until it either goes down or spontaneously vomits up. But I will not purge. That is history. I think the clonazepam is helping – I’m more relaxed at meals, although equally teary. But food is staying down more easily. I am a complete zombie though. I’d like to stay in bed and never leave. Aside from eating regularly six times a day, I don’t know what else I’m learning . It’s just repeats of CBT/DBT/ACT that I’ve done before. Plus art therapy which is loathsome and I don’t get the point. I don’t really know what I want from groups – some kind of strategies I guess, and open discussions where we can learn what is helpful for other people. But for the most part my group sit there like stunned mullets – saying and sharing nothing. At the end of the day I’m in the right place – I know this. But I’m miserable as all hell and I’ve made no progress.

Day Eleven

Exhausted. Depressed. Alone and disconnected. Hopeless. Fearful. Pointless. 

These are the thoughts that have preoccupied me for days. I awake in tears, afraid to face another day. Afraid I’m going to fail at this recovery business, letting down all the people who are cheering for me back home. 

But today I feel a small shift. Just a few simple little things that remind me I’m not alone. I have a very powerful image in my head of a scene from Harry Potter, where he is about to confront Lord Voldemort. but suddenly all the spirits of his loved ones are surrounding him. They have his back. They form a protective circle around Harry and Voldemort, and while Harry has to wield the wand alone, the support and love from his friends and family tip the balance to his favour, and ultimately Voldemort is vanquished. Despite feeling so far from home, I can sense my husband and my boys, my dad and my close friends, all holding a safe space for me. Ready to believe in me, to steady me when I wobble. The image is very powerful and very comforting when I feel so incredibly isolated and lost.

I got through yet another day without vomiting or purging. Of the 11 days I’ve been here, I’ve purged twice and vomited once. Three more times than I’d hoped for, but what is done, cannot be undone. I still stare at my meals with fear – will I keep it down? Will I get into trouble? I have a ward round tomorrow with the doctor, nurse and dietitian, and I’ll discuss options for the dreaded lap band. Loosening it consumes me with fear. Looking at food consumes me with fear. Eating consumes me with fear. Everything is fearful. I’d love to life a life without fear surrounding such a basic human need.

My pristiq is increased – don’t know how long the effects will take to kick in. I’m taking 1 mg of clonazepam prior to lunch and dinner which makes me sleepy and dopey but is contributing to the food staying down. I’m still struggling with the self harm and the desire to escalate, but the disappointment that I succumbed after four months free of self harm is also overwhelming. They will give me a contract tomorrow and if I breach it I face discharge. I just don’t know the other coping mechanisms. The staff are always so busy I hate to disturb them. The whole hospital is very chaotic with renovations and fire alarms and sewage leaks and patients being moved here, there and everywhere. I lost my lovely room today. I feel so sad about that – like I’m being punished for something but I don’t know what. I’m behind on all my writing exercises because I’m too sleepy to focus each day. My goal was to complete three thousand words of the draft and to finalise all the bits for my “Your Story” website. Haven’t got anywhere with either as yet. I have time to be productive – I choose to sleep.

My lovely friend face timed me today and that was gorgeous. I felt so much more connected to my ‘real’ life. I talked my husband through how to face time and we chatted for half hour after dinner. It was really great. I think I’ll touch base with more friends to get a bit more connection to home. The more connection I feel, the less obsessed I am with trekking to the pharmacy to purchase an overdose. It is so quick and easy to become institutionalised. I have to remind myself this is a small blip. While I can’t say I feel great at the moment, I can definitely say it’s an improvement on yesterday. So I’m going to count that as progress.

Day 12

It’s Australia Day. Hard to tell when you’re stuck in an institution – all the days roll into one. I will be the first to confess that I have found this admission very difficult. Very confronting. Everything I expected it to be. Nothing like I thought it would be. The highly structured meal plans are incredibly confronting. The serving sizes are enormous but I’m repeatedly told they’re small serves. If they’re small serves I should be losing weight. I’m not. I’m not gaining weight either so that’s a blessing. I “measure” my weight by my rings and my waistband on my pants. As far as I can tell it’s all very stable. Lunch and dinner pretty much reduce me to tears every day. The food is unappetizing and I have to eat it fast enough to not require a supplement – so I risk having the lap band get stuck. So far so good and it hasn’t stuck since those initial disasters last week – but there’ve been some close calls. There is discussion about having the lap band loosened and when my doctor returns on Monday there will be further discussion. He’ll contact my bariatric surgeon at home and they’ll talk about me and decide what to do. Loosening the band will be freeing and terrifying. I’ll be able to eat more comfortably here, but I’ll be too easily out of control when I return home. I’m not sure I have yet learned any anti-binging strategies as the vast majority of patients are anorexic and binging isn’t their biggest issue. Not sure how to learn this or even if it’s possible. I have for the most part felt a lot less desolate today. Connecting with friends and family via facetime was awesome. It reminds me I have a life to return to and this is just a short stint that needs to be survived. I want to drop my clonazepam back to a half dose but wondering if I should leave that until the lap band is loosened. I’m quite sure the clonazepam is keeping me sufficiently relaxed (aka stoned) to allow for easier digestion of my meals. A lot of the time I just wish someone could tell me what to do. Having to make decisions is exhausting and I’m never sure if it’s the eating disorder talking. I’m looking forward to tomorrow. My cousin will visit in the morning (have to stay here though) and then at 4:5 I’m getting my tattoo – Angel wings and the script ‘stalked by demons. Guarded by angels.’ I think my friend believes it’s been sent to me by God. But I’ve always believed in angels and I definitely wanted something angelic for my second tattoo. When I saw that text it seemed perfect. So that’s what I’m getting. I hope it matches the other hand okay!

