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All of these are early signs, none of them alone mean much, you may see any combination of them. Most of these comments and behaviours can seem innocent, teenage behaviour. Mostly though they are out of character for your child. They will be a departure from their normal personality and family routines. Watch, ask, challenge. Don’t let any of these go unnoticed or uncommented about. Keep watching, keep asking, keep challenging.

If you do, if you have any suspicion at all, bring your child to the doctor and insist, insist and keep insisting.

early signs of an eating disorderThings they say

I just want to eat healthier
I want to be a vegetarian
My stomach hurts
I am not hungry
I already ate
I think I am allergic to….
(foods they never had an issue before or diagnosed allergy)
I don’t eat this
This is not organic or gmo
I just don’t like this any more
I am so sick
What’s in this food (nutrients)

Things they do

Disappearing after meals
Checking out the nutrition labels
Increased exercise
Pushing food around plate
Cutting food in tiny pieces
Chewing food forever
Stop making plans with friends
Taking forever to make it to the table for meals
Frequent showers (especially after meals)
Spending forever in the bathroom after shower – body checking
Sleeping at meals time
Watching cooking shows, reading cook books none stop
Cooking/baking obsessively without eating it
Going to the grocery store and reading all labels
Buying expensive foods that go uneaten
Frequent body stretching and movement
Wearing baggy clothing (despite temperature)
Refusing to go out with friends if meals are involved
Writing calorie/meal/fitness journals
Taking a lot of body checking selfies
Picking fights at meals so they can be sent to room, or storm out
Eating only low calorie foods
Spitting food into napkins
Having to exercise even when injured or sick
Spitting food into napkins
Having to exercise even when injured or sick
Notice the calories in everything
Dissect the ingredients of a meal
Interested in high metabolism foods
Lots of gum chewing
Taking ice baths
Very emotional response if any of the above is mentioned
Skin picking

Things you can observe

Over dressed in summer, under dressed in winter
Blood shot eyes after meals
Social withdrawal
Unnatural seating positions
Constant foul mood especially at meal times
Weight decrease – A child should never ever lose weight
Anxious, distracted, avoidant behaviour at school
If pets, notice if the dog/cat is seating closer to your child
Cats will gravitate to someone with an illness
Dogs will gravitate for food being dropped
Increased perfectionism, rigidity, ritualistic behaviour
Increase in anxiety, depression, OCD if these are already part of your child’s character
Cold hands and feet
Bad breath or personal smell
Small sores on body which take a long time to heal and can bruise easy
Blue finger nails
Obsessive body checking
Thinning and failing hair
Soft down on skin particularly chest, neck and upper back
Loss of menstruation
Panic attacks out of nowhere
Weight gain despite exercise due to B/P or binging
House plumbing issues from: purged food, hair lumps.

With thanks to The Dirty Laundry Project with additions from me.

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This reprinted here in full, making it easier to read. Thank you to Helen Razer for putting it so well and so correctly about eating disorders and the current ‘DIS’ campaign. To read her original please go to: http://www.crikey.com.au/2015/05/07/were-making-ourselves-sick-with-the-publicity-of-eating-disorders/

I will follow in a while with my own post and thoughts on where Butterfly are and aren’t heading and the damage they do because they heavily mix body image campaigns with eating disorder awareness.

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To survive the current calendar, health advocacy groups must claim a month and shake it. January starts with glaucoma and thyroid conditions, and the year ends with Alzheimer’s and AIDS.  This month is given over to a number of health campaigns with notable new May player The Butterfly Foundation currently raising funds and awareness for eating disorders (ED).

Theirs is a well-regarded organisation providing outpatient services to ED sufferers who, in the case of an anorexia nervosa diagnosis, face what is estimated to be the highest standardised mortality figures of any psychiatric disorder. The help they offer is practical and based in firm research. But, like so many other advocacy groups, the public messages broadcast are entirely theoretical and based on flimsy hope.

