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

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My now 16year old d, was diagnosed with RAN in September 2017, aged 14. BMI 13 at diagnosis. She was diagnosed after restricting only 6weeks and received good care (imo). We did FBT, she was seeing a youth psychiatrist every week to every 2weeks. Weight restoration after a couple of months, then weight going up and down around minimal healthy weight and very difficult to eat fear foods. She only missed 3months of school. Definitely no remission, with all these fear foods. No compulsive exercising.

In the summer of 2018 we went on a holiday in South- East Asia and RAN became very strong. She lost 5kg in 2weeks while my husband and I were watching and we were paralysed. Then from September 2018 on, I found this forum, together with a lot of very good books (Eva Musby, Lauren Muhlheim, Carrie Arnold, Julie O'Toole ..) and then I gradually  learned how beat AN. We tackled (almost) all her fear foods and she stays at a healthy weight now. She finds it still difficult to eat certain (actually a lot of ) foods. We are still in complete control over what she eats. Her state has improved (most of the time) since she is at a better weight.


 Since about September/ October 2018 we started noticing that my d was studying more and more. Like a lot of AN patients, she always was a perfectionistic, academically doing very well, high achiever. But by the exams in December 2018, all she was doing was studying all day long (starting at 5:30 am!). This problem was already noticed by and  worked on by her psyhiatrist. Sadly, she doesn't follow the doctors instructions to reduce the hours of studying. Problem stays the same: she has a scheme she has to follow, with some (minimal) obligatory free time, but even that is impossible to follow through.  Clearly to her doctor and me the problem is her fear of failure, which cause her to study sooooo much! As adviced by the psychiatrist, she will probably start taking medication in July (SSRI type medication: sertraline).

Anybody who's d has/had the same problem? How did you handle this problem? For me, I know how to handle the RAN (well, at least most of the time, still learning,…), but I find it very difficult to handle the compulsive studying. It's really like OCD. I'm a bit worried that it might need the same 'treatment' as AN, complete control over how much and when to study….?  And I'm already sooo exhausted from treating the RAN.. It feels like: 'here we go again'.


I'm not a native speaker, so sorry for any mistakes in my English.
I'm located in Western Europe.

Thank you for any advice.

Great that you have posted Flori, and hope that you will find the support here on the forum that will buoy you through this challenging phase.  I wonder if your d has had anxiety issues that might have predated the AN dx?  In hindsight, we realized that our d absolutely had been dealing with some anxiety throughout her preteen and early teen years.  Meds have most definitely helped her, and in the early days of refeeding, were able to 'take the edge off' the terrible anxiety she felt about eating.
It's great that your d has a psychiatrist that will help you with the studying/potential OCD issue.  Those perfectionistic tendencies are certainly present for so many of our kids, and so having exposure to activities that are not based on scores or grades can be a possible way to combat this.  Volunteering with animals if she enjoys that kind of thing, reading with kindergartners, any kind of volunteer activity really that boosted one's self-esteem and helps others is one idea.  Art activities, drawing, painting, jewelry-making....anything really that is not based on achieving something other than pleasure.

Is your d motivated to study by wanting to attend a certain university/college?  Perhaps letting her know that colleges want 'well-rounded' individuals, and volunteering can be a useful addition to her resume?

I have heard from others that they have found the Tamar Chansky book helpful in dealing with OCD tendencies.  Might be worth a look.

Sending warm support,
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Not compulsive studying but a lot of other OCDs with AN and some before. Hi and welcome from Germany.
My d was 17 at diagnose and we had to stopp all the OCD behaviour to get rid of it.
What can you do to stop the studying? You could cancel her internet access for not more than 2-3 hours a day. You could lock away her books after 6 p.m. and give them out again at a "normal" time. You could keep her busy by asking her to help you with things. Just some ideas.
She might not be able to stop it herself...
Keep feeding. There is light at the end of the tunnel.
Hi Flori,
My d I feel had significant anxiety prior to ED. She does not study compulsively but wants to be perfect. This seems to go in stages and she is only 14 and 12 at diagnosis.
My d has been on sertraline and I do think it helps. 
I like sk8r31’s ideas of finding activities where she is not graded may help. And other therapies to help anxiety ie CBT, DBT etc..may be worth looking into. I want to do some of that with my d. 
Also there is CRT cognitive remediation therapy done with AN That helps them think through problems differently and not so black and white and rigid.
As for your English it is great.
please ask all the questions you have. We all wish to help in anyway we can.
We can offer what we did for our kids and hope that something may help you too.

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)
@sk8r31 : Thank you for your advice. Finding activities where she cannot earn 'grades' sounds like a great idea. She did a little bit of yoga recently, which she liked, so I will be looking for some more yoga lessons. Also babysiting would be nice for her, I think. I will certainly order and read the Tamar Chansky book. Books helped me already a great deal beating AN.
@tina72 : Yes I think she isn't be able to stop it herself, the fear to fail is too intense. I'm starting to realise that we will have to take full control.
@scaredmom: Hard to say if my daughter had pre-existing anxiety, but in hindsight I would say probably yes. Great to hear that sertraline helps your daughter, I hope it will help mine to. I guess preventing her from studying too much is sort of behavioral therapy, isn't it? I'm not sure what DBT is.

