The Curse Of Being A Young Person

I often feel that being young is a bit of a curse when it comes to having mental health problems. In the early stages of mental illness in a young person it’s often seen as a phase. A young person will start obsessively calorie counting, cutting out food groups and losing weight and it will often be seen as a phase until it reaches a dangerous point. Self harming is worryingly seen as a ‘teenage thing’ that people will grow out of. Low mood and depression are seen as hormones or being a grumpy teenager.

Looking back to when I was in school, my mental health problems weren’t seen as mental health problems. The most it was recognised was an ’emotional problems’ mark next to my name in the register. My overdoses would get me in trouble, throwing away my lunch had my parents called in. School took me to my doctors once and my gp just brushed over it as a teenage phase, never mind the fact I had been having eating problems since primary school.

In general hospitals I’ve had a lot of “Oh you’re so young and beautiful, why do you do this to yourself?”and “you’ve got your whole life ahead of you.” Comments that just made feel guilty about the way I felt and the thoughts that went on in my head. I was never taken seriously, I guess the way I was wasn’t seen as illness. It was just seen as behaviour and a teenage blip.

It’s definitely a curse to be a young person in adult mental health services. Let’s talk assessments first. My mental health has been judged on the way I am dressed and presented in every single assessment I have had. As a young person I have a wardrobe from shops such as Topshop, ASOS, Miss Selfridge and so on. The clothes in my wardrobe do not disappear and get replaced by ‘mentally ill’ outfits just because I am unwell. So yes, I do turn up to assessments in relatively fashionable clothes but that does not say anything about the illnesses in my brain. Maybe if I borrowed my mum’s clothes for these assessments they would take me more seriously. The outcome of assessments has been ridiculous in the past and I know other young people who have had similar outcomes. I have known people who have been very unwell and have waited 6 weeks for an assessment just to be told to go back to their GP if things get bad. I had an assessment when I moved to Wales, bear in mind I’ve been unwell since childhood and in and out of hospitals. Their outcome was that I was a young woman who felt low in mood because of a recent life change as I had just moved to the area. It was like NO this is not because I’m young, this is not because I’ve moved house. I have severe and enduring mental health problems. They now realise this but it took a lot of persistence in order to be listened to and given support.

In inpatient treatment I found it particularly hard to be a young person on a ward that was very focused on older people. The activities on the wards I’ve been in have been gardening, knitting, bingo, newspaper group. They’re just not very young person focused and the staff don’t always know how to deal with young patients. I also feel quite awkward being young on a ward full of people older than my parents. I shared a room with a 60 year old when I was 18.

The general public don’t always understand young people with mental health problems. They are hidden illnesses, just because you think that someone is young and fashionable it doesn’t mean that they’re not severely unwell. With anorexia, I’ve been very unwell to the point it’s affected my memory, my eyesight, I’ve been weak and cold and unable to walk very far. It’s been physical agony as well as mental agony but a lot of the time when I’ve tried to explain to people how I’m feeling the other person has laughed and said “wait until you’re my age!”

I think it can be very hard to be listened to, heard and taken seriously as a young person with mental health problems. I think that stigma and stereotyping is slowly being reduced in adults and older adults with mental health problems but there tends to be an awful lot with younger people not only in society but also in mental health services.

Crisis Plans Should Be The Most Important Part

Following my recent detention under Section 2 of the Mental Health Act, I received my care plan in the post this week. I am receiving aftercare from my mental health team and I am in treatment and I am grateful for that because I know from past experience how fortunate I am to have help. However, I feel the purpose of a care plan on paper should be that people can refer to them. For example, if things were deteriorating or if I was in a crisis situation then my family or myself could look at the care plan and know exactly who to contact and exactly what the plan of action is. The thing is, the most important box on my care plan is blank:

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The crisis plan has no plan. There are no names, no contact numbers and it has never been discussed. If I were to be in a crisis tomorrow then I would have no idea who to call and it would end up going around in circles as always because in a crisis situation I always feel as though nobody is really sure whose responsibility it is to intervene. It usually ends up with the police involved.

