pica

Residential care

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The first couple of weeks at residential were really rough. I was afraid that Arabella was going to get kicked out of the program. They told us while she was on the waiting list if she did any self-harm, such as banging her head against the wall like she did at her second inpatient stay, they would release her. She knew that because she was part of that conversation. She hated it there at first. She didn’t have any friends. They purposefully kept her alone to increase her tolerance in a safe environment.

We received nightly calls from her which were not always good. She begged us to send her expensive gifts overlooking the cost of treatment. She bragged about her arguments with staff and how she broke the rules. They had a hard time waking her up in the morning like we did. It wasn’t going well because she didn’t want to be there. She argued with us and hung up on us on multiple occasions. I was always waiting for a call that we should come pick her up and there was nothing they could do for her.

The first call from the therapist was rough because she said that Arabella made allegations of abuse against us which they had to report to social services. Nice! What were they going to do anyway? Take her away? I jokingly said to my husband that maybe then the county would pay for her residential treatment. But nothing ever happened.

Arabella caught on fast, but she couldn’t focus. She was easily distracted which lead to a diagnosis of ADHD. She improved greatly in the program after she was treated for this. I felt like this was a turning point in her treatment. She wanted to be there after that and wanted to get better. She could finally focus on studying and new hobbies.

Some other strange things happened while she was there. Arabella went into a dissociative state and freaked out scaring other patients. She didn’t know who she was or where she was. In this dissociative state, Arabella ate plastic which prompted more testing for pica. Dissociation can be a symptom of borderline. After this she had every single diagnostic characteristic of borderline. I wondered if this had anything to do with her eating nonfood items before. I was completely puzzled.

Before this I did not know she experienced dissociative episodes. She admitted to dissociating in the shower. She also said that she had episodes in her room where she looked down at herself and thought that she was a very bad person that didn’t deserve to live or a very good person. I found it very hard to understand and didn’t even know it was possible or likely without experiencing major trauma.

After the treatment for ADHD and after her dissociative episode ended, there was a time of tremendous growth. She started working on learning and applying skills. I guess what I’m trying to say is that we were very fearful at first about whether or not this treatment was going to work. We had a lot invested in it and not just financially. I think our fear in early treatment was normal, we just didn’t know what to expect.

I think the residential DBT program was a lifesaver. It gave her (and us) more tools to work on some of her mental health issues she was struggling with. But we were also worried about how things were going to be when she got home. Would the skills carry over? Would she be able to live independently or would she need lifetime care? Again, we just didn’t know what to expect in recovery.

New diagnosis

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I was very concerned about the things that were happening with Arabella.

On New Year’s Eve, she made a strange comment when we had some friends over. She told everyone that her dad was walking on the ceiling and laughed about it. No one else laughed. They glanced at me and looked at her as if she was crazy. Was she on something? Was she delusional? Was she just trying to get attention?

She said strange things before like the time she said that Jordan’s mom was her mom and I wasn’t. She said other things that weren’t true. At times I could classify her as delusional or paranoid.

Then there were other things like the eating of non food items such as plastic forks. The binge eating and weight gain. The extreme fluctuations between us being evil and the world’s best parents. She fluctuated that same way with herself. Sometimes she saw herself as fat and ugly. Then at other times she wanted to be a stripper and show the world how gorgeous she was. Sometimes she was gay and other days maybe straight.

Then there was the impulsivity. Money in her hands was money spent. The shoplifting. The need to be more extreme than everyone else. The cutting, the suicide attempts. All her relationships were turbulent.

She had unusual emotional reactions, laughing instead of crying upon the loss of friendships that once meant everything to her. She seemed almost manic. She had a hard time sleeping at night even with the sleeping pills. I wanted to tell the doctor that all of this happened within a month’s time. Perhaps her medication was off.

Arabella was in rare form when I picked her up from outpatient to take her to her psychiatrist appointment. She was bouncing off the walls. A combination of caffeine, candy, and mania perhaps? She couldn’t keep a constant thought. She talked about the heating ducts in the office. Things people really don’t care about. She was talking a million miles a minute and I was feeling frustrated. In my mind she was acting pretty crazy and I wanted her to stop. But did I? It was the perfect place to act like this. Every time before this visit, she was quiet and depressed. She couldn’t sit still. She told the psychiatrist that she had crackhead energy.

I explained to the psychiatrist everything I’ve been trying to explain to you. Something was really wrong with my daughter. He got it. He said it was obvious to him that my daughter had more than a case of depression. He said she had disordered mood, thoughts, and personality. He thought she had Schizoaffective disorder with Bipolar 2 along with Borderline Personality Disorder. I didn’t see it coming, really I didn’t.

