More Fun With Psychiatry

*Skritch, skritch, skritch* "Aha, mm-hmm, can you tell me a little bit more about that?"

More skritching as a pen scrawls more notes across the page. It's my third, one hour session and so far we haven't got past the history taking part. Man, I know I'm a tad fucked up, but three separate one hour sessions and we haven't even finished taking a pertinent history level of fucked up?

"You mentioned a considerable history of an Eating Disorder, when were you diagnosed?"

"Um, well the first time was around 1989, that was when I was diagnosed with Anorexia Nervosa Subtype 2 Purging, I think they might've called it Bulimarexia back then. I was rediagnosed earlier this year with Anorexia restricting subtype, that's been the main one for me I guess."

More skritching across the page, "Okay, and who diagnosed you?"

"Flinders Hospital Eating Disorders Unit, I can't remember who I saw, appointment's can be a bit of a blur when you're anxious". I look down at the floor and then over to the door as if I'm considering running like a frightened jack rabbit. Then I remember another piece of information that might be pertinent. I can never tell with these early sessions, although if I remember too much that needs to be added we could be here for a month of Sundays. "I was also retroactively diagnosed as having Child Onset Anorexia starting from the age of 8."

She stops skritching and looks up from her notes, it looks as if she's mentally cocking an eyebrow at me. "I'm sorry, 'retroactively diagnosed?'"

"Well, yeah, after they took a detailed history and stuff, it was pretty obvious I'd had problems for longer than just the initial diagnosis in my teen years. It was the Eating Disorders Unit that diagnosed me, "I add, as if this is somehow vitally important for her to know. No fly by night operation here, Miss, I was diagnosed by the real Mcoy, a Unit no less! I don't know why I suddenly feel the need to prove myself.

She's back to her usual pen skritching now. "So I take it you no longer menstruate then?"

It's more of a statement than a question, the holy grail of a DSM IV check box diagnosis of Anorexia Nervosa.

"Well no, I mean yes I still have my period," I start to try and explain the mystery that is the workings of my body. "Even when I was at a BMI of 12.9 I was still menstruating like clock work."

Her pen draws a sharp line through the presumably presumptuous notes she's just written as she takes a sharp breath in, and then huffs audibly. "I find that very hard to believe."

Before I can respond she shifts the subject onto to the topic of food.

"Let's talk about your daily intake then."

(Let's not)"Okay, then," I respond a little quieter this time. The door is looking inviting again.

"So what do you usually have for breakfast?"

More scrawling across the page. I want to break the pen in half, I'm sure she's about to write down what a fat, greedy pig I am with how much I eat.

"I usually have a cup of tea or coffee..."

"...black, no sugar of course."

(Wow, presumption much?) "Ah, no I put milk and sugar in my tea and coffee."

"Oh-kay, what about food, what do you eat for breakfast"

"It's usually half a slice of toast"

"Dry, no margarine or other toppings."

More presumption, more pen skritching.

"No, I put butter or margarine on it."

She stops scrawling for a moment, and looks up from her notes. "Well you can't be anorexic then, not if you put sugar in your tea, and have butter on your toast. I think we need to look at a different diagnosis"

Wait, hold up, excuse me?

Okay, at this point, dear readers, let me just try and paint a picture for you. I am sitting in front of this woman weighing less than 43 kgs at 5'7; I have a BMI of 14.3, which puts me into the category of 'clinically emaciated' according to charts at that time; my hair is falling out; my skin is breaking down, I am covered in sores and rashes; my body can no longer regulate its temperature properly; I am so consumed with the rituals of food and losing weight that I can barely follow the simplest of conversations, and 500 calories a day is on the upper level of a 'healthy' intake for me at the time.

But I sugar my tea and coffee, and I butter my half slice of toast in the morning: therefore I am not Anorexic.

HALLELUJAH, I'M CURED!

At the end of the session she finally presents me with her version of a treatment plan. It goes a little something like this - 'go home, eat, gain weight, get your anxiety under control, sort out your sleep difficulties, and then come back and see me'.

So, patient heal thyself?

Seriously.

#funwithpsychiatry #badpsychiatrists #psychiatry #anorexianervosa