Discharge from outpatient ED program?

Eating wise, things haven’t been going well these past few weeks. My daily diet has been consisting of a protein bar, a bowl of diet yoghurt, a bowl of vegetables, sugarfree jelly and half an apple, and I haven’t been able to bring myself to eat and keep down anything else apart from this group of safe foods. My weight hasn’t dropped by more than 4kg so far, however, as of this morning my BMI was 15.98 which it hadn’t dipped to since being discharged from hospital. Part of me is pleased that I’m losing weight, the other part of me is thinking “Why am I doing this? I just want to recover.” But maybe I’ll feel more comfortable maintaining if it’s between a BMI of 15-16? That way my weight would still be underweight but on the higher end of underweight, it’ll give me ~2kg leeway between being a BMI of 15-16, and I’ll be able avoid being put into hospital under the Mental Health Act.

I’ve been seeing my psychologist at the outpatient ED program weekly. However, because they’re an outpatient service, they have a duty of care and won’t see clients if they’re medically unstable, keep losing weight or are below a BMI of 14. I’ve lost weight three appointments in a row now, and I’ve been warned by my psychologist that she is not allowed to continue seeing me if I continue to do so. I’m meant to at least maintain my weight at my next appointment which will be in a week’s time, whether I do or not remains to be seen.

The day after my appointment I did try. I had a bread roll at breakfast, but then once I started eating I felt like I couldn’t stop, and it led to a binge/purge. And now I’m afraid to try again because I’m afraid I won’t be able to stop eating and it will lead me to binge and purge again, and I’m afraid of the feeling of fullness, and gaining weight.

If I’m discharged from the service, well I guess that’s that. On one hand I know that they can’t have clients declining under their care and you have to be committed to recovery, on the other hand, it sucks that they may discharge clients for struggling. It’s hard to be able to turn things around by yourself, and it’s unfortunate that there’s no day program and/or outpatient meal support to help people to be able to do so.

Outpatient ED treatment

I’m always relieved and a bit surprised when I eat adequate amounts of food and I don’t gain a load of weight. In hospital when I began refeeding, I gained 4 kg in a week. Even the nurse was surprised at how much weight I gained in such a short time- “How is that even possible? You must really want to get out of here,” she said. And because it’s happened before, there’s a part of me that’s afraid that’s going to happen every time I start eating more. But it hasn’t.

These past three days I’ve been eating well and my weight has remained at what I think is possibly my body’s set point. On Friday when I saw my psychologist we talked about weight and the fact that while I’ve managed to maintain the weight I was discharged from hospital with, I’ve also been controlling it so that it hasn’t gone above that number. Technically my current BMI is just under the “healthy weight range,” but I am naturally petite anyway. I said that I may be okay with it if I gained a couple of kilos from eating what a person is supposed to eat in a day- regular meals and snacks that are balanced and nutritious. What I can’t justify is gaining weight for the sake of gaining weight or if I gain weight from overeating, eating lots of unhealthy foods and/or bingeing and purging. My psychologist is fine with that, which makes me so glad I’m getting outpatient treatment for my eating disorder instead of inpatient treatment. Instead of inflexible and ridiculous rules being imposed on me, I get to have a say in my own treatment and recovery. Which means for me eating regular and balanced meals and snacks throughout the day, and if I gain weight that’s okay, but if I don’t gain weight that’s okay too. What recovery and good treatment doesn’t mean to me is being forced to eat to the point of almost vomiting, and being forced to gain a certain amount of weight and punished if I don’t.

Though being in hospital was such an awful experience, it’s almost a good thing it was so bad, because it serves as an additional motivator to be well and stay out.

At the goal weight

I’m at the goal weight that was agreed on- 43kg. Originally they wanted me at 46kg, thankfully they’ve lowered it to a weight that is both healthy for me and a number I’m more able to cope with. They want me to maintain the weight for a few days before discharge. Technically I’m now “voluntary” as the Form 6 of the Mental Health Act I was under expired. However when I said I wanted to leave, I was told I wouldn’t be allowed to do so, and that I’d just be formed again if I did. Doesn’t sound very “voluntary” to me. I realised though it’d be better for me to play the game and comply for a week rather than run the risk of being put on a Community Treatment Order when I’m discharged, which could last for up to six months. It’s what I continue to try to tell myself- play the game, not long to go now so don’t screw it up for yourself.