With the achievable aim of funding itself and the rather more incredible one of stopping ED at its source, the foundation has launched Don’t DIS My Appearance campaign. Let’s set aside the antique hip-hop language that had passed its best before date before Snoop Dogg had packed his first bowl. Let’s also overlook the decision to ask ambassadors to display a middle finger, which I imagine may seem less like a moment of cheeky defiance than a bleak reminder of the toilet bowl to those who suffer from bulimia. Let’s look instead at how this organisation, and others, can so easily extinguish the very awareness they seek to create with crude messaging.

We spend much of the year in a tangle of awareness ribbons and there are those who reasonably argue that we’re bound to stop noticing the meaning of such decoration at all. But even if a public health campaign is good enough to cut through all this shiny bunting, it may achieve the terrible opposite of its intention.

In a study undertaken to assess the effectiveness of the famous breast cancer pink, researchers unexpectedly found that the women have become both more likely to underestimate their risk of the disease and less likely to donate to charities. The marketing professor who undertook the study concluded that in an effort to make the matter of breast cancer seem less taboo, organisers had also drained the matter of its urgency. After all, it’s pink like Barbie.

In a literature review on gender-based violence awareness, authors found that such campaigns can end up describing a standard of behaviour. If audiences believe that violence is very prevalent, as they reasonably might when viewing such ads, the message can license “violent behavior rather than activating behavior to reduce [it]”. In other words, violence is normalised through its depiction.

The Butterfly Foundation runs a similar risk of normalisation with its campaign. It’s a high-profile, celebrity-studded effort that posits EDs as normal and as prevalent enough to ask us all to change our behaviour in order to prevent them.

The thing is, though, this campaign is really not aimed at anorexia patients.”

Of course, all reasonable people would like to see a reduction in the incidence of anorexia nervosa. This disorder, which has a lifetime prevalence of between 0.3% and 1.5% in females and between 0.1% and 0.5% in males, is horrifying. That treatment, if accessible, promises a very high rate of recovery would seem to make the task of “awareness raising” all the more urgent.

If we can save a few lives by making death and extreme disordered eating seem a lot more common than they are — and the campaign absolutely does this by conflating EDs, a diverse group of mental illnesses, many of which have no extreme physical side effects, with anorexia in stating they collectively “kill more Australians than any other psychiatric illness” — then what of it?

The thing is, though, this campaign is really not aimed at anorexia patients. Professor Susan Rossell, a highly regarded expert in EDs with qualifications and associations too several to cite, sees “awareness” of this type aimed chiefly at people with “super anxious body consciousness” rather than an actual illness.

Rossell says that campaigns that demand an end to bullying might have some benefit for some ED patients. But the at-risk anorexia patients whose mortality statistic is used as a call to action are unlikely to be rescued by the injunction not to “dis”.

While there are accounts of anorexia patients who suffered chiding for overweight in early life, this is just one tiny potential element of a complex range of influences, including biological and genetic ones, which can provoke ED. While some patients may report bullying as a factor in their disease, others may report endorsement. Just as the so-called “Pro Ana” and “thinspiration” online community of extreme dieting normalises anorexia, campaigns of the Butterfly type can do exactly the same. To the potentially anorexic mind, the “everybody’s doing it” nature of this campaign is as much of a catalyst as a “dis” or a size 4 pair of skinny jeans.

Scholars in anorexia and all ED commonly use the biopsychosocial model to explain this disorder range. While it might be nice to end the “dis”, it might be also of great benefit to legitimate patients, as opposed to the simply body conscious, to understand that their disease has more of the “bio” and less of the “social” than most of us suspect.

“All eating disorders have a strong biological component,” said Richard Newton, Austin Health’s medical director of mental health and board member of The Butterfly Foundation.  When I suggest that the foundation’s newest campaign continues to situate ED entirely in the realm of the social, he explains that the illness-shaping or “pathoplastic” effects of the culture can switch the disease on. There are, he says, historical accounts that describe anorexia some 3000 years old. The “Holy Anorexia” of ascetic women who sought to become pure through fasting was, says Newton, “apparently epidemic in the Middle Ages”. The culture can turn this genetic predisposition on and off.

