For a few minutes I was acceptable to myself because I had gotten rid of my binge. But depression quickly rolled back in, burying me in a dark pit of solitude with no one to pull me out. I just cried and wanted to die. I was crying so hard my entire body hurt, and my lungs ached from vomiting and coughing and constant crying. I had no set suicidal plan, no knife, no gun, no jumping off a bridge. But I was alone and it would be easy to take a bottle of sleeping pills with alcohol. No one would find me for a while. I’d probably get some phone calls from my friends and parents but the only people that would get suspicious would be my parents. They’d probably get worried and keep calling and eventually come up to see if I was okay, and I still wouldn’t answer their calls. Maybe they would find my resident assistant to let them in the room, explain the situation; that they had been calling for a few days and I hadn’t called back and now they’re worried and they knocked on the door but I didn’t answer, and I still didn’t answer their phone calls. I would be dead in my room, either on my bed because at least it was a comfortable place for misery, or on the floor in a pool of vomit. The R.A. would let them in my room and they would find me. Their lives would be shattered. Even my R.A would have been shocked. He liked me and enjoyed my company from time to time. News would spread quickly and everyone who knew me would be lost for words because they had no idea I was that depressed. And maybe they would start questioning themselves for not seeing the signs or asking questions when my cheeks were always puffy and I became less and less social. Perhaps that’s what would have happened if I had killed myself, but I never could do it. Something kept me going, and I still don’t really know what it is. Maybe my parents or a distant glimmer of hope.
sheila: Every few days we called Lisa, praying she would pick up, and when she didn’t, counting the hours until she called back, or we’d call again and again. We were happy to hear her voice even if she snapped at us or complained about something we said or did, or didn’t say or do. We could deal with her contempt better than her despair. Maybe it was time to take Lisa out of school and bring her home, but to what? We needed a plan. I called psychiatrists who had been recommended as experts in eating disorders. Some called back, but their practices were full. Some didn’t even call back. Then I heard about the UCLA Eating Disorders Program, which had helped a young woman who sounded a lot like Lisa. The friend of a friend had a severely anorexic daughter who left college and went into treatment at UCLA, starting with several months in the locked neuropsychiatric facility. Her mother generously shared their ordeal and hopes. Their daughter was doing well in school again, and though she would always be aware of her eating disorder, she had her life back.
I called UCLA and got an appointment to meet with the director in two months. Lisa and Ned would fly to Los Angeles in July 2004. Ned had an idea that they could go out to lunch, even have fun.
lisa: An entry from my journal, dated May 2004:I think I’m going into a treatment program for my eating disorder. The bulimia has gotten so bad, twice a day at least. It hurts so much to swallow. Basically the doctor said I couldn’t continue this pattern before something fatal happens. I am desperate for more help, I don’t feel safe in any place and I need a stronger form of security. I can’t let this continue. I think I might leave school early, if I feel I can’t pass for the next three weeks.
It’s really time I put my health first, I don’t know what to do anymore. I really need intense daily treatment. I want someone to be there as I eat, as I go about my day, guiding me and being there when I get scared or anxious or feel like I can’t control myself. But I’m scared to go into a program because then I’d be around a bunch of people who are starving themselves. And I know they will see me as fat and I will feel ridiculously fat, and I’m scared I’ll try starving myself and I’ll end up getting worse and come home really thin, or still throwing up. But then it could also be the best thing that’s happened to me. I guess I’ll just have to see. But the most important thing in the world for me is that one day I can have babies. If this is preventing that in any way, then send me to treatment now. I need babies. Most of all I need my life back, I know that I am beautiful outside and inside so I need to stop ruining that and loving myself and every inch of my body.
Damn this crazy cycle. Well, if I go, I hope people will come visit me.
July 7, 2004
Tomorrow we’ll see if this “camp” will help me get past my eating disorder and start anew. I don’t know, maybe. It’s all complicated, but I’m still here for some goddamn reason and I won’t give up . . . there’s something out there for me and I’m going to find it . . . yeah . . . I will.
