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NellyMac_UK Show full post »
Doitagain
Yes we have experience with Mirtazapine. Seems to be very good for sleep. D has been on it for a while after a disastrous experience with Prozac. Has worked well - took ages (about six weeks and a high dose but once it kicked in was very good.
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lostandfound
My daughter had been put on many, many different meds with little to no effect so when her psychiatrist tried the mirtazapine i was very skeptical, but it has helped her a great deal! He recently added cymbalta as well and for the first time in 5 years, my daughter has relief from her severe anxiety and depression.

We did notice in the beginning that she craved many sweets and carbs which caused her some distress, but she did not gain any additional weight and those cravings decreased fairly quickly. For a short period could you make these foods less available to her or offer them in small amounts? My daughter's AN  is purely restrictive so I don't have experience with binge/purge issues.

Hopefully the cravings will subside soon and all will be well!!
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NellyMac_UK
thank you, this is reassuring, if the food craving are just temporary whilst  she adjusts to the medication it will be alright.  She has been sleeping really well which should make a huge difference to her state.
Diagnosed RAN October 2013, w/r but struggling with depression and anxiety.
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NellyMac_UK
Today I get home from a really stressful day at work and am just about to try to grab a couple of minutes relaxing time in the garden to help keep me sane when Social Services turn up and ask to see D to "check that she is still alive and that we are looking after her properly".  Apparently this is routine procedure when a minor tries to kill herself.

After eyeballing D social worker was happy that she was okay and went said she would close our case.

This country is a joke.



Diagnosed RAN October 2013, w/r but struggling with depression and anxiety.
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Doitagain
OMG - this country is a joke sometimes - but glad that your D seems to be sleeping well at the moment. it does seem to help a,little.x
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NellyMac_UK
She seems so much better since starting on the mitrazapine. 

She even met up with a friend for a walk for the first time in months, which is a huge step.  It was lovely when she came in happy, though I was on the edge of my seat the whole time she was out, lol! I needed a glass of wine when she got back in!

Still having sudden urges to eat huge amounts - particularly in the evening, and she is feeling bloated.  I noticed she has bought figure slimming/control underwear.  Hopefully the appointment for psychiatric assessment should come through soon.  But she does appear much more steady and the evening/night time hyper attacks have stopped. Sleeping every night too.  

A huge improvement when I look at what I have just written [smile]
Diagnosed RAN October 2013, w/r but struggling with depression and anxiety.
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LauraRu
I also have a daughter with depression and anxiety. We are weight restored and the eating disorder behaviors are well contained. The clinical director at the eating disorder program we went too said that getting them weight restored and eating allows you to deal with the issues that triggered the eating disorder. I love Decoding Anorexia. That author says that something like 75% of kids with AN also have a diagnosable anxiety disorder and in 50% it PRECEDED the AN. Reducing food intake is an *effective* means of reducing anxiety (has to do with seratonin production, most of you have probably read the book).

Since discharge, my D has run off, stolen alcohol and an exacto knife and cut deeply enough that it required stitches (for the first time), and last week, jumped out of her grandmother's car at a red light and ended up on an overpass. Thank god she didn't jump. She spent the weekend in a psych hospital. 

Someone above mentioned DBT - we started that in earnest on Monday (went direct from hospital to the therapist). Even the little we have learned in ONE visit is awesome. Plus they talked a lot about DBT concepts in the hospital. My D too has resisted mindfulness. I think it has to be introduced VERY carefully to our kids. If it's simply equated with being quiet then they end up inside their own heads, which can be quite scary.

One of the most important things we have learned is about the escalation cycle. So every four hours (9a, 1p, 5p, and 9p) I check in and ask where she is on the cycle, where her depression is on a scale of 1-10 and anxiety on the 1-10 scale. Then I can employ DBT skills and/or medication as needed. Only been doing this since Tuesday, but have learned A LOT. Most importantly, that her anti-anxiety meds have stopped working.

For the first time this morning, she is in green zone, depression 1 (low), anxiety 1. I know this won't last forever. But i'll take it for right now.


Laura
Stepmom of 16 year old with AN. Dx disclosed to parents 11/11/14. Restrictive eating, compulsive exercise. Also major depressive disorder, anxiety, self-harm, and mild OCD. WR 2/15. The journey of a thousand miles starts with a single step.
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peony
NellyMac,

Mirtazapine really helped my girl with depression after she was WR.  Helped her sleep at night as very sedating.  She was on them for about 6 months but eventually the sedating effect of the Meds was too much for her to function in the day.

