What's it like to be in eating disorder treatment?

I would be lying if I said I have been asked what it's like to be in treatment for an eating disorder, because not a single person has asked me. 

But I find myself wanting to talk about it, because some people have to wonder, right? And I'll tell you, it's fucking weird and uncomfortable... and sad, happy, exciting, defeating. 

It's a lot of things, which I hope to bring to light with this blog post. 

I'll start by saying that the treatment I attended was a partial hospitalization program (PHP). Depending on the level of treatment you're receiving and where, the restrictions, policies and supervision can change. 

Where I attended treatment, PHP was an eleven hour program. It started at 8 AM and ended at 7 PM every single day. You attended, breakfast, snacks, lunch, and dinner meal times within those 11 hours as well as group and individual therapy sessions (including meeting with a dietician) or any medical appointments you had within this time. You would go home at the end of each day and be back at it the next morning. 

You could only use the bathroom within an allotted time after meals, every meal was supervised, you were assigned a dietician which you created a meal plan with and saw a therapist who you were also assigned. Sometimes you'd see your therapist daily where other times you might see them once a week, same with the dietician. 

When you got there at 8 AM, your vitals would be taken by a nurse, blood pressure and your weight. I hated this, I thought it was such a waste of time and was annoyed at the fact that I had to be at my treatment center by 8 just for them to do this, I just wanted to sleep; I was so fucking tired all of the time. 

You'd eat your breakfast according to your meal plan, when I first got into treatment I wanted to be the perfect patient, so I clung to this. A meal plan was like a secret code in the eating disorder world, were you restoring weight? Were you on a maintenance meal plan? How many grains did you need? Fats? Since we couldn't count calories (no one should, it's stupid), we had a meal plan that looked like the following: 

Breakfast: 

2 grains
3 proteins 
1 fat
1 fruit

Lunch:

3 grains
2 proteins
2 fats
1 vegetable/fruit

or something, the list would continue with snack and dinner requirements. I never quite cracked the code here because it was never explained to me, obviously. This is still the biggest issue I have with the treatment center I went to (maybe they have changed it since I was there, but for the sake of this blog, I'll continue). They were creating rules around food when all the patients attending their program were trying their hardest to relinquish the rules they had previously created. I became so regimented with this meal plan that I would argue with my dad, and others, about it. My dad would ask why it mattered so much how many pieces of toast (grains) I had, and why I couldn't have more than 2. "because that's what my meal plan says, dad. I don't need more than 2". I thought this regardless of what my body was telling me, if I was still hungry following a meal I wouldn't continue eating because it wasn't on my meal plan. The meal plan is ultimately the reason I discharged, I couldn't handle the restraints around my meals because of this fucking meal plan. When the treatment team moved me down programs to intensive out patient (IOP), my weight dropped and they wanted me back in PHP. I said no and ghosted my dietician, maintaining contact with my current analyst (therapist), Joe, who is no longer affiliated with their program.

Anyway, you eat your breakfast, probably play some sort of card game (does anyone still play Nertz? I play it every night before bed on my phone), eat a snack sometime in between, maybe do some group therapy and get onto lunch. You'd eat, again according to your meal plan, there's a dietician sitting at the head of the table, there may be conversation, there may be crying, laughing, anger, you name it. I have so many memories sitting at the dark brown, wood table in the center I attended, hating my life. Hating that I had to be watched in order to stay alive. I was completely out of control at many points in my recovery. Showing up hungover, showing up on the brink of death.. But at least I showed up. The dietician would be there in an effort to make sure people felt supported, to make sure no one was causing any funny business with their food. Eating disorder 'symptoms' can be so entertaining, I'm able to laugh at them now, I still have some during my meals to this day. I can't let things touch, I can usually eat out of order now but sometimes that can be tough for me, I used to avoid eating by making conversation with those around me. Some people would push their food around, organize it, plate it to make it look 'pretty', eat faster, eat slower. Imagining some of the meal supports I attended, I just giggle. We were all just doing our best, seemingly normal people, with these odd little quirks around food. It was comforting to us, though, which I know is odd. We were just trying to survive the most difficult parts of our past and current lives.

