Newly diagnosed eating disorder. Maybe.

LegacyUser

I apologise for any incoherence. I'm trying to give as much background / context as possible.

I was diagnosed with borderline personality disorder a few years ago. I'm at my wits end in terms of treatment through the public service. If you're familiar with the disorder it's not that easy to treat. There are no proven medication that work. The "gold standard" treatment for BPD is dialectical behaviour therapy, but I don't live in the catchment area for treatment. Thankfully I did some research and found a private DBT program which I'm participating in currently, and I'm making huge progress.

As part of the disorder I engage(d) in a variety of self destructive behaviour: self harm, cutting, burning, abuse of substances, promiscuous behaviour, dangerous driving... I could continue. But given that these behaviours are firmly in my past thanks to therapy, I won't go into detail.

One behaviour does, however, randomly continue. That is the behaviour of binge eating, secret eating, earning food, exercising away calories, and on occasion, purging food. I'm drastically overweight - currently need to lose ~20 kg. I have already lost 43 kg though, so it's going in the right direction.

Anyway. I'm randomly discharged from my psych back to my GP when he thinks I'm under control, and my GP sends me back when she's out of her comfort zone. I'm sick, but not really sick enough to be under constant care of the psych team if that makes sense, and because I'm seeing my own therapist privately (due to a 6 month wait for assessment through the public system), I don't have much interaction with the mental health team. Only when I'm having a struggle.

One of those struggles started last summer. I became suicidal and I was having very distressing paranoid thoughts and actions. I was also experiencing auditory hallucinations and extreme depersonalisation. I tried the usual antipsychotic that works, but that increased the binge eating. I put on 7kg in ~3 weeks.

So my GP sent me up to the psych clinic and he essentially said that the psychotic episode needed medicating but due to my weight they needed to be careful with what I took. They prescribed me a new generation medication and that reduced the auditory hallucinations and paranoid thoughts, and I managed to lose the extra weight I had put on.

Things were going well. Had a bit of a stumble and a rough patch where I became suicidal again, this time I was fully ready to jump in front of a train only for a well timed intervention from someone I will be eternally thankful to. I spoke to my psych who said that given the stress I was under (a recent bereavement), it was expected that I'd hit a low and to go easy on myself.

Things improved again. And the thoughts / voices had all but disappeared. Psych sent me for bloods and an ECG to make sure they weren't having a detrimental effect on my heart / body. All okay.

I was feeling fine, so I stopped my meds. Had no return of symptoms either, which was great. At my last review I told him I had quit cold turkey and that I felt great, and that my GP was happy for me to be discharged back to her for day to day maintenance.

Here is the issue!

But he said he won't discharge me until I get my eating disorder under control. This was the first I'd ever heard of me having an eating disorder; I always assumed the issues with food were symptoms of the personality disorder. It was, is, a mindfcuk, because it was a whole new diagnosis. I asked what could be done or what I needed to do, and he said just to continue with my therapist and incorporate some work on the food issues.

I never knew I had an eating disorder, but it's not bad enough to warrant treatment from the psych team.

If I manage to continue with steady weight loss he will discharge me back to my GP at my next review.

But my weightloss currently is not healthy / sustainable. I vigorously exercise 6 days a week. Proper vigorous exercise.

But I binge eat on the 7th day. Totally undoing all of the good that the exercise has done midweek. I mean proper binge / 6000 calorie binges. I'm ashamed of the amount of money I spend on junk food on those days. This weekend was particularly bad - I was upset after my psych appointment so the binge lasted 3 days.

So I'm losing about 0.5 kg a week. Sustainable but not healthy.

Also, if I have a treat / cheat on a day that I exercise I feel the need to exercise more - take the longer route on the journey home from work, do extra circuits - to counteract the extra calories.

When I write it all down, I suppose it does seem I have certain issues with food, but to the extent of calling it an eating disorder???

I spoke to my therapist briefly about it, but I guess I may have omitted some of the details. I've actually never spoken about the extent of the issues I have with food with anyone.

I suppose next step would be to open up to someone who can help in terms of eliminating destructive eating patterns out of my life. But I'm embarrassed by it because I'm so overweight, so I find it difficult to discuss my weight with anyone.

Also, I'm making HUGE progress in so many other areas of my life - I don't want to be dragged back into the world of dealing with destructive behaviour.

Anyone any advice?

Taltos

Hi OP

Apologies but from your post above there is nothing this forum can safely add here.
Please raise your concerns or print off the above and bring it to your therapist & GP, you really do need to discuss all of the above with them and maybe they just need to see it as you've written it out above.

Asking for advice here we feel could result in well intentioned advice causing you more distress and that is something we just can't risk.

Sorry but thread closed.
Taltos