My daughter often says that it is to difficult to tackle both problems (AN and compulsive studying ) at once. Do you agree that we don't wait for one problem to be 'solved' (AN) befort start tackling the other one (compulsive studying)?  Do you think that opting for a less demanding study schedule would be beneficial for her compulsive studying? At the moment she has chosen a very demanding schedule. Typically for her, and probably for a lot of AN patients, always pushing themselves to be 'perfect'.
Any other parent with experience in beating compulsive studying or OCD more in general? Anyone with experience regarding sertraline?
All your advice is welcome!
Hi I can only share that we have similar experience but sorry- no solution yet!!!
I had noticed my D's compulsive study several months before ED diagnosis around exam time. It has been an issue recently again during refeeding. It leads to exhaustion with study late into night, repeatedly going over same material and D has noticed that this can lead to her making mistakes then in exams which is a useful connection to make. We have an added dimension in that D also very dependant on someone else- usually me to support her with studies to the extent of needing me to read the information aloud or try answering questions alongside her for hours on end. During refeeding, I went along with it as it enabled me to get food into her, ie she was motivated to eat as she wanted me to help her study but I am fully aware that this is a problem which needs to be addressed. I have assumed it is due to anxiety.
We did drop one subject to lighten the schedule. I think the excessive study used up lots of energy, and think more intake will be required if study increases again. I think what will help us is to work on rules for acceptable bedtime. We have been a bit lax on that. We have thought about yoga and that she may need some form of therapy to support her to manage study.
Courage is not the absence of despair; it is rather the capacity to move ahead in spite of despair
This was definitely an issue with my D particularly whilst her ED thoughts were at their most intense. We had a very slow remission of symptoms so we are talking about a number of years. When D first went back to school we reduced hours dramatically to reduce the work load and allow some time for her to think outside of ED. Interestingly when she looks back now she can say that the intense hours of studying were because of anxiety, however she is also aware they were nowhere near as productive as she is now with a much more balanced lifestyle. 

The trouble with "controlling" her study time is that it is very hard to know how much and what she needs to learn or do. If she is being inefficient because of anxiety and ED thoughts it will take her longer to learn. For my D having outside activities has really helped, early on it was spending time with her dog, going for walks etc.. but later it has been socialising as well. The performance anxiety is definitely there but it is much less than before as time has gone on, and it is reduced alongside her ED thoughts, so perhaps working on one will actually with time just help with the other. 
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.
Flori wrote:

My daughter often says that it is to difficult to tackle both problems (AN and compulsive studying ) at once. Do you agree that we don't wait for one problem to be 'solved' (AN) befort start tackling the other one (compulsive studying)?  Do you think that opting for a less demanding study schedule would be beneficial for her compulsive studying? At the moment she has chosen a very demanding schedule. Typically for her, and probably for a lot of AN patients, always pushing themselves to be 'perfect'.
Any other parent with experience in beating compulsive studying or OCD more in general? Anyone with experience regarding sertraline?
All your advice is welcome!

She does not want you to tackle both, that might be true, but it is not because it is "too difficult" and sometimes it is needed to tackle 2 things at once if the problems attack to much of normal life.
When my d went back to school after IP we asked her to do the lowest schedule possible and she was not allowed to do any extras in schedule that are not needed for A levels. That was our deal. She was angry at us at that moment but looking back she said it was best decision ever because she had much freetime after school and could do a lot of other socialising things that were not school and learning all day.
She could be "perfect" at that low level too and do all the classes she was allowed to do with 100%. In fact she graduated as best student of the year although there were no "extras" in her schedule.

For the other OCD behaviour we had (some of it she was born with but it definitivly increased A LOT with ED) we tackled it like fear food with exposure. We mad it sometimes impossible to do and increased these situations slowly or in some cases we blocked the behaviour totally to get rid of it (if possible). When she for example only uses THAT plate and THAT glass it might help to lose it in the dishwasher. If she only wants to wear THAT pants it was in the laundry quite often and in some case clothes got lost in the laundry...🙂

She needed to learn that life is not black and white and that she can stand things NOT to be perfect. We showed her a lot that we are not perfect either (she thought we are). Today she is on lowest level of OCD we ever had. She can stand to get a grade that is not A. She can stand to do things only 90%. She can even miss classes at University to have more freetime. She can do homework on public transport in last minute. She can even GO on public transport which was unthinkable 2 years ago...🙂
Keep feeding. There is light at the end of the tunnel.
Hello from the north of England. We had the same on the run up to GCSEs (16yrs) from our D and led to her breaking down a couple of months before the exams. She was devastated and cried that she had ruined her life. It was sad to see and she also ignored advice from us...school...to study less. 
We prevented her from studying in her bedroom and set up a space in the dining room for revision. We talked through what a balanced schedule was and insisted on her having short periods of revision with regular breaks. We also encouraged relaxation activities (art etc). 
We spent a lot of time reinforcing that the exams were just a pathway to getting on A levels and even though they were important to her (we avoided saying they were unimportant even though that’s what we thought) she would still get on the courses she wanted due to hard work. Hey presto the exams came and went and she got on the courses! 
Since then she has reflected and seen it is not the right approach to overstudy as ‘studying as you go along’ is beneficial however recently she is struggling with stepping off the gas so to speak. Exams are in a couple of weeks so the anxiety levels are up along with the desire to work but recognising her expectations of herself are too high. 
We are giving her space in the run up to the exams but insisting on more food to address the energy she is losing through worrying and brain processing! 
Good luck with anything you try. Xx
My D used to work all through the night and would only allow herself at the most 3 hours sleep a night, using her alarm to wake her up. We didn’t know the full extent of this at the time and only found out when she was diagnosed. Recently in family therapy she told us that it was how she punished herself if she ate or dropped a mark in a test. Recently she sat her AS levels but wasn’t allowed to over work as she is in IP, so I’m hoping that she doesn’t go back to this pattern in the future. X
Thank you all very much for all these wise words, great advice and for sharing all your experience.