Nina with her dog. Own picture.
20-year-old Nina suffers from severe anorexia and trauma. She has already undergone several treatments, but without lasting results. Everywhere she turns for help, she is rejected. But now she has finally found a clinic that can help her, in South Africa. Nina has pinned her hopes on Imani, but has to raise no less than 15,000 euros. That is why she has set up a crowdfunding campaign.
Nina grew up in Gorinchem. She then moved to a sheltered housing facility in Hoenderloo for people with eating disorders, which went bankrupt. She has been living on her own for a year now, in a studio in Apeldoorn. “Things are not going well,” she says. She feels very alone. “Anorexia prevents me from living a normal life. The whole day consists of eating, and sometimes I have to eat something and then feel guilty about it. I feel anger and constant struggle. I also suffer from the urge to exercise. Even when it rains, I have to go outside for a walk. That is very tiring.”
Nina’s problems started at an early age. “I was an insecure, sensitive girl who picked up all the emotions of others.” At the age of eight, she ended up on a pro ana platform, a forum where girls encourage each other to lose as much weight as possible, by cheating on food or spitting it out. She also started self-harming. When she was 11 years old, her eating disorder became visible because she lost weight. The GP referred her to a clinic in Leiden, where her parents were also involved in the treatment. As a result, she had to miss a lot of school.
When Nina was 15, her mother was diagnosed with pancreatic cancer. “My mother was someone who did not talk about her feelings. She didn’t talk to anyone about her illness.” After just five months she was gone. That was extremely intense for Nina, who was there when her mother breathed her last breath. “The moment I lost my mother, I lost all my zest for life. I still had hope for that.”
Nina with her mother. Own picture.
Panicking for a cookie
Her depression worsened. Because of the grief over the loss of her mother, she couldn’t swallow anything. “I thought: what’s the point of life? I was doing so badly that I stopped eating completely.” She was forcibly admitted to hospital to recover with tube feeding. She arrived, but when she had been home for a week, things went wrong again and she had to pack her bags again to go back to the hospital. “That year I had seven hospital admissions,” she says.
Her BMI was too low for many eating disorder clinics. There were also long waiting times. As a result, Nina was forced to move to Tienen, in Belgium. “Even though I wanted to recover so badly, the eating disorder had completely taken over me. I panicked for a cookie. We came to the conclusion that it didn’t work that way. In the hospital I was pumped full of tube feeding, but I didn’t even dare to eat or drink.”
Turned away by clinics
Another period followed with admissions to clinics, where she was continually sent away. When she called her GP in desperation, he said: ‘You ruined it all yourself. There is no one who can help you now.’ “And then a switch went on in me,” says Nina. She no longer wanted to live at all and took an overdose. Her stomach was pumped in the emergency room.
Behind her back, an RM was applied for, a ‘judicial authorization’, which means that you can be treated forcibly. She was admitted to a closed ward, her worst nightmare. “There were all kinds of people there who were suicidal, a very nasty environment.” She ended up physically worse and ended up in hospital. Sedative medication was administered through the tube, so that she did not get much of it.
Several treatments followed, some of which she completed. But she keeps falling back into her eating disorder. Ultimately, practitioners suspect that Nina has personality problems and she undergoes treatment for this. “I was diagnosed with borderline, which I cannot agree with at all. I am actually an anxious girl, afraid of discussion, but I was placed in a group with all kinds of angry, emotional people. That was completely inappropriate.”
The GP said: ‘You ruined it all yourself. There is no one who can help you now.”
Ultimately, all treatment options are exhausted and Nina can no longer get help anywhere. “The biggest problem with healthcare in the Netherlands is that they cannot do anything with multiple diagnoses. If I relapse into my eating disorder, treatment will be stopped. Trauma treatment was also not possible because of the eating disorder. Then try to get a bite down your throat. The waiting lists are also very long.”
