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.

[jojo0328]

Hi Apple,

I have been where you are. I understand how youre feeling. Anorexia can take over your life. It doesnt matter if youre underweight now or not. I'm surprised your doctor made that diagnosis. A lot of people with anorexia started out with ENDOS. They really just had anorexia, but because the diagnostic criteria is the DSM requires your BMI to be below 18.5, most doctors wont diagnose until you hit the threshold.

The above poster, while trying to be helpful, may be a bit misinformed. I dont want to scare you more than you already are, but (as you probably know) ENDOS is the most deadly of all of these diseases because people aren't underweight, so they think they're fine.

I know that it is not as easy as just eat. People who have never had an eating disorder can't truly understand what it feels like when food is an enemy. Try to at least get some electrolytes through gatorade or an Ensure for now, and in the morning, ask your family if they would feel comfortable taking you to urgent care. I know this is a health anxiety forum, but because you have an ED, it is really important that you get prompt medical treatment if youre feeling these kind of symptoms. At the very least, it will be nothing and you will be comforted. If it is more serious, then you will be in the right place for help.

I truly wish you the best on your journey. The road to recovery isn't easy. The thoughts are difficult to silence and you are going to have to fight hard not to let them in. Listen to your doctors and try your best not to be secretive. They are there to help (although I know that you probably wont feel that way in the beginning.) Lean on your family and friends, and try to associate yourself with people who are in recovery. Don't spend time on those who aren't, it will make the process that much more difficult. Stay strong, you can do this.

[AyAna_Apple]

Hi Apple,

You are feeling all of these feelings because you are wearing your body out through your anxieties. You must let go now and start looking after yourself. You are very important!

The first things to correct now are your water and sleep. Try to drink two glasses a day to begin with for a while. You can do this!

Space them out if they are too large to gulp down all in one go. Have a glass over 30 minutes or so and have an electrolyte drink too.

You will not die in bed. You will not! So try and relax and settle down and sleep. Bed is a lovely soft place to be, a safe place, and if you let yourself sleep you will just be feeling better and better each day! Keep remembering this! Then you will also feel less anxious, and it will be a knock-on effect. A positive upward spiral.

Eat as much as feels comfortable in your stomach and as often as you can handle. Food is nourishment and love and your body wants it so much! This will be a positive spiral too for you too, and make you feel better and better also.

So, do try to see your anxieties as just that - anxieties. They feel horrible and scary at the moment but remember that it is not the thing you are scared of that is scary, but the feeling itself. With enough sitting with it, you will find that it's a passing feeling, even if it takes an hour, it does go away.

When you start looking after yourself you may still feel bad initially, but don't rush success. Do the things you need to do for your mind and your body and it will pay you back in not too long in strength, clear-headedness, a steady heartbeat and happiness.

Start now I believe in you!

Thank you for your positivity, it is really appreciated. Water I should be getting more of, but the food thing is really difficult for me to face. But once again, thank you so much for your support. It means a lot. Taking care of myself is a really big struggle when eating is apart of that.

---------- Post added at 20:37 ---------- Previous post was at 20:25 ----------

Hi Apple,

I have been where you are. I understand how youre feeling. Anorexia can take over your life. It doesnt matter if youre underweight now or not. I'm surprised your doctor made that diagnosis. A lot of people with anorexia started out with ENDOS. They really just had anorexia, but because the diagnostic criteria is the DSM requires your BMI to be below 18.5, most doctors wont diagnose until you hit the threshold.

The above poster, while trying to be helpful, may be a bit misinformed. I dont want to scare you more than you already are, but (as you probably know) ENDOS is the most deadly of all of these diseases because people aren't underweight, so they think they're fine.

I know that it is not as easy as just eat. People who have never had an eating disorder can't truly understand what it feels like when food is an enemy. Try to at least get some electrolytes through gatorade or an Ensure for now, and in the morning, ask your family if they would feel comfortable taking you to urgent care. I know this is a health anxiety forum, but because you have an ED, it is really important that you get prompt medical treatment if youre feeling these kind of symptoms. At the very least, it will be nothing and you will be comforted. If it is more serious, then you will be in the right place for help.

I truly wish you the best on your journey. The road to recovery isn't easy. The thoughts are difficult to silence and you are going to have to fight hard not to let them in. Listen to your doctors and try your best not to be secretive. They are there to help (although I know that you probably wont feel that way in the beginning.) Lean on your family and friends, and try to associate yourself with people who are in recovery. Don't spend time on those who aren't, it will make the process that much more difficult. Stay strong, you can do this.

Thank you for your feedback. It is nice to get a different view from someone who understands the context of the situation. I guess I’m just scared because I don’t feel like I’m in control of knowing what’s going on with me, as I can no longer tell if I am okay or not, yet eating is still so terrifying anyways. I do have Powerade, and I don’t have ensure but I have boost drinks. I am going to try my best to listen to my doctors, as well as getting to know the people that will be in the partial hospitalization program with me. Although with friends and family, I find some difficulties. My family is aware of what’s going on, however I’ve spend most of my life holding everything in and so telling them personal things kinda makes me panic. But I know I need to push through that. As for friends, I just get worried about putting too much stress on them. But I do have a few I trust.

