Jami Wilmarth - Amarillo Counselor: Blog

FRIDAY, JANUARY 6, 2012 One week down, five to go Note: My client's series on transcranial magnetic stimulation continues. All that pecking on my head is supposed to make me feel like this! Or maybe it's really a hammer smacking me upside the head? I finished my first week of TMS therapy. I really hope it all works in the end. I have high hopes that it will work. Today, out of the 37-minute treatment (the "pecks," or really the electrical impulses are given at intervals), I spent four minutes at 115%. As I said yesterday, the goal is to reach 120%. I went a majority of the time at 110%, and it wasn't at all as painful as it was yesterday. It's really amazing how the brain adjusts so quickly. At 115% today, I felt like I was being beaten in the head. Interestingly enough, and probably with the aid of Excedrin Migraine, I didn't have a headache the rest of the day, and if I start out with a headache, which I frequently do, it's gone when the treatment is over. I think this kind of treatment could be a breakthrough for many issues and illnesses; I know through doing some research that it's being looked at closely in many areas. There's even a device much like a heart pacemaker that is designed to be implanted in certain places in the brain for magnetic pulses to treat various problems. Is this the wave of the future? Sure sounds like it. On another note, the nurse told me today that it's likely I will experience a mood dip on Sunday due to the lack of treatments on Saturday and Sunday. I guess I'll find out soon. THURSDAY, JANUARY 5, 2012 Day 4, a new high Note: My client's series on transcranial magnetic stimulation continues. Today, I reached 110 percent out of 120 percent in intensity of treatment. It meant not talking to the nurses, closing my eyes the entire time, and listening to my iPod. Otherwise, I'm not sure I could have stood how hard the woodpecker pecked. :-P My eye watered again like I was crying, like it did the first treatment. Oh, and because I knew we were going to up the intensity, I took some Excedrin Migraine so I could function the rest of the day. It worked. I have to say that I definitely felt the pecker. To cope, I imagined the little electrical impulses working on my nerve endings to distract myself. I imagined a life without depression. I imagined having energy to do all kinds of things at the end of the day. I imagined a life as a so-called "normal" person. And every time Woody started pecking away, I braced myself, my jaw and my eyes. Frankly, today's treatment made me want to yell, "Mother F***er" every time Woody pecked. But I didn't. I would also remind myself: "Get the most bang for your buck," so I kept my mouth shut if it hurt too much. I guess I did pretty well, because I functioned great the rest of the day. I was able to work, communicate, socialize and be "normal." Today, I continue to hope and pray this is the end of the end of depression for me. God is good, and He is amazing. He gave Man brains to discover and invent all kinds of things. Maybe this is it for me. I'm choosing to believe it's so ... and at the very least, maybe I'll get a placebo effect. :-) MONDAY, JANUARY 2, 2012 Patient's journey through transcranial magnetic stimulation Note: A client who has suffered from depression for years and tried many different treatments, including counseling and various antidepressant medications, decided to undergo a lesser-known treatment called transcranial magnetic stimulation. I encourage you to give a quick read to the link to understand more before reading through this client's experience ... a six-week journey. In addition, if you are interested in watching what the procedure looks like, here is a YouTube video that shows you not only what the procedure does, but shares three patients' stories. In Amarillo, the FDA-approved NeuroStar TMS Therapy System is owned by a team of psychiatrists: Dr. James Avery Rush, Dr. Michael Jenkins, and Dr. Lorraine Sommerfeldt. You can "like" them on Facebook. You can also visit them at their web site: http://www.centerfortms.info/ Follow my client, who has agreed to share her six-week experience of receiving TMS therapy. **** Today was my first treatment of TMS. I decided to undergo this insanely expensive and not-yet-covered-by-insurance treatment because I have nowhere else to turn, I don't think. I have suffered from depression for most of my life. I really don't remember not being depressed, even as a child. I remember feeling as if I looked at the world from the outside in, and I felt sad a lot. I felt afraid, too. I experienced brief moments of happiness, but was I ever at peace or just plain satisfied? I don't remember. I don't think I asked for depression. I know I didn't ask for it. I am who I am, and I have worked on myself for years. I've worked on my thinking and done everything ever asked of me in counseling. I have a good life. I've had bad experiences, just like everyone else, but this depression, it just hits me over the head inexplicably. Truly, there is no explanation except, in my own opinion, biology, genetics, and my own temperament. Otherwise, I work hard to not be depressed. So please, if I have anything to say if you are reading this account of my depression, try not to be judgmental. Depression isn't something people with true depression can just "snap out of." If you want to judge, I guess that's OK, but maybe you'll learn something, too. And maybe you won't judge me or others in the same situation anymore. I can hope for that. Either way, I'm fine with it. I have accepted this as a sort of thorn in my side. Maybe God will use this treatment to help remove the thorn, or maybe not. Only time will tell, and you get to journey this with me. Here goes, but first, a little background: I first went to counseling at the age of 8 or 9. I had a lot of stomachaches. I don't remember much. I don't think I talked to that man enough to help me. I started taking antidepressants when I was 16, way before the currently popular Selective-Serotonin Reuptake Inhibitors (SSRI) became popular. I took tricyclic antidepressants but couldn't tolerate the side effects. I started the first SSRI made, Prozac, in whatever year it was approved. It never helped me until I hit a high dose of 60 mg. By the time I stopped taking Prozac, I was on 80 mg per day, and it no longer worked. Not to take up too much time or space on medications, I will just say I've been on just about every antidepressant there is: Prozac, Paxil, Celexa, Lexapro, Wellbutrin, Effexor. I think there are others, but I can't remember all of them. I've been on small doses of an antipsychotic medication that, when used in conjunction with an SSRI, is shown to be effective in treating depression. I've been on anti anxiety medications, too. My pharmacy knows me by name. I've even tried self-medicating with too much alcohol -- anything that would change the way I feel. Nothing has worked. My current medication regimen is the best I've had yet, but I'm still not not depressed. My wonderful psychiatrist who has worked hard to find ways to help me finally suggested the TMS therapy. First, I said no because of cost. But desperation is desperation, so here I am. I'm praying this is the magic bullet, the treatment that pushes me over that mountain top into an area of freedom I've never experienced. **** This morning, the 37-minute treatment began with the doctor and nurses finding just the right spot on my head to place the part that would ultimately transfer electromagnetic pulses into my brain, in the prefrontal cortex. That is the area where emotions are regulated. The doctor showed me a picture of an MRI of a healthy brain and a depressed brain. The depressed brain had very little neuro-activity. The normal brain was lit up like a Christmas tree -- almost all happy-like. I suppose the goal of this is to restimulate the activity of the brain so that it becomes like a normal brain, especially in the area where depression and other emotions occur, such as anxiety. After they located the spot, the treatment began. At first, it didn't hurt. It wasn't comfortable, but it wasn't uncomfortable, either. As time progressed, the feeling became increasingly uncomfortable, even painful. It wasn't so painful I wanted to cry, but there was wincing involved. It caused my left eye to water and my nose to run, but not because of crying. It was an involuntary reaction to the treatment. I have heard others describe the intermittent applications of the -- I don't know, is it magnetic stimulation? -- like being pecked on the head by Woody Woodpecker. It definitely felt like pops and clicks to the spot on the left side of my head, sort of towards the front. And I will do this every day except weekends for six weeks. The stimulation should get stronger as I go, but the nurses and my doctor said I would get used to it. Tomorrow, I'm taking my iPod. As for the effects today, I went home and slept for two hours. My eye feels heavy, like I've been crying. The weirdest thing was that at one random part of the day, I got really emotional and just started crying in the grocery store. I was embarrassed and glad to leave. We will see what happens tomorrow, and I don't expect that every post of this journey will occur every day or will be as long. I will just give you the significant parts. The doctor says it will take a while to see improvement. The nurses say I will be the last to notice differences, that they will see differences first, and family members closest to me will see differences or changes. I'm not sure what that means, but, you know, I guess I'm just along for the ride now. Note: Edited by Jami Wilmarth, MA, LPC SATURDAY, DECEMBER 31, 2011 Depression: Tamara, pt. 10 -- Series end Note: It's been a while since I have written about "Tamara," the person I created to represent anyone who might suffer from depression. It's time to wrap her up. :-) After two weeks in the inpatient mental hospital, Tamara graduated to working with her counselor on an outpatient basis. During her therapy, Tamara's counselor taught her about turning her pain into peace. Tamara learned to identify her triggers to her deepest pains, such as rejection, and tell herself new "truths" about herself. For example, during times in Tamara's life when she felt rejected or was actually rejected, she learned that her self-talk went something like this: "No one loves me." "I am worthless." "If I were better, more perfect, prettier, smarter (etc.), he would love me (or they would want to be my friend)." Tamara learned these were lies she told herself. She believed them her whole life, and she lived and acted upon those lies. To get out of her "pain cycle," Tamara began to tell herself new truths, such as, "God made me the way I am; I am good the way I am." "I am a good person." "God loves and accepts me." "God puts people in my life that he wants me to love and help." By practicing these new truths, Tamara learned