22 November 2017

What Can I Do?

What is it going to take for things to change? How many more people are going to slip through the net and find themselves without the critical support they need? Please, someone tell me what more I can do to make people realise how lethal an eating disorder is!

We have all heard about mental health on the news and it is amazing to see the ripple of confidence throughout society as the topic is now being more openly discussed. Personally, I think it is an amazing change and something I am proud to be a part of, but is it making a difference? So many more people are being more open about mental health, yet I often wonder if they are being supported. Those that are suffering are being so brave to open up about their difficulties and taking so much courage to reach out for help, but what happens after that?

Speaking from experience, I can tell you that there is nothing more distressing than asking for help when a voice inside your head is screaming not to. The thoughts are relentless on a day-to-day basis, but I can remember that moment so vividly when I begged to go into a specialist eating disorder unit. I was sick of referral after referral, assessment after assessment, and getting no help whatsoever. I often wonder if those professionals know how it feels to be rejected, passed on or pushed aside. All that effort, emotion and exhaustion to ask for help, and what does it lead to? I never like to suggest that anybody gives up, but I would just like those healthcare professionals to think about what they would do in that situation.

Now more than ever, those that are struggling have to find their own support. Thankfully, now more than ever, there is a wealth of self-help resources out there! But have we all forgotten something? Can an eating disorder sufferer check their potassium, magnesium and phosphate levels using a CBT worksheet? Do eating disorder sufferers know that they may be at risk of refeeding syndrome if they follow a meal plan they have found on a blog somewhere? I am in no way saying that the resources out there are not useful- they absolutely are! But how can anybody absorb the psychological support when they cannot concentrate or focus on anything other than the constant circulation of negative thoughts taking over every second of their day. Medical intervention is crucial. Every sufferer should be monitored regularly and nothing should be left unnoticed. Even if an individual’s BMI is not alerted as being critical, there can still be imbalances on electrolyte levels and they need to be supervised through regular blood tests. It petrifies me to think of the state my body was in, but what scares me even more is to think of the devastating results that could have occurred had I not have had the level of physical monitoring that I did.

I know that I am always going to hear of situations similar to mine, and I know that I am always going to feel the same level of frustration and despair. But what I cannot deal with is the horrific stories that surface of individuals that have fallen victim to the carelessness or misunderstanding of health professionals. I am aware that I cannot help everybody, but I constantly think about what I can do to prevent people from suffering from this horrendous mental illness. 

What is it going to take?

8 October 2017

One Comment at a Time...

As written back in May 2016...

Being a woman, it is impossible to avoid conversations about food and body shape; they make an appearance in almost everything we talk about. What is being planned for tea, where we are having a meal out at the weekend, or a new flaw we have discovered on our body; it is inevitable that these topics form the basis of most discussions.

As somebody that has been very sensitive to these subjects in the past, I have established an increased awareness of the frequency that the topics occur in everyday life. If it is not communicated in people’s conversations, it is plastered across various media sources, and these are aspects of our life that we cannot escape. In the depths of my illness, I chose to isolate myself as a form of avoidance from having to hear or see anything that could cause me any further distress; but this proved to be impossible. It seems that restriction was the ultimate goal for all elements of my Anorexia, most prominently seen in my diet, but also in my social interactions. The fear of discussing food, diet, exercise or body shape was overwhelming, and the rapid changes in my mood swings could have seen an absurd response to any comment or question, regardless of whether or not it was directed towards me.

Throughout my ongoing recovery I have questioned what I was trying to achieve by avoiding the previously mentioned topics of conversation. Was it the fear of being caught out by other people about the lifestyle and choices that my Anorexia was prompting me to make? Or was it due to the difficulties I had in actually discussing food, particularly regarding the acknowledgment of enjoying a certain meal or snack. In each instance, I can see that the origin of my fears was the prospect of letting my Anorexia down. The anxiety and complex emotions that came with doing something that went against everything my eating disorder was telling me was just so incredibly overwhelming, that I did all I could to satisfy it. This is why recovery is so difficult.

