Treating anorexia- it's extreme

The need for specialist care took center stage in a news story about Scotland's first anorexia unit that is opening soon. Although I could comment for quite some time about the need for urgent, appropriate intervention for ED treatment (whether or not the patient is ready), that's not what struck me in this article. What really gave me pause for thought was this one sentence:

A major criticism of the present system is that patients with eating disorders are often kept in wards with those suffering from more extreme forms of mental illness.

Because...anorexia isn't extreme?

There are arguments both for and against treating EDs on general psychiatric wards. Though I have been in residential treatment for my eating disorder, the times I was in the hospital was on a general psych unit (under the care of an ED specialist psychiatrist). The system wasn't perfect; cheating was rampant. One of the units I was on tended to be a holding tank for geriatric patients waiting to get into nursing homes.

The one benefit of being thrown in with addicts and people with schizophrenia, bipolar disorder, depression, anxiety, you name it, was that it drove home the point that my eating disorder was a mental illness. I wasn't just a stupid girl who wanted control and if I could stop being so damn stubborn and just eat already, then I could bust this joint.

People who are hospitalized for eating disorders are generally so phobic of food they would rather die than eat. They cannot perceive their body accurately. They cannot perceive hunger and fullness. They cannot stop exercising or bingeing or purging or starving. They cannot function in day to day life. They cannot. It's not a matter of will or choice or any of that. It's an illness over which the sufferer has almost no control.

There are lots of good arguments in favor of specialist ED units. But one of them is not because eating disorders aren't "extreme" mental illness.

Just ask me.

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8 comments:

Lisa said...

More extreme? How does one of the the highest fatality rates of any mental illness not translate into extreme? Sheesh.

julie anna said...

Exactly. Though I think there are better treatment options for patients with a primary eating disorder diagnosis than a general psych ward, that does not mean they are less severe than other mental illnesses. I'd argue that the high mortality rate, low recovery rate and all the associated medical issues make it more severe than your average psychological illness.

And I also think it's a very valid point that a more inclusive recovery community has its merits. I was in a 12 step program that had an ED house, a women's substance house and a men's substance house. With our additional medical and food needs, it was pretty vital to have a separate ED unit, but we did a lot of group work with the whole community. I think that was a very useful way to gain perspective.

I always enjoy your posts, keep 'em coming!

Brwneyedgrl08 said...

I agree that a more well-rounded recovery environment, is more beneficial for the patient. Having a designated area for eating disorder patients is definitely a useful way to gain perspective.

There are many different treatment options out there for eating disorder patients, the question is which is the best treatment? Personally, I feel that it depends on the person, as well as their situation.

I know from seeing a close friend of mine suffer from an eating disorder, that seeking treatment through an eating disorder treatment center was the best bet. Again, that may not be for everyone but I feel it's the most inclusive and most effective.

ja said...

I think ALL mental illnesses deserve specialized treatment, not just eating disorders. Do people not care about specialized treatment centers for people with schizophrenia or bipolar disorder? Sometimes I get the feeling that the family members of eating disorder patients almost feel "superior" to other psychiatric patients. Kind of like, "Oh my god! They threw her into a general psych ward with a bunch of schizophrenics!"

ja said...

Not saying that you feel that way personally. This is just a general vibe that I get after reading many articles on mental illnesses and eating disorders. Just wanted to throw that point out there.

Susie said...

with others about the "more extreme" remark and also agree with others that specialist units are the best place for serious help.

My battle with anorexia began when i was no longer able to self harm as i had been doing. why? because i was sectioned and being watched on a general mental health ward. so i stopped eating as another form of doing damage to myself.

the majority of the staff there did nothing at all. the 3 who did care and show concern had no power to get me the appropriate things like a dietician appointment because they were nothing to do with my team. When i left there my psych and CPNs still did nothing. my psych refused to set up an appointment with the dietician saying i was "knowledgable enough about food".

the person i felt most understood by was the psychiatrist in charge of the inpatient unit where i went for an assessment.

Unknown said...

Thank you for this, Carrie. Needs to be said.

NEEDS TO BE HEARD!

Carrie Arnold said...

Any disease needs expert care. One of the main arguments for specific ED units is the need for close medical and mealtime monitoring combined with staff training. Most psych units cannot take you if you're too medically unstable.

People have a hard time figuring out mental illness. EDs and other biologically based brain diseases are still seen as a choice. When I was first in the psych unit, I was wondering why I was in there. I wasn't, like, crazy. But I was still very ill from a brain disease. Mental illness has such stigma, still.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote



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