Tomorrow [July 8, Dad’s birthday] I’m meeting the director of the UCLA program for eating disorders. I’m supposed to (according my parents) have a laundry list of questions, but this is my only question: Will I get better and can I stop? I know no program is going to fix me, there is no magical solution. I didn’t become bulimic overnight and it won’t just go away because I’m in a hospital. I have to completely change my mind and convince myself that I am better than this and better off without it. I have moved on from being 104 pounds—yes, I was once 104 pounds, I was even as low as 95 pounds. Look at me now and you wouldn’t believe it. But even 104 meant unhealthy, it meant no kids, it was too little.
sheila: When Lisa and Ned went to check out the eating disorders program at UCLA, they did not have a fun day revisiting Ned’s favorite restaurants. It was Ned’s birthday, July 2004, and they flew to Los Angeles in stony silence, then met the staff. Lisa found the director and the place very forbidding. Maybe she had been expecting summer camp, but by the time the UCLA facility had an opening at the end of August, going there would have required Lisa to miss a good portion of school. She refused to go, and then miraculously got better, even bringing love into her life.
We didn’t know how much Lisa was aware of the long-term consequences of eating disorders. We were just learning ourselves. I was starting to notice well-dressed women in their forties and fifties with very thin, brittle hair and missing teeth. In restaurants I’d watch them order a salad with vinegar as the dressing, and nibble on lettuce and a couple of raspberries. Sometimes I’d find out who they were, and a pattern emerged: accomplished professional, prominent in her field; very thin; insomniac; no children, often no spouse or lover.
lisa: Deep in my depression I doubted any man’s ability to love me, but I was glad to be wrong. In the fall of my sophomore year I took a stimulating course on the history of jazz, and there I noticed a charming yet reserved gentleman who always sat by himself. I surprised myself with my assertiveness, and he was even more surprised, but we hit it off immediately.
From that class on, we sat together, discussed our lives, family, friends, goals, and ambitions. Scott began to drive me home from school, which led to our first date, at a popular Thai restaurant. My heart told me to be honest. As we lay together on his vinyl sofa, covered in dog hair, I confessed that I had struggles with eating disorders and although I worked every day to pull myself through, I did not consider myself recovered.
Scott’s piercing cobalt eyes caught mine and for several moments we just embraced. He said he wanted me to be happy and healthy, and that his attraction to me went beyond physical attributes. He saw a genuine, good-hearted person. He met and was attracted to the real me. He trusted in me to gather my strength. Even though it was going to take time, he would be supportive while I regained a sense of independence. Most important, we discovered balance in each other, establishing a stable relationship based on love, some grief, anger, and sustaining companionship.
Yet even with my incredible relationship I still felt such extreme self-hatred, and most of it stemmed from my eating disorders. I wrote in my journal:I don’t know how Scott finds me at all attractive. Every time he picks me up I want to enjoy the moment but I can’t stop thinking I’m too heavy for him. I hear him breathing like he’s lifting too many weights and as much as I wouldn’t actually want to hear his truthfu
l answer I ask, “Am I too heavy?” He always says no. I’m convinced he’s lying. My stomach is supposed to be flat—not poochy. I’m too short to have thick thighs and wide hips. If Scott seems distant I think I’ve done something wrong. Maybe he’s just stressed, but I assume it’s me. He says no and I get frustrated because I think he’s holding back.
I hate myself for not resisting temptation and losing control. I hate myself for being out of shape and not pushing myself harder to lose weight. I hate that I can’t work out for as long as I used to be able to, that I my chest hurts and when I sneeze I cough up mucus. At the moment I hate my body . . . No, actually I hate my body most of time. I feel repulsive and fat. I hate the way my thong stretches across my big thighs and behind. I hate my love handles. I hate how my saddlebags fold over my thong. I hate myself for eating cookies sometimes and craving sweets and liking cheese so much. I hate myself for caring so much.