that she could accept herself and behave differently and definitely not self-destructively. She has also learned that this is a journey she will be on for the rest of her life because replacing old lies with new truths takes time, practice and effort. The hope this technique provided for Tamara helped her to move forward in her recovery from depression. She continues to be on antidepressant medication, but she understands the majority of the work will come from changing herself and her thought processes. Tamara has found a new job she enjoys and is saving money to make a down payment for her own home. She is rebuilding her relationships with her daughters and aims to make a good home for all of them. Tamara also continues to work toward healing from the hurt in her relationship with Jason and his new wife. She knows this will take time. In the meantime, she also has decided to take a two-year break from dating until she feels stable enough to choose someone good for her. Tamara also has stopped drinking completely and is attending Alcoholics Anonymous. She has been sober since she entered treatment for her depression. Tamara's counselor is pleased with the direction she is taking and the choices she is making. Because Tamara entered the hospital in a poor emotional condition and multiple suicide attempts, as well as having lived a life of making self-destructive choices, her counselor believes Tamara needs to continue to work out her pain and continued better decision-making in therapy. She encourages Tamara to keep a personal journal or prayer journal, to faithfully attend AA, and to stick to the goal of abstaining from dating for awhile. Tamara's prognosis for living a healthy life is good if she remains on the current track she has taken. Next: One person's journey through Transcranial Magnetic Stimulation in the treatment of major depression. For more information about TMS, click on this link. TUESDAY, NOVEMBER 29, 2011 Support Group News Yesterday was the first day we held our eating and weight loss support groups at Gold's Gym at the Puckett location. From now on, the groups will be held at the same location, at 12 noon and at 7 p.m. on Mondays. Yesterday, we had one person come to the noon group. As of now, this group is still wide open. I will continue to show up until and unless it becomes clear no one is interested in this time. Five ladies attended the 7 p.m. group, and I think it went well. We did discuss that not only is exercise and nutrition important in reaching weight loss and weight maintenance goals, so is what goes on in our minds. This is where I, as a licensed professional counselor, come in. Gold's staff have expertise in the other areas and will help when necessary in these other key areas. I believe there are many other women (who work out at either location) who are appropriate for these support groups. Our evening group discussed many ideas for making the group meet their needs, both as a group and as individuals. Discussion included those internal beliefs and emotional issues that sometimes sabotage our abilities to meet our goals. That is where I come in. Anyone new is welcome to join at any time. I have a new proposal, thanks to Britt Rea, General Manager at Gold's Gym: ANYONE WHO IS NOT A MEMBER AT GOLD'S CAN ATTEND FOR THE FIRST TIME AT NO COST. If you should decide you would like to continue attending after the first visit, as well as enjoy the services at the Puckett (only) location, you can do so for only $19 per month. That's a great deal, ladies! Exercise is a huge part of weight loss. Give it a chance! I am encouraging more of you to attend, whether at noon or at 7 p.m. ... again, on Mondays. Please, please message me at jami@jamiwilmarth.com if you have questions and to let me know that you are interested. I look forward to meeting more of you. Together, all of you can reach your goals!! WEDNESDAY, NOVEMBER 9, 2011 What's happening with the new business? Please check the "events" link on my site periodically to see whether I'm doing something you might be interested. For now, it reads I have teamed up with Gold's Gym to offer a support group every Monday at the Puckett location to help those who struggle with food and weight loss. Participants can choose which group works best for them: Mondays at noon Mondays at 7 p.m. We plan to begin Monday, November 28, right after Thanksgiving, and we will discuss a variety of topics. Participants will have the chance to get to know others who struggle with the same things they do, plus learn skills to help them be successful with food and eating. Sessions are free for members of Gold's Gym. Non-members can attend for $8 per group. For more information, you can contact me at jami@jamiwilmarth.com or call 806.236.0418. I also am doing some public speaking, and am more than happy to continue doing so. Tonight, I am speaking about "forgiveness" at Hillside Christian Church to a ladies group that has been doing a study on forgiveness. I would love to do more ... just have to get the word out. Word of mouth has helped me the most. As my friends, acquaintances and strangers who read this blog, I hope you will remember me when things like this come up in your organizations and you need speakers. I have also been speaking at the high schools some about eating disorders. I would love to talk about bullying, too. Actually, I would enjoy speaking to businesses about workplace bullying, so, again, please keep me in mind. **** I am slowly but surely getting in place with insurance providers. I expect to hear from Blue Cross/Blue Shield any day about being in-network with them. Just waiting on a formality. I'm waiting on a call from FirstCare, which also carries some Medicaid and CHIPS. There are several others, but the process is slow. In the meantime, for those who want to see me and I'm not yet with their insurance, I am negotiating fees. **** Last but not least, I will get back to the depression and eating disorders blog series to finish them up so I can begin something new. Thanks so much for reading!! Thursday, November 3, 2011 Tamara, part 9 Tamara still wasn't ready to present her homework to her counselor ... the assigned homework, anyway. She had been doing some work on her own, because she felt more than ready to put Jason and all the damage of that relationship behind her. "I'm done," Tamara said. Her counselor looked confused. "Done with what? Are you thinking you are ready to leave here?" "Oh, no," Tamara said. "I still have work to do ... but I'm done with Jason." Her counselor said, "Wait, just a few days ago, you thought it would be impossible to give up and let go. You didn't quite want to ... or you weren't quite ready. What has happened?" Tamara responded. "Well, part of it comes from the sessions we've had here, and just talking about it. The last session we had got me to thinking long and hard about how I've put my whole life on hold, fallen into the deepest depression I've ever been in ... and it's been all because I allowed the rejection I felt from Jason and the buttons his girlfriend pushed. "I guess those are the things your homework assignment will help me with later, right." Her counselor nodded. "But," Tamara said. "You know how some of the group members suggested writing a letter to Jason, one I wouldn't send, but a letter that got all my feelings out? I tried that. I sat down, paper and pencil in hand, and the words wouldn't come out." The counselor said, "Why do you think that is?" "I've run out of things to say," Tamara said. "There's nothing in that letter that I would say that I haven't already actually said to him in an email. I've said good things. I've said horrible things. I've begged and pleaded. I've done it all. And, of course, he never responded to any of it, which only made me crazier inside. "So, I decided, 'Why bother?' Why say anything more?" Her counselor responded, "Well, the only thing I might have to offer is that you could be succinct in your new and last letter ... without sending it. You could get your feelings out once and for all and be done with it." "That's the funny thing," Tamara said. "I think I am done with it. When I realized I had nothing left to say ... except maybe one last paragraph 'hurrah,' I felt ready to let go and follow through on those things that would help me let go. "I mean things like you suggested: Not crossing paths with them, not sharing in things I know he likes or does, not social networking in ways I might come across him or purposely seek him out. Stuff like that." Her counselor responded, "That's great, Tamara." Tamara nodded. "I realized there will always be a little piece of my soul that he inhabits, and it will be a sad part, until maybe someday with time I wake up and realize I only think good thoughts. But I know I can't MAKE him or my past with him, or even the feelings I've had, just disappear. So, he gets a tiny portion, and that's it. When he tries to move in on the rest of me, I'll just have to come back and revisit these things we've worked on ... and who knows, maybe what we're going to do next will help me keep him at bay?" Her counselor nodded, "I do think that's true. I think you'll find what we're going to do next to be extremely helpful, not just with the situation with Jason, but with everything you've ever believed about yourself and others." Tamara looked hopeful. "I so hope you're right. I'm tired of hating myself. Tired of blaming myself for everything. Tired of feeling like a reject. Tired of feeling worthless and ugly and stupid and all those things I've felt my entire life." "We'll definitely get there," her counselor said. Tamara said, "So, can I tell you what the last paragraph of my letter to Jason would say?" "Of course." "It would say something along the lines of me forgiving him. You are the person who taught me forgiveness is for the person doing the forgiving, not the one being forgiven, right?" Tamara asked. "That's correct," her counselor said. Tamara continued, "And I would no longer ask for his forgiveness, because I don't have that right. Forgiveness is a gift, if he's going to give it. I did some mean things (which I've forgiven myself for, by the way). I would wish him the best, and I would tell him that he would discover for real this time that I truly am letting go. He is free of me, but only time would tell him that. ... That's because I promised him many times before I would leave him alone and didn't. That's embarrassing to me." Her counselor asked, "Do you think you will do it this time?" "Yes," Tamara said. "For two reasons: I'm not in the depths of my depression anymore, which has given me strength, and two, I want to prove I can do it. I have to start somewhere. And here is where I have the support to do what I need to do." "Good," the counselor said. "Do you believe you've truly forgiven him?" "Yes," Tamara said. "I still have work to do with her, but at least I understand where she was coming from. Even so, though, I'm leaving