DBT was also  very useful for her during that very LONG spell of depression after WR.  Unfortunately she only had access to DBT during an in-patient stay but the tools she learnt stayed with her.

Keep going - it's a long slog for some after WR but my daughter is now very well.  Time, time, time and addressing each issue as they come up along the way.  You are doing brilliantly. there is very real hope of recovery from ED and the co-morbids that come along with it. xxxxx
Peony
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NellyMac_UK
This is such a long and bumpy road.  I thought I would post an update for anyone who is following and in the same boat!

D is still coping better overall.

Since my last post she has 'come out' as bisexual.  We are fine with this but perhaps a little confused as apart from an interest in gay rights she hasn't shown any signs of it throughout her childhood - but maybe she just hid it?  Anyway, we are happy as long as she is healthy and happy.  So she came out and volunteered to be a steward in the local Pride event.  This is huge step for her (overcoming her social anxiety and agrophobia) and she managed the event really well, even enjoyed it and made lots of new friends.  She went out to parties and was like a normal teenager for the weekend.  Whilst we stayed at home having our own anxiety attacks!!!!!

She continues to binge eat in the evenings.  I have been buying less trigger food (such as crisps, biscuits) but she just buys her own and eats it.  It is hard to watch and she is putting on a lot of weight.  But the medication is definitely reducing her anxiety and she is still sleeping much better.  I am worried that her relationship with food is still skewed and that now instead of restricting she is going to overeat/binge. Hopefully the GP will monitor and pick up on it.

The appointment for the psychiatric assessment came through - they took her into a room and asked her to fill out a questionnaire and then compiled a report from it.  I was not allowed to go in so don't know the questions or her answers.  The report has come through and they say she is a normal teen who is finding the transition to adulthood difficult and that no further treatment is required and that they are discharging her to the GP who should begin reducing her medication. Oh and that my genes have been a contributing factor.  I did have ED/anxiety/depression as a teen, but seeing as they didn't even say hello to me I find that hard to take. 

She is developing a bit of an attitude.  It is hard to know whether this is normal teenage behaviour (but perhaps more extreme as she has a lot of catching up to do) OR whether it is the next twist in the road.  She seems to be so angry - and I can't blame her, I feel angry about a lot of things too!!!!

We are still coping with this situation on our own - but we are managing at the moment. 

The good news is that I have booked myself into a yoga retreat at the end of the summer, and I am so looking forward to it.  I am worn out and hope that this will help me relax and gain a fresh perspective. I am already worried about leaving her at home (with Dad/Grandma) but I have to do it sometime, for my own sanity.   I am also worried that I will be crap at yoga!!!






Diagnosed RAN October 2013, w/r but struggling with depression and anxiety.
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Foodsupport_AUS
Thanks for the update. There are some positives in that she seems to be finding her way and learning more about who she is, something that all teens need to go through as they move on towards independence.

I agree with you about your concerns with binging. She may well have ongoing distress as the weight goes on, and may also have guilt about the behaviours. It is a very tricky one to address in someone who has previously had AN. Hopefully the GP addresses the behaviours rather than the weight gain.
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
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NellyMac_UK
We had an awful day of binge eating yesterday. I am starting to panic.

She got up and ate a part baked baguette, then had two bowls spagetti for lunch (which she made), a bowl of popcorn, a bag of crisps, biscuits (she wanted the whole packet but I took it away, but just noticed they have gone!).  Then evening meal of veggie burger, aubergine and sweet potato and kept asking for more food, I can't actually remember everything she ate.

All with a challenging look in the eye.  I have tried talking to her about it but she won't discuss it at all. 

She is not purging which is good.

Is this a common occurrence in YA recovered from AN? Does AN often morph into binge eating? 

She has also started to buy alcohol and drink it at home, particularly when she is feeling anxious.  So it seems to me that she is comfort eating and numbing herself with the alcohol. 

She really needs therapy but as you know that isn't working out for us at the moment.  Since we got the psych report I feel really disheartened and that we have exhausted all avenues of treatment.


Diagnosed RAN October 2013, w/r but struggling with depression and anxiety.
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NellyMac_UK
I hope this gives encouragement to anyone who needs it!

D is currently out night clubbing with some new friends.  Can't tell you how happy this makes me that she is slowly rebuilding her life (I am also worried about her being out but this is normal teen behaviour!).

