How to manage an ED with DBT??? Help!

Angel- I'm sorry for the delay in reply. My attention span the past few days has been about this big >>o<<! It's been a sh!tty week altogether. I'm so effing OVER this crap! ! ! ! ! Needless to say, I've been in a terrible mood.

I did get a little smile reading how you play with your son. Children are so wonderful, so honest. When I'm out and about, shopping or something, and hear children laughing it makes my heart leap a little. That sound is just magical.

Isn't it interesting that we all use cleaning as one of our distractions? What's with that, I wonder? They say our house symbolizes our body. Maybe there's something to that concept.

I'm glad to hear your sister has been supportive. And I definitely agree that these issues are genetic- that there's a physical component. My sister would be a help if I let her in on my story. But she has a very hectic life with her own kids and work and school and problems- I just can't bring myself to burden her with my drudgery.

Karen- I don't know how to heal the neglect we endured by our parents, either. Like you, I try to not to live as a victim of my past. But I believe if we could heal these wounds, it would make a giant difference in our ability to overcome the ED. Whenever I try, though, like in therapy, it seems like I'm even worse off for it.

I hope you're having somewhat better days. We've gotten a big snowstorm since yesterday- and the well pump at the barn wasn't working last night, frozen I guess, so that means I need to haul water from the house through 15" of snow. And MAN I don't feel like it. I hate hearing myself complain- I just don't feel like doing ANYTHING.

Hi Stella

I'm so sorry you are having such a rough week. I sympathise because I'm feeling exactly the same - depression worse than ever and no motivation or energy to do anything. I have spent the day in bed and didn't even contemplate getting dressed.

I wish I knew what the answer is. All I can say is I understand what you are going through and I wish I could make it better.

Karen

Hi Stella,

Karen and I have created a private chat room. Would you like to join us? If so, please send an email to the address on my profile and I will provide you with a link.

Hope to hear from you,
Debbi

HI Angel- Thanks for the invite! It made my morning! Unfortunately I have dial-up internet on 50 year old phone lines. My connection is unbelievable slow and live chats are impossible. By the time I get the feed, the conversation has moved on. It just doesn't work for me. Someday maybe we'll get a tower out here in the middle of nowhere land! We've looked into satellite internet, but it's some $350 to sign up + a monthly fee and there's no guarantee it will work.

But thank you!

briary wrote:Hi Stella

I'm so sorry you are having such a rough week. I sympathise because I'm feeling exactly the same - depression worse than ever and no motivation or energy to do anything. I have spent the day in bed and didn't even contemplate getting dressed.

I wish I knew what the answer is. All I can say is I understand what you are going through and I wish I could make it better.

Karen

Thanks, Karen. I'm feeling nervous this morning- I have to get CMP and CBC levels drawn in a couple of hours. I just had them done last monday- my pdoc is keeping a close eye b/c they were low. She said if they're worse this time we'll have to consider some "alternatives." I have no idea what she means by alternatives- but it worries me. I intended to not purge or restrict yesterday, to try to get my levels up. I only purged once, in the morning, but then I restricted all day- not good decisions and I'm regretting them, now.

Hope you're finding some renewed motivation to face the day. One thing that helps me when I'm in such a bad spot as that is to open a window. Even if it's the dead of winter and absolutely freezing out- the blast of fresh oxygen and outside smells and sounds are like medicine for the soul. Maybe you could give this a try?

Hi Stella

stella_blues wrote:I'm feeling nervous this morning- I have to get CMP and CBC levels drawn in a couple of hours. I just had them done last monday- my pdoc is keeping a close eye b/c they were low. She said if they're worse this time we'll have to consider some "alternatives." I have no idea what she means by alternatives- but it worries me.

I'll be keeping my fingers crossed for you that the results are alright this time. When do you see your pdoc for the results? I know it is worrying but we would only be guessing trying to figure out what she meant by 'alternatives'. She could've been referring to supplements, or medication review or anything really. I know it is hard but try not to panic about it.