her alone, too. I never wanted anything to do with her anyway. Like I said, I just don't like her as a person. It makes me sad to know he's with her, but that's beyond my control, right?" Tamara smiled sadly and reminded herself, "From now on, he only gets a small part of my soul. For now that part remembers him with sadness. Maybe someday, it will be fondness." Her counselor said, "You've done some hard work, Tamara. I think you are on the right track, and I, too, hope you one day remember him and your times with him with fondness. Time is on your side." Posted by Jami at 7:17 AM 0 comments Email ThisBlogThis!Share to TwitterShare to Facebook Links to this post Labels: depression, forgiveness, Tamara Tuesday, November 1, 2011 Tamara, part 8 Tamara sat with the other group members: Katherine, Samantha, Henry and Sean. After seeing them and interacting with them every day, she had gotten to know them well and discovered they were all good people ... just really messed up at one point like she had been. Because of his drug problems, Henry's situation seemed the most complicated. Now that he had been in the mental facility long enough to address his Russian Roulette incident and staff was relatively confident he no longer wanted to kill himself, Henry was getting ready to leave the group and move to a drug rehab facility. Tamara related to Henry's drug use, and if she didn't agree to stop drinking ... as in attending AA and trying to stop ... she was being threatened with drug rehab, as well. Tamara didn't want to go, but she also wasn't ready to give up her alcohol. The problem with alcohol for her, though, was that she said and did stupid things under the influence. All of her suicide attempts and sleeping around had happened while drunk. When sober, she was able to talk herself out of taking pills, and she really had no desire to have sex. She knew she needed to stop, but it had become her crutch for dealing with happy, sad and boring times. Sean would be in treatment for quite some time, Tamara learned, because of the severity of his reaction to the stresses in his life. People take you more seriously when you threaten to kill others besides yourself. Funny thing is, in this treatment environment, Sean is a really nice guy. It was hard for Tamara to imagine he had nearly wiped out an entire office building. Sean had been suffering from depression for years. His depression had been a low-level dysthymic type of depression, and he had been on meds for most of his adult life. Then, Sean was faced with several stressors that put him over the edge into a major depressive episode, even to where he got psychotic. Because he worked too much and was depressed a lot, Sean's wife left him; he also was passed over for a major promotion at work that he had expected to get. He tried to deal with things "maturely," as Sean liked to say, but the losses were too much. He just completely "lost it" one day, got into his guns and went after his co-workers, threatening to kill them all and himself. He said if his wife had been around, he's certain he would have killed her because most of his rage had been focused on her. Sean was here to get regulated on meds and to deal with years of abuse he had suffered at the hands of his own father. He also had to learn positive coping skills. Again ... he would be here awhile. Katherine was doing well. She had already been in treatment for a while before Tamara got there. She had dealt with the fact she had been depressed off and on most of her life. She was dealing with the years of childhood sexual abuse by her uncle. She had begun to understand how she "all of a sudden snapped and swallowed a bunch of pills." She had simply kept her life and her feelings buried under a cloud of depression her whole life, all the while on the outside appearing as a cheerful, funny, outgoing and beautiful woman. Katherine was getting ready for discharge. She no longer wanted to die. She would be leaving and going into an outpatient program where she would continue to deal with the soul-damaging effects of the sexual abuse. Katherine had been Tamara's favorite group member, probably because of her kindness Tamara's first day in group. Tamara somewhat related to the sexual abuse. While not abused as a child, Tamara had been raped as an adult three times when she was into her wild promiscuities. Last, but not least, was Samantha ... or Sam, as they all called her. Sam was doing well, but she struggled with pretending to be more well than she really was. She always had on a happy face, but she admitted she cried every night still. Because she was in the military, she explained, she would be in treatment for quite some time. She didn't mind. She said she felt safe here, and she had learned a lot. She also had found others who had been sexually assaulted with whom she could relate. She still struggled with blaming herself for what had happened to her, and as long as she did this, she would struggle with shame and depression. As for Tamara, she had begun to share her "business" with the group, and they had accepted her. For this, she was grateful. She never felt like she fit in anywhere else before. Tamara didn't miss the irony. She told the group she felt like they were on the island of misfit toys. She wondered if life would always feel that way ... Posted by Jami at 11:03 AM 0 comments Email ThisBlogThis!Share to TwitterShare to Facebook Links to this post Labels: depression, suicide, Tamara Tuesday, October 25, 2011 Tamara, part 7 Tamara marched into counseling the next day with an announcement. "I did my homework, but I want to talk about something else first," she said. Her counselor consented, "OK, sure." "I want to just block Jason out of my mind forever. I don't want to just let go. I want him gone forever," Tamara said. "If he can't apologize to me for how he's hurt me and take responsibility for his actions, I can't get closure. Therefore, I want him gone, like he's dead. He clearly never gave a crap about me." Tamara's counselor was taken aback a little. Tamara had protected Jason in most conversations, always blaming the girlfriend, but now her anger at Jason came steamrolling out. "Keep going, Tamara. Let's get this out, too." "When I was really in the thick of this illness, I told you I did really stupid and crazy things to Jason and his girlfriend. I was rude and played childish games. I think I really was crazy. I was drinking a lot then, too. I'm really embarrassed, and I'll never be able to make up for it. Add "Tamara the crazy psychob$tch" to my list of labels. "Anyway, I would feel bad, because it's not really like me to be hard-hearted and mean -- but I was so furious at the girlfriend -- so I would write emails asking for forgiveness and such. They wouldn't stick because I'd turn around and do something dumb again. I'm so, so angry at myself for that. Repeatedly in all that, though, all I wanted was for Jason to take some responsibility, too. I wanted him to make his wench stop acting like one and egging me on. I was furious at him for not caring enough about me to make her stop. "In all the emails or texts I ever sent, which he refused to reply to, I kept asking him to please forgive me, don't hate me and to please see how he had a place in the mess, too. I never got that from him. Of course, by ignoring me, I only got angrier and felt more rejected, so I sent my fair share of 'fuck off' and 'I hate you' emails, too." The counselor said, "That must have hurt to take all the blame and to be ignored, too." "Yep," Tamara said. "Not even worth a word, was I? And it only made me feel crazier and dumber and more worthless and more rejected and more like a piece of crap because I wasn't even worth him wanting to say goodbye. I wish to God he would do that for me, just because I think it would help me let go. "But because he won't do that, I just want to forget he ever existed. Is that possible?" Her counselor paused. "I don't think it's possible to forget him completely, especially not right now. Only time takes care of these things. But you also have to do your part, and that means not putting yourself in his or her path. If you have pictures, you let go of them. If you have phone numbers, you delete them. Same for emails. It means you need to get rid of all temptations that remind you of him and of getting in touch with him. It would be healthier for you, too, to convince yourself you most likely will not grow old with him ... not if they are getting married, and especially not after all that has happened. I'm sorry if that sounds harsh, Tamara. It's just, I don't want you to continue hurting yourself with false thoughts and hopes of this 'relationship.' "You also have to find something to replace that desire of being with Jason. New focuses. New hobbies. New desires. Your children. You know what I'm saying?" Tamara nodded slowly and sadly. "It isn't fair. How'd I get so stuck on someone who was only going to end up hating me? How come I can't let go? WHY WON'T HE GIVE ME WHAT I NEED? Then I can let go, I know I can." The counselor said, "Tamara, tell me again what you think you need from him." "I need him to say he is sorry, too. I need to know I once meant something and that he still cares about my well-being. I need him to forgive me for that crazy period in my life," she cried. "Tamara ... the counselor said. "I can't pretend to know what is in the mind of someone I've never met. I could take a thousand guesses, but this I know: We cannot force anything out of anyone else. We have to learn to live our lives with what we have ... whether it's what we want or not. You've been dealt a hand of cards in life, and you've played a hand or two, some of them not so wise ... now it's time to play with what you've got at this time and do the best you can. "The good news is, you have time on your side, and you have decisions and behaviors you can choose that will help you overcome this very painful wound in your heart. That's playing your cards you have now." Tamara was crying as she listened to her counselor. Nothing was ever easy, was it? She felt so angry at the world and at herself. How can a smart person do such stupid and self-destructive things. How was she supposed to crawl out of this hole and get back on her feet? "Tamara?" her counselor said. "What are you thinking?" "Oh, nothing important," she said. "Just feeling sorry for myself. ... Can we start on my homework tomorrow? I'm really tired. Or can we maybe focus on my group members in group for a while. I'm sick of myself and my problems." Her counselor smiled gently. "Let's see how you feel tomorrow." Posted by Jami at 3:39 AM 2 comments Email ThisBlogThis!Share to TwitterShare to Facebook Links to this post Labels: depression, suicide, Tamara Monday, October 24, 2011 Eating Disorders Causes/Laura, part 7 “Genetics make the gun; the cultural and familial environment loads it, and it takes the experience of unbearable emotion to pull the trigger.” Aimee