Anorexia Nervosa Chronic Social Anxiety

See attached prescription list Side effects; Therapies; Aids/adaptations;

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X cannot cook or prepare a meal due to the severe strain this has on his mental health. He struggles around food due to feelings of guilt, associated with his Anorexia. He cannot peel or chop vegetables nor be around food. X cannot prepare a meal due to his great aversion to food. X mum has to cook and prepare all meals and ensure the food has nutritional value, with vitamins and minerals which X body needs, at his lowest, his weight dropped dramatically so needs the nutrition to build him back up.

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X does not eat due to anorexia. Since discharged from hospital he has had a regimented routine of meals and times which mum prepares and gives to him. Mum has to sit beside him to ensure he eats the meal and that none of the food has been disposed of in bins, purged or vomited. X cannot eat in front of anyone else, other than his mum. Mealtimes are a very stressful process. X natural reaction is to avoid eating, and spends a lot of time curled up in a ball in the corner of his room afterwards. Mum will try to motivate and encourage him to eat but this can be extremely difficult. It is important to add that although X eats some food at the moment, it is because of this continuous supervision and because he feels he has to eat. X still has an obsession with his appearance and continues to feel overweight.

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Mum has to administer X medicine, he has a dosette box which is kept safe and secure, mum monitors his medication closely to ensure every dose is taken and X does not purge the medicine. Although X takes his medication, he suffers frequent low, fluctuating moods to the extent of self harming, although this is not happening at the moment, he still has thoughts of this and is aware mum will check his body daily for evidence. Medication needs to be kept securely in an unreachable space. X has suffered from suicidal thoughts many times, although these haven't been acted on, this remains a concern for his mum. His emotional state and mood requires constant supervision.

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X needs encouragement to leave his room to wash. He suffers with low mood and lacks motivation, he wears oversized clothes, as seeing himself makes him feel incredibly low with negative thoughts of how he looks, and believes himself to be overweight. The bathroom door has no lock in place, this is to ensure that mum can monitor to make sure he isn't self harming, even though everything hazardous has been removed from the bathroom, ie, razor blades to bleach, as he could potentially try to harm himself. Due to his low blood pressure X has a tendency to become dizzy and fall over, so needs help while in the shower. Mum washes his back and hair, because of the severity of fatigue he is unable to hold his arms up for very long Although X has been discharged from hospital, he is very fatigued and often complains of having little to no energy. Quite often, bathing is too much for and he will need to rest afterwards.

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X is able to use the toilet without difficulty.

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X needs prompting and encouragement to dress. Mum tries to encourage him to do this but it causes a lot of upset so it has to be done in a careful manner. He continues to feel negative regarding his appearance, and believes he is very overweight. This is a continuous battle within his mind. X wears loose comfortable clothing such as oversized hoodies and loose bottoms as he believes that when he eats something he can feel his legs becoming bigger. He suffers severe fatigue, which also makes it very difficult dress by himself. As well as being bullied, X frequently took time off school which evidences his struggles with having the motivation and energy to get up, and dress daily.

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Independent with this activity

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Independent with this activity

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X has no friends or social life, for the majority of the time he isolates himself in his room, where he curls up into a ball in a corner, so mixing with others makes this very difficult, he associates being around groups of people with being bullied at school. X does not like large crowds of people and does not mix with others easily, he worries that he is being judged and laughed at. X becomes incredibly anxious around strangers and worries about being seen by people he knows. X has recently started to attend classes weekly but he finds it very difficult to be around people, especially boys. He is one of two boys in the class which is easier to manage. His social anxiety has impacted his education.

X is unable to make any budgeting decisions for himself. Mum controls all finances, and makes all budgeting decisions, however simple they may seem due to X continuous fatigue and state of mind.

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X struggles and finds it very difficult to go out. It requires a lot of motivation and encouragement for him to leave his bedroom, and substantial encouragement to leave home he cannot go anywhere without mum. X could not plan a journey anywhere due to severe anxiety, mum tries to encourage him to go out, at least once a week but this can be difficult. X worries about being seen by bullies he went to school with, this causes panic attacks when in crowded places even if it's somewhere familiar, so mum has to plan the journey and route making sure it is secluded. X attempted shopping with mum but was unable to do this, he suffered a panic attack and had to be taken home. This set him back, where he remained in his room for some time. X has been going to a new school for one day a week with a view to increase but mum has been accompanying and staying with him, he would not go or stay without her.

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X suffers with low energy, and fatigue which can affect how far he can walk. Some days he can be crawling and holding onto banisters and rails, barely managing 10 metres. On better days, he can walk up to 30 metres with encouragement, providing it is somewhere secluded and has a low risk of him bumping into anyone he knows. Mum encourages going out for walks, and on better days X is able to walk to the river and come home, but is still very fatigued afterwards and often needs to rest. On bad days, X does not move from the corner of his room where he spends hours curled up in a ball and will not leave his room, X suffers with severe low mood, not speaking to anyone during this time.

We would like to request a home assessment with someone trained in mental health. We would like it noted that X did not speak to mental health professionals when hospitalised and finds it very difficult to speak to new people.