Last straw
Then, through an acquaintance, she ends up at Imani, a private clinic that offers treatment in South Africa. It is the last straw she is still clinging to. “I have been surviving for so long, it is no longer bearable for me this way. It’s barely possible, I’ll be up soon. If I had not found Imani, I would have started a euthanasia process.”
Nina feels comfortable with Imani from the first contact. “It immediately felt so different: the way the employees spoke to you, the understanding. From the start they said: you don’t have to do this alone, we support you. I have often spoken to a practitioner without her charging any costs. She gave me hope. Defense letters have also been drawn up by a psychologist, because my treatment is not reimbursed by the health insurer. Unfortunately without results.”
What appeals to her is the holistic approach. “They look at me as an individual. They also work with animals. I also believe that that can help. My hope is that I can live the life of a normal 20-year-old again. That I get my zest for life back, that I can deal with food and exercise in a normal way.”
She finds it difficult to look to the future, but she does have dreams and desires. “My dream is to help other girls with an eating disorder later, when I have recovered, to give them hope and support them. I find it very difficult to give it to myself, but I do want to recover to help other people.”
Huge increase in complaints among mentally ill people
“This is very tragic,” is the reaction of psychiatrist and professor Jim van Os to Nina’s story. “We have seen a huge increase in psychological complaints among young people in recent years. That group is struggling tremendously. Over the past fifteen years, the number of young people with psychological complaints has almost doubled.” Van Os thinks it is partly due to society, in which success is a choice and perfection is the norm and there is no longer room for vulnerability. “People become deeply unhappy if they have to grow up in such a society.”
Young girls in particular are in trouble, he notes. “We see many girls with eating disorders. Underneath it there is self-loathing and a lot of fears. You always have to look at what lies beneath, which is that people write themselves off and hate themselves, and don’t love themselves.” In the most distressing cases, this ultimately leads to a euthanasia request. This also occurs regularly in young people.
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Anorexia in the Netherlands
In the Netherlands, it is estimated that approximately 5,500 people suffer from anorexia every year Nutrition Center to tell. There are more women than men, as 95 percent of patients are women. About 45 percent of patients recover completely, 30 percent improve partially and 25 percent do not recover, we read on New ones.
Complex patients are rejected
Van Os says that Nina’s case is no exception. It is much more common for patients who desperately need help to be turned away for treatment. This has everything to do with the way mental health care is organized in the Netherlands, Van Os explains. “It is a market economic model, in which it is all about feasibility, efficiency and measurability. It is based on decent patients, who are motivated to get better and come to appointments on time.”
But the reality is in many cases unruly, due to the complexity of the problem. If you have one diagnosis, it is easy, clear and also cheap. But as soon as there is more to it, you quickly become ‘too complex’ and too expensive for health insurance and mental health institutions, which also have to compete with each other.
“If you have a combination of, for example, severe autism, an addiction and chronic suicidality, you exhibit wandering behavior or have serious potentially fatal problems such as anorexia, then you cannot simply get into it. This creates unequal accessibility in healthcare. The more serious the problems, the more difficult the accessibility,” says Van Os. In other words: the people who need help most are left out in the cold.
Long breath
Complex problems are usually not solved within a year. As a healthcare professional, you have to be persistent for this, says Van Os. “It’s a matter of plodding, pulling, pushing and lashing, trying to motivate people to change. You actually need ‘relationship acrobats’, who try to do things with very difficult problems. Those types of employees are worth their weight in gold, but they do not fit into the current DBC system.”
According to Van Os, there must be a shift towards a social system in which professionals collaborate creatively in the neighborhood and there is an integrated range of assistance, instead of the current split between WMO at the municipality, medical care (including mental health care) in the Health Insurance Act. and youth mental health care back at the municipality. This is already being worked on, under the name ‘ecosystem social health’, where ten regions are trying to shift towards a social model, instead of a medical model, where many people are declared ill and have to go to mental health care. “We need to work together more and there must be more room to think outside the box.”
You can donate to Nina via this link.
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2024-04-03 16:16:00
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