Well done for purging only once yesterday. I realise you compensated for this by restricting, but it is a step in the right direction. I do think trying to tackle the purging and restricting at the same time is rather tough, regarding the goals set to you by your DBT coach. Perhaps you could work on lessening the number of times you purge, definitely not more than once a day and perhaps try to see if you can resist that completely. Once the purging is under control then look again at the restricting. It sounds to me like you are not bingeing at all now and therefore you are probably taking in very little food at all if you are restricting AND purging the little you do eat. I worry about you getting sick if this continues.

Hope you're finding some renewed motivation to face the day. One thing that helps me when I'm in such a bad spot as that is to open a window. Even if it's the dead of winter and absolutely freezing out- the blast of fresh oxygen and outside smells and sounds are like medicine for the soul. Maybe you could give this a try?

Thanks, I'm not really. Yesterday was the worst day I've had in a long time and I was very close to the edge. I don't know what I would've done without the help from Debbi yesterday. It is a shame you are not able to get into the chat room, we were hoping we could all chat there but I understand it must be very slow on dial up.

Karen

Hi Stella,

Sorry about the dial-up, must be frustrating Maybe I'll think of some other way we can all communicate.

How have you been doing? You sound in a better mood lately.

Debbi

Some good news in my world- my levels worked out okay, today. Some are below "normal" - she (pdoc) said indicates malnutrition, but not terrible. I did find out that she'll tell my partner if my levels get dangerously low. I really don't think it will come to that, though.

I don't know why I think that- I guess b/c I'm pretty resilliant, physically. I think I can cruise along this way for a long time and not get into too much trouble with my health. I'm pretty careful. I take care of my mouth, teeth, and throat (water with baking soda to neutralize the acids). And when I purge, I do leave some food in my stomach most of the time. Not very much, but enough. I know how lame that must sound. But I just don't feel worried about it. Maybe part of it is the suicidality/wrecklessness talking.

She's set up an appointment next week to meet together with her superior, for another opinion. She hasn't given up on me, but seems stumped as to what direction to take. For the appt. she asked me to put together a brief timeline synopsis of my life- events and treatments. No small task! She said she'll wait on the ECT to see what comes of the meeting next week. I'm so grateful to her for hanging in there with me. I know I'm a frustrating patient by never getting better.

Yesterday was the worst day I've had in a long time and I was very close to the edge. I don't know what I would've done without the help from Debbi yesterday.

I'm so sorry things are just so hard right now. I'm very glad Debbi was there for you. You deserve support- I'm glad and relieved you're reaching out and receiving it. I'm sorry I can't do the live chat, too. I hope you'll continue to use this forum in addition to it. I'll be glad continue connecting here. It's been a huge help.

Hi Stella,

Are you really considering ECT?
Please don't go that route.

Deb

Hi Stella

I'm glad the blood results were fairly ok. Of course, having physical signs of malnutrition is not particularly good, but it is something that would be expected with anyone with an eating disorder.

stella_blues wrote:I don't know why I think that- I guess b/c I'm pretty resilliant, physically. I think I can cruise along this way for a long time and not get into too much trouble with my health. I'm pretty careful. I take care of my mouth, teeth, and throat (water with baking soda to neutralize the acids). And when I purge, I do leave some food in my stomach most of the time. Not very much, but enough. I know how lame that must sound. But I just don't feel worried about it. Maybe part of it is the suicidality/wrecklessness talking.

I think most people with anorexia/bulimia or any eating disorder think that to some extent. I know when I've been at very low weights and people around me were telling me I was very ill I never believed it and thought I was fine and nothing would happen. I guess it would be pretty impossible to continue with any eating disorder behaviour if we had worries about our health and what it was doing to us. People do get very ill though and that's why your pdoc wants to monitor you so closely.

I'm with Debbi regard the ECT, although it is ultimately your choice. I would touch it with a barge pole personally and think it is bad news.

Hope you are ok today.

Karen

On the ECT, it's been saved as a last resort. I've been dubbed "treatment resistant"- and I actually agree with that. I've been on so many different meds- different cocktails of meds- therapy makes me much worse- I take a veritable handful of supplements everyday- there's just nothing left. I'm not afraid of ECT. I used to be- I was pretty freaked out by it. (I had a roommate in the hospital this summer who was getting ECT treatments. She seemed to feel awful after each one.) But now I just feel like - "whatever." I guess I just feel apathetic at this point. Like I've given up. My pdoc is wary of using ECT- she just doesn't know what other direction there is for me. And she's seen it work on other patients. So I don't know.

