Sometimes the truth slams into you when you least expect it.
We’ve just passed the anniversary of Ollie’s admission to the inpatient unit. Plodding along, one foot in front of the other, looking forwards. It’s going ok. We’re through the worst. It’s not all that bad.
This week we learned that my husband’s colleague has just lost his teenage daughter to this illness. It’s tragic, horrific, unimaginable.
Anorexia is deadly. It’s statistically the mental illness with the highest mortality rate.
I look at our son and I’m rocked by the enormity of what has happened to him. I’m so thankful that he’s here, he’s home, he’s whole. Or is he? Can he ever be whole? Will the voice in his head ever be silenced? Will he ever be able to live a “normal” life? What happens when we no longer control every single thing he eats?
We were perhaps “lucky” that Ollie was so very young when he became ill. As parents, you generally have control of a primary school-age child’s diet. It’s not unreasonable to portion out your child’s food or make their packed lunch. The child is not expected to do the food shopping. An eleven-year old isn’t likely to be eating out without his family; they might buy sweets with their pocket money but that’s as far as it goes. It’s all up to the adults.
We have an iron grip on Ollie’s diet. Although he makes some decisions, everything is overseen by us. I plan our main meals, and buy in the snacks that Ollie can then choose from. My husband makes the packed lunches and supervises football training, to offset the activity with appropriate calories. Ollie isn’t responsible for his intake. We are.
If the sufferer is older, perhaps a teenager who goes out independently with friends, buys their own school lunch, and spends much of their time away from their parents, managing anorexia must be so much harder. An adolescent is unlikely to accept such close parental supervision. It would be unusual for the parent to portion out food or insist on watching the young person eat their evening snack. The responsibility for choosing to recover is a huge weight to bear, and for a teenager it must be overwhelming.
Due to Ollie’s young age, we were able to exert our parental power over him in other ways. When he was an inpatient, he resisted treatment, often with violence. It was clear that he didn’t want an NG tube and he didn’t want to be fed. Although he was initially held under Section 2 of the Mental Health Act, we were able to subsequently consent to his treatment and avoid a Section 3. Ollie was mute, physically tiny, and only eleven. We were able to decide on lifesaving treatment on his behalf, and he did not have the option of refusing.
Again, older patients have more say over their treatment. Although a severely ill patient can be “sectioned”, an older adolescent will have more say, more rights, more independence. If they won’t comply with treatment, ultimately there’s less a parent can do. Of course everyone will always do their utmost to help the patient - there is no doubt whatsoever of that - it must be so much more complicated with a young adult.
Ollie is recovering, and he is also growing older. Puberty is well on its way. Ollie is currently highly motivated to beat anorexia, and is complying with treatment completely. But as he gets older, and as we get further down the road, he will have to start taking more responsibility over his diet. I will have to let go, a little at a time. And it’s terrifying. He will need more independence, more privacy, looser boundaries. He’ll need those things to become a “normal” teenager. Will be cope? Will we spot any cracks that appear? Will he stay motivated? Will he grow whole?
Hearing of the death of an anorexia sufferer is sobering. When that person is so young, it’s heartbreaking. It’s too close to home, it’s too frightening. The truth of this illness is nightmarish.