Bye-bye bulimia?
February 23, 2012 9:10 AM   Subscribe

Raging ED-filter: My eating disorder is back with a vengeance. I need to find a way to finally deal with it (or at least make a tangible start on recovery) before my entire life gets turned upside down when I leave the country for graduate school in September. Advice? Encouragement? Kick in the pants? All are welcome (and needed) here...loooong story inside.

I shall try to be as succinct and sensical as possible, but anticipate failing miserably at both. Apologies. Please e-mail me at anonyasker@hotmail.com if you want/need more info, or prefer to share your insight that way.

I've been dealing with (suffering from? struggling with? occasionally reveling in? getting generally fucked around by?) an eating disorder since I was about 12 years old (I'm 27 now). During that time, the severity of my behaviours have ranged from the mildly concerning (the most prominent mode), to the deeply serious (though never so much so that I've required hospitalization), with a few prolonged periods of more-or-less "normal" eating patterns scattered throughout the years. I've been diagnosed (by a GP, not a therapist or psychiatrist) as both bulimic and anorexic at different periods of my life, and my behaviours tend to cycle through aspects of both diseases (severe calorie restriction, over exercising, purging, etc) . Apart from a very brief stint with a therapist when I was 14 (like, 3 sessions brief), I have never been in treatment for my issues. My periods of "health" (a relative term) have been characterized by a reduction, but not an elimination, of disordered behaviours (though very little if any change in the thought pattern which leads to the behaviours) to the point where I considered myself to be more-or-less in recovery. These bouts of sanity were almost always spurred on by some sort of crisis or ultimatum. For example, at one point in my teenage years I was threatened with the prospect of expulsion from my dance school if noticeable improvements in my health were not made, and this prompted me to restore my weight to a place deemed reasonable in order to stay in the program (just one example of ultimatum -> behavioural change). All this to say that my efforts to be "healthy" have in the past been motivated entirely from a superficial, external place rather than from a real desire to change/get better/get on with my life.
*deep breath*
BUT. I will be finishing up my BA this June, and will be heading off to a PhD program in the U.S. (I'm in Canada now) in September. Since graduating from High School and continuing through my undergrad, I have been working professionally in a purely creative/artistic field, and the transition to a life focused entirely on academics will be an abrupt one (though one that I welcome and truly desire). Essentially, in less than 6 months my entire world will be turned upside down: I'm leaving my work (which I've been training in literally since the age of 3), my country, and my friends behind and jumping into a new life....and I don't want my eating disorder to follow me.
However (and yes, I'm aware that there is almost certainly a relationship between what I just wrote and what I'm about to write), for the past 8 months or so, my disorder has reared its ugly head in a way that is far, far more intense or severe than any of the episodes I experienced in my youth. Despite being continuously healthy (or as close as I get to healthy) for almost 5 years, I am suddenly finding myself utterly submerged in the world of ED. My life is in shambles, the effects on my body are obvious and multiplying, and I feel entirely out of control and in thrall to this thing. Without getting into the gory details, it's getting scary fast.
I know that I cannot possibly succeed in a rigorous and intense PhD program with this thing running my life, but I have absolutely no idea how to even begin to get the help I clearly need. I'm 27 years old, and still dealing with the same psychological fucked-upness I had when I was 12. Something needs to change, and SOON. For once, I feel like I'm desiring health for its own sake, rather than as a means to prevent some crisis or avoid some undesirable consequence. This time, I want to be healthy because I want my fucking life back, and I want to make sure that I do this RIGHT.

So, Mefites:
1) How/where do I begin to find treatment? Do I see a therapist? A Psychologist? Psychiatrist? Dietician? I know that finding someone I "click" with is going to be very important for this having any chance of success...so how do I go about finding help that fits me? Do I just pick up the phone and say "Hi, therapist. I'm screwed up. Please help me" ? My window for trial and error is pretty small, I fear, so I need to get this right.
2) Assuming I find someone who works for me, is it going to be incredibly disruptive to my recovery when I move in 6 months? What can I start doing now to help make that transition smoother when it comes? How can I be proactive about ensuring that my major life change encourages recovery, rather than exacerbates disorder?
3) Having only a very brief (and very negative) experience with therapy, I'm terrified of it. Please tell me what I should expect (i.e. what is a typical "session" like? What will be expected of me? How do I prepare?)
4) Since my physical (and mental/emotional) deterioration have been rapid and obvious, I'm having to deal with many well-meaning people trying to "help" (but actually just exacerbating the problem/feeding my disorder). What's a good strategy for telling these people (some of whom are very close friends, some of whom are in positions of professional authority over me) to mind their own business, without hurting their feelings/upsetting them?
4) Any thoughts, insights, useful considerations about your own experiences in finding recovery would be very much appreciated. I'm really lost here, and don't even no where to begin.

