Lynne’s story (Rachel’s mother)

Case study - Lynne

“From our point of view, she fell into it quite quickly”

Rachel was a healthy teen and an excellent swimmer, training four times a week. She’s never been skinny, nor has she ever had to lose weight.

She was hitting 14 years old when it all happened. Her best friend at school emigrated and it was a very stressful and upsetting time for her, plus she hadn’t been placed with any of her friends in her new GCSE groups.

At dinner she would push her food around her plate, but we knew she was upset so we put it down to that. She would also get up earlier than me in the morning and it took a while to realise she wasn’t eating – she was just putting crumbs in a bowl, making it look like she had.

It happened so quickly, over only a couple months. She passed out on holiday in Spain in October of that year and that was our first real inkling anything was wrong.

“She missed breakfast and threw her packed lunches away”

By December, Rachel’s school agreed she could come home for lunch and our GP put her on a mild antidepressant and referred her to CAMHS for an initial assessment.

Christmas wasn’t a nice time at all. She nearly completely stopped eating and lay on the sofa crying from morning to night, thinking we were putting calories in the water. I had already started reading books and doing research on anorexia, which was where I heard about the Maudsley.

Our local CAMHS were great, calling and supporting us between Christmas and New Year. They spoke to the Maudsley directly and referred Rachel immediately as she had already gotten to the stage where she couldn’t feed herself. We’d begun spoon feeding her ourselves and watching her constantly because she was self-harming, scratching her body raw with her fingers.

She was five stone thirteen pounds when we got to the Maudsley and her heart rate was so weak she had to have an ECG.

“With the support of the Eating Disorder Service, we felt we had permission to insist on food”

The plan was for us to try and feed her at home while seeing them three times a week. Before leaving though, we had to try and get her to drink a high-nutrition milkshake. It was like forcing her to take down poison because she’d already seen how many calories it contained.

We started family therapy, which was really helpful because, for one, it gave us permission to insist on food. I think when we spoon fed Rachel she accepted it because she could blame us for making her fat. She was so malnourished, it made her violent and rancorous. She’d open her mouth for the food, like a baby, but if we gave her the fork she’d scream and drop it like a snake.

At that stage, the hospital rang us every day and we took her in two or three times a week. It went well, she began to gain weight but Rachel was really upset because it wasn’t what she wanted.

“Like Jekyll and Hyde, she was there one minute and then not”

She did it, but it took all of January and into February for her to put on weight, and she was still panicky and cried often, but slowly she began to come back to us.

The thing with anorexia; it’s not just physical, it’s a mental illness, a chemical imbalance caused by malnutrition. Rachel often wasn’t herself and I realise now it was due to malnourishment.

Through my research and experience, I’ve learned how important it is as a carer to separate the sufferer from the illness. It is the illness that is hateful and violent, NOT the child.

Medication and therapy just won’t work until you start to feed the brain, but once her body was getting nutrition again, every so often we’d see sparks of Rachel. As she got stronger though, she reached a point where she was resistant and violent, still unable to feed herself.

“Leaving her at inpatients was the hardest thing I’ve ever done”

The Maudsley recommended a short stay of six weeks on an inpatient unit and, though we agreed, remembering our trip there still upsets me. I didn’t want to leave her, but knew it was the best thing.

Rachel did everything they asked of her, but it was clear that being cut off from everyone was making her more depressed, so she came home after five weeks and went back to school part-time. She was very nervous – almost agoraphobic – but she started catching up on work with tutors. Life had moved on quite a bit, but all her friends were really supportive. Since then, she passed all her GCSEs and has started studying for A levels, which we’re really happy about.

“She has off-days, but these are fleeting”

Rachel is still on medication, but she was discharged from the Maudsley in August. That felt like a big step, as if we were being cast adrift – like when your kids are being taught to swim and they first take the armbands off – but she’s eating freely now, her weight is great, she’s not fixated on exercise anymore and she’s so much happier.

We know it would only take a letter to the Maudsley should the worst happen, and that’s really comforting, but she doesn’t need them now. She has a wide circle of friends and has realised that people like her for who she is.

I’m still vigilant, but realistically we’re at a point where I should step back. In fact, I’ve no idea what she weighs now!

“I want Rachel to have everything she deserves”

We nearly lost her, which is the hardest thing to bear, so I’m thankful every day for our families, our GP, CAMHS and the Service at the Maudsley, because the results speak for themselves. Rachel is living proof that Multi-family Based Therapy works.

I’m also grateful for resources I found when I needed them; sites like www.feast-ed.org and books like Help Your Teenager Beat and Eating Disorder by James Lock and Daniel Le Grange and Anorexia Nervosa: A Survival Guide for Families and Sufferers by Janet Treasure. When you’re at the bottom of the well, it’s so important to hear other families say you’ll climb out. You never believe you’ll feel happy again, but you do, you can find it again. It just takes food and endless patience.

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