Two Weeks In Treatment

IMG_0146Written by Gillianne Ross 

Art By: Grace Monahan

 

I taught myself how to use the Red Line last December. I ran down the stairs from the sidewalk of Mass Ave into the bowels of Boston, my mind suddenly set on getting out of Cambridge and back to Downtown Crossing. Harvard Square was painted black in my mind and the Red Line was the only accessible way out. Once I got onto the train I contemplated not coming back. Did I really need my stuff, no. Did I really give a shit what my insurance company would think, no. Was I scared of myself at that point, yes.

For almost every large writing project since freshman year in high school I have concentrated on eating disorders. I did an extended presentation on Anorexia Nervosa in my 10th grade health class to an apathetic and tired teacher. In a psychology class I tried to unravel the causes and resolutions of eating disorders to another disinterested group of people. 

For all the time I spent trying to comprehend these elusive disorders, I was trying to pick at my own brain, answer the age old teenage question, what’s wrong with me? Because there was something wrong with me. I was and still am officially fucked up according to the DSM-5 guidelines. 

“We’re going to have to search all of your stuff,” I stared back at the two women who surrounded my three bags of belongings. ‘Are you kidding me,’ I thought to myself. ‘I’m not a convict am I?’ They put gloves on and asked me to step back and not touch any of my stuff.

“Do you have any sharps?”

“What?” I had no idea what that meant and I already wanted to push them away, grab my bags, and walk out of the building.

“Razor blades, nail files, pins, scissors, glass…” I cut them off and said no, then tried to calm myself down as I realized my mother was going to have to leave soon and I would be left with all these strangers. 

“We have to take these books. Carla will give them back in a few days if they’re cleared.”

I looked at my stack of books: 1984, Winnie-the-Pooh, and a book on the spice trade. “To make sure they don’t have triggering material in them,” The taller of the two women offered after she saw me raise my eyebrows and make an irked expression. “You have to give us any pads and tampons you have too.”

The education people generally get around eating disorders are a few days in health class. The information is brief and largely stereotypical. Anorexia and Bulimia are the two main disorders that people hear about. Lifetime has made multiple movies centering onthem, which paint an eerie trope-relient image. 

The individuals the mass media associate with eating disorders follow a very tight pattern: thin, tall, white, middle class, female.. All can apply but this is not the case for all people suffering with these disorders, which extend far beyond the parameters of Anorexia and Bulimia Nervosa. It’s often not taught that a person can have an ED and look relatively “normal.” In addition, men also suffer from EDs. The ratio is 1:3 male to female, though in a larger scope this is nothing to minimize. Minorities also deal with eating disorders, as well as a large subset of the transgender community, though they are rarely represented.

My alarm went off at 7:30am, and I slapped at my phone’s screen to make it stop. A good night text from my dad was the only other notification on my screen. By my third day I knew the morning routine. At the end of the hall was the pantry full of johnnys which I was required to put on before going to get vitals. My first morning I was mortified when I was informed I had to wear nothing underneath, not even underwear, unless I was on my period. I don’t think any of us got our period while we were there, but we saw each others asses frequently.

Lie down on the couch, get your blood pressure taken. Stand up, get your blood pressure. Report being light headed, because duh, who doesn’t get dizzy standing up quickly. Go to the scale, which only displays on a tiny screen that the RAs hold. My third day the scale was broken, and we all had to traipse up to the third floor for weigh-ins. Second floor was where I was (age sixteen to twenty-two), third floor was twelve to fifteen, and fourth floor was twenty-three and up.

Getting off the elevator on the third floor I stopped dead. In front of me sat four waifs. They couldn’t have been more than fifteen. I was accustomed to seeing my own hip bones pop, and boney elbows were normal to me. Their faces were gaunt. A few of them had yellow tinged skin. One girl in particular caught my attention. She had lanugo on her arms, a fine hair that the body grows as a last resort to keep you warm.. That, I had never seen. They all turned to look at me when I sat down. One girl, the youngest looking of the group, actually scooched closer to me when the RA came to get the next person. Sitting there, realizing that I had been where these girls were only a few years ago made me wantto start balling and wrap them all up in a blanket of healthy fat.

After my first day having to “go up to third” for weight checks, I began asking the girls how they were doing. I got empty stares with a few quiet alrights mixed in as responses. They appeared more depressed than those of us downstairs. A goal board was hung on the wall opposite the front desk. Their goals, written in marker, were so simple, but only added to the hollow air the entire building had. “To go to homecoming” one message read. “To not miss more school” another said. “To stop making my dad cry”. Christmas was three days away and we were all going to be stuck in the facility for at least part of the day.