But what this awareness campaign does not give us is any indication that the disease may be genetic. Researcher in risk factors for ED at the University of Melbourne Isabel Krug rattles off a list of studies on potential endophenotypes, heritability, genome wide association and other data that we lay people can trust to mean that these disorders, particularly anorexia, involve a genetic predisposition.

There are even emerging biomarkers for anorexia, and Rossell was lately involved in a study on a particular eye movement called the “square wave jerk”. It is my lay understanding that imaging for anorexia shows more evolved promise than for those in the study of all other psychiatric disorders. It’s odd that common wisdom, and a great deal of general medicine, treats a common mental illness like depression as a case of “chemical imbalance” or genes, and anorexia as purely the result of social factors like bullying or super-skinny ladies in magazines.

Depression, despite its lack of biomarkers and clear prevalence among those poor in social capital, is read as biological. Anorexia, despite great evidence of its biological basis, is read as social and The Butterfly Foundation certainly overplays this by recommending being nice to people as a cure for death.

I asked Rossell about our willingness to see anorexia as an entirely manufactured disorder and she said: “It’s because it occurs so often in young girls”. She is unwilling to elaborate much further but when I asked her if it was due to the assumption that young women are empty vessels whose untainted bodies just wait to be filled by the culture she makes an ambivalent noise.

She is not ambivalent, however, on the enduring refusal to study and describe anorexia as having a biological basis. “There are papers I have tried to publish and these have been refused on the grounds that I am trying to overly medicalise anorexia,” she said. “Of course the biopsychosocial model is one that should be observed. But if you continually refuse to acknowledge the ‘bio’ in that complex, then you will end up with no idea of how the different elements interact.”

With medicine so reluctant to commit itself to an explanation for ED, it’s hardly surprising that groups like The Butterfly Foundation would follow suit. But even if we agree that it’s better to take the potential social catalysts for EDs out of the picture, the “dis” campaign fails miserably on that score.

Let’s even allow that the foundation’s normalisation of extreme ED and selective mortality statistic will do no harm and just think about the phrase “don’t DIS my appearance”. Given that the most at-risk ED sufferers are those who are underweight and gain at least as much momentum from the compliments their tiny silhouettes routinely attract as they may have from an early life “DIS”, perhaps “don’t praise my appearance” might be a more effective tactic.

Approbation is, perhaps, even more hazardous to ED patients than condemnation. As Rossell suggests, many public conversations that purport to address ED patients are really just intended for gals who feel like they might be a bit unattractive. And even if making the super body conscious feel a bit better about their flab is considered a good outcome, the “don’t DIS” edict doesn’t even really work here.

If women, both those who suffer an ED and those who just feel a bit shit about their bodies, want to be liberated from the primacy of the image, then surely an obvious solution is to detonate the power of the image.

Here’s my campaign, free of charge, to The Butterfly Foundation next May. How about you try “completely DISregard my appearance”? And instead of using attractive ambassadors and expensive manicures to underscore the lack of importance of the image, try a picture of me after 24 straight hours of researching EDs in my pyjamas. I’ll show you just how visual perfection has very little currency in one adult human woman’s working life.

 

 

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This is worth repeating again, thank you to PEDAW and VanCityBuzz

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Online chatter these days often illustrates there is a long way to go before many people fully realize what an eating disorder truly is: a mental illness, or a disease of the brain.

On February 2, we published an article detailing the struggles of a 21-year-old B.C. woman who has resorted to crowd-funding to treat her severe eating disorder. Some of the publicly posted responses highlight the common misconceptions about eating disorders, so we thought we’d take a look at the kinds of misinformation that gets in the way of the good work being done to help those struggling with eating disorders.

While many of those who responded to our story were supportive of the woman’s endeavors to receive help, another fair share could not understand why her disease warranted help, let alone a news story.

