Living with PTSD

PTSD is not often what young adults and teens think of when you say the words 'mental illness.' More often they'll jump to Depression and Anxiety. I know, personally, I always associated PTSD with survivors of war and never realised that a young woman in Australia could experience it. That was until I felt the steering wheel go through my chest every day even after my fractured sternum had healed.

While mental illness never discriminates, it is always personalised; no person experiences any illness the same. The stereotypical image of PTSD is flashbacks and some people think that this is all there is to it. I did too for a long time. Sometimes it can take the form of panic attacks which can be triggered by anything, it can be psychosis, night terrors, drug and alcohol abuse, it can be out of the blue twitching. Every person has their own triggers and responses.

It becomes difficult because no one can understand it, even I had trouble to understand my own, but often they don't need someone to understand why they're shaking randomly, or why they're feeling physical pain for no reason. Most of the time they just need someone to hold them and tell them that they're safe. They just need someone to love them while they think they're going crazy.

Just like any mental illness PTSD can be detrimental to relationships with other people. It can make it hard to be close to people and spending lots of time with someone because that leaves you vulnerable to be seen on bad days. You feel like a burden and an effort. Some people think that you're crying because of something that was said about you, when that is actually the furthest thing from your mind because all you can focus on is your trauma. But they will never understand it. They'll put it down to you being a 'drama queen/king.'

Unfortunately, after years of losing people to your PTSD you realise, just like you are wired to react to your triggers, some people are not wired to be able to handle mental illness. But you also learn and realise who will assist you in different ways. One friend may be awesome at listening while another will be able to distract you while another will be able to make you feel like a million bucks.

If you know someone with PSTD, figure out how you can help them, you don't need to understand how their brain is wired. You just need to know how to be a friend. They just need people to love them, even if it's just a message every couple of weeks to remind them you're there. Sometimes they'll want to talk to no one but at least they'll know you're there and they will appreciate it more than you'll ever know.

Written by reader, Ashleigh Rankin, who suffers from Post-Traumatic Stress Disorder

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The Meaning Behind the Paper Crane

During my most recent admission to an eating disorder unit, I met a nurse who taught me how to make paper cranes. What started as a crazy, intense attempt at a piece of dinosaur origami involving a 25 minute you-tube tutorial and 5 pages of instructions from a massive booklet full of weird technical terms such as blintzing, triangulation and pythagorean stretching, we decided to call it quits and stick to something a little bit easier, the classic paper crane. After a solid 3 hours of practice, we were determined to make 1000, as the legend goes, if you make 1000, you get to make one wish. Over the next 48 hours, almost every single patient and nurse was in on it, contributing what they could to the gigantic pile. One simple act had the power to bring people together in a shitty situation whilst creating something beautiful. The project kept me busy and distracted, it kept me from harming myself, it kept me calm and it kept me focused on something other than, what I like to call, “the terrible”. This nurse taught me to live in the moment, how to appreciate the little things, how to be compassionate, empathetic and understanding, that my thoughts and opinions are important, and the fact that I matter. Most importantly, she gave me hope. Hope that things will get better, that this is only temporary and the reassurance that there are always people who care. So this is for her, and every other person I’ve met along the way who has inspired me, pushed me to keep going and had faith in me. It’s a constant reminder that there is always something and someone out there. That there will always be hope. 

