Lamictal side effect: Bulimia ????

[stella_blues]

Hi Karen- I've been thinking about you. You'd mentioned last week that you were having a hard time. You really do seem so strong and positive in your posts. I reckon you've learned to put on a "brave face" living with an ED. I'm sorry this world is like that- it forces good people who are suffering to hide it all away. That's really heartbreaking to me.

The past several days have been pretty rocky for me, too. I think the meds are waning already. Sometimes I wonder if I just get a placebo effect when I go a new med- which picks me up a bit and then reality sinks back in and down I go. I do think the Prozac exacerbated the mood swings and the suicidality- but I don't want to change it b/c it's helped EMMENSELY with the binge urges. I haven't had a binge since- when?- early last week? I have been purging still, though. Didn't seem to do much for that part. I hate doing it- but I obsess over it and then feel so much better after I purge.

I'm calling today to reschedule my appt with my p-doc. Supposedly there are openings for Friday. I also don't have my regular appt. with my therapist this week b/c she's going out of town for a seminar. I don't know that that's a bad thing though b/c I often feel so much worse after I've seen her! I do have DBT class tomorrow night. It's a good thing. But I'm also sort of dreading it b/c I've neglected my DBT skills this past week. Whenever I try, it does nothing for me- and makes me feel even more like a flop. I haven't done my DBT diary card for most of the days this week- which is a no-no. And I'd volunteered to do one of the mindfulness exercises (we do two every class), which I regret. Listen to me- god I'm such a whiner, lately! I'm getting on my OWN nerves!

I hope today is better for you. It's no problem if you don't feel like posting on my thread. I totally understand- don't give it another thought. Just want to give you a gentle reminder that support goes both ways. If you need anything, a kind word or to share experiences, this is a good place to reach out. Even for a super-woman moderator. You're allowed to have bad days, too. Thinking of you.

[briary]

Hi Stella

Believe me, I am nowhere near as strong as I might appear from the outside. I'm struggling just as much with this eating disorder and with depression as you. I also have at times posted daily on this forum for support; it's just at present I tend to write to a couple of good friends for support.

I'm sorry you've been going through a rocky time over the past couple of days. I guess it isn't surprising after the difficult therapy session you had, plus the fact you are feeling very alone with this at present.

I would think it is a little early to decide whether the Prozac is going to help since it takes upto 6 weeks for antidepressants to take full effect. Even then, as you know, not all medications suit everyone. It is good that it seems to be helping prevent the binge urges. I think I might settle for that myself right now. I haven't had a binge free day for several months now

The purging is a concern though, and even more so if you are not eating a lot. I think you could definitely do with some more help and support to help you try to get this under control. The health consequences are serious, as you know.

I hope you get your appointment with the psychiatrist sorted for Friday. It will be good to discuss what is happening with the mood swings and suicide thoughts, as well as the eating disorder symptoms.

Try not to worry about the DBT group. We all have times when it is harder to implement tools that can help, or to do set work. I am sure you are not the only one in the group who has ever not done their diary or felt like taking a more active role in the group.

Don't worry, if I don't post it's not because I don't want to offer support but just that if I am too entrenched in eating disorder thoughts myself, I am not sure I will have anything constructive or helpful to say.

Just want to give you a gentle reminder that support goes both ways. If you need anything, a kind word or to share experiences, this is a good place to reach out. Even for a super-woman moderator. You're allowed to have bad days, too. Thinking of you.

Thank you Stella., I really appreciate your support too. Oh, and I am anything but a 'super-woman moderator'! I do more than my fair share of leaning on others for support.

Karen

[stella_blues]

Your sharing your experience has been incredibly helpful. Sometimes that can the most helpful thing someone can do for me.

It's the Lamictal that I think is waning. I've been on it for some time, now. Prozac is supposed to start working pretty quickly, from what I was told. Some women only take it for a week before their periods for bad PMS. But who knows. I'm so confused about the meds. You could be absolutely right that it hasn't kicked in, yet.

The best they could do for the appointment with my p-doc is next Tuesday. This really threw me for the morning. I've become SO dependant on her support- it's so messed up. It makes me want to quit seeing her - it's just too painful when there are changes in my appointments. I hate the attachments/abandonment crap I form - I just hate it. It's so out of my control- it takes over.