Saw the psych registrar today who told me if I dropped the weight again they may bring me back into hospital which could result in a longer stay and they’ll increase the goal weight even more. Next sentence he’s telling me they want me to continue to see the doctors and the dietitian as an outpatient. I almost laughed and asked him why I’d attend outpatient appointments if it ran the risk of being forced back into hospital? At this stage I’m not sure whether I’ll maintain or lose weight when I go home, but I sure as hell am not coming back here to obtain treatment for anorexia. It makes me so angry to think about the punitive way I was treated here. Taking away my control, insisting on putting in a nasogastric tube without even giving me a chance to eat, taking away my dignity by not even allowing me to walk 3m without a wheelchair, not allowing me any of my clothes and belongings and not even my glasses, being so rigid to the point of ridiculousness in following the “management plan”, confining me to a room on “bed rest”, focusing entirely on weight gain with daily weigh ins, forbidding my friend from being put on the same ward as me even though her doctors were fine with it, taking away the one thing that may lift my mood and take away from being so miserable. I’m not opposed to treatment entirely, just treatment here after this awful experience. On principle I don’t plan on attending any future outpatient appointments here. As for treatment in general, I’m feeling so tired of it all and at the moment it seems futile. I’d seen a clinical psychologist three times during the past couple of weeks, last session however my defences were up, I didn’t talk and told her it was pointless. I’m sick of starting over and over again with countless psychologists and I feel like nothing will work anyway.

I’ve been feeling hopeless about everything and anxious about the future. One of the nurses was saying she’s excited to plan for the future, which I’m envious of, and wish I was too. Instead it just seems bleak with nothing to look forward to and I’m too afraid to think ahead as the future just scares me. When I’m restricting and losing weight it takes away from my emotions and my feelings and now that I don’t have that, the sadness and hopelessness and anxiety is intensified. When I’m eating disordered I can pretend that food and weight are the problems and can delude myself into thinking that if that is solved, everything will be fine. On the surface that’s easy to cure, eat and gain weight and life will be fine and dandy. The reality however is much different- I may be eating and a healthy weight but then I have everything else- the feelings of being alone, hopelessness, feeling I can’t cope with life as well as everyone else, and desperately wanting a way out. That’s much much harder to fix and I can’t even pretend I have a solution to it because for this I really, really don’t.

Struggling with being over 40kg

Since the last post I’ve been transferred from the open ward to the locked ward, then moved back to the open ward where I’ve been for a few days now.

On Monday I was reviewed by the dietitian. I was told my weight had stagnated as it had hovered at 39.2kg for a few days ever since I’d come on to the open ward which was attributed to me “walking around” even though the most walking I was doing was 5m from my room to the lounge room. It’s a ridiculous distance to have to be wheeled in a wheelchair when I can walk, and honestly, walking that short a distance is not going to affect my weight in the slightest. She again reinforced the restrictions of being wheeled around in a wheelchair and having meals in my room as opposed to the dining room with everyone else. I was upset after this review, as I felt I was being blamed for my weight stabilising, and despite me eating most if not all of my three meals and drinking all three Ensures a day, I was still being so restricted. I was already upset, and it was made worse when two nurses came in and started going through my belongings. I can’t stand having my privacy invaded and on two previous occasions when I’ve had my room searched, I’ve ended up restrained and put in the seclusion room. I tried not to completely lose my shit again this time. I took the blade I had in my bag and held it in my hand to try and calm myself down with the knowledge that it was there just in case. Unfortunately the nurse who was specialling me cottoned on after a while that something was up, and came to investigate. She had a glimpse of the blade, which I quickly took in my hand. She tried to get it off me, I wouldn’t let it go, and other nurses were then called and the duress alarm pulled. I was restrained and taken to the seclusion room where the security guards prised the blade out of my hand, I had all my clothes, glasses and jewellery taken off me, and was given an IM injection. After a period spent in the seclusion room I was wheeled out of the open ward where I found myself once again in the locked ward.