Then he said that he was retiring. He didn’t have a replacement. He didn’t want to change her medication which was a mess and not even adequate for her new diagnosis. We would have to wait for residential to figure that out. He pretty much said good-bye and good luck.

I was heartbroken. I cried the whole ride home. How did I not see this coming? Schizophrenia?? My brother is schizophrenic. He hears voices.

I grieved for a long time. All my hopes and dreams for a normal life for her were dashed. I wasn’t even sure she would graduate from high school at that point. Remember when she was an honor student? I couldn’t stand to hear about the bright futures of other kids her age. Your daughter is going to college for physics. I’m spending my daughter’s college money for psychiatric care. Yup, hope she doesn’t kill herself.

I remembered the last play she was in. I cried not knowing it would be the last time everything seemed fine. I cried thinking about the last dance she went to where she wore a pretty sleeveless dress before she started cutting her arms.

I grieved for what was that will nevermore be. It was painful that somehow I could’ve caused this. Bad genetics, nary a sane soul on both sides. I was riddled with shame and guilt. I couldn’t understand why my daughter hated me. I was doing everything I could to help her. I couldn’t stand seeing other normal families doing normal things. I resented them. I envied them for what I didn’t have. I would give away everything I had just to have that one thing, normal.

My mom was very comforting at the time. She experienced a lot of the same feelings with my brother Matt.

Now I just had to wait. My life was in limbo in a chaotic holding pattern until residential, if she could make it until then.

Carrying a heavy weight

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She gained 13 lbs. in a month.

Arabella wasn’t on any medications that could cause weight gain. She also went through periods of restricted eating. This really didn’t concern me as much because at the time she was easily over 250 lbs. I was more concerned about diabetes and other health related issues. She wasn’t eating meals with us anymore. I would tell her it was time to eat only to find her eating a bag of Oreos in her room. She only wanted junk food.

It struck a painful chord in me. I show I care about my family by doing nice things for them such as their laundry or cooking nice meals. It was triggering of childhood memories of my own mom working hard to cook nice meals only to have my dad ask her what kind of dog shit she made for supper. I feel hurt and unappreciated when my efforts are scorned. It takes a lot of work to cook supper and make healthy homemade meals for a family of 5 or 6. It makes me angry when my cooking is replaced by a cheap sugary substitute.

My dad also struggles with obesity and unhealthy eating. He does not exercise and now can barely walk. I saw how he struggles with his weight and I don’t want that for my daughter. Not only that but it is hard to care for someone who is elderly and prone to falls. He is over 300 lbs. and there is no way I could lift him.

What was even more concerning besides her obesity and binge eating of junk was that she started to eat non food items as well. She ate woodchips. She cut up a Capri Sun pouch and ate that. She ate paper and several plastic forks. What if that was to tear up her intestines? To me it seemed like a whole new way to self-harm. The doctors were puzzled by it as well. They ran all sorts of blood work but nothing could be determined what was causing her pica. Was it some strange side effect to her medication? Was it for attention?

One of the hardest things was that I didn’t have any control over it. She was twice my size. Although I could share with her my experience with healthy eating and exercise, she wanted nothing to do with it. In fact, to this day I am not allowed to talk about it.

While she was in residential, Arabella still went through periods of eating paper and plastic silverware. Again, more tests were run and not surprisingly nothing was found. The best anyone could tell me was that she should take a multi-vitamin because she wasn’t getting any nutrients from what she was eating. Things haven’t really gotten much better since she came home. Her meals consist of chips, candy, cookies, and sugary foods. I can’t stand it really. I don’t know what to do about it. If I talk to her about it she gets angry with me. She tells me that I don’t understand and quite frankly I don’t.

I won’t take her shopping because she fills my cart with junk. I don’t mind buying some snacks, but I don’t want to fill my cart with them. When she has money, she buys her own snacks. It was hard when she worked at the grocery store because she would spend her paycheck there. It didn’t matter if she didn’t have money. Sometimes her friends would be her junk food junkies and bring her a new stash.

The therapist said that I shouldn’t be nagging her about it because it would cause her to feel shame which would cause more stress eating which would cause a perpetual shame cycle. Instead she should feel natural consequences, such as diabetes. Who wants their teenager to struggle with body image and health concerns due to obesity in a society that pressures women especially young women to look a certain way? I am in my 40’s and I still feel the pressure to look a certain way. It’s not as bad as when I was a teenager, but still.

My intention is not to fat shame my daughter. It’s hard to talk about because I’ve never really struggled a lot with my own weight. But it’s a big problem and I’m not sure she is going to be able to fix it. It’s going to have to be another thing I have to let go because there is nothing I can do about it. When I do try to help I only seem to make things worse.

Sometimes it’s really hard to let my adult children go and watch them struggle.