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

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

Join these conversations already in progress:
• Road To Recovery - Stories of Hope
• Events for Parents and Caregivers Around the World
• Free F.E.A.S.T Conference Videos

Visit the F.E.A.S.T website for information and support.

If you need help using the forum please reach out to one of the moderators (listed below), or email us at bronwen@feast-ed.org.

Norah_US

My D was first diagnosed with anorexia 5 years ago, at age 14. Following a short hospitalization, we were able to successfully refeed her within a few months. We supervised her eating closely for a year, after which time it appeared that all restrictive behaviors and thoughts were well extinguished. She continued to suffer from major depression for several years, but by the time she graduated high school, her depression was well controlled. She went off to college a significant distance from home. We were nervous about the distance, but she completely her first year with great success, not just academically, but socially as well. She seemed to finally be thriving after many dark years. 

Sadly, she has just returned home for the semester break, and anorexia is back with a vengeance. She had to have her wisdom teeth removed just prior to the start of the semester, and was not completely healed when she returned to school. Her father and I believe that the difficulty eating as she recovered from the surgery triggered the return of restricting behaviors. We were too comfortable with her recovery, and after a successful transition to college, we let our guard down. Sending her back to school before we were sure she was eating fully let her fall down the rabbit hole. The distance to her school meant that we weren't able to keep an eye on what was happening. 

I'm at a loss as to my next steps. The last time we dealt with AN, my daughter was a minor and I had much more control over the situation. Now, dealing with a young adult, I feel powerless. I am sad and heartbroken, and not sure how to move forward. 

Daughter dx at age 14 with AN and depression. Currently 19 and experiencing a relapse.
Quote
melstevUK
Hi Norah,

I am so sorry to hear about your d, especially after things had been going well for so long.  

There are a lot of emotions around when a relapse occurs  - anger, disappointment, despair, frustration, guilt, fear, anxiety, a sense of hopelessness, loss, and self-recrimination about what you think you could or should have done.  All these feelings are absolutely normal because we are so desperate to have our children fully recovered and able to get on with their lives without fear of sabotage by this horrid illness ever again.  And also without us having to supervise, maintain vigilance and feeling the need to stay involved with how and what our children are eating.

It's really infuriating, and it is also really terrifying because you fear you are moving right back to the start and watching a gradual slide which can end in death and you feel that old sense of helplessness creeping back in.  

Your d has been doing well and I am sure you are absolutely right when you say that eating difficulties after the surgery probably caused the relapse - not because in themselves they caused deliberate restrictive eating, but it would have been easier to eat less at this time, and that no doubt led to the weight loss which allowed the illness to take a hold again.

However, have you talked to her openly about the situation?  While you are not going to have the same control around eating which you had when she was a minor - can you ask her to sit with you and create a meal plan which will get her weight back up?  Do you think she has the self-awareness about what is going on or do you think she has no real understanding that she is ill again?  Without an open discussion about her weight loss, you won't really know what is happening.

My inclination would be to be as open as possible - and if she gets angry or storms off, keep modeling compassion and understanding that you know that this is not her fault, and that you want to try and get her weight back up over the holidays so that she will be in a better place.  If she gets angry - don't let her see that you feel any fear or self-doubt, show a confident front that you know what needs to happen and that you are going to ensure that it happens.

The reality is that she IS going to pull through again - she has plans for her life and she has been enjoying college.  Maybe you can offer to visit her at college more often over the coming semester.  Warn her that if she cannot turn things round now with you at home, she may well end up back in hospital again.  If you can get her on board about thinking about the consequences of not facing up to getting her weight back up, you may find less resistance than you are expecting.

Your d is still young and it is realistic to expect some difficulties while her brain develops over the next few years and she transitions into adulthood and she develops the self-awareness around her susceptibility to go down the anorexic path and can finally fight and resist it and move away from the illness altogether.  Maturity plays a huge part in the recovery process and things will get easier again.

I wish I could give you a magic wand - but we all know there isn't one.  What we do know is that love and commitment from parents can achieve amazing things and while it might be in a different way to the one you used before, you will get your d back onto that recovery path.  

Sending hugs and energy to get yourselves reinvigorated and back on the warrior path once the shock and disappointment are over.


Believe you can and you're halfway there.
Theodore Roosevelt.
Quote
Torie
Norah, I'm so sorry to read about your d's relapse.  I'm confident, though, that you will drag her back to health again this time like you did last time.  Do you have any financial leverage to draw on? xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
Quote
tina72
Hi Norah,
so sad that you have to be here again.
As the others said: you know what you need to do. You know that it works. You do not need to go back tp square 1. Try to get in charge asap and help her to get out of that.
Teeth op is a often heard problem because they cannot eat for some days. My d might need to have that, too. I try to push time a bit so she will be healthy enough but I am frightened about that, too. So, good that you found out and that she comes home now and you can help her.
Send you a big pack of power from Germany! And a hug!
Come here and ask or vent, whatever is needed.
You are not alone and there are a lot of parents here that experienced relapses and can help you to get her back on path.
Tina72
Keep feeding. There is light at the end of the tunnel.
Quote
Kali
Hi Norah_US,

So sorry you have to join us here again. 
I have a college-age daughter also and we too had some issues with wisdom teeth removal and eating last summer before she returned to school.