The first few days there I wasn’t allowed any of my personal possessions, not even my glasses, as apparently it would pose “too much risk.” On the second night there I got very frustrated at the situation, took myself into a bathroom stall and started hitting out and punching the wall. The nurses heard me banging around, led me out and into my room where I pushed over a chair in anger. I was then escorted to the seclusion room, where I was made to lay down and once again given an IM injection.

Whereas on the open ward they’re a bit more relaxed, the staff on the locked ward were very rigid in following the management plan down to the letter. I was told I couldn’t have honey with my weetbix at breakfast because it’s “not on my management plan”. There was a plum on my dinner tray and I don’t like plums so asked for an apple instead and was told no. And though the point is for me to gain weight, when I asked if I could have a tub of yoghurt or an ice cream, I was also told no. Out of spite I then ate exactly what it said on my meal plan, nothing more, went everywhere in a wheelchair and drank only a minimal amount of water to prove that it wasn’t being in the open ward that was making my weight stagnate and by not allowing me extra food, I wouldn’t gain weight. I did end up dropping 0.2kg and was 39.0kg on Friday morning.

Thankfully on Friday afternoon I was transferred back to the open ward and have been here ever since. Still on a 1:1 special which means it’s been three weeks that I’ve been continuously watched by a nurse. The dietitian added even more to my meal plan which means daily I’m having three full meals, three snacks and 200ml of Ensure Plus three times a day. Eating six times a day feels excessive and surely normal people do not eat this much.

Up until now I’ve been eating and gaining weight quite easily without it being much of a struggle, but these past couple of days I’ve been feeling awful as my weight is now over 40kg. Being under 40kg felt safe, and now that I’m over that number, I feel like I’m fat enough and any more weight gain is unnecessary. Clothes that used to be loose on me now feel tight, and I feel like I need to punish myself by self harming for being such a fat, disgusting pig. But of course I can’t, and I just feel low and I can’t cope with them wanting to be 46kg which would be a BMI of 18.5. I’ve never been that heavy in my life and at that weight I’d either just restrict again to lose it or kill myself. I could go home and eat without trying to restrict at about 40kg, but 46kg? There’s no way I could deal with that and that’s just setting me up to starve and lose weight all over again.

Back in hospital

So I’m back in hospital and have been since 17 December. It seems like everyone saw it coming; my mum, my aunt, my friends, the nurses, even readers of my blog. Everyone except me that is. Huh. Naively I thought if I didn’t have any physical health problems, they wouldn’t form me under the Mental Health Act, and I believed my case manager when she said they wanted to keep me out of hospital. This is a new low for me, one month out before being back in again. Usually I’m able to keep out for at least four months between admissions.

So how did it happen? It started with two of my friends whom were also inpatients last admission voicing their concerns to me. They were concerned I wasn’t eating much and I’d lost weight all over again, and had convinced themselves I was at risk of dropping dead overnight. They asked me to come to the Emergency Department with them, I told them there was no need and that I was fine. After much convincing and my friend saying that she wouldn’t sleep at night worrying about me, and that they couldn’t forgive themselves if they had to attend my funeral, I came with them into the psych triage at A St. I went out of guilt and I was sure whoever I saw would also agree that I’m fine. Spoke to a nurse and a doctor who were happy for me to go home and said they’d talk to L, my community mental health nurse/case manager. The next day I had a visit from my case manager who said that she’d talk to the psych registrar, Dr D, to see if I could get an appointment with her during the week. On Tuesday morning I then got a call from L asking me to come in for an appointment with Dr D that afternoon. I went and drove to my appointment without any inkling whatsoever that I wasn’t going to be able go back home that afternoon. I was told by Dr D they had spoken to the inpatient consultant psychiatrist and that they wanted me to come into hospital. If I didn’t agree, I would be formed under the Mental Health Act. My relatives had to pack my bag for me, come drop it off and drive my car home for me.

