Silver Hill Hospital

Has anyone with an eating disorder gone there this year or in 2016? The recently (sometime in 2015, but Idk when) opened a ED residential house and specifically mentioned sending some ED patients who needed “extra help” for motivation or weight gain to their inpatient acute care unit.

Do they ever use NG tubes or NJ tubes at Silver Hill Hospital?

I can’t find the answer anywhere!! I asked them online and they wouldn’t tell me; they said to call.

Deleting “Friends”

I just deleted over 100 Facebook friends. It started with girls from inpatient treatment. Some of them are getting married and having kids. I’m happy for them, but seeing their happiness also makes me feel alone, inadequate, and jealous. They were just as sick as I was once. Why are they happy, successful, and in love? Then I started deleting people from high school who I haven’t talked to in 7 years and from there, it spread.

Except now I feel more lonely. WTF? This reaction makes no sense! I’m annoyed at myself.  I wish I was either so sick I was in the hospital or well enough to be happy. This half in – half out existence sucks. I’m not good enough to be inpatient or good enough to be normal.

Inpatient

What are you looking at. never seen a hypocrite before_BBT.gif

One of my best friends is going to inpatient this week for her eating disorder. I’m sad for her. I also feel somewhat guilty because to be honest, I should’ve gone inpatient last week for my suicidal ideation. I’m glad the acute crisis seems to be over, but I feel guilty because I refused to go out of fear and she is afraid right now.

Hmm, I’m not entirely sure why that causes guilt. Maybe I feel guilty because I’m trying to talk her out of fear when I didn’t go to treatment because of fear. Therefore, I feel guilty because I am a hypocrite. In that case, I should feel guilty all day, every day because I tell kids to use coping skills instead of inappropriate behaviors and I don’t do that.

I wonder if that is part of my excessive irrational guilt. Perhaps it is so easy for me to feel guilty in any area because I have guilt constantly bubbling under the surface from work.

I know it is the right thing for her and I’m trying to help her feel better about it.

Acting and Trapped because I Care too Much

Is everyone always acting too?

Everybody lies_House.gif

I act happy most of the time. Both my mom and Ginny recently said if they didn’t know any better, they wouldn’t know I was depressed. Mark’s lies make me wonder if everyone is also always acting.

My co-workers and I  are dumbfounded, but we all went back to work and pretend nothing happened with Mark. We are all acting.

Recently, I acted as if I like the new BCBA, even though I am jealous and wary of her. In fact, today I asked her opinion.

If everyone is acting, then maybe no one is happy?

 

In other news: I wanted to cut when I saw Ashley mess up the behavior plan of the regressing student. I took specific notes on observations of her and others. I gave my notes to the new BCBA. Maybe I care TOO much.

For example, I thought she could teach empathy and coping skills in the morning, instead of reading joke books. She liked the idea, but said she was too busy teaching 3 classes. When (more like IF) Barb leaves and I take over Science and History, she wants to do that. I offered to research empathy training and impulse control games. Even though last night I didn’t want to do that. I’m not getting paid to do this. My boss doesn’t know. Before not getting the promotion and The Conversation, I would’ve done it without a second thought. However, now I don’t feel like going the extra mile for them because they don’t think I am good enough. My boss and Ginny always say I work hard and my ideas are good. Yet their actions belie that. Therefore, why try to prove them wrong? If they think I am sub-par, I will stop trying to be anything other than average. I will be as small and inept as they make me feel. I know that is wrong of me. 😦 I feel guilty and want to cut again after typing this. Regardless, I feel stuck. I told Ashley I’d give her games and class plans. I don’t want to be someone who offers help and then never follows through.

I think Prozac is helping. My psychiatrist almost hospitalized me again. “Do you think you can not listen to them (the suicidal thoughts)?” *sigh* I told him I’m still having suicidal thoughts multiple times a day, including while driving and that I’ve thought of causing accidents. Still no mention of the noose in my bedroom. The thoughts are still there, but the urges aren’t as strong.

The Medication Merry-Go-Round

I haven’t napped during the day since lowering my current anti-depressant. My mom seemed to think it made me tired, but I never noticed a correlation. I’ve been on it for 2.5 years. I guess she never said anything because it lifted the last suicidal depression and she figured napping 1 – 3 hours a day was better than suicidal ideation. However, if she was right, she could’ve mentioned it and suggested taking it at night. I think the blog helps me not nap. Usually I have something to vent about regarding my day and I do that as soon as I get home. By the time I’m done writing, it is less than an hour until my mom gets home. So it seems pointless to nap. Nonetheless, I’m done with my current medication tomorrow. Then I start Prozac. Unfortunately, that takes at least 2 – 3 weeks to kick in. So, I’m relying on my mood stabilizer and stimulant to pick up the slack.

I’ve been on the mood stabilizer since my last suicide attempt. No one before, or since, the inpatient psychiatrist agreed with his diagnosis of Bipolar Type 2, but it seems to help. I’ve been on my current stimulant since law school. In college I tried a different one and in middle school I was an a non-stimulant ADHD medication. However, after my first suicide attempt, they took me off of it because they blamed my suicide attempt on it.

