F.E.A.S.T's Around The Dinner Table forum

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PaddySpade
My 15 year old daughter has been diagnosed with Atypical Anorexia. She was dieting and lost weight but her eating has stabilised now. She is still very restrictive in what she eats but is responding well to having the "control" taken away from her, being supervised and monitored. She is within the normal weight range.
Her psychologist is focusing on the eating, rather than the emotional side of therapy which she says comes much later in the therapy but she is now not coping. She refuses and is unable to talk to us or her friends, is very distressed, e.g. screaming at us that we don't care and are awful and is now missing school. She knows there is something wrong but is so overwhelmed. She is very guarded about opening up to anyone. She's a high achieving perfectionist.
I am concerned that her psychologist's approach is too "relaxed". Her psychologist has said her anorexia is a cry for help. I think that my daughter may be depressed and am concerned she is having suicidal thoughts but she wont cooperate with any support. She says she doesn't want to get better. What's the point?
I have now made an appointment with a specialist Pyschiatrist for an assessment and a more wholistic approach, especially since her anorexia is atypical.
Any advice? 
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Enn
Welcome,
I do hope you find the support and information you need
I have a few thoughts and questions:
  1. How long are you into your journey? If you are really in the first 6 months it is common and expected that she will be restrictive. The brain can take months to over one yr to really heal. It takes time. Pace yourself. 
  2. I agree with the therapist. The emotional part can be dealt with later again depending how long you have been at this. For my D feeding and getting and keeping her weight up helped the brain a lot and only at about 2 years WR + were we able to start addressing the anxiety  issues.
  3. The inability to talk and discuss is common and expected for awhile.
  4. I am not sure the anorexia is a cry for help. That I would defer to a specialist Many say they don't wish to get better UNTIL they GET better.
  5. IS your d expressing suicidal ideation to you? Is she acting out that would make you believe she is suicidal? If so please ensure meds, toxins, sharps are hidden, ropes, ladders and windows locked.

I think it is smart to get more specialist input if you feel you need. I would just suggest you ensure this psychiatrist is very educated about Atypical AN and other Eds.
Please ask all the questions you have. We all do wish to help.

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Foodsupport_AUS
Welcome to the forum, sorry that you have had to find your way here. 

It is really common for those with eating disorders to often seemingly get worse in mood before they get better. Being required to eat each meal and gain weight can raise their anxiety levels, there is also a thought that the restrictive eating often numbs their emotions leading to a ramping up of emotions once regular meals are reintroduced. 

As Enn has mentioned it is not clear how far into your journey you are, but it is really common for them to deny they are ill, and to not want to get better. Very commonly mental health support is all that can really be offered whilst the hard work of nutritional rehabilitation is being undertaken. 

One added difficulty of atypical AN is the issue with trying to work out how much weight should be gained. You bio says you are in Australia which makes it likely you have little growth information about your D and where she was in the past. How are things going on this front? Is your D's increasing resistance and isolation related to her fears of weight gain, in which case perhaps all part of the illness. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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ValentinaGermania
Is that psychologist an ED specialist?
"Her psychologist is focusing on the eating, rather than the emotional side of therapy which she says comes much later in the therapy but she is now not coping."
That is a quite good start to concentrate on eating first but how does he do that? Is there a meal plan? Are you involved? Is there a plan to work on fear food and tackle all these restrictions?

Can you see an ED specialist that offers FBT in your region? If you tell us in what region you live we might be able to help you find one.
They call that AN "atypical" because your d is still in the normal weight range. About 25% of patients are seriously ill with AN on a normal weight level.
It is normal that she is depressed and does not want to get better. That is a normal AN symptom of brain malnutrition. It only gets better by eating normal food without any restrictions.
Keep feeding. There is light at the end of the tunnel.
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Torie
PaddySpade wrote:
Her psychologist is focusing on the eating.... I have now made an appointment with a specialist Pyschiatrist for an assessment and a more wholistic approach, especially since her anorexia is atypical. 

That psychologist sounds like a wise person.  I found it very counter-intuitive but really, what the Torie family needed was a laser focus on full nutrition.  My D was depressed and cutting and experiencing suicidal ideation, and I was desperate to address all that.  So scary and traumatic for all!  In the end, what she needed was food + time.

AN does such strange things to their minds.  Many so-called professionals use an outdated approach that can be worse than no help at all. (We initially found a few of those ourselves.)

My vote is to trust that psychologist.  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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nel
I have a slightly different perspective.  For my daughter, anorexia was the outward expression of long-term undiagnosed anxiety.  When we started this journey, we learned that she had been experiencing anxiety since she was very little; we knew that she was a perfectionist but didn't know that it was actually anxiety.  After consultation with her care team, we decided to take a two-pronged approach, and she met with a psychiatrist, as well as a psychologist. 

The 3 questions the psychiatrist asked were 1) Is there a family history of anxiety/depression? 2) Has she been experiencing symptoms of anxiety for a long time? 3) Do the feeling significantly impact her life?  We answered "yes" to all three, so the psychiatrist recommended medication, alongside refeeding. Honestly, if she hadn't started taking medication, I think that it would have been even more difficult, and it was already awful. If that perfectionism you describe was there prior to anorexia, I would encourage you to feed, feed, feed, and consult a psychiatrist knowledgeable about anorexia at the same time.

Best of luck to you both.
Nel
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Mandycarr
My son was diagnosed with a thought disorder.. though I think they are grasping for straws.. which they say caused his Eating disorder. I have never seen excessive anxiety with him, despite divorce of myself and his father and then us both remarrying.. I am wondering how much he internalized. Hearing what you are all saying, I'm wondering if we should not worry so much about the WHY and the emotions clearly behind the ED but getting him weight restored? 
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Torie
Mandycarr wrote:
Hearing what you are all saying, I'm wondering if we should not worry so much about the WHY and the emotions clearly behind the ED but getting him weight restored? 

Yes, I absolutely agree with that.  AN is a biologically based brain illness with inherited genetic vulnerability that is activated by weight loss for whatever reason (e.g., dieting, illness).  It doesn't matter why; it doesn't matter whether he realizes he is ill; it doesn't matter if he wants to recover - it only matters that he regain the weight he has lost.  All of it.  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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