Attempting to rebuild my social life, starting back at work full time, and discussing my mental illness have all thrown challenges at me regarding listening and talking about the previously delicate subjects of food and body shape. ‘I am so full, I don’t think I am going to eat tomorrow’, ‘I should not have eaten that chocolate bar, I am so fat’, ‘I am allowed this biscuit, I am going to the gym tonight’ are all examples of just a few of the comments I have heard. Now, for the people that have said these remarks, it may not have had any significance or meaning to them whatsoever. Chances are, the person that said they wouldn’t eat the following day undoubtedly did; the person that ate the chocolate bar was not fat; and the person that ate the biscuit probably didn’t go to the gym. But I now want to detail how these comments translated in my head. ‘I don’t feel full, does that make me greedy? If they aren’t eating tomorrow, then I definitely shouldn’t!’ ‘Well if they think they are fat for eating a chocolate bar then I am never going to eat one’, ‘So if I eat a biscuit then I must go to the gym. What about that cookie I ate last night, I didn’t go to the gym after that, should I go for an extra long walk tonight?’ These are just some of the thoughts that go through my head, even now at this stage of my recovery. I hope now you can see why avoidance of certain conversations was so vital in attempting to prevent my already weakening condition.

Strength, self-belief and rationalisation are key when trying to reduce the impact that certain comments can have on a sufferer’s mental state and behaviours. Avoidance and weakness, although difficult to challenge, are not helpful in the recovery process. I battle everyday with the conflicting thoughts in my head that ricochet after hearing a passing comment, but I have to learn to deal with it. I do not want to live my life being scared to engage in conversation for the fear that it may ignite the emotions, feelings and behaviours of my Anorexia. I must continue to cement the work I am completing with my dietician and psychologist into my mind, and silence the voice that still believes holds all of the power to rule my actions.  

1 October 2017

One Return at a Time...

So here I am- a second year nutrition and public health student at Sheffield Hallam University! I was going to write “I never thought I would be saying that!” but the truth is that I always knew I would. Obviously, I knew it would ultimately come down to my results from first year and that was an element that I had to leave to the judgment of the academic tutors; but there was no doubt in my own mind that I would be returning to complete this course. Throughout the long summer my motivation heightened, my aspirations developed and my confidence soared.

As I mentioned, the summer was long, but I think there is no denying that I tried to utilise my time effectively. A 4-week work experience placement with the Nutrition and Dietetic Department at the Royal Devon and Exeter NHS Foundation Trust was the first of the opportunities I planned. This experience was a challenge considering the last time I had been in a hospital setting was when I was being discharged from the eating disorder service, but it was an incredible opportunity that I never expected I would gain so much from. I was allowed to shadow dietitians from all departments, work on health promotion activities and develop information resources for various departments. I truly felt like a member of the team and that the work I was producing was genuinely appreciated! I developed so many skills, knowledge and respect for those that work within the NHS. I made the most of every chance I had to gain the most from the placement and I am so grateful for all of the guidance, support and time that the staff within the team dedicated to helping me succeed with this goal.

Two weeks later and it was time for Bali! I am not going to regurgitate my previous blog post, but my goodness this was a journey, both personally and professionally. I had the time of my life, yet now that I look back even then it fuelled a determination to return to university and get engaged with the introduction to public health module I have during second year. This is an element of university that I love, the ability to explore subjects that you may never have considered as being applicable to your desired career path. Similarly, it allows you to use your personal experiences to bring a deeper level of understanding to a topic that you cannot gain from a textbook or journal article. These are all aspects of university that people tend to overlook, and something I wish I had told myself before! This time last year I was petrified about the core scientific modules on the course and felt that this was going to set me right back, but in fact, what I lacked in scientific knowledge, I made up for in passion, motivation and a desire to succeed. This all links back to one of my previous triggers- a focus on academic success. Before my journey to recovery, I would have absolutely dismissed the opportunity to apply for this course for the fear that failure was inevitable due to my shortage of scientific qualifications, yet I took that step regardless of every thought that told me otherwise. After seeing the deprivation in rural Balinese communities, I have returned from my travels acknowledging that if the children in those populations can excel fighting against every social and economic barrier that they face, I can continue working on my self-awareness to excel fighting against every mental barrier that I face.

Welcome Week pretty much confirmed that my determination to make the most of my three years at university did not subside over the summer break. With stalls at the Societies Fair and Feel Good Fair and a range of Alternative Welcome Week events, we got straight to work with promoting Sheffield Hallam SU Student Minds- and raised £42 for Student Minds! It was tiring, but to see people engaging with all of the work we had done over the summer and making the effort to join in with our events was absolutely amazing. In my mind, there is nothing that I enjoy more than seeing individuals enjoying the resources and activities that we have worked on. We said right at the beginning stages of starting this society that if we can manage to just make one person happy, then we feel that we have done our job- and I think we have made a good start in achieving this goal. We still have a long way to go in reducing the stigma around mental health and encouraging people to develop skills to benefit their mental wellbeing on campus, but for now, the knowledge that so far we have 40 members that are passionate about doing this and helping others is more than I could have expected!