Although I really want to try an MAOI because they are efficacious for atypical depression, my psychiatrist insists on trying Prozac again. He says, in some people, their brains adjust to the medication and it suddenly stops working. I think the stress from my eating disorder and especially not getting the promotion contributed to the depression relapse. I don’t think it was purely a medication issue. Part of atypical depression is that it is cognitively mediated. In other words, the thoughts in my head about external events contribute to my depression. In normal depression, people’s moods remain sad regardless of what is happening around them. I have mood reactivity,  I can feel happy  if good things occur. Malnutrition also causes depression. Therefore, I believe the eating disorder and work stress combined to cause the relapse. Last week, the Conversation caused me to spiral. I read some interesting articles about atypical depression. Part of how psychologists know it is a distinct illness from melancholic depression is that it responds differently to medication. It is less susceptible to SSRIs and SSNRIs. However, it is more susceptible to MAOIs. In my research, I found various studies that support a specific MAOI’s, Phenelzine, efficacy for Bulimia. Prozac is the only medication FDA approved to treat Bulimia, but I’ve been on Prozac a few times and it doesn’t seem to change my impulse control or bulimic symptoms. Therefore, I’m curious about Phenelzine for bulimia and depression. My psychiatrist is against MAOIs because they have potentially fatal interactions with certain foods. However, recently the FDA said those fears might be overstated. Plus, my uncle, a psychiatrist, says they now have skin patches, which are less likely to cause that problem.

I am somewhat hopeful about the Prozac, even though I’d rather try Phenelzine, Ketamine, or NSI-189 because I’ve been on all current classes of anti-depressants other than MAOIs. I remain somewhat hopeful because Prozac was the first anti-depressant I tried and I distinctly remembering catching myself whistling as I left gym class. Also, despite not remembering any effect on my Bulimia in the past, maybe it will help this time. In addition, my psychiatrist says Prozac is helpful increasing energy.

I was curious about Ketamine and NSI-189 have novel anti-depressant mechanisms of action. That is, they work differently than any FDA approved anti-depressant. They are both experimental. The first study I attempted to join was for NSI-189 and the second was for Ketamine. Wellbutrin is one FDA approved medication with a distinct mechanism of action. However, my psychiatrist will never approve it because it lowers the seizure threshold and I had seizures as a kid. Moreover, Bulimia can cause seizures. In fact, specifically bulimics on Wellbutrin had a higher incidence of seizures.

Other Studies of Phenelzine in Bulimia:

Treatment of bulimia with phenelzine. A double-blind, placebo-controlled study.

A double-blind placebo-controlled comparison of phenelzine and imipramine in the treatment of bulimia in atypical depressives.

A double-blind trial of phenelzine in bulimia.

Sadly, much of the MAOI research is old because they fell out of favor once SSRIs and SSNRIs came on the market.

 

Vacation

I’m leaving for a week long family vacation. It’ll be fun, but stressful because of the ED. I’m officially no longer weight restored (I weigh less than the weight I had to gain to during inpatient treatment at 17 years old), but I doubt that will last through the week because we have huge meals and candy and snacks everywhere.

See you in a week!

Art Therapy

I tried looking for my Affirmation Book (at the end of inpatient, everyone got a small journal where patients and staff wrote well wishes and encouragement) last night, instead I found a stash of art therapy pieces. In some ways, not much changed over the past 6 years. I still suck at art and I still feel the same way about myself.

This the battle for recovery symbolized by two stick figures playing tug-of-war. And look! I’m winning!

art therapy

This is the cyclone of emotions and thoughts that I used my eating disorder to silence.

MM art ed11MM art ed8MM art ed9MM art ed7

This represents my identity; without my eating disorder I am no one/nothing/nobody.

MM art ed10

This is the program for an impromptu talent show we put on. Surprisingly, they let a few of the girls do a short gymnastics routine and they did not supplement them for the lost calories. Usually, they were very strict about movement. If you were redirected more than twice about frequently shaking your leg, sitting up too straight, etc., they gave you 60 CCs Ensure.

MM art ed1

For the 4th of July we had an extra Nutrition Group, yay! The topic was managing recovery around the holidays. I also wrote some notes from my dietician. According to her, I disliked eating because it meant being around family. Oh, treatment teams and their propensity to blame others, especially family, for mental health problems!

Firefly_Saffron eye roll

Photo_00023

Since we weren’t allowed books, magazines, TV, radio, etc., the only things we were allowed to do when not in groups was make up silly things like the following words set to The Twelve Days of Christmas, color on Disney coloring pages the nurses printed for us, and make friendship bracelets.

MM art ed6 MM art ed4 MM art ed3

All the help I got for discharge meal planning! Haha, it didn’t matter because I went straight to PHP, but they didn’t know what my discharge plans were until the day before I left because some people thought I should stay longer.

MM art ed2

Um…I’m not sure what this is! I think it represents the confusion and chaos created by emotions.

emotions

Lol, I have no idea what the shriveled, psychedelic Eye of Sauron, afflicted with pink eye, floating on its side means!

eye

This looks like pure boredom, not an assignment. I see a green balloon that says “Happy Birthday” (I spent my 18th birthday in treatment). I also see an unhappy purple ghost (A Monster? That one purple gaseous Pokémon? Something else?)

bday

Who the hell is Stella?!?! In case you haven’t noticed, I’m not much of an artist! :p I doubt I drew this.

stella