Saturday, March 17, 2012

My Visit to the Psychiatrist

Some of you may remember that at my last physical my doctor suggested I get back into therapy and see a psychiatrist.  I am back in therapy, making progress, and this past Monday I finally met with a psychiatrist.

I've been both eager and anxious about going.  I was eager to feel better and had hopes that she could help me.  And I was very anxious about the medicinal roller coaster of trying new meds until we find something that works or give up in failure.  But I trust my doctor and had a good recommendation for this psychiatrist.  So, off I went.

It was kind of like going to therapy with a doctor.  Lots of psychological and medical questions.  She took an extensive history and asked follow up questions about my life and behaviors.  The history part took about forty-five minutes.  I'm telling you, she asked questions I've never been asked.  And considering my therapeutic and medical history, that's saying something.  Some of these questions sparked thoughts I hadn't had before.  They changed my perception.

She asked about my sleeping habits.  I don't sleep well.  I haven't for years.  I gave a description of my typical bedtime, rising, and nap habits.  She asked me to quantify it.  In a twenty-four hour period, how many hours do you sleep?  I'd never quantified it before.  I knew my habits were bad.  I knew I should be getting more sleep.  But until she had me add it up I had no idea that I was sleeping only 4-6 hours on a regular basis, including naps.

She asked about my eating habits.  Ugh!  I hate this topic.  I described my general aversion to food and my typical eating patterns.  I knew I didn't eat well.  I had no idea how bad until she asked me to quantify it.  Do you eat enough to sustain life?  Calorically, probably.  Nutritionally, not even close.

Having someone ask that and having to admit how badly I was failing was eye opening.  But not as much as her next statement.  Earlier in the interview, we'd discussed my history with self-harm.  I'd explained that I hadn't purposely hurt myself for over a year, except for once after a particularly difficult therapy session.

She said that sleep deprivation and starvation are forms of self-injury (common with a history like mine).

Now, I don't know if that hit you hard, but it hit me hard.  I had never thought of those behaviors as self-harm.  But after considering it for a few moments I realized that she was absolutely right.  It didn't mean I was converted and ready to change in that instant, but it made an impact.

She also said that sleeping during the day is a self-soothing strategy.  An unhealthy one.

Again, not something I'd thought of.  (After thinking of that and the other bomb shell I spent a lot of time over the next few days wondering why I am self-injuring and self-soothing my way through my life.  I guess I still have lots of work to do.)

She said she wouldn't think of trying meds until I start sleeping.  So many of my symptoms could be sleep related.  Also, she'd like to build on success rather than failure.  In other words, let's try something we know will help instead of working our way through things that might not.  Once we fix the sleep problems we can see if we still have things to work on.

Of course, she doesn't simply want to work on the sleep problem.  That's just the beginning.  Basically, my life is in complete overhaul.  She wants me to change several of my behavior patterns.  She was very direct and specific.  She said I am well on my way to an eating disorder (something I'd actually considered before).  And then she gave me the following goals.

*  I am to eat three meals and three snacks a day, on schedule.
*  I am to sleep 7-8 hours a night, going to bed and getting up at the same time each day -- zero naps!  (Melatonin is allowed)
*  I am to drink 96 oz. of water a day.
*  I am to walk at least 20 minutes a day 4-5 times a week.
*  No soda after 3:00pm, as the carbonation interferes with sleep.

Having her spell it out so definitively is helpful.  No thinking on my part, just follow through.  She set standards.  It's my job to do my best to meet them.  It was also helpful when she told me that changing patterns like this can take 3-6 weeks.  You see, I've done it for a month at a time before and seen no change.  It helped to have a time frame.

I agreed to do my best.  I will go back and see her in two months.  She also ordered a sleep study; I meet with that doctor next week.

She works in the same office as my therapist.  I saw him a couple of days later.  I am not exaggerating to say that he was tickled pink with how well it went and that I was taking it seriously.  He said only about 30% of patients follow through with a plan like this.  They both also agreed that whether these changes take away all my symptoms or not, they will help my therapy to be more successful.  I know that's true.  Therapy always goes better when I feel better, especially when I have the energy needed to maintain boundaries.