Once lunch was over, you'd jump straight into a 3 hour group therapy session; sometimes this was talk therapy, other times it was art therapy. But, yeah, you read that right, 3 hours. When I first started, this shit was torture. THREE HOURS to talk about some of the deepest, most painful shit you have ever endeavored in your life. There were arguments, there were tears, there was comfort. I will never forget the people I was in treatment with because they probably know more about me than most people I have ever met; definitely some of the most deep, meaningful connections I have ever made. I was silent for a lot of these sessions when I first attended, I didn't want to talk, I was scared, didn't really know what to do or say. I remember journaling some, which I ended up getting in trouble for eventually, I needed to contribute, listen. I hated that, being in trouble, it meant so much to me when someone disapproved of me. If you read my last blog post, you know that this is not as big of an issue for me, but it's something that I have struggled with all of my life and it's a really big deal that I no longer allow something like this to carry so much weight anymore. As I continued through treatment, I became more vocal, I was genuinely comfortable with these people and felt that my voice could be heard and take up space in a room. I would ask questions, which used to be really hard for me; I didn't want people to think I was stupid. In this treatment center, these group therapy sessions, I really started to blossom into who I was meant to be. I didn't realize this at the time, but going to treatment was a major turning point for me in my life, not only because it saved me from myself but also because there were parts of me that I had never even met. 

After group therapy, you would eat a snack (again according to your meal plan), and then prepare for dinner. During these times I would sometimes turn on Grace & Frankie (Netflix, watch it if you haven't.. Still a comfort show for me to this day), scroll through my phone, read a book, journal, go for a walk, play more card games with other patients, visit with a fellow patient, maybe have an individual therapy session, go to your doctor to make extra sure you weren't dying or you could just hang out. You'd eat your dinner, have more group therapy for an hour and then eat snack. 

At this point in the day I was over it. This mindset applies to any point in my treatment career, I would often try to hide my snack somewhere on my person so I didn't have to eat it and thus leave the center. I posted on my Instagram story around two years ago about peanuts falling on my head from a purse I used while I was in treatment. That's the thing about karma, it's always watching you. These fucking peanuts were falling on my head from 2 years prior, out of this purse that was on my closet's shelf all because I just couldn't bare to eat another bite of trail mix. I recently threw that purse away (it was not in a condition to be donated), peanuts still in it; I'm not sure why I kept it all this time seeing as I haven't used it since I was in treatment. Anyway, I just wanted to leave and I thought I was so sneaky, but the dietician knew, she told me she knew when I posted that Instagram story. At least I can laugh about it now, I'm chuckling at myself while I type this. 

And that would conclude your day at treatment where I attended, hopefully you ate your evening snack, though. 

There are specific stories that stick out the most in my mind, I can't discuss stories of other patients and I certainly don't want to as those aren't my stories to tell. But, to give you and idea of where I was at at this time in my life, I'll share some more vulnerable and raw stories with you. 

I had a really hard time trying new things, this translated into food. In the event we did a "meal challenge", I was often encouraged to try something new, different, out of my 'comfort zone'. Growing up, if I didn't like what my parent made me for a meal, I would ask for something else and in turn receive exactly what I had asked for. This is something I still struggle with, but I do my best to break out of this comfort zone as I need to encourage Aubrey, my daughter, to try new things while she's still so young. One night, at a dinner meal support, we made a curry. I have never tried curry in my life, I was irritated the entire time we were making it, knowing this was going to be the worst experience of my life. I was pouting, being mean to others, specifically the dietician. When it came time to eat, I tried one bite and knew this was not something I was going to be finishing. I started talking to everyone around me, as I mentioned previously this was one of my "tricks", I was avoiding my meal. I would try to be funny, make jokes, and it would work. In the moment, I would think I even had the dietician fooled. My cleverness did not work in my favor, it would be brought up to me later in an individual therapy session with my dietician. Once the dietician noticed I wasn't prioritizing my meal, she would (try) to encourage me to eat some more, when I resisted, she tried having a conversation about it with me (in front of all the other patients at the table), my response was to push my bowl away from my body and start yelling. "Why do I have to eat something I don't like?", "This tastes disgusting and I hate it", "I have never had this before and I know why now", "I'm not eating this, I won't eat it and you can't make me. I'll have something else instead". The argument here, from the dietician, is that you don't *really* know if you don't like something until you have eaten it x amount of times. Long story short, I didn't finish the curry, I ate a substitute option, all the patients agreed that they were fine with it. I met with my dietician some days later and was told I had a "tantrum" over being served something that wasn't in my comfort zone. At this point in treatment, I stopped caring about trying. I just wanted to die.