I know that purging is dangerous. I take your warning seriously and to heart. I guess I've gotten to a point where I just don't care so much. There was a time when I wouldn't think of doing such a thing. But now I feel the comfort it brings is more of a "pro" than the hazards. I realize how short sighted that is. The "healthy" part of me is just cringing seeing myself write this. Didn't purge, today. I worked very hard all day- removing a roof. (I'm a carpenter.) And I ate very little. So I don't feel a great need to purge.

Can I ask what a binge is for you? I realize this is a very personal question, maybe even taboo, so it's okay if you don't feel comfortable answering. I ask because a binge for me has really dwindled. Now I feel like half a lite non-fat yogurt is a binge. Or if I chew and spit out half a candy bar. I know I must have swallowed a trace amount, so I feel guilty like I've binged. Do you experience this? I guess the strangest part is that I KNOW it's completely irrational.

[briary]

Hi Stella

I'm glad sharing experiences is helpful for you. I know how alone it is possible to feel with this.

I realise it feels such a long time waiting a week to see your p-doc, especially when you are struggling, but just aim to get through one day at a time, an hour at a time if necessary.

The attachment and dependency issues do make everything feel so much more distressing because relying on one person so much usually leads to feeling such intense feelings of need. I'm in this situation myself, but with a friend rather than someone treating me. Despite all the difficult feelings I wouldn't want to be without her though.

I too don't care much what damage I do to my body now. I think it is part of the self neglect and self destruction that having an eating disorder for such a long time brings. All I can do is say be careful and take care of yourself as best you can, as none of us know when the abuse of our bodies might come back to haunt us.

Can I ask what a binge is for you? I realize this is a very personal question, maybe even taboo, so it's okay if you don't feel comfortable answering. I ask because a binge for me has really dwindled. Now I feel like half a lite non-fat yogurt is a binge. Or if I chew and spit out half a candy bar. I know I must have swallowed a trace amount, so I feel guilty like I've binged. Do you experience this? I guess the strangest part is that I KNOW it's completely irrational.

I'm sorry but I don't feel comfortable describing what I eat during a binge because I am so ashamed and disgusted with myself that I do it. I can say it varies, but this year has been probably the worse year ever. It can be any food that is in sight, or drive me to going to the shops several times a day to buy yet more food. My finances are in a mess because of it.

From what you've described, and I think you know this deep down, what you are eating now is not bingeing. Half a fat free yoghurt or whatever is not a binge, but I do know that when I was in a strict anorexic phase I also felt that eating practically any food was bingeing, especially if it wasn't one of my 'safe' foods. Really, as you say, rationally, that isn't bingeing but that's how the eating disorder causes us to feel.

I hope today is ok for you.

Karen

[stella_blues]

Hi Karen,
Just wanted to share that last night's DBT class went really, really well. I was having a good day and able to openly talk about some of the "nuts and bolts" of my eating habits without feeling regret or like I needed to crawl in a hole. The facilator offered to let me call her on the cell for coaching during times I feel I'm able to reach out for help, before a purge or to manage restricting. I'll try to do that. The need to do these things is so strong- sometimes the fear of not doing them is much stronger than the desire to overcome them. Still, it's nice to know that kind of support is there!

Really, as you say, rationally, that isn't bingeing but that's how the eating disorder causes us to feel.

Right. It's like an eating disorder is a completely seperate entity, with it's own voice- it's own beliefs- it's own agenda- it's own plan. It demands of us what to do, what to think- like an abusive spouse. I plead with it when I'm so hungry I just want to collapse and it says ABSOLUTELY NO FOOD- NO WAY! I can see myself bowing to it. The times I refuse to obey it- like last night I talked myself out of purging - I know I'll be punished- today I'm paying the price b/c now I need to really restrict, to make up for the calories.

I'm sorry but I don't feel comfortable describing what I eat during a binge because I am so ashamed and disgusted with myself that I do it.

I totally understand. Thanks for sharing what you have.

I was wondering- do you take supplements? I feel like the more I get into the ED, the more obsessed with supplements I become. I was sitting there at the kitchen table this morning and looking at the pile of little pills in front of me. It's maybe getting absurd- and it's expensive.