Liu, “Gaining” The causes of eating disorders are complicated, serious and multifaceted. Many factors must come into play to create an eating disorder in an individual, which we will spend discussing in this part. I will later use Laura’s story to illustrate how the factors work together to cause an eating disorder. In fact, I prefer to describe the causes of eating disorders by using a pie chart (seriously … no pun intended). So, if you will, imagine a pie, and divide that pie into four pieces. Imagine, too, that the left side of the pie is divided into equal halves. On the right side, the top triangle (ish) of the pie will take approximately three-quarters of the half, leaving only one quarter for something lesser to “blame.” As I talk about “blame,” keep in mind that reality is in any individual, the pie could be quartered in any number of sizes. Let’s look at the parts of the pie and discuss what they are and how they may vary among individuals. Biology Because of the amount of research and especially brain studies performed in the last 20 years, I have chosen to cut my eating disorder pie making the “biological” part the largest – the one I had you imagine on the right side taking up three-quarters of the space. Included in the biological component are a person’s temperament/personality, brain chemistry and other DNA factors. After looking at people with eating disorders long after their behaviors had stopped, basic temperament, discomforts, depression/anxiety, compulsiveness, obsessiveness about any number of issues or projects, perfectionism, etc., remained. In fact, many women in author Aimee Liu’s study discovered that at any given stressful point in their lives, they were vulnerable to picking up the eating disorder again, simply due to their DNA and personality quirks. In addition, brain research has shown that the brains of people with eating disorders are slightly different than the brains of those without eating disorders. Now … is this a chicken and egg question we’re looking at? I don’t know. I don’t think researchers are certain either, but it is something that clearly needs to be looked at in future research. Family My familial part of the eating disorder pie is smaller than the rest. Aren’t you happy to know, if you have a child with an eating disorder, that my pie blames you the least? J Actually, at one time, families/parents truly got the brunt of the blame, but because of research, once again, that part of the pie is shrinking – although, again, remember that with any individual, that part could be cut larger. Included in the family portion of the pie are family values, whether or not there is a history of eating disorders in the family, the structure of the family, abuse, and substance abuse. Family values can mean something as simple as how much emphasis the family places on looks, dieting and body image. Structure assumes how the family fits together: Are the family members close, far away, enmeshed, disinterested in one another, etc.? Abuse is obvious and includes emotional, physical, sexual, spiritual and neglect. Eating disorder research has a long history of showing substance abuse, specifically alcoholism, to be a factor in families with eating disorders, as well. Sociology The sociological portion of my eating disorder pie includes friends and friends’ values, the culture at large, activities the eating disordered person is involved in, such as sports, music, dance, etc., and media. I hate to say a big “duh,” but ladies, we’re all subject to the cultural and media impact that creates eating disorders. Research shows that most of us diet and most of us are unhappy with our bodies. Now … why is that, do you think? (I am being sarcastic, here.) And with eating disorders, research has tied some activities to higher instances of eating disorders, such as ballet, gymnastics, theater/acting, and wrestling. These clearly are all activities that place emphasis on weight. Triggers Finally, let’s look at the triggers part of the pie. Ninety-nine percent of all eating disorders begin with a simple diet. I cannot tell you how many times I’ve heard, “All I wanted was to lose five pounds.” Another trigger is a loss of some sort – an important relationship, divorce, death, a dream or goal. Life transitions make important triggers. Stress, change … those things bring out great fear in most people, and if not handled constructively and with good coping skills, a problem could arise. I am referring to life changes such as puberty, starting high school, college, getting married, having children, becoming an empty nester, and divorce. Other triggers include any perceived stressful life event and changes in one’s body, such as puberty, the “freshmen 15” and post-baby weight. **** As you can see, many, many factors mix together as ingredients to make an eating disorder pie. It just depends upon how many of the ingredients in the pie one person gets to determine whether he or she becomes eating disordered. We’ll take a look at “Laura’s pie” in the next part. Posted by Jami at 11:07 AM 0 comments Email ThisBlogThis!Share to TwitterShare to Facebook Links to this post Labels: eating disorders, Laura Sunday, October 23, 2011 Tamara, part 6 Note: "Tamara" is a composite of several people suffering with depression. The therapy session in which Tamara talked about Jason had been somewhat of a breakthrough, although Tamara didn't see it that way. She had walked out, gone to her room and stayed in her bunk for two days before anyone talked her into participating in treatment again. During those two days, Tamara cried nonstop. It had been the first time she had really cried about the sadness she felt. She had grown used to drinking and hiding behind her sadness in rage at both Jason and his girlfriend. Finally worn out from crying, she emerged from behind her covers. **** "Tamara," her counselor said. "You've had a rough few days. I'm sorry you are having to go through this, but I am glad it's finally coming out." Tamara smirked. "I'm not. I'm exhausted from all the crying. And I'm still angry ... although maybe not as mad as before. Just really, really sad. I don't want to let go, but I know I have to. All holding on does is bring me pain. I don't know why I keep holding on. I ... I just thought he was the one." Tears welled up in her eyes again. "How do I let go?" Her counselor said, "Time. And, we're going to work on some things about your personal beliefs that will help. Remember how we've talked about the lies you've believed about yourself? We have to replace them with truths." "Truths?" Tamara said. "Jason's girlfriend is right, you know. I am a whore. How do I get past that one?" Her counselor said gently, "Tamara, you have made some decisions in your life that have not been the best for you. They have been self-destructive, but that doesn't define who you are. You may have behaved in ways that have caused you to carry that label and allow someone who wanted only to be mean and insulting to reinforce that for you ... but you have to let go of the label. "Those were behaviors for which you feel deep shame and guilt. Forgiving yourself will be a key in this, and it will take time, but again, we will have to examine the truths about you, not the lies that this world would have you believe. Another thing I have to ask, though, is ... are you ready to let go of that kind of self-destructive behavior? Are you finished with those behaviors?" Tamara nodded. "Yes. I hate hating myself for it. I don't want to be that way. The ironic thing is, I don't remember half of it, because I was drunk most of the time, and I really don't even like sex. It was just something I did. I don't even know what true intimacy means." Her counselor nodded in understanding. "There is no intimacy in one night stands or in sleeping around, that's true. And, in whatever relationships you've ever had, it sounds as if one or both of you have been emotionally unavailable. No intimacy there, either. Any time alcohol or other drugs are involved, there will be no intimacy. I don't think you ever learned true intimacy. Again, these are things to work on." Tamara shrugged in frustration. "We're over-hauling me ... which is good ... but I don't know that I can do it. That's a lot of work." Her counselor agreed. "Yes, it is. It will take time, patience and daily practice of what I'm going to show you, but you will be a healthier, more at peace person for the effort." Tamara thought this sounded good, but she was going to wait to see it to believe it could happen for her. "Tamara, where are you on the extreme hatred for the girlfriend?" the counselor said. "You can't carry that around, either." Tamara thought for a while. "I'm holding resentments, but not really hatred. I was just expressing myself the other day. I just think she's a mean, rude, hurtful person. I think she's a b$tch, plain and simple. I don't have to like her, do I?" Her counselor laughed. "No, of course not. It's impossible for everyone to like everyone in this world, but carrying resentments is not healthy for you. It's not doing a thing to her. It's bad for you. "The more you work on yourself ... and not only forgiving yourself, but others, too ... the less of an issue this woman will be for you; the less you will even think of her ... or of him, for that matter." Tamara wasn't sure she was ready to give up hope on Jason, but she didn't really see another choice; she was pretty sure he was going to get married to the wench. Tamara took a deep breath: "I'm not sure I can do this. I'm not completely sure I want to do this, but I do know I'm tired of pain. I also know in my heart no man is worth taking my life over, or wanting to die because of him." "Great," her counselor said. "You have homework before tomorrow's session. Go back through all we've talked about and learned about the deep pains you felt when you overdosed each of those times, and write down some of the beliefs that you hold about yourself. Your feelings of rejection would be just one example. Then, we will get started on correcting your unhealthy beliefs and unhealthy coping mechanisms." Tamara said OK and got up to leave, looking and feeling overwhelmed. "Tamara," the counselor said. "You can do this." Posted by Jami at 11:49 AM 0 comments Email ThisBlogThis!Share to TwitterShare to Facebook Links to this post Labels: depression, suicide, Tamara Saturday, October 22, 2011 Tamara, part 5 Note: "Tamara" is a composite of several people suffering with depression. Tamara had begun to respond to treatment. She was open to the things her counselor had to say, was interested in the stories and successes of her group members, and discovered that one of the medications in her new concoction was a quick responder med. She was beginning to feel the boost and lose the desire to take her own life. She quickly was becoming a leader of sorts in her group and helpful to them when they were struggling. She also had become interested in dissecting