I know the day to day bits that they have included on my care plan, I know who my psychiatrist is and who I see for appointments. I didn’t need that written down for me but the crisis plan. The life saving plan that everyone needs to be able to access isn’t included. I don’t even think it’s been thought about. Surely it is the most important part of the plan?! How useful would care plans be if everyone involved had a copy and in a crisis everyone knew exactly what to do from family to professionals? I feel like this is a box that isn’t optional to fill out, it should be a MUST and it should be thorough and up to date.

What is the point in a care plan that misses out the vital parts of care?

Urge Management

I thought I would share this because we learnt this skill in DBT and I have found it incredibly helpful. It is all about delaying an urge when it strikes. Urges such as self harm, binging, purging, using alcohol or drugs and so on.

  1. Rate the intensity of the urges from 0-10 (0 being no urge and 10 being intense urges)
  2. Set a timer for 15 minutes.
  3. In the meantime use mindful distractions so that you move your attention from the urge to something else. Choose a pleasant activity that is opposite to the intention of the urge. For example. watch something funny. And/or write out the pros and cons of engaging in the urge. When writing pros and cons it can be helpful to then highlight which are long term and which are short term, often engaging in the behaviour is helpful in the short term but not in the long term.
  4. Check your urge intensity after 15 minutes, if they are the same or higher then repeat. If they are lower then carry on with your day.

How To Manage Feelings Of Guilt After Eating:

This was set as homework for me by my dietitian but I thought it might be helpful to share my list of coping strategies with others.

How to manage feelings of guilt after eating:

  • Go for a walk, don’t over exercise or do it to compensate though. Be cautious of using this one. It can be helpful but it could turn become disordered.
  • Have a bath.
  • Paint your nails.
  • Do a jigsaw puzzle.
  • Puzzlebooks.
  • Watch something.
  • Play a game.
  • Talk to someone.
  • Listen to music.
  • Play with a pet.
  • Social networking or blogging.
  • Collaging.
  • Reading.
  • Cleaning/tidying/organising.
  • Make an amazon wishlist.
  • Writing.

I think the most important thing is that it grabs your attention. I know that my concentration isn’t the best so it works better for me to do something like a jigsaw than to watch something. It has to work for you.

Perfectionism: How Can it Affect Mental Health?

When I say perfectionism, I do not mean striving to do well and getting things right. What I mean by perfectionism is a crippling fear of getting things wrong, having unreachable and unachievable standards for yourself and maybe others too. I’m talking about the perfectionism that gets in the way of someone living their life, affects relationships and usually leads to a lack of achievement. I recognise that when channeled in the right way, perfectionism can be a good trait to have but without training it can be devastating.

I am a perfectionist and I would say that perfectionism plays a huge role in my mental well being. I am not only a perfectionist with myself but often without realising it I put my perfectionism on others. I had never really thought about my need for everything and everyone to be perfect until I was set a task by my psychologist to look at the costs and benefits of my perfectionism. I found it a fairly frustrating task as I felt it wouldn’t change things and it hasn’t. I am still my anxious, perfectionist self but I think that being aware of my perfectionism and of the way it affects my life is very helpful and I hope that this can help others too.

I found some benefits to my perfectionism, I felt that it gets the best out of myself and others and that it makes me feel safe and my life appears better to outsiders. I am less anxious when I know that things are right and without error despite how exhausting it is to make sure that things are just so. I felt that by everything being right it made me feel strong and powerful, like it was impossible to reach me and hurt me but I also recognise that it makes me rather unapproachable and leads to a lot of loneliness and isolation. Doing this task made me realise I had a huge fear of embarrassment and ridicule and felt that being wrong and making a mistake would open up opportunities for this. I felt like others would accept me, like me and want me if I was perfect and did everything perfectly. I guess a part of it is worrying about the way other people view me. I also wrote ‘nothing is done halfheartedly’ and I agree with that, I always put in a lot of time and effort into the things I do. Other benefits included, going the extra mile, not relying on others, working well alone, motivation and determination.