Now, I realize, the love handles and saddlebags were only imagined, but at the time they felt real.
sheila: The first time we met Scott, he was down at the Santa Cruz Harbor, working for a fish wholesaler. Lisa was calling him her boyfriend, but we didn’t know what that meant. Confronted with parents, this blond kid in rubber boots and a bloody apron was properly shy but not stand-offish, warming up when we expressed interest in seafood. When he offered us some soft-shell crabs, Ned and I thought, “How sweet. This guy could be a keeper.”
Lisa and Scott fit immediately. He moved her stuff twice and then they moved into a studio apartment together, a feat that had to prove they were in love. He brought us lots more fresh fish, news of the seafood industry, and a heroic level of caring. How Lisa was just suddenly ready for a relationship, three months after nearly going into treatment for bulimia, we didn’t get. But they were so in tune. She made soup for him when he was sick, introduced him to more exotic fare, and waited up for him when he had a long film project for his major. They moved to a one-bedroom apartment, acquired furniture and kitchenware, and sweet memories. Until it all fell apart again.
lisa: During my senior year, I began to feel the familiar intense loneliness return. I couldn’t really put a reason behind the loneliness, and this time I wasn’t actually alone. I had Scott, I had friends, I had a job. I baked and gave the cookies away. Trying to ignore the scent of fresh-baked morsels quickly encouraged the rebellious bulimic voice: “Eat a cookie, do it! You know you want it!” I refrained for what felt like forever but was most likely five minutes—until it was almost as if a sumo wrestler shoved me from behind, forcing a cookie down my throat. One bite and all sense of control disappeared. I felt so good to be so bad. Cookies broke so many of my anorexic rules: They’re full of fat, white flour, butter, sugar, and chocolate. But that was okay, even if I ate five because that “fear” disappeared with a trip to the bathroom.
I was purging again and with the purging came depression. I was crying daily and suddenly. There was this intense loneliness inside and no matter what I tried to do to escape it just grew worse and I would start to cry. Then I’d tell myself to stop crying, that I am okay, and I’d get it together, but that just made me cry more. I felt sure that no one else was going through what I was, that I couldn’t quit or recover from purging. There was a part of me inside that was always crying and reminding me of the horrible times I have suffered.
I became afraid of reliving my last semester of high school, when hunger kept me from sleeping and even if I did eat a satisfactory amount I was still too exhausted even to watch television. There were always noises in my stomach. Wherever I was, I was waiting to get through it. To do what? I had no idea. Thinking about it now, I understand why people commit suicide. I understand that intense sorrow and excruciating pain inside that no matter how hard you try to escape it, you can’t. It won’t go away, no one else can make it better. I once thought everyone would be better off with me dead, but I think I couldn’t face suicide just as much as I couldn’t face life. So I decided to stay stuck in the middle.
I was suffering every day from my bulimia, depression, loneliness, and intense pain inside, but I didn’t give up.
twelve
Relapse Spring Warning Signs Prompt Action
On Mother’s Day 2007, Lisa was working at a store in Santa Cruz. Ned, Jake, my mother, and I went to see a play in Berkeley that afternoon, and Lisa met us for dinner. Though tired from standing all day and dealing with customers, and the long drive, she was cheerful and brought me a gift. We enjoyed seafood at a cool new restaurant. The second time Lisa went to the restroom, my mom asked, “Is she all right?”
I laughed. “Oh yes, she just has a small bladder! She always has to go a lot.”
Two months later, Lisa had a breakdown.
There were signs, as there had been four years before, but none of them struck Ned or me as emergencies in themselves. That it was her senior year in college, and the previous disaster happened during her senior year in high school, had occurred to us. But she had come so far since then. She emerged on the other side of anorexia. She got a job, was doing well in school, and lived with Scott, her wonderful boyfriend. Nobody wanted to go back to that horror, so how could it happen? Please, let the plague pass over our house this time. Maybe what we were seeing was just bits of backsliding that wouldn’t stick. They would remind her of the worst time in her life, then she would bat them away.
