Presenting Problem:
Ophelia presented with symptoms of severe depression and severe levels of anxiety (as indicated by scores of 22 on the PHQ9 and 17 on the GAD7 respectively). Ophelia told me that she is obsessed with her weight and how she looks. Ophelia explained that she will restrict her food for a few days, and then will eat a lot and vomit afterwards. Ophelia said that this is having an impact on her studies, and she won't go out to lectures if she is feeling particularly bad about her appearance.
Risk Issues:
Ophelia said that she often has thoughts of suicide, but said that she would never act on those thoughts. Ophelia also explained that she does self-harm about once a fortnight. She told me that these cuts are fairly superficial, and she has never needed medical treatment for them.
Treatment Plan:
Ophelia and I agreed that I would refer her for a further assessment with one of our high intensity therapists. In the meantime, I have sent Ophelia some self-help materials around eating disorders. Ophelia will be contacted as soon as an appointment for a further assessment becomes available.
Such is my most recent diagnosis.
Isn't it nice to be reduced to such an insensitive list. Such heart-rendering stuff.
The NHS is one long waiting list. They don't really care if you have an eating disorder unless you are so thin you are about to die.
I should probably never have left treatment two years ago. I might have been saved. But I lied my way though and escaped. I don't believe you can be an expert in depression or eating disorders until you have suffered the hell yourself and realised that you can't escape it. They force fed me CBT and I went home and threw it up. And finally, I said thank you, shook hands and promised I would be ok. And they never noticed or cared that I never came back. They only care about you when it's too late. I have always been able to physically stand on my own two feet - therefore I could do so mentally too. But I can't.
So you see, even if I wanted to recover, I couldn't. I'd need to kill myself first to get attention. (But as my diagnosis above states, I won't, PHEW!)
Now, here's the thing.
I am going to see D.
Ok, so on New Years Eve, I decided, while facebook stalking, that D has a girlfriend. So I decided that that was it. I was filling my head with hopes that were just going to tear me up. I was committing myself to stay in a club which I had no interest in remaining. I couldn't bear the thought of making myself look perfect for him, taking on new work at the club and then finding out it was all for nothing. That's the kind of shit which makes me bed ridden for weeks. Ridiculously pathetic, but true.
So I deleted all the text messages from my phone which had bought incomprehensible smiles to my face, deleted his number, and posted on my facebook a declaration that I had removed the last guy from my head and was leaving the club to enjoy a sane 2010.
And that was it, all the pressure lifted. No need to push myself to lose weight. I was not seeing him, I was not going back to see anyone that mattered.
He was out of my head.
Until, of course, he commented on my facebook status.
I doubt he knew the guy I was removing from my head was him... well, maybe he does, but, I don't think it's that obvious... anyway he said I shouldn't leave the club.
So, brilliant, back into my head he goes! And there he stays.
So I managed to subtly ask a mutual friend... and find out he's single. Of course he's single. I bloody knew this all along! And of course he likes me, a guy who didn't like me would not have gone out of his way to keep asking to help me out with stuff.
So, now he's single, and I'm pretty certain he must like me - even if only a little and even if only superficially - it's ok for him to be in my head. It's ok for me to pursue this.
I dug out his number and added it to my phone again. And I texted him.
He said of course. Of course, he was still going to help me fix some kit. He's back in London from tomorrow. I can pick and choose when to go and see him.
Andddd I'm fat.
I am so fucking fat.
Just. Brilliant.
I'm going to give it 10 days. I am going to see him on 14th/15th January. Primarily because that's when my exams are over, but also, because I am going to work out every day until then. That, combined with the ABC diet should make it possible...
I need something to look forward to ok. I can't function without a goal. D is my goal. I'm so excited. I'll by a new outfit, spend all morning doing my hair, make my skin smooth as silk, and prance, light-footed into his world.
It's the only thing that can make me smile at the moment, the only thing in my life worth living for, worth starving for.
When I took it away for that brief time, I found myself staring into a year where nothing mattered. I did not matter.
But now, it gives me a reason to survive. THRIVE. I will find a way to live off this barren land, and bloom into that flower.
Mmm we of the medical profession are none too sensitive. It's sad, isn't it? I would like to work in the field one day... I kind of feel I know it inside and out now. It is a rare thing.
ReplyDeleteGood luck with the ABC my dear. What day are you up to? I am just coming to the end of day 3... but I've had a few setbacks...
x
My (evil)therapist shares your thoughts exactly, he knows that people don't care about it till its too late. He did this thing with me where even though I'm at a perfectly fine weight he made my parents watch my every meal, cook every meal for me, make sure I'm eating like 2k calories I think, and he did all of this before even talking to me. He says he wants to stop it before it gets to bad. But yeah.
ReplyDeleteAlso, isn't it amazing how much inspiration you get from a guy? Right now I'm doing it for my boyfriend, it's humiliating sitting on someones lap being fat yuck.
Soo I read your blog but I've never commented, but I just wanted to mention about the therapist. Good luck with everything, and good luck with getting the high intensity therapist.