Centrum multi
B complex with C (boost immune system)
Calcium with D (don't eat much dairy)
Cranberry cap (to prevent UTI from times I get dehydrated)
Chromium Picolinate (balance blood sugar- I get the shakes sometimes)
Flaxseed Oil (Omega 3's)
Fiber supp. (to help prevent constipation)
Acidophilus (gut flora)
Biotin (for hair falling out issue)
Also just added an iron supplement this week for the hair issue

Plus there's the Prozac pill in the AM and Lamictal in the PM.

[briary]

Hi Stella

I am so pleased your DBT group went well last night and it shows what amazing progress you have made that you were able to talk openly about the problems you are having with the eating disorder. Once it is out in the open it makes progress possible.

The offer from the facilitator was very kind and I hope you will feel able to take her up on it. I know I often wonder if that would help me - to have someone I know I can trust to turn to and call whenever I feel the compulsion to binge and/or purge, but unfortunately I don't have anyone I can speak to in person at the time it is actually happening. I would encourage you to try this and see if it does help and I'd be interested to know how it goes.

The need to do these things is so strong- sometimes the fear of not doing them is much stronger than the desire to overcome them. Still, it's nice to know that kind of support is there!

Yes, I understand that, particularly when it comes to restricting food or purging. When I've been in an anorexic phase I know the last thing I ever wanted was someone to try to convince me to eat. It is how the eating disorder reels us in until we are so entrenched in it that there seems no way out. I think I would feel differently about reaching out for help to stop bingeing though, as this is something I am desperate to stop doing.

It's like an eating disorder is a completely seperate entity, with it's own voice- it's own beliefs- it's own agenda- it's own plan. It demands of us what to do, what to think- like an abusive spouse.

That's exactly what it is like. Someone who has been supporting me for a long time suggested it was very important for me to recognise the eating disorder as something separate from me, almost like someone with their own identity. We even named the anorexia (which was most prevalent for me at the time) Edie to help me try to separate from the illness.

I have just started reading a book you might find interesting, if you have the concentration to read. It is called 'Life Without Ed' by Jenni Schaefer. She describes how she started her recovery from her eating disorder by 'divorcing' Ed (her eating disorder). She said it was like being in a relationship with an abusive partner. I haven't got far with it yet as I find it difficult to concentrate on reading, but what I have read so far does make sense.

I plead with it when I'm so hungry I just want to collapse and it says ABSOLUTELY NO FOOD- NO WAY! I can see myself bowing to it. The times I refuse to obey it- like last night I talked myself out of purging - I know I'll be punished- today I'm paying the price b/c now I need to really restrict, to make up for the calories.

I recognise those kinds of conversations, only about bingeing. The eating disorder orders me to stuff myself, manipulates and bullies me. I wish I could tell you how to make it stop but I've not managed that myself.

I was wondering- do you take supplements? I feel like the more I get into the ED, the more obsessed with supplements I become.

I'm actually the exact opposite. I shouldn't really say it but the truth is I don't care about my health, so I've bought entirely into the self destructive path of my eating disorder. I am supposed to take a multi-vitamin daily, plus quite a high dose of Vitamin D and calcium because I've been diagnosed with osteoporosis, but I don't take either. I do think it is a good thing you are looking after yourself to an extent by taking supplements to help replace what you are missing out on from not eating properly. Just watch that the use of supplements doesn't become an obsession in its own right. Of course, the ideal is to get all necessary vitamins and minerals from food, but that's often such a long way off when in the midst of an eating disorder.

I do take laxatives daily, but I don't abuse them (often) to the extent I once did and I think I suffer such problems with constipation now due to my past history of serious, daily laxative abuse. I wouldn't recommend it.

Karen

[stella_blues]

Hi Karen- I'll definitely look up Life Without Ed. Sounds like a really useful read.

I do take laxatives daily, but I don't abuse them (often) to the extent I once did and I think I suffer such problems with constipation now due to my past history of serious, daily laxative abuse. I wouldn't recommend it.

This is a tough one. I'm sure you know that a very high fiber diet would probably allow you to wean off the laxatives, but that would require eating and not purging the foods with the fiber.

I shouldn't really say it but the truth is I don't care about my health, so I've bought entirely into the self destructive path of my eating disorder. I am supposed to take a multi-vitamin daily, plus quite a high dose of Vitamin D and calcium...

