Update + Positive GP Appointment

I'll try and do a proper catch up post, but in summary a lot has changed since this time last year. I've pretty much knocked ED behaviour on the head and I'm back to a "safe" weight/BMI. I've recently been diagnosed with bipolar disorder after an episode in March.

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I saw my GP today to get another quetiapine prescription.

I hadn't booked a longer than normal appointment or anything, but she chatted to me for ages. She said that she could tell as soon as she saw me that I was doing really well in terms of mood stability. (The last time she saw me was in March and I'd been hypomanic and starting to verge on mania/psychosis). I talked about how I was doing a lot of reading about bipolar disorder and trying to come to terms with the diagnosis. I knew a few years ago I had been diagnosed with borderline personality disorder and I asked about this as it's something I'd been thinking about. She said that it was now thought that was the wrong diagnosis and bipolar is right and it was fairly typical for a bipolar diagnosis to take a long time.

She asked whether my psychiatrist had discussed long term plans for medication and I said I was hoping to try and manage without long term medication and how I'd prefer to only take medication if I got early warning signs of an episode. My psychiatrist had mentioned this as a possibility before but had said he wanted to wait until my mood had stabilised before making decisions with me. My GP didn't dismiss the idea and said that I had responded really well/quickly to medication when I got ill in March and that she thought I generally retained good insight (which was nice to hear) so didn't see why it wouldn't be managable. She then went on to talk about some of the benefits for long term medication. But it was a relief to know my GP would be supportive of whatever decision I made with my psychiatrist. I also discussed how I was trying to change my lifestyle (stopping recreational drugs, cutting down caffiene and alcohol).

I saw her add a lot of what I said into my notes. "NoN is doing really well, is managing triggers and has very good insight". Awesome!

Giving up seems like an excellent proposition.

I've worked really hard on eating these last few days, though I did purge once yesterday. I've been adding a few pieces of chocolate to my diet, which was very difficult, but obviously adds to the total number of calories I'm consuming. If my calculations are correct I've actually been getting the right amount of calories since my last post. If the scales were right this morning, however, I've lost another pound. Obviously it could just be down to dehydration, but I guess the fact that I'm not gaining any weight at all, and potentially still losing a bit, means that despite all my efforts I'm still not eating enough.

It's ridiculous as I feel like I'm constantly eating at the moment and my abdomen feels swollen, huge and disgusting. How on earth can this not be enough food? How on earth am I meant to eat any more? How on earth can I not have put on weight when I look so huge. I feel in a constant state of panic/anxiety. This morning after eating breakfast I sat down to read the news and the world felt like it was spinning and I felt so sick. The more I try and fight the thoughts and eat and not purge the worse it gets. I guess there's no option but to keep trying. Though giving up and going back to secretly purging regularly seems so attractive right now.

Can't trust myself

My weight has been stable so far this week. I've done ok with eating except for today when I've failed miserably at not purging. Boyfriend is out with friends this evening and it's kind of left me to my own devices. I'd agreed a meal that I would eat with him. It just needed heating up. But I think because it didn't feel that there was the accountability, someone who'd notice if I went straight to the bathroom, I purged almost immediately afterwards. So I tried to make something else but purged that. And then I gave up. I think in this case not eating is less destructive than repetitive purging. 

Maybe when boyfriend gets back I'll try and eat something with him. But I don't think I'll tell him about the purging. I'll be honest and that's partly as he'll shout/be disappointed/be angry and then I'll feel bad. But it's also partly because I don't want him to feel that I can't be trusted to eat by myself. And connected with that I don't want him to feel a responsibility for looking after me and making sure I eat and don't purge.

I'm nearly 30 for f**ks sake. I don't want to have to rely on other people. I hate the fact that I need tablets to keep my mood stable. I hate the fact that I have to see a psychiatrist and that I'm waiting to see a psychologist. I hate the fact that apparently I can't rely on me.

Counting points the none WeightWatcher way

After posting yesterday I did managed to eat about another 700 calories. I made a mushroom and aubergine stroganoff with rice and garlic bread. I don't know exactly how many calories as I've taken various ingredients out of there original packages as I was getting far to hung up on calorie content. Now the packaging reads things like "rice, brown, 20 mins to boil", "tomatos, chopped" and "garlic bread, slices, 8 mins to grill". I'm trying to focus on what is actually the correct amount/ratio of each ingredient rather than what my thoughts tell me is ok.