I will see if I can see a doctor soon or even urgent care, but I’m worried I’ll be asking for a lot. It was a hassle to get the appointments figured out because of insurance. I can’t see my original doctor anymore because I have to only see my new primary care doctor because of insurance and The Emily Program, and my soonest appointment with her isn’t until March 6th. So if I don’t end up going to Urgent Care, I just hope March 6th isn’t too long of a wait.

I don’t have a problem with going to Urgent care, it’s more so going back to having a hard time with being vulnerable and seeking that kind of help from my mom and grandma.

Once again, thank you so much. It was really easy to understand what you said, and it’s pretty clear to me that you do have really good insight and understand.

You’re right, I do know that EDNOS is really serious because of the misconceptions with thinking if you aren’t underweight then you are fine. As well as knowing that people don’t often seem to look at Atypical Anorexia as seriously. But I’m really bad at taking my own advice, and I don’t always take it because of the fact that I am scared of taking care of myself and eating

[MyNameIsTerry]

This thread is worth a look as the OP went through her eating disorder in detail along with other members talking about their experiences of them. And the OP is much better these days:

www.nomorepanic.co.uk/showthread.php?t=155655

---------- Post added at 01:53 ---------- Previous post was at 01:51 ----------

They really just had anorexia, but because the diagnostic criteria is the DSM requires your BMI to be below 18.5, most doctors wont diagnose until you hit the threshold.

When will the medical community realise BMI is BS? It was never created for half of what it is used for and isn't reflective of modern diets anyway. Every weightlifter/bodybuilder/athlete going is considered obese on it yet they are extremely fit & healthy.

[jojo0328]

Thank you for your positivity, it is really appreciated. Water I should be getting more of, but the food thing is really difficult for me to face. But once again, thank you so much for your support. It means a lot. Taking care of myself is a really big struggle when eating is apart of that.

---------- Post added at 20:37 ---------- Previous post was at 20:25 ----------




Thank you for your feedback. It is nice to get a different view from someone who understands the context of the situation. I guess I’m just scared because I don’t feel like I’m in control of knowing what’s going on with me, as I can no longer tell if I am okay or not, yet eating is still so terrifying anyways. I do have Powerade, and I don’t have ensure but I have boost drinks. I am going to try my best to listen to my doctors, as well as getting to know the people that will be in the partial hospitalization program with me. Although with friends and family, I find some difficulties. My family is aware of what’s going on, however I’ve spend most of my life holding everything in and so telling them personal things kinda makes me panic. But I know I need to push through that. As for friends, I just get worried about putting too much stress on them. But I do have a few I trust.

I will see if I can see a doctor soon or even urgent care, but I’m worried I’ll be asking for a lot. It was a hassle to get the appointments figured out because of insurance. I can’t see my original doctor anymore because I have to only see my new primary care doctor because of insurance and The Emily Program, and my soonest appointment with her isn’t until March 6th. So if I don’t end up going to Urgent Care, I just hope March 6th isn’t too long of a wait.

I don’t have a problem with going to Urgent care, it’s more so going back to having a hard time with being vulnerable and seeking that kind of help from my mom and grandma.

Once again, thank you so much. It was really easy to understand what you said, and it’s pretty clear to me that you do have really good insight and understand.

You’re right, I do know that EDNOS is really serious because of the misconceptions with thinking if you aren’t underweight then you are fine. As well as knowing that people don’t often seem to look at Atypical Anorexia as seriously. But I’m really bad at taking my own advice, and I don’t always take it because of the fact that I am scared of taking care of myself and eating

I'm glad I could be of some help/comfort. I know you have atypical anorexia, not ENDOS, but they are pretty similar because you have not yet hit the BMI threshold so everyone thinks you're fine, when in reality you could very likely be having heart palpitations, low blood pressure and etc. which cant be sustained over the long term. You also probably have numerous vitamin deficiencies. I know it must be difficult for you because you also have anxiety, so you arent sure if this is just that, or the anorexia or etc. It is probably a combination of all of them.

Feeling out of control is a pretty common thing for ED sufferers and a reason why a lot of them limit food intake. It is great you are going to be getting into a program, I know its quite difficult to get in in the UK. Obviously, your doctors are taking your condition very seriously, and thats great. You should probably continue to monitor yourself over the next few weeks, and if symptoms get worse, head to urgent care (especially if youre blacking out, losing time, fingers turning blue etc.)

Most of all, if you are on MPA, stay off of there. That isn't going to help, and it is just going to get worse becayse everyone there is sick qnd in the midst of their own disorder and encouraging everyone else. If you need anything, or just to vent, please feel free to send me a message.

---------- Post added at 05:30 ---------- Previous post was at 05:26 ----------

---------- Post added at 01:53 ---------- Previous post was at 01:51 ----------

[/COLOR]

When will the medical community realise BMI is BS? It was never created for half of what it is used for and isn't reflective of modern diets anyway. Every weightlifter/bodybuilder/athlete going is considered obese on it yet they are extremely fit & healthy.[/QUOTE]


It is even worse for eating disorder sufferers because not having one of the "good" eating disorders (anorexia) because of the BMI threshold is more of a challenge for them to get to below BMI. I think the DSM is starting to do away with some of this stuff, but even anorexics are bitchy about it "well, you arent under 18.5, so you arent REALLY ANA" etc. This is such a big problem!

[pulisa]

BMI analysis is a joke. It just depends on body frame so if you have a large frame you weigh more despite being very thin.