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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Hi. This is my first time posting.
My daughter is 19 and was diagnosed with AN 8 weeks ago. We are following the FBT and she is gaining weight each week. She is compliant with food and meds (20 mg fluoexatine in morn, olanzapine 5mg evening). My worry though is her anxiety, paranoia and OCD behaviours have worsened over the last week. She is struggling to cope mentally with all of these heightened anxieties. Should we ask GP to increase meds??? (She is about 5 kgs from being “weight restored” ) Im so overwhelmed with everything. TIA. 
From your daughters point of view she’s in a really horrible place right now, the ED voice is strong yet she’s stuck in a heavier body, it’s very common for anxiety to sharpen close to WR and something to push on through.  

How is she mentally apart from the anxiety?  I’m wondering if she’d be able to take on board video or written thoughts on this subject as Tabitha Farrar is great on this and coaches adults in recovery.   Worth a thought? 

From what  you’ve written her feelings are kind of to be expected at this stage and would hopefully fade with further ongoing nutrition.   https://tabithafarrar.com/blog/
Hi and a very warm welcome from Germany. Sorry that you need to be here with us.
I think it is worth to ask for increasing meds but can you tell us what is her anxiety about? Is it food/weight gain related or other things too?
You are very early in state and maybe it is part of first "extinction burst" (use the search button, that happens often around WR that bad behaviour increases again). It is also possible that ED now realises that you mean business and weight gain will continue.

Try to keep her safe and get through this episode. Keep feeding and try to stay calm. It it very possible that next week is better again.
It is normal that anxiety and OCD increase in refeeding and part of the therapy is to learn to stand that anxiety and that nothing bad happens when you eat a cookie for example.

By the way, if your nickname includes part of your real name please contact a moderator to change that. Be aware that this is a public forum and names can be found by google. Last thing you need is getting your d to know what advice you get here. If it is a fantasy name forget my concerns.
Keep feeding. There is light at the end of the tunnel.
Welcome to the forum. You have done a great job getting consistent weight gain over the first 8 weeks. It is quite common for anxiety to increase during re-feeding and many report it occurring more as their child gets closer to weight restoration. 

In terms of medication it is important to know that it is of very limited benefit when it comes to eating disorders. It can improve anxiety and depression but often only after weight restoration and dose changes take a number of weeks to take effect. Olanzapine is mostly use to help manage the immediate anxiety around food and for sleeping. It has a shorter time to act - but one thing to remember is that eating causing anxiety is actually part of the treatment. It helps to rewire their brain that food is not scary and terrible. By being repeatedly exposed it helps to learn to adjust, trying to medicate it away in some ways defeats the purpose. 

Given she is having more symptoms is she seeing any therapist to help her work on strategies at the moment for dealing with her anxiety, be that CBT or something similar?
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.

I am glad that you posted. Here you will find many people who can share their experiences. Everyone wishes to help. 
It is common when tackling the ED that anxiety depression and OCD thoughts come out more.  So this can be part and parcel of the stage you are at and may alleviate over time. The meds may need adjustments, and it still may be to early to do that.Some have found weight gain  and time helped those thoughts,  and then and some did not find that and ongoing mental health support was needed.  I would consult with your physician about the meds issue too. Some have pre morbid mental health issues. The first thing is to ensure her physical safety. Some do self harm and please ensure sharps, and items like poisons, meds, and ropes need to be inaccessible, high windows are locked and there is plan for all in the home to be safe.
I do agree that ensuring you have all available therapies at hand, like CBT, as Foodsupport_AUS, mentions, as well as acute mental health services. 

I am glad she is gaining weight ,that is critical at this point in time. It is really challenging dealing with ED. Are you able to take care of yourself as well? 

Please keep asking questions.  We all wish to help you.

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)
I agree with what’s been said. We had awful anxiety and OCD and I couldn’t even bring myself to post here at the time as I felt it was all so bizarre, but having read a lot on this forum I now understand it is usual behaviour. As long as your d keeps gaining weight that is the most important thing, even if other aspects feel stuck. It takes time and a lot of perseverance and patience, but I have found that the anxiety and OCD lessened gradually. Wishing you all the best. 
Thankyou. She has her first appointment with the Eating Disorder clinic at the Hospital in 2 weeks, so I am hoping there, that they start CBT.
Her doctor has said to take another half tablet of the fluoexatine every morning, this may help with her anxiety a little more. Strangely, its not really the food that shes having the anxiety with (i think shes just resigned herself to the fact that she HAS to eat it), its more “everday” stuff, like being on time, no one going into her room, etc, and obviously her weight also. Thanks for your advice.
My d's anxiety hid in other places when she started to eat more regularly. She worried about how her face looked, how she spoke, her hair etc. Only after several months post WR did her anxiety go away. I used over the counter meds to help her cope. I hope the increased dose of medication helps your d.
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
Wow, theres so many variables with this illness. Thankyou everyone, it is so great to hear everyones experiences. It has helped get my thoughts clearer. I seem to be constantly second-guessing everything I do/think/say regarding the ED. I feel like im going MAD myself. So thankyou🙏🏻
That is also normal. 🙂
This disease is so strange that you start to question everything you said and did.
ATDT saved my own sanity so please feel free to ask all your questions and we try to help.
It is a game changer when you can speak to someone who has been through this.
Keep feeding. There is light at the end of the tunnel.