I did find positives to my perfectionism but the costs were huge. I didn’t realise what a painful, lonely, difficult life my perfectionism has created for me. I upset others because they are unable to live up to my standards, standards that they aren’t even aware of. It creates a ‘walking on eggshells’ environment. It affects my treatment and therapy as I lose all trust if they get anything wrong and I expect my treatment and recovery to be perfect and have no ups and downs. It leads to a lot of avoidance, whether that be avoiding a situation or avoiding my GP surgery because they got something wrong and I cannot cope with that. Nothing is perfect and so every situation becomes a negative, nothing is relaxing or safe and I often feel disappointed and let down. I find myself getting stuck on the smaller details and completely missing the bigger picture.

I would not say that my perfectionism has made me successful. I take ages to start anything because everything must be right before I begin. I have difficulties in relationships and find it hard to work with others. I feel suicidal because I will never be good enough for myself and that’s a difficult way to be. I doubt myself, I judge myself, I isolate myself. I don’t even realise I’m doing it. I didn’t even realise I had problems with perfectionism until recently. Perfectionism is not my illness but it contributes to it.

Perfectionism can have a huge affect on mental health. It has the potential to take all enjoyment out of life, cause huge amounts of anxiety. It’s isolating and can lead to self hatred, low self esteem, low mood, obsessive compulsive thoughts, suicidal thoughts and eating disorders.

An Honest Account of Relapsing With Anorexia

I’m going to start by warning you that this may potentially be triggering. I am not writing this with the intention to trigger anyone, that is the last thing I want to do but I am in the grips of quite a bad relapse and hope to give a true picture of my situation to raise awareness and understanding of what it is really like to live with this life destroying illness. I don’t often open up so much, usually when asked about my current situation in media interviews I will say, “I still struggle but I’m getting there.” I hope that my honesty helps others in some way.

Today I woke up and the first thing I thought about was the scales, I went through my obsessive routine before standing on them. My scales weigh in kgs so I then figured out my weight in stones and then in lbs. I worked out how much weight I’d need to gain in order to be healthy. It isn’t just a case of getting on the scales and getting off. It’s a long routine and a maths lesson, I hate maths.

Breakfast time. I decided that after 3 days of thinking about it I’d actually drink a mug of chocolate almond milk, I sipped it thinking of actual chocolate. In fact, I don’t really remember drinking it because I was thinking about food, planning my next ‘meal’ and my plan for the day in terms of exercise.

I got dressed, put my ipod on full volume and walked up and down the kitchen for hours. Occasionally I’d worry about neighbours seeing me and thinking that I’m nuts but it didn’t stop me. I carried on until my friend came to pick me up. I’ve been walking up and down the kitchen a lot lately, nothing has really been achieved this week because I’ve probably spent way over 10 hours just walking around the same room. That’s fairly frustrating to think about. I’m sat down at the moment but I’ve got this whole leg jiggling behaviour going on.

I’ve mainly been living off of fruit and vegetables which is totally unhealthy because we need protein and carbohydrates and fat in order to function properly but not only that, my intake is fruit, vegetables, water and pepsi max and trust me after a while that makes you feel so sick! Your digestive system won’t appreciate it either. I’m spending hours looking forward to a ‘meal’ that then makes me feel sick-great!

My obsession with food seems to have gotten worse each day. I couldn’t concentrate in my psychologist appointment yesterday because he said about putting all your eggs in one basket and I started thinking about eggs and Easter eggs and chocolate and how I couldn’t eat chocolate and figuring out if there was a way I could before coming to the conclusion that no I couldn’t. Standing in a cinema foyer and I was so amazed by the sweets and chocolate and popcorn around me that I nearly said to the other person, “oh my gosh look at all the food!” but then I remembered that they are not in the depths of anorexia and therefore probably do not stare at food in a mixture of amazement and disgust. I spend so much time looking at pictures of food on instagram, who knew the chocolate hashtag could be so thrilling. I completely zone out, I’m not in reality, I’m just obsessing over foods that I couldn’t bare to pass my lips. I mean, I’m not even taking my liquid medication because it has a flavour and therefore my mind is telling me it’s full of calories. This illness is so ridiculous.

