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melstevUK

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Reply with quote  #76 
HateEDwithApassion,

I don't know what the situation is with regards to the money, how much she has and if she earned it herself so that technically she could support herself for a while.  It seems to me that in talking about moving out, she is just assuming that you as her parents will pay for her rent or accommodation, which does not lead to her being responsible on any level.  

I don't always see things the same as others but I would be telling her that these are the boundaries, you will not give her any of her or your money right now for her to go off and live by herself because she is too vulnerable, but that I would happily sit down with her and think about how she is going to get to the stage when she can be more independent.  She needs to cooperate with you so that you can all live in the same house.  If she storms off, does she have friends that she will go and stay with?  I know I would not want her in the streets but when she is so volatile I guess she could storm off.  

If she is willing to see her local team again, that has to be a positive even if in reality she needs a higher level of care.  If she starts shouting, tell her that growing up involves learning to negotiate in a reasonable fashion and that making demands and holding everyone hostage to her wishes is not going to work any more.  If you can stay calm even when quaking inside, you might get somewhere.  If she storms off, tell her you want her back before whatever you think is a reasonable time - midnight? - and that you will see her then and be waiting for her.  You will have put the idea in her head that you will be there.  I would also be saying that, while she is so angry and making poor choices, she can't be happy, and that you would like to see her happy for once.  You cannot be angry and happy at the same time so she needs to give up the anger and she might actually feel a bit better.

Things are definitely not in your favour right now, and decidedly not easy - but start as you mean to go on.  

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mjkz

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Reply with quote  #77 
I did not release any of my daughter's money when she was so intent on moving out.  It forced her (after couch surfing for a few days with friends who got sick of her quickly) to have to come home and continue working with me.  While she may have earned the money, she is not in any state to be living in a hotel or apartment.

I would also make that clear to your daughter up front so she can make a informed decision about going into this other program or having ERC help her find a place to stay if she will not agree to your rules and the contract.  That way she has an out and a safety net of ERC being able to help so that you are not just leaving her in the street.  Not allowing her to come home and making that clear was what got her to stay at ERC.  The more avenues you cut off for her that aren't good decisions like getting her own apartment, the more chances you have she will make a better decision.  I do think you have to be up front with her 100% though while she is in a hospital that can help her find alternative living arrangements.  It can't be that much of a shock to her if you say she can't come home until she is on her meds again because she knows that is a condition of living with you.  If she was truly willing to work with you, she'd have take the opportunity over the weekend to get back on them.

I would also let ERC know that if they send her home like to say a homeless shelter knowing how unstable and volatile she is, if something happens you will hold them responsible.  With my daughter they couldn't get rid of her fast enough so they were going to send her wherever would take her.  I wouldn't say that in front of your daughter because if she gets angry enough at them, she may act out just to get back at them.  I would let them know that you are holding them responsible because they allowed her to go off her meds (and didn't tell you!!), that they shared how erratic her behavior really has been (a couple of days prior to discharge-really bad form) and they know how unstable she is.  If she doesn't come home, she needs to be placed in a group home or supported housing for mentally ill patients where there are staff that can monitor things.
Torie

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Reply with quote  #78 
How's it going, HEwaP?  Thinking of you and your d during this challenging week. xx

-Torie

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mjkz

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Reply with quote  #79 

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How's it going, HEwaP?  Thinking of you and your d during this challenging week. xx



Ditto.  I'm hoping no news is good news.  Sending thoughts and prayers your way.

eternalhope

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Reply with quote  #80 
Thinking of you HateEdWithAPassion. Keeping you all in my prayers.
HateEDwithApassion

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Reply with quote  #81 
Thank you all for checking in. I haven't even known what to say, so I've taken a break. D was asked to leave program for noncompliance, insurance cut off and drinking while in PHP apartments. Yep. Other patients were involved in similar behaviors, but because they are still compliant in the therapy part of the program, they had different sanctions and were allowed to stay. 

What this has meant is an abrupt return to home with no transition at all. No wellness plan completed, no repair plan, no appointments set up in advance. No transfer to intensive IOP. When you are asked to leave, apparently none of the normal discharge transition that would have been pre-set happens. She was out and on a plane within 12 hours - and the day before Thanksgiving too! Great timing. I'm pissed even though she did this to herself too by fighting them, having cops called, not taking meds. I had a list of hot button issues I wanted to bring up to the program but she was kicked out before we were able to. This was my worst nightmare - coming home with no structure ready to go.

