Jesska Denise is an Irish beauty, fashion and lifestyle blog

10.2.18

Anorexia is a mental illness


I have struggled with anorexia for longer than I would ever care to admit. But the last three and a half years have seen me fall further down the rabbit hole so to speak. I have been in therapy for three years and outpatient treatment just isn't helping. The last couple of months have been particularly taxing. From the outside you would be forgiven for assuming everything is fine. Because that's the thing with anorexia, once you look relatively good 'weight wise', people assume everything is fine. Even the professionals who should know better.

Physical consequences

My body is struggling to keep up with the lack of nutrients I give it and if you look behind the makeup and nice clothes it becomes obvious. My blood is fine and right now, my bmi is considered okay in comparison to other anorexics. Everything is not fine. Blood tests mean nothing. I am 25 years old, and in December I found out that as a result of my anorexia I have developed Osteoporosis in my spine and Osteopenia in my hips. Right now, I'm scared of falling or moving wrong or being hugged too tight because my risk of spinal fracture is high. Three weeks ago I received an injection called 'Prolia' to help preserve my bones and I will have to repeat this in 6 months. My pharmacist said she had never prescribed it to someone so young which shocked me, but not as much as being told I had osteoporosis did.
When my weight dropped dramatically I developed Amenorrhea and since my weight has increased, my period has become irregular.

I am constantly cold. Cold to the point that my Mum recently had to buy me another duvet to put on top of the one already on my bed. The electric blanket just wasn't cutting it anymore. I wear thermals to work and sit with my scarf on. The colder I get the harder it is to think about anything else and sometimes I turn a bluish grey. My body aches. Aches in a way that I could never truly describe, but it's like the cold is lingering in my bones. I prefer being at home. I can be wrapped in layers, in front of the fire with a hot water bottle and not feel uncomfortable/embarrassed about how cold I am. I'm even freezing at home, where my brothers give out about how warm it is. I'm not cold because it's cold, I'm cold because despite what my eating disorder tells me, I don't have enough fat on my body to actually keep me warm. My back and upper arms are covered in lanugo because my body is fighting to keep me warm. It's embarrassing.

I work, spend time with friends and family and walk my dog but I have no energy. My sleep is poor and sometimes I'm so tired I could actually cry. I get B12 shots to help keep my energy up and to feel semi alive. I'm even exhausted walking upstairs. My eyes have the darkest circles, no concealer is strong enough. My blood pressure drops when I stand up and if I sit for too long. My heart flutters and beats too fast and too slow. There's been many nights where I thought I was going to die because my chest felt tight and weak and my heart was beating wrong.

My skin, my hair, my nails? Brittle, dry, sore. Beautiful skin and hair doesn't happen without proper nutrition. The body rules them out. Not important. It's focused on keeping me alive. Putting what energy it does get into my organs and heart. My hair falls out. It's dry. No hair mask could ever replenish it. Two chunks of it snapped off a few months ago and I've come to hate how it looks ever since. I have painful acne like I've never had before, dry skin and dry lips that make me look ill. I'd rather not put make up on it, but make up makes me feel semi human and hides it for the most part. My legs are forever covered in bruises, the B12 injections have improved this massively. But theres always a few lurking away.

But my bloods are totally fine. B12 was low for a while but has come up thanks to the injections. My blood is tested regularly because anorexia destroys your body from inside out. I've had more EKGs than I can count and at my lowest weight I was prescribed ensure to keep my weight level.

