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

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Hi, This is my first post. My daughter was diagnosed with anorexia 5 months ago at 17. We are doing FBT. She is now 18. She is wr and has been for 1 month. What complicates her situation is she was diagnosed with PTDS symptoms from being bullied in school. She has been struggling with anxiety since grade 8. I feel the ED was her coping mechanism for the trauma. She is now doing trauma therapy. She has been out of school for the last two months of her final year of high school. Her social anxiety is through the roof. She will not go for walks in our neighbourhood for fear of running into the girls she went to elementary school with. Things feel like they have gone downhill since she left school. She had a job as a cashier at a grocery store, but cannot even go to work. They have put her on a leave. We worry she will lose her job. She was able to work on school work at home and we are hoping she got the required credits to graduate. She will not go to her graduation ceremony. I have taken time off work, but need to return to work the end of July. She is eating what is put in front of her. We went through a faze where she was refusing to eat, that was very tough. At times now, she does seem more comfortable with food. Although, she complains about the amount I give her to eat and the higher fat content food that I give her. She says she is always full. She gave me a list of what foods she ate when she was home on her own for lunches. I have discussed with the family therapist about having her get her own lunch, with my supervision. I am trying this for a week to see how it goes. She started on prozac about 3 weeks ago. Still waiting for it to kick in more. She had tried 3 other medications, did not help her. Olanzepene she ended up in the hospital under suicide watch. It was taken in combination with zoloft. I have seen posts that mention genetic testing, is this done to determine which medication works best? Does anyone know if it's available in Canada? Has anyone had experience with ED and trauma? Thanks for your help.
Hi shadyspot and a very warm welcome from the north of England.
So sorry you find yourself here. I have no experience of trauma but have a 16yr Old D who was diagnosed with RAN in Feb who is now in strong recovery.
The description you give is very typical of what we went through, minus the medication and bullying.
It sounds like you’ve done amazingly well to get her to this point. My D had dreadful social anxiety too but she seems to have turned a corner and is doing things she wouldn’t have done before. She went to high school prom after vowing for many months that she definitely wouldn’t go. I never expected it. She is socialising much more freely now.
I’m hopeful for you that you too will see a change in circumstances/symptoms with true weight restoration and appropriate professional support. We found CBT really helped her manage her perfectionism/anxiety.
Virtual hugs. Xx
Welcome to the forum. What an amazing job you have done to get your D weight restored already. 

I don't have experience of trauma here either, but like teecee and you my D had issues with social anxiety early on. A lot of it in her case was to do with adjusting to the changes in her body, she was also suicidal for a prolonged period of time. We worked with her slowly but surely increasing her experiences, I would take her out to places, we would walk the dogs together, and I arranged "play dates" and activities for her. Not really appropriate to her age, but at the time it was what she needed to slowly ease her anxiety. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
Hi Shadyspot

I'm adding my welcome here as well. It is very hard if they don't want to go out and face the world. My d loved nothing more than to sit alone in her room the whole day during refeeding, so I had to drag her back into life.

Is it possible to go to places where the possibility to meet the girls from school is slim, such as shopping centres and parks at the other side of town? My d still avoids her classmates from her (old) school where she became ill, but otherwise she socialises with friends from (new) school.

Another thought is to get her involved with animals, volunteering at a shelter or helping out at a pet shop. My d spent some time grooming horses and that comforted her a lot. My sister-in-law gave my niece a dog when she was small and my niece would place the dog on her lap and tell him all about her problems of the day.  
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
Hi shadyspot,

I looked into getting the genetic test done here but in the end did not need it. I used this site. The test is used to detemine which meds are likely to cause bad/no reactions and which are most likely to help. Like everything else, there is no 100%. I was prepared to pay for the test myself but it needs to be done by a doctor even though it is only a cheek swab. I was going to ask either my GP or pediatrician. 

Warm wishes,

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

May 2017 Hovering around WR. Mood great, mostly. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. 2018 growing so fast hard to keep pace with weight. 2020 Off to university, healthy and happy.
  • 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.