So, here we are... she's back home. Quiet. Depressed. Not eating great. Resistant to basic conversation about anything. She will see her med doctor tomorrow and her DBT therapist on Friday who she wants to return to. Apparently, he has some very strict criteria she must agree to in order to work together again. Group DBT skills commitment, med compliance, eating disorder team compliance. 

We have not yet laid down the law for what she must do to continue living here because of how she came home so shockingly and how depressed she was. Also, my DBT therapist let me know that the transition time is a risky one for those coming from structured psychiatric stays in terms of suicidality. We think we need to talk with her tonight about our rules, but I'm also wondering if we should wait for her therapist to have this conversation with her on Friday. She bucks everything we say, but he has a way of getting her to agree to things. He got her into PHP and to stay at the residential center when she was signing herself out. So he seems to be a voice of influence. 

I'm also to the point that I feel like just saying forget it - let her spiral down and go back to the hospital or whatever and feel the natural consequences of not engaging in recovery at all. The more control we exert, the more she does the opposite.  So that's where we are. Now you can see why I didn't write sooner. Trainwreck. [smile]

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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.
eternalhope

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Reply with quote  #82 
HateEDWithAPassion, I will continue to pray for you all. I wish there was more I could do. God bless you.
Francie

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Reply with quote  #83 
Hi HateED, So sorry for the position you find yourself in. I have no words of wisdom, just support and prayers. Hang in there. It's good that your d has 1 therapist who she'll listen to. If your d doesn't want to talk to you I say then don't talk, respect her wishes and let her figure this one out a bit on her own - she will eventually want to talk with you. And when she does talk remember the 4 c's: be Calm, Compassionate, Consistent and Confident. And validate her. She's not doing this to you, her disease is causing her to behave in this way. Also remember to give her (and you) support, love, care and assistance.

Do you and hubby have a list of rules you want her to follow? My h and I keep going back and forth with stuff just because we really don't know what to do.

Our d also resists a lot of what we try and say and do so the only leverage we are using at this time is validation and support. I do a lot of hugging (I ask first if I can hug her because sometimes she doesn't want a hug) and I say 'I Love You' a lot. We are learning that recovery will unfortunately have to be on her terms, on her timeline as much as it pains her and us to live through this. We can nudge her toward treatment, gently point out how the eating disorder gets in her way but that is it. We forced her into treatment two times and she has not engaged as much as we would have hoped.

Maybe you feel frightened for what could happen. I do, too. When I catch my thoughts going to unthinkable places I try to stop those negative thoughts and instead be in the moment. I love my daughter so saying I love you and hugging her is natural and feels good. I also do those things in case the worst outcome happens and I can know that my d always knows that I love her.

Wishing you hope and faith and recovery. XO
 



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mjkz

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Reply with quote  #84 
Ugh HateEd.  Once they decide your kid is difficult or not responding to their treatment, they can't get him/her out fast enough can they?  Same thing happened here.  No follow up, no discharge planning, labeled as a trouble maker and shipped out as fast as they could get her out.  Mine came out worse than she went in and even more convinced she was not worth helping.

Anyway, I'd move forward the way you wish to continue.  I'd give her your rules and let her process them with her therapist.  The longer you wait, the harder it will be.  Yes, you could just let her fail until she needs to go back inpatient again but do you really want to watch that?  You have other kids too and is it fair on them to have to watch that?  I couldn't do it which is why I ended up making her leave home. 

I wish you had better news but I'm still thinking and praying for you and your family.

HateEDwithApassion

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Reply with quote  #85 

mjkz,

Yes! Happened exactly as your situation did. I'm sorry to hear the same thing happened to your D. Last Monday, I wrote to her therapist saying - "Isn't AN a resistant illness? I mean isn't that what we expected?? Why are we considering discharging her for noncompliance when we know that's a factor in this illness??" But then she was kicked out, so they never had to answer that question! 

Like your D, my D has come home more pissed off, and with a worsened relationship with her family. She has zero interest in rebuilding our relationship! I've been reading this great book called Letting Go about prodigal children. And how to know when you have to let go and live in the negative consequences of their choices in hopes they turn back at some point. I know it's more complicated with ED because of the genetics and ambivalence around recovery, but at the same time, it's not. She has to find a sliver of motivation to do the next thing even when it's hard, and all she's done is fight us and the doctors tooth and nail. 