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I first started to restrict my food intake in October of 2014. That fall, I decided to not do cross country as I’d done in years prior, and for the first time in my life I felt fat. All through elementary school I’d been underweight to the aggravation of my pediatrician Dr. Rude (ironically,  she was a real bitch, let me tell you). I was an active kid, so there was no real concern. In middle school I was still small, and actually had people come up to me and ask, “Are you anorexic?” I wish I’d had the guts to punch those kids in the face back then. Never, never, ask someone that.

The spring of 2015 I quickly built lists of what I now know as fear foods. “No pizza. Only two pieces of fruit. Eat breakfast, but no lunch only dinner—but half of the serving. NO dessert,” read one list from that March. I lapsed into periods of binging where I would go through massive quantities of food, before descending into a depression that left me questioning if anything was worth this horrible sense of self hatred. My health classes only made me feel more alone. “What freaks,” I remember one boy saying during the section on eating disorders. I had to sit there while the teacher spouted information I knew to be largely false from my own experiences. I had no diagnosis until December of 2019, as my doctor at the time never seemed to notice how low my weight was.

Somebody had lost the bathroom key. All seven of us girls were put into the common room and told that our rooms were going to be searched and that we would have to put our stuff back afterwards. One girl, Melissa, stood up and proclaimed that, “This is fucking bullshit. We all know that it’s your own fault for misplacing the key!” We were then each asked to step into the hall and take off out socks, snap our underwear and bras, and empty any pockets. I felt like a five year old who was accused of stealing an extra cookie. To kill time, I sat on one of the couches chatting with the other girls about the breakdown this girl Ashley’d had when we were informed they were going to rip our rooms apart. Ashley is no doubt that most interestingly distressed person I’ll ever meet. This seemed to be the consensus for all of us.

Substance abuse is often a byproduct of eating disorders. Everything feeds into each other. Depression runs rampant among people who deal with eating disorders. Of those with Bulimia, 95% qualify for having co-occurring disorders; and 64% of Bulimics meet criteria for three disorders. Compared to the general population, people suffering from EDs are five times as likely to abuse alcohol or illicit drugs. Caffeine is the most abused drug; which may be surprising. Personally, I drank massive amounts of caffeine throughout the worst of my eating disorder. Not only is it an appetite suppressant, but it dehydrates, which cuts down on water weight. Through various side-comments and group sessions, I found out that Ashley not only dealt with Bipolar 1 and ADHD, but that she had lost a full ride scholarship to U Mass Lowell once she got hooked on heroin. All of this was in addition to anorexia and bulimia. On one of my first days I noticed the lattice work of scars that ran up both hers arms from wrist to elbow.

We all listened intently as Ashley freaked out to the RAs that she needed her vape pen. After each outing we’d have our person and bag searched, so I’ll leave it up to you to figure out how she got the vape in without discovery—and I’m serious. For all of the terrible shit that we were dealing with, the group of girls that I was with bonded quite quickly. The lack of trust that the administrators had for us was quite evident, and we found comfort in each other. Melissa’s personality always kept things exciting. She would scream out the windows at the smokers below. “Hey fuck-tard! Move down the street, you’re stinking up our space. Yeah, I see you!”

It was a few days after Ashley’s meltdown and eventual departure that I went up to my assigned nurse to ask about a new supplement she’d put me on. Every evening we’d go up to the front desk and take meds. Whatever they had you down for, you had to take it. No refusing meds. I didn’t like being force fed any kind of medication, supplement or not. My nurse simply stated that my bones are at risk for weakening due to lack of calcium intake. “It’s very common for women with anorexia like you…” I didn’t hear what she said after that. I just stood there with ‘anorexia… like you’ running through my head. At that point, I’d been dealing with my unnamed eating disorder for four years. I felt like a black mark had been painted across my face with her tying me to the word. The most common gripe amongst us girls was that the staff did not treat us like people, but like a diagnosis. Emotions were always last. It was assumed we were all lying, conniving, manipulative women. In truth we were all scared and fragile girls who wanted nothing more than to be “normal.” 

By the time that I got to college, I had gone through innumerable relapses. At sixteen I’d reached my lowest rate. My period had somehow managed to hold on and keep coming sporadically. Three weeks before move-in day I’d hit another regression caused by a break up. I ate nothing but toast, cereal, water and tea for those three weeks. My head was constantly spinning, and my anxiety was controlling everything. Despite this I made friends and started classes. By mid-September I was desperate to be free of the eating disorder, and launched into a series of appointments which brought me all the way to finals week. That Monday I was told that if I didn’t go into residential treatment during the semester break, I probably wouldn’t make it through the second semester. That I’d have to drop out and be hospitalized. 