Treatment

As I mentioned at the start of this post, I have been struggling a lot these last few months. Mentally, I'm exhausted. My anxiety increased to the point where I was left with no other option than to start medication to help me manage it. Eating has been a rollercoaster. I stick to a rigid number of safe foods that I'm okay eating and I get by. I hate eating in front of people who aren't my family. I hate, hate, hate eating in restaurants. Before Xmas we had a work party at a restaurant, and I actually thought I was going to vomit because I was so anxious and nervous and there was no nutritional info online and my head was spinning right up until I got home after. I couldn't focus on the conversation at the table and the whole time I hated myself for being there. It's the same with lunch time. I can't. It pains me to do it. Breakfast is a massive no. The whole day is one big assault course that I have to tackle my way through. Anorexia is constantly screaming in my ear. Screaming about food. Screaming about eating in front of others. Screaming about eating too much. Screaming about sitting all day. Screaming about drinking too much water. Screaming about exercise (I'm no longer allowed to run which is killing me). Screaming about everything. It's like a bully who never leaves you. I don't have a life, I exist. Work. Home. Work. Anything outside of this is dangerous because it's not part of my routine. I'm not trusted. If I bring lunch to work it's not believed that I've eaten it. I'm constantly asked 'what have you eaten today Jess'. It's like being on trial.

Just this week I found out that I would not receive funding from the HSE to cover a 12 week inpatient stay in St John of God hospital. Why? Because, ignoring all the above physical and mental complications I experience due to anorexia, I'm 'too healthy'. My 'bmi isnt low enough'. The HSE keeps that money for people who really need it. I'm too physically healthy to receive intensive treatment for a mental illness. My current mental state doesn't matter. My weight is relatively okay now(in comparison to other anorexics), it was below 40kg for a long time, and my blood is fine. I get to live like this everyday because the HSE doesn't want to pay money for a course of treatment that 'might not' change anything. If you're on your death bed, then yes, they will. And yes, there's an HSE ED service being rolled out, but it's being rolled out over the next four years and yes, there are public beds. But a handful. If like me, you're in that limbo of underweight but not underweight enough? Forget about it. Fend for yourself. They don't want to know.
When my weight fell below 40kg, my GP and Mum wanted me admitted to hospital. At the time I had booked a flight to Malta to see my cousin, I was scared, sad and since she's the closest thing I have ever had to a sister, I just wanted to be with her for a few days. My Mum didn't want me to go. She was afraid the flight would put my heart under pressure and I would die. When I came back I gave up and co-operated. I was sent to our local general hospital by my GP but despite being severely underweight, I was physically healthy. Nothing they could do. Inpatient treatment was mentioned but nothing was ever done. I fought hard to gain back weight. I'm still 10+kg away from my actual 'healthy' weight.

Outside of Dublin however, the treatment options for Eating Disorders are for the most part, non-existent. There are no dedicated dieticians, no day patient treatment, nothing. There's counselling, where you can go through 'cbt-e', which I have done and unfortunately found it didn't help. To me, me the part who is Jess, buried away in behind anorexia, I wanted this treatment. I thought it was going to help. To help me fight this. No one wants to be in hospital, but nothing else has helped.

When the physical trumps the mental

If I had any other mental illness, the severity of my illness wouldn't be measured by bloods and weight. So why is it deemed okay to do this for anorexia? Why must you hit rock bottom before they're willing to fund proper treatment. Funding that wouldn't be needed if they would just provide better services publicly. They say early intervention is the key to fully recovery, but how can that be achieved if specialist help isn't going to be provided until your 'bmi is considered low enough'. Anorexia has the highest mortality rate of any other mental illness and I live with it daily. I coast along. Maintaining a weight that's low for my height, and struggling mentally every day. Everything I eat is a struggle. You don't see the argument I'm having in my head with a voice that's just so loud and  one that has only become louder since I was told my 'bmi isnt low enough'.
I think something needs to be done to raise awareness about this lack of treatment and how what treatment you do receive is based on a) you can afford it and b) you're physically at risk. I'm very lucky to be receiving counselling, I know that. But counselling isn't cutting it. It helps. To have someone that isn't friends or family to talk to but it isn't getting me better.

I'm not the only person in Ireland who hasn't received funding or specialist help based on current weight and bloods. If you speak to anyone with anorexia, they will share a similar story to me and in recent weeks, many have done so. Anorexia is a mental illness and should be treated accordingly.

(I haven't edited this so if you find errors or anything that will be why. I haven't blogged in a year but I figured it was important to shed some light on this issue and I'm still very upset about it because now I don't know what will happen.)