I wonder if buying these supplements and keeping them out on the kitchen counter to look at every day, day after day, would put a chink in the armor of that self destructive thinking. Then maybe forcing yourself to take them once a week for a specific period of time- say one month- after which time you can promise to re-evaluate (so you don't feel trapped into taking them.)

I haven't called my DBT coach, yet. The frustrating thing is I purged and took a laxative (couldn't purge it all) last night and it didn't occur to me at all to call her until long after the fact. I think in the moment, I don't feel like I need help b/c purging IS the help. The need to purge is so uncomfortable that of course purging is the solution to feel good, again. I have the feeling you know what I mean! Just another manifestation of being so entrenched (<- great descriptive word for it, btw) in the dysfunctional thinking. It almost seems like I need someone else in my head with an alarm bell to sound off when I get into that thinking!

I think I'm realizing part of the problem is not allowing myself to be human- not forgiving myself for my mishaps. "Edie," as you call it, is the ultimate perfectionist- never allowing me to screw up, not even the tiniest bit. And it's always ramping up the perfectionist standards so they get harder and harder to reach. The more I mess up, the more I need to be punished, to make amends by paying a price (purging and starving.) At some point, I've convinced myself that if I try just a little harder, purge and starve a little better, I can reach that standard. And THAT will be success. Even with my hair falling out, the headaches and sinus congestion and fatigue and the "shakes" and the sneaking around, the gut pain and heart palpitations muscle cramping.. even with all that I feel like I need to keep pushing- Pain = progress.

[briary]

Hi Stella

Sorry I've not been around but I'm having a bad time at the moment. I've got something to do today but I'll try to reply properly later.

I haven't called my DBT coach, yet. The frustrating thing is I purged and took a laxative (couldn't purge it all) last night and it didn't occur to me at all to call her until long after the fact. I think in the moment, I don't feel like I need help b/c purging IS the help. The need to purge is so uncomfortable that of course purging is the solution to feel good, again. I have the feeling you know what I mean!

Yes I know exactly what you mean. I do that all the time with self destructive behaviours. The need to do them is just too strong. I don't know if it would work for me if I had someone to call when I felt the compulsion to binge though as that is something I definitely do want to stop.

I think I'm realizing part of the problem is not allowing myself to be human- not forgiving myself for my mishaps. "Edie," as you call it, is the ultimate perfectionist- never allowing me to screw up, not even the tiniest bit. And it's always ramping up the perfectionist standards so they get harder and harder to reach. The more I mess up, the more I need to be punished, to make amends by paying a price (purging and starving.) At some point, I've convinced myself that if I try just a little harder, purge and starve a little better, I can reach that standard. And THAT will be success. [/quote]
Yes, I totally understand that too. I have an ultimate goal and I believe if I reach it then everything will be OK, even thought I have never yet reached it one yet.

How are you today? I hope things are OK for you.

Karen

[stella_blues]

I've been on an "upswing" with my moods- which never fails to amount to INTENSE binge urges! Argh!

I'm either depressed and able to restrict (ironic b/c I feel "best" when I can restrict) or I'm not depressed and constantly battling urges to eat everything that isn't nailed down! And then when I DO eat, I have to purge it. Sometimes I resist the purging, but the obsession of all that food sitting in my stomach rivots my attention- it's almost like I can't think about anything else.

The b/p cycle gets me really down and I can feel myself spiraling back into a depressive phase. The ability to restrict returns with the depressed feelings- it's so confusing!

This is SO frustrating!

I have awful heartburn today from purging.

Sorry to hear you're still in a bad patch, Karen. This way of life is NO FUN!

[stella_blues]

The binge urges freak me out more than any other part of this disorder.

I wonder if I just need to let myself go? Just give myself the permission to be out of control?



One of the skills in DBT goes off the premiss of relinquishing all control and giving in to the "monster" at hand. So if one is feeling anxious, for example, like an axiety attack coming on, to actually encourage the anxiety - to push oneself into it- to purposefully bring it on. It sounds counter-intuitive, but I've tried it and it does actually work. It feels crazy at first- scary- but at some point, you do actually realize you're at the wheel, driving the vehicle, and can at that point stop it.