My H is going to take her out tonight to talk about house rules and where we'll go next. They have a rocky relationship for sure, but since Family Days, my Hs anger toward her is minimal. He's been a lot more patient and gentle with her, which I'm grateful about. She cares desperately what he thinks. In any case, she meets on Friday with her outpatient therapist, and we'll have a good idea if she's willing to meet his criteria, which are pretty much going to be ours. 




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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.
mjkz

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Reply with quote  #86 
I filed quite a few complaints about how my daughter was treated and it really helped me.  That might not be the answer for you but I wanted to do as much as I possibly could to be sure that it didn't happen to anyone else.  I don't recommend this treatment center to anyone just for this reason.  There are others on here who have had the same experience.  It is sad and really vilifies our kids.  Don't get me wrong.  My kid was an obnoxious kid who pushed every single button she could find on every single provider who worked there but they are supposed to be professionals who can deal with that.

My daughter had the same attitude you are describing.  I absolutely agree with you that at her (and my daughter's) age that they do have to find some internal motivation to keep working if not for recovery.  I hope the talk goes well tonight with your husband and she agrees to the conditions.  If she does not live up to them, I hope you find a way to deal with it (with her still living there or not) that you can live with.  I don't regret kicking my daughter out.  She had a very comfortable life even with ED until I kicked her out.  It was a real wake up call for her to see what life could be like.  She had all her basic needs filled but nothing extra and it was the only thing that motivated her to start working with me instead of against me.
Kali

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Reply with quote  #87 
Hi HateEdWithaPassion,

Sorry things are so tough right now. One day at a time.
The treatment center seems incredibly irresponsible to discharge her without a transition plan. Maybe the therapist who she likes and you and your husband can help put together some sort of treatment structure and a way to move forward for her taking her input into consideration?

I'm trying to think back about when our d. arrived home after treatment and what we wanted her to do:

Eat all meals.
No purging or self harm.
Continue in treatment for as long as necessary.

She certainly did not come home well although she was weight restored. 

We tried to motivate her by discussing some things she would be able to do when she was better, travel and college.
She also found a part time job and kept busy with that and later tried taking some college courses, part time, while living at home.

Your daughter has been through a lot and her friends are probably off at college and/or doing interesting things while she is ill and depressed and wondering what her place in the world is. Someone held out a promise of recovery to her and she went into treatment and it was disastrous...She must be very discouraged right now. Is she weight restored and how is her eating?

Can you plan some nice things to do with her? 

Kali

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HateEDwithApassion

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Reply with quote  #88 

Hi,
I'm not shining around here much lately because I think I'm depressed myself.

My D is home, beginning to attend appointments with dietician, outpatient therapist, psychiatrist which will set the course on where we go from here. 
I honestly have no idea if she is weight restored - we have yet to get the repair plan from her treatment center. GRRR. I'm so mad at the way they handled this.

She is not eating much. She appears to be taking her meds when I count them; she knows meds are required by her outpatient therapist to begin seeing him again. She will be weighed today at dietician, but I don't know what weight she came home at (thanks treatment center) - and she's not eating hardly at all. She needs intensive outpatient and more likely PHP again, but honestly, I have no fight in me anymore to push this kid into treatment when she signs herself out or refuses to engage in the therapy. I'm mentally numb. I can't seem to get myself to care.

We were asked by the DBT team to hold off on laying down rules last week since she came home the day before Thanksgiving and the anxiety around the big food day and also the abrupt discharge made her a risk. We followed that and tried to just do things to repair our very broken relationship. She is talking to my H, but is distant and almost silent with me without being outright rude. 

We have a contract we wrote up but haven't shared with her yet since we wanted to get through Thanksgiving. I imagine most of what we are asking for will be the same criteria her own DBT therapist will require if he is to work with her again, so we wanted to hold off and see if it came from him, if she wold agree. She 100% oppositional on anything we ask/require. 

My guess is by this weekend, we'll know if we need to ask her to leave - follow our rules or move out. I'm pretty sure it will be that she needs to move out. She has no job. No college classes. No friends. She lays in her bed, looks like a homeless person, and refuses to engage with much of life. 

