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.

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Plumms
Hi, I live in the UK. I have been using this forum for advice since my D was diagnosed with RAN in late June. She is 15 and started restricting in May. Prior to this she was probably suffering from depression with the pressure of school work as a trigger. She is highly intelligent and a perfectionist but hid her depression well. We have been in CAMHs day unit for 3 days a week for the past 6 weeks. We have managed the refeeding reasonably well after a rocky first month and she continues to restore weight weekly. My biggest problem has been her constant suicidal thoughts. They have been present since the start. We have been on constant suicide watch with calls to help lines some nights. She was started on Fluoxetine 20mg in the first 2 weeks at CAMHs despite her being underweight and i was not sure they would work. They did not help and after 8 weeks this was increased to 30mg about 6 weeks ago now. She has struggled in the day unit being amoungst other children with anorexia as it fuels her sense of failure for not losing enough weight. Three weeks go she took a paracetamol overdose after a body image session at CAMHs (we had cleared the house of medication earlier in the summer, but she had hidden them before this). I found out 11 hours later and she was lucky to recover after a couple of days treatment. After discharge 5 days later she was still very suicidal and was started on Olanzepine, which really helped. My D was back and we were so positive of recovery and she started to believe recovery may be possible. This changed 2 days ago and we are back with really bad suicidal thoughts and distress. The house is safe and she is never left alone. I am increasing her Olanzepine tonight. She is finally sleeping (first 2.5mg Olanzepine given already) after a day from hell with her banging her head constantly and repeatedly saying she is going to kill herself again. We are hoping not to have to take her A&E as not sure inpatient will be any good for her and may come out with more problems. She has no will to live for anything in the future and no belief in recovery again. I don't know what to say or do when she is really bad. I listen and just say the same supportive words and keep feeding! Any advice would be really appreciated.
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Enn

Hello Plumms,
I welcome you to this safe place. Please ask all the questions you have. 
You seem to have caught the restriction early and that is great. The feeding is the main treatment. Many has used olanzapine with good effect and it seems to be working for your D at the moment so that is a positive. As for the suicidal ideation, it can be a comorbid and or part of the AN and with better nutrition it could get better. 
If you feel that her threats are truthful, I would urge you to take her to the A+E. You need to keep her safe at home. Hide all meds and detergents that she could ingest. Hide sharps and long string like materials. Lock windows that she could jump out of. Hide keys to cars etc..

The perfectionistic qualities are very consistent with ED. As for her constant suicidal thoughts, I would always ensure her safety first. The listening and validation that it is really hard at this time and that it will hopefully get better may help her. We did not have that. Others will be here soon to give you more support and advice.
And you have it right-KEEP FEEDING!

I am glad you are here. We all want to help you. Please ask away.
XXX

Food+more food+ time+love+good professional help+ATDT+no exercise+state, not just weight=healing--->recovery(---> life without ED)

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Torie
Hi Plumms, So sorry you needed to join us here.

My understanding is that about the only thing that is higher priority than ED is suicidality.  If you have to choose between long-term weight gain and short-term survival, the latter takes precedence.  

It sounds like you are confident you can keep her safe at home.  If that is true, then yes, keep feeding.  She can't recover unless she regains the weight she has lost.

My d expressed suicidal intent as well.  That was the worst.  The very worst.  The only thing I know to do is to tell her that it WILL get better.  No matter how much she argues and insists it will never get better, just keep telling her it WILL get better.  She is adrift in the sea, and your job is to stand on the shore waving a banner: "It WILL get better."  If you aren't entirely confident that is true, fake it until you make it.

I wonder if you have talked to the psych about the fluoxetine.  My d was prescribed that early on, and then she became more suicidal.  The psych then discontinued the fluoxetine.  So I would want to hear a professional opinion about continuing that.

If it helps to hear a happy ending:  I was skeptical that weight restoration would resolve the depression as the depression had set in before any weight had been lost.  But after she had been well and truly weight restored, the depression started to lift  She has been weight restored more than 4 years now, and is in her second year away at university, doing really well.  So there is loads of hope.

