Trigger warning: Eating Disorders, Medical Emergency, Hospitals, Mental Capacity
Its no secret that I have a lot of mental health problems, and that I can fluctuate quite significantly. But on a day to day basis, one thing that I’m generally sure about is that I’m not mad. For me, a majority of my mental health issues are pretty logical to tell the truth. They may not look logical to you as an outsider looking in, but inside my brain, knowing the experiences I have had, and the memories I carry with me and the scars they have left – the way I live my life, the way I avoid certain triggers (however much that impacts my life and ability to function), the way I respond to things (with emotions that could look disproportionate to the situation but are actually emotions from the past that have been triggered by the here and now) – is all actually pretty logical.
But the one area that challenges this is my eating disorder. When I am in the grips of Anorexia or Bulimia, I am a mad woman. I’m a mad woman because I believe wholeheartedly the lies that Anorexia tells me. I’m a mad woman because I can’t see anything else outside of my final goal. I’m a mad woman because I can’t see even the most serious of situations as serious.
Eating Disorders (for me), are just one mad thing after another. I’ve suffered with both Anorexia and Bulimia over the 20 or so years I’ve had an Eating Disorder. When Bulimia is in power I am mad when I am frantically scouring the supermarket for binge food. I am mad when I am driving around town, shoving pastry after pastry into my face, not caring about crumbs in my usually clean care. I am mad when I am desperately downing pints of water in preparation for bringing it all back up again. I am mad when I am throwing up in bins, in the back of my car, in bushes, in multiple different toilets in that hotel in Jordan in 2012 that the fragile Middle Eastern plumbing couldn’t handle and I ended up blocking a whole floor of toilets. I am mad when I’m eating anything that is in the cupboard, or in the freezer, or picked out of the bin. When Anorexia is in power I am mad when I scour the supermarket for food I will not buy. I am mad when I spend shedloads of money on expensive, low-calorie food with no nutritional value. I am mad when I spend £80 a week on laxatives. I am mad when I think that 5 hours of exercise a day is a “rest day”. I am mad when I think that water is the perfect accompaniment to weetabix instead of milk. I am mad when I look in the mirror and see a horrible fat mess when in actual fact I am underweight.
I’m a girl totally consumed by this point. There is nothing, nothing at all in the world more important than obeying Anorexia and Bulimia and their toxic lies. And the worst part is that I don’t realise I’m mad at this point.
So I find myself, where I left my last post. I’m feeling confused as to why everyone is making such a big deal. I can’t understand the gravity of the situation. There are about 10 medical staff around my bed – but its the middle of the night? Maybe they’re just a bit disorientated. Night shifts can do that to people. Eventually they all go away and I drift in and out of sleep. Kind of annoyed that people keep taking my blood pressure and disturbing me, it has been a long day.
The next morning I see a doctor. I’m still attached to fluids. I’m feeling pretty good actually compared to yesterday. I think of the plans I have for that weekend, the week ahead – plenty of moving about, no food, definitely no water. I feel fine now – so I’ll definitely be off home later. Even though I wasn’t happy about the fluids, they’ve happened now so that will do for a while. I can’t understand that humans need to keep drinking, and keep eating – it’s not a one off event.
It’s great here though, because the housekeeping staff soon catch on to the idea that I don’t eat when they bring the trolley round – they’re missing me out now so I don’t even have to say no. No one is bugging me about not eating. The doctor says I have to see liaison psychiatry before I can go. I’m fairly used to this (see first paragraph re. plenty of other mental health problems) and I’m also fairly used to it mainly being a formality before being sent home. I feel pretty confident in my personal assessment of myself – had a bit of a wobble, but I’m fine now.
This is not what liaison psychiatry think. “You’re physically stable because you’re attached to an IV, when you go home you won’t be”. OK that makes sense, but I don’t actually need it do I? I was doing just fine before I came into hospital. I haven’t had a drink for a whole week now. “What about Friday night? Do you know you nearly had a cardiac arrest? It made scary reading in the notes. Does that scare you?” Not really if I’m honest. I am slightly anxious wondering what it might have been like for my carer to find me like that, but in regards to myself I am not particularly worried about it. I just fainted surely, I’m fine now – everyone was just overreacting. I list all the things I have to be at home for – work, social plans, exercise plans, my garden. I become very infatuated with the idea of sitting in my garden in the evening over the coming weeks. Like it’s the most important thing in the world – over physical health, mental health, anything.
“I don’t think you have the capacity to understand decisions about your nutrition and hydration and how that relates to your physical health”. Well this is confusing. I’ve had times where I’ve not had capacity before – but I usually don’t remember them. I’m definitely in the here and now right now, I’m having a sensible conversation. I have insight, people always praise me about my insight. “We’d like to speak to your parents and your carer, and for you to stay until the consultant psychiatrst is here tomorrow – can you stay one more night?”. I respect the professional in front of me, she is a colleague as well. For this reason I agree (reluctantly) to stay. I guess one advantage is that the ward still don’t realise I’m not eating so at least I’m getting away with that. The thought of that makes me feel a little bit better. “One night, I’ll stay one night, but then I’ve got things to do”. This whole situation is bizarre for me. I’m used to being moved on as fast as possible in services or in hospital. I have the label of BPD so usually this is how things are approached. It confuses me now because it feels like the opposite is happening, and for reasons that don’t make sense to me.
The next day is for some reason, a little more blurry. I see the psychiatrist. He wants to speak to my parents too. For the first time, tiny alarm bells start ringing, but probably not for the reasons that they should – I’m just ever so slightly anxious that I’m being backed into a corner and if I don’t agree to what people say, I might be facing a section. This thought is to distress me quite a lot over the coming days as I struggle to come to terms of the reality of where I am. The psychiatrist also asks me to stay in hospital. Why are people making mountains out of molehills? I really don’t need to be here. I’ll accept I do have some issues with food, but they’re not that serious.
Towards the end of the day, someone from the Eating Disorders Service arrives. I’ve known this person for about 15 years by this point, initially I’m comforted by this because I feel like that must mean they know I’m fine. But that is definitely not how the consultation unfolds. “You’re very unwell, your heart rate is dangerously low. You could have had a cardiac arrest” (Why are people making such a big deal about this – I fainted – its not a big deal). “You need to stay in hospital. You need to give up your control and hand it over to us and trust us to make the next steps” What about work, and everything else I have to do? “Thats not important right now, tomorrow you will start on a refeeding meal plan. You will eat. You will be moved to the correct ward, you have to trust us”. I don’t trust easily, so this doesn’t seem like a nice idea from any angle.
I feel trapped. Feeling trapped is a huge trigger for me. I’m sitting alone in my hospital bed, with not many friends knowing I’m here. For the first time, I get upset. I’m scared. I’m trapped. I’m confused. I’m fine. I’m not fine. I’m fat. I’m anxious. I’m a failure. I’ve let people down. All these thought start wizzing around in my head and I start hyperventilating. A support worker comes and I ask to be taken outside. We stand outside next to A&E and the helipad. Once again – seeing real ill people. I still don’t understand why I’m being classed in the same category as them. The helicopter arrives, delivers someone in a critical condition, then takes off again. The down thrust from the blades and the extreme noise makes every atom in my body shake. I feel very alive. This intense all-body and senses experience brings my anxiety back in check, I actually feel somewhat exhilarated. I have a few moments of clarity – accepting that there is a journey ahead of me. But it doesn’t last for long.
Part 3 to follow