Physically I’m destroying my body, my concentration is almost non-existent and I have little tolerance for others. I’m an unexplainable degree of cold. My blood feels cold, my bones feel cold, my organs feel cold. I have become my illness, psychotic, delusional. I’ve become mean and harsh from hunger and the false sense of power that starvation gives me. It’s not nice to be me or to be around me. Negative thoughts flood my mind. This is not who I am. This is anorexia taking over.

Opportunities are disappearing, doors are closing. I used to have drive and ambition. I wanted to make a huge difference to mental health, I wanted to speak out to as many people as possible and to fight for better health provision for people. Now I’m too tired, or simply don’t have the head space and energy for things. And those brief moments where this illness isn’t stealing my thoughts I do feel sad and disappointed and I do want to grasp life with both hands and achieve things but I feel as though I have to put those things off. I am not well enough now.

I want to change, I want to be posting pictures of kit kat chunkys on instagram and saying, “you know what, today I enjoyed my food.” I want to follow my meal plan and eat the pizza I’ve spent three weeks thinking about. I want to sit in group therapy and eat the white bread we have to eat. I don’t want this illness. But then there’s so much stopping me, scaring me. I’m not sure I’m capable of coping with the guilt, with feeling the calories crawling on my skin. I’m doubting myself a lot. I also don’t feel ill enough, like this relapse isn’t that bad, like my weight isn’t that bad. I can’t justify eating that food, which is stupid, who needs to justify eating?! That’s like justifying breathing. We need to eat. But it’s a thought and it’s there and it’s real to me. I just find it so frustrating that with anorexia I often struggle to recover because I don’t feel ill enough to, as though things need to get worse first, but you’d never hear me say, “I didn’t take my inhaler because my asthma isn’t bad enough yet.”

Anorexia is such a frustrating and confusing illness. I feel very trapped right now but I am determined to find my way back out. Even if the achievement is as small as sitting down for an hour or drinking a hot chocolate. I am going to do my best to fight it. I hate this illness, I do not understand why some people strive to have it. I’ve had a lot of pro-ana accounts follow my instagram and twitter this week and I just want to say that if you are striving to have anorexia, please seek help. If you want to look good, go and buy a new outfit. Anorexia has made me ugly inside and out, I’m miserable and it has cost me dearly. I wouldn’t wish this on anybody.

If you are suffering from an eating disorder you may find the following links helpful:

www.beat.co.uk

www.somethingfishy.org

Anorexia 101

Even typing ‘anorexia’ into Twitter, the first suggestion to come up is ‘anorexia motivation’. I often worry that society doesn’t see it as a life destroying mental illness but instead see it as a lifestyle choice that is both glamorous and okay. Pro-ana is so easily accessible that even those that don’t want to see it do, pictures of rib cages, thigh gaps and low calorie meals are all over the internet. People are actively trying to have anorexia which is absurd. You don’t see people who are pro-schizophrenia or pro-bipolar. @Justdreamingof (twitter) and I noticed this and decided to come up 101 things that no one tells you about anorexia. So here they are:

