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annabanana

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Reply with quote  #1 
Hi everyone, I was reading through some of the posts on anxiety and wanted to see if any of you can relate to what we are experiencing.

My twin girls are now in 1 yr recovery, and while they were anxious as kids (thanks to my husband who is anxious about EVERYTHING--didn't know that would rub off on my kids this way) and had night terrors, I didn't think much of it at the time. My 2nd twin is doing well, still waiting for her body to stop looking like she's 6 month pregnant (that's another issue), but my first twin's anxiety is getting worse, even after she was deemed 'well' by the hospital.

I separated the twins for a week in the summer but while it was good for T2, it was horrible for T1, as she is more anxious than ever before. She's so paranoid and anxious all the time that she's not gaining weight properly. She's crying pretty much every day and not sleeping. She eats the same amount as my T2 but is not gaining any weight. She's crying and begging every single meal for me to make sure she's not eating more than her twin sister and that she doesn't want to be the fat twin. (It didn't help that I had 2 doctors that told her that she looks healthy, and that she should now 'take care of herself' even after I told them that she has ED.)

I have written about our situation before but I just wanted to address anxiety for this post. People have said that it should get better as her body heals but I know it's worse now. I feel as though she has other issues (resulting in ED). She's not willing to try drugs anymore because of the side effects of weight gain.

Is there anyone who has seen a similar pattern? If she suffers only from ED then I expected her anxiety to be high in the beginning and eventually taper off as time goes, from what I've read before. How long after WR did it seem to get better? If she's comorbid, will her anxiety not get better until she's able to get either medication and/or therapy? I am in general against mediation but I see her case as an exception.

I'd greatly appreciate your comments!


mjkz

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Reply with quote  #2 
It sounds like you are willing to try meds and recognize it may be the needed step.

The other thing and I know this is hard but what you allow will continue.  My daughter would be anxious and stuck (for lack of a better term) on things just endlessly having meltdowns and wanting to discuss them over and over again.  I finally had to set some pretty firm boundaries on what I would talk about with her. 

Quote:
She's crying and begging every single meal for me to make sure she's not eating more than her twin sister and that she doesn't want to be the fat twin.


I wouldn't allow the crying and begging to be honest.  I'd ask her to go to another room to collect herself and then come back when she can interact in an appropriate manner.  I know I've talked about other things we've tried but I do think part of it is setting boundaries around how much you can take.  She may get desperate enough to try meds but if she won't try meds, you don't very many options other than behavioral controls like not being willing to listen to the begging and crying, giving her time outs to get herself under control, etc.  My daughter has insomnia and melatonin was a great over the counter med that helped and has no real side effects.
momofalexa

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Reply with quote  #3 
Unfortunately with comorbids, unlike anxiety and depression stemming from starvation, they tend to worsen with recovery and weight restoration. This is particularly the case if the eating disorder came about as a way of subconsciously managing that comorbid and mitigating its impact on our kids' lives. The eating disorder has a numbing effect, its like taking a pill. If (to put it into a physical context) you have a chronic pain condition and stop taking the pill that helps you manage your pain, it comes back. Same thing here.

Long story short-
1. no youre not crazy, its actually a thing
2. it sounds like anti anxiety meds might be the way to go, poor kid sounds like shes really struggling
3. struggling or not, i agree that firm but fair boundaries need to be set
annabanana

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Reply with quote  #4 
Thank you, I just don't know what else to do with her crying. MJKZ, melatonin actually did not work for us except to make her drowsy, believe it or not. She'll eventually dose off, but not for long, and not good sleep either. She always sleeps better when she's with me, which interrupts my own.

She is a nervous wreck so she needs my reassurance, she says, to keep pushing but we'd talk for hours if I let her, about what she ate, what she thinks her sister ate, etc. Then the cycle starts again. I do know talking to me helps her to calm down--meaning her crying is more low key instead of the panic attacks that she gets when I walk away to end the conversation. Quite frankly I am ready to go crazy with this day-long roundabout conversation.

This is the reason why I have concluded that medication is the next step for us but our family doctor was not willing to prescribe because she told her she didn't want it. We are stuck here until my daughter is willing to take it. Momofalexa, I agree with you--what to do about it is our current dilemma, and we are still without professional help after a year.
mjkz

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Reply with quote  #5 
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Thank you, I just don't know what else to do with her crying. MJKZ, melatonin actually did not work for us except to make her drowsy, believe it or not. She'll eventually dose off, but not for long, and not good sleep either. She always sleeps better when she's with me, which interrupts my own.


Sorry!!  The melatonin is for sleep, not anxiety.  My daughter takes 3 mg a night and it has been wonderful at helping her sleep.