D has been doing well, still having ups and downs, but the downs are becoming fewer and shorter.  She is still taking all the medication and the mitrazapine is continuing to give her the urge to binge eat, but she is coping well.  She has put a lot of weight on and at times finds this difficult to cope with but she is trying so hard to be positive, I can't explain how proud I am of her.  She put on jeans tonight and said "I think I need to get bigger jeans" without any upset.

We were watching Adele's new video the other day and I was astounded when she said that she really liked Adele as she has not changed and gone on a diet since becoming famous, but continues to be herself.  It hasn't occurred to me before, but Adele is such a positive role model for young women!

She is still battling with her anxiety and sometimes this completely exhausts her, but she is managing to function well and keep going to work.  It has been difficult seeing her old peers from school going off to university and she had a couple of weeks when her mood was very low, but I think we are getting past it now. Her life has changed so much and is on a different track, it takes a long time to accept that, but there is no way that she would cope with the exam stress of university.

A sign that she is struggling with her anxiety is that she has become a compulsive picker and her fingers are in a real mess - but I think this will pass eventually and it is better than other coping mechanisms she had in the past!  I am so proud of how strong our D is and amazed at her strength as she continues to fight and adapt her life to cope with the mental health issues.

I am seeing light at the end of the tunnel!

Diagnosed RAN October 2013, w/r but struggling with depression and anxiety.
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NellyMac_UK
I am so tired, and in need of strength.

Nothing dramatic, just tired of the constant stress.  D is probably doing well overall - but it's not good enough, I don't want her to be (barely)coping I want her to be happy and enjoying life.  I don't want her to be dependent on medication to function.  There is no plan and no help. 
Diagnosed RAN October 2013, w/r but struggling with depression and anxiety.
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momon
Hi Nelly
Sorry to hear you are down, and hoping that you get some good rest and can come back stronger. This is a good time to think of adding in a little more self care if there is any way, between work and caring for your family.  This is NOT a marathon this is a cross-continent run. Cross continent runners really need good fuel.

I am so sorry to hear you feel there is no plan and hope some other people can give you ideas of where to go.  We are still in the food-is the plan thing mostly but hoping more help can be found for her.
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linefine
Torie,

I have just been reading this thread today and came across your posting with the following questions.  I'm VERY interested in this and would like to know what your experience is following this time with your D?  See my answers in bold.

1) Was re-feeding relatively easy for your d? Yes, compared to lots of others on here.  As with you, no walk in the park, but she very rarely refuses to eat, and is gaining steadily.

2) Did / does your d have terrible self-loathing, and if so, did it precede Ed? Yes and yes.  She "hates herself" all over, only likes her eyes.  She doesn't want to be so skinny, doesn't have a fear of weight gain.

3) Did your d fast? Yes.  Gradually reduced the amount she was eating, because she wasn't hungry, often felt sick when eating, and thought she should be following what her body was telling her.

4) Have you ever wondered if your d is on the autistic spectrum?  An ED Mum friend suggested this (over the phone - she hasn't seen D for a lot of years).  19 year old S has Aspergers, but never occurred to us with D.  But she does have OCD tendencies and has had general anxiety and not coping with stressful situations (especially if they involve deadlines, like school tests or exams) for years preceding ED.

5) Does your d want to NOT get better from the depression? Yes!  Has said so on numerous occasions, and specifically to CBT therapist last year. Sometimes says she feels safe in the depression, and being "well" from it is a bit scary because it's unknown.  Went to CBT because we "made" her (not realising about the ED), but got no help from it because a)she wouldn't tell the therapist about the self-loathing, b) she wouldn't put any of the techniques into practice (to the extent that the therapist said she couldn't help her unless she was willing to change) and c) probably because we needed to get her weight up and brain starting to heal first.  She actively will NOT take medication (even herbal St Johns Wort) or see any sort of practitioner, ED or psych, except the GP, who isn't an awful lot of use.

6) What else do our d's have in common?  This! (Copied from your other thread)  Could be our D you're describing!   "She just wants to spend all her time on the computer and text messaging, neither of which imo are helpful to her. She is fixated on maintaining straight A's in all her classes, which I view as unhealthy for her, but I don't know what to do about it right now because she has so much anxiety as tests approach - so much anxiety in fact that she goes into avoidance mode and spends all the more time on the computer or working on non-essential homework even as the deadlines loom and the pressure mounts.   But she won't go to sleep unless and until she is satisfied that she is "ready for the test."  So I find myself forcing her to get off the computer and study even though I really don't care about her grades any more, and I think she needs to face down her fear of getting a bad grade, bite the bullet, and walk into a test she feels unprepared for on occasion."