Ophelia, thank you for your amazing comments. You’re so inspiring and I’m so lucky to have your support through all of this. You’re right. Seeing progress is the best motivation to continue. When you begin to see your body changing... when you actually start feeling better because you’re eating healthier foods... You start to realise that this is for the best. What we’re doing will make us better people. It will make us happy. We need this. Because it will make us thin and beautiful. Beauty is confidence and health. It’s a glow. Something vibrant and positive that so few people have... It’s not just about having perfect features and model proportions. You can be beautiful no matter what genes you’ve got. All it takes is a little bit of effort. And as you said: dedication.
ReplyDeleteWe both know that neither of us will stop until we’ve reached perfection, until we’re the very best versions of ourselves. And it doesn’t have to be about pain! Food and exercise – you can enjoy it. Just stick to the healthy stuff and make sure you move around every day. Remember those alabaster thighs? That’s strength! It’s fabulous to have a powerful body. I want that.
Ok. This is really random and I don’t know why I’m saying this... but my sister (I’ve got two, one’s 15, the one I’m talking about is 10) she literally has the PERFECT body. She’s tiny. But it’s not just that, she’s really fit and healthy. She’s toned and defined, every single part of her is sculpted. She doesn’t have a single flaw. I mean, she’s beautiful! She has a beautiful body. Rock hard and solid. And the thing is... she eats. Actually she eats a lot – well she has to, she’s growing. The thing is, it’s so weird but she’ll eat these big meals and you look at her stomach (she wears a lot of tiny T-shirts) and it’s exactly the same. It’s not sticking out or bloated or fat in any way. She’s still perfect.
I know it’s not the same for us. We’re not growing anymore so we don’t need all the extra calories in those big meals. And we definitely don’t need all that junk food in our bodies anymore! (That’s sooo last year). But I think the general rule still applies. The thing I’ve noticed about her is that she stops when she’s full. She only eats small amounts. As long as you fill your stomach up, three times a day, with food that would fit into a loosely curled fist (that’s the size of your stomach) you won’t get fat. You especially won’t get fat if you choose to fill it up with fruit/veg plant-based food. Not only will you not get fat, but you’ll also feel better because that food is healthy. Food isn’t the enemy here. It actually makes us more beautiful. Think about all the vitamins in a freshly blended fruit smoothie. Think about the minerals in green leafy vegetable salad. Our bodies need them to survive and to do it’s job every day. We need food. It’s fuel for life. But we need to be eating the right foods.
I’ve been doing a lot of research into this ‘raw vegan diet’. It’s so interesting reading what the raw foodists have to say about food and all the stuff we’re eating. They say that green vegetable juice is a better source of protein for our bodies than meat – not to mention it’s full of iron and calcium. Think about gorillas. They’re these great big animals with huge muscles and yet they don’t eat meat. They eat loads of bananas! We’re the only species that cook food. And cooked food (apart from meat) when you think about it, is just junk food. Pasta? Bread? Biscuits, cake and crisps? It’s not natural at all.
I’m not saying that we need to become raw vegans. I’m not saying that we need to stop eating meat. We actually need meat for vitamin B12. But I am saying that although the healthy stuff expensive, it’s the very best food we can possibly eat. We need to do the very best for ourselves. Vegetables, protein and a little fruit.
Comment part 2
ReplyDeleteI'm reeeeeeaaaalllllyyy sorry. I wrote loads and it said I'd written too much to post! Evil little blogger. Lol once you get me started, I won't shut up! I hope you've got a few hours to read this... :D
But oh what would life be like without the occasional indulgence? This website: therawchef.com
It has some of the most amazing recipes that only use fruit/veg/nut/seed/grain ingredients – plus some fattening things like olive and coconut oil though! Too much of that can’t be healthy. But occasionally... it couldn’t hurt to have the occasional slice of passionfruit cheesecake or have some buckwheat bread when you’re craving carbs. It’s all completely free from artificial additives and preservatives. It’s natural food. But you do need certain equipment – like a processor/juicer and dehydrator. It is expensive and time consuming hunting down the specific ingredients. But maybe that’s a good thing. It means you won’t be able to eat the dehydrated stuff that contains loads of fattening nuts every day! You’ll have to stick to salads and smoothies most days and only have the other stuff some days. Nuts are actually a really good source of protein though.
However. There are always social occasions revolving solely around ‘bad’ food that you just can’t get out of. Like when you get dragged to wagamamas by your friends to eat chicken and ginger noodles. Oh the torture! (I’m joking. I love that food!) But hey, a little junky food from time to time can’t do too much damage. So long as you eat it with other people, you’ll be ok. You won’t eat too much. It’s much easier not to overindulge when you’re with other people.
It’s all about the mindset. We need to treat food and exercise in the same way – a little every day.
I know that we’ll both reach our goals in no time. And best of all, we’ll be able to maintain thin because we’ll both have the right attitudes. Plus – fasting is actually good for your body. Sometimes it needs to rest so that it can cleanse out all the toxins and regenerate.
