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Re: Help
Aug 12, 2007
Hi needhelp,
It's funny you should mention you are studying towards your clin psych - so am I!!!! I decided on the career change after my two mental in-patient stays. But yes, I still struggle with my eating at times, and my depression.

Anti-depressants can be, and are, used for some patients with ED. This isn't to directly treat the ED, but as the other poster stated, they are used to treat the symptoms of depressioon which are often co-morbid with ED, especially in the more advnaced stages as the body begins to go into 'knock-down' mode meaning that cognitive functions become hindered and depression ensues.

I have personal experience of the old MAOI's, SSRI's and and SNRE. The SSRI's were all terrible for weight gain - I went from size 6 to pushing a size 14!!!! The MAOI's didn't affect my weight at all. The SNRE, Mirtazapine (which I have been on for 3 years now), gave me a little weight gain at the start (about 2kg) and this then stopped. Although, the weight was much needed at that stage - so it was ok for me.

Typically, anti-psychotics such as risperidone or olanzapine are used for ED's as well, especially anorexia. These drugs are aimed at affecting the delusional thoughts that one has about one's own body image. I know several who were on risperidone - none had weight gain. My pdoc wanted me to go onto olanzapine - but I refused as it nearly always has weight gain, and I didn't want to have two drugs giving me weight gain at the same time.


Do you find that you do suffer with depression?? My ED was a co-morbid syptom of my depression, rather than the ED appearing first. Either way, without Miirtazapine I wouldn't be around today. If you don't have depression, then I don't envisgae you would be prescribed an anti-dep.

One important thing... ED's cannot get better with drugs. ED's are enmeshed in the cognitive understandings of the self. Wihtout therapy, no drug can eliminate ED on their own. Therapy is the best key to ED freedom. Anti-psychotics are also normally only prescribed for AN if you require in-patient care.


Bear in mind too.... if any drug puts weight on, then that weight can also come off again too!!! Mind did!!! It is generally only drugs used to treat the thyroid which 'actualy' put weight on people as they directly affect the metabolism. Psychotropic meds simply increase your appeptite, but they don't directly cause endogenous weight gain by eating the same amount of food as before as thyroid drugs do.


I understand you don't want to gain weight - but you at least need to attempt to regulate your weight so it doesn't drop lower than present as the ED takes hold. You may be of the opinion at the moment, 'it won't go below this weight - this weight is safe for me, this weight is ok',... BUT.... this is how ED's work... before you know it the ED will be in control, you will have lost all control and your weight may reach dangerous levels which you yourself will not notice, nor accept. It is at this point that control is taken out of your hands completely, the control that you THOUGHT you had that is. I was put in a clinic by my other half and my pdoc - watched 24/7 by a nurse at arm's length, force fed. It isn't pretty. Please be careful - noone noticed ED creeping up on them - it is a silent killer.


Also, you want to be a clin psyh right?? Just like me, and I've been through ED too - so we're pretty similar. So, here's a question that I thought to myself once...'How can I practice clin psych and be reponsible for the psychologically well-being of others if I refuse to practice what I preach myself??' What do you think?? Is it ethical???


My guess is, that you have alot of trauma deep inside, of which your ED is merely a physical outward symptom. Therapy, as you know, will get to the root of these. I have found, 3 years of therapy later, that I have been the best case study ever to learn from for my clin psych - much more than I could ever achieve from any clin psych text book or lecturuer or placement. I have been my own 'practical' if you like. Not only was it an interesting theoretical journey with my own clin psych, but it has also enabled me to be much more confident in who I am, what I am. It was both a personal and professional jounrey which I know will prove invaluable in my professional work with my own clients one day.



Hope this helps,
nut





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