At this point we were pretty familiar with the warning signs. Just about every book and website on eating disorders has a list of warning signs, but none of them was defintive. As with the possible side effects of medications, your experience may vary.
We’ve been reading and writing lists since we became parents, to help organize our thoughts and actions, and to draw comfort. Sometimes the lists and flowcharts telling you what’s an emergency can lead you astray. A friend will never live down having whisked her baby to Urgent Care because of the white spots in his mouth, an alarming sign of thrush, a fungal infection. The spots were drops of breast milk. On the other hand, your child spikes a fever but doesn’t have a stiff neck. Check the list. Okay, phew! Probably not meningitis. We print out lists, like Signs of Choking, and post them by the phone.
The warning signs of eating disorders can be trickier. There are so many possible symptoms, and they often describe feelings that aren’t out of the range of normal, or they are open to wide interpretation. At the very well-respected site www.somethingfishy.org, there are thirty-two signs and symptoms of anorexia/bulimia, and eighteen for compulsive overeating/binge eating. Some are helpful, others not. Who doesn’t, for example, occasionally “make self-defeating statements after food consumption”?
Parents might turn to page 21 in the book Help Your Teenager Beat an Eating Disorder by James Lock, MD, PhD, and Daniel Le Grange, PhD. There are two very specific lists. First are the heads-up signs, then the signs that mean it’s time to call in an expert.
Warning Signs of the Development of an Eating Disorder
• Diet books
• Evidence of visiting pro-anorexia or eating disorder websites
• Sudden decision to become a vegetarian
• Increased picky eating, especially eating only “healthy foods”
• Always going to the bathroom immediately after eating
• Multiple showers in a day
• Unusual number of stomach flu episodes
• Skipping meals
• Large amounts of food missing
Act-Now Signs and Symptoms
• Fasting and skipping meals regularly
• Refusing to eat with the family
• Two skipped periods (in girls) in conjunction with weight loss
• Any binge eating episodes
• Any purging episodes
• Discovery of diet pills or laxatives
• Excessive exercise (more than an hour a day) and weight loss
• Persistent and unremitting refusal to eat nondiet foods
• Refusing to allow others to prepar
e foods
• Extreme calorie counting or portion control (weighing and measuring food amounts)
• Refusing to eat with friends
Our observations were limited to visits and phone calls, but in the spring of 2007, just before Lisa was to graduate from college, some of the most common warning signs were adding up.
1. Criticism of Other People’s Eating Habits
Lisa started mentioning what she didn’t like about what other people ate. She had done the same thing in high school, in great detail, when she’d gone overboard into the sea of nutritional facts and figures. But since then she had pretty much stayed on the positive, nurturing side of food. She introduced Scott to fresh produce and stir-fries, and they now had a kitchen stocked with quality utensils and cookware. She replaced Ned’s ancient set of barbecue tools and gave me The Essentials of Healthful Cooking, to encourage me to cook a little more, now that I worked from home. She scouted out restaurants, selected places for her birthday dinners, and enthusiastically joined us when we went out for restaurant reviews. She called to talk about the great teriyaki chicken dinner she had made, and the one that flopped.
We always criticized food. Constructively, I like to think. It is my job and my nature, as well as Ned’s, to tease out the details of good and bad meals. We encourage people to try new foods, although as a writer I keep in mind that what you eat is like how you pray: your own business. Not to be forced on others. Worship at Burger King or Chez Panisse, depending on your tastes, wallet, and personal needs. It may be that you need a mediocre Thai restaurant to stay open, because you like the owners and there’s nowhere else to eat in your neighborhood. Just don’t make me go there.
Hungry Page 19