4 March 2017

Recovery is like learning a new Language: It's never too early to start #EDAW2017

This year, Eating Disorders Awareness Week is focused on the importance of early intervention. As someone who has personal experience of delayed intervention, along with reading the stories of others, it is an issue I will always lend my voice to. 

As with many things in life, time can have a huge influence on the ability to change. I've used the analogy of learning a language before, when talking about recovery, yet I want to approach it from a new angle; specifically, why recovery grows harder with age and time.

When you are are knee-high to a grasshopper *cue mental image of Picket the Bowtruckle* your mind becomes is like a sponge; you are taking it all in, ready to learn and adopt new ways of speaking. At the start of recovery, I remember being a bit like a sponge, in that outlook. I am by no means saying recovery was easy - if it was I would be recovered! Nevertheless, I was far more ready to embrace the language of recovery, as I could still see my life before the illness.

There is a big difference between existing and living; an eating disorder steals the latter from you. Imagine that, for argument's sake, everyone in the UK is raised bilingually. In this baguette-filled Britain, the French language comes to symbolise the Joy de Vivre of life. Friendships, laughter, travel, love - the difference between an existence and life.

For a small number of people, however, they never continue their lessons beyond the pomme de la terre days. La vie is replaced by the vocabulary of an eating disorder, which erases the smallest joys from your speech. How many of you can recall the French from your Primary School days? My memories consist  of the odd bonjour, a side plate of je m'apelle and a whole sack of pomme de la terre. For some odd reason, I really loved that word. Yet if you don't speak a word of French for 6 years of your life, 22--old you is going to be one confused little spud on that next trip to France.

I do strongly believe that recovery is NEVER impossible; or rather, I have to believe this for my own (future) sanity. Nevertheless, the longer you live exist with an eating disorder, the more it becomes your 'normal'. The effort on your part, to remember the language of life, is that much greater.

So, on that note, what pomme de terres and recovery have in common, besides the joy of French Fries? Answer: they are alien; abnormal; unrecognisable to your ears, eyes, mind... and reality.  This is the encompassing reality of an eating disorder; recovery should be the most natural thing in the world, yet the illness brings a language entirely of its own. With dangerously effective methods of teaching, it replaces logic with a 24/7 lesson on lies and limitations.

Consequently, you reach fluency with terrifying speed. Through the mirror monster on the wall, everything is distorted in the blink of an eye. The illness becomes your native language, directing 1001 criticisms at Mr Spud and tossing the french fry into the fire. It is a dictionary of censure, rules and restrictions; moreover, the longer you spend with this language, the more foreign your mother tongue becomes. 
Looking back on my own experience, I was struggling with an eating disorder for over a year before treatment. My parents raised their concerns with my diabetes consultant at the time, who dismissed it and in turn silenced any inclination I had to speak up. Deep down, I wanted them to intervene, yet this didn't happen under my paediatric team; conversely, the consultant used my "excellent" HBA1C (underlying blood sugar) as evidence to counter the numerous 'red flags' of weight loss, blood test results, behaviours and - most importantly - my mental state. 

It was only after I moved to the young adults clinic and was reunited with my childhood diabetes nurse, that the eating disorder was diagnosed and the process of treatment began. My nurse immediately identified that something was wrong, yet also realised how entrenched the illness had become; not least of all due to the complexities of my diabetes, which I've dedicated a whole post too (because I do love a ramble, in case you hadn't noticed...!)

Nevertheless, my treatment was delayed further by the cliff edge of CAMHS/Adult services. I was referred to CAMHS 3 months before my 18th birthday, only to be told that it was "pointless" to begin psychological treatment" prior to my transfer - so, like Wayne Rooney at Manchester United, I wasn't getting a game with CAMHS. What's more, the psychologist helpfully wrote that I "didn't meet the criteria for bulimia because of x/ didn't meet the criteria for anorexia because of y". Let's just say that, by my 18th birthday, I did meet their "criteria" for the latter. 

Since then, my treatment has been bittersweet; my new diabetes team, especially my nurse, have been hugely supportive and helped me access both IP and OP treatment at STEPs. My diabetes nurse and the staff at STEPs have been like a translator; a vital means of communication between me and my loved ones. On the other hand, I've been ever so slightly vocal about my negative experience with Exeter services, which I've spoken about on here, Exeposé and Huffington Post. Those early incidences of delayed treatment have had a huge impact on my mental and physical health, and my case is not unique. 

It is why early intervention is so important. If this foreign language can be detected and early on, the chances of being heard are so much higher. An eating disorder exploits miscommunication. Sufferers are often scared of speaking out, for fear of being misunderstood; consequently, they become more entrenched in the eating disorder language. Yet if this is identified near the beginning, treatment can help to restore a positive mindset and recover healthy communication. 

Moreover, effective treatment needs to target the language itself, rather then the solitary words of meal plan and weight - the pomme de la terries of recovery. This is a mental illness. Yes, weight recovery is important; CBT treatment, for example, is ineffective before adequate nutrition and weight is restored. However, one pomme de la terre is not going to achieve fluency (despite what my primary school French teacher may have believed).

Mental Health services need early intervention and treatment. The argument of "it costs too much" is not addressing the future repercussions of early negligence. Emotional argument aside, the risk of SEED (severe and enduring eating disorder) cases is far greater, leading to more crisis interventions, more hospital admissions and the inability to hold down a job. Yet when we consider the fatal voice of this illness, the true cost cannot be measured

You cannot recover a life that has ceased to exist. You cannot give words to irreversible silence. This illness needs to be listened to from the beginning. A stich in time can save lives; the individuals with so much more to say and a right to recover their voice. 

There are not enough words to illustrate the value of this. The value of being heard. 


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