After a week of fairs, trampolining, ice skating and gaming, I was not expecting the wake up call I experienced this week with a very thorough introduction to what was to come in order to achieve my degree qualification. Essays, lectures, assignments, presentations, placements- you name it, I heard it at least 6 times. Undeniably, a wave of doubt swept across my mind about why I had returned to study for a second year, but I reflected back on those very same thoughts I had this time last year when I arrived at university. Every thought convinced me that I could not do this, but I proved to myself that I could, and I can. Yes the modules are different and this year ‘actually counts’, but I really want to be able to apply myself to the university experience like I did last year. I have acknowledged that I need to be more conscious of the roles that I get involved with, but it was those roles that made my first year the incredible year that it was! I also believe that it was those roles that aided me in my recovery and restricted any possibility of relapse, because they provided me with the confidence, social interaction and motivation I needed through those inevitable difficult days.

This year is going to be tough and I know that. There will be days when my negative thoughts will sense vulnerability, possibly achieving the impact it desires, and I know that. The course is probably going to expose me to more potential triggers and I know that. But I live in a house with four amazing girls, have an incredibly supportive network of friends, and have the strength, support and love from my family. I have no idea how this year will toy with my emotions and effect my behaviours, but I need to trust myself and my awareness of signs that things are going wrong. But don’t let me fool you that I am not in a positive frame of mind! I am ready to learn, enthused by the potential for Sheffield Hallam SU Student Minds and want to work on the personal and professional skills I developed last year. I am starting the way I am determined to go on!

20 August 2017

Bali, Bali, Bali...

How people go travelling for 3 months, 6 months or even a year and manage to find the strength to board that flight back home I have no idea. I was in Bali for just 1 month and yet getting out of the taxi at the airport seemed to require more motivation than hauling myself out of bed for my 6:00am yoga classes. However, as the one-week anniversary of my departure from that beautiful country approaches, I have decided to switch my negative mindset of the reality that I am not there anymore, to focusing on the incredible 4 weeks I was fortunate enough to experience.

2 flights, 2 films and 1 entire TV series later, I landed in Ngurah Rai International Airport. 45 minutes after everybody else had left the baggage reclaim area my suitcase crawled out onto the empty conveyor belt. After 19 hours of flying, the relief of knowing that I had made it to the other side of the world with everything that I intended to bring with me was, unsurprisingly, a relief. Making my way to the airport exit I eventually found the driver that would be taking me to my final destination, and there I met the first 3 of an amazing group of volunteers that I was going to have the pleasure of spending my 4 weeks with. It was from that moment that I realised that not only was I going to be learning about Balinese culture, but I was also going to have the opportunity to learn about cultures from all over the world!

An hour and a half drive led us to Penestanan Kaja, near Ubud, where I would be living for the next month. As I dragged my suitcase up the stairs to our volunteer house, I met some of the most special ladies that literally made my entire time in Bali the best that it could have been. From all over the world- Spain, Denmark, Ireland and, well, Barnsley; yet we all had something in common, the desire to travel and volunteer. Every day I would discover something new about their lives and every evening I would go to bed feeling inspired by their stories. As the weeks went on I met so many more incredible people from the USA, Scotland and Germany, similarly leaving the same impact on me following every conversation. It is those moments that reaffirm exactly why I travel- to meet likeminded and inspiring people I would never be lucky enough to meet in any other situation.

Anyway, let me move on before I start getting emotional!

So week 1 was aptly named a cultural induction week, with activities such as visiting the Sacred Monkey Forest, watching a Balinese dance and fire show, learning how to cook a traditional Balinese meal, producing a batik painting and visiting the Pura Tirta Empul Temple. The activities were great to learn more about the culture, but nothing compared to the experience of living amongst the community in Penestanan Kaja. Every time I walked through the village, the locals would say hello with a big smile on their face. Toddlers, teenagers, or elderly people, I never came across a single person that did not make me feel welcome in their village. It was fascinating to watch their daily rituals of leaving flower offerings to the Hindu Gods all around the house. One of our activities was to make a flower offering and having spent 30 minutes making one, I was shocked when I later found out that the women make 100 of them every single day!

Week 2- volunteering! Having spent the first week learning about the lifestyles of Balinese people, I was very keen to know more about the current state of the population’s health. As a healthcare promotion volunteer we were very fortunate to have the opportunity to speak to a local GP who gave a very detailed presentation about common issues within Balinese communities. Having used public toilets in both urban and rural areas around Ubud, I did not need to be told that personal hygiene was a significant issue. Also, having eaten a Balinese diet for a week already (more on this later!), it did not come as a surprise that deficiency diseases and malnutrition were a concern. Of course, it was fantastic to be armed with this knowledge, but trying to utilise it in order to educate a group of 10 year olds with a basic understanding of English was going to be a whole other challenge.

