Road Block

I canceled my last psychologist session with S and didn't show up to my appointment with CA last Thursday.  I have actively not been following my meal plan for the past 2 weeks.  I am having a lot of thoughts about not going back.  I know they are all excuses, but I got so overwhelmed the last few weeks.  It's a huge time commitment to go to an appointment every Thursday and I'm so drained after each one, whether due to getting emotional or the effort to stay unemotional.  S's appointment I missed because I had last minute obligations and unexpected work stress.  Her appointments aren't until 6 which means I'm not home until almost 8 and that's just a very long day.  I need to talk to her this week about trying to find an earlier time.  While I skipped CA's last week to help with a thing at work and in order to support coworkers at an award ceremony, I must admit it was an easy decision.  I'll have to talk to S about this whole dietician thing.  I just don't like going.

This whole process is unbelievably uncomfortable.  This is probably the worst time of the year for me to have decided to 'get real' about treatment.  I have been plagued with stressmares.  I've always had insomnia and have been treating it medically for 8 years.  My issue has always been how long it takes me to fall asleep versus when I have to be awake.  With my dose of ambien (and my sensitivity to drugs in general) falling asleep isn't the issue anymore.  I may have a bad night here are there, but most nights I get my 7-8 hours in if I'm responsible.  Since this whole 'real' treatment thing started, however, I have been waking up on average 2-3 times a night from dreams so stressful that I am rigid and stiff with anxiety, every muscle hurts, and I spend the next 5 minutes or so calming myself down and assuring myself that it was just a dream.  These dreams are everyday social, family, and job related (students and staff situations) events and yet they always turn ugly as far as anxiety over one issue or another.  It wouldn't even be so bad if it weren't so hard to tell them apart from reality.  Sometime I catch myself thinking I've had conversation with people I really haven't.  I'm normally so worked up after waking to a stressmare that I don't go fully back to sleep and often have a few more stressmares before it's time to get up.  From mid January to a few weeks ago, I was averaging about 4 hours of real sleep a night.

Since I blew off my last two appointments and threw my meal plan to the wind, I've slept much better.  Shocker.  I guess that will be the next road block to treatment.  How do I do all the things I'm suppose to do and not allow it to affect my personal and professional life?  I can't walk around at work ready to burst into tears at the slightest thing (which is how I've been feeling) and I can't function well in general if I'm only getting 4 hours of sleep a night.  This was a big part of why I started thinking I'd need to check into some place this summer.  Well that was a nice idea until I found out that one place I found near by charges almost a grand a day for a min of 60 days.  There's no way I can afford it even with my insurance.  So what I'm doing now, while draining me financially as well, is about my only option that I know of.

S and I are going to have to have a very serious discussion this week about how this can all work.  Because it just isn't right now.  I know I'm the biggest obstacle, but I feel between S and CA they've got to be able to come up with a better plan to help me through this part.

Sia - Breathe Me

A diet means, medically, the overall eating habits of person...

I can't do this.  I'm trying so hard but I just don't think I can.  Last week I did okay.  The weekend was no good as always.  I think those will be the hardest and last areas I fix.  But I tried again on Monday and felt beyond disgusting.  Which then led to me not following my plan well today because I am so bloated that I am nauseous and uncomfortable.  It makes me not want to leave the house...  And then because I have to be able to put on a happy face and get to work doing my job well I'm left feeling strained and exhausted each day and slowly creeping back to the normal behaviors I know will make we feel better.  


How am I suppose to 'get better' and work a high pressure job that I am passionate about and stay as social as I am and want to be?  I don't ever have time to sit down and just process how hard this is all for me.  Because it is soooo very hard.  Not even just the eating stuff (though that sucks in a giant way) but all the emotions and reactions to things that are bubbling up.  I don't know how to deal with them and still function normally.


For instance I cried the other day while handing my partner papers I didn't get passed out that she would then need to pass out.  She was just giving me a hard time and teasing as we both always do, but that day I was so on edge I started crying.  She felt so bad she almost sent me flowers.  I just don't have the control I have always had on my emotions and it's really scary for me.  


I'm starting to see the benefits of inpatient treatment.  To be able to take a break from the world for 2 months and just work on me without the distractions and without being able to avoid the things I've spent my whole life avoiding.  


Hospitalization has always terrified me, but this would be a step above that.  And let's face it, if this thing doesn't work and I go off the deep end (And I've been feeling close for quite a while) I don't have 40 pounds to lose this time.  If I fall like last time I could very well end up hospitalized against my wishes. Surrendering yourself to a treatment center has got to be better.  I need to look up more information and talk with the insurance company about costs....

To be continued....

Living One Day at a Time

"Eating disorders, then, are really not about food.  They are about how you feel about yourself; they are about low self esteem, a tremendous need to feel in control of yourself and your surroundings, unrelenting perfectionism, and an alienation of the mind from the body.  They are also about a brain gone awry, frayed wires sparking and igniting as the brain is unable to process messages about food and anxiety normally.  While an eating disorder usually begins as a deliberate act by the sufferer to lose weight in order to feel better, the eating disorder soon takes control of everything.  As a person's problems become worse, the deeper one falls into the eating disorder.  It's like living on a sinking ship, continually bailing out water, refusing to leave even as help arrives and the water level continues to rise.  You still think you can saver your leaky boat- you do not trust the help, you cannot see the shore that beckons, and you fear the life raft that is being thrown to you won't keep you from drowning.  I can't guarantee you that you will make it to shore if you abandon your leaky boat.  But I can guarantee that you will surely drown if you do not let go."
-From Next to Nothing-Adolescent Mental Health Initiative


Session 3 with CA was today.  I went in feeling very anxious.  I barely got through the work day because all I could think about was how badly I had followed my meal plan.  And even though I knew she wouldn't be mad or disappointed, that was my natural worry.  