The issue is complex.

But those without the education, life experiences or personal struggles that create compassion for and understanding of eating disorders will continue to criticize the publicity of this disease. They will mumble under their breaths something like “just eat a hamburger” or whisper to their friends “she doesn’t look anorexic.”

And that is where a direct response to these comments is needed. For eating disorders to receive the support they need, the stigmatization needs to be removed and the harsh reality of the disease needs to be learned.

Here are some common misconceptions and comments made about eating disorders, along with responses to the issues from professionals:

1. Just eat if you’re anorexic.

“Having an eating disorder means having neurological or neuroanatomical organization of your brain that creates enormous barriers to eating normally. These barriers include visual and sensory distortions, impacts on reward centers and executive organization of the brain, distortions of senses of fullness and hunger, and over evaluation of body size and shape, in addition to other issues that may be present. The combination of all of these things makes eating incredibly hard to do.”

Dr. Mark Warren, Cleveland Center for Eating Disorders

2. Just smoke weed, then you’ll get the munchies!

“We definitely want individuals to eat and digest food in order to heal their physical bodies. This being said, balance is key, so optimally they will work with supports to find ways of eating without using other substances that further promote numbing out to their present experience.”

Natasha Files, Individual and Family Therapist, Looking Glass Foundation

3. It’s more important to donate money to underprivileged children who can’t afford to eat.

“Suffering takes many forms. I have worked with individuals from all socio-economic realms, with some people having money for food and others not. Please choose to donate money to what moves you, but know that eating disorders are an illness cloaked in shame and secrecy. Many individuals do not get help unless their loved ones encourage them to do so, meaning that asking for support takes significant courage.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

4. #firstworldproblems

“There have been many reports about eating disorders in Western countries in the late 20th century. It has been claimed that those with eating disorders have mostly been white women and that few cases have been seen in non-Western countries other than Japan. Recently, eating disorders have been reported in non-Western countries, such as the Middle East and the People’s Republic of China.These recent studies suggest that the prevalence of eating disorders has been rising among non-Western countries as well. However, eating disorders may present differently in different cultures, and diagnostic criteria based on Western norms may not always be appropriate.”

– Makino, Maria, Koji Tsuboi, and Lorraine Dennerstein. “Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries.” Medscape General Medicine 6.3 (2004): 49. Print.

5. There are people fighting cancer who can’t eat, and other people far worse off. Stop being so selfish and just eat.

“These kinds of statements just increase the guilt and shame of a person suffering from an eating disorder- which can lead to an increase in coping behaviours designed to avoid those uncomfortable feelings… cue the binge purge cycle or restriction!”

Trixie Hennessey MSW, RSW, Individual and Family Therapist

6. Anorexia is a serious disorder… but it’s not as bad as cancer or AIDS. We should focus on helping those people.

“Categorizing eating disorders as less deserving of support than other illnesses proves the ongoing struggle with stigmatization in our society. One outcome of struggling with an eating disorder is death. Eating disorders are the third most chronic condition among adolescent females (after asthma and obesity), yet have significantly less funding towards research and treatment.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

“Actually, more people die from eating disorders (350,000) than from breast cancer (approximately 40,000) every year. Females aged 15–24 are 12 times more likely to die of an eating disorder than any other cause of death. More people die of eating disorders than any other mental/behavioral disorder including depression.”

– Atlanta Center for Eating Disorders

7. You don’t look anorexic!

“Being the most lethal of psychiatric illness, eating disorders come with a number of serious health consequences, even if the individual looks “okay”. Low blood sugar, blood abnormalities (electrolyte imbalances), enamel erosion, dizziness/confusion, esophagitis, arrhythmias, acrocyanosis, edema, growth retardation in children and adolescents, and sometimes death. Eating disorders affect every system of the body, meaning that glancing at someone’s body shape does not determine the level of physical impact.”

