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

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myhelp
Hi All, it's been a long while. I posted a long time ago ( feels like that anyway but it was probably in July )  about my D and her relationship with Camhs, her therapist and us. 
So we hit a real low around my birthday end of Sept 16, when her weight dropped to ~35Kg BMI ~ 14.

After this date something happened and she started to eat for 'mum and dad' BUT 'not for herself' . These words seemed to help and we have gained ~ 1 Kg / week toughly since then . Her current weight is 41.8 kg BMI 16.3 today. This is a tremendous achievement and is solely down to her, so why am i writing ?

My D has underlying depression and anxiety and has been seeing a private psychotherapist since Oct 13 and probably 18 months before her ED set in. As the weight improved the emotions and yuck from within increased and so did the low mood. I finally caved in and said yes to anti depressants so she is on Fluoxetine 10mg nowbut before this she was on 2 weeks of Olanzapine T 5mg ( antipsychotic ). She started fluoxetine last week.

Over the last few weeks ( esp this last week ) her mood has been upbeat and willing and we thought we had a glimmer of hope. Then this Sat just gone, she became sober as if a dark cloud was hanging over her, withdrawn and difficult. There is a long story behind this so I won't bore you with it but at ~ 11.30pm Sat night I got a call from her therapist to say that I need to go up to D's room as she is taking / about to take tablets. I got there on time and stopped it. 

The long and short of this is that we have now been to Camhs today and I don't know what to do. Do I help her at home with the Depression voices that are so strong as I did with her ED or is this now beyond me and she needs to go to Hospital ?
She says she planned it - for one weekend in Nov ! that she won't be around for Xmas ? that it's always been like this ... but she doesn't want to go to Hospital , yet surely I can't look after at home ?

I don't know what the trigger was ? or whether this is the deepest darkest part of recovery ( fluoxetine can cause suicidal thoughts but I do not think that she had enough of it to do so... I could be wrong ), or do I have a real horrible extra problem in the shape of clinical depression on top of the ED ? Perhaps they are both the same or one has led to other.

My head feels as if it's about to explode as I don't know what to do now [frown]

Camhs - are asking the specialist eating hospital for advice but I know they always like treatment to be at home but I am not sure I have the resources ( possibly the will power ) to watch her 24/ 7. I have a younger child 11 ( things are very diffcilut for him right now ) and am on my own as husband works abroad Mon to Friday. 2 teeanage children at university - older girl with depression and anxiety too.

D is still eating - I am insisting on that ... so does that mean she still wants recovery ?

I have lost all trust now ... how can she 'fake' it for the last few weeks making everyone think that she was behaving in a certain way to only be planning things ?

I am so disheartened and lost, i can't believe this is my little girl, what happened to her to grip her in this tight depression ?

Feeling pitiful and low... will my life be now fighting the depression voice and the Ed voice ... when will this end ? OR is this NORMAL ED recovery ? She never committed an harmful act before ED set in but then as ED is thawing is this the real her ??

Thank you for listening .... x
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skechers
I would say from her current and still quite low BMI that you are still very much dealing with the ED and its accompanying depression. They are really one and the same right now. Until she gets to a good weight for a long time, I would definitely look at it this way and fight the ED. She needs to keep eating and gaining. Just because she has been eating willingly doesn't mean her ED is gone. She is going through the really tough part right now so it doesn't surprise me that the depression and threats of suicide are hitting now. When we started refeeding my d, she also said she was suicidal. We placed her on anti-depressants as well and it actually did help quite a bit, but I think that's because she was also eating and gaining at the same time. Of course, some anti-depressants can make you more depressed at first, so you kind of have to watch. I know, it's hard to tell whether the anti-depressants are making her mood worse, of if it's just the ongoing ups and downs of ED.  You may just have to watch her closely for a while, but safety and getting food in is what's important.

Don't lose hope. My d was so depressed and suicidal when she was gaining back her weight the first month to two. Things slowly got better with continued weight restoration and she's still on meds because she had depression and anxiety well before her ED. ED just made them worse. We are more than 3 years out and she is doing great with eating normally.

I also remember one day during the first month or two of refeeding I got a similar call as you did from my d's therapist saying that she had written in her shared feelings log that she was suicidal. I thought the therapist was making some kind of mistake, perhaps reading an older log entry because at the time my d seemed happy. They just have so many ups and downs until the weight is on for a while.

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Torie
Hi myhelp - It sounds like you and your d have made a lot of good progress so thank heavens for that. Good job!

After this date something happened and she started to eat for 'mum and dad' BUT 'not for herself' . 

That's what my d says, too.  Really, I don't care why she eats, I just care that she does.