Before the curry incident, I started relapsing, meaning I was using eating disorder behaviors again (restricting food intake); I had a lot of time away from the treatment center because I was in school and used this to my advantage. I was taking chemistry, statistics, philosophy and some other classes that I can't remember. I hardly remember this stint of my life, when I think back on it, everything was very dark and felt cold; almost like I was in a haze. I woke up dreading the day and would often oversleep, I created my school schedule around my treatment schedule. The agreement with my treatment team when I registered for classes was that I would create blocks in my schedule for meal supports and therapy sessions, I was doing well when I registered for classes, so well that I don't think anyone saw a relapse on the horizon. The thing that people don't talk about with malnourishment is that your brain can't function, you are constantly thinking about food, even when you're sleeping. This may seem obvious to others, but when you're purposefully doing it to yourself, you don't realize how miserable it really is. With the many distractions I had in my mind, I couldn't think straight. This was reflected in my grades, I got my first D letter grade that semester of college (in statistics, so is it really that surprising?). I would often forget appointment times I had made, I would be flakey with plans so that I could sleep instead. That's the other thing, you're so unbelievably tired when you don't eat, but sometimes you can't sleep because your body just wants you TO eat; this is where the dreams about food come in. Anyway, I was struggling so much in statistics that I would attend material reviews before an exam. I remember a specific review I attended, I went to the usual room they were in at Gaines Hall on MSU's campus. As I was sitting there, a classmate walked in, who was also in stats. I was confused because other people started to show up that I didn't recognize. It wasn't until the professor started passing out exam sheets that I realized I was in the wrong building and was instead about to take an Anatomy and Physiology exam, a class I was not in at that time. I suddenly remembered the review was moved to a different building last minute in observance of the exam that was scheduled in the "regular" room for our reviews. Conveniently enough, I missed a dinner meal support so I could attend this review, I am admitting for the first time I did this purposefully. I wanted an excuse to not eat, and when I went back to treatment after missing the review, I told everyone I got Wendys on the way there but was sure to tell this whole story about how I almost took an A&P exam. I cried on the way to the treatment center, knowing what I had done in an effort to skip a meal but also disappointed that I missed a material review that I so desperately needed. At this point in treatment, I felt so out of control of my own body. 

I'll stop my story telling there, but I want to close with something that has been heavily on my mind recently. 

Your life is worth living. 

No matter what you're going through right now, there are better things to come. No matter how shitty, miserable, trapped, worthless and lifeless you feel, your life is 100% worth living and I can promise you that there are people in your life that would cross the ends of the earth to help you. If you don't, then consider that person me. 

All of my life I have battled with mental illness, it's nothing foreign to me. But I can confidently say, finally, at 23 years old that I am so happy I am alive. I would be so mad at myself had I chose to end my own life because look at what I have accomplished! I look at my life now and am so fucking proud of myself for the mountains I have climbed. 

Because I chose to stay alive, I get to be a mom, I'm planning a wedding, I am gaining ground in a career, I get to play with my dogs and cat, I bought a house and sold it, I'm an auntie, I have the best friends I could ever ask for. Life is so miraculous, it has its moments, but there's no better high than feeling yourself get through something extremely difficult. 

So, if you needed a sign today, tonight, tomorrow, yesterday... Whenever you read this, if you need(ed) a sign, let this be it. 

Please stay alive. 

-Madi