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Stereotypes

• That the only types of eating disorders are anorexia nervosa and bulimia nervosa
  Although these are two of the more widely known types of eating disorders, there are so many more including…
  1. Binge Eating Disorder (BED) which involves recurring episodes of binge eating followed by high periods of distress however; a person won’t indulge in compensatory behaviours.
  2. Pica which is characterised by an appetite for substances with no nutritional value such as paper, hair, paint, glass or metal.
  3. Rumination which involves the bringing back up and re-chewing of partially digested food that has already been swallowed.
  4.  Avoidant/Restrictive Food Intake Disorder (ARFID) is where the consumption of certain foods is limited based on the food's appearance, smell, taste, texture, or a past negative experience with the food, such as choking.
  5.  The diagnosis of Other Specified Feeding or Eating Disorder (OSFED) is given when a person may present with symptoms of other eating disorders however, they don’t meet the full criteria to be diagnosed with these disorders.
  6. Orthorexia, although not clinically recognised in the DSM-5, it involves developing an unhealthy obsession with ingesting only healthy food.
• That you’re not sick until you’re emaciated
  Weight is merely a psychical symptom to a mental illness. A person’s weight does not determine how sick they are. A person’s weight does not illustrate how much they’re suffering. This belief is what drives sufferers deeper into the illness, making sufferers believe that they’re not “good” at being “sick enough”, and leading to an increase in self-destructive behaviours.
• That when you reach a healthy weight, you’ll automatically have a healthy mindsetWeight restoration is extremely important in furthering a person’s recovery, however as eating disorders are complex psychiatric illnesses, it takes a lot more than a healthy weight to remove all thoughts and behaviours.  Just because someone in recovery is a healthy weight and eating all their meals, doesn’t mean their cured or not struggling. They’re just simply further along in their recovery.
• That a person with anorexia doesn’t eat at allThis is complete and utter bullshit. If someone with an eating disorder ate absolutely nothing they would be dead within a few weeks. Sufferers of anorexia do eat, however the portion is small and the food is usually low in calories. Eating behaviours are extremely individualised.
• The assumption that a person’s illness was caused from a dysfunctional family environmentThere is no evidence that particular parenting styles are a direct cause of eating disorders. In fact, there is no identifiable cause for the development of an eating disorder, only a variety of predisposing factors such as genetics and certain personality traits.
• That you’re only struggling and malnourished if you’re extremely underweightA person’s struggle is not defined or shown by their weight, and neither is their state of nourishment. Malnutrition is defined as the insufficient, excessive or imbalanced consumption of nutrients. It can occur at ANY weight when a person’s diet doesn’t contain the right amount of nutrients, whether it be undernutrition (lack of nutrients) or overnutrition (more nutrients than needed).
• That people with eating disorders only eat “healthy” foodNot everyone with an eating disorder lives off healthy food. Some may eat candy bars in the morning and nothing else all day. Others may eat lettuce and mustard every 2 hours or only condiments. Every case is different, however, in the case of orthorexia; it’s slightly different as it consists of the obsession with only eating foods which are considered healthy.
• That all eating disorders stem from body image issues and vanityBody image and self-esteem issues may contribute to the development of an eating disorder however; that is not what drives them. They are usually related to emotional issues such as control and low self-esteem and often exist as part of a dual diagnosis of major depression, anxiety, or obsessive-compulsive disorder. It is a way to cope with unpleasant and overwhelming emotions in the short term.
• Eating disorders only affect white, middle class females
  Eating disorders do not discriminate. Both males and females from a range of socioeconomic, sociocultural and religious backgrounds can suffer from an eating disorder during any stage of life. Although it’s mostly common in females, an estimated 10% to 15% of males suffer from anorexia or bulimia and another 40% exhibit BED, with the percentage continuing to increase.
• That eating disorders are a choice 
  No one on earth would choose to have an eating disorder. They’re not a choice, they’re complex psychiatric conditions that develop over time and require a range of treatments to address the underlying issues.
• That people with eating disorders are deceitful and manipulative In order to cover the shame and protect their eating disorder, some sufferers may lie about their behaviours. This is their illness and not the person themselves. On the other hand though, there are others who will be completely honest about their behaviours however, due to this stereotype, health professionals will generally believe the sufferer is just lying about everything.
• That it’s all about food
  Eating Disorders are basically coping mechanisms. By focusing on food and weight a person is able to repress or numb painful feelings and emotions.
  