the details of her suicide attempts so that maybe she could get to the bottom of her poor coping skills. She realized when things got really tough on her, running meant dying. It also meant partying and sleeping around. Tamara discovered that this past year of multiple attempts had made each time easier and easier, psychologically. She knew that if she stayed on her current path, she would eventually kill herself. Her counselor continued to push her in going through each suicide attempt and the triggers that led to them. She hated that, because she felt so weak. She realized as she talked them out that while they had been traumatic at the time, she saw she could have survived the difficulties and moved forward if she'd been stronger. While she wanted to beat herself up for being "weak," her counselor was teaching her that being stronger just meant she had to develop healthy coping skills, healthy self-talk, and practice using them. "Which suicide attempt do you want to go through today, Tamara?" her counselor asked. Tamara sighed. She had done her thinking already and tried explaining it to her counselor. Three of the other four suicide attempts were relatively similar, and they were all because of a man. Tamara had fallen in love with an emotionally unavailable man who had a girlfriend. She considered him her soul mate, because, like her best-friend-at-the-time-Kristi, Jason understood her. He knew she had issues, and he didn't run from her, at least not at first. He understood her because he had issues, too. Tamara had always figured that she and Jason would end up together when they had each chased everyone else in their lives away. They'd be old together. Tamara couldn't imagine her life without him. "His name is Jason," Tamara said. "I'm not over him yet. Every day, I hurt because of him. Every day, I long to tell him about my day and hear about his. I cannot imagine my life without him, and right now, I'm still refusing to let go. My heart won't let me." Her counselor nodded, as if she would be returning to that statement at some point, and said: "What happened with Jason three times that caused you to want to take your life." Tamara responded with, "The usual. He wanted to break off contact, i.e., rejection. Because he had a girlfriend, one or both of us would begin to feel bad because of that, so we would decide to just be friends. I never wanted to break it off completely. I always thought we really could just be friends. Jason didn't, so when he would stop communication, it was for weeks at a time. When communication was 'ended,' I always fell off the deep end. Jason never knew, either." "How could he not know?" the counselor said. "Did you not end up in the hospital?" Tamara said, "I didn't go to the hospital, and I never told him. I knew that if he knew, it would for sure be over. I told you I had gotten to where I was trying to make my death look accidental. I would always be drunk, too. So, it was easy to swallow the combination of pills I was taking. Because the girls were staying with my parents for most of last year due to my partying and depression, I was alone in my apartment. I would take my pills, fall asleep, and then be extremely angry when I woke up two or three days later because I was still here. By then, what was the point in going to the hospital?" "Your kidneys and liver?" the counselor said. "Well, apparently, I'm OK there, too," Tamara said. "Blood work is all good, isn't it?" Her counselor nodded. "Were you still working in the office administrative position during this time?" Tamara said, "Yes, that's how I afforded to live alone and not with my dad. These attempts, which caused me to miss work, plus the conniving wench at my work, are what eventually caused me to lose my job -- and that was the second-to-last time I tried to kill myself." The counselor said, "So, with Jason, it was feelings of rejection and not being good enough to be loved or wanted that prompted the overdoses." "Right," Tamara said. "Maybe the worst time was by the time Jason's girlfriend found out. She called me every name in the book. I was trying to say I was sorry. Everything I did to say I was sorry only dug a deeper hole for me and things got worse. I acted so crazy with Jason and with her. I was trying to let go. I was trying to be good, but she just kept telling me I was a 'whore.' I couldn't deal with that. So I acted crazier and crazier and did stupid things to them. "Truth is, I feel like a whore. I am one. I have slept around so much in an attempt to find someone to love me or to just get attention. When Jason was not having anything to do with me, I was all over the place. And deep inside, I've hated myself for what I've done. I hate it that I had sex with all those men. I had done pretty well about not doing that after my second daughter, Sheyenne, was born. I mean, second kid with an unknown father. Isn't that slutty enough? I was going to try to get myself together. For most of Sheyenne's 10 years, I've kept to myself with men. "Then Jason came along ... and Kristi, who parties ... and the door opened again. When his girlfriend -- who I hate with a passion, by the way -- came along and called me all those names, she brought out the shame in me that I haven't dealt with. She only called me what I have believed about myself. I hate her for that, and I hate her for being Jason's girlfriend. I also hate her personality. I may have done stupid things, but she seemed to take pleasure in hurting me, too. Oh, my gosh, I freakin' HATE her!" By then, Tamara was crying. It was the first time she had cried since she had gotten to treatment. Clearly, nerves had been touched. "I'm ready to go now. I don't want to talk about this anymore. THIS, this I can't get through. I can't undo my past. I will always be a whore. I will always want Jason in my life, and he's gone. I can't deal with that." Posted by Jami at 11:45 AM 1 comments Email ThisBlogThis!Share to TwitterShare to Facebook Links to this post Labels: depression, suicide, Tamara Friday, October 21, 2011 Eating Disorders Basics/Laura, part 6 “Recovery is like a big old house. The anorexic or bulimic is always going to live in that house … I prefer to think of it this way: She used to rule the house in a kind of tyranny. She was in charge of everything. Now, she still gets to live there, and she may still have some of those old fears and vulnerabilities, but she’s got only one room in the house and has to make way for more and more occupants as time passes.” – Sheila Reindl, “Sensing the Self” TREATMENT OF EATING DISORDERS It has been four weeks since we have discussed Laura or eating disorders. She has been fortunate to receive inpatient treatment for her anorexia, especially for the length of time she spent. For a variety of reasons, insurance companies do not typically cover the cost of treating eating disorders. According to the South Carolina Department of Mental Health, in the United States, treatment typically ranges from $500 per day to $2,000 per day. The average cost of a month of inpatient treatment is $30,000. It is estimated that individuals with eating disorders need anywhere from 3 to 6 months of inpatient care due to the complexity of the eating disorders and because of their chronic nature. The cost of outpatient care – typically seeing a counselor once a week in an office setting – can extend to $100,000 or more. Sadly, because of cost and other psychological factors, fewer than 50 percent of all people with eating disorders ever receive treatment. EATING DISORDERS DEFINED Eating disorders, which can be defined as a severe disturbance in eating behavior, coupled with extreme distress or concern about body weight or shape, are long-term, most often chronic, illnesses. It takes years of treatment before individuals recover from disordered eating behaviors, and even then, the potential to return to the thoughts and behaviors awaits the person who fought so hard to beat the illness. Anorexia Nervosa: a person (Laura) with anorexia has an intense fear of gaining weight and/or of being overweight. This person tends to starve herself, and she obsesses about food, her body, her weight, often how much she exercises, and keeps her body weight far below that which would be considered healthy for her age and height. People with anorexia do not see themselves as thin; they most often see themselves either as overweight or as having a normal weight. Bulimia Nervosa (Bulimia): a person with bulimia will eat large amounts of food in a short period of time (binge), and then compensate for that binge by getting rid of it (purge). Purging might be done by vomiting, taking laxatives, enemas or syrup of Ipecac (extremely dangerous). Another form of purging is excessive exercise. A person with bulimia feels out of control during the binge part of the cycle. When she is not bingeing and purging, she often eats very little or nothing at all. People with bulimia most often fall within a normal or even overweight weight range. However, like anorexics, bulimics feel intense fear of fat, desperately want to lose weight and are extremely critical of and unhappy with their bodies. Binge Eating Disorder (BED): BED is more newly recognized as an eating disorder and is fairly similar to bulimia. The main difference is that people with BED do not compensate for their binges by purging. PREVALENCE According to the latest census, there are approximately 309 million Americans. Of that number, an estimated 8 million Americans have an eating disorder (7 million women and 1 million men). That is roughly 2-3 percent of the population. Researchers and those who work with people with eating disorders believe this number to be underestimated because many people do not come forward and get help for the problem. Statistics also show that about three percent of all 13-18 year-olds have eating disorders; 1 in 200 women suffer from anorexia nervosa, and 2 to 3 in 100 women suffer from bulimia. An estimated 10 to 15 percent of all people with eating disorders are male. In addition, anorexia nervosa is considered the third most common chronic illness among adolescents. Other statistics show that 95 percent of people with eating disorders are between the ages of 12 and 25; 50 percent of girls between 11 and 13 see themselves as fat!, and 80 percent of 13-year-olds have attempted to lose weight! DANGERS Eating disorders are particularly troubling because they are considered chronic and because of the amount of damage that occurs to the body over the long period of time in which people actively suffer from the disorders. For example, complications of BED include depression and anxiety, Type 2 diabetes, high blood pressure and high cholesterol; gallbladder disease, heart disease, and certain types of cancer. Complications of anorexia include: malnutrition, fainting, poor memory, depression and anxiety, thin and brittle hair, low blood pressure, slow heart rate and even heart failure. Other complications