What do you do about her crying?  Give her a time out.  Put her in her room by herself until she can calm herself down and rejoin you.  I would tell my daughter I could see how hard it was for her and then ask her to take a time out until she could calm down.

Quote:
She is a nervous wreck so she needs my reassurance, she says, to keep pushing but we'd talk for hours if I let her, about what she ate, what she thinks her sister ate, etc. Then the cycle starts again. I do know talking to me helps her to calm down--meaning her crying is more low key instead of the panic attacks that she gets when I walk away to end the conversation. Quite frankly I am ready to go crazy with this day-long roundabout conversation.


The conversations you are having will just feed into the anxiety.  You will never get anywhere talking about food and weight, what her twin ate, etc.  In fact, it just feeds the cycle of anxiety.  You give her a time out to get herself under control and end any conversations about food, what she ate, what her twin ate.  Instead focus on other things.  What do you think will help?  Are you ready to try medication?  Etc.  Panic attacks will not kill her nor will anxiety.  She may have to ride out a few panic attacks until she gets the message that she has to do something to control her out of control anxiety and also that she needs help with it.  It is a hard thing to do but you are going to stay stuck where you are right now if you continue with the conversations.

Is she back in school yet?  It might be worth looking into having her attend school for a few hours.  It will force her to focus on something other than food and what her twin is eating, how anxious she is, etc.  Distraction is the key as is letting her know that the out of control anxiety and crying needs to be reigned in.
Playball40

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Reply with quote  #6 
My daughter's anxiety has really not improved since she was diagnosed.  I realize she was always anxious but it has gotten worse as she's gotten older - I just don't know if it's the ED or her age (middle school, blech) or what anymore.  However, she does take Prozac and I do believe that helps.  I realize now looking back that her anxiety is much less centered around food and the urges not to eat are in response to some exterior/outside stressor as opposed to eating.   Definitely give medication a try.  It really did help in the early days with eating.
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Caroline
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Reply with quote  #7 
Hi annabanana,

My D's anxiety was the worst as she got within 5-10 lbs of what ended up being WR for her.  It got to the point of a crisis.  Her self harm increased and she was obviously suffering greatly.  That's when we asked for her to be evaluated for anxiety medication.  Shortly after that she started taking Prozac which helped.  We'll never know exactly how much Prozac helped vs. WR and time, but I believe it was the combination. 

*  I have to ask the question that is always asked on this forum . . . is it possible your T1 has not fully reached WR?  Is she still in the high anxiety phase of being close to WR?

*  My D was not keen on the idea of taking meds at first.  She was concerned about addiction, about it changing her, drugs are bad, etc.  I talked with her a lot, her psychologist talked with her, we asked questions of her ED doctor, etc.  When it was finally time to take the first pill it took me 2 hours to convince her to take it.  It was much smoother after that.

*  I don't understand a doctor who won't prescribe a needed medication because the minor prefers not to take it.  

*  I remember having long, circular conversations with my D during which I thought I was helping allay her anxiety only to get to the point where I was exhausted and emotionally depleted and her anxiety was back in full force.  One thing I learned is that what has the best chance of reducing ED anxiety is not to discuss all the details of the food, weight, the body image, etc that ED wants to discuss, but to assure your D that you are in charge - that you know the right thing to do for her - and that you are going to do it.  (I think I learned this from Eva Musby's materials . . .)  It is SO much easier said than done, but it helped me to have that mindset.  Sometimes when my D would start one of those circular conversations I would not answer her questions but would tell her that she is going to recover, that it is going to get better, that I will not leave her in this state (i.e. just let her stay sick and do nothing), that we have hired/consulted/read what the best minds have to say about recovery from ED and that is the plan we are following.  I knew it worked when it short-circuited the ED conversation and she let me hug her.  Disclaimer - it didn't always work, but it was so worth it when it did.

Thinking of you . . .
annabanana

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Reply with quote  #8 
Thank you for sharing, Palyball40 & EDAction. It seems as though everyone else, including the staff at the ED hospital is in agreement that her weight is restored. In fact, our family doctor told her to start working out more regularly, so I had to change our doctor. I am staying cautious and watching her intake but her weight does seem to be stable for the several months even though she’s crying about her ‘huge’ thighs.

The biggest issue is her endless comparison to her twin. This is what’s causing all of her anxiety. She wants me to guarantee that she won’t be the fat twin again. After my assurance of her being the size that her body needs her to be, everything is good until the next meal. Today it was me asking her if anything from her candied apple (with chocolate) dropped to the napkin she had under it, and when she said she ate a piece that fell (whether it’s true or not, I don’t know since I was driving) I said “oh, good!” That indicated to her that I let her twin sister not eat whatever that had dropped on her napkin, because I sounded surprised. So she had a melt down—but it’s build up from the previous meal, not the candied apple incident necessarily.