  1. You will become obsessed with food and it will feel like everywhere you look people are eating and drinking just to taunt you.
  2. It will make you jealous and angry towards everyone eating. Which is um everyone!
  3. Food is all you can think of, however if someone talks to you about food you will want to stab them in the eye with a fork!
  4. On the odd occasion you cook yourself food you will feel extreme anger towards anyone in the kitchen.
  5. You will rapidly learn all social interaction involves food and so will end up isolating yourself away from friends and family.
  6. You will spend weeks alone in your room in silence and utter despair.
  7. You will have showers instead of baths as your spine and bum are too bony to relax in a bath.
  8. You will never look fashionable because you will be too freaking cold to care.
  9. You will wear layers, partly to hide your shape and partly because you will have no control over your temperature!
  10. You will feel too cold and weak to leave the house. The thin you were striving for is only seen by doctors.
  11. It will take a long time to learn, and you may never, but it will NEVER be enough.
  12. You will probably end up binging. It will torture you both mentally and physically.
  13. And you will most likely purge. It will be horrific and you will clutch your stomach at 3am wishing you were dead.
  14. You best have a good pain threshold when your laxative addiction reaches 20+ a day.
  15. Your nails will flake, split and bend. Forget having pretty hands ever again…
  16. You will make everyone cry and fear for your life. You will become everyone’s problem.
  17. A trip to the supermarket may take you hours and you may well leave empty handed in tears as hunger pains shoot through you.
  18. You will scream at them about fat whilst they inject you to calm you down in hospital.
  19. You will feel fat. Always. In fact, the thinner you get, the fatter you feel. It doesn’t get easier.
  20. You will feel any food you swallow growing on you. Your skin will itch with it. You will want to tear it off.
  21. You will hurt. Every last bit of you will ache with pure exhaustion that no amount of sleep can cure.
  22. Your medication won’t work at a low weight and without food. You cannot ease the depression you will feel.
  23. You won’t remember what it feels like to feel okay. And to be okay. What is okay?
  24. You will wake up sweating from the nightmares where you eat and eat and eat.
  25. Your memory will become appalling. You will spend your time walking into rooms forgetting why you are there.
  26. Concentration will become non-existent. You will spend hours doing absolutely nothing.
  27. You will zone out during phone calls/at important meetings and only realise when there is silence that you need to reply.
  28. You will be so absorbed in your eating disorder that you will miss weeks, months, years.
  29. You will hate yourself with a depth and a passion you never knew possible. You will hate yourself more than you hate spiders.
  30. You will do everything to please your eating disorder. Cut all your hair off, your beautiful hair. Gone.
  31. Your hair will become your nemesis; oily, lanky, dull, frizzy, falling out. It will do all of these, sometimes at once!
  32. Your bones will ache. Your teeth. Your spine. Your legs. The pain will be unbearable.
  33. When something goes wrong with what you planned to eat you will wonder if it’s a sign…
  34. You will look forward to the food you have planned 3 days from now. You will think of little else.
  35. Your skin will be dry and flaky, no amount of exfoliating and body butter will improve it.
  36. You will have so many stomach problems, especially when you refeed.
  37. People you don’t even know that well will tell you that you don’t look well. Get used to it. It will happen a lot.
  38. You will get so used to it and if you hear anything else your mind will twist it and convince you they’re calling you fat.
  39. Someone telling you you look better will translate to you look fat, ugly, horrific and disgusting. You will be crushed.
  40. You will worry about the ‘calories’ in your tablets.
  41. You may develop a fear of having food in your house, in case you eat it when asleep.
  42. You will lose count of the number of times you weigh yourself in the day. You will be chained by the scales.
  43. You may go to the other extreme, and have cupboards full of food. It is for show. It is not to be eaten.
  44. Special occasions will make you want to die.
  45. You may have multiple sets of scales, to compare results thus ensure accuracy and also as back up should a battery run out.
  46. You will feel everyone is judging you.
  47. Occasionally people you don’t even know will comment on your weight ‘have a biscuit, you look like you need it.’
  48. And everyone will stare at the state of you. A mixture of shock, horror and concern.
  49. You may on occasion allow yourself to eat something as a treat. You will regret it, you will feel it tainting your body.