With my volunteer partners we started to plan the topics we wanted to focus on and different activities we could do in order to try and engage the children as much as possible. We decided to use the first day as an introduction lesson and to gauge an understanding of children’s English skills, from which we established that we needed to keep things as basic as possible. We taught topics such as physical activities, fruits and vegetables and hand washing, through the use of picture games, bingo and worksheets. It was fantastic to watch the children engage with the work but also to develop their skills so much within the space of just 4 days. It was overwhelming to see their gratitude for volunteer participation, but also for things that we may just take for granted here in England. On my final day, one of my fellow volunteer partners and I decided to buy the children plastic folders so that they could keep their worksheets safe. I can honestly say that it was the most worthwhile 47,000 rupiah (£2.73) that I spent during my time in Bali. The delight on their faces was an absolute joy to watch- even more so when we awarded smiley face stickers for a game of bingo, which they all used to decorate their folders! Even though I only spent 5 days at the school, it was an incredibly enriching experience. I will treasure those incredible memories for the rest of my life, from the yoga session lead by a lovely young girl, to the leaving party the children surprised me with on my last day!

For my second weekend in Bali, I decided to go away to the beaches in Sanur. Although the weather was not great, it was exactly what I needed- an opportunity to explore, relax and reflect. I walked along the extensive beachfront path admiring the beautiful sea views and café-hopping, enjoying delicious Indonesian dishes. Naturally, as I was alone that weekend, I had a lot of time to think. It was not by coincidence that I decided to fly out to Bali on the 16th July, it was because that was the 2 year anniversary of my hospital admission, and as I sat sipping a glass of orange juice reading my book in Sanur, I was suddenly aware of how different my life is now compared to 2 years ago. At first, the realisation did not quite sink in, but shortly after the memories started flooding back and so did a few tears. I looked up from my book to see the white sand and clear blue sea. What I was viewing right at that moment was what I had been looking at on a computer screen as motivation to recovery whilst sat in my room at the specialist eating disorder unit. Now I was not only looking at it but I could hear it, I could touch it; I had made it.

After a weekend of relaxation it was time for my adventure week! Following the development of a new-found confidence from my uncharacteristic antics last year in Europe (e.g. paragliding!), I was more than ready for some activities that I was only ever going to be able to experience in this amazing location. I was not disappointed with the itinerary of a cycling tour around Kintamani, a visit to a turtle sanctuary, whitewater-rafting down the Ayung River and a sunrise hike up Mount Batur. Similarly with everything that I have come to understand about being a solo traveller, the enjoyment of most experiences is heavily reliant on the people you get to share those experiences with. Fortunately, during this adventure week I once again had the pleasure of meeting some very inspiring ladies, who all had the same determination to get the most out of the activities. Particularly with the sunrise volcano hike, that enthusiasm was exactly what I needed. A little lesson was learnt that day- do not try to embark on a 2 hour trek at 4:00am up an active volcano wearing 5 year old Converse trainers in the pitch black with a dim torch when you have not had any sleep. Nonetheless, although the sunrise views were incredibly well masked by a thick layer of clouds, I was just immensely proud of myself for making it to the top of the volcano!

When I booked my trip to Bali, I was adamant that I was not going to leave without visiting one of the Gili Islands. After some investigation into the atmosphere on each of the 3 islands, my friend and I decided that we would head for the relaxing ambience of Gili Air. Little did we know how much we would cherish that relaxing ambience after the tiring ordeal we had to go through to get there! Without going into all of the lengthy details, we set off at 7:00am and arrived at our accommodation on Gili Air at 9:00pm (we should have arrived at 11:30am!) Basically, we had a 2 hour bus drive to the harbour, followed by a 6 hour ferry ride to a harbour on the west coast of Lombok, which meant another 2 hour ‘bus’ (tin can) ride to a different harbour and finally a 25 minute boat ride to our final destination. Throughout that time we had about 4 hours of waiting between each transport method, as well as being scammed out of a further 300,000 rupiah by locals in Lombok demanding money for transport services we had already paid for. It was an intimidating, tiring and frustrating experience but waking up the following morning to a beautiful sunrise made it all worthwhile. When I look at photographs of the most idyllic beaches, I sometimes question whether sand can be that white and the water can be that clear, but the beaches in Gili Air were exactly like that! Beautiful views teamed with the peace of having no vehicles allowed on the island, the weekend was every bit as relaxing as we had hoped for. Well, I say that, but as an onlooker, watching one girl that is petrified of the sea and another girl that is petrified of fish trying to snorkel may not have quite been the depiction of tranquility! Nevertheless, sitting on beanbags on the beach, eating a delicious meal and watching the most spectacular sunset was enough to bring us straight back into the relaxed mindset we set out to achieve.