The rest of the family is so very tired. For now we are trying natural supplements like the ionic magnesium citrate powder to see if that helps a little bit. I wish it was as easy as sending her to her room when she’s having one of her episodes.

LIke Playball40, it’s not the eating that she’s having issues with. I believe I read one another post about anxiety increasing toward the end of recovery, but my gut feeling is that most likely her weight is restored and that she has a bigger issue to deal with than eating at this moment.....
mjkz

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Reply with quote  #9 
Quote:
The rest of the family is so very tired. For now we are trying natural supplements like the ionic magnesium citrate powder to see if that helps a little bit. I wish it was as easy as sending her to her room when she’s having one of her episodes.


It is that easy.  It can seem more difficult but it really can be that easy.  It sounds like she is overwhelmed and needs to calm down.  Her way of calming herself down is to badger you into reassuring her that she is not the fat twin again.  Once you do that, you are stuck in that endless cycle that there really is no way out of.

She needs to find different ways to soothe her anxiety that don't involve you reassuring her and tiring you and the rest of the family out.  If she won't take meds (and quite frankly I wouldn't be giving her other options if this continues), then behavioral is all you got left to use.  If she is truly weight restored, then more weight probably won't help.  The point of putting her by herself is to reduce the amount of stimulus she has to deal with and also to force her into trying different ways to soothe her own anxiety.

Think of it as a 3 year old throwing a tantrum.  You try to soothe her and it only makes it worse.  So what do you do then?  You change the scene by leaving and stop rewarding the anxiety driven behavior.  Once the kid sees you are paying attention to something else and doesn't get whatever reward he/she is seeking, the tantrum stops.  Same concept only your kid is much older.
Foodsupport_AUS

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Reply with quote  #10 
Annabanana if she is weight restored then as you say dealing with her anxiety is the main issue, however every time she is reassured about her size, her meals etc.. it gives extra strength to her anxiety, it makes those fears more real rather than less. Other than medication and CBT which are good tools for anxiety, if she refuses to work with that then it is left to you to carry the load. 

Have you read this book: http://tamarchansky.com/books/freeing-your-child-from-anxiety?

Many parents have used this, as quite a few of us have had anxious children well prior to ED. It teaches lots of skills for parents to help their child. 

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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
momupnorth

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Reply with quote  #11 
I must say, meds certainly helped my d especially in the first while of her ed.  made her more amenable to treatment and eating in general.  My d's anxiety definitely predated the ed diagnosis...I actually believe it is still the driving factor in all her issues though it seems to have exploded out of her control.  I also had issues with sending d to her room to calm down as, for one, she is a very strong willed young lady and often would not go and for 2, she could not be trusted to just calm down and not exercise  or escalate further when sent off on her own.  It sounds like your d can be as stubborn as mine and will not give up until she gets the answer she wants.  I have often had to just stop the conversation and absolutely refuse to discuss certain things anymore...this, she eventually can to accept.
mom up north

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annabanana

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Reply with quote  #12 
Thank you all for your input—I do realize our talks are not helpful overall, and I’ve given her 10 min limit in our talk times and she really tries to abide by it. I can see she’s suffering and we’ve tried many different coping mechanisms which didn’t really work for her. I suppose our talks are the best coping mechanism for her right now but because of my inability to do this for every meal, we need to find something else.

I’m sure that her anxiety is directly related to the fact that she cannot see her twins’ intake any more. If her anxiety is going to be the worst at the last stage of her recovery, like EDAction, should I relieve her of that by making food equal for both of them (and that will calm her down) and wait for her brains to heal so she can think more clearly during the meal times OR should I continue to push her by continuing to separate them during eating time?

When we go out to eat, which we’ve never stopped doing (mostly fast foods and casual food court type setting), I am pushing them to order different things, foods that they like. This is part of the reason for the increase of her anxiety as well.

When will she able to see that her anxiety over her being fatter than her sister is unfounded? She is having suicidal thoughts as well, which is scaring her, because it’s been a very long time since she had those thoughts and they are more prevalent now. Most posts I’ve read are opposite so I was feeling as though I was going in the wrong direction the past month or so, but perhaps this is the route her ED is taking her. I just don’t want her to suffer so much unnecessarily.
HateEDwithApassion

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Reply with quote  #13 
Hi,
Just heard an excellent speaker on this last week. Your daughter will not likely respond to anything you say if she is still in her delusion that she is going to be fatter. The doctor explained that while in the illness, they are delusional and you can't convince them that their reality is not true with rationality. He likened it to telling a schizophrenic that they should stop seeing or hearing delusions. They can't.  It may be a while before she's able to believe you even though what she is worried about is truly unfounded.