• That Binge Eating Disorder (BED) isn’t a serious eating disorder
  Binge Eating Disorder is just as serious and dangerous as any other eating disorder. Binging episodes often result in intense guilt, shame and self-hatred resulting in crippling depression, anxiety, self-harm and suicidal tendencies.
• That one admission will cure an eating disorderThis varies with each sufferer. Some individuals may only need one admission; some may need multiple over a period of years. Recovery is very individualised the one method won't work for everyone.
• That every person with an eating disorder counts caloriesIncorrect. Each sufferer struggles with different aspects of things surrounding food and weight. One may count calories in everything they consume while others may go purely off size and what’s considered “safe” and some might not care at all. Not everyone counts the exact amount of fat, sugar and carbs in what they’re consuming. It doesn’t make a person’s illness any less valid if they don’t struggle with this specific behaviour.
• That sufferers of anorexia don’t get hungry
  Anorexia isn’t defined by some mysterious absence of hunger, it’s the denial of hunger, not its absence. Everyone gets hungry, it's human, however, when your body is screaming at you not to eat, you learn to ignore the feeling of hunger.
• That everyone with anorexia excessively exercise to lose weight
  Another myth. Some sufferers may struggle with excessively exercise however, not everyone does. Some sufferers will hate exercise with a passion (like me!). This does not make a person’s illness any less valid. 
• That purging is only throwing up
  Purging can occur in a range of ways including self-induced vomiting, fasting, the use of laxatives, enemas and diuretics, insulin abuse and excessive exercise. Each of these methods are as dangerous as each other and can lead to a serious medical emergency.
• That you have to be clinically diagnosed to suffer from an eating disorder
  Many sufferers can go undiagnosed for years due the will to protect the disorder, the stigma surrounding it and the denial that there is even a problem. If someone identifies with a majority of the symptoms of a disorder, it doesn’t make their illness any less valid. An estimated 20% of females in Australia live with an undiagnosed eating disorder.

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Things I wish I knew before I went Inpatient

In every facility you go to, you will get the good and the bad. Nurses who have the ability to change your life, as well as nurses who will make you question how they ever got their degree. You will come across medical professionals who are completely lacking in their knowledge of psychiatric conditions such as nutty professors who will compare your illness to a “crazy religion”. Depending on the illness and the type of clinicians treating you, it’s likely that no one will believe a word you say. Even if you are explicitly honest with your team, they will often believe in the stereotype associated with that illness.


If you’re medically unstable, you will be admitted to a medical ward. Depending on your age, you will be either in a pediatric ward or a general medical ward. Not all nurses will understand what you’re going through, and will make insensitive comments. Sadly, that’s the reality. In a general medical ward, it’s likely you’ll be surrounded by elderly people. You’ll see a lot of urine and faeces floating around, smell weird smells, hear strange noises and learn a lot of medical terminology. You will meet some of the nicest, sweetest people on the planet. You’ll learn the kindness of strangers who may go to the effort of inviting you into their bed when you’re upset to distract you and let you watch their TV or nurses who will make the time to braid your hair or draw cute doodles on your patient board.

On the other hand, there are psychiatric hospitals which you can to go for a range of reasons including the breach of a Community Treatment Order, if you’re deemed not safe enough to be at home or if you’re in crisis. These hospitals are nothing like the way they’re portrayed in Hollywood. They’re not a bunch of rooms with padded walls with patients in straight jackets, rocking back and forth. Imagine going on a school camp, except it’s with a bunch of strangers who are mentally ill.


In an adolescent unit, they try their best to keep a normal schooling routine. In my experience, school was split into two blocks going from 10am-12pm, breaking for lunch and then again from 1pm-2pm. The teachers try their best and are extremely understanding and won’t force you to work if you’re clearly distressed or just having a bad day. From the get go, you should try and socialise with other patients. As hard as it can be, it makes the day go a lot quicker and it helps to have someone you can complain too that understands. 

An adult unit is very different to adolescent; however this does depend on the unit itself. From my experience, its people from the ages of 18 to 70, clumped together in an uncomfortable setting with no groups, no therapy and minimal social interaction. If you like things clean, chances are you won’t get that here. Whether it’s a bedroom with specs of blood on the wall or the dining area covered in unrefrigerated milk, coffee sachets and raw sugar. However, units in more populated areas are usually more equipped with programs and skills to help treat patients. You can expect to have groups such as Dialectical behaviour therapy (DBT), nutrition groups, psychology groups, art therapy, meal planning, cooking groups, weekend debriefs, and a range of others depending on the unit and what it’s treating. Although, even in a specialised unit, you will come across clinician’s who have no idea how to treat your condition.

With each admission you will learn a little bit more about yourself. You’ll learn how to be compassionate, empathetic and understanding. You’ll learn how debilitating a mental illness can be to others around you. You will meet all sorts of people. People who make you laugh, people who make you cry and people who will inspire you to do more with your life. Chances are you’ll make friends you’ll have for the rest of your life. 