include anemia, weak muscles and joints, fractures and osteoporosis, kidney stones and kidney failure, low potassium, magnesium and sodium, poor intestinal functioning, amenorrhea, dry skin, yellow skin, brittle nails, and a feeling of coldness at all times. Bulimia shares most of the same complications as anorexia, but also include swollen and sore cheeks (from vomiting), cavities, tooth enamel erosion, gum disease; sore, irritated and torn throat/esophagus, ruptured esophagus, muscle fatigue, stomach pain and ulcers, dry skin, and abrasions on the knuckles of the hands (from putting their fingers down their throat and being scraped by teeth). When one considers that many people suffer with these disorders and abusing their bodies for many years, it is easy to see how damage can occur. Longitudinal research is also beginning to show that even years after the behaviors have stopped, those who once engaged in disordered eating can have complications later. According to research, eating disorders have one of the highest mortality (death) rates of any mental illness; this is due to the damage on the body, as well as because of suicide associated with the illnesses. A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 to 10 percent of anorexics die within 10 years after first becoming anorexic; 18 to 20 percent of anorexics will be dead after 20 years, and only 30 to 40 percent ever fully recover. The mortality rate associated with anorexia is 12 times higher than the death rate of ALL causes of death for females 15 to 24 years old. And 20 percent of people suffering from anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems. Information regarding complications from the United States Department of Health and Human Services. In the next part, we will talk about what causes eating disorders. Laura’s story will be used as an important illustration. THURSDAY, OCTOBER 20, 2011 Tamara, part 4 By day 4 of Tamara’s stay in the treatment facility, she was feeling slightly better. She felt a little more hopeful about the possibility of getting better – although she knew she would be going back home to stay with her dad and stepmother until she could financially get on her feet. In the past, and because of the number of jobs Tamara had held down and then lost, the easiest job for her to find was as a server in a restaurant. Later, she usually found something that suited her interests better. The psychiatrist had changed Tamara’s medications on the first day. Tamara had known for a while her Prozac no longer was working. This wasn’t her first rodeo, and she knew what it felt like. She also had tried every antidepressant known to mankind, and nothing ever seemed to work for long. The best for her so far had been Prozac, so she always went back to it. Dr. M put Tamara on a combination of medications that he said are more recently known to help people who do not respond to basic selective serotonin reuptake inhibitors. He warned her, however, Tamara would have to stop drinking. He said the alcohol she was drinking was interfering with any medication’s ability to do its job properly. Tamara frowned at that. She wasn’t sure she was willing to do this. Dr. M also told Tamara that feeling any difference due to medications would take a few weeks. Tamara focused, instead, with her counselor and the people she was meeting, on her problems and fixing her depressed way of thinking. **** “Why do you want to keep focusing on the suicide attempts?” Tamara asked her counselor. “I’m embarrassed about it, and I think it’s time to move on.” The counselor responded. “I agree you need to move on, but you can’t move on until you’ve dealt with them in the first place. In addition, we still need to be aware of the pains that were so deep as to trigger the attempts. Remember, you’ve been depressed a long time, you’ve had seven attempts, but not all of your depressive episodes have ended with suicide attempts. Some things in your life have emotionally hit you harder than others.” The counselor continued: “We know your mother’s death and all the secrecy surrounding her illness and not being able to properly grieve was a big factor in the first one. We know in the most recent one, rejection of someone extremely important to you was another. Now, let’s see what else we can find out.” Tamara nodded a reluctant “OK.” “How many attempts have been in this past year?” the counselor asked. Tamara answered, “Five.” “What’s been going on this year, Tamara?” the counselor asked. Tamara said, “I don’t know. Things seemed to be going well. I had some friends. I had Kristi, the friend who dumped me recently. I had a good job as an office administrator. I had enrolled in school for my master’s degree –“ “Wait,” her counselor said. “You have your bachelor’s? You’ve managed to accomplish that in spite of your depression through the years? What is it in?” Tamara laughed, “Psychology, of course. But what can you do with a bachelor’s degree in psychology?” Her counselor laughed. “Still, though … you must have gone to college sometime shortly after your first suicide attempt and maintained yourself for awhile?” Tamara responded, “Yeah, it was strange. After the first suicide attempt, I went wild for a while and got pregnant with my first daughter. She straightened me up pretty quickly. As distant as I have been from my dad for all these years, he still has been good to me financially, and I think he cares but doesn’t know how to show it. And, he and my stepmom had recently gotten married, so they let me move in with them. They helped me raise Shay. “This helped me to get it together and go to school. I did keep it together long enough to get my degree at the university in our town. I had school to focus on, and I had a goal. I’ve always made good grades. I also had Shay to keep me busy and away from the party scene. It’s when school was over and I couldn’t find a job like I wanted, and I felt that letdown of having completed something with nothing to take its place … I couldn’t shake it. “I think I go through medications in a cyclical kind of way, too. I did so well on Prozac for a time, then when school was over, it seemed that quit working, too. I just sort of crashed.” The counselor said, “We’ll get back to this past year in a minute, but I want to note, and I want you to note, that you can accomplish and achieve things. You have proven that. You said yourself. You had a goal and a focus, and you found something you liked and were good at. It seems that you begin to have trouble when you lose focus and sort of start floating about.” Tamara agreed whole-heartedly. “OK, so back to this past year. I had enrolled in school for my master’s degree because I wanted to be a counselor – don’t laugh at me,” Tamara grinned. “Ironic, huh? And I was taking care of my kids on my own, being a ‘good’ mom. I thought, actually, I had a handle on my depression. I thought that I had learned to live with it, that it would just be a part of my life, and I would take medications the rest of my life. “I also knew that I would have to work on my crazy negative thinking and low self-esteem. I had gotten into counseling, and we had started working on some of my stuff because of the first suicide attempt of this year. That happened … that took me by surprise. “I was doing well in my job, and then this new person started. She was a Super B$tch know-it-all, and she pointed out things she thought I was doing wrong all the time. She even made up some mistakes I made, or if she made a mistake, she would place the blame on me. I tried working things out with her, but it wasn’t happening. She would have no part of me. “The straw was when my boss called me into his office to tell me about all the complaints they’d had about me and the mistakes I was making lately. He wouldn’t say who was complaining. He also said he was really disappointed in my behavior with this other employee, not trying hard enough with her, that she was new and I was supposed to be the leader. He sent me home for the day so I could think about how I would make things better. I was devastated. I didn’t think I had done anything wrong. I knew I had gotten catty with the girl sometimes, but overall, I was trying with her. I didn’t have any control over the scheming things she was doing, although I tried to explain it to him. He wouldn’t hear it. He said I was making up excuses, and I was wrong. “I remember feeling so trapped and helpless,” Tamara said. “And I felt angry that this girl was getting away with something so wrong. I was mad at my boss for not believing me, and I was mad at myself for not being able to control the situation. I just wanted to run.” Tamara’s counselor continued to listen. She seemed a little angered by the situation, too, as if she had just heard that someone had been physically beaten and no one stepped in to stop it. “I went home, alright,” Tamera said. “The girls were at school. I just grabbed whatever pills I could find, not thinking about anything except there was no way I could escape this situation, and I downed them all. “Whenever I realized what I’d done, I called Kristi to come get me and take me to the hospital. Reality hit me and I thought about my girls,” Tamara said. “That’s also the last time I ever called anyone for help. After that, all attempts were calculated to try to look accidental. I didn’t want my girls to think I would leave them like that.” The counselor looked at her. “Wow, Tamera, that was quite an ordeal. I can definitely relate to the feelings you had during all of that – except for blaming yourself for something you didn’t do; it’s the way you coped that was off. What do you think was the root pain … the deepest pain … you were feeling when confronted by your boss?” Tamara thought for a long time. “I don’t know. Maybe helplessness, like when I was living at home and had no control over my mom or what was happening. Feeling like everything was my fault when it really wasn’t. When I was sitting in my boss’ office, I felt like a complete failure and screw-up, like once again, I just wasn’t good enough. If I was good enough, he wouldn’t have believed that b$tch.” Tamara’s counselor nodded. “I think your assessment of your thoughts is point on, and we can work on the thoughts behind the feelings, because you see, the thoughts you’ve had in each of these situations have been lies you’ve believed about yourself, and you’ve reacted on those lies. Does that make sense?” Tamara only hoped her counselor was right. Ad she thought about the others at the treatment center who were in her group. Had they been believing lies about themselves, too? If so, what were they? Tamara wanted to find out. TUESDAY, OCTOBER 18, 2011 Tamara, part 3 Tamara looked around at the people in her therapy group. She wasn't at all sure she was going to like it. She didn't want to share her business with others. She wasn't sure she wanted to hear others' depressing stories, either, so she spent the first part of the group sizing