– Natasha Files, Individual and Family Therapist, Looking Glass Foundation

8. You should be grateful you can afford to feed yourself. If you knew real hardship, you wouldn’t have this problem.

“Individuals who develop eating disorders are usually very sensitive.  They are physiologically more sensitive from birth than the average person. They are very in tune with the feelings of others and have a strong drive to want everyone around them to be happy. This often leads to perfectionism as they try to reduce any negativity that they or others will experience. As the disorder progresses they become caught in a vicious cycle where their attempts at being the best that they can be actually does cause others negative feelings — but at that point they can’t just stop. The attempt to be perfect is primarily a way to ensure that nothing about them will cause anyone else any distress and to ensure that others will not find fault in them, something that they are very sensitive about.”

– Atlanta Center for Eating Disorders

9. Starving yourself to death is a choice, just like taking drugs or drinking too much.

“There is no choice when it comes to an eating disorder. There is a choice to start out with behaviours such as dieting, exercising, fasting, etc… but there are many people that diet, exercise and overeat that do not have an eating disorder. There are many people unhappy with their weight and shape who do not have an eating disorder. Eating disorder treatment is complex and an intense process. I would encourage you to question this assumption, as I feel it perpetuates the stigma and feelings of shame that keep people from reaching our for help if they need it.”

– Trixie Hennessey MSW, RSW, Individual and Family Therapist

“Someone can make the choice to pursue recovery, but the act of recovery itself is a lot of hard work and involves more than simply deciding to not act on symptoms. In most cases, the eating disorder has become a person’s primary way of coping with intense emotions and difficult life events.  In order to heal from the eating disorder, a person needs appropriate treatment and support regarding medical monitoring, nutritional rehabilitation as well as learning and practicing healthier ways to manage stress.”

– The Center for Eating Disorders

 

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This is another choice of words that aren’t used correctly or appropriately. Very much like my post on preventing an eating disorder. It gets bandied around so much that it sounds like it’s a simple choice. That it is something totally within your control at whatever stage of an eating disorder you are.

Eating disorders are a mental illness. They do not conform to normal thinking standards.
The normal decision process is compromised. The lower the weight – the more compromised.
If this was any other illness, medical intervention would happen regardless.

The medical profession would step in and save their lives. But for some weird, unknown reason, the medical profession thinks that eating disorder patients should be treated as normal sick people and can make their own decisions about their health. They assume that as adults (16 and up) anyone has the ability and right to choose, that any intervention is wrong or intrusive or demeaning. They assume that people with eating disorders can choose logically and clearly. My heart is wrung from letters  and stories I am sent from parents with adult children, who are ignored by the medical professional. They are sent home from treatment places and hospitals because they don’t cooperate or discharge themselves. No severely sick ED patient cooperates. It is always a fight as the ED is in control. They are given no ongoing help after suicide attempts or almost heart failure emergencies. They are told over and over again, they simply have to choose to recover – then they will get the help they need. There are a million cute posters and pics depicting the ability to choose. It’s not a blanket, one size fits all. Choosing comes at an appropriate time in recovery.

What heartbreaking bull-shit! At very low weights most ED sufferers  cannot choose to make the right decisions for their health. Their perception and thought processes are compromised heavily by the ED. Their ability to rationalise, make decisions, be logical and to choose a healthy life is radically and negatively challenged. Most cannot do this. Age is not the deciding factor of whether they can choose. Regardless of age, the ED is in full control. They deny, compromise, side-step or whatever to not give up the eating disorder. Many cannot even see it is the eating disorder that controls and distorts their perceptions. It’s not that they love their eating disorder – most of them hate having to live a life that is controlled, miserable and painful. Many do see what they are missing out on, but cannot make the choice to change. If they do manage this, they end up compromising with the eating disorder. “I will gain this many kilo, but not enough to be this weight.” ” I will eat enough to stay out of hospital”. ” I will eat just enough to have a baby”. Forward steps, but not really choosing recovery. It doesn’t matter what age the sufferer. Under the heavy control of the eating disorder at low weights all thinking and choice/decision processes are heavily distorted.