My finals week was spent in the library’s study rooms dialing numbers of treatment facilities. As my friends packed up the see their families I cried in the bathroom at the fact that I’d be spending Christmas locked away in Harvard Square. The semester ended on the fourteenth of December; I was in treatment Monday the 17th. 

Despite what my parents claim and what the media may portray, the time in residential did more mental harm than good.. The one good thing it gave me was the fear of ever going back to one of those facilities. Staff made me cry for not eating fast enough. I’d almost involuntarily thrown up, which I rarely ever do, after having to eat a bowl of frozen strawberries that had defrosted into a mush. We were made to pee and shit with the door open and only a stall to shield us from complete annihilation due to embarrassment. I was not even allowed to flush for myself.

I was supposed to stay in Cambridge for an entire month, which is the usual insurance-mandated minimum, but I bailed after two weeks. My “team” of specialists were not happy and visibly annoyed at me. I didn’t give a shit—they all treated me like less than human. I’ve always been an honest person, and to be constantly accused of having ulterior motives was an entirely new level of insult to me.

Melissa had supposedly run away one night. In reality she’d had enough of the constant bullshit we were being put through. While we all may have been legal adults, this must have been lost on the RAs, who spoke to us like misbehaving first graders. After dinner, Melissa had grabbed her coat and slipped down the stairs. Nobody was at the ground level desk on weekends, so she left the building unnoticed. For three hours she had walked around Harvard Square smoking cigarettes and calling her boyfriend and brother. She said that the best part was being able to sit on a bench and have nobody look at her, and to blend in and be ignored just like everyone else; how we were never able to into our building, under constant surveillance.

In group sessions we were told about all the ways that we were only hurting ourselves. How it was up to us to make the changes necessary to actually stay alive. We had a few RAs that ran sessions and spoke to us as equals. Then we’d have to go to the kitchen and set timers and eat as fast as we could to get it all down in time. We’d have to take meds we didn’t want to. A fifty year old woman that resembled a scarecrow had made me cry, accusing me of thinking I didn’t have an eating disorder when I did. I’d wanted to scream at her how I obviously knew that I had one, that I was literally sitting next to her in rezy, and how I’d watched the city buses speed by the front of my dorm and held myself back from jumping in front of one because I felt so shitty. I wanted to shout at the RAs that they made me feel even worse than my own mind made me feel, and how dare that put everything back on me when outside factors are a strong influence in the development of eating disorders. The day after an RA scolded me for asking for my weight, telling me that it was a ridiculous request for me to make, I taught myself the Red Line, and stood in the middle of Downtown Crossing for ten minutes thinking about how close South Station, or Logan Airport was.

One of the larger gaps in education around eating disorders are the factors that go into making one. It is not like in the movies where the already stunning girl doesn’t eat her granola bar one days after soccer, and she suddenly develops and eating disorder before prom, but overcomes the condition at the end of the 90 minutes and finishes the school year happy and cured. By the age of six, girls are already mentioning concern over their body and weight. Forty to sixty percent of elementary school girls are concerned about becoming fat. 

This is a systemic problem, not simply an individual’s problem. Images from magazines, movies, and advertising influence the concept of an “ideal body” which doesn’t exist and never will. The concept of clean eating has only influenced diet culture in a negative way. For fourteen and fifteen year olds, dieting was the leading factor in the development of an eating disorder later on. Extreme dieting in this age group made it eighteen times more likely to develop an eating disorder. Genetics are also a factor that goes into EDs. If a parent or sibling has an ED, the chances are higher that the child or other sibling may develop an ED as well. Home environments, particularly those with higher stress factors, including alcoholism or drug abuse, are leading factors as well. 

The recovery process is incredibly complex for each individual. There are three rough tiers of care: outpatient, residential, and inpatient or hospitalization. Eating disorders continue to have the highest mortality rate of any psychological disorder. Relapses are common and interrupt  a recovery process which is already far from linear. Considering the nature of eating disorders is to have co-occurring disorders, multiple layers of care are involved.

After I left treatment, I felt incredibly fragile and was overly sensitive to any mention of weight loss. I felt that I’d been sheltered from the reality of being a functioning adult. Positivity statements only went so far, though after months of practice, I found that they did in fact help. I emerged from Harvard Square with a “fuck you” outlook at the world which allowed me the slide back into regular life armed with a hearty dose of cynical humor.

I assume I will continue to write about eating disorders. Each piece has given me a better sense of myself and what it means to live with a condition that never fully leaves you. While my own eating disorder took things from me, it also gave me things as well. I have learned to filter out what people say to and about me. I have come to claim my mental health as strictly my own. I have come to accept that I really fucking hate cauliflower. I’ve taught myself the navigate the Red Line through the depths of a city as much as maze as my own mind.