I think that food and eating is a big part of many mental health problems, it may not be that the patient necessarily has an eating disorder but their eating could be impacted by their illness. For example someone suffering from depression may be under eating because they struggle to get the energy to make and eat the food or someone may be comfort eating. Eating disorders are a mental health problem, my battle with anorexia has involved psychotic symptoms, depression and delusion as well as an incredible amount of distress that has lead me to feeling suicidal.
In Wales, there is not an Eating disorder unit so many people with eating disorders end up staying in general psychiatric wards, but there are also many patients on psychiatric wards all over the UK with eating disorders as well as those who have disordered eating as a symptom of another mental health condition and yet very few staff, if any, seem to have training in eating disorders on psychiatric wards.
Eating disorders are very complex and sensitive illnesses. It is very easy to trigger or upset someone who is suffering from an eating disorder because messages are often confused and interpreted wrongly and I know from my experience that when I am very unwell with anorexia I read into everything that people say and I cling onto triggering comments. They really do have a detrimental affect on me.
I don’t think the comments that staff have made towards me and my eating disorder have meant to cause me harm or upset, it is purely down to a lack of understanding but when I am very unwell it is hard to think in that way. Telling someone with anorexia that they are not the thinnest person you have seen is not helpful. It made me feel like I wasn’t ill and didn’t need to gain weight. There have been many comments around diet, exercise, physical appearance and so on that have been triggering and made an inpatient admission much more difficult. I remember feeling like I couldn’t talk to any of the nurses and health care assistants when I was struggling because often what they said back to me made me feel worse. I felt like nobody there understood me and that was really difficult.
Refeeding is a difficult process, physically my body getting used to food again wasn’t a nice experience, I would get stomach aches, night sweats and feel very full quickly. I was constantly thinking about the next thing on the meal plan that I had to eat but not being on an eating disorder ward meant that it wasn’t consistent. Meals or snacks were sometimes forgotten or very late and staff didn’t always sit with me when they were meant to. It wasn’t that the care was poor, it was that they had very little understanding of what anorexia actually is and what the treatment needed to be. Food was my medicine, it should not have been forgotten.
I think if the staff on my ward had eating disorder training it would’ve helped me to feel less distressed, more understood and more trusting that I would be able to recover there. When I know more about my illness than the staff, it makes me doubtful that they can help me to get better. I also think it would help the staff to be trained because then they would feel confident that they are doing and saying the right things and providing a good standard of care rather than feeling out of their depth with an illness they don’t understand.