Doctors Lounge - Psychiatry Answers
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Forum Name: Psychiatric Topics
Question: Depression & Anorexia Relapse
|slippingaway - Wed Apr 01, 2009 5:26 am||
Hi, I'm a 21yr old female that has recently relapsed with depression and anorexia. I was hospitalised for a week a couple of weeks ago because of suicidal ideation. I'm not coping and I don't know what to do. I have no energy or motivation to do anything. I've been cutting to relieve pain & have been taking avanza at night (an antidepressant that i used to take on top of 225mg efexor) to help me sleep bcoz my daily calorie limit of 500cals> is not giving my body enough to survive. I fainted onto my bed earlier 2day, its starting to scare me.
I've been seeing a GP and a psychologist but inside I feel like there's no point, there's no hope, why even try? It scares me to be alive. I'm sick of feeling like this. ='(
|Dr. E. Seigle - Sat Apr 04, 2009 6:41 pm||
The screen name that you have chosen highlights how anorexia causes people to "slip" into this illness of starvation and dislike of one's body appearance. You have shown much courage and honesty to disclose to us your difficulties and to acknowledge how little you are eating. Your having fainted is of very much concern, as it suggests that you may be dehydrated, have low blood pressure, and/or have an electrolyte imbalance. Fainting can also come from an irregular heartbeat, caused by anorexia.
As you know, anorexia can make you quite ill and can even be fatal, and when one is malnourished,this can distort your thinking and judgment. The poor eating and nutrition can also worsen the depression that usually goes with anorexia, causing people to feel more hopeless. Please let your psychologist and family doctor know immediately what is going on with you, as you may be having a medical emergency, or be near one. You may need to consider going to an emergency room for medical evaluation, and you may need emergency treatment for the anorexia.
It is important to know that many people with anorexia can recover fully and stay healthy by being treated in a hospital that specializes in working with individuals with eating disorders. Often, only such hospitals have the expertise and specialized programs to adequately help people fighting anorexia. These in-patient hospital programs are also often associated with other, less intensive programs for people fighting eating disorders. These comprise a range of levels of care that are not as medically oriented or intensive in treatment as a hospital. Such programs include what is called a RESIDENTIAL program (people stay there for one or several weeks to months, with less medical oversight than a hospital), a Day Hospital Program (people go home at night), and an intensive, out-patient program (3-5 hrs/day, 3-5 days per week, day hours only). Often, people with anorexia will start in one of these programs, and as they recover, "graduate" into the next, less intensive program, as they need less treatment time, less medical oversight, and as they become increasingly able to monitor and actively manage their own recovery. This happens as people troubled with anorexia become more self-aware, feel stronger, have healthier thinking, better self-esteem, and they feel both physically and mentally better.
Remember that anorexia is an illness that has come upon you; it is NOT your fault. I am sure that you did not ask for it, nor choose it, and that if you could feel and eat better without help, you would. Like other illnesses, anorexia needs the appropriate treatment for it to get better; people cannot treat it themselves. It often takes a couple or more treatment efforts for people to recover well from this very tricky, confusing and overwhelming illness.
Thanks for being willing to share your situation here; I wish you the best; if you would like to keep us posted on how things are going for you, I'll bet that there are many other people with eating disorders, including anorexia nervosa, that would be encouraged by hearing from you. I'm sure that there are many who, along with me would ask you to resist the anorexia's efforts to cause you to "slip away".
With warmth and concern,
E. Seigle MD
PS- If your providers do not seem concerned at the symptoms that you have been having, you may want to also get the opinion of a psychiatrist with experience in eating disorders.
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