Difficulties

Long story short, I’ve had depression including self harm for approximately 10 years, and been purging on and off for around 4. Last year in May I got so low that my friend managed to persuade me to go to the doctor.

At the time my purging wasn’t particularly prominent; I was referred to the mental health services, prescribed sertraline and placed on a waiting list for CBT. Fast forward to last month, I finally got an appointment for therapy. However, recently due to a few reasons, my purging has become daily, and after two initial assessments, the therapist decided that I needed to see an eating disorder specialist.

I agree that this was the right decision, but unfortunately it’s not possible to be under 2 departments at the same time, so despite still needing help for my depression this has to take priority. I was assessed last week, and again put on a waiting list for bulimia therapy. No official diagnoses atm but it is most likely I have purging disorder, as I don’t binge, I just restrict food, over exercise and vomit.

The wait time at the moment is 4-6 months, which really got to me as I feel very low with this right now. So I did some research and decided to do everything I could to help myself, even if it would be difficult.

My behaviours all stem from a desperate need to lose weight, so I decided to start the NHS weight loss plan and try and do it a safe/healthy way. For two days I was incredibly proud of myself - I ate two reasonable meals, exercised a normal amount, allowed myself some sweet treats and still maintained a calorie deficit. Today was the third day and was going well, until I decided to eat some jelly beans. This was the first food I haven’t weighed/recorded and I felt so guilty and awful that I had to purge. It was gross as ever, I god bad acid reflux and I feel like I’m back to square one. As much as I want to carry on trying to be sensible and safe I’m terrified that in the past two days I’ve eaten way too much food.

Sorry this is so long, I don’t expect any replies, this isn’t an easy problem to solve. I just needed to vent

[crazycrossstitcher]

Try writing out a meal plan - mine is based on 3 meals and small snacks each day - I found I was more able to maintain control this way - whenever I felt tempted to eat/not eat I referred back to my plan. Perhaps the GP has a nurse with some nutritional experience who could give you guidance - or try contacting Anorexia and Bulimia Care or BEAT. Hope this helps.

[lillyofthevalley37]

Has the sertraline increased your disordered eating and purging?

[Hidden in reply to lillyofthevalley37]

I don’t think so, I’ve been taking it for a year and this increase has only happened in the past couple of months

[lillyofthevalley37 in reply to Hidden]

I think you definitely have an eating disorder

I hope you choose recovery , this is the first step - a commitment to recover -even though it might feel wrong

[Hidden]

I am really sorry things are tough for you right now. You post brings up a lot that I would like to respond to, and I hope you understand what I will say is intended to help. My position on some issues surrounding recovery probably seem strange, but these mindset shifts were very necessary for me to accept in order to get better. So with that, and the warning that I will be long-winded, here it goes:

Working on ED recovery and trying to lose weight are mutually exclusive activities. Pursuing weight loss is what tends to be the first step into ED land for most of us, and I do not believe that is a coincidence. In hindsight I also realize that my ED behaviors got progressively worst the smaller I got--again probably not a coincidence. There is a reason many of us travel along the ED spectrum--dieting-->anorexia-->bulimia and back again. Despite what your ED (and the broader society) tells you, humans cannot successfully control their food or bodies long term, at least not without sacrificing physical and mental health. It is actually not something we can do by sheer force of will.

Your body is fighting to keep you alive and at the weight where it functions most optimally. This weight may not be one you like, but if you have to resort to disordered behaviors to keep yourself at a certain weight (both at the higher and lower ends of the spectrum) then this is not your natural genetically determined weight.

Your weight is similar to your height--something predetermined and part of your physical blueprint. Sure, you can push it around temporarily but at some point biology takes over and you eat more than you think is "right" or eat off your diet plan. This convinces you that you cannot "control" yourself around food, so you compensate somehow--over exercising, restricting harder, purging, etc. Unfortunately, the compensating behaviors just set you up for more disordered behavior down the road. Under eating (or dieting or starving) causes "reactionary eating" which is a basic, biological survival mechanism but something your ED tells you is a lack willpower and a character flaw.