A therapist this week said something interesting to my daughter. She said - it's ok to feel helpless/anxious, etc. It's actually a normal part of your recovery to feel those things. You can feel those things AND still do the next right thing, in spite of what you feel.

Don't know if saying that would help. I don't think backing down from what you are doing right now will help with the anxiety, to be honest. I think it's something she has to learn, for the moment, to sit with and still eat.  [frown]


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17 yo D. Diagnosed in July 2013. W/R in Sept. 2013 and has remained so. Roller coaster on and off since, mainly with ED under control but co-morbid depression and other negative coping mechanisms making our life hell. Trusting in God for daily strength and wisdom.
Foodsupport_AUS

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Reply with quote  #14 
Quote:
I’m sure that her anxiety is directly related to the fact that she cannot see her twins’ intake any more. If her anxiety is going to be the worst at the last stage of her recovery, like EDAction, should I relieve her of that by making food equal for both of them (and that will calm her down) and wait for her brains to heal so she can think more clearly during the meal times OR should I continue to push her by continuing to separate them during eating time?



I would rephrase this. Her anxiety is directed towards not being able to see her twin's intake. There is no rational or logical reason why seeing her twin's intake is important, it has nothing to do with her. Realistically she needs to be aware that she has not control over her twin's food whatsoever. So yes continue to separate them, and for what it is worth I would not offer any time towards these discussions. 10 minutes is an incredibly long time. She does need to learn to sit with this anxiety. Not have you in any way allay it. 

Warn her beforehand then  the next time she complains," I am sorry it is not helpful for us to discuss this any more" the  first time, then every other time " I can see you are feeling anxious" Keep going like a broken record. Name the feeling. Her anxiety is not rational and by in any way considering going back to feeding both girls the same I would suggest that you are giving it credence rather than helping to stop it. 

Yes, your D is suffering, but I would argue that by allowing her to go over and over about this problem is not helping her at all. As parents we hate to see our children suffer, but one of the important things that we have to learn as parents of kids with ED is their own distress tolerance. She also has to learn to tolerate this distress. 

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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
mjkz

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Reply with quote  #15 
I agree with FoodSupport and HateED that going back to letting her see what her twin is eating isn't going to help.  You would be taking a huge step backwards and while it may seem to appease her anxiety, she is going to have to learn how to deal with whatever goes through her mind when she thinks she is becoming "the fat twin again". 

I think limiting the conversation to 10 minutes is just taking a step backwards too.  Just don't have the conversation.  One of the things that I did (and it seems so obvious that I don't know why I never did it before) was ask my daughter what she thought would help!!  I would tell her that having the endless conversations is not an option nor is seeing what her twin is eating.  Then ask her what she thinks would help.  My daughter came up with ideas that I would never have thought of and instead of simply asking her what she thought would help, I tried all my ideas and got really frustrated when they didn't work.[frown]

I don't think you are causing her to suffer unnecessarily.  I can see how having the endless begging not to be made the fat twin again could cause the other twin to suffer though!!  Nothing is going to work well the first time.  Coping skills become helpful the more they are utilized so sit down with your daughter and make a list of ten things she can try with #11 being go back and try #1 again. The more she practices, the better the skills will work but you will have to see her suffer with anxiety.  The more you try to appease it, the worse it will get so get her input and make her start thinking about things that could help.  Obviously none of them can be self destructive but for instance my daughter would start wearing her ipod and listen to music she liked after eating to drown out the thoughts.  That doesn't really work for me so I wouldn't have ever suggested it but it worked for her.
HateEDwithApassion

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Reply with quote  #16 
I daresay, in seeing a DBT therapist myself for coaching, she pointed something out to me... I too have to learn to live with my own anxiety and distress when I see my child in distress. Wow - that was an eye opener to me. I am lecturing my child about using her skills and using mindfulness etc. and yet - I wasn't doing it myself. I was reacting, trying to relieve my own stress at seeing her upset. 

All that to say that, you, too, have to sit with the anxiety of seeing your child so miserable and it's not easy, but necessary. I stink at that myself, but at least I am beginning to recognize it and not activate immediately to relieve my D's anxiety.  

__________________
17 yo D. Diagnosed in July 2013. W/R in Sept. 2013 and has remained so. Roller coaster on and off since, mainly with ED under control but co-morbid depression and other negative coping mechanisms making our life hell. Trusting in God for daily strength and wisdom.
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