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Unhelpful comments to someone with an Eating Disorder

• "You've gained so much weight, you look so much healthier" 
  The most common and most hurtful comment. Although this is usually intended to be a compliment, it's usually twisted into the complete opposite. This comment only fuels the voice criticizing the sufferer for gaining weight and draws attention directly to the individuals body image.
  
  
• "Wow, you're so disciplined, i wish i had that kind of self control" or "I wish i could lose weight like you"
  This isn't a matter of self control. The sufferer feels they have no other choice other than to obey the rules of their eating disorder.
  
  
• "Have you finished your food/meal already?"
  Although this may just be a simple question, the sufferer can interpret this as you thinking they're greedy, a pig, that they must not have an eating disorder since they're eating at a faster pace, that they have no self control, ect.
  
  
• "You've lost so much weight!"
  This statement fuels any eating disorder and the dangerous behaviours behind the change in weight. Some sufferers may interpret this as a lie and fuel them to lose even more weight.
  
  
• "That type of food is really unhealthy"
  It doesn't matter if you're recovering from anorexia, bulimia, EDNOS or binge eating disorder. The goal is to eat all foods in moderation. This statement just reaffirms the belief of certain foods being "bad" for you and why they should be avoided.
  
  
• "Just eat" or "Just eat normally" or "Why don’t you just stop throwing up?" or "Why don't you just keep it down?" or "You just need a little self-control. Just don’t binge, it’s simple"
  If it was as simple as just eating normally, no one would have an eating disorder.
  
  
• "You're not skinny enough to have an eating disorder" or "You don't look like you have an eating disorder"
  A person's weight is merely a symptom of their eating disorder. These are mental illnesses which come in many forms and although Anorexia is the most reported and known eating disorder, it only makes up 3% of sufferers in Australia, while 47% makes up Binge Eating Disorder.
  
  
• "Don't you know the kind of damage you're doing to your body?"
  Yes, almost everyone with an eating disorder can see the damage they're doing to themselves however, as time goes on, the eating disorder part of the brain gets stronger, and the negative impacts of the disease are not enough to completely give it up.
  
  
• "You know laxatives don't make you lose weight right?"
  Logically, sufferers who abuse laxatives know they don't do anything besides drain your body of important electrolytes but there's more behind the abuse than weight loss. It could be a form of self harm, a way of feeling like you're purging your body of everything inside or a way of making the number on the scale go down slightly through dehydration. It varies for each person.
  
  
• "You're not sick though because you're medically stable and not extremely thin" or "You seem healthy enough"
  This will differ from person to person but just because someone is medically stable doesn't mean they're not sick. Eating disorders are a mental illness with physical symptoms and consequences. A persons weight doesn't determine the state of their mental health.
  
  
• "At least this is in your control, so you can change it"
  If it was as simple as flicking a switch, everyone with an eating disorder would be cured almost instantaneously. It varies with each individual however it takes a team of professionals and alot of internal strength  and will to change behaviours and thoughts that have been ingrained over a long period of time.
  
  
• "Oh my god, are you still hungry?"
  During recovery and/or re-feeding, hunger cues are all over the place and in most cases, extreme hunger occurs. Many describe it as “I’m not hungry, but I’m hungry” and can eat up to double a normal intake in 24 hours. This is completely necessary to give your body back the nutrients it needs however, many people are unaware of this phenomenon and may question why you're eating so much or why you're hungry which can result in eating disorder fueled thoughts and dangerous, compensatory behaviours.
  
  
• “If you think you are fat, you must think that I’m obese”
  An individuals perception of their body doesn't translate onto the people they surround themselves with.
  
  
• "You're tearing this family apart" or "You know you're just hurting the people around you"
  Sufferers are acutely aware of the damage they're doing to the people around them. The more a person is blamed, the more guilt they will feel and the more they will despair the idea of recovery.
  
  
• "Why are you choosing to be like this?"
  No one chooses to have an eating disorder. It is extremely difficult to even think of changing ingrained patterns of behaviour, let alone actually going through the steps to recover. 

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