the other members up. Tamara sat in a corner to herself and didn't speak unless spoken to. There were only four other people; it didn't take much time for Tamara to decide she wasn't going to like anyone. She just wasn't in the mood to have friends, acquaintances or support. She still just wanted out of this world. "Tamara," the counselor said, interrupting Tamara's thoughts. "Why don't you tell the group why you are here." Tamara rolled her eyes and said, "The same reason everyone else is here. I'm depressed. And I don't want to be here, and I don't want to talk. I look around, and I don't belong." One of the other group members, a petite, pretty, older woman with the most beautiful auburn hair Tamara had ever seen, nodded. "I know what you mean. Most of us feel that way when we first get here. It's OK to just listen until you're comfortable." She smiled understandingly at Tamara. The woman, whose name was Katherine, surprised Tamara. She hadn't expected anyone to tell her it was OK to be silent. She certainly hadn't expected a smile. She had really expected to be emotionally dog-piled by the other group members. Hmmm. Maybe this wouldn't be so bad, Tamara thought. So, Tamara just sat and listened. She learned Katherine, too, had attempted suicide. She had been impulsive about it and didn't understand why she had done it, except that too many overwhelming events just pushed her over the edge, she said. She said she now was dealing with the shame of having nearly killed herself -- she had been on a ventilator for two weeks -- and facing her grown children. Tamara discovered that Henry, a 20-something-year-old kid, came into treatment for playing Russian Roulette with a gun. Henry was drunk at the time and also had a problem with drugs. Henry didn't talk much. He smirked a lot, too. Sean was a 40-year-old successful businessman who decided he couldn't take the pressures of his job, his family and caring for his elderly parents anymore; as a result, he went off at work with a gun, threatening to kill everyone. His choice was prison or treatment for what Sean said had been a long history of depression that caused him to sometimes just shut down and do "out of character" things. Last in Tamara's group was Samantha. She had been there the longest. She had been raped while in the military, and Sam had had a breakdown as a result. The military was paying for her treatment, of course. The man who raped her had been court martial'd and faced prison time, and Sam was left to deal with the depression, shame, guilt and violation she felt from the attack. She said she had been ripped to pieces during the trial and later tried to kill herself by hanging. **** While Tamara at first thought she wouldn't like group therapy, she discovered she felt comforted to know others had felt similar feelings and done similar things. She wasn't sure, yet, that she could share her own story, but she did appreciate hearing the others'. SATURDAY, OCTOBER 15, 2011 Tamara, part 2 Tamara woke to the second day of her stay in the mental health hospital. She had been in a coma in the hospital because of the overdose; upon awakening and being cleared physically, she was moved in for treatment. It had been her father who sent her to a unit specifically for those dealing with depression. In their home town, there simply wasn't adequate mental help available. He knew, because he worked in one of the local hospitals and saw people needing help come and go nearly every day. Instead of long-term care, the patients were triaged and sent on their way. As much as Tamara's father felt he had failed as a father, he still loved his daughter. He wanted her to be better. He wanted her to live a better life than Tamara's mother had lived. **** In Tamara's second counseling session, the counselor asked, "Tamara, when were you first actually treated for depression? You must have known you needed help as you got older and got out on your own." Tamara responded, "After my first suicide attempt. I was 18. I tried to overdose. I was tired of the BS life of lies in my family. NO ONE would discuss my mother. I didn't know why she was so sick, and I didn't know what had caused her to finally kill herself. I mean, I knew something was terribly wrong for her to lie around all the time. There would be times I would go in her room to talk to her, and she was perfectly coherent. She would ask me about my day and tell me she loved me. Other days, she wouldn't respond at all. She just stared at the wall. And then there were times she would say crazy things and scream at me to get out because I was there to kill her. She scared the crap out of me." The counselor nodded. "As an adult, do you understand now what was wrong with your mother?" she asked. "I did my research," Tamara said. "Mom was clearly schizophrenic. There was no help for her. After I tried to kill myself, my dad talked to me a little about it. Everything made more sense, of course, but I was so angry because all these years, I believed it was MY fault, my brother's fault, and especially my dad's fault that Mom was like that. I thought we should be able to do or say the right things to make her snap out of her funk or her crazy talk. I couldn't figure out what I had done to make her think I wanted to kill her. "Now I know that if we'd just TALKED about it, I might have been better and not blamed myself. I could have understood a little. Maybe I wouldn't have blamed myself so much. I still blame my dad for not getting her help. I don't understand why she wasn't in a mental institution or something ... well, I do, sort of. Things were different then. She would have just been warehoused, I guess. "I remember feeling so helpless and hopeless about my mother. And embarrassed. I never had friends come over, of course." The counselor responded, "You are right that there wasn't good treatment for schizophrenics during that time. Maybe your dad did the best he could at the time. Is that possible? At the same time, I can imagine how you must have been horribly confused and afraid. It sounds as if everyone was stuck and left to fend for themselves and their own feelings. I'm sorry for you that you blamed yourself." Tamara nodded, "Yeah ... I know today, intellectually, it wasn't my fault, but I'm still carrying those original childhood feelings." The counselor said, "You know a lot, have much insight. You have had counseling?" "Yes, off and on through the years. I had to, you know. Every time I made a suicide attempt, I'd be stuck in the hospital for a while," Tamara said. "My dad even paid for outpatient counseling for me. I was the one who would go, start to feel better ... or worse ... and then quit. Dealing with all this BS is sometimes more than I can handle, you know?" The counselor nodded. "You've been through much trauma, but as we discussed yesterday, something must start being different, or one of these days, you just might surprise yourself and really die. I don't think you want that. I think you just want to be without the pain and feel some peace about your life and the things you've done that you believe are so horrible you can't live with them." Tamara said, "You are right and wrong. I want to live peacefully. I don't want to feel pain ... but that's impossible in this crazy world. And I have so much to fix that I don't think I can do it. So, no, I really do want to go on to a better world. I am tired of this one. This one dealt me a sh$%@y hand of cards." The counselor said, "That may be so, but here you are now. Safe from yourself and getting help, so that's where we'll start. Now ... in all, how many suicide attempts have you had?" "Seven," Tamara said. "All overdoses. Each time I try, they get more and more. If I keep at it, I will do it." "Statistically, that's true," the counselor said. "That's why I am anxious to show you that you CAN feel better and cope with life constructively and healthfully, rather than destructively. I've seen others do it, and you are a smart woman. I know you can be a success story, too. But you have to put yourself into it. "Tamara, tell me one reason you have for living." Tamara responded, "My kids ... but only if I can be a better mom." "You can," the counselor said. "Tell me another reason." Tamara thought quietly for a minute or two. "I want to win. I don't want to let all I've been through beat me." The counselor smiled. "You can do that, too. It will take time, and there will be ups and downs, but if you trust me just a little, you can make it. While you are here, you will interact with others who also have depression. Some have come quite far. Others are just getting started, like you. And one of my favorite parts of your treatment here is that you will get to meet many who have battled and won. Some of those people work here, and they can give you encouragement and hope." Tamara nodded, hesitantly. "It's time for a short break and then group therapy begins," the counselor said. "Are you ready?" Tamara, part 1 Note: "Tamara" is a composite of several people suffering with depression. "I try to kill myself because it seems the only way I will ever be able to escape ME and my craziness!" Tamara told her new counselor in the mental health hospital. She was being treated for major depressive disorder, recurrent, that had steadily grown worse during the past year -- to the point of having several suicide attempts. The counselor looked at Tamara and asked, "What's wrong with the person you are?" "I cannot do anything right. Ever. People reject me. I can't keep a job. People walk on me. Criticize my personality. And I make horrible decisions. In spite of my best intentions, I make bad decisions. "I want to be independent, yet I need someone like a nanny to hold my hand and help me make all my decisions for me so I won't do anything stupid." The counselor asked Tamara, "What decisions do you make that are bad?" "The question is what decisions haven't I made that are bad," Tamara said, disgusted with herself. "I'm 35 years old and have slept with half the State of Texas; I've been married and divorced twice, had two abortions, left my kids for long periods of time with my dad and stepmom while I would be irresponsible, and I cheated on the only man who ever really treated me right until he finally couldn't take it anymore, and he left me. "The sad thing is," Tamara continued, "I didn't used to be this way. I was once a good person, now that I look back. A kind and responsible person. I wouldn't say I've ever been happy, though. I remember being depressed as a kid. I would look around at others and compare myself to them, and I would always fail by comparison. Everyone was always prettier, more talented, smarter ... whatever. In my mind, I never measured up. "I made good grades, and I had friends," Tamara continued, "but I always felt as if I didn't fit in. I always felt like something was really, terribly wrong with me. I felt like a fake, like no one would like me at all if they knew who I really