Back to the Basics...

Looking back, it's been a little while since I've been fully committed to the Candida Diet. What began a few years ago as a strict, but healthy diet, has become a painfully pathetic attempt to walk to line between health and my chronic sugar addiction. I have slowly allowed myself to eat more and more foods, which has inevitably caused all of my original symptoms to return. I often feel bloated and lethargic, my acne has returned with a vengeance, and my weight has reached my "NO GO" point, so it's about time I commit to change my life with a strict regimen once again. It is difficult to remain completely true to a sugar free diet, as life is a bit hectic as of late, and I am often finding myself eating out. I have slowly begun to incorporate more protein and less carbohydrates/sugar into my diet, but I'm finding sugar moderation difficult. I believe I will have to return to a completely sugar free diet in order to keep my mind sane and my body healthy. I will keep you posted on my progress and results!

The Anorexia Prison

I have been in recovery from an eating disorder for many years now, the process has been a roller coaster ride, and at times, I forget what the madness really feels like. That is, until I have an experience like I had tonight, which brings me back into the anorexia prison I spent so much of my adolescence in. The real madness of an eating disorder is different from the everyday anxiety and uneasiness I feel about my body. The madness of an eating disorder starts deep within, it peameates my whole body, moving from cell to cell. It starts as fear, but quickly and uncontrollably turns into panic. I feel my hands shaking. My mind is racing, thoughts moving quickly trying to find the solution. How can I fix this?! How can I make this all better?! Then I begin to feel helpless and hopeless, which only furthers my fear and creates increasing panic. My whole world feels shallow and empty, I feel like a shell. I have nothing anymore, as my life is completely out of my control. I feel disgusted with my body, myself, my mind. I am too stupid to fix the problem, even dumber for not seeing this coming, not being strong enough to do what I needed to in the first place. My hopelessness turns to rage, its directed at anyone and anything around me. I throw stuff, yell, punch the wall, anything to release this horrible feeling of doom deep within. I eagerly seek exercise as a resolution to my problem. I work out hard, intensely, praying for results. Hoping that the sweat will bring the scale numbers back to a range where I can breathe again. I take frequent breaks to get on and off the scale, I anticipate the change, but dread the outcome. The number is stagnant. I continue to exercise, more, harder, longer….I feel dead inside, helpless again. This is a pathetic and futile effort. I quit and collapse in a pile of despair. The panic has subsided, but the disgust for myself remains. I shower off the sweat and resolve to be better tomorrow.

Occupational Therapy in Mental Health

Mental health has become a niche field more recently in Occupational Therapy. The field has its roots in mental health, but has become more based on physical conditions and disabilities as time has progressed. That being said, this post will focus on providing a brief overview of the current types of treatment occupational therapists administer to patients in psychiatric settings.

OT is often administered in a group setting, and is sometimes referred to as "activity therapy". Groups usually focus on teaching patients life skills as well as coping techniques to deal with mental illness and substance abuse. The length of the groups is dependent on the attention span of the group, and how in depth the material and discussion will be. Depending on the setting, length of stay, and type of equipment available, patients may be able to participate in actual cooking tasks, where they are monitored for safety and taught important skills to use when they are discharged. Other facilities may not have access to large areas and cooking equipment, so the focus could be a discussion and handout on nutrition, cooking and/or meal preparation. Whatever the topic or group, the focus is always on helping the patients engage/participate in an activity that will challenge them, teach them skills, and help them with socialization.

Some common group topics include: nutrition, cooking, coping, relationships, sensory integration, art therapy, leisure exploration, self-awareness, substance abuse

Sensory integration is another important aspect of OT in mental health. Many settings have what is called a "sensory room", where patients can be taken for short periods of time, usually 10-15 minutes, in order to help them calm down and reorganize during stressful or anxious times. These rooms are usually quite small, and often include comfortable chairs/bean bags, fidgets, adjustable lighting, music and nature videos. Patients are brought into the sensory room for an individual intervention, in which a staff member must be present to facilitate. These rooms are best used on a regular basis (i.e. once per day), but can be used on an as needed basis as well. Staff are encouraged to take patients to the sensory room when they are first noticing increased anxiety or escalating behaviors; once the patient is in crisis mode, the sensory room is no longer appropriate. Sensory rooms can be a great intervention which can help patients learn to reduce stress and self-regulate without medication.