I tried really hard last Monday to follow the plan.  But then the snow days hit and I just slipped back into familiar time off from work behaviors of eating little outside of beers and snacks with friends at bars.  This week I started off good.  I followed my plan exactly Monday and made it all the way to dinner on Tuesday on track.  But then it just hit me... I felt so horribly full, bloated, fat.  I couldn't handle it and I purged part of dinner.  At least it wasn't a violent purge.  We were off school again for weather Wednesday so I ate out with friends and had some beers and purged as usual.  


Today I got back on track.  Had my greek yogurt in the morning, sandwich at lunch, and a snack on the way to my session with CA.  I felt disgusting and on edge all day.  I feel like I'm gaining weight and I'm not sure I can handle it.  


We talked about it and she explained the typical weight fluctuations in a normal young woman.  Then she took me through what happens to women like me when they go into 2 month hospitalization for treatment.  Here they have no choice but to follow their meal plan everyday and in doing so they tend to at first gain weight for a while.  Since the body is still naturally in starvation mode, it will cling to anything coming in and that person will therefor become bloated from that and liquids.  It doesn't last too long before it adjusts to the fact that it is not being starved anymore and most bulimics leave treatment thinner than they came in, but eating and keeping down more food than they ever had before treatment.  


It all makes sense and really it wasn't anything I didn't already know...  But this is me getting bloated and feeling almost nauseously full, and my scale going up.  I have a lot of anxiety over how I'm going to handle that and if I'll be able to handle it at all.  I'm already 5 pounds more than I want and to gain even more all on the faith that it will go back down soon.  How soon?  


I'm not sleeping through the nights anymore.  I'm hoping its just due to a lingering cough, but CA is concerned it may be from my heightened anxiety during this part of treatment.  I guess if it happens again tonight (which would make 5 nights of waking up starting at 3 or 4 with some nights not being able to sleep again and others able to have a few cat naps until the real time to get up) then I guess I'll have to call Dr. M.  Only anxiety meds I'm willing to take are one at night.  I don't want to be all drugged out during the day.  I don't know how anyone can function that way.    


I'm suppose to start finding inspirational books/quotes to help me through the rough patches.  This feels like one of those times and I find it slightly funny that the first quote to catch my heart is the one that is used so frequently among the types of support groups I really don't want to join.  Oh well, the prayer itself is just a classic and calms me tonight.  


"Grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference. Living one day at a time; Enjoying one moment at a time; Accepting hardship as a pathway to peace."  -Serenity Prayer

The simple things are so hard

"Trouble is part of your life, and if you don't share it, you don't give the [people] who love you enough chance to love you enough." -Dinah Shore


This quote really spoke to me tonight. I'm at a bit of a plateau with treatment. I'm really having a very hard time with my meal plan. I started off good when she was only asking me to add 40 grams of protein. That meant having a greek yogurt at breakfast (even though I haven't eaten breakfast consistently in 15 year) and keeping my small already there lunch, and then a cup of low fat cottage cheese when I get home. I was able to go to the grocery store and buy those items with only mild anxiety. And outside of the 4 days off from the ice store, i've been doing well with adding them.


But then CA put me on a more specific meal plan. I knew I was overwhelmed when she gave it to me, but today as I walked around the grocery store I felt like my heart was racing and scared. I've never felt that way in a grocery store. I avoid them mostly but when I go it's always to get foods I like and have already made peace with the fact that I'm going to purge them so I don't usually feel anxious and actually pretty excited about whatever I'm going to get.


This trip was different, This trip was to buy things that would be my dinners for the week, fulfill the diet plan, and hopefully not be purged. I felt lost in the store, almost like I'd never gone shopping for myself before. After putting in a few items I had to stop and pull myself together so I wouldn't cry in the store. I hate that I can't even do simple tasks without falling to pieces. I did get it together eventually and accomplished my mission. It doesn't quite cover what CA would have wanted, but baby steps. I can't image what it looked like to those around be as the skinny scared looking girl spent almost 2 hours picking 15 items to buy. In the end I bough fresh bread, turkey, fat free cheese, precooked chicken breasts, vegetable soups, fruit cups, and a pasta mix.


Today I have had my cup of coffee, my greek yogurt, a lunchable, cup of low fat cottage cheese, and then for dinner a small turkey and cheese sandwich (no dressing) and a fruit cup. I feel uncomfortably full. I am constantly fighting the urge to run and purge. I know I'd feel better, but I know that it would mean that I'm not getting any better. So I haven't and I won't tonight. I don't know how tomorrow will go with tonight ending so full.


The quote spoke to me because I'm having a really hard time asking for support from people in my life. I hint around the fact that I'm not good in hopes they will pick up on it and just be there for me, but that's unrealistic with as guarded as I typically am. The only times I seem to directly ask for help and support is normally a little too late for whatever immediate crisis and only because I'm drugged up on my ambien which is worse than a drunken conversation.


I need to share more of what I'm feeling with my friends and not feel like I'm only burdening them by asking for their support. That's going to very hard to do.