Please feel free to ask all the questions you like. xx

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

Torie wrote:



If it helps to hear a happy ending:  I was skeptical that weight restoration would resolve the depression as the depression had set in before any weight had been lost.  But after she had been well and truly weight restored, the depression started to lift  She has been weight restored more than 4 years now, and is in her second year away at university, doing really well.  So there is loads of hope.

Please feel free to ask all the questions you like. xx

-Torie


Torie, May I say that is a happy beginning!!

XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Plumms
Thanks Torie. Thankfully, having read some of the other suicide threads here I know that things can improve. I just seem to always be repeating the same words 'this will get better" and she counters with the same response, "I have nothing to live for and I just want it all to end".

I did discuss suicidality and fluoxetine with her psychiatrist but he said this was usually only increased when starting or with dose changes. However I don't think it has helped at all and will discuss withdrawal next week.

I am off work at the moment and do feel like I am able to give her 24/7 support and my husband helps to ensure I get breaks. I have been sleeping with her for months now. After her OD I realised how little support is available in hospital and I had to beg to get a psychiatric nurse for her last few days on the ward.  We would use A&E only if we felt her anxiety was so great and we couldn't calm her down enough to keep safe. we also have diazepam but have only used this once since hospital discharge.

This forum has helped me so much. I don't feel so alone fighting this awful illness. Today I just needed reach out.
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teecee
Dear Plumms
I just wanted to offer my support from Yorkshire. My 16Yr Old D also developed RAN and the suicidal thoughts. Luckily we were able to intervene before she took action that day and we did what you are doing now...supervised 24/7 including sleeping. We had a joiner put a mortice lock on an internal door and that’s where everything (sharps, cleaning products, meds) got stored. That was back in Feb/March however the depressive, suicidal thoughts melted away when she became WR and maintaining.
Even though we had a fairly large relapse recently the suicidal thoughts did not return.
You are doing everything you can do. I just reassured her I would keep her safe and wouldn’t let anything happen to her as well as telling her it would pass.
Sending you virtual hugs and strength xxx
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Torie
Plumms wrote:
She has no will to live for anything in the future and no belief in recovery again. I don't know what to say or do when she is really bad. I listen and just say the same supportive words and keep feeding!


That is pretty much exactly how it was here in the beginning, too.  You are doing the right thing - the only thing you really can do.  One of the things that helped me the most was when a senior member of the forum explained that my d didn't have to want recovery or believe it possible - that she had dragged her own d back to recovery despite all that and that I could do that, too.  And so I pass that along to you in duplicate - not only did hopefulmama drag her d back to wellness despite her d's lack of will to recover, but I did, too.  And so will you.

Hang in there.  It does get better.  Really. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Mamaroo
Hi Plumms, sorry this is so hard for you now.

The others have already given you good advice. How close is your d to WR? It is vey common to have a spike I anxiety close to WR (the last 10 lb or 5kg), we call it extinction burst.

I hope you are able to get a break today. Sending you lots of hugs 🤗🤗🤗🤗🤗
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
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Foodsupport_AUS
  Welcome to the forum. You have done a great job getting your D gaining weight. Is it going up quickly or a much slower process? It seems counter-intuitive but  for a  lot of kids gaining weight faster or slower doesn't necessarily  make much difference to their mental health, so it makes sense to get it over and done with faster if possible. My D was suicidal for several years early on in her illness, with a number of attempts and a lot of self harm. It is very confronting and difficult to deal with. She could not see that she would ever improve or get better either. That of course is part of depression it feels never ending. 

 D tried doses of fluoxetine up to 60mg. She was on Olanzapine at that time too, it helped her sleeping but not her depresssion. Ultimately the turning point with her depression came with both ongoing feeding and also switching to Venlafaxine. D started this at age 15. She required high doses of this for effectiveness too. Keeping her safe is really important as is making sure she keeps on eating. That can mean taking her to emergency if needed. My D had a clear crisis plan worked out - who to call when for what behaviours along with  sedating medication (locked away) that could be given in a crisis). 

My D did have a general mental health admission for suicidal thoughts as well as hospital admissions for her eating disorder. It did keep her safe when she was most at risk of hurting herself. I would even suggest that saying she can see no reason to go on is very much a cry for help to deal with this. 

