When the mind becomes the enemy of the body

Sunday Star Times May 21 2017

What they tell you about an eating disorder is: don't try to work out what caused it. Concentrate on getting her well.

What they may also tell you is: her vital organs are failing, we need to admit her today.

You may hug her and it may feel as though you're holding a cold ghost.

It can build slowly: friends take her to see the school counsellor. There's private therapy, and then a nutritionist. It may seem OK until the nutritionist insists on a simple cup of hot chocolate at night, and then the illness will be forced out from the shadows and there will be howling anguish, and you will realise the recovery was a complete illusion.

A few weeks on, at dinner, you'll ask her to take a second, third mouthful and you will be asking her to drink boiling oil.

She doesn't want this, any of it, but her mind has become the enemy of her body. Whichever side she takes, she loses.

There is before, and there is after. You feel quite alone and utterly helpless and then the system swings open its doors and you are beyond grateful because you thought there was not a thing in the world that could be done, and yet here it is.

They have a regime that works, for many patients, though not all, not yet.

It begins with a feeding tube. Over time, if she does all they ask of her, and mostly that will be: eat, then by degrees she'll be allowed her freedom back, to get out of bed, to sit and eat with the other girls, eventually to be rid of the hated tube.

You can't believe she lets them do any of this and many months later she will tell you she was just too weak to resist. That first night, in the dark, she will turn off the feeding tube, and the nurses will expect it and they will know what to do, and so will all of the clinicians, so knowledgeable, so dedicated. What they insist upon is utterly simple but completely unyielding: eat, many times a day, in great proportions.

If you buckle, you go back to the start. These girls of 13 and 14 and 17 do all they can to not buckle. They want to press forward, even as they break down sobbing, even as they glare at the dinner plate with black anger in their eyes.

And then one day they will be home. The counselling will continue, and they will  be cheerful with the psychologist and then curled up in a sobbing ball in the car coming home, but you will keep moving forward and their friends will say to them Come on, eat this, you've got to eat and come to the cafe with us, you've got to eat, and they will, and slowly colour will return to the world.

Even as they get steadily better, and stronger, able to see food the way they once did, they will say: "You can think you know what it was like, but you can't. You just can't imagine it."

And then one day the whole thing will be five years in the past, and she'll be at university and she'll send you a text message after a class on gender, sex and bodies. Inevitably eating disorders came up, she'll say, It's so interesting to learn about this years on as someone who hasn't thought about it in yonks. I completely forgot that it's a legitimate epidemic now. It's fucked.

She is 18 going on 30 and she has got through it, and you give thanks every day, and you want that for every other parent and every other daughter.

What they tell you at Starship is that perhaps 150 girls come through the ward each year. The visible tip of an iceberg. Only the most ill are admitted, but thousands more need treatment. And so it goes for our suicidal, our desperate, our tormented: treated only if they're fortunate, if they're bad enough, because there just aren't enough resources.

Our family was lucky. I hope yours will be too, should you ever need help. And I hope this government would never overlook the needs of our most fragile, just to ensure its budget figures looked thin enough.

WHERE TO GET HELP

Lifeline (open 24/7) - 0800 543 354

Depression Helpline (open 24/7) - 0800 111 757

Healthline (open 24/7) - 0800 611 116

Samaritans (open 24/7) - 0800 726 666

Suicide Crisis Helpline (open 24/7) - 0508 828 865 (0508 TAUTOKO). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Youthline (open 24/7) - 0800 376 633. You can also text 234 for free between 8am and midnight, or email talk@youthline.co.nz

0800 WHATSUP children's helpline - phone 0800 9428 787 between 1pm and 10pm on weekdays and from 3pm to 10pm on weekends. Online chat is available from 7pm to 10pm every day.

Kidsline (open 24/7) - 0800 543 754. This service is for children aged 5 to 18. Those who ring between 4pm and 9pm on weekdays will speak to a Kidsline buddy. These are specially trained teenage telephone counsellors.

Your local Rural Support Trust - 0800 787 254 (0800 RURAL HELP)

Alcohol Drug Helpline (open 24/7) - 0800 787 797. You can also text 8691 for free.

For further information, contact the Mental Health Foundation's free Resource and Information Service (09 623 4812).