OT's may also lead groups on music or art therapy. Art groups challenge patients to use cognitive skills such as mental organization, sequencing, and problem solving, while creating something for themselves or someone they care about. Engaging in art activities allows patients to try new things, and discover new talents and hobbies. Music is another important coping tool that most of the patients have access to at home. It is important to discuss how to functionally use music as a tool, and allow patients to experience the healing power of music.

Food Addiction: A Love-Hate Relationship

The cycle of food addiction is all too common these days. Individuals with and without eating disorders suffer from unhealthy relationships with food. Like so many others, I have a food addiction. The common cycle looks something like this:
1. I dislike my body - I want to lose weight
2. I go on an unmanageable diet which may or may not include severe restriction and/or purging
3. I feel brain fog, severe fatigue, hunger and cravings
4. I become so hungry I binge
5. I feel guilty, full, bloated
6. I dislike my body and begin restricting again

Of course, often the foods that I crave are also the foods I restrict. These foods control my thoughts, I daydream about them until I eat them. The foods are usually high in carbohydrates, sugar and fat; they are the types of foods that make me feel disgusting every time I eat them, but often the elusive pull of my cravings eventually wins out over my willpower and knowledge of the foreseeable future torment.

Unknowingly, when I began the Candida diet, I removed my biggest obstacle in fighting the addiction, carbohydrates and sugar. These foods are addicting on their own, but combined with an eating disorder, they are mind controlling. I began to realize that cutting back on these foods was not enough, I needed to remove them completely from my diet. This sounds incredibly difficult to do, and it was initially, but over time I began to enjoy that food did not control my life, and I did not miss the ups and downs of the food addiction cycle. Removing the temptation was made easier because I made sure to eat more of the healthy foods which curbed cravings and kept me from being constantly hungry. Even now that I've been on the Candida diet for years, if I eat certain foods I begin to feel the guilt, the shame, the need to begin the cycle again. That feeling helps keep me on track. I know what it's like to live without the constant feeling of addiction, and I try to remember that in order to stay away from the foods that trigger my eating disorder.

Going on the strict version of the Candida diet was easier for me than most, because I used my obsessive nature to aid me in eating healthier. I made the diet a challenge. I used all the willpower I had always been using to harm myself, and I turned it into positive willpower. I admit, when i first began the diet my intentions were less than honorable, I felt that the diet would help me lose weight. Fortunately, over time, the diet still worked its magic on me both physically and mentally. I was able to maintain my weight easier, control my addiction to food, and live a more meaningful life. The longer I was away from the food cycle, the less power it had over me, and the less I felt I needed it to live. Ironically, most eating disorder treatments are focused mostly on refeeding and teaching individuals to eat all foods (good/bad) in moderation. Moderation has never been something I could do, especially when it comes to carbs and sugar. I look at these substances like drugs, and you never hear a drug addiction center tell their patients to learn to enjoy drugs in moderation! I think this diet has helped me to feel more powerful and in control, just as my eating disorder did, but in a more healthy and manageable way.

Occupational Therapy (OT) Overview

Since many people are mostly unaware of what Occupational Therapy is, I thought I would provide a brief overview of the profession by answering some common questions.

1. What is Occupational Therapy?

"A form of therapy for those recuperating from physical or mental illness that encourages rehabilitation through the performance of activities required in daily life." (Google Search) 

Unlike what it initially sounds like, Occupational Therapy is not all about helping people find or maintain jobs. In fact, occupation is just another word for activity. It is a fundamental concept in OT that individuals will be more motivated to attend therapy and complete a HEP (Home Exercise Program) if therapy includes functional and meaningful activities as opposed to repetitive and/or boring tasks.     

2. What types of settings does an OT work in?

An OT can work in many types of settings including inpatient/outpatient hospitals, skilled nursing facilities (SNF), schools, clinics (public and independent), communities, health centers, psychiatric facilities, etc. 

3. What populations do OT's work with?

OT's work with diverse client populations including pediatrics, geriatrics, adult rehabilitation, mental health including dementia and psychiatric conditions, hand therapy, vision rehabilitation, driving rehabilitation, sensory processing disorders, etc. 

