andante, andante: notes on recovery

Mental Health

It’s been nearly two weeks since I took the plunge into honesty, and I want to continue sharing my struggles and successes with you all. Though recovery will never be completely rainbows and butterflies, this week I’ve found love and laughter in unexpected places.

Back on the EDU last year, one of the nurses told me the average time it takes someone to recover from an eating disorder is seven years. At the time, I thought she was depressing and disheartening. Now, I realise she was just trying to warn me: there is no quick fix, and even when your physical health stabilizes, there will always be emotional issues to tackle. It’s never as simple as ‘just eating’: it’s a long, winding road of learning and un-learning thoughts and behaviours.

This being said, the last week has been a good week for me, recovery-wise. After the initial sharing of my story for the first time (which was equal parts terrifying and liberating), I started the week positive and motivated. I’m currently on a 16-month waiting list for one-to-one therapy (tell me NHS budget cuts don’t exist, I dare you), but I’m lucky enough to be in regular contact with the EDU here in Oxford, and I’ve found their support really helpful so far.

A few days ago, I had an appointment with my new dietitian. It’s always nerve-wracking meeting a new member of my key support team, but she was a cracking lady; really supportive and down-to-earth. We had a ten-minute conversation about our shared love of sourdough, so that was great. I thought it’d be helpful to share some of the processes that I go through with my recovery – for those still suffering who have yet to seek help. Seeking help for your ED is the first step – and the hardest one – but I’d like to raise awareness of the fact that, although it’s scary, it’s vital in order to get the freedom you deserve.

So, my appointment with my new dietitian lasted about two hours. This is totally normal for dietitian appointments, though sometimes they vary and can be a little shorter. Usually for this kind of thing, I’ll be expected to go up to the eating disorder inpatient unit – though some units will have separate buildings for outpatients, and sometimes I might meet my dietitian at the main hospital. We talked about my current situation and how we could work together to make small changes that would benefit me in my recovery. While I’m still waiting for psychological support, it’s important to have a steady intake and sleep schedule, and to try and drop some of the unhealthy coping mechanisms my little brain has been clinging onto.

Because I’ve made some progress with my diet and weight over the past few weeks, this meeting was different from the others I’ve had. My dietitian has given me some timetable-come-meal-plan sheets that I have to use to keep track of intake and compensatory behaviours, and I’ve also been given a little CBT hand-out to help me remember the ‘new rules’. I thought it might be helpful for you guys to see:

You may find it totally bizarre that there are times when anorexics are ‘not allowed’ to eat – but this is a big thing in recovery! Even back in group therapies, we weren’t allowed any food or drink (aside from water) inside our sessions. There’s always been a huge emphasis on eating at the *right* times, and this is because a) it’s important to get into a good routine, for physical things like your metabolism, as well as psychological impact and b) it allows you to listen to your hunger signals.

Hunger signals are another big thing, let me tell you. For your average non-disordered person, they will feel hungry around lunchtime, and they’ll eat. For someone with an ED, feeling hungry is almost constant; sometimes we might feel hungry even after we’ve eaten, and sometimes we’ll feel so hungry that this can lead to periods of ‘bingeing’ which damages our stomachs – constantly shrinking and swelling – and our minds. So, until we’ve learned to train our minds and bodies to expect food at certain times, we’re unable to trust when we’re hungry and when we should be eating.

As you can see from the handout I was given, there are rules about the flexibility of mealtimes (1hr max), using compensatory behaviours (that’s a no-go) and eating outside of these set times (totally forbidden). So, my new rules are pinned up in my bedroom and I’ve jumped head-first into trying to achieve my goals. Also, my dietitian has clocked on to my competitive-ness and is definitely trying to provoke me in any way she can. She’s a smart lady (I hate that).

Another thing you can expect when recovering with the help of ED services is a lot of scans and blood tests. You kind of get over the needle thing after a little while! This week I didn’t have any blood tests, as I had them the week prior, but I did have a good old ECG and a DEXA scan.

So, for those who don’t know – an ECG is where you go (to your GP) and they stick lots of sticky pads all over your body and measure your heart rate. This is because those with ED’s will often have heart irregularities, like a heart-rate too quick or too slow. Deep in my disorder around fourteen months ago, my heart rate was very slow due to over-exercising (yeah, that can happen!), but this time, it was looking pretty healthy (#winning). It’s important to ask for an ECG if you think you may have an eating disorder – even if you feel you don’t ‘look underweight’, your heart can suffer from lack of nutrients, and it’s important to keep an eye on it.

A DEXA scan scans your bones to check their density. When people develop ED’s whilst their bones are still growing and developing (aka teens – twenties), it can lead to osteopena and osteoporosis. DEXA scans are super quick and easy – you lie on a table and put your legs on a raised block. It takes maybe ten minutes, if that. It does not involve getting in a tunnel. But, if you’re very lucky (and you forget to wear a non-underwired bra), you might get to rock one of these cool hospital scrub gowns.

My radiologists were hilarious and super interested in my writing: in fact, both of them jotted down my name and book title to ‘buy it when it’s published!’. So, uh, I guess I have to get it published now, if only to save me the embarrassment…! It’s always lovely to have good chat and banter with hospital staff: they make a routine check-up an actual enjoyable experience.

So, that’s my week for you! Lots of appointments, kind, friendly nurses, and laughter with some rad radiologists. It’s been wild; and I’ve mostly stuck to my new plans, so I’m calling this week a Recovery Win.

I also just want to throw it out there that my diagnosis of Atypical Anorexia Nervosa means that for most of my disorder, I was not underweight. A common misconception – and one that AAN sufferers often internalise – is that you have to be underweight to be ‘actually sick’. This isn’t true. If you can relate at all to what I’m talking about, I’d urge you to seek help. One of the nurses at the Bristol EDU once told me that AAN can often be more dangerous than other eating disorders, because your internal organs are suffering, but you might not ‘look the part’ and therefore not seek treatment. There’s a reason it has the highest mortality rate of any mental illness. You’ve nothing to lose by speaking to your GP. Trust your instincts and find freedom through honesty.

Thank you so much for your comments on #FreedomFriday’s COURAGE issue, it does – and always will – mean the world. As always, questions and feedback can be shot my way at tomlin.bethany@gmail.com – as can submissions for #FreedomFriday.

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