I expected sleep to be the toughest one.  It's not.  Not by a long shot. 

Walking is tough because I have a bit of a social phobia thing happening right now.  The idea of going out and walking through my neighborhood makes me anxious.  It doesn't mean I won't do it, but it's tough.

The water has been relatively easy.  A lemon Propel Zero packet in my water bottle and I'm good to go.  It's also cut way down on my Diet Coke consumption.  I am making a lot of trips to the bathroom, but that is supposed to level out over time.

The biggest difficulty for me has been food.  I really had no idea it could possibly be so hard to eat.  I eat every two and a half hours now.  Meal, snack, meal, snack, meal, snack.  I have to set an alarm on my phone to keep myself on schedule.  I try to make healthy choices, but I'm not working super hard on balance throughout the day yet.  Right now the goal is to teach myself to be hungry and respond to it.

I did okay for the first few days.  I ate on schedule.  I made healthy choices.  But it got harder yesterday.

It was time to eat lunch.  I went to the kitchen and tried to find something that looked good.  Nothing.  So then I looked for something that would meet the basic needs of a meal.  I ended up choosing a peanut butter on wheat sandwich and yogurt.  As I took my first bite I started crying.  I desperately didn't want to eat this food.  It didn't taste bad, I just didn't want to eat it.  I forced my way through.  It was hard just to open my mouth and put the food in.  I sometimes gagged as I swallowed.  And I cried the whole time, but I did it.  Then I was super nauseous afterward.  For several hours.

The high and determination I felt those first few days seems to be gone.  Now it's just a chore.  It's so hard to find food that I like.  It always has been.  I prefer somewhat bland food with few ingredients.  Today, as I make up the grocery list, I find myself struggling to think of things to put on it that I will eat.

It sucks.  It seems like I spend my whole day thinking about food.  What am I going to eat next?  With all these changes I'm working on, I'm struggling to even think about anything else.  I'm not taking on anything new or making any other plans for a while.  I just don't have the time and mental energy to do one more thing.

But I am doing my best.  I have always been one to do my homework.  I just hope it's worth it.

**********
To see how it was all going a year later read this.

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21 Comments:

Blogger Bonnie Atkinson said...

I can so sympathize with holding your own feet to the fire. Keep at it. I 100% concur with your doctor's thoughts on food and sleep. So much of us is chemistry and those are the two biggest contributors to our body's ability to work the chemistry. Hang in there with the changes. It is so stinking hard to change.

March 17, 2012 at 3:49 PM  
Blogger K and D Roylance said...

One step at a time. One bite at a time. Sending positive vibes your way.

March 17, 2012 at 4:05 PM  
Blogger From Tracie said...

"She said that sleep deprivation and starvation are forms of self-injury"

"Sleeping during the day is a self-soothing strategy. An unhealthy one."

Wow. Those two sentences hit me really really hard. I'm having a lightbulb moment right now looking at them, and realizing how much they apply to my life. Ouch.

I'm proud of you for sticking with the new schedule. One day, one meal, one snack, at a time. You can do this!!

March 17, 2012 at 5:22 PM  
Blogger Bonnie Atkinson said...

I was reading through my journal and found this. It's inelegant, but it hung in my kitchen for years and got me through some serious things. I offer it to you, with a guarantee of encouragement and support.

Don’t Quit

When things go wrong, as they sometimes will,
When the road you’re trudging seems all uphill,
When funds are low and the debts are high,
And you want to smile but you have to sigh,
When care is pressing you down a bit,
Rest if you must, but don’t you quit.

Life is queer with its twists and turns,
As every one of us sometimes learns,
And many a failure turns about,
When he might have won if he’d stuck it out.
Don’t give up, though the pace seems slow -
You may succeed with another blow.

Often the goal is nearer than
It seems to a faint and faltering man;
Often the struggler has given up
When he might have captured the victor’s cup,
And he learned too late, when the night slipped down,
How close he was to the golden crown.