Some of us with college-aged kids have found that having them take some time off from college and going on a medical leave of absence to go into treatment/refeeding can help them make progress against the illness. My daughter took time off and it was really beneficial. It also showed her what can happen if she spirals down due to the disorder; she needed to completely interrupt her life and spend months in residential treatment, and I think she will not forget that anytime soon even on the days when she struggles more so than other days. 

So a few questions: How long is her winter break? Some schools don't go back until the last part of January and that could give you some time to help her get back on a better track. Is she compliant with what you are serving her or is she very resistant? I know you said in your previous posts that she has a history of depression; how well is that under control at the moment? How severe is the relapse and how much weight do you figure she needs to gain to be weight restored again? Did she have a team at home she can contact and you could encourage her to see this coming week for an evaluation and to make a plan about how to proceed? How far is her university from home and if she did go back, could a team be set up there for her and would she be compliant with seeing them, and could you visit frequently and do you think she could eat enough in that situation? I guess that the answers to some of these questions will inform how you can proceed to best help her.

 

Quote:

I'm at a loss as to my next steps. The last time we dealt with AN, my daughter was a minor and I had much more control over the situation. Now, dealing with a young adult, I feel powerless. I am sad and heartbroken, and not sure how to move forward. 



Ok so try and believe that really—there is no difference when they are young adults. Numbers—be it weight or age—don't define us. If someone is not well they don't magically wake up the day when they turn 18 able to make healthy and correct decisions about their eating disorder. You still have the same relationship you had before, you are her parent and an advisor in her life. So, as they say, fake it until you make it. Refeeding is exactly the same, and the resistance is the same. There will be a few more eggshells to walk over and you will need to somehow get your daughter to feel that you and your h. are on her team and are here to help her be successful in her goals. You will also want to insist that any HIPPA forms be signed. As I told my d. this does not mean I am calling her providers behind her back, our agreement is that I will speak with her first if there seems to be a problem, and will let her know that I am getting in touch with them. Which I have done on a few occasions when I thought it necessary.

Once, when I was a much less experienced parent, my son was young and really testing my limits in front of his taek won do coach. The coach looked at him and said "Your mother is the black belt in your life and you need to do exactly what she says" Think of yourselves of having the power of being the black belts in your daughter's life and believe that if you and your husband were able to help her last time, that you will be able to help her now as well.

Think about all of this....and then go into the kitchen and start planning those meals with a new set of big girl pants AND a black belt—which you earned last time you helped your daughter— in eating disorder meal support.

Warmly,

Kali
Food=Love
Quote
tina72
"Think about all of this....and then go into the kitchen and start planning those meals with a new set of big girl pants AND a black belt—which you earned last time you helped your daughter— in eating disorder meal support."

Yes, Kali!!!
We should all print that out and place it on the wall where we could see that every day.
Thank you for that extra power shot!
Tina72
Keep feeding. There is light at the end of the tunnel.
Quote
mjkz
Norah, I wasn't around the first time you were here but I can say it isn't much different with a YA than a minor.  There are a few more hoops to jump through but the basics are still the same.  I'm so sorry you have this facing you now but better to catch it early and get her back on track than later.  I don't know if she will realize what has happened but you can make this a learning experience for what she has to look out for.  Each time my daughter has slipped, she has learned that she needs to be more vigilant and in the end, it has been a true learning experience.  I think that's one of the benefit you get in dealing with a YA than a minor.

It is a scary slap in the face "how did we get back here???" kind of experience though.  Thinking of you and your family during this time.
Quote
sk8r31
Really sorry that you are dealing with such a setback for your d.  Unfortunately, relapses or 'sidesteps' can happen; many of us have dealt with bumps in the road when it seemed that life was ticking along well and ED was a thing of the past.

As Kali says, you have helped your d before, and you are the 'black belt' parent who can kick ED to the curb again.

I assume you are paying for your d's education, along with other necessities of life...use of car, cell phone,  rent etc.  You can use these things as leverage.  Putting together a contract for health restoration was instrumental for our family, and we used another contract for our d when she went off to university.  

You may also want to consider that your d may need to take a medical leave to get back on track and that a program such as the 5 Day Multi-Family Intensive for young adults at either UCSD or the Center for Balanced Living in Ohio would be a great resource for all of you.

Our family had great success with the UCSD program when our d was 17 and had been ill for 3 years.  Other ATDT families have also used the CBL program with positive results.

Sending warm support,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Quote
Norah_US
Thanks everyone for the encouragement. The thought of going through this experience again is just so hard to face. I really just want to bury my head in the sand and pretend that it isn't happening. Not a productive or helpful sentiment, but an accurate description of what I am feeling at the moment. I am  having a tough time separating her from the illness. I am finding myself angry and frustrated with her behavior. I need to relearn how to approach this vile illness objectively rather than emotionally.