We've done literally everything I can think of other than the tough love angle, which so many here have advocated. With her suicidality and risky behavior choices, we have hesitated doing this final push, and still struggle with it. But we do get that it may be the only thing that will end up, in the end, possibly leading to recovery. 


__________________
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.
Francie

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Reply with quote  #89 
Hi HateED, so sorry for the current situation but you are doing all the right things. I am wondering: did your d ever receive a complete psychiatric testing? to see if there are other comorbids that aren't being addressed either in treatment or with medicine?

My d is also not eating much but I am happy when she at least eats on a regular schedule, which is rare. I just keep praying and remaining calm. Try and practice self care, as much as you don't feel like doing it. It won't be doing your d any good to see you despairing over her situation. I will continue to keep you and your d in my prayers. 

I found this to be very uplifting, with good ideas for communicating at home, maybe you will, too: http://anorexiafamily.com/emotional-support-parents-anorexia/ 

XO

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Kali

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Reply with quote  #90 
Hi HateEdwithaPassion,

I want to chime in here and say that although I understand how difficult this is, I, personally, feel uncomfortable about the tough love stance with someone with a mental illness. I would never allow my daughter to leave home severely depressed and not eating enough. 

Imagine that she goes. You will not know where she is and you will not know what she is doing or eating. Your anxiety may be through the roof. And she is ill-equipped to be able to fend for herself with a high school education and a malnourished state. She may find herself in serious trouble. At least now she is home and you can try to keep her safe and you have the opportunity to prepare 3 meals a day, speak gently with her, work slowly and surely and lovingly to repair your relationship, like you said you had started on, and encourage her to move forward in her life with baby steps toward some worthwhile interests. 

Kali



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HateEDwithApassion

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Reply with quote  #91 

mjkz,
Thank you for sharing your experience. Gosh we really mirror each other's journeys.

I emailed a complaint to our therapist last night making some very strong points about their decisions around her care and discharge. She is setting up a call with the director to discuss. I'll find out after that about lodging something more formal. Their discharge and no follow-up has been nothing short of disastrous. Yes, my kid was resistant, but seriously - aren't all ED kids who have to be sent to residential? Would I send her there if she was eating and agreeable at home??? Seriously.

Francie - she hasn't had a full workup of psychological testing that I'm aware of. Her DBT local therapist said she has BPD traits but he would hesitate to give her that full diagnosis. The treatment program doctor told us - yes, she has BPD. Nice way to break it to us - oops. He also said they saw some bipolar traits and a lack of remorse which was "troubling". Okay, so she's a sociopath too? Jeez.

Again, who knows... the kid was off the rails, on meds, off meds. Eating, not eating. I have little confidence in any diagnosis they verbalized other than undernourished!


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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.
Francie

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Reply with quote  #92 
Hi HateED:

she hasn't had a full workup of psychological testing that I'm aware of. Her DBT local therapist said she has BPD traits but he would hesitate to give her that full diagnosis. The treatment program doctor told us - yes, she has BPD. Nice way to break it to us - oops. He also said they saw some bipolar traits and a lack of remorse which was "troubling". 

Sorry if the following is a repeat of anyone's past advice or your own experiences, but, is it worth looking at the possibility that your d's problems are more than ED? That ED treatment isn't effective because ED treatment isn't targeting the root of the matter and that there are troubling co-morbids that are getting in the way of any effective treatment for any of her ailments? And that medications are not targeting the root causes of her issues and relieving her core symptoms so why should she take them? You would want an MD - a psychiatrist - to do full testing, not simply an evaluation. 

My heart goes out to you, your family and your d. XO


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mjkz

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Reply with quote  #93 


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We've done literally everything I can think of other than the tough love angle, which so many here have advocated. With her suicidality and risky behavior choices, we have hesitated doing this final push, and still struggle with it. But we do get that it may be the only thing that will end up, in the end, possibly leading to recovery. 


I'm glad you are following up with ERC.  They did far more damage than good with my daughter.  She came home so sick-and medically unstable.  They just didn't care once the decision was made to kick her out.