The next morning I was reviewed by the doctors and dietitian where I was told I’d be put under a Form 6 under the Mental Health Act, they’d be inserting a nasogastric tube, I’d be put on bed rest, be on a 1:1 nursing special, and whereas last admission they discharged me at a BMI of 16, this time they wanted me at a BMI of 18.5. “What if I eat and or/drink orally?” I asked, desperate to avoid an NG tube. They replied that it’s “Not negotiable.” Obviously I was upset at all I was told, and after the review I tried to abscond from the ward. Unfortunately it was my poorest effort yet, and I didn’t get very far before a nurse and a doctor caught up to me, grabbed me by the arms and forcibly escorted me to the seclusion room of the PICU/locked ward.

It’s there I stayed for six long days. I refused to let them put the NG tube in so I was restrained and injected with midazolam so that they could try and force it up through my nose. The events are a little blurry, but I remember a nurse trying twice to get it in, me trying my best to prevent that from happening, and somehow or other I actually got out of it and thus far no NG tube has been put in. A short time after that, my blood pressure apparently dropped quite low, and a code blue was called. I was pretty out of it by then, but remember having an oxygen mask and getting IV fluids put through.

For the first few days on the locked ward I was confined to my room on bed rest. I found that very hard to handle, with nothing to do except read a book or stare at the wall. Being a PICU, everything is taken off you- phone, iPad, electronic equipment, cords, toiletries, anything breakable, jewellery, bag, keys, wallet, and plates and cutlery were all plastic. I self harmed at one point by using my nails to scratch my arm and using my watch to hit my arm- until I was restrained by nurses and security guards on my bed, and had my watch taken off me.

On Monday when the dietitian and then doctors came to see me I was told I would be allowed to be wheeled in a wheelchair to the lounge room to watch TV- but still not allowed to have my meals in the dining room or participate in OT activities. Though those conditions were a tiny bit better, I was upset that I was still so restricted, and not allowed to even walk 5m to get from A to B. In addition to this, because aforementioned friend was also in the locked ward, staff wanted to prevent us from interacting and we were told we weren’t allowed to talk to each other. At one time when we were both in the lounge room, a nurse told me I had to go back to my room, as we were apparently communicating with each other. That’s when I got pissed off and started arguing- we had not said one word to each other that whole time in the lounge room and it felt so unfair that I was the one kicked out when there’s nothing else I can do. There was one night though where the nurses didn’t care that we were talking to each other, and it really helped my mood to be able to chat and have a laugh with her, other patients and nurses. On the locked ward I was so bored and depressed that I didn’t give a shit any more and actually ate, even extra food like ice cream, chocolate and cheese toasties.

I was moved back up to the open ward on Christmas Eve. After being in such a controlled and restricted environment, it is such a relief to be back on an open ward. It’s much more relaxed, I have all my belongings back, I’ve been having my meals in the dining room and have been to the OT groups of cooking and art. On Christmas Day I had a few hours leave with my relatives, as my parents are overseas at the moment. I was seriously contemplating killing myself if I was still in the locked ward and confined to my room, but as I wasn’t and had been moved to the open ward, I was in a good enough mood that I didn’t bring back to the ward things to harm or kill myself with. It was nice getting away from the hospital, being away from being constantly watched and getting to see my dog, even if I did eat then purge while home.

I’m still on constant 1:1 nursing, and this is the longest that I’ve continuously been specialled. The doctor on duty came to see me today, and it happened to be the doctor I was seeing whilst inpatient at another psych ward during October/November 2011. He remembered me, and joked “You’re always needy!” about me being specialled….again.