Things are definitely different this time around. My daughter acknowledges the illness and is seeking treatment, but is keeping parents at arms length.
She is meeting with a counselor today, and hoping to arrange IOP placement for the winter break. I suspect that she needs an inpatient stay, but her previous stays were very traumatic and she is unlikely to consent to inpatient admission.

When I refed her as a 13 year old, I could insist that she sit and eat by making it very clear that if she didn't eat, we would be seeking an inpatient hospitalization. Now that she is an adult, that leverage is gone. 

Our relationship certainly is much different than it was when she was thirteen. At this stage in her life, she is accustomed to making her own decisions about just about everything. She is unlikely to cede that authority back. We actually have very little financial leverage - her tuition is fully paid by scholarship, she owns her own car (which she purchased herself) and pays all related expenses. With the exception of health insurance, she is largely financially independent. 

Thanks again to all for the encouragement. This group really made all the difference in the world the first time round.  



Daughter dx at age 14 with AN and depression. Currently 19 and experiencing a relapse.
Quote
sk8r31
I completely understand that this time around things are different. You have a young adult that is mostly financially independent.

However, this is an illness that involves anosognosia.  You d may be unable to understand how ill she may be.  Getting some kind of buy-in for the best possible care in treatment would be a great strategy.

What motivates your d?  What might you be able to leverage to help get her to accept the best evidence-based treatment option?

Carrie  Arnold has written a good book about ED, Decoding Anorexia.  She also has a blog which might be interesting for your d to look at.  Carrie moved into recovery as a young adult with the help of her parents, using an FBT-based approach.

What really helped me with the worry of relapse with my young adult d was that I felt I had the skills, tools and good professional support to handle things if it all went south.  It was a source of comfort to know that all that we learned from UCSD, along with the support of this forum, would get me through the tough times.  

I hope you can gather your strength, rely on the supportive parents on the forum, & move forward to help your d as best you can.  You CAN do this.  

Sending warm support,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Quote
tina72
"I suspect that she needs an inpatient stay, but her previous stays were very traumatic and she is unlikely to consent to inpatient admission."

So maybe you can offer to help her at home to avoid that IP. Just an idea...
I also would seak for things that motivate her. There must be something you can use.
If she really sees that she is ill and searches for help, I would read the book of Carrie Arnold, too. She was sick herself and is now a bio-chemistry professionel and she made me nod on nearly every side of the book because she describes where all this behaviour comes from. So maybe that would be something to read for your d?
Tina72
Keep feeding. There is light at the end of the tunnel.
Quote
mjkz
Quote:
When I refed her as a 13 year old, I could insist that she sit and eat by making it very clear that if she didn't eat, we would be seeking an inpatient hospitalization. Now that she is an adult, that leverage is gone.


Actually it's not really gone.  You can still seek inpatient care for her if she needs it and use pressure in different ways to get her there.  Kali did an excellent job of just that when her daughter needed inpatient care.  I have done the same many times with my daughter.  Even though she is financially independent, you can still notify her school that she is sick and needs inpatient stay.  Schools more and more are becoming very risk avoidant.  It is probably more a legal issues with them not wanting YA's to die on their campus but either way you can harness that to help you get her help.

I really like Tina's idea of offering her help at home to avoid an inpatient stay along with her idea of IOP.  It is encouraging to me that she is seeking help.  Just remember you can share anything with her team that you want too and that you feel they need to know.  As sk8r31 noted, often times they don't realize how sick they really are and mislead their team (intentionally or unintentionally) so you could be her team's best hope for seeing how sick she is.
Quote
Kali
Hi Norah_US,

Hope that things are going a little better. It is very positive that your daughter acknowledges that there is something wrong and she is willing to go into treatment. If she needs inpatient they will assess her and let her know that. In my d's case, she had a team who told her she needed residential treatment, and then I helped make arrangements and make sure she went somewhere where I believed she had a real chance of recovery and where there was excellent evidence-based treatment. I'm sure I'm making it sound a little easier than it was because there was lots of drama, but that was the big picture.

Quote:
When I refed her as a 13 year old, I could insist that she sit and eat by making it very clear that if she didn't eat, we would be seeking an inpatient hospitalization. Now that she is an adult, that leverage is gone. 


In the meantime, you DO have this as your leverage. And you could try to phrase it like this: If she can't eat enough at home and at IOP, her team is going to probably have to recommend inpatient/residential, and you would like to be able to help her at home if possible along with her outpatient team. That is what I told my d. at some point when things were sliding backwards and it seemed to have some effect although the refeeding was still torturous. In phrasing it like that, you become someone who is on her side and wants to help her claw her way back to a regular life. And that help includes full nutrition. But honestly, if she needs residential it is not the worst thing in the world if it might help her. My opinion is that therapy is important with the YA group since, well, they are older and have more independence and at some point after treatment and weight restoration will need to be able to feed themselves adequately. I was pretty hands off (and still am) about my daughter's providers and only step in if I think there is a problem, and they will all speak with me. I consider my function as part of her team at this point to monitor her mood and motivation and make sure she is at an adequate weight and if there seems to be backsliding, I step in and do what I can to change those things. 

warmly,

Kali




Food=Love
Quote

        

WTadmin