@Victoria'smom I wouldn't say it has to be well written. You could even make a list of symptoms/thoughts going through your head and what you're doing to not act on stuff they'd see as an immediate danger like "drawing on your skin," (obviously the disordered eating and getting high isn't healthy, but in my experience that's not super concerning to the pros unless it's repetitive use of hard drugs. When my ED is bad and I tell my pdoc I don't feel all that great physically or she sees obvious symptoms she sends me for bloodwork that raises concern and she makes me agree to nutritional drinks like instant breakfast or ensure. My bloodwork from her only came back abnormal once. Not sure what she would've done otherwise, but I refused to be medically treated while also self harming and yeah, I went IP involuntarily (which was ****ed up because I went to the ER voluntarily after the appointment and they assessed me and were about to d/c me but my case manager petitioned for an IEA which somehow judge said "yeah, state hospital for 10 days"???? Literally hospital psych said I was good to go, and agreeing with them was reason to get the court involved? wtf? sorry, tangent.)

I'd still get some thoughts out in case you don't get to the point you feel like you can write well enough before the appt. You can always revise if you do feel better, but it'd be good in the case it goes the other way and gets harder to write.