Thanks for your help, Metafilter. Sorry for the rambliness....
posted by anonymous to Health & Fitness (18 answers total) 4 users marked this as a favorite
 
Do you have someone you trust in face-to-face space to tell that you're going through this? Asking someone to watch out for you and to hold your hand as you make appointments, face therapy, and to talk about what's going on might be helpful here.

A great deal of this type of disorder relies on keeping it away from others' eyes, and if you tell someone who sees you in person that you're in this situation, and you trust them to help you as you get help, that may cushion the blow a bit.
posted by xingcat at 9:18 AM on February 23, 2012


National Eating Disorder Helpline. Start by calling them. Ask if they can help you find a local therapist.

As I am not a therapist or trained in any way, I won't attempt to offer any opinions on the other questions.
posted by kavasa at 9:49 AM on February 23, 2012 [1 favorite]


Overeaters Anonymous has meetings for eating disorders.
posted by brujita at 10:00 AM on February 23, 2012


Does your undergrad school offer mental health services? Because if so, they will have experience dealing with terrifying numbers of students with ED and would be my first port of call.
posted by DarlingBri at 10:05 AM on February 23, 2012 [2 favorites]


I am currently in recovery from an eating disorder myself and the best thing I did to get myself into recovery was to find a clinic that specializes in eating disorders. They were fine with me doing a sort of a la carte selection of their services--I have a therapist and a dietician that I see, but there were lots of other options, including inpatient services, partial day programs, and groups. Initially, I came in and had an intake interview where we went over questions regarding what was going on with my eating habits, why I had decided to get help, etc.; I was terrified to do the intake, but bringing a friend with me helped a lot, as did the fact that the intake therapist was incredibly supportive and encouraging. Much of the staff at this particular clinic are in recovery from EDs and they understand how it feels to be on the other side of that desk.

Before I found a group of ED specialists, I had seen a therapist whose supervisor specialized in eating disorders and it didn't end up working for me. She was relatively inexperienced and her attitude was very much "Well, just eat!" It wasn't very helpful for me. YMMV.

A typical therapy session for me involves me coming in and literally talking about whatever I feel like talking about that day. If it has nothing to do with food, my therapist will check in with me to see how things are going in relation to eating. But for the most part, I kind of lead the conversation and my therapist is really fantastic about getting me to expand on things that I've said or asking me questions that make me think. When I came in the very first time, I told her how scared I was and how hard it was for me to be there and she was really supportive. A therapist that clicks for you should be easy to talk to.

When you do talk to someone, tell them everything you told us here about your PhD program and moving. They will help you come up with a plan for the transition. A dietician will be especially useful for this (but get one with ED experience!) in that they will help you figure out the nuts and bolts of day-to-day eating. When I see my therapist, we tend to talk about big-picture things (though it would be fine if we didn't) and when I see my dietician, we tend to talk about day-to-day stuff. And much like my therapist, my dietician has always let me lead the way in terms of what I will or won't eat, why I won't get rid of my scale, etc.

If you don't want to talk about your issues with well-meaning friends/coworkers, you can always say something to the effect of "I'm dealing with some stressful health issues right now, but thanks for checking in with me."

Don't let your impending move put you off from getting help now. In the space of six months you can get systems in place that will help set you up for success.

MeMail me if you want to talk. Hugs to you and know that you're taking a huge, brave step in just asking this question.
posted by corey flood at 10:09 AM on February 23, 2012 [3 favorites]


3) It makes sense that therapy would seem scary if you've only had a bad experience in the past. And the truth is that sometimes even good therapy is scary - you're dealing with scary stuff, you project your fears onto your therapist, and it can all get a little weird. Give yourself permission to have introductory talks with multiple therapists before settling on one. You don't have to go to a therapist you don't like or who makes you feel uncomfortable or unsafe. Maybe do a little research to determine the qualifications / characteristics you'd like your therapist to have so you know what questions to ask.