Under 18’s are subjected to early intervention and refeeding programs to get weight back to the correct level and to keep it stablised at this point for a few months. The brain is nourished and it thinks more clearly and is able to make more logical, clear decisions. The longer the stable weight, the better the brain function. Once recovery gets to this stage of stable, correct weight THEN the choice to recover becomes a real thing.  Sufferers are learning by now they are not the ED. They learn they are separate and can continue to separate further from the ED. Choosing to recover from this point is a hard decision in itself. It means leaving the ED, means facing fears of eating and food. It means striking out into the unknown, confronting mental and emotional issues and learning to heal and find other ways of responding to life without retreating to the ED. All this goes through the mind of a sufferer. The strength is in knowing recovery is possible and recovery is real.

Tchoosing to recover from eating disorderhe sufferer chooses to fight back on a daily basis towards a goal of higher, strong recovery. Each meal, each thought, each behaviour becomes a choice – the ED or recovery. It’s not easy. At first the choice is pretty much always lost or is a serious struggle. But it gets easier with each victory – no matter how small. Celebrate each small choice – it’s a step away from the ED. This is choosing to recover. Each day, many times a day. Choosing to recover does not at the very sick, low weights.

Sophie only survived because of medical intervention. If her heart had been that little bit stronger, the hospital would have allowed her to choose!!! Really?? She was too sick to make a logical decision to eat. She couldn’t and wouldn’t. If they had left her to choose, she would have died or been on life support. She was strident in her fear and denial and refused all food. The NG tube saved her life and nourished her brain. Her choice to recover came after her 3 trip to hospital and she had been at a reasonable stable weight for a few months. Her daily choosing to recover started from this point. Choosing to stay strong. Choosing to keep moving forward. Didn’t always happen, but the goal and choice was there.

It’s exhausting choosing to recover, despite the correct weight and with a nourished mind. So many give in for a meal, a day, a week and so on, just to give themselves a rest from the screaming ED voice in their head. It takes a lot to fight back. It is again, a mental health illness, not an illness about weight and food.

Sophie sits beside me as I write this. She agrees with it all, and has verbally said some of what is written. She said she could not choose to recover until her body and brain had reached a stage of feeling better and thinking more clearly. Her thoughts – when she is an adult and if this happens again, I have permission to get full medical intervention and tube feed her again. She knows and agrees that there was no way she could have ever made a decision to save herself at the low weight she was. Adult sufferers are not different to teenagers. We just give them rights that do not exist in the realm of eating disorders, and with faulty medical care, old beliefs and myths they remain where they are, attached to the eating disorder.

believe in recovery

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This post is two excerts from Weightless about the inner voice that is part of a lot of mental health illnesses and how to manage them. Worth reposting for my readers. I really like the bit about saying “Oh I’m hearing the critic now”. Sophie was taught to say “Oh it’s that anorexia voice again, it’ boring”. We learnt that pushing or arguing with the voice just adds more fuel to the fire. Taking away it’s power to hurt you by ignoring or downplaying it can be far more effective.

And yes the asperger post is next.

Distinguishing the Inner Critichttp://blogs.psychcentral.com/weightless/2014/10/how-to-distinguish-your-core-self-from-your-inner-critic/

  • It’s harsh and mean. If you’d never say these things to someone you love, it’s your inner critic.
  • It’s black and white. You are either beautiful or ugly. Your dreams are either possible or impossible.
  • It’s the voice of reason. It mentions things that are supposedly in your best interest, such as “If you go forward with the book, you’ll ruin your reputation. Your work isn’t ready for that level of scrutiny. Better hold off for a while.” I’ve realized that, today, my inner critic is largely made up of this voice. It’s the voice that says, Are you sure you should be the one writing this book? Can’t you think of 50 other writers who should be writing this book instead of you? You’re not very good at public speaking. Let’s never do that, OK?
  • It says, “you aren’t ready yet.” “You need more time to prepare,” or “You need more experience.”
  • It spews self-critical thoughts about aging or your weight, shape or size. It says that you look too big or too old. It says you need to lose weight or shouldn’t be wearing this or that.
  • It rehashes negative core narratives.
  • It attacks you with critical thoughts, and then shames you for having those thoughts.
  • It sounds like your parents, siblings or your boss or anyone else who’s been critical.
  • It sounds like your company or culture.

