‘Voices in my head said I wasn’t working hard enough’

Cara Neary was 14 years old when she became increasingly concerned with following what she called a “healthy lifestyle.”

He became obsessed with exercising more and eating less, and within a year it had taken over his life.

At the age of 16, she had been diagnosed with anorexia, an eating disorder and mental health condition in which people limit the amount of food they eat or exercise too much.

And as his condition deteriorated, he said he began to hear voices.

Cara told BBC Scotland: “Eating out especially and eating with people was making me very uncomfortable and scared.

“When I was 17 years old it really shot up and that was my critical point.”

He started lying to his family, found ways to hide food and secret ways to burn calories.

Cara, now 20, said: “Everyone was telling me, ‘you have a problem’ and I couldn’t see it.

“And all the time I hear these horrible voices in my head saying ‘you’re not working hard enough’.

“It’s like being bullied, but you can’t go home and get out of it.

“You can’t turn off your Facebook or your Twitter, it’s there and no one else can see it, no one else can hear the voices. It’s just you.”

At her lowest point, Cara sometimes felt like there was no escape and sometimes wondered if she would die.

He said it was the hardest experience of his life, but he was lucky and was able to access specialist help.

At first he learned to eat small, regular meals every day with no more than twenty minutes of walking.

And she credited her family and school for stepping in to help her, and she is now three years into recovery.

Cara has now moved from services for children to services for adults. She was referred for cognitive behavioral therapy in Edinburgh and says that she has been very helpful.

“Now I feel very good, I am very happy, I am very healthy.

“Sometimes I struggle and have to fight horrible thoughts and there are a lot of things I have to work on and deal with, but I never worry that I’m going to die because I’m not eating enough.

“I can’t really remember what that felt like now, it’s hard for me to remember that this was me.”

Cara is one of a growing number of young people diagnosed with an eating disorder.

Referrals to specialized services have increased significantly.

The most recent government data shows that the number of patients admitted with an eating disorder increased from 434 in 2013 to 556 in 2018, a 28% increase over the five-year period.

Full data on the course of the pandemic is not currently available, but Scotland’s two regional adolescent psychiatry units reported a combined 161% increase in admissions for eating disorders from 26 in 2019 to 68 in 2020.

Last month, Healthcare Improvement Scotland published a new clinical guide to help healthcare professionals working with people affected by eating disorders.

And in October, the Scottish Government created an implementation group to improve support for patients, families and carers affected by eating disorders.

A total of £5m has also been allocated to NHS boards to respond to a surge in referrals due to the Covid crisis, with the Beat charity for eating disorders also giving over £400,000.

Doctors say things are improving, but there are still significant gaps in provision, and more data is needed on the types and underlying causes of eating disorders.

Dr Jane Morris, vice president of the Royal Scottish College of Psychiatrists, warned that since the pandemic there has been “a huge increase in demand and need for eating disorder services” across the country.

He continued: “While we have many centers of excellence, there are unfortunately whole geographic areas of Scotland that are underserved and whole areas of the population who feel they are either completely ignored or that services are not tailored to their particular type of service. eating disorders”.

The Scottish Government said early feedback indicated that the boards had used the additional funds to ensure their staff had access to proper training, extend doctors’ time and for recruitment.

A spokeswoman added that NHS boards have already agreed to allocate £40 million to provide better Mental Health Services for Children and Adolescents, including removing waiting list backlogs.