With the relentless noise from the 65 roosters residing opposite our house, it was not as difficult as I would have initially anticipated waking up at 5:20am for the first of my yoga classes for my yoga week. As I made my way to the yoga house in the pitch black whilst half asleep, I was already praying for a relaxation session at the end where I could regain those much-needed lost minutes of sleep! As the exercises commenced, I looked out across the rice paddies and watched as the transition from a heavy black sky to a beautiful display of pastel blues and pinks began to take place. With my mind initially preoccupied with frustration and self-criticism about my tiredness, lack of flexibility and inability to do the hardest variations of exercises, it was like watching the darkness of my thoughts fade away to reveal the beauty of a new day. With a free day between the morning and evening yoga class, I decided to spend this time relaxing either by the pool or by reading my book in a local café. This is the beauty of travelling alone- you fill your days with anything you desire! In fact, it was during this final week in Bali that I found some of the most interesting and inspiring people; one man that had literally done the Eat, Pray, Love journey, a couple that had started a charity helping vulnerable women in New Zealand and a group of lovely ladies who I had the most mind-clearing conversations with. Through sharing our stories, you begin to appreciate how no two lives are the same and everybody experiences challenges, but the main focus is how you deal with them. Not only does it show you the realities of life, it also shows you that what may seem impossible is more than achievable.

So that’s my Balinese journey in a nutshell- a wealth of adventures, inspiration and memories. But I know that some of you reading this will be wondering about how I actually dealt with certain situations whilst I was away, and as always, I am going to be completely honest about those moments when anorexia tried to grasp onto those tantalizing strings of vulnerability. When I consider those strings, I think it would be fair to say that as soon as I boarded that plane, all of those were within reach, and I think it would be even more fair to say that anorexia had a little go at tugging each one of them.

There was one thing that I was so incredibly grateful that I had spent so much time working on during my recovery- food rules. I hinted earlier about the Balinese diet, well, lets just say that I was extremely pleased that I have managed to minimise my fear of carbohydrates- refined carbohydrates in particular. Basically, to put it bluntly, my diet for 4 weeks consisted of toast for breakfast, rice for dinner and noodles for tea. Considering that 2 years ago it was taking hours of therapy for me to accept putting a piece of bread in my mouth, let alone the vast array of obscure behaviours I adopted before it even made its way to my lips; I am sure you will now get an appreciation for how thankful I was of all of the support I received during hospital to abolish those fears and behaviours. To say that my time in Indonesia would have been a catastrophic situation is an absolute understatement. However, I think it is important for me to acknowledge that although I ate the food, most onlookers would not be aware of the tiring tug of war battle going on in my head. Serving size, how it had been prepared, greed, impact on body size and lack of control; they all had a go at trying to make me retract myself from the enjoyable situation I was engaging with. However, I was proud of the resilience I have developed to prevent this from happening, albeit an exhausting fight.

Undoubtedly, whilst I was away I embodied the holiday frame of mind. Every day I enjoyed a sweet treat or 2 from one of the local cafes. It became something that I would look forward to at the end of the day, and although guilt rushed through me from all angles- more so from a financial perspective- the strength in my own voice broke through the negativity raging on in the background of my mind. We were fortunate enough to be living in a village with some great cafes, and when you pick up a huge brownie with vanilla ice cream and chocolate fudge sauce for £2.20, there is no surprise that I had about 4 of these during my first week! For me, it was all about remembering that life is for living and if I wanted something chocolaty then I was not going to deny myself that. I was literally having the time of my life with the most amazing company and my issues with food, financial guilt and body image needed to take a backseat to make these wonderful memories.

As with every challenge I face, I try to remember that although the issues are niggling away, the fact that I am where I am right now and not in the situation I found myself in 2 years ago is, in my mind, a miracle. When I think back to who I was- and I mean that literally, I was not even me- I cannot believe how different my life is now. Sometimes all I need to do is revisit some of my first blog posts that touch on my destructive behaviours to realise how far I have come. I still wake up every morning and thank everybody that has helped me along the way to reach this point where I am at now, who knows where I would have been if it hadn’t have been for them.

I guess the only concluding remark I can leave now is, where to next?