As hard as the tough love approach is, it was the only thing I hadn't tried and at that point it was all I had left.  It was a huge wake up call for my daughter and truly broke through her "who the hell cares and screw the world-I'll do what I want" attitude.  Finally it was someone else telling her exactly what I had been telling her and not in a loving way or even a caring way.  It was this is how you are going to live now kind of thing.

I would be very honest with her team so that they can try to find supported housing for her if she can't live by your rules.  My daughter landed in a group home where she had no choice but to follow the rules and was told when to get up, go to bed, etc.  It was the wake up call she needed.

If you ever want to talk about what steps I took when my daughter came home, email me.  I'd be happy to share what was done and the outcomes.

eternalhope

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Reply with quote  #94 
HateEDWithAPassion, I am so sad about what has happened. ERC should have done a better job transitioning her home. I’m glad you have a call set up with them to file a complaint. I hope they listen and understand the terrible position you are in. I’ll continue to keep you in my prayers. I wish there was more I could do. Take care of yourself.
Torie

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Reply with quote  #95 
I've been trying to think of some brilliant advice to offer, but I'm not sure what to suggest.  Such a lousy, rotten deal that they sent her home so suddenly, without attempting to transition, and with such terrible timing.  Ugh ugh ugh.

Please take care of yourself as best you can.

Thinking of you.  xx

-Torie

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melstevUK

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Reply with quote  #96 
I don't really know what to say either.  But you have complained and that is a good thing.

"My D is home, beginning to attend appointments with dietician, outpatient therapist, psychiatrist which will set the course on where we go from here."

For me that is your starting point right now - your d is willing to work with people which means she is looking at recovery, even if she cannot imagine what that means or looks like.

I had BPD traits in my twenties, they were hellish years full of emotional instability.  There is probably a higher incidence of BPD traits in young people now because society is much more liberal, money and alcohol are all more freely available and self-regulation on all levels is so much more difficult now.  We had TV when programmes were only on air from midday until midnight.  No programmes available 24 hours, no phones, no screens to interact with.  Learning to behave in a stable manner, even if your emotions are all over the place, is a start.

Personally, I would be very gentle with her and encourage her to find one nice thing to do a day.  I would also encourage her to shower every day - standing in a hot shower for ten minutes is a cleansing and comforting experience when everything around is hellish.  I have no idea where you live but a walk out in nature is also enriching and uplifting.  Would she accept any beauty treatments at a health spa?  I love pedicures, some people like massages - whatever works if you can get her to agree to doing something like that.  You yourself would benefit from a treatment as well.  Could you go together?

After being expelled from the programme, taken a flight home and been on and off medication she is likely to be totally 'zoned out' and not feeling as if she is real.   Periods of huge instability leave you washed out and frightened and as if you are in another dimension to everyone else.  In my experience, creating stability and offering nurturing and understanding while expressing expectations around behaviours could be a way forward.

Can you have a walk together just the two of you?  Don't worry about the relationship - even if she expresses hostility and anger, as much will be directed against herself as against you.  

You were really let down by the treatment centre - but put it behind you right now and keep looking forward.  Looking back wastes energy.  
Hugs. The old story of 'Pick yourself up, dust yourself down, start all over again'.  And it is hard, so very hard - but what else as parents can we do?


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mjkz

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Reply with quote  #97 
Good luck today with her and therapist.  Got my fingers crossed something will shift for you.
Torie

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Reply with quote  #98 
Thinking of you.  xx

-Torie

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eternalhope

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Reply with quote  #99 
Also thinking of you HateEDWithAPassion. Keeping you in my prayers.
HateEDwithApassion

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Reply with quote  #100 
Thank you everyone! How are you all doing? I hate always posting about my situation because there are so many more families out there going through the same hard times.

D was accepted back into DBT program. Will be doing the group skills group. Still on medication as far as I can tell. Saw dietician and will see her weekly. Extremely depressed. Mostly in her bed. That makes me sad.
Did go shopping with me etc. Not eating her full meal plan. Usually very little for breakfast and lunch. Normal dinner and a snack or two. I'm guessing she has a figure in her mind of what she will allow herself. 

We have to talk with her tonight about having to eat at least three meals and snacks, as best as she can if she wants to drive the car and have us pay for her phone. We are going to start there. That will probably go badly, but it must be done. That's all for now. I did go to a wedding last night and danced and had a few cocktails and it was great! So not all is lost!  [smile]
How are you all doing? 

__________________
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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