In the meantime definitely start off with your campus health services and the number above.

4) You can tell people "Thanks for your concern. I do have a health issue and I'm working with my doctor to address it. Right now I don't wish to discuss it further, but I know I can count on you if I feel I need help with this in the future." If there's something they CAN do to help you, tell them what it is. "I'm feeling low and it would mean a lot if we could go to a movie together / hang out and knit / talk about my worries over the future / etc."

Do consider confiding in your closest friend/s and family if you haven't yet. Going through this alone would suck - you need all the support you can get.

Good luck to you.
posted by bunderful at 10:58 AM on February 23, 2012


Do NOT under any circumstances goto Overeaters Anonymous. Its program is built around restriction and elimination, which may be great for people working through binge eating issues, but is disastrously triggering for people who have any history of anorexia or anorexic behaviors.

See a therapist with experience in helping people with eating disorders. The therapist should have recommendations for dietitians with similar experience.

Best of luck to you. I know how challenging it can be not to slip back into disordered eating patterns in times of stress.
posted by Sidhedevil at 11:20 AM on February 23, 2012


It is very understandable that you're acting in the old ways during this stressful time. Those are patterns you have used in the past to deal with stress. So, you need to find a therapist who can help you establish new patterns - that is a concrete goal for therapy. As you recognize, grad school will be a time of stress (you can handle it, definitely, but it's a lot of work and so on). So you need to find treatment in the place you are right now, and crucially, you need to set up continuing treatment in the place you're moving to. This disease is something you need to manage as if it were diabetes or a similar ongoing physical disorder - regular monitoring even when you are feeling good.

If you find a therapist who's really great, and you decide that you need to remain in your current city to continue treatment for an additional time, many grad programs will work with you on this - you can take a medical leave of absence. You can cross that bridge when you come to it. Don't let your fear of disrupting therapy prevent you from seeking therapy immediately.

A therapist can help you to set up a continuing treatment plan with a new therapist in your new city. Either they will know someone, or you can ask them to help you work with the campus resources in the new school to identify a suitable therapist in the town you're moving to. This is another concrete goal that you should plan to cover in therapy.

Be aware that lots of students in undergrad and grad programs have these kinds of problems - you are not alone, and if you ask for help from the campus health center, they should know what to do for you in the short term. (They should have a list of people they can refer you to, if nothing else.)

I second the idea that it would be useful to work with someone/a center who specializes in disordered eating. If you email the mods (or use the contact form, bottom right corner of this page) they can update with your current and impending locations, and maybe people will have recommendations.
posted by LobsterMitten at 11:26 AM on February 23, 2012


Oh and I meant to link to this:

OmieWise commenting about what to look for in effective therapy

As you suspect, finding a good match is important. This means you might have to have introductory meetings with several candidates to find one you click with and who seems to have an approach that will work for you. This is ok, you can do this.

1. Get referrals if you can, from your campus health center or from anyone who has eating disorder experience in your area. Maybe even your doctor, if you have one? Or post your location here and ask for suggestions.

2. Make a short list of what you want from therapy. The main symptoms or problems you want to address, and what you want the outcome to be.

3. Call at least 3 therapists and ask them if they specialize in people with your symptoms and goals. Ask what their methods are. If it sounds good, set up an intro appointment.

4. Keep the appointment. See what you think. If it's not a good match, that is okay. It is a normal thing within the world of therapy. Keep going down your list.
posted by LobsterMitten at 11:36 AM on February 23, 2012 [1 favorite]


Sidhdevil OA DOES have bulimia/ anorexia groups.
posted by brujita at 11:45 AM on February 23, 2012


Brujita, I sincerely think that the risk of being exposed to OA's pro-restriction materials like the "sheets" is tremendous for anyone who has a history of restrictive disordered eating. Especially where this OP has so little history of seeking help for her restriction and purging, I think turning to OA as her first port of call would be a terrible choice.
posted by Sidhedevil at 11:57 AM on February 23, 2012 [1 favorite]


I think you should treat this like a medical emergency, meaning: get the intensive care you need, no shame, and make it your #1 priority. This isn't really a situation to be calling around to therapists or trying out self-help groups, like the average depressed patient; this is a *medical* problem. You yourself said that your body is deteriorating -- so you need to get healthy.

