All three?!

Hey guys, I'm just curious as to who can help me find something out.

I know I have an eating disorder, but I don't know what it would be. NOS? I thought it was Binge Eating Disorder but apparently they don't purge. I feel frantic sometimes about eating and I get in a huge snit if I don't want what's being cooked. I binge. I starve. I purge. And I know I need help for it, but I'm curious.. what will they do to help me? I've been like this for years, and that coupled with anti-psychotics has really messed up my metabolism.  I've recently switched to ziprasidone from risperidone. The risperidone is the medication that messes up your metabolism and the ziprasidone is a relatively new drug (in Canada) and people who were on previous anti-psychotics have been shown to lose some weight when switching to it. I haven't lost anything. I yo-yo between 284 and 289. I weigh myself every day and I know I need to stop that too.

Anyway, what will they do to help me? Is it just therapy? I know it's impossible to tell because every case is different, but I just want a rough guideline for how long it'll take to get myself normal. I can't see the psychiatrist until next Monday and it's been worrying me that she'll brush it off, or not know how to help me. Irrational?

Thanks you guys.

Often it is a combination of cognitive behavioral therapy (CBT) and professional nutritional advice and meal planning.

The cognitive part is connecting the emotional challenges to the logical part of your brain and the behavioral part is learning and practicing the techniques on how to successfully short-circuit the previously locked in thoughts which have inevitably resulted in unwanted behaviors (in your case bingeing, purging and starving).

So it's not just talk therapy. You get assignments and tasks to challenge locked-in behaviours and develop skills and have eventual success in laying down new behaviours.

The nutritional advice and meal planning is provided by a qualified nutritionist and ideally one practiced in eating disorder support. The nutritional advice and planning helps to reduce the anxieties and locked-in thoughts because you follow the plan which helps to reduce the amount of time and effort you assign to thinking and worrying about food.

Psychologists as opposed to psychiatrists are practitioners of CBT. Whereas a psychiatrist can prescribe drugs as they are MDs, a psychologist cannot. So for issues like psychosis or schizophrenia, a psychiatrist's involvement is best.

I cannot say whether your psychiatrist will react well or not. However, you can always go back to your GP and request a referral to a psychologist specializing in eating disorders. Best of luck.

Thank you so much. That really helps, I honestly had no clue what would happen. I know my psychiatrist I have now offers CBT, so she does that as well. I've been to the nutritionist she offered once because I wanted to lose weight..but all the nutritionist did was show me Canada's Food Guide and say "Here follow this". And that was it. That helped nothing..and I'm hoping there's a seperate person that they can send me to.

Again, thanks a tonne.

There is no specific timeline I'm aware of, since everyone is different.

From what you've described it sounds like you are both anorexic and bulimic (yes it is possible), which is someone who starves themselves, than binges and purges. People can alternate between the two. Often being obsessed with food.

Its great that you are getting help, and realize you have a problem. So many people refuse to admit anything is wrong until they are in dire straits and even then when they are in the hopital for related issues, refuse to admit it.

Bravo and best of luck.

I dont' have and ED,but I do have other issues and the right counselor can be life saving.

Eek -- yeah, a nutritionist with a bit more experience than Canada's Food Guide would be much more useful for you. 

If you like your psychiatrist and feel a decent level of trust with her, then that's where you can start, given that CBT is an option with her. If you have some intuition or feeling that she cannot necessarily help with your disordered eating then another referral through your doctor is the way to go -- in fact keep doing that until you find someone you like. And do that with nutritionists as well.

We aren't given a lot of training on how to deal with professionals in our lives and often we continue seeing them despite the fact that we really don't trust them because we assume that it is their competence that is important. Competence obviously needs to be there as a baseline (a nutritionist offering up Canada's Food Guide would not really meet the bar as far as I'm concerned!), but being able to be listened to, heard and interacted with in a way that empowers you is most important. As the crankyone points out, the right counselor will be life altering and life saving. Absolutely the best of luck to you!

Binging, starving and purging is all typical of the eating disorder bulimia. Bulimia often includes periods of restriction or starvation, so I wouldn't say you have both anorexia and bulimia. Ultimately though, the label isn't really that important.

You might find the following website helpful - http://www.bulimiahelp.org/. The website teaches you a structured eating method of recovery. It's about learning not to restrict so that the urges to binge (and then purge) diminish.

My therapist for EDs did not use CBT per se but we did talk about how I was feeling, how my eating was going, and then we talked together to come up with better coping strategies and things to do instead of resorting to ED behaviours. We also just talked about other issues in my life - family, friends, relationships etc, that were an issue for me at the time. It did help to sort out why I was feeling like I did.

I also went to a nutritionist who explained to me the benefits of different foods that I was afraid of - for example, she helped me recognise how vital fat is to staying healthy. We also made a food plan which I had input in, and we would tweak the plan at our meetings depending on how well I was able to follow the plan I had been given. She was also helpful for monitoring my weight and answering questions I had about different foods.