Has anyone had experience with ED and trauma?

Hey Shadyspot.  Welcome to the place no one ever wants to be but is happy to be here when they need it!!!  I've had more than my fair amount of experience with ED and trauma.  My daughter's ED kicked off after she was sexually abused (in addition to bullying at school) so we have been fighting trauma, severe enduring chronic AN, PTSD, dissociative disorder and treatment resistant depression.

A few things I have learned along the way.  You have to actively treat them all at the same time for any of them to really get better.  When we treated just the AN, her PTSD and trauma related symptoms got horribly bad especially with weight gain and regular nutrition.  If we concentrated on just the trauma, that got better but only because she was binging and purging 20 times a day and starving in between.  We only made any progress when we treated both the AN and trauma issues at the same time and also did not let her anxiety get so bad that she dropped out of life.  It can be done although it feels most of the time like two steps forward and then three back.

I would get the genetic testing if you can get it.  It made a huge difference to my daughter but it is not a magic bullet.  Deenl explained it well and it is a simple cheek swab and three days later we got the results.  We only had 3 drugs come back as green light and only one antidepressant that she hadn't tried but went on.  She has been stable now for years on the same med regimen without needing to be inpatient at all which was nearly impossible in the past.  Even when she was doing well, she still ended up inpatient at least twice a year on important anniversaries.  Her last hospital stay was to go on the med suggested by the genetic testing about three-coming up on four years ago.  It really helped her depression and gave her what she needed to be able to face the things she dealt with by starving, etc.

Anxiety is a huge issue in those with PTSD and EDs.  My daughter is on a very low dose of an atypical antipsychotic (for her Seroquel has worked wonders).  It helps her sleep and helps keep her anxiety under control.  She had OCD before and all those symptoms practically disappeared with the Seroquel.  I also did not allow her to hibernate at home.  If she couldn't work, I made her volunteer in the community.  I can't stay enough about how her volunteering kept her grounded and also helped get her out of the house and face her anxiety head on.  The more she stayed at home, the more anxious she got about leaving the house so it became a catch-22.  It fed her anxiety to stay at home away from the world.  She couldn't at that point hold a job so volunteering fit in nicely.  We had a lot of rules about what was appropriate at first but she worked with animals.  She had a billion excuses for not going-I'm afraid, my anxiety is too bad, what if I fail, what if I have a flashback, etc. but I stayed firm to she made the commitment and needed to keep it.  She worked with the elderly-reading to people, etc.  We started with very low key low interaction experiences where all she really needed to do was show up and gradually worked up to other experiences.  There were some weeks when all she left the house was to see her therapist, doctor and volunteer but that was a win in my book.

I obviously needed to keep food going in order for her do the work (she had to double her body weight to get to a minimum healthy range).  Exercise was a huge issue for her but I did make her go for a walk with me on the days she didn't have other things to get out of the house. My rule was she had to leave the house at least once a day.  The walks were slow and around the block-not easy for her in any way but I insisted and as she got healthier, we extended our walks. 

It wasn't easy and it wasn't fast but she is such a different place now.  She is thinking of moving out to the farm she works on and she is a very vibrant outgoing person now.  She speaks her mind and doesn't have full blown flashbacks anymore.  She has learned a lot of skills through individual therapy and many DBT classes and experiences.  Things looked pretty darn bleak for years at our house but right now doing well and I'm enjoying it.

If you need any support or anything feel free to email through my profile here.  Keep asking questions because there is a lot of wisdom here.  For every kid forced to eat and face their panic, having been inpatient, etc. all of those were traumatic so people here really know what helps.

Thank you for all your responses! Thanks for sharing your ideas and stories. I struggle to stay positive through all of this, it seems like such a long road at times.
Trauma certainly adds to the length of recovery no doubt about it but there is a light at the end of the tunnel (and not necessarily an oncoming train!! [biggrin])