Have you tried looking for small patches of joy to help her move forward - non physical activities she likes, pets? We ended up with a puppy who also gave her a focus outside of her misery. 

I reminded my daughter regularly that there was hope and she could recover, even though she thought it impossible. She is now mostly recovered, and enjoying life. 
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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Plumms
you are already helping me stay calm today when i read your messages. She has slept reasonably well but became very anxious after breakfast (bagel and peanut butter is a tough one for her) more rocking a repeating words. I managed to calm her down with some techiniques CAMHs have thought me. We are showered and doing puzzles and i have told her we have to go out to walk our dog. Our cavapoo, Elle, has been a life saver for us and rarely leaves Ds side.

I have told her I will take over for a few days and make her keep doing things, that I will not leave her and we will get her back to where she was recently. She seems to like me talking like this and doesn't fight me. When she came out of hospital and was this low she let me hug her (not able to do this for 3 months) and said 'mummy I need help". I am still able to hug and comfort her now which makes it so much easier for me and I believe there is more of my D and less ED than in the first few months. I really hope this is extinction burst.

Regarding her weight we are at a BMI 18.4 now (15.7 lowest at diagnosis). We mostly put on 0.5kg a week accept for her hospital admission where she refused food and lost about a kg. We quickly restarted her meal plan on discharge. We also slowed and lost a bit a few weeks into refeeding when we were didn't realise she was hiding some snacks etc. I think we need another 3-4 kg to get her to her previous weight but I know that state not weight is the way to go. She is 5ft like myself. We really don't have a target weight and I don't want one. Some of the very high calorie foods are difficult for her i.e. smoothies/cream/chocoloate. But we add oil where we can and we were making progress with fear foods.

Just hope the Olanzepine increased dose helps in the next couple of days like it did when we started it.

Thank you all for your support. I wish I had posted earlier. I really don't feel so alone.
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ValentinaGermania
Hi plumms,
yes, it helps so much to talk to the others here, come here as often as possible for your own sanity.
Great to hear that she slept a bit. Try to distract her as much as possible, that helped a lot here. TV, card games, walking the dog, whatever.
Keep feeding until you see a change in state. Don´t give up. You have already achieved a lot. It will get better but reconnecting all these damaged lines in brain needs a lot of time.
We are 20 months since diagnose now and my d went off to University this week. Do not give up hope.
Tina72
Keep feeding. There is light at the end of the tunnel.
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teecee
Distraction is so important. We walked (when calm) and played card games/watched box sets on Netflix. Journaling is also something my D took up and still continues to do even now. Her journals at first were dark but then became positive. It helped her make sense of her thoughts and as she became positive the drawings and writings changed. She then started collecting event tickets...bus tickets...leaflets from good experiences to stick in to them. It’s helped a lot.
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Torie
Plumms wrote:
We are showered and doing puzzles and i have told her we have to go out to walk our dog. Our cavapoo, Elle, has been a life saver for us and rarely leaves Ds side.


So glad to hear about Elle.  Pets can help a lot - it's great that Elle seems to understand that, too.

Did your d shower before breakfast?  Most here find it prudent to do it that way so that ED-kid can stay with us for at least an hour after each meal/snack.

It's really great that you have joined us, although it sucks that you had the need.  Please remember that we are all with you in spirit. xx

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

Dear Plumms, 
It is wonderful that she lets you take care of her. You say above:"I have told her I will take over for a few days and make her keep doing things, that I will not leave her and we will get her back to where she was recently. She seems to like me talking like this and doesn't fight me. When she came out of hospital and was this low she let me hug her (not able to do this for 3 months) and said 'mummy I need help". I am still able to hug and comfort her now which makes it so much easier for me and I believe there is more of my D and less ED than in the first few months. I really hope this is extinction burst."

Keep feeding most need to go really much higher than the predetermined goal and I am glad that you say that you don't really want a target weight- GOOD FOR YOU!
Adding oils and tackling some fear goods, I must say you are doing exceedingly well! 
Keep feeding!