She started fluoxetine last week...at ~ 11.30pm Sat night I got a call from her therapist to say that I need to go up to D's room as she is taking / about to take tablets. I got there on time and stopped it. 

Ugh but yay, if you know what I mean.  When my d was put on a similarly low dose of fluoxetine, she experienced increased suicidal ideation. The psych discontinued the fluoxetine right away when we told her.

I don't know what the trigger was ... or do I have a real horrible extra problem in the shape of clinical depression on top of the ED ? Perhaps they are both the same or one has led to other.

I don't know either.  I was just reflecting on those dark, difficult days and realized that one of the few bright spots was that I did know she needed to regain the weight.  I think it was really helpful to have that one thing to focus on and strive for.  

D is still eating - I am insisting on that ... so does that mean she still wants recovery ?

It doesn't much matter if she wants recovery or not - it just matters that she eats. And, of course, the added wrinkle that you have to worry about her physical safety.

I have lost all trust now ... how can she 'fake' it for the last few weeks making everyone think that she was behaving in a certain way to only be planning things ?

It's a mystery, isn't it.  I've never been able to figure out to what extent they're hiding their misery and to what extent they just think they always feel so awful - teens are famous for confusing "right now" with "my whole life."

Feeling pitiful and low... will my life be now fighting the depression voice and the Ed voice ... when will this end ? OR is this NORMAL ED recovery ? She never committed an harmful act before ED set in but then as ED is thawing is this the real her ??

As you may have gathered, I was never able to figure out much of anything.  All we can really do is take it one day at a time and keep our Ed kids eating, and as safe as possible each day.  I remember DH saying to me one Friday, "You kept her alive another week. Good work!"

How the heck do we end up in this Twilight Zone world where even the basic basic BASIC things are so godawful difficult - making sure our kids eat and don't kill themselves.  Such a vile illness to take that from us.

Anyway, I guess there is never any way of knowing for sure what tomorrow will bring - no guarantees at all in life.  The only thing I really know is that our kids must regain all the needed weight to have a good shot at normalcy.  Focusing on that like a laser helped me ... a little.

Hang in there. You can do this. xx

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

I am so sorry that this is happening.

Have her meds been reviewed?  It sounds like the attempt to take the pills was shortly after the start of her fluoxetine prescription.  As you mentioned, one of the possible side effects of fluoxetine is suicideal ideation, especially at the start of a prescription or increase in dosage.  Also, is her weight high enough for fluoxetine (or any SSRI) to be beneficial?  I understand that SSRIs do not help until a person is close to WR.  Correct me if I am wrong, but my understanding is that SSRIs taken when weight is too low can actually make things worse.

Thinking of you . . .


DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)
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myhelp
Thank you all for your answers. The sense I get from reading your posts is that this may well be part of the 'journey' but I have been pushing for hospital admission today because she says her thoughts don't go away, she thinks about it all the time, and that she will find another way etc etc . I feel as if I am deserting her, because when her weight was really low and she was in the danger zone ( still not clear ) we stayed as outpatients and pushed through, but now having come through the lowest point I am pushing for hospital... seems wrong but also right as I have to keep her safe now and protect her.

Has anyone admitted to hospital for the depressive/ suicidal thoughts whilst weight is in recovery ? Did it work ? or should I continue at home? But can I watch her 24/7 ? Not sure what to do .
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mjkz
Have you asked her what she wants or needs?  Suicidal ideation seems to come along with weight gain along with depression.  Obviously depression fluctuates so there will be good days and bad days.  The fact that she reached out for help is great.  My daughter was not able to do that and we nearly lost her several times.  I would not be so quick to think either that the last couple of months were just an act either.  She might have had the fleeting thoughts but not really the plan or feeling like she was going to act on it until very recently.

Having the thoughts and acting on them are two very different things.  My daughter has an arrangement now with her therapist that she will call her and talk to her in person before she does anything.  It has been a real hard time for me to trust in that but she has managed to do that.  When she couldn't, she is honest about it and knows when she needs to be inpatient so we let her call that shot.

I don't know how much you feel you can trust your daughter or if something like this is even possible for her to agree too. I do keep meds locked up during the times my daughter needs it.  There are times during the year (like now with the time change) that her depression surges and she starts having suicidal thoughts.  I have had to become somewhat comfortable with that knowing she will let me know if she can't stop herself from acting on those thoughts. 

When in doubt, I ask my daughter.  If she cannot tell me she will keep the promise of talking to her therapist in person before doing anything, then we head to the hospital.  If she can keep that promise, we go on a day by day basis of evaluating.

It is a hard thing to deal with.  My thoughts are with you.

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