I wonder if this works with eating disorders, too?

[briary]

Hi Stella

Sorry to hear you are struggling at the moment. Have you considered taking your DBT facilitator up on her offer to call her whenever you feel like bingeing/purging or restricting. Catching the compulsion to binge before it becomes so strong it feels impossible to ignore could help a lot.

I recognise it is often even harder to ask for help to prevent purging or restricting because these are the behaviours that we feel have some benefit to us, ie making us feel better, even though they are just as destructive.

I also think it would be sensible to discuss your mood changes with you psychiatrist this week, as you've said you felt it might be the Prozac possibly unsettling you, but whatever the cause it would be a good idea to discuss it.

I'm either depressed and able to restrict (ironic b/c I feel "best" when I can restrict) or I'm not depressed and constantly battling urges to eat everything that isn't nailed down!

I am the exact opposite, but then I don't have bi-polar. The worse my depression the more I have this compulsion to binge, which causes me to feel worse and even more depressed, so I binge more and the cycle keeps going. When I am restricting I feel less depressed because losing weight lifts my mood significantly.

And then when I DO eat, I have to purge it. Sometimes I resist the purging, but the obsession of all that food sitting in my stomach rivots my attention- it's almost like I can't think about anything else.

Yes, I am like that too and when I can't purge I feel so awful that I punish myself in other ways. It is very difficult to break the cycle and you need to take little steps - resisting for 5 minutes, or 10 minutes, distracting yourself by ringing someone or being with people and sometimes it fades. However, I do know from experience that the temptation then is to restrict the next day to compensate, which isn't very helpful either.

I have awful heartburn today from purging.

Please be carful of that. There are so many complications than can arise from constantly purging, dsome very serious and others that lead to lifelong problems. I'm on medicatoion now for stomach problems due to the abuse I've put by body through over the past few years.

Sorry to hear you're still in a bad patch, Karen. I am the exact ppposite, but ,This way of life is NO FUN!

Thanks. it certainly isn't.

Karen

[stella_blues]

Hi Karen-

I am the exact opposite, but then I don't have bi-polar. The worse my depression the more I have this compulsion to binge, which causes me to feel worse and even more depressed, so I binge more and the cycle keeps going. When I am restricting I feel less depressed because losing weight lifts my mood significantly.

This is really interesting. Yours is more logical. I think the bipolar is definitely the culprit. When I'm manic, I throw all caution to the wind and have absolutely no impulse control. I think, "Oh, what the heck- I'll just eat and eat as much as I like b/c I just feel so darn high right now- who cares!" When I'm depressed I feel like I want to disappear. And I have no interest in taking care of my body. I also crave punishment and a sense of control. So starving myself makes perfect sense.

No, I haven't had it in me to call my DBT coach, I'm ashamed to report. Part of it is that my partner is always around. She isn't really aware of the extent of my eating disorder- I feel it's just one less thing for her to have to worry about. She's had to deal with enough with me. High chance that she'd ask who I was talking to- I could tell her my DBT coach, but then I'd feel the need to make up a reason. And I really don't want to get into out-and-out lying to her. I might hide the truth, but I don't make up lies to her.

I guess it's just another way I'm doing the addict's dance. This is totally what alcoholic and addicts do with their families and spouses. I see that.

I'll bring up my mood changes as my next appointment, yes. I have the feeling nothing much will come of it, though. I predict she'll up my Lamictal dose. I'm feeling pretty apethetic. A different kind of helplessness.

[briary]

Hi Stella

This is really interesting. Yours is more logical. I think the bipolar is definitely the culprit. When I'm manic, I throw all caution to the wind and have absolutely no impulse control. I think, "Oh, what the heck- I'll just eat and eat as much as I like b/c I just feel so darn high right now- who cares!" When I'm depressed I feel like I want to disappear.

I think everyone has different triggers for their eating disorder behaviours. For bingeing for me it is definitely depression, feelings or hopelessness and of having failed - since I used to be severely anorexic and now believe I have messed it all up. I binge because I feel so bad about myself, which obviously leads to me feeling even worse and then I punish myself by various means, either purging or self harm. And when things get really bad the suicidal thoughts take over. I think that's probably the equivalent of why you do it and don't care when manic, because I always think that soon I won't be alive so none of it will matter. But, of course, it does matter and I sink further into depression. I never have any 'highs' just varying degrees of 'lows'.

