Atypical Anorexia - Fear of dying

[AyAna_Apple]

My name is Apple. I am 17 years old. Recently I have been diagnosed with Atypical Anorexia, and I am taking part in The Emily Program.

When I had the intake, I thought I would be fine. That maybe I would be diagnosed with OSFED (or EDNOS) at most, or they would say I just have some disordered eating that hadn’t developed into a full-blown eating disorder.

At the end he told me “I’m just going to be straight up. After talking with you, I know you have an eating disorder.” And then eventually he told me he was diagnosing me with Atypical Anorexia. This already was a shock. I was so surprised, as I believe I am fine. Which I know stems from the fact that I’m not underweight so I thought I was fine, as well as simply being in some denial. Then we got into talking about treatment plans. He told me he wanted to start me off with partial hospitalization (where I am there Monday - Friday 7 hours a day), and then eventually I can move to intensive outpatient (Monday - Thursday for 3 or 4 hours I believe). I didn’t understand why he was that concerned.

Basically his reasons were:
- rapid weight loss through restriction (35 pounds within 3-4 months)
- I am showing symptoms (feeling cold all the time, stomach pain, I had a kidney infection over winter break, almost passing out more than once a day, feeling “out of it”/dissociated, lack of sleep, etc.)
- My calorie intake is about 1/3 of the average calorie intake
- Frequent obsessions over calories, body checking, food labels, and loss of focus due to thinking about food/what I ate/my body, etc.

Up until this morning (02/22/18), I was in shock and constant panic because I couldn’t understand. The panic was because while I am going to be there, I HAVE to eat 2 meals and a snack a day. I can barely stand eating ONE FULL MEAL a day. Often I’d prefer to not eat at all.

And he told me “yeah. Keep doing this and you’ll lose a lot of weight fast. But you’re going to end up dying.”


But this morning changed things. I woke up feeling awful. Not just the average feeling of being sick, but I felt like I was shutting down. I was very cold in my room that was at 72 degrees, my head felt really fuzzy, my heart was beating kinda weird. So I went to bed. Things only got worse. I had a terrible nightmare. In this nightmare, I was in the hospital dying. I told my family I would always love them. And then my heart rate increased, chest was pounding, and the last thing that happened before I woke up was I heard a flat line and everything was going blank and I felt... light. When I woke up I was scared because for a few seconds my heart was pounding just as hard and fast as in the dream.

I went to school, tried eating lunch (on a meal plan). I only managed to get 9 small bites of soup in. I kept panicking because people kept coming around me even though my school counselor set me in a room alone. I didn’t feel as sick at this time, but I still had that feeling that something was wrong. This whole day I’ve been feeling off.

I’ve been in denial that I’m not okay, but now I am paranoid that something is totally wrong and that the nightmare I had would come true. And part of that worry is because my doctor appointments/medical clearance isn’t for another two weeks. And now I’m afraid I won’t make it by then, or that something bad will happen before then. I’m so tired of waiting, and I’m so scared. I’m at a huge loss. My perception on what is healthy and unhealthy is so warped because of this disorder, that I don’t know when I’m okay and not okay. I don’t know if I’m overreacting due to anxiety or if something is going on.

When I’m sitting down, I can feel every beat of my heart. And it never feels normal. My breathing will effect it, especially when I take a deep breath. Taking a deep breath makes my heart speed up and pound harder for a few seconds. It is notable that I am on adderall, so I’m aware that could very well take part of it - my resting heart rate always ranges from 100-120. But it’s not just the heart rate that scares me.

I’m always dizzy. Standing makes my head pound, makes me almost black out and I end up having to close my eyes and hold onto something, or I’ll sit down. My stomach is in pain, whether I’ve had food or not. Sometimes stabbing pains, sometimes cramping. Eating is so difficult because I’m not used to normal amounts of food. If I try to follow my meal plan, I feel sick and I’m hurting. I don’t feel right. I always feel like I’m in a grey room, where everything is blurry. Of course I’m always cold because I don’t take care of myself enough. I don’t drink enough water. I’ve gone 4 days without water very recently, and the only water I had was like. Through Powerade. But not straight up water.

So here’s my problem. I have to be up for school in 4 hours. And I can’t sleep because I am so seriously afraid that I will not wake up. I know that probably won’t happen. But I’m fighting myself. One side is saying I’m going to die, and the other side is saying I won’t and I’m just scared. And of course that I’m not skinny enough to die (irrational I know). But I’m so tired of being tired. I just want to sleep. My sleeping schedule is basically staying up for 24-60 hours, 3 hours within two days, and then eventually I can’t stay up much longer and I’m sleeping for 12-20 hours (sometimes 3 days in a row). I want to sleep so bad, but I’m so scared I won’t wake up. And then I get paranoid. I start to think “if I die, how will I say goodbye to everyone. How will I let everyone know how much I love them. I don’t want people to see my death and think about how many goals I have to get better so I can have a future but now I’m dead so I can’t.

I don’t want to die. I do have really bad suicidal ideation. But I am not at a point of wanting to die. I’m absolutely 100% terrified of death, yet I think about it all the time.

What do I do?

Extra: if it helps at all, I have also been diagnosed with generalized anxiety disorder, severe Major Depressive Disorder with mood congruent psychotic features, and PTSD.