Your body is reacting to starving, and this sounds scary but it's actually pretty smart. Your body interprets periods of restriction as famine, so when the opportunity arises it tries to get in food when it can to protect it from the next bout of famine (restriction/compensation). The reason we are drawn to eating the most calorie dense foods like candy or pastry or whatever during these episodes is that your body is seeking out the foods that will most quickly make up for the lack of calories from before. Of course when you try to compensate for that "uncontrolled" eating you keep yourself in the ED cycle. I never understood this, and no one ever explained it to be, so I always reacted by engaging in disordered behaviors to compensate because I thought I should be able to control things. Under eating is one of the few activities that people get worse at over time, and this is because, on a primal biological level, your body is fighting to return or stay where it functions the best.

The link between EDs and other mental health issues is strong, and I suspect at least some of the severity of those are the results of starving (look into the Minnesota Starvation study for some really interesting information about this). Even if starving doesn't directly cause mental health issues, it definitely seems to exacerbate them. Without enough fuel your brain cannot function properly. I'm not pretending that eating adequately cures these issues, but it certainly does not make them worse.

I am sorry for this novel, but I am trying to make things clear. Living with active ED behaviors is hell--I spent the majority of the life suffering, but am celebrating 2 years in full recovery this month. I'm not trying to sound brag-y, but when I was sick I didn't think recovery was even really possible and learning about people who actually have gotten better really helped me start to take necessary steps to get better. I hope knowing it is possible helps you in that way too. I hope some of this makes sense, and maybe gives you something to think about.

[Hidden in reply to Hidden]

Thanks so much for your reply; I really appreciate your thoughts - you should 100% be proud and brag about your recovery because it’s an incredible achievement. It feels impossible for me to recover unless I get my shit together but I don’t think I’ll ever be happy with myself

[Hidden]

Thanks for your kind words. I understand feeling like it will never happen--I started my behaviors as a kid and spent ~20 years of my life fighting, so I had really given up hope of ever doing better. However, when I started recovery I thought of it like an experiment, like I will try this for a few days and reevaluate, then a few weeks, then a month and so on. In order to start, I had to have the comfort of knowing I could go back if things didn't seem to be getting better. And step by step I went on; I am not pretending it was so easy, but it can happen. I mean most of us are pretty stubborn (it takes a lot of dedication to actively fight biology everyday) so we know we can stick to something for long periods of time--recovery is the same. It's work, but it can happen.

[Lulet99]

I don’t know if it helps but I try to live day to day so if I muck up one day I try not to let it affect the next. So instead of thinking that I’ve ruined everything and failed etc I get up in the morning and try to do the best I can for one day. Don’t think about yesterday or tomorrow. If it’s a good day that’s great and if it’s a bad day it’s just one day! If you have two good days then a bad day it’s still two good days, forget the bad one and try for another good one on the 4th day!!!!

[brokenankle75]

All I know is that I have asked my family doctor, my psychiatrist, my counselor, for help with my eating disorder because I binge eat bad. Year ago in my teensI tried to be bulimic but I couldn’t make myself throw up not even sticking a toothbrush down my throat so I became Anorexic. And now it’s moved into binge eating..I feel like I’m not being taken seriously but I know that for myself I have to take care of my mental health and my eating disorder at the same time because I have several mental disabilities. It’s crazy how when you totally need help for something whether it be an eating disorder or mental health addiction they put you on this waiting list and you need help immediately. It’s ridiculous . it just upsets me how the system works. I really hope that you get this under control and that you’re able to manage your eating disorder and mental health and anything else that’s going wrong with you. You’re in my thoughts take care

Also if you look online you can find someone who is a specialist in that field hopefully your insurance will cover it but that’s just an idea to think of