[1 point for eating something when I didn't know the exact calorie content]

And today I've managed 1227 so far. It would have been less as I really wanted to skip lunch, but I knew a friend was going to be in town today, and when I started thinking about throwing my lunch away I made plans to meet her and have our packed lunches in a nearby park.

[1 point for making time for relaxing and 1 point for stopping myself from skipping lunch]

But I've really no idea where I'm going to get any more from today. I keep running over what we have in the cupboards and trying to think about what I feel ok with. But either way I've still consumed more than last week and I guess it's a work in progress.

Eating Enough

I did purge yesterday. But I tried to be proactive in battling it. We went out to visit friends last night and it involved about 45mins on buses to get there. Just before we left I made myself eat an entire bag of mixed nuts and fruit (about 800 calories worth) knowing that I probably wouldn't have the opportunity to get rid of it. It played on my mind all night and I was only slightly reassured when I weighed myself this morning to see that the number hadn't changed. But it has given me the ability to convince myself to eat a bit more today. I'm managed some fruit, some bran cereal with milk, and a piece of toast with light spread. I've calculated it to be 429 calories, which is above my batting average for this point in the day.

With the 800 from the dried fruit/nuts I think I managed just under 2000 calories yesterday, for the first time in months. This isn't really enough to gain weight back, but if I can keep it up I could try and not lose anymore until I can cope with adding a bit more. I'm by no means seriously underweight and if I can stay on top of this and keep a lid on the purging hopefully I can manage. I'll try and get a supply of nuts/dried fruit in as I think that's something I could trust and use to make up calories on the days when I do purge or not manage to eat enough in normal meals. Fingers crossed.

Start Again

I've decided to try and see today as a fresh start. I've been mentally beating myself up and berating myself over my slip back into purging the last couple of days. I'm going to (try and) stop doing that - both the purging and the beating myself up if I fail. When I saw my psychiatrist I had already gone a couple of days without purging and they said (and this is completely paraphrased, but how I understood it) that the early stages of trying to combat any kind of self-destructive behaviour would always be the part where you were most vulnerable to giving in to the destructive urges, and that I should be gentle with myself and get support if I need it.

Piling more self hate on top of what's already there is just making it harder to fight and I'm just going to try and ignore the slips and move forward. When I finally stopped self harm, it wasn't an overnight miracle, it took months of gradually harming less and less. Prehaps I'm naive, but I expected, wanted, this to be different. Flicking a switch that turns off the ED thoughts and the behaviours magically stop. So the "new" paradigm is that although it's not ok to slip, it's not the end of the world and doesn't mean I've stopped trying to fight this.

This morning when I woke up I felt really crap and partner wanted to eat fried eggs, toast and beans for breakfast!!! I knew that if I ate that I would find it very difficult to resist purging. But I'm also really really trying to eat as I know I need to try and gain back about 6lbs to be back at a minimum healthy weight. So I made breakfast for us both. And I didn't eat it all, but I did manage to eat 3 bites of bread with a bit of egg on it. I had to stop then, but I'm pleased that I managed to eat egg, fried egg at that, and bread. Both of which are not salad (which is all I really feel ok with eating without purging). We've agreed on something light for lunch so I'm hoping that will be easier and that I'll be able to eat more.

Purging again

I'm hoping it's just a temporary blip but I've been purging again the last couple of days. I was trying so hard. Trying to actually eat a "reasonable" amount of calories. But the amount I know logically I should aim to be eating just seems so utterly unreasonable and when I try and eat more the urge to get rid of it is unconquerable. Or at least it feels like it is. 

The thing that pushed me over the edge yesterday was a small bowl of icecream. I'd had 190 calories while at work and then ate a small evening meal (bulking up my plate with salad to hide how little I was eating). Then partner, who is now in the "you need a gain a few pounds" camp gave me a bowl of icecream. I tried so hard not to, but I ended up purging. Though I did force myself to eat a piece of toast and a raw mushroom to try and replace some of the calories. 

I think giving in that one time made it a lot harder. Tonight I couldn't resist the urge. *sigh*

Though I'm trying to remind myself it took me several false starts to quit smoking... so maybe next time will be the charm.