Unlike last time in hospital, this time I’ve actually been eating and mostly compliant. I’m trying not to think about it, how much I loathe being controlled, being made to gain weight, eat way more than I’m comfortable with and how fat and disgusting I feel. I’ve been told they want me to be 46kg before discharge but there’s no way I’ll be okay with that. I’ve never been 46kg in my life, the most I’ve ever been is about 43kg, and that’s when I was eating normally and hadn’t purged in months. I’m Asian, 158cm with a small body frame and 46kg is too high, none of my clothes will fit at that weight. Right now I don’t even plan to go home and lose weight all over again, I could probably live with maintaining at around 40kg which would be high enough so that I don’t get scheduled under the Mental Health Act, but I’d rather kill myself than be 46kg. If necessary, I believe I do have the means to do so properly. When I came into hospital I was 34.8kg, just 11 days later I was 39.0 kg this morning. I’ve been told they expect a gain of about 1kg a week, and in less than two weeks I’ve already gained 4.2kg. On one hand that gets me out faster. On the other hand it proves to me that this amount of food is way too much for me, I’m always bloated and I’m ballooning with how much I’m eating.

The need for public inpatient eating disorder treatment

Today I attended a forum for consumers and carers to discuss the 10 Year Mental Health Services Plan, facilitated by the state Mental Health Commission. The four categories discussed were bed based services, community clinical services, community support services and prevention & promotion. There has been talk of this already, but one of the points I raised under bed based services was the need for a specialised inpatient eating disorders program for adults. Currently in my state there’s an inpatient eating disorders program at the children’s’ hospital for those under 16 years old, and for adults there’s one at a private hospital which is only accessible for those with private health insurance. In the public mental health system this is non existent, so you either get put in a general acute mental health unit or you get nothing.

This is problematic for a number of reasons. As we all know, the number of beds in psych wards are limited, and there’s almost always greater demand than there are beds available. Most beds are occupied by those who are suicidal, have psychotic or affective disorders. Even those who are suicidal sometimes get turned away. So if you have an eating disorder, unless you’re quite underweight or physically compromised, there’s slim chance you’ll get inpatient help for it. It seems as though EDs being treated in acute psych wards are so rare that nurses were quoted saying to me “Last time we had an eating disorder patient here….” It’s hard enough to eat and recover with supervision and inpatient care, I imagine it would be even harder to do so on an outpatient basis. It just doesn’t seem fair that it’s so hard to get that help if you’re in the public system.

Then there’s the care for when you are an inpatient. It’s better than nothing. But there are also many reasons why an acute psych unit isn’t appropriate. I get that it’s hard to cater for everyone, but often groups weren’t all that relevant. I know that at the private ED program, the groups offered are actually somewhat relevant to those with EDs. The focus while I was inpatient was all on just food and weight and there was nothing to help with the psychological side of it.

There were some staff members who did seem to have experience and knowledge of EDs, but then there were others who did not. I got nurses from one extreme, who told me I’d eventually be dead if I didn’t come to hospital, to the other extreme who asked me “Why are they so worried about you anyway?” and told me “I thought you’d be home by now.” I got the feeling some nurses wondered why I was in hospital and didn’t think I needed to be there. There were nurses who didn’t seem to get that it’s not that easy and would tell me “Just eat and put on the weight so you’ll get to go home, simple,” as if there wasn’t a battle going on in my head when it comes to doing so. When I was caught exercising and told to stop by the nurse, “Put on the weight so you can get out of hospital, then when you get home you can do what you want.” Lol, kinda defeats the purpose of being in hospital, but ooookay then.

There was even one nurse who asked me how I managed to lose weight on more than one occasion. Eventually I asked her “Why would you ask someone with an eating disorder that?” There was a particular conversation I remember she was having with my friend on the ward and myself. The nurse was talking about being envious that Asians are all so slim and and asked me how it is that Asians do stay slim and what they eat to do so. “Rice,” I answered. She laughed and said no, she’d probably gain weight if she ate rice. This conversation was upsetting to me as I feel like I’m meant to be thin because I’m Asian. Because I’m Asian, even at my lowest weight, by Asian standards it’s not even considered skinny- just average. And if I gain weight and go back to my highest weight of ~43kg, it’ll be considered fat for an Asian.

