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

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My daughter has been weight restored for over one year from RAN. However still struggles with high anxiety. With recent change of school year we have noticed her ED behaviour of restricting again more noticeable than in previous blips.

 I am keen to try get some physiological input even an actual mental health assessment would be a starting point. Both the school and GP disagree and think it’s just a matter of time.

during our FBT sessions under local CHAMS she was never given any one to one therapy only the family session
focused on the ED. 12 months following discharge she struggles with low self esteem, and avoids anything that triggers anxiety including attending school.

do I trust my gut instinct that more help like CBT or similar is needed or listen to the professionals to wait and see?
I think you need to listen to your gut on this.  Transitions are particularly challenging times for our kids, even for one in strong recovery.  Several years out of ED hell, and I still keep a closer eye on my d when she starts back to her grad program or is starting a new research project, etc.
Particularly if your d has struggled with high anxiety throughout this past year, I think it is quite reasonable to explore options to help her, be that with CBT or meds or anything else that might be appropriate for her.  I don't think 'wait and see' is the best option, especially if your d has been struggling for some time.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
Thank you for your reply. I have just started a peer coaching initiative offered by BEAT, which has been helping me to feel a bit more confident to try to have my concerns listened to. Definitely will listen to my gut. Will approach GP and school again. 
Hi Silvermoon,

I don't know if this is an option for you but where I am GP's are usually the gatekeepers for referrals to other specialities. In the past, when our GP has not shared concerns over various things, I have (while shaking inside - I was much less assertive before the ED journey) said that I was still concerned and would he please refer us on to a specialist, in your case a psychiatrist. I found that when I talked calmly but stood firm, sometimes over a few visits, eventually he would cave. A psychiatrist may have better insight into your daughter's needs.

Best of luck,

2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
It sounds like you are on the right path. I agree, listen to you gut- your D may improve with time however what you seem to be looking for is more skills to help her deal with stress rather than resorting to restricted eating. For her long term health she needs to learn those skills. 
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.
Silver moon - of course listen to your gut!! You have the most data and most experience about your daughter. Deeni’s advice is spot on, be calm and clear with your GP. Make multiple appointments if necessary and direct them to evidence that shows even after WR support must continue. 

I know now sometimes I struggle thinking my view is too negative and/or I’m to worried but in the end - what is the downside of more support - can’t think of any. 

Goid luck!! 
Thanks for all the replies, sometimes it’s too easy to fall into the track of believing other people’s views about it being my fault for being too anxious, lacking discipline in my parenting style or even being too strict. Had them all and I will be calm and go back to the start with another GP appointment. Persistence is needed but I will just keep on going. This forum has been a life saver over the last 18 months. Bless you all x 
Visit to GP yesterday confirmed what I feared, 1 kg weight loss in the last few weeks. GP has agreed to refer D to CHAMS tier 2, not what I was hoping for but better than the generic version that is currently on offer in school.

Is there any evidence out there that ED recovery can be aided with both weight restoration and some type of psychological therapy/intervention?? . I think CBT might help .... Any “ammunition” to help me build a case.

May ultimately need to  just pay privately to avoid the 18 week wait for initial assessment. Reality of over stretched services in adolescence mental health in Scotland.
In my experience no therapy can help if not weight restoration is done first. The brain needs to recovery and then you can tackle the issues that are left then. Food and WR are most important.
Keep feeding. There is light at the end of the tunnel.

Dear Silvermoon,

In our experience therapy can be very helpful with comorbids, such as anxiety and/or depression, which often can predate or accompany an eating disorder and can remain after the sufferer is weight restored. As you mention that your daughter has been weight restored for a year it might be a good idea to address the comorbid anxiety. My daughter also has high anxiety and depression, and has been in therapy since the very beginning. She has done DBT, CBT and individual therapy. She was also placed on medication after weight restoration because the anxiety and depression did not lessen. While she was being weight restored she had multiple therapy sessions a week. While therapy can't magically cure an eating disorder, greater awareness of one's self and problem solving skills are important tools (I think) in the journey to wellness. In addition, any time a person is diagnosed with a serious illness, be it anorexia or cancer, I believe that there can be benefit from having the additional support that a good therapist can provide. Studies have shown the people suffering from anorexia can have difficulty in discerning other peoples facial expressions and what they might mean, leading to misunderstanding and difficulty in interpersonal relationships. For example they can often misinterpret other people as being angrier or more disapproving than they actually are. And I have often found myself talking her down off the ledge, as they say, during times of transition.

I think this is true mostly for older teens and young adults and adults, not so much the younger kids. And it is important to find a therapist who is a good fit and knowledgable about the intersection of ED and comorbids.

Also it seems as though transition times such as the start of a new school year, can be difficult for them to navigate and therefore it is not surprising that she is having a blip at the beginning of the school year. 

Trust your gut and see what arrangements you can make for appropriate support for your daughter. There are parents who have recommended the books about freeing your child from anxiety by Dr. Tamar Chansky if you want to take a look at them and see if you get any ideas about how to proceed.



Great advise above!

i would say don’t ever not trust your gut!

you are the mother and you know your d

in our experience simply getting our d WR didn’t solve all the problems (as much as I was led to believe and wanted to believe)

my d had HUGE anxiety issues and depression (who would of guessed she was the happiest bubbliest energetic kid you ever met) but the same as your d, her school and local physcologists weren’t too worried about it and at the time d claimed it wasn’t helping 
i WISH we continued to keep our d seeing her therapist (it may or may not have saved her a huge relapse and much pain and suffering)
but we will never know

i do know that now we won’t stop her seeing her “team” 
it takes a village IMO
and as Kali says maybe therapy works best once they are older?? and their brains mature and I guess to a point accept they need some kind of help
I can’t remember how old your d is ours now 20 
dx at 17
IF I could turn back time she would of continued seeing her therapist
in saying that it can be hard to get the professional help you need (and this unfortunately took us some time) but once you have a”team” in place it is a hugely beneficial 

early intervention is better than waiting IMO
my d is now thriving, glowing, happy, living her life, working, has hopes, dreams and goals
its been a rocky road to get here though 

I just wanted to express that not always WR solves everything but obviously important and necessary 

plus as you know they still gain into their 20’s so your d will need to continue to gain and therefore isn’t technically WR