4. What type of education do you need to become an OT?

In order to become an occupational therapist you must graduate with a Master's from an ACOTE-accredited program. There are many schools available which provide occupational therapy degrees, some include just a Master's program, and some which include a combined baccalaureate/master's program. I have provided a link below to AOTA's website which provides a list of accredited universities. I would suggest researching each program, as not all programs are created equal. I think one of the most important parts of my education were the 4 fieldwork experiences I had through my university. I had 2-level 1 fieldworks and 2-level II fieldworks. My level 1 fieldworks were shorter and less intensive, encompassing about 10 hours per week. My level 2 fieldworks were each 40 hours per week, where I was expected to be at the level of an entry level practitioner by the end of the fieldwork. These experiences were very helpful at bridging the gap between school/theory and real world occupational therapy practice.     

http://www.aota.org/en/Education-Careers/Find-School/AccreditEntryLevel/OTMasters.aspx   

5. What do you do after graduation?

After graduation, you must begin the process of registering to take the National Board for Certification in Occupational Therapy (NBCOT). This can be done by visiting www.nbcot.org. This website will walk you through the process of registering for the exam. I would suggest beginning the process soon after graduating, as it often takes a month or so before you are actually eligible to sit for the test. Once you apply and are in the process of waiting, you will begin to study (if you haven't already). This process can taken anywhere from 1-3 months, depending on how much time you spend per day. I began studying the middle of January 2014, and ended up taking the test the end of February 2014. I studied with another OT student I had worked with during college; we met about 3 times, once per week which helped keep me on schedule. My study sessions were based on the TherapyEd book by Rita P. Fleming-Castaldy which can be purchased through: http://www.therapyed.com/nbcotstudyguide.htm 

My studying was very sporadic at first, usually 1-2 hours per day, and I took many days off. The last two weeks before the test I studied about 8 hours per day, took countless practice exams and likely overdid the studying process, but hey, I'm intense!  

After taking the NBCOT you will wait about 1 week to get your online results of pass/fail. You can now begin the licensure process. You will have to have your scores sent to each state you intend to be licensed in, and yes, you will have to pay for each separately. Licensing can be a lengthy process, 1-3 months is not uncommon. Each state has its own process, so you will need to visit the website of the state you intend to be licensed in, and it will walk you through the process. Check the state's website often after all your paperwork is received, it is likely you will be licensed on the state website before receiving your hard copy in the mail.     

Stimulant Addiction

For many years now, I have struggled with an enormous amount of fatigue and exhaustion. Perhaps this harsh reality stemmed from countless years of eating disordered behavior and psychiatric medications, specifically Topamax; but either way, I often feel I lack the energy required for many daily activities. Unfortunately, in a feeble attempt to manage the debilitating fatigue, I resorted to using various stimulants over the years: energy drinks, caffeine pills, diet supplements, vitamins, and OTC medications.

My stimulant use may have began as a way to manage fatigue, but it progressed into a physical, mental and psychological dependency. Not only did I feel a greater sense of happiness and joy when I took stimulants, but I also felt thinner and often ate less, which only fueled my eating disorder addiction. Stimulants also make me more outgoing and often decrease my social anxiety. All of these reasons made stimulants an integral part of my every day, which allowed me to live the life I so desperately wanted. My stimulant abuse continued for many years, waxing and waning, and often the times I chose to decrease stimulant use was only a method to increase their effectiveness once I started taking them again.  

It was not until recently that I realized how unmanageable my fatigue and stimulant use had become. I often take caffeine pills in the morning and afternoon, and for a while was dependent on asthma medications to keep me going throughout the day. I began to notice the various side effects taking a toll on my body: acne, anxiety, irritability, headaches, and eventually total exhaustion unalleviated by stimulants. It was then that I decided to clean up my act and work on healing my body. I am currently in the process of decreasing my stimulant use, and increasing my vitamin and supplement use in an effort to normalize my adrenals and general hormone function. I am also looking to start exercising on a more regular basis and increase the amount of hours I sleep to at least 8-10 every night.

Can you choose to have an eating disorder?

This is a very interesting and highly debated topic. Many outsiders will look at someone with an eating disorder and wonder why they choose to live that way. Most people with eating disorders will defend themselves by saying, "I don't choose this, it's a disease" (or something to that extent). In my opinion, both are correct. Anorexia is clearly a disease/addiction, and most people need help in order to recover. This being said, I believe that many anorexics chose the lifestyle to begin with, and then became so consumed that their choice turned into an addiction. Looking at my own life, I made a clear choice to pursue self-starvation in order to lose weight and become thin. This process was intoxicating, and I slowly became less and less in control of my actions.

For many people, the process of developing an eating disorder is less clear. Some people may start a diet with perfectly good intentions and become addicted. Unfortunately, many people with eating disorders also choose to play the victim which only furthers their disease. Even addicts must choose to get better, so choice is always part of the process. Those who say they have no choice are not being honest with themselves or others.