If I were you (and I don't actually have any experience with ED) I would check myself into a residential treatment clinic, the best money can buy, to really focus on getting well intensively. Spare no expense; borrow money, get a loan, whatever. You need a whole team focused on you -- therapists, dieticians, psychiatrists, etc. Like any other serious medical condition, you want specialists, not random therapists.

You have six months before you start your PhD. If you make getting well your priority, I think you have plenty of time! You also have time to set up a support network in your new city.
posted by yarly at 1:00 PM on February 23, 2012 [4 favorites]


Here is an example of a residential clinic.
posted by yarly at 1:04 PM on February 23, 2012


I didn't encounter the sheets or anything restrictive at the meetings I attended.
posted by brujita at 1:41 PM on February 23, 2012


Anon, I don't know what your family life is like, but what has helped me the most is making it clear to my abusive mother that I want nothing more to do with her. Simply moving to a location far away didn't do it.
posted by brujita at 2:11 PM on February 23, 2012


I think you should start with any professional you feel comfortable talking about this with--your GP, your OB/GYN, a therapist, a dietitian, whatever. There's no one right way to seek help. Whoever you talk to first will get you on the road you need to be on.

I wouldn't let the prospect of moving in 6 months deter you from seeking help. I mean, if you got diagnosed with cancer, you wouldn't put off treatment because of this. This can be just as catastrophic, so try to prioritize it as such (and it sounds like you are). If you have to defer your studies, then defer your studies. They'll let you do that.

Good luck. I'm glad you are seeking help for this.
posted by elizeh at 8:03 PM on February 23, 2012


I second yarly so much. Fighting this has to be your priority. And you know what? You are in an awesome position to fight this thing; your determination to do so rings out clear in your question. Many (maybe most?) people in ED treatment do not want to be there or aren't sure if they want to be there. I'm not saying that this will be easy for you (it won't be), but the single most important factor in recovery is wanting it.

You mentioned that your GP has diagnosed you with ED in the past: have you discussed this latest bout with them at all? Because you should start with them. You need a full check-up, now. I'm sure you're aware of the damage EDs can do to your body.

Next I would suggest getting in touch with the top ED clinic/facility near you. You should be able to schedule some kind of sit-down with them to discuss your history and situation re: school. They will either want a report from your GP or give you a check-up themselves, do blood work, etc. Taking all that into account, they will come up with a recommended plan for you. Heads up: they are more than likely to recommend that you don't go to school this fall. They can't force you not to, obviously, and if you do still end up wanting to go they will work to coordinate your care in the new city. My 2 cents: find out now if the program would allow you to defer for another semester or year. I know you don't want to because you want to get on with your life, but you won't be able to get on with your life till you kick the ED and all the baggage that causes it and comes with it. So please, be open to whatever they suggest.

I was actually pretty similar to you: I was bulimic on and off from about 12, and then it became an anorexic/bulimic nightmare around 22 and I kind of went off the deep end. Even though it was so awful and consuming, I still tried to complete my senior year of college during it because I felt like I would be a total failure if I didn't and that my whole life would be thrown off 'course' (though it obviously already was off course). I wish so much now that I had just said, 'ok, this is going to be my single focus until I start to feel like a normal human being again.' This kind of thinking is very hard for people with EDs, though. It's not usually a disease that allows you to be kind to yourself. But I urge you to try.

Other than finally wanting recovery (and to not feel like such shit all the time), what truly saved me was having the awesomest therapist ever. I know you had a crappy first therapy experience -- and so did I, it took about 4 therapists before I found the right one -- but you need to try again. Keep trying till you find one you trust.

Good luck.
posted by imalaowai at 10:44 PM on February 23, 2012


My heart goes out to you.

I've been there.

I'm better now (14 years and counting!)

It's scary. It CAN be conquered.

It's okay to need help.

It's okay to confess all the horrible, awful, disgusting things you think/do/wish you could do to your body to someone else. To confess all the lies you told to those around you ...

But when you finally realize it's been a month since you dreamt about food (or, more commonly for me, had a nightmare about food) ... that's worth it. It's worth the embarrassment a hundred times over.

All the comments above are good ... just pick up the phone. Start.
posted by athena2255 at 8:03 PM on February 24, 2012


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