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

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Yael826_
My 14 y old daughter was diagnosed with restrictive ED about two months ago. Prior to that about 8 months of intermittent binge/purge. We are now in FBT full steam and although not as fast as we would like, ( initially we're flaky about the three snacks) she is putting weight back on and it taking her meals. About once a week she has insane and frightening postprandial outbursts, threatening suicide, cutting, hyper exercising and basically pretty uncontrollable. Called 911 last week, they came and calmed her down. It's so scary and backfires by making me scared to feed her. Therapist is really against meds until weight is way up. She is now five pounds from baseline but probably needs to be a lot heavier than her pre anorexia weight. During a few of these episodes I've given her a benzo which did calm her down.  Again therapist very against it and wants her to learn to manage her waves of emotions. Having suffered from terrible anxiety as a teenager myself ( not around anorexia) I know that sometimes riding the wave can be actually traumatizing rather than growth enhancing. I've heard compazine is terrible because kids gain weight to fast and very triggering and can backfire. She is in full flight or fight mode and no words, gestures, presence is helpful. Should I put her in some type of in outpatient facility. What about more therapy. Therapist believes until she gaines all weight in her experience therapy doesn't stick. Any words of advise.
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ValentinaGermania
"Therapist believes until she gaines all weight in her experience therapy doesn't stick."

That is very realistic.

"About once a week she has insane and frightening postprandial outbursts, threatening suicide, cutting, hyper exercising and basically pretty uncontrollable."

To be honest, it is a blessing when you see that behaviour only once a week 🙂. Not that it is easier to handle then but some parents here saw that daily...it is totally normal ED behaviour. Great that calling 911 helped.

We bought our d a punching bag to get rid of all the anger and frustration. I do not know if that would lead to more hyper exercising in your case (then that is no good idea) but maybe worth a try. Mine did stop self harm with that.

" She is now five pounds from baseline but probably needs to be a lot heavier than her pre anorexia weight."

That is quite probable but lot of anxiety was here pre AN and we had to tackle that like fear food after good WR (before it does not make sense).
Some parents here had good exeriences with cannabis oil (the medical cannabis). If that is available there worth a try?

"Again therapist very against it and wants her to learn to manage her waves of emotions."

You are the parent. You decide. Unless the therapist does not offer to live with you 24/7 she does not need to handle those outbursts and if you find something that helps then do that. She can learn to manage her emotions later when all the AN problems are done. Now in that state anything that helps is worth a try...just my personal opinion.

You are still in very early days and brain recovery needs a long time so it is very likely that after she reached a good weight and brain recovery started you can work on anxiety much easier. We first tackled weight gain, then fear food, and then about a year after WR we started to tackle anxiety and social problems.


Keep feeding. There is light at the end of the tunnel.
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Ellesmum
Yes I saw that kind of outburst daily last summer, with food and weight gain we only have the odd weepy moment now.   
It is frightening and what helped us sometimes was to ‘baby’ my d like I did when she was scared as a toddler, I mean acknowledge her feelings and go full on ‘mummy’ in the aftermath.  I know these rages terrified d too.  CBD oil can be worth a try and OTC drowsy antihistamines can help with sleep as can a weighted blanket.   I grew to learn what was a ‘AN rage’ and what was a blood sugar crash, very similar and the second managed by a sugar/carb snack.  
Ellesmum
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ValentinaGermania
Ellesmum wrote:
  I grew to learn what was a ‘AN rage’ and what was a blood sugar crash, very similar and the second managed by a sugar/carb snack.  


It is great that you mention that, Ellesmum, if that happens once a week and if it is maybe always the same day it is worth a try to look for some longer food gaps ahead of these outbursts. Low blood sugar can cause that too.
Keep feeding. There is light at the end of the tunnel.
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Foodsupport_AUS
Welcome to the forum. What you are experiencing does sound very typical at this stage. Your therapist seems knowledgeable. It is true that most therapy is not particularly helpful when their brains are malnourished. It is definitely scary to watch and the question for me is about what is setting this off? Is this an ordinary meal or is this something that has been particularly challenging? There is no recovery from eating disorders without repeatedly facing the fear of eating, however laddering which is a common way of working with phobias does work with ED's as well. That is the concept of working from least feared to most feared foods in a stepwise approach. The only problem with this is some kids are just not eating enough to make headway. We can't compromise on caloric intake but sometimes it is reasonable to compromise on the form it takes if these emotional waves are all too strong to handle. They do definitely calm down, but it takes a number of months for the roller coaster emotions to diminish. 
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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Yael826_
Thanks for all the great responses. Interestingly she doesn't have any "trigger foods" I think it happens after several days of being "good" and holding herself together around her friends, then giving her a final late night snack when she's tired and just can't hold it together any longer. You really need a crash course in psychiatric nursing to handle this. Therapist today stressed how important it is to remember that the behavior is ED and not my lovely d. She reminded me that anger, criticism has been correlated with worse outcomes. It's just so hard to be loving when you're dealing with the exorcist. It's horrid to see the child you love so much in such mental anguish. I hate it and can't wait to get to the other side. I keep reminding myself that if we stick to this crazy meal plan and restrict all exercise she will eventually improve. Our very close family friend was diagnosed this weekend with esophageal cancer. That's a bad one with a grim prognosis. Definetly gave me some persepctive
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Mamaroo
Yael826_ wrote:
During a few of these episodes I've given her a benzo which did calm her down.  Again therapist very against it and wants her to learn to manage her waves of emotions.