Thinking about you,
XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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smileymum

Hello Plumms
It's amazing to read how even in the depths of her distress your d so trusts you and can articulate how much she needs you and wants your help.
It sounds like you have found the right compassionate and strong words to say to reassure her and keep her safe and well-fed. You are doing so incredibly well. Hats off to you.

My d needed inpatient for suicidal thoughts (after an OD the year before) and then ED inpatient. She asked to go in as she didn't feel safe. She couldn't talk and still won't much about her feelings which has been hard as otherwise we have a lovely relationship. I would loved for her to ask for help from me in her distress as your d has reached out to you. In her case Olanzapine helped + time + food and then a desire to come home and get stuck into life.   Far from out of the woods 4 months after discharge but certainly more into life and interests.

When sleeping with her to keep her safe, I didn't know if she'd ever improve but they can. They are young, healing is possible and especially so when they have proper food intake and such loving and consistent support. You are already giving all that and more to your precious daughter and she is blessed to have you. 

Smileymum
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melstevUK
Hi Plumms,

Welcome and glad you have found us. Others have given you great advice already.

I guess for me I am wondering if some of the depression and hopelessness are linked to not being in school and worrying about how she is going to get back on track, particularly. Has this been discussed? Nothing is worse for depression than having unresolved issues to worry about.

It must be devastating to have a child make a suicide attempt and thankfully I have never been there. My own d was depressed but responded well to weight gain and fluoxetine. However I took a matter of fact approach and said we have one life to live as usefully and as fully as possible and that I would do everything to support her but would not allow her to give over her life to illness and that she had to and would come through it. She did, it took a long time to get there as we did not have great clinical support but she is fully recovered from an today.

The fact that d reaches out to you is such a positive and when things feel really bad she had to learn to talk about her despair and not act on it. Adolescence is such a tough time but an and depression certainly make it an even tougher time for our poor kids.
Believe you can and you're halfway there.
Theodore Roosevelt.
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Torie
melstevUK wrote:
I took a matter of fact approach and said we have one life to live as usefully and as fully as possible and that I would do everything to support her but would not allow her to give over her life to illness and that she had to and would come through it. 


Melstev is such a kind and sensible person that we would all do well to emulate.  

When my d was begging to be allowed to die, I eventually told her that was not an option because I would never recover from that, and the whole family would be shattered.  She argued against that of course ("I know you would be really sad for a while, but you would get over it") and also argued against the sheer unfairness of that.  ("I didn't ask to be born, and I don't want to be alive, and it isn't fair to make someone live for another person when the someone wants to die.")  I don't know if it made a difference or not, but my guess is that it did.  I suspect it added some weight to the side of the scale that was life.

Years later, for reasons I cannot now dredge up, I was listing some of the things I had done for my kids (all the driving, cleaning which I hate, etc etc) and (former) ED-D said, "Yes, well, I ATE for you.  I didn't eat for MYSELF - I ate for you."

Life is so weird. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Plumms
Thank you all for helpful and supportive comments.

Melstev, Unfortunately school was a significant trigger to her unhappiness. She was in an all girls private school and was doing exceptionally well as result of her constant hard work. The school continued to acknowledge her accomplishments this and she says she felt huge pressure to continue to do excellently. She can explain that this was in her, not from us or the school. I have recently briefly discussed school with her, explaining that at some point she will need to return or go to a new school and we will look at all options when she is well enough to cope with this. Previously she just said, "mum, i don't want to go on living so I can't even think about school" . I have asked her team in CAMHs to help me introduce discussion on this fear subject with her when she improves.
            I have also discussed with my D that we would never recover if she ever killed herself. I have had exactly the same arguments you had back! I repeatedly tell her I will fight to get her back until she is able to want to recover and she can take over, and that recovery WILL happen for her.

Torie, We did shower after breakfast but I am in the bathroom with her as I don't feel she is safe alone at the moment. She has a fear of purging which is helpful to us!

We have had some improvement today, We have kept busy making dog bandanas and baking! She ate one of the biscuits she made for her snack!!!! I swear Olanzepine has been wonderful for her and the increased dose seems to work by day 2. More talk of how fat she is rather than a will to die....very happy with that.