2010 is our year. We’ll have it sorted sooner than we think.
I'm glad you've started things back up with D. Maybe he's the motivation you need? It's so horrible feeling hopeless. Like you've got no reason to even try... I know that feeling only too well.
We can both do this. I know we’ll both do this.
But don't worry about him until after your exams. Your exams are way more important. Guys come and go ;)
And remember that you're probably not as horrible as you think. He doesn't think you're a monster. He's interested right? And for good reason. You have to believe that. Because if you don't... what else have you got?
Keep going. Never ever give up.
Sending you lots and lots of love x x x
I sat and read your blog from beginning to end yesterday. I was impressed with your raw honesty with yourself. I was mostly impressed with your writing. I too am a writer (one of my favorite pasttimes) and I love how eloquent your words lay on the screen.
ReplyDeleteContinue to be honest. You don't know who you are affecting. One person is me. Who would have thought a 21 year old europen-asian woman from Europe could touch a 30-something african american woman from America??
I too have been diagnosed with lots of "mental illnesses." From depression, anxiety, bipolar II (yes! there's a part 2 to the disease! LOL) OCD, love addict...the list goes on. It seems like every time I open my mouth to a psychologist, there's a disorder based on what I just said.
I've struggled all my life to be happy with who I am. My happiness is always contingent on something else. What someone else says or feels. Therapists act like this is the stupidest thing ever. But who else do we live for if not for love, approval and acceptance of those around us?
I'm not anorexic or bulimic, but I do think I have a dis-order with respect to food. I think about it ALL THE TIME. I hate myself everytime I eat, and if I go a day without eat because I'm busy I feel so happy. I hate sitting on my boyfriends lap, or getting up from my desk at work. I feel that unless I look like Alicia Keys (I love her too) or Scarlet Johanson, there's no point in leaving the house.
I wish I didn't feel this way about myself, but I've felt this way since I've been ..... about 18. I feel very incomplete and I'm trying to search the world for the missing piece.
Read my blog if you want or have the time. You'll see what I'm trying to control FINALLY in my life. everything.
~Kandi (p.s. - remember, please continue to tell it like it is and be honest. it helps me, and I know many others, to see that there are other women out there also who have struggles.
I too need something to make me thrive because I can't do it on my own, and I find that men work best.
ReplyDeleteGood luck on abcs, I'm sure you'll stun him when you see him again ;)
Stay strong <3
Guys will do that. They get in your head, make you think one thing at one moment and then they make you think something else. I hope that things work out between you and D. And you are not fat or crazy. You are beautiful and wonderful. I hope things work out for you. Good luck on the ABC diet. I am on day 3 so if you want to talk or need any inspiration I will be more than willing to talk to you. =)
ReplyDeletei convinced my therepist im fine even though im still self harming but i was so busy she agreed i didnt have to go back for 3 months because i seem like im doing fine (she doesnt even know im bulimic even though i go in after just vomiting half the time)
ReplyDeletegood luck with abc and with D xx
Haha totally agree about the NHS help... my therapist can barely speak english, and last meeting he actually said- 'really, you're not so bad- i mean, i deal with people who have tried to kill themselves'... obviously a slow, painful starvation doesnt count...
ReplyDeleteThank you, I wasn't sure that what I'd said came out very coherent >.< Next time you brain tries to feed you a load of crap, tell it to go jump. You are too awesome to have to listen to it.
ReplyDeleteUgh, you just put me off pizza for a long time! It never occurred to me before that the cheese on pizza is that awful processed plastic D: THANKYOU!! *Tacklehugs*
It seems to be that mental health doctors are fucking retarded everywhere. I was told by the counsellors at the university I was "Fine" Here I am 5 failed suicide attempts later STILL wondering what the hell is going on. Roll their dehumanising diagnosis up and tell them to insert it anally. Offer to help, if it will get you better treatment :p
I hope D brings a watering can to the wasteland to help you bloom <3
You know what? You're absolutely right! These "experts" on eating disorders really don't know. They've never had an ED and they don't understand how you're never going to actually recover. You'd think they'd notice, but they don't. Hopeful people, aren't they?
ReplyDeleteMen are so confusing, aren't they? But you'll have him so stunned by your beauty that he won't be able to be confusing! ;) Stay strong!
I totally get the whole guy issue. I am hung up on this one guy from undergrad who I fooled around with, and who I knew had a long-time girlfriend who was going to a different school, but he would always tell me that he was going to break up with her. Obviously, he never did. I deleted his number from my phone a year ago, but we are still facebook friends, so I know that he is now engaged to that same girl. However, if he were to message me on fb, and want to see me, of course I would jump at a seconds notice to see him. And I know how stupid it is, but I can't get over him.
ReplyDeleteI wish we could just get along without guys, but it is impossible. Good luck with D, hopefully he will be a good guy!
xo
omg. i ve just read your entire blog. wish i could mail u.
ReplyDeleteall the love, beauty.