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

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tireddad
Hi folks

Hoping for some insight or advice here. I posted a while back about my D who has restrictive AN and is in FBT with CAMHS. Things have been OK regarding the eating. FBT support has been patchy and D was in CBT with a CAMHS psych for a while until she left for maternity - we now have a new psych and are back on FBT to move things to the second phase (we still feed her lunches at school). Generally, the eating has been good. She eats everything she's given and asks for pudding, snacks etc. Her weight is up to its highest ever level and she looks great. There are very few signs of AN behaviours and it all feels like significant progress - we are around a year into this.

But - D's mood is very low. She has confessed to some minor self harm but that does not appear to have stuck, and she has also talked about wanting to go to sleep and not wake up which is obviously a concern and we are taking it seriously. She is frequently tearful and is disengaged at school. She still engages socially but that has become more inconsistent too and she spends long period of time alone in her room. The phone is another issue of course. In short, all of these signs suggest depression and there is family history of that.        

Low mood was also a feature when she was restricting and we tended to ascribe that to her not eating - her mood would visibly dip when she went without food. But this is different and more recent. We have a psychiatrist in the family who says that post trauma it is common to fall into depression as the entirety of what has been happening starts to dawn. D says this is more than the eating and that she is different to other people - its like she knows something is not right. We have spoken to CAMHS who are continuing with CBT but did start to mention the possibility of medication if things don't progress. We are also taking D back to the GP to make them aware. 

Does anyone have similar experience of this - depression as they start to pull away from AN?  What about medication? I know (form experience) that it works for adults but teens?
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Foodsupport_AUS
My D had depression throughout her AN illness, along with the typical anxiety. Her depression did respond to medication but it took a few different types to find the best combination of things. Fluoxetine is the most studied in teens but was not effective for my D. She had side effects to sertraline but responded well to venlafaxine. We then had to stop that as she developed issues with teeth grinding and sleep apnoea which was worsened by the medication. She is now on duloxetine which is working well. 
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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greekdude
Hello @tireddad , glad things are going well with food! They gave fluoxetine and risperidone to my S starting from Oct (admission) to at least 6 months since Jan (discharge), which means till mid July 2020.
I think medication helped for a while, but in real world scenarios it did little. My S again got socially "minimized".
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ValentinaGermania
"She is frequently tearful and is disengaged at school. She still engages socially but that has become more inconsistent too and she spends long period of time alone in her room. The phone is another issue of course."

Can you limit that time alone in her room to the absolute necessary? To be alone with AN thoughts is not helpful at the moment. Keep her busy, keep her in company with others, keep her socialized.
What is she doing with her phone? Does she have contact to other anorexics there? Instagram etc? Are you sure she does not use bad internet sites about AN?
Keep feeding. There is light at the end of the tunnel.
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Scaredmom2019
We have a no laying in bed rule at our house. She can lay around but it needs to be on couch or in main areas. It is less isolating. 
Also she has to make at least one plan for the weekend... something social. Also if no social plans are available than she has to go to grandparents house for a change of scenery. Any options for places she could spend time besides your house? 
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Torie
At one year in, my d was still quite depressed.  At two years in, she was less depressed.  We tried meds and therapy, but the only thing that worked in our case was food + time.  

We had a weird seasonal aspect - not the typical cycle but rather downturn in about August and then upward climb starts in about February.  Each year the valleys came at that same time but were less pronounced each year.  So maybe pay attention to seasonal variation.

Sorry, I don't have any advice for you so I am just telling you what my experience has been.  Good luck with it, and congrats on your success with the weight gain. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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MKR
We have a no laying in bed rule at our house. She can lay around but it needs to be on couch or in main areas. It is less isolating. 
Also she has to make at least one plan for the weekend... something social. Also if no social plans are available than she has to go to grandparents house for a change of scenery. Any options for places she could spend time besides your house? 

I like your rule. Good habits to practice. It's sometimes hard, having taken the initiative, to have plans cancelled due to the weather or friends' xyz reason, but I would reward the effort made.

Torie wrote:
At one year in, my d was still quite depressed.  At two years in, she was less depressed.  We tried meds and therapy, but the only thing that worked in our case was food + time.  

We had a weird seasonal aspect - not the typical cycle but rather downturn in about August and then upward climb starts in about February.  Each year the valleys came at that same time but were less pronounced each year.  So maybe pay attention to seasonal variation.

-Torie


This is interesting, @Torie, a cycle I had experienced myself, when living in Europe. October to December were the worst, until Christmas frenzy took over.

In NZ it's the dark rainy months of May to September that never seem to end. Sport is the only distraction for children in early evening after school (but we had a moratorium on all sport for our daughter).

I wonder if this is nature's way to slow down our bodies in some way, some sort of hibernation?
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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tireddad
Thanks folks. This is helpful. The GP is calling CAMHS to suggest that D sees a psychiatrist so will see what that brings. Meanwhile I got her out of her room last night and she did seem a little brighter. Periods are back too so that may also be part of the picture here. 
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ValentinaGermania
Put her in front of TV and keep her busy with asking her for help in the household. I asked my d to do our laundry and to help cleaning the windows and had some jobs like that for her every day. That helped her structure her day and feel "needed" and not so guilty.
Keep feeding. There is light at the end of the tunnel.
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