When my d got very anxious I asked for medication, but was denied, even though she cut herself and ran away. So I went and got over the counter meds, tried it on myself first for a week and when I saw it worked, gave it to my d. I didn't see the need to tell our team what I gave her, but it made a world of difference. So in your shoes, I would continue giving her the benzo to get her over the wave. If your d had broken her arm, you would give her pain meds. I seriously think that unless one had lived with ED, that one could not really comprehend the level of anxiety they experienced. 
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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Yael826_
What over the counter meds did you give? Benadryl? You’e absolutely right when you’re kid is gesturing to jump out of window, banging head on the ground in between jumping jacks in that moment of horror I would give her anything to take pain away. It is not happening daily, but definitely an episode maybe two a week. Last one not quite as intense.Maybe good sign. I made appointment with psychiatrist ( pediatric) who deals a lot with eating disorders next week. Maybe she’ll prescribe something an SSRI or a short acting benzo when things are really bad. Therapist said stay away from antipsychotics due to SA of rapid weight gain that can really backfire and be triggering for a kid whose big fear is not being able to stop eating once she starts.
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Mumtoteens
Hi, I’m new here so apologies if my question is daft, but how does Benadryl help?
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ValentinaGermania
Yael826_ wrote:
You really need a crash course in psychiatric nursing to handle this.


That is definitivly what cahms and all therapists should learn us first!

Yael826_ wrote:
Therapist today stressed how important it is to remember that the behavior is ED and not my lovely d. She reminded me that anger, criticism has been correlated with worse outcomes. It's just so hard to be loving when you're dealing with the exorcist. It's horrid to see the child you love so much in such mental anguish. I hate it and can't wait to get to the other side.


It is correct that you should try to seperate your d and ED but I also understand that this is not easy to do 24/7 and we all lost some fights with that. And I think we should not allow them to behave totally uncontrolled and then in that case some criticizm is needed. Some here said to their kids it is an eating disorder and not a rudeness disorder.

Yael826_ wrote:
I keep reminding myself that if we stick to this crazy meal plan and restrict all exercise she will eventually improve. Our very close family friend was diagnosed this weekend with esophageal cancer. That's a bad one with a grim prognosis. Definetly gave me some persepctive


So sorry for your friend. I hope there will be some chance to get therapy.

Stick to that "crazy meal plan" (why is it crazy?). Restrict all exercise. It really gets better with food and weight and time.

RE those outbursts: are they mostly in the late evenings? Is it possible that she was too tired on these days? Some patients lose their feelings for tiredness and I had to send my d to bed much earlier in the dark days so she got enough sleep (she needed at least 10 hours). She went to bed at 9 p.m. at age 18...🙂
Keep feeding. There is light at the end of the tunnel.
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Ellesmum
Mumtoteens wrote:
Hi, I’m new here so apologies if my question is daft, but how does Benadryl help?


Hi there, we’ve spoken elsewhere. Welcome, Benadryl has anti anxiety properties as does Phenergan, it can also help sleep.
Ellesmum
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Mumtoteens
Thanks I never knew that.
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Ellesmum
Mumtoteens wrote:
Thanks I never knew that.


we have phenergan prescribed but it’s available OTC and my d takes it with her fluxotene (Prozac) as it isn’t contra indicated.   Have a good read around the forum and feel free to make a post about your specific situation, I dread to think where I’d be with d without the collective wisdom here. 
Ellesmum
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Mamaroo
Yael826_ wrote:
What over the counter meds did you give? .


I use Ashwagandha, in Australia it is sold in concentrated form as sensoril under the name EQ Control. I still give it to her when she's anxious. It does take a week or so to start to work.
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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debra18
Lemon balm is supposed to help with anxiety. I didn't try it but I know some people that did.
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