Thanks for the warnings on ECT - I give your opinions a great deal of credance. You both have much more experience and knowledge on this stuff and I respect that a lot. I hope I don't come across as disrespecting your thoughts on it. It's just that I feel so helpless at this point- and unafraid of being harmed. Foolish, I know. I hope you can understand.

Feeling down this morning. I never know how I'll wake up, anymore. I have a small job this morning and then the rest of the day to obsess about food.

It's very windy and cold here. Wind chills below 0 today.

Hi Stella,

Thanks for your reply. I understand your position on ECT, that you may be treatment resistant, and that is very frustrating, but please don't consider it. It causes brain damage, mainly to the frontal lobe which is where higher thinking is. It causes memory loss and many other irreversible side effects. You are, in essence, frying your brain. And you only have one brain, once there is damage, that is it. I couldn't bear to see you do this and lose your creativity. It is done to make people more docile, so that they don't think so much, motivation is gone.

Please be very well informed before you make a life altering decision such as this. There are other alternatives.

Blessings,
Debbi

Thanks for the serious warning. I hear you. I totally do.

I guess the thing is... I'm not worried about damaging myself b/c I have so little will to even continue living. Oftne my suicidality is so tangable, so huge, it overshadows any concerns for my welfare. Sometimes every moment is a strain to keep going. Today is one of those days. Just one example, while mucking the barn earlier, all I could do was obsess about throwing myself off the highest loft. But I don't want to end up paralyzed or otherwise alive but broken, so it's not a viable option- just a giant temptation. I'm very logical, methodical, calculated, about it. It's crazy- insane. Just an hour ago I made sure to put my pdoc's cell number in my wallet so I could call and leave a message on her voice mail of where to find me when I asphyxiate myself in my car this week. (I want her to identify my body - I DO NOT want my partner called on for this!)

So the worry of harming myself, it's just not there. I know how foolish that may sound. What are the chances I'll actually follow through with my suicidality? A possibility, but probably slim- afterall, past behavior is the best predicter of future behavior.

I guess I'm just not scared, anymore.
I know I should be.

My pdoc senses things are going badly - she's even called me at home to check up on me. She's personally dedicated to her work and I think she's getting desperate to find anything to pull me up out of this black hole- even if it means drastic measures like ECT. She's not gung-ho on ECT and has been holding off since spring to go that route.

I think it's gotten to the point where it's better than me killing myself- b/c I really feel that's what this whole stupid 36 years of life experience has been leading up to. As melodramatic and ridiculous as that may sound.

I genuinely appreciate your thoughtful warning.

Stella,

Is your suicidality a constant feeling or does it come in waves? Is there anything that triggers it? Have you felt more suicidal since being on Lamictal?

I am more than happy to be of support if you'd like to talk on the phone, just send me an email with your number

Debbi

Hi Debbi- Thanks for checking in. I'm feeling so anxious tonight- just tied up in knots.

The suicidality comes with depressive mood swings. The bigger the swing, the more despairing and hopeless I feel- and it's so emotionally taxing that I just crave any relief, any means of freedom from it. I feel like a caged animal.

It's increased since starting the Prozac. Lamictal actually seemed to help shorten the duration of my depressive phases. But the Prozac has ramped up the frequency of mood swings. Prozac is contra-indicated for Bipolar disorder, but is the drug of choice for bulimia. Lamictal isn't good for bulimia (can increase impulsivity) but is the drug of choice for rapid cycling Bipolar and BPD, esp. in treatment resistance. Tricky medicating for one without exacerbating the other. My pdoc wants to d/c the Prozac, but it really helped reduce the binge urges, so I've been voting to stay on it. It helps me restrict my eating. Messed up, I know- but the less I binge, the less I purge.

The increase in the eating disorder has complicated an already impossible-to-treat condition.

Who knows. This is why I feel so helpless and hopeless. It's like having a terrible disease for which there is no cure. The internal suffering can be so profound, so deep, I can't remember what it was like to feel well. It's so isolating - so utterly painful- so disabling- I wouldn't let a dog live this way. I'd put it out of it's misery.

It sounds like you've battled your own demons over recent years. I'm sure you know what it's like.