And I have no interest in taking care of my body. I also crave punishment and a sense of control.

Ashamedly I don't care about my body either, or the damage I do to it. I think the core cause of any kind of eating disorder is virtually non existent self esteem and feelings of being worthless. Therefore the punishment makes sense - whether it is starving oneself, purging, or any other self destructive behaviour. The eating disorder plays right into the hands of this, using beliefs about being worthless to manipulate and control behaviour. It is a hard trap to break free from.

No, I haven't had it in me to call my DBT coach, I'm ashamed to report. Part of it is that my partner is always around. She isn't really aware of the extent of my eating disorder- I feel it's just one less thing for her to have to worry about. She's had to deal with enough with me.

I understand your reasons for not calling your DBT coach, but I think if you were to ask your partner whether she would prefer to know what is happening with you, or be kept in the dark to 'protect her', I bet you'd find she would want to know and to be there to support you and help you through this. She would, I am sure, be pleased that your DBT coach has offered to help and support you. All too often we struggle on alone, trying to hide this from the people closest to us but you might be surprised at how much she has guessed already, or she might be very confused and worried about what is happening with you.

Why not reconsider confiding in her? I know that is a scary thought, but it could really help you both if she knew how much you are struggling.

I guess it's just another way I'm doing the addict's dance. This is totally what alcoholic and addicts do with their families and spouses. I see that.

I have been there too and I think it is the nature of the illness to be secretive and hide things. You are definitely not alone in that. But those close to us have a way of knowing something isn't right and I've learnt from experience who I can trust to let in and share how I am feeling.

I hope things pick up for you too. It seems it is a difficult time for us both.

Karen

[stella_blues]

Hi Karen- Is your ED basically embedded in Chronic Depression? I wonder if trying some different medications to treat the depression would help alleviate the compulsive parts that drive the ED? I imagine you've explored many different solutions at this point.

I think the core cause of any kind of eating disorder is virtually non existent self esteem and feelings of being worthless.

I couldn't agree more. Well said.

As for confiding in my partner about the purging in particular - I just can't even fathom telling her. It's not that I'm so against her knowing in specific- it's just that I'm so ashamed and embarassed- and also I hate the thought of her having yet ANOTHER thing to fret over with me. I worry she'll get burnt out on dealing with all of my crap. She was pretty traumatized by my recent crisis'. I do think you're right that she knows something is up with my eating. She's always known I tend to restrict. I do wonder how much she knows about the other stuff.

I did end up calling my DBT coach, today. (My partner was away for a few hours.) She didn't have time to talk between clients, though. She felt really bad- but I told her no problem- maybe I'll call tomorrow. *shrug*

Having a pretty rough day. Not good. Really tired of this. Everyday feels like an eternity.

[briary]

Hi Stella

How are you doing?

Is your ED basically embedded in Chronic Depression? I wonder if trying some different medications to treat the depression would help alleviate the compulsive parts that drive the ED? I imagine you've explored many different solutions at this point.

I've had depression of varying degrees since childhood, but my eating disorder only started about 5 or so years ago. I find my depression gets worse when I'm in a bulimic cycle, as anorexia and losing weight helps me feel better about myself. I think it's really about my complete lack of self worth. I just believe I am worthless and nothing.

Regarding confiding in your partner about any aspect of the eating disorder, that is totally your decision and if you don't feel comfortable talking to her about it then that's fine. There is no pressure. I completely understand that it is difficult to talk about what is going on and letting others in. I would just say that my experience is that my closest friends knew long before I was willing to admit anything that I had eating problems, although probably not the extent until I started talking about it. They have also been incredibly supportive and have stood by me through it all - and there have been and still are some pretty horrendous times. If or when you feel you want to talk to her, I doubt she will feel burdened or badly of you. She will probably want to support you and try to help you through it.

It is a shame your DBT coach wasn't able to talk when you called but well done for reaching out to her. People have good intentions but cannot always be available all the time. Have you phoned her since?

Really tired of this. Everyday feels like an eternity.

I empathise and hope today is a bit better. Sometimes the struggle feels just too much to bear.

Karen