Q. I am a 26 yr old female. I was born in 1980 with multiple physical disabilities. In 1988 I started Self-Injuring and August 2005 is when I started making a serious effort to stop Self-Injuring (My one year anniversary for no Self-Injury will be January 9th, 2007). Aug. 2005 is when my Eating Disorder started. >From August to October I dropped over 40 pounds. My parents did not believe me when I told them I thought I might have an eating disorder so I started looking for therapists on my own. I finally found one spring of 2006. August of 2006, my therapist and I started talking about more intense programs as I was still loosing weight. Finally in November I knew I needed help quickly. From November 22nd to December 19th I attended an inpatient eating disorder program and stabilized. I was admitted with Anorexia NOS, Depression/Anxiety, PTSD, Rape/Molestation and Self-Injury. I was discharged on the 19th because of insurance reasons. My doctors fought to keep me however at $1800/day I was not able to afford to stay on my own (w/o insurance). I have started looking for IOP (Intensive Outpatient Programs) and Transitional Homes that take insurance. So far it looks like my insurance will pay only for inpatient programs. I have been out of inpatient a little over a week and am starting to relapse with my Restricting. Is this normal? There are no EDA meetings in my area. I know if I do not get help with the Restricting soon I may switch over to the Anorexia again. Should I try to go back to Inpatient, try an IOP or try the free programs like EDA groups online? I am open to any and all suggestions as I am at a loss and feel like my control over ED is slowly slipping out of my control.
A. I have heard many stories similar to yours when it comes to eating disorders and insurance companies. The scenario that you are describing is very common in the United States mental health system and has plagued those suffering with eating disorders for far too long. It is the same story over and over with little variation. That is, the insurance company will only pay for a certain number of inpatient days, and will also limit the number of outpatient days they will pay for. Just when an individual is starting to get better the insurance coverage runs out. It is right at this point that an individual has to stop seeing their mental health workers and then winds up relapsing, and is essentially back where they started. Sadly, you are a victim of our “revolving door” and very ineffectual, public mental health system.
It is difficult for me to know exactly what you should do. If you need to go the hospital because you have stopped eating, then you should absolutely go. If you are eating but are restricting and you have your doctor’s blessing, then perhaps you can try an IOP program. They are intensive programs and are believed to be very helpful. My last piece of advice is to try a community mental health center for help. They can assist individuals for a sliding scale fee, or even free in some cases. I would stay away from the eating disorder online groups if you are having symptoms and are using these groups as your only form of treatment. I am not saying that the online groups are not okay, many people do find them helpful and a source of support. But it would not be wise to use the online groups as your only source of help, especially if you are finding yourself resorting to old behaviors or slipping back into Anorexia. If this is the case, and from what you have written, it does seem that your eating disorder is “slipping out of [your] control, then it is in your best interest to see a mental health care profession in person, and as soon as possible. I hope that I have helped at least in some small way. Take care.