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Plumms
Smiley mum....your post made me cry, thank you. It is lovely to hear I am doing the right things and everyone needs to get a well done when so many days are just so hard to get through.

Big hugs to all those loving parents out there. x
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Enn
Oh Plumms,
She ate a cookie that you both baked!! That is amazing!!
Olanzapine has good evidence with AN. So glad today is better!
XXX
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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melstevUK
Plumms,

So glad the Olanzapine seems to be helping. That is a huge achievement to eat a cookie she had made! Olanzapine is supposed to help with sleep too and everyone feels better when they sleep well, that is for sure.

It would seem that the issue of school is just too scary a topic to broach right now but my bet would be that, after being a high achiever in this hothouse environment, she is likely to feel a real sense of failure right now, rather than be able to acknowledge she is ill. My own d was in a private girls' school and did her last year in one of the state schools as she could not face being with girls who knew her history For a long time she held it against me that she was given a private education but has a very good circle of friends from that time now.
Are any of your d's friends visiting her? It may help if she sees some of them. I don't know what is happening on that level but I know that for my d, her friends' loyalty helped keep a sense of her self worth. Eating was kept separate from activities with friends for a long time.

Torie - your words are very kind, thank you. I think it is a question of being much older than many of the parents on here. I didn't have my d until I was 35 and so am in my sixties! Extra decades bring further wisdom maybe, lol!
I am pleased to say that we are planning a wedding as d got engaged recently so things are very good for us now. And while the journey was a long one, as I have mentioned before, we have a recovery that I would never have believed possible after the severity of d's illness at the beginning. And I have the forum to thank for that, beyond all doubt. And so interesting that your d said that she ate for you. Yes, it brings home what an enormous thing our children have to do by eating - but also reveals how getting them to do it for us as parents in the beginning is such a good strategy, and the basis of FBT.
Believe you can and you're halfway there.
Theodore Roosevelt.
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deenl
Dearest MELSTEV UK,

I am also someone who has highly valued your point of view. I love the way you help focus on the 'life worth living' strand of recovery.

And whooping here at your wonderful news. It is one of the few silver linings; that we savour small day to day pleasures and life's big events with an intensity and gratitude we wouldn't have otherwise. So happy for you all.

Warm wishes

D
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.
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deenl
Plumms,

What a win! It took us months to get to that stage. It is very challenging to deal with the collection of symptoms your daughter is dealing with but you are doing a fantastic job.

When my son was at his most undernourished he was suicidal (letters, plans and time) and self harmed. Luckily we were able to intervene and did all the usual; remove sharps, ropes and meds, slept with him, locked doors and windows, car always fueled and parked for a quick departure and keys and phone in pocket. We were lucky, he was one of the ones for whom these symptoms disappeared with renourishment but it probably took us a long time. It is not always the case but even with co-morbids treatment for them is more successful with a nourished body and mind.

Wishing you continued strength and an easing of your daughter's distress.

Warm wishes

D

PS My son ended up staying home for 2 full school years. This was the right choice for him as he could not cope with recovery and school stresses at the same time. He is now in his second year back and reintegration has been very smooth. He will be doing final exams on schedule.

PPS I struggled to get regular nutrition started because techniques such as life stops until you eat couldn't work as he had no life. He sat keening on one particular spot on the couch all day and stopped eating all together if pushed. But where there's a will, there's a way. Many people gave us lots of different ideas on a thread called 'super resistors' Sorry can't lunk on my phone so use the search button.
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.
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HopeNZ
Melstevuk, I echo everything deenl says. Both about valuing your positive, pragmatic wisdom (another older mum here, but not feeling particularly wise for it!) and also being really delighted at your wonderful news. Congratulations, warrior mum, for fighting and winning the battle for your d's health and happiness.

Hurray!
Hope
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Enn

melstevUK wrote:

I am pleased to say that we are planning a wedding as d got engaged recently so things are very good for us now. And while the journey was a long one, as I have mentioned before, we have a recovery that I would never have believed possible after the severity of d's illness at the beginning. 


I want this too, someday. 
Love to you all!!

XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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