Then there are aspects that I, or rather my ED, likes that some staff aren’t experienced. Times when my Ensure Plus has ended up down the drain rather than down my oesophagus and into my stomach when I haven’t been watched or watched closely enough. Times when I’ve managed to hide and/or throw food in the bin. When at a mealtime a nurse has said, “I’m meant to watch you eat but I won’t, just makes sure you have everything you’re meant to have.” Lol, sure I will. It seems like some don’t realise how sneaky eating disorders can actually be. Before I got caught out, I managed to go a few times to weigh in wearing multiple items of clothing and hiding extra weights on me. A friend who’s been through the private eating disorders program couldn’t believe I’d gotten away with that- it seems that over there where they specifically treat EDs, they’re a lot more clued in to the tricks that people with EDs use. One morning when I’d been up early, I blatantly had two cups of coffee before weigh in and didn’t hide it, and they didn’t pick up on it or say anything and weighed me as usual.

One advantage I will say though of not being in a specialised eating disorders program is that I was the only one in the ward at the time being treated for an eating disorder. I worry that if I were to attend an eating disorder program, I’d be triggered by patients who were thinner than me, or who ate less than me. When you’re the only one in the place who has an ED, there is far less competition for who can be the thinnest, who can be the sickest, who can eat the least.

Cancelled the appointments

I was meant to have an appointment with the inpatient psych registrar on Thursday and dietitian on Friday. I cancelled both and didn’t attend either. I talked briefly to one of the nurses on the ward yesterday when I was visiting a friend, and she reckons something will happen if you don’t go to appointments. I disagree. I’ve done it before and cancelled the follow up appointment with a psychiatrist after being discharged from hospital and it was fine. Besides, I am only one of many clients who attend the mental health service, I’m sure they all have better things to do than bother with someone who’s stated she doesn’t want help, when there are people who do.

It’s been over a week now that I’ve been out of hospital, and I’ve pretty much gone back to doing what I was doing before being admitted. Although, whereas before I wasn’t purging regularly any more, this week I’ve already done so four times. A few years ago when I was regularly purging I only managed to gain weight instead of losing, and I’m afraid of doing so again. I have lost a bit of weight since coming home, and weighed in at 37.2 kg this morning. It doesn’t feel like even nearly enough though.

I don’t feel sick enough to want to recover yet. Looking back, I wasn’t even that thin at my lowest weight. I know I can’t go on like this forever. But maybe if I got down to say, 30 kg, then I’ll stop.

Banned from blogging (but doing it anyway)

Well thank you to whoever reported me/my blog to the staff at this hospital. Not happy.

On Saturday night the registrar came to see me, and it was brought to my attention that they were concerned about what I post on the internet. I asked them to clarify for me what exactly it is I’m not supposed to be posting, as I have many accounts on social media and couldn’t be sure what they were referring to. I was told I’m not allowed to post about myself because “You’re under the Mental Health Act” and “We have a duty if care to protect your reputation.” I call bullshit. Protect my reputation? More like protect their reputation. It’s not like I even use my full name in association with this blog.

Sunday night nurses and security guards came into my room to search it again and that’s when I got angry and tried to take off. Unfortunately they caught up to me in the car park, I was again restrained, put in the seclusion room and sedated. Fun times. My hands are now all bruised from when I punched and hit the wall, and I was knocked out the whole of yesterday from the two shots of midazolam and 100mg of chlorpromazine I was given that night.

The consultant on my team is back from leave. Apparently I’m not meant to be blogging as my reports of being restrained and secluded can “give people the wrong impression of what happens here” and can perpetuate the stigma of mental health. “I don’t write anything that’s not true,” I shrugged.

A tentative discharge date has been planned for this Thursday, as well as a discharge meeting with my mum. The sooner I’m out of here, the better, I say.

Still not discharged

It’s been over 6 weeks and I’m still in hospital. My 22nd birthday came and went, the second birthday stuck in a psychiatric ward. The Form 6 of the Mental Health Act which allows for a patient to be held involuntarily for up to 28 days expired, and I was put on a Form 9. I thought 28 days was long, but a Form 9 allows someone to be kept for up to 6 months. Not that I’m going to be here that long, but it’s scary how much power psychiatrists hold.