Torie, I'd be so grateful if you could give me any insights!  Email if you think it's more appropriate.


Heather

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonour others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always PROTECTS, always TRUSTS, always HOPES, always PERSEVERES. Love never fails.
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Torie
Hi Heather and NellyMac - 

FirIst, NellyMac - so sorry you are having a rough time of it. I hope you are able to take the time to do little things for yourself and that you are able to sleep OK. This vile illness takes such a terrible toll, especially since it just goes on and on and on...

Heather - I think I might start a different thread and copy the pertinent posts from this thread into it (if I can figure out how to do that). 

Interesting that your d is OK with her eyes. My d once told me the same thing - I wonder what it is about eyes.

More later ...

xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Sotired
I am sorry to hear that you also are feeling pretty down.im struggling with this myself.i try to accomplish two things a day at the moment,if I manage more,great.if it's just two things,still great as at least I got out of bed to do the.with co morbid so alongside anorexia or bulimia it's hard for others to understand that weight restoration doesn't fix everything,that sometimes other things have to come into play,like DBT coping skills, or for us, a level of acceptance that our child may need to find something within,we simply cannot provide everything they need , a bitter pill to swallow.once they start in adult treatment our ability to help them also gets harder as we can be shut out of treatment.
Is your d willing to search out some therapy for herself nelly mac?or can you find the therapist, the bus she would take to get there and back and say that this was your part,but the next part is hers?the getting there,learning and implementing?
I really know how hard this is but please do one thing for yourself every day.pick some flowers,walk on the beach,listen to music.every day,take one hour for you.fill up your tank.no car keeps running on empty,neither do we.eat chocolate cake for breakfast,anything that lifts the cloud for a while.
I send you a virtual hug and the hope that today you do one thing for you.
Sotired42
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NellyMac_UK
I'm just a loss what to do.  We have tried everything with therapists - cahms were useless, adult mental health refused to see her as she was too anxious for a telephone assessment, private said she was too ill for them to treat, psychiatrist said she was a normal teen and discharged her (she obviously didn't tell the truth).  I think part of the problem is that she looks good, she is bright, articulate and can turn on the charm and they fall for it every time. She puts on a very good act of being totally healthy then falls apart at home.

Today I found evidence of self harming and found out she has been taking diet pills. She is buying vodka and knocking herself out with it.

I am going to see if the GP will talk to me on Monday but I don't think he can discuss her case as she is 18.  She won't even let me in the building when she goes for her monthly appointment. 

I am seriously concerned that another suicide attempt is imminent.  I know it is.  I feel powerless to stop it.
Diagnosed RAN October 2013, w/r but struggling with depression and anxiety.
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admum
I am new to all this and have no wise words. Just wanted to say my thoughts are with you and your daughter.
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Sotired
This just sucks eh.put all pills in a lockbox, hide her implements of choice ( Stanley knives,cords,scissors).when you feel a suicide attempt is imminent do what you can and those are the easy things.the harder things are trying to be around her 24/7, so if you have someone that you can split this duty with that's for the better.trying to get an assessment done and explaining to the people assessing her that she will put on a face for them.she may have to go to a secure unit for help there.its scary but we do what we have to.can you do a clean sweep of her room while she is out or even if she is not to remove any implements or more diet pills?in terms of the gp, he can't tell you anything,but you can tell him what you are experiencing at home and what you fear.no one can stop you doing that.i sure have.then he can maybe suggest a different therapist.i remember going to one,babbling on brightly and then right near the end she just gently said to me 'you are really afraid aren't you?' I burst into tears.this was well pre children but she was fantastic at seeing through me.another one I had later was awful,primal scream therapy and role playing,not my thing at all.each therapist is so different,so maybe try another one? I hope something I have said is useful.oh and when you talk to the doctor don't let him prescribe her anything.hugs to you hon,you are really going through it.
Sotired42
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Foodsupport_AUS
NellyMac sorry that things seem to be taking a turn for the worse. I think talking to your (I am assuming you see the same one) GP is a good idea. No they may not be able to discuss what she is telling them, but you can tell them what is happening at home and your concerns about suicidality. It may be easier to write down all the things that you have observed that make you feel very concerned: self-harm, taking diet pills, excessive substance use, her eating and social habits. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
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