What to do when the Inner Critic is LOUDhttp://blogs.psychcentral.com/weightless/2014/10/what-to-do-when-your-inner-critic-is-roaring/

  • We never win an argument with our inner critics.
  • Instead, when we hear self-doubt,  name the inner critic: “Oh, I’m hearing the critic now.”
  • Explore the inner critic’s motives. We can ask: “What are you trying to do? What are you trying to prevent or protect me from?”
  • Tell the inner critic in a sincere way: “Thanks, but I’ve got this one covered.”
  • Separate yourself from the inner critic. Instead of saying “I’m having a freak-out right now,” say “My inner critic is having a little freak-out right now.” This helps to train our minds to realize that the inner critic is just one voice within us, and “not the primary one.”
  • Seek out humor. Ask yourself, “What is absurd or funny about what my critic is saying right now?”
  • Pretend that you’re putting all the inner critic’s thoughts away into a cup, box or bowl. Then move it into another room. Get back to whatever you are doing knowing that the inner critic is no longer present.
  • Notice where the inner critic’s voice resides in or around your body. Then picture that voice withdrawing, or moving away from you.
  • Picture a volume dial for the inner critic. Simply turn it down.

One thing she does miss in the ‘what to do’ is using your distractions toolbox. Friends, movie, doing something different or active can be like changing the channel on the TV. Removes you from the place where the inner voice was trying to get attention.

The inner critic

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This might end up a long post – I apologise. I want to say this right.

Sophie at this moment is hysterically yelling she is going to jump of the balcony. That she wants to self-harm. Will is on suicide watch (STILL) because he has a date (which is getting closer), but says nothing much about it unless pressed.

A friend has advised that “If they are going to commit suicide then that’s just the way it is”. Inference – watching them is a waste of time as they will do it anyway. Get on with your life. Your kid might not be serious if it’s been this long.

Others have clearly shared we should be past this – I mean how long do you have to suicide watch for? Aren’t you over-doing it? They haven’t sat in the psychiatrist, psychologist, counsellor or GP appointments we have had. They don’t see the continued concern and worry from the professionals. As they said, you don’t leave anything to chance.

Young people don’t often have plans as such in the way medical and media put out there. They are seriously depressed or anxious to the point they often not want to have a future or life, but most don’t have an actual suicide plan. Some have loose plans but not a definite “I am going to do this”. And yes, there are some who do have a definite plan or plans. Often the suicide or attempt at suicide is based purely on impetuousness or a bad day on medication. Its a ‘spur of the moment’ so to speak. Something strongly affected them or happened that pushed them to the edge. The ‘event’ just underlines all they are feeling and they act immediately up on. On the spur of the moment, they grab medication, drugs, jump etc to just “not wake up” to “not be here”.  They don’t even wait to be alone or have no one at home.

Where do you jump as a parent?

First. Sophie is loud and out there. By expressing herself in the way she has, I know fairly accurately that she will be ok. Once past the outburst and getting the emotion out (read dumping onto mum), then the real chance of her doing anything other than self-harm is very slim. She will warn me – that is Sophie’s way. It doesn’t mean I don’t believe her emotions are really that bad and she feels that awful about life. It means that I understand her way of communicating.

Second. Will, in being silent and not saying anything is the one to watch. He has plans but doesn’t act on them as yet. He has a date but ‘might be flexible’. His anxiety though when pushed to the limit by an ‘event’ means he is the exact candidate to do the ‘impetuous’ behaviour. He just wants the voice and the bad feelings to stop – and instantly.