  50. You will bin your Easter eggs and advent calendar. You will want to cry at everything you are missing out on.
  51. You may be taken into the office at work, and told that maybe you shouldn’t be there, that maybe you are too ill to work.
  52. You will exercise until you cry or pass out.
  53. You may be treated like an idiot, with contempt and made to feel like you are wasting the professionals time.
  54. You will lose your hopes and dreams. No. You will forget your hopes and dreams.
  55. Other people may give up on you too.
  56. You will feel there is no escape from your nightmare other than death.
  57. You may manage to stabilise things. Don’t be lulled into a false sense of security. You are not safe from it.
  58. You will convince others you’re recovering when really the weight gain is from binging and purging.
  59. Your previous laxative abuse will leave your bowel unable to function normally. But you’re too scared to take laxatives…
  60. Your most glamorous moment will consist of nurses measuring your wee when your period has returned!
  61. You will fear a period. It is a sign of weight increase and its arrival is truly devastating.
  62. You will want to harm yourself over eating chocolate.
  63. You may hate to see other people eating in a carefree manner. The thought, the sound and the smell induce both fear and nausea.
  64. You will be stopped from exercising and be forced to sit down for months. It’ll feel like torture.
  65. You will become devious and lie about what you have eaten to those who love you. You will hate yourself for it.
  66. As a woman you will detest your womanly features.
  67. You will sit in the clinic waiting room praying no one else comes in. If they do you fear they will think you are fat.
  68. You will be so disinterested in sex. You won’t give a hoot about having a boyfriend.
  69. You may become irrational and irritable, pushing the few people who’ve stood by you further away.
  70. You will set yourself impossible standards. You will always feel useless.
  71. You may sit in the exam hall and struggle to write your name legibly with a pen as you have not eaten for over a week.
  72. You will think you can snap out of it but you can’t. You are trapped.
  73. Your grades will drop as you’re now scarcely eating, and punishment for the low grades you’ll eat even less.
  74. You will probably end up with no qualifications. No career. No life.
  75. You will struggle to pick up your beautiful toddler goddaughter as she runs towards you to be lifted up.
  76. You will feel unworthy and undeserving of everybody’s time.
  77. You may develop random phobias which will fill you with terror.
  78. You will cling to the walls as you walk to the toilet. Your legs will ache with weakness.
  79. Someone may call you chubby as a joke because you are painfully thin. You won’t find it funny. You will be crushed.
  80. You will body check until it drives you mad. Pinching skin. Obsessing over flaws in the mirror.
  81. You may avoid mirrors all together, and windows, and glass doors and anything else that may reflect your image back to you.
  82. If someone takes a photo of you, you will stare at it and how grotesque you look. It’ll make you cry and want to die.
  83. You may set yourself goals of what you can wear when you lose weight. But when you get there, you will still feel too fat.
  84. I hope you like GP and hospital appointments. Your life will become a timetable of them.
  85. Any physical problem you develop will be written off as due to your anorexia. You may feel no one listens. A lot don’t.
  86. You will forget what the air outside feels as you rarely leave the house due to depression and weakness.
  87. When you do go out, you may feel everyone is looking at you. You are sure they are all thinking you’re fat.
  88. You will cancel on your friends and family because you feel too fat to see anyone.
  89. When you are unable to avoid seeing them, you will exhaust yourself pretending that all is well. No one will be fooled.
  90. You will have the weakest bladder imaginable. You will worry all the time about where the toilet is.
  91. You will rapidly realise that mental health is not an NHS priority. Neither are you. You will be seen as selfish and weak.
  92. And when you are screaming that you are not okay no one will hear you. You have no choice but to suffer in silence.
  93. ‘All you need to do is eat. It’s not difficult’ will be something you hear over and over and over again…
  94. You will cry with frustration when everyone refers to your nightmare as a choice.
  95. Everyone will have an opinion, usually the same one and they will all tell you it’s obviously all about control.
  96. You will sit in group therapy and you will hate it.
  97. You will have osteoporosis before you are 30.
  98. You will sit in waiting rooms full of elderly people.
  99. You will look back and realise you have wasted 20 years of your life, and yet still you can’t stop.
  100. You will find it easier to visualise yourself dying than to visualise yourself eating.
  101. It is all consuming. You will no longer recognise who or what you have become.