The five weeks since we discovered Emily's relapse has been the proverbial roller coaster ride. Week one was a descent into the pain and anxiety that re-feeding brings on, coupled with regrouping with the ED Team. Week two saw some improvement in Emily, both physically and mentally as she became nourished again, but that was short lived due to the decision to take her off of the antidepressant. She had been taking a very low dose of Zoloft since October but her Team was beginning to suspect that she might have bipolar disorder, in which case that particular drug wouldn't be appropriate and might even have contributed to the relapse. She stopped taking the medication on Tuesday and by Saturday she couldn't eat, by Sunday she couldn't drink, by Monday she was in the hospital with a feeding tube.
While the process of diagnosing bipolar disorder was engaged she was started on Seroquel. For the next ten days, she got to experience, the angst of dealing with a feeding tube, re-feeding on hospital food with strangers, life on a psych ward, group therapy, triggering and being triggered by another patient with an ED, the joy of a good night's sleep, regular therapeutic sessions with her psychiatrist and increasing clarity over the high cost of AN. During this time we watched her transform as her, Seroquel induced, anxiety free personality emerged. It was utterly amazing to hear her say things like, 'I'm getting so behind on my school work, but I'm not going to worry about that right now'. But at the same time she was clearly torn by the prospect of leaving the safe, trigger free, cocoon of the ward, for her life that was waiting on the outside.
In the end, the desire to attend a school dance and an upcoming three day school trip, won her over and home she came. Re-feeding at home this time has been much easier, we are controlling her food choices and portions but she is doing lunch on her own at school. This week coming up, in preparation for her school trip, she will be making her own selections, dining out, and eating with others. This weekend, hubby and I are going away and Emily will be staying at home with a friend of mine who will help her with meals and keep her company.
We can see that she is working very hard at re-establishing her life but more importantly she is expressing a different mindset. She told us, in a Team meeting, that this is the first time she has felt like she really wants to get rid of the AN. Last fall when she came home from the hospital, she was planning to do what she was told to do until we stopped controlling her food or until she moved out and then she would revert back to the AN. Now she wants to get rid of the AN and get her life back. She wants to get to go to PEI this summer, learn how to drive, fall in love, go on the school trip. She went out by herself to meet up with friends three times last week, something she would never have done this time last month or last year.
She has also decided that she doesn't want us to refer to her eating disorder as 'Ed' anymore because it doesn't deserve a name, or a term of familiarity. So we are now referring to it as the AN, or the E.D. like we would if it were Alzheimer's Disease.
So the roller coaster ride continues. We had a great week but now with the stress of studying for exams, and perhaps spending a little too much time with friends, she is feeling more anxious and it appears that eating is more overwhelming. But she says she is trying to focus on the positives rather than the negatives and today feels better to her than yesterday did. It is clear to me that when her thinking is not fogged up by the anxiety she is able to shift her thinking to more positive and productive approaches.
It turns out that she doesn't have Bipolar Disorder but the Seroquel, seems to be working very well for her by reducing her anxiety and enabling her to sleep well. Although the idea of using a potent drug on a developing brain is scary, and this drug has the potential for significant side effects, the side effects of the AN are even scarier.
One final thought about the Seroquel side effects is that, without her anxiety to squash her ability communication negative emotions, Emily's adolescence with all of its raging glory is finally emerging. I say a big happy welcome to the sloppy, moody, can't decide what to wear teenager, who doesn't want to spend time with me any more unless I am taking her to get something she wants. What a sight her messy room is for my sore eyes.