I was told a few weeks ago by the psych registrar that I’d need to get to 38kg before discharge. When I next saw the consultant psychiatrist however, he said he doesn’t know why I was told 38kg, and that I have to be at a BMI of 16 (40kg) or close before going home. I asked both the registrar and the consultant whether I have to maintain that weight for a certain period of time before being discharged- both told me I wouldn’t.

Come Monday I hit 40.1kg. Okay, so it may have taken a bit of water loading, wearing shorts under my pants and having a deodorant and mobile phone in my pocket. However, both doctors have gone on leave and I’m stuck with two completely different doctors until my doctors come back. Apparently it’s not documented by my doctors that I don’t have to maintain, and the only documentation that IS on my notes is by the dietitian, who’s written I DO have to maintain for a week.

It all just went downhill from there. I was fed up that they keep changing the target and angry that they didn’t keep their word about being discharged once I hit that 40kg. It seemed as though even if I comply, I still don’t get to go home, so may as well not comply. I started refusing to have the Ensure Plus.

Tuesday night was an absolute low point. As I’d previously self harmed and had just come back from leave, two nurses came in to my bedroom because they wanted to search it. I was told to get off my bed and stand by the door, which I refused to do. Security was called and I ended up being restrained by three of them on the floor. When they let go of me and left my room, I lost it- I smashed my mug on the floor and started chucking stuff around my room. That’s when the security guards again entered, took me to the seclusion room and I was restrained while given an IM injection of midazolam. I was then left in there and they locked the door behind them.

Yesterday I absconded from the ward. I left at about 10:30am. I ended up being brought back by my parents as the police had contacted them. I wasn’t going to pick up the phone when my mum called, but after 6 missed calls I felt too guilty.

The weigh ins of the past two days I got found out about having stuff in my pocket. Unfortunately it means my weight has dropped- it was 39.2kg this morning.

I’ve repeatedly told everyone that I don’t want their help and I don’t want to recover from anorexia or stop self harming. I don’t see why they insist on keeping me here when I’ve made it clear I intend to lose weight all over again when I get home and I won’t attend outpatient appointments. A nurse has warned me they could put me on a Community Treatment Order. I replied that I don’t care, I still won’t come to appointments, and besides, I don’t think they would anyway.

So it looks like I’m here for yet another weekend. Well, at least I still have stuff to self harm with that the nurses haven’t found for now.

Forced ED treatment

In many ways, hospital admissions for depression are easier than hospital admissions for anorexia. With this admission it feels like there’s so many more rules and restrictions, and so much more to lose.

I’ve been getting my feeds through the nasogastric tube, as well as eating the majority of each of my meals so that I can get the NG tube out and ultimately leave hospital as soon as possible. With that, it feels as though I’m rapidly losing control. I’ve only very occasionally self harmed these past few months but over the past couple of days I’ve found those urges to cut returning. Of course, being in a psych ward I don’t have the means to do so and get increasingly desperate and distressed. I’ve tried to make do with punching the wall instead.

Over just the past two days I’ve gained 1.1kg. My stomach is so very bloated, and I look like I could be pregnant. On one hand that gets me out of here sooner. On the other hand, I’m disgusted at myself for eating. For gaining weight. For getting fatter and fatter, after months of hard work in losing that weight. I don’t want to see my body expanding before my eyes, feel the flab returning to my arms and legs, for my stomach to protrude, for my thigh gap to disappear.

The doctor said today that I could be here another three or four weeks. Tomorrow marks two weeks already that I’ve spent in hospital, the thought of another three or four weeks in here just feels horrible. I miss my freedom, and I miss having control over my life. Not to mention this screws up uni for me, yet again. Right now I want nothing more than to discharge myself from all mental health services so that I’m never ever forced into treatment and imprisoned against my will again. Unless they put me under a Community Treatment Order I don’t see what’s stopping me from just going home and losing this weight all over again.