Stalemate and resources

[Solar]

For the last 9 months I have been under both the eating disorder service for anorexia and the mental health team for Bipolar disorder. It has come out that they have been talking with each other and my GP and the have decided I am at a stalemate and that something needs to change. Now I don't know what that means for me?

*Sorry apparently this is going to be longer than I planned*

With regards to the eating disorder I will agree I have reached a stalemate. I am now weight restored (thanks to a increase appetite when on the Olanzapine which I am no longer on) but my relationship with food is worse than ever. I am either restricting or ( as learnt whilst on the Olanzapine) b/ping. I no longer feel like I can even attempt a meal plan as I am so uncomfortable with my body that gaining any more weight by eating normally is unthinkable. So I am stuck. But now I am scared they are going to discharge me as I can't see what else they are going to do.

My Psychiatrist want to see me to discuss changing all the resources I am currently using including the eating disorder team. Admittedly the only time I see anyone on the MH team is either for a med change/review or once a month I see my CPN. What other resources do the mental heath team have? I am about to try some new meds but thats it.
All my therapy is provided by the ED service ( psychologist, groups and dietician) and is as intensive as they can provide. I don't know how I will cope if they take that away?

What resources could the Psychiatrist put me on? Is it likely to just be further therapy or I don't know?

[talaiporia]

I guess it means they'll shake things up a bit. It might mean they focus on getting one of them under control, rather than both.

How is the bipolar right now -are you stable/ish? If so, it might be worth having focused help with the ED, and leaving the other stuff for now. Weight restored really doesn't mean a lot if your ED is worse than ever, because a) you may well lose the weight and b) it's ruining your life.

Do you know what triggered the ED or the ED behaviours?

[Solar]

My Bipolar isn't great I guess but it's not too bad. I have been on Quetiapine for the last 3 months and it hasn't really done anything but made my depressive episode flat with no variation. I am now coming of that to try Aripiprazole so I guess in a way that is being dealt with.

ED wise part of the problem is I don't know where it has come from, there is no specific event or accumulation of certain situations. It has developed slowly over about 10 years and it only got really bad last year. It makes it difficult because it means I am only tackling the eating side as I don't know how or what the underlying issue is. Realistically I should have gone inpatient for it 5 months back when I had the chance, I regret not doing that.

[talaiporia]

Could you go inpatient now?

[Solar]

No, they stupidly have a weight limit and I well exceed it now.

[talaiporia]

Okay, well it's worth talking to your doctor.
In any case, not all hospitals will have a weight limit (imagine Bulimia or BED).

[Solar]

The nearest ED hospital to me ( one county away) only accepts people under the weight limit or with dangerous bloods, I have neither.

I guess I am just scared of what they are going to do. It's taken me this long to feel comfortable with my current therapist and I really don't want to go through all that again. I just don't know what they are going to change and its freaking me out

[talaiporia]

Oh I see.

It might be there's other therapies they can offer.
Sorry, I don't know much about EDs, but the Eating Disorder Forum might be able to help you.

[Solar]

Thanks. It's the MH team that will be instigating the whole thing so its more that side of things that I don't understand. I suppose deep down I am worried that they are going to send me inpatient at a psych ward, claiming that it is to stabilise my depressive episode, but actually using it as a way of forcing me to deal with my ED.

[talaiporia]

Ohh, I see. Sorry.
Would inpatient be so bad?