Given that, what is our role as parents and carers? Be on watch, regardless and always. Have someone there as much as possible. Let schools know and have a safety plan. If your child has been diagnosed with depression, anxiety, eating disorders, or some other mental health illness and there is a risk of suicide (even small), your role is to be on guard. Don’t take it lightly. The kids who survive an attempt are the ones who have someone around to get them to help, or stop them attempting. You don’t ever be complacent about a suicide wish – the regret will devastate you. Both my kids, but particularly Will (and he still does) had a safety plan whilst at school. If away from school or home, his next backup plan was to promise to contact me immediately. And he has several times.

On a personal note, this has come close to home with those I know. The fact the parents are on hand during the moment of impetuousness has been the life saver. Parents who have been ‘wired’ into how their child’s mental health is, means the child will turn to them or friends of the child will tell the parents. The constant being there of the parent/carers in some shape or form is the clincher. Other personal stories I know, are the same ‘spur of the moment’ suicide attempts as I have described. Half an hour earlier they have no suicide plans, an ‘event’ happens, they find the quickest way to kill themselves.

For me it means not leaving Will alone. It means checking in on Sophie as many times as I can given the kilometres between us. Watching late teenagers, young adults isn’t easy. They want independence. So watching become a subtle thing. Just being there, or having if you can’t, having someone the child trusts and allows into their life to be there. It certainly isn’t something you just hand over to just anyone. It’s also exhausting being on suicide watch for almost a year (that’s just Will alone – that’s not even getting into Sophie’s area). It’s a long, draining time but one that always has importance and precedence.

Regret is something that those left living have a long time to live with. Suicide of a loved one (particularly young people) devastates every family and person it touches. Knowing what suicide is actually about and the reality of how it happens is critical. Nothing is ever exactly as it is portrayed in the media or many medical reports. They are often generalised and people in their ignorance, then generalise for everyone. Not so. Please don’t make that mistake. Be an active part of your child’s life and be there.

This post has been on my heart for sometime, writing it and getting it right was the harder part. The next post will be a similar thing. Stayed tuned for how asperger’s affects those with ED or anxiety/depression and it’s affects on the treatment path.

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What I won't share

 

To all those who want information for school projects, media blogs, uni projects:

I will not share or comment on:

  • my daugher’s lowest weight
  • pictures of her at her worst
  • a detailed state of her fingers nails, hair or other physical attributes
  • how eating disorders affect your looks
  • my daughter’s detailed list of safe foods or fearful foods
  • BMI weight for either my daughter or make suggestions for your BMI
  • the words healthy, beauty, inner beauty, protein diets, fresh diets
  • dieting or food tips
  • what are better foods or healthier foods to eat

why:

  • it takes the focus of just how dangerous and devasting eating disorders (particularly anorexia) are
  • it diminishes eating disorders to the physical and superficial
  • it is not helpful or useful for recovery or media intake
  • sends the wrong message about foods, health, body weight etc.
  • eating disorders are not an illness about food or weight
  • there are far, far more devasting consequences and ill health from having an eating disorder than your nails, skin, hair etc
  • there are no good or bad foods

However, I will share:

  • the real body and mind breakdowns that occur (did you know the uterus thins out to almost paper and only thickens once the body is repaired and periods start – just learnt that)
  • how incidious, manipulative, dangerous and all consuming eating disorders are
  • that it is an illness of the mind that affects all genders, cultural and social areas
  • that physical health and healing comes when a varied and wide food range is eaten
  • the long lasting effects of eating disorders are those under the skin: the mind, behaviours, organs, bones, teeth, reproductive system, endocrine system …
  • what research has been done and how much more needs to be done
  • what resources (including financial) are not being funnelled into eating disorder areas
  • how eating disorders affect families and relationships
  • recovery and healing that encompasses all areas of an eating disorder.

I have met some wonderful people who are creating great stuff, from documentaries, short films, very informative and balanced websites. But others still have a lot to learn about eating disorders. These are the ones I want to grow and stretch in their ideas of what an eating disorder is really all about.

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