Success is failure turned inside out -
The silver tint of the clouds of doubt,
And you never can tell how close you are -
It may be near when it seems afar;
So stick to the fight when you’re hardest hit -
It’s when things seem worst that you mustn’t quit.

Author Unknown

March 17, 2012 at 8:33 PM  
Blogger Rubye Jack said...

She said that sleep deprivation and starvation are forms of self-injury -- this hit me really hard also. Only, I overeat rather than starve myself. And the part about walking, I do the same thing in that I look out the window and am simply scared to go out there because I don't want to see people. I usually drive to a park to take a walk so I won't know anyone. What a great doctor you have here!

Oh, I'm also so glad to hear that she didn't want to put you on meds right off the bad.

March 18, 2012 at 10:55 AM  
Blogger order_of_the_mark said...

You should really try some of those protein/nutrition/enough calorie shake/drink thingys. Like "Ensure." Sometimes it is easier to drink than bite and chew?

Good luck, girl. It sounds like a good plan! I'm pulling for you! And if you walk by, I promise to close my eyes and not see you. :)

March 18, 2012 at 1:25 PM  
Blogger MaggieJo said...

Prayers and closed eyes here. Best of luck Robin. Keep at it. The Atonement is powerful and works in wonderful ways.

March 18, 2012 at 10:12 PM  
Blogger Christa aka The BabbyMama said...

You're strong, I know you can do it! And I bet it will get easier for you as time passes.

Just out of curiosity, have you tried exercise beyond walking - like aerobics (which you could do at home). I find that everything in life - eating, sleeping, social things - are better when I get exercise. And sometimes terrible when I don't.

March 19, 2012 at 8:29 AM  
Blogger Anne said...

Writing about yourself the way you do is is half the job done. I admire your strength and determination. Keep at it. There's no other way to go but up.

March 21, 2012 at 12:30 AM  
Anonymous Positively Alene said...

So thankful you stopped by for my SITS Day yesterday. Oh my - your post really makes me think. Change is hard. Then when we get focused to change it seems that consumes our minds. But you are doing it right girl - add nothing new to your agenda and spend this time focusing on you. It really is OK to do that when it's needed. Blessings!

March 22, 2012 at 3:00 PM  
Anonymous Libby said...

You may not be able to see this but you are such an inspiration Robin. I read this post just after you wrote it and I've been thinking of you everyday since. Sending you thoughts and prayers. I can't help but feel you are going to be fine. I'm sure it must be hard for you but you must see how brave you are. Sending warm Aussie smiles your way.

March 24, 2012 at 2:26 AM  
Anonymous Barb - The Empty Nest Mom said...

You're helping all of us by posting this. It's so personal and so honest and so enlightening, really, to read the advice you've been given. In varied arenas - it's something we can all learn from. I'm sending you positive encouragement and a reminder of how it felt at first. Stay with that. Soon those things will be habit and yes - it's great to work through it and make those changes yourself - rather than with meds.

March 24, 2012 at 9:06 AM  
Blogger Day said...

Robin, I love you and I'm so proud of you for your courage, you honesty, and your commitment the difficult, difficult task of learning to care for yourself. I'm also very grateful for your willingness to share this.

Your description of forcing yourself to eat really hit home--I had a moment like that at a time in my life when I was well on my way to an eating disorder, and it seems like something very few people understand. Something about the combination of physical discomfort and being forced to realize, for true, what you've actually been doing to yourself. . . It's so hard, and so important.

I still struggle with caring for myself in basic ways. What do I do when I can't self-sooth? How do I replace that with some healthier, more healing way to deal with my pain? So often, the only way out is through. Thank you for sharing your struggle, and hang in there!

March 25, 2012 at 10:19 AM  
Blogger Blond Duck said...

I'm sure you'll feel much better soon!

March 27, 2012 at 5:42 AM  
Blogger Lisa said...

I'm way behind again... On reading. Im proud of you! You've got this. And even if you don't today, theres always tomorrow. :)

April 1, 2012 at 3:46 PM  
Blogger Lisa said...