Day 13

Backwards or forwards or just plain stagnant? I can’t tell. I’ve been beaten down by the lap band and I’m ready to have it loosened. It can’t happen right now though. I have to wait for doctors to talk to nurses to talk to doctors so decisions can be made. In the meantime I stare at these enormous meals with full knowledge they won’t stay down and after hours of pain and discomfort when it finally comes back up I’m told it’s my mindset and I just need to relax more – to let the food digest slowly and take my time and it will all be fine. Not one of these people has a lap band or any clue how it actually works. Sometimes when it’s completely blocked I’m asked if I’d like a tablet for the nausea. Of course I can’t take a fucking tablet – my lap band is blocked. I spent an hour today with a sick bag bringing up bits and pieces. I DID NOT PURGE. I put up with the pain and wandered around looking deathly and feeling sicker. I drank hot tea and a glass of water knowing it would either force everything down or force it up. Up it came. Black mark against my name for purging – drinking the water was considered a purge. I feel so misunderstood and out of my depth. I cannot keep down the types of food available at lunch and dinner. I cannot get the volumes in. I don’t know what to do. This band will be loosened but not today and not tomorrow and each day there are more black marks against my name for being non-compliant when all I desperately want to do is comply with the program. I’m here to learn and be guided and changed and go through whatever misery needs to be got through, but I struggle with the absolute inflexibility with the band. What have other people with lap bands done? Did they find recovery? I am terrified I’ll be kicked out of the program. There has been a contract drawn up discussing self harm and purging. It needs to be discussed with the ward round team and if they apply it and insist I sign it, then one incident of self harm or purging will see me immediately discharged. The sense of failure would be overwhelming. The loss of hope. I know I need to be here and to learn the skills required to conquer the disordered thinking. I cannot bear the shame of rejection or the sense of failure. I am so very, very tired of crying. I want a day where there is a sense of success and achievement – something I can take home and maintain long term. I want a life and there are moments where I feel it slipping away. I went out this afternoon and got my new tattoo – angel wings and “stalked by demons. guarded by angels.” There’s too much stalking and not enough guarding right now. I really hope I can connect with my doctor on Monday. The interim doctor has been amazing and I wish I could stay under his care. I have no choice though. I have met the registrar and I feel very comfortable with him – I suspect I’ll spend more time with the registrar than the doctor. I do know my doctor has worked here for 15 years and he’s at least 70 so I guess he’s a very experienced psychiatrist. I’m hoping he has a little empathy – there often seems to be a lot lacking at present. If I had a choice I’d go to bed and never get out again. I’m not even sure I can be bothered with writing my book any more. I’m losing interest in everything and focusing on just surviving. I don’t recall having this level of depression and anxiety for quite some time. I bought myself an anxiety rabbit. Something to keep my hands busy when I need to scratch. It says jellycat on the tag but my friend felt Hope was a better name, so I’m going with Hope. I’m finding it very useful and have found band aids for most of the deep scratches as they keep weeping and bleeding and I’m perpetually wanting to pick at them. I’m so tired of feeling tired and dreary and I look forward to the day when I turn a corner and things pick up. Assuming that day comes…

Day 14

Today would be my mother’s 74th birthday. She has been dead for nine years, but despite the difficult and damaging relationship we always had, I miss her every day. I wonder if she watches over me. Does she know where I am? Does she recognise the part she played in my emotional failings? I suspect not – but she would still hope for my recovery.It is now two weeks since my incarceration. I have ventured out into the sunshine and fresh air on two occasions. I have plumbed some horrid depths of depression and anxiety. I have learned virtually nothing about changing my eating behaviours. I am being fed six times a day with meal plans that are carefully monitored by a group of dietitians for good balanced nutritional intake. I’m being challenged on the concepts of “good” and “bad” foods and I’ve started eating “bad” foods at snack times. Naturally this increases my desire to binge which in this controlled environment is not possible, but I won’t be here forever. The lap band has been an instrument of torture and I’ve struggled so much to work with the program and the band simultaneously. The doctors will return tomorrow and I will relent and discuss the options for loosening the band. I have discovered I can have a toasted gluten free sandwich for lunch which is an absolute blessing. 1. it is half the volume of food as the hot meals and 2. It will stay down really easily. This now only leaves dinner as a difficult choice. I got through tonight – just. It was a bit touch and go but once post meal supervision was over I had hot tea and glasses of water and paced and stretched and it eventually went down. So I’ve now kept everything down today – no failures! I will seek out another appointment with the dietitian tomorrow to chat more about that evening meal. If I can have more mashed veggies and fewer things like rice and broccoli I think I can manage better. Despite feeling floppy as a wet fish from all the clonazepam, I feel today was a much better day. I’m hopeful that this week is going to see the beginnings of change. First I need all the meals to be safe and sustainable, then I need the emotional and psychological strategies for managing long term. I don’t really feel we’ve touched on this much. I want coping strategies – throw them at me. Reinforce them. Let me practice them. Just reestablishing good nutrition is not enough. My husband will also be coming over in a couple of weeks for family therapy so I can go home with ongoing support. Fingers crossed…