I don't know if my previous comment showed up or not.... But good job! You've got this. And like I said in the previous comment that may or may not be there, if you don't have it today, there is always tomorrow. :)

April 1, 2012 at 3:48 PM  
Anonymous Anonymous said...

I have the same problem...I've been this way all my life, I feel so weird.
I have no idea why but I just dont like most food, i feel hungry yes, but I see the food and I just dont like it.

I feel weird and sad being this way, i want to change.
I really admire you...what you're doing, I hope to have the willpower to change.

thanks for sharing this.
hope you make it
and hopefully I will too!

September 12, 2012 at 11:24 PM  
Anonymous Anonymous said...

Hi, thanks for writing about your struggles with food because I didn't know what was wrong with me. I think I have the same problem as you, I have a unhealthy relatinship with sleep and food. People constantly assume I am anorexic or bulimic because I am so underweight. However I know I'm nt because I WANT to gain weight, and look normal. However I cant. I don't like food. I thought it was just meat, so I became a vegetarian, and due to that, I developed serious health complications. I forget to eat if I'm not with other people who eat. I don't notice until I pass out or get a really bad headache. I eat because I need to, and I have to force myself. I gag often not because the food tastes gross, I just don't like it. Thank you so much for posted about this, I think I may look into seeing someone. Although I don't know why I would be subconciously self-harming myself. I am definately going to try to organize my eating habits like you did. Thank you, Thank you, Thank you. I thought I was the only one out there.

January 14, 2013 at 7:30 PM  
Anonymous Terri said...

Hi Robin,

I was searching through blogs trying to find some answers to my troubled step daughter who just turned 14 today. When I read your posts, ESP the one about your relationship with food and your trip to the psychiatrist. I began to cry. It really hit home HARD! I think she struggles with the same things you do, self harm, etc. I have always been so troubled by her obvious aversion to food, ESP since I myself suffered from eating disorders in my teens. When you write, I feel like I am getting inside her head, although she has never expressed herself in the way you have. I just instinctively know its the same for her. I never considered not eating a form of self harm. Just the other day, she was in her room all day while dong schoolwork, and when I asked her if she wants breakfast, then lunch hours later, she says, " I am not eating anything until I'm done". We went out for dinner and that is all she ate the whole day. It disturbs me so much to think of her self harming herself, starving herself. She too is a bad sleeper, wakes up frequently all night and is exhausted all day. Has also had a bout of hair pulling. She has been to therapy but not continuously, as I suspect she needs.

Could you possibly respond to me? I know this is a old blog and I'm not sure if you are still checking it.

Thank you, good luck in your journey too! Reading your blog is very enlightening!

T

March 14, 2016 at 5:51 PM  
Anonymous Terri said...

Hi Robin,

I was searching through blogs trying to find some answers to my troubled step daughter who just turned 14 today. When I read your posts, ESP the one about your relationship with food and your trip to the psychiatrist. I began to cry. It really hit home HARD! I think she struggles with the same things you do, self harm, etc. I have always been so troubled by her obvious aversion to food, ESP since I myself suffered from eating disorders in my teens. When you write, I feel like I am getting inside her head, although she has never expressed herself in the way you have. I just instinctively know its the same for her. I never considered not eating a form of self harm. Just the other day, she was in her room all day while dong schoolwork, and when I asked her if she wants breakfast, then lunch hours later, she says, " I am not eating anything until I'm done". We went out for dinner and that is all she ate the whole day. It disturbs me so much to think of her self harming herself, starving herself. She too is a bad sleeper, wakes up frequently all night and is exhausted all day. Has also had a bout of hair pulling. She has been to therapy but not continuously, as I suspect she needs.

Could you possibly respond to me? I know this is a old blog and I'm not sure if you are still checking it.

Thank you, good luck in your journey too! Reading your blog is very enlightening!

T

March 14, 2016 at 5:53 PM  
Blogger misssrobin said...

@Terri - I would happily email with you, but your email address isn't connected to your comment name, so I have no way to contact you. Please feel free to email me at misssrobin@yahoo.com (that has three esses).

Robin

March 14, 2016 at 9:08 PM  

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