was." "Who were you?" the counselor asked. Tamara thought for a minute. "I ... I don't know. I was just this stupid, ugly little girl who managed somehow to fool others that she was good inside. I am not good. I don't know why I wasn't good then." Tamara laughed. "I certainly have made up for it now, though." The counselor said, "You said you don't remember ever being happy. When ... or were you ever ... treated for depression as a child?" Tamara laughed again. "No. My family was a little on the chaotic side. I think everyone was depressed or had something wrong with them, so no one noticed I was any different from anyone else. I mean, I was always able to function. Like I said before, I had friends, did well in school ... that sort of thing. It was just in my head that something was wrong with me. And I sure as heck wasn't going to talk about it with my mom or dad. My dad worked all the time and was distant from all of us. My brother was a wild child. My mom stayed in bed most of the time and slept or watched TV. I don't know why. She died when I was 17, so I never got the chance to know her or understand the family problems. Mom died because she shot herself and that was that. Dad wouldn't discuss it. My brother just got wilder. He's a raging alcoholic now." "Wow," the counselor said, "It sounds like you've been through much more than you give yourself compassion for or have even begun to deal with. Do you think that's true?" Tamara sat quietly for several minutes. "Maybe. I don't know. I don't even know if I'm willing to go there. All I know is, I don't want to be here, in this world. I'm angry that I have failed so many suicide attempts this year ... the last one, the one that got me here, should have succeeded. I had been researching and learning more and more about medications. The amount I took and in the combination I took should have worked. If it had, I wouldn't have to be thinking about these things. I wouldn't have to be this screwed up, wanna-be successful adult who can't do much right ... including kill herself." The counselor said, "Well, I am glad you are still with us, and I think we have much work to do that will help you get past wanting to die, including prescribing medications. Working through "your stuff" and your deep pain, and utilizing antidepressants as another tool to help will move you past this point in your life. Do you think you might want to give that a try?" Tamara said, "It sounds hard. I don't know." "Is what you are doing for yourself now working to help you feel better or worse?" the counselor asked. Tamara smirked, "Thanks for that, Dr. Phil. What I am doing only hurts me. Duh." "Then it looks like we have only one other option, and that's to do what helps," the counselor said. "Tamara, before we end for today, I want you to trace back to what set you off on this latest suicide attempt. We need to find some triggers to your excessive pain." Tamara sighed. "I lost my best friend. Kristi had been in my life a few years and seemed to really get me. We had great times and great talks. Then, she found another friend she was spending lots of time with .... I think I got dumped for another girl! All of a sudden, it seemed me and my problems got to be too much for Kristi to deal with, so she quit responding to my emails, calls, texts, etc. I finally got the message that once again, I had screwed up, and once again, someone important to me didn't want me in his or her life. So, I got drunk, put together my combination of pills, and when I woke up five days later, I was 300 miles from home, here ... in this place." SATURDAY, SEPTEMBER 10, 2011 Laura discovers changes she doesn't like Note: Laura is not just one person; she is a representative of many who have battled eating disorders in their lives, whether, anorexia nervosa, bulimia, or both. Laura was 14 when she realized her body was changing. She despised gym, when all the girls had to change clothes in front of one another. She knew that just as she was secretly checking out the other girls' bodies to see whether they had gained weight, or curves or become "fat," they were doing the same to her. Self-consciously, she dressed as inconspicuously as possible. She was envious of Vickie; all the girls were, actually. Vickie had the perfect body, and she flaunted it. Flat stomach, perfectly toned legs and butt, and the "right" sized breasts. The boys were noticing, too, because all of them wanted to be with her. Laura hated her body. All of a sudden, over the summer, she had gained ten pounds, and she saw herself as nothing but fat now, especially her butt. Once a fast sprinter, it seemed she couldn't make herself move any faster than her grandma could run. The only thing she sort of liked was now having boobs. She could leave the rest: Fat butt. Fat thighs. Laura and her friends spent a great deal of their time together, when they weren't playing sports, talking about boys, and criticizing their bodies. They read all the teen fashion magazines, and, of course, none of the girls felt they measured up. Laura talked some, but much of the time, she internalized what was being said by the others. She personalized that because she didn't look like Vickie or the girls in the magazines, there was something inherently wrong with her. No boy would ever want to date her, she thought. The truth was, however, Laura was a normal 14-year-old girl whose body was changing quickly and awkwardly. Laura just didn't understand, and she wasn't keeping up gracefully in her mind with all the changes. She simply saw "fat," when in reality, she still was thin and athletically built. While all of her friends were concerned with their weight and the way they looked, Laura seemed to take things harder than the others. The other girls might complain about weight, but they continued to eat "like pigs," as Laura liked to say. At lunch, Laura chose to eat a snicker doodle cookie for her meal. That was it, and that was the extent of her dieting for the next couple of years. SUNDAY, SEPTEMBER 11, 2011 Laura's family, part 2 Note: Laura is not just one person; she is a representative of many who have battled eating disorders in their lives, whether anorexia nervosa, bulimia, or both. Laura was a cute, petite, curly-haired brunette who grew up in a loving, perfect-on-the-outside home. She was the youngest of four kids, and by the time she came along, her parents had relaxed in their parenting expectations --- a little. All the kids were expected to make good grades in school. A's, in fact, and if a B came along, the question from her parents was always, "Why didn't you make an A?" Still, Laura managed to make mostly A's and weather the occasional B's. The one time she made a C in geometry, she got grounded for a month. Laura's mother chose to be a homemaker, until Laura went to kindergarten. At that point, she went back to school to pursue a career as a psychologist. Her father was an anesthesiologist and self-described work-a-holic. He headed a group of physicians in the Central Texas area, which kept him busy and out of the house. Occasionally, he was able to make it to Laura's athletic events, or her other siblings' activities. Laura learned to not let her father's absence bother her. Her mother usually attended all events. Laura's sister, four years her senior, was an accomplished pianist. She followed in her mother's musical footsteps, who played first violin in the city's symphony. Laura had two older brothers, one of which already was out of the house and married with a family of his own. He had become an attorney, but only after a long and rebellious high school career of drugs, girls and parties. Laura's mother always said she thought that boy would be the death of her. Laura's other brother, Ryan, was two years older than she; he did his own thing most of the time. Like everyone else in her family, it seemed, he could do just about anything well. He normally made good grades, but just to piss off their parents, he sometimes messed around and made B's and C's. He was the family's funny man and charming, so it was often hard for his parents to stay angry with him when he messed up. The girls chased him, and he ignored them, unless he wanted something from one of them. Laura and Ryan sometimes felt close to each other, but at other times, they were World War enemies. Then Ryan became vicious with words; he called her fat, ugly, stupid, the family's black sheep ... anything he knew would make Laura cry. Laura learned to believe her brother's words, even though she had athletic talent and often stood out on her own. Laura seemed to be a child who lacked for nothing, and materially, she didn't. Anything she asked for, she got. She had all the right things, clothes and even the physical attractiveness to give her what she needed to be popular at school, even though she often felt like a loner on the inside, shy, untalented and lonely. Laura's hypersensitivity to the feelings of others and her uncanny ability to perceive things going on around her often made her the "go-to" girl with everyone else's problems. She didn't mind that so much. She enjoyed helping others, and it made her feel, at least for a little while, worth something important. However, that sensitivity often was the cause of great distress for her, as well. She frequently got made fun of by others for crying over sappy commercials or at movies. She got to where she chose not to go to movies because she knew she would cry, and that embarrassed her. What Laura wanted most was just to feel normal, whatever that was. She rarely understood or knew what she was feeling; she could easily pick those things out in others, but her ... she didn't have that ability. And that inability made it all the more difficult for Laura to handle the problem no one in her family talked about: Her mother's drinking problem. TUESDAY, SEPTEMBER 13, 2011 Laura's life takes a negative turn, part 3 Note: Laura is not just one person; she is a representative of many who have battled eating disorders in their lives, whether anorexia nervosa, bulimia, or both. Laura considered her first of year of high school somewhat fun --- or the first semester, anyway. Even though she was in a bigger school mixed with kids who had come from other middle schools (which intimidated her), she enjoyed having her brother Ryan at school with her. It seemed she was "safe" from some of the craziness that occurred, and Ryan, in his own right, was popular ... popular with girls and popular because of his talent in baseball. Being Ryan's little sister got her noticed by boys she thought would never glance at her. She enjoyed the attention, although she couldn't see why they cared. Even though Laura's shyness prevented her from meeting as many new people from the middle schools as she could have, she naturally picked up a few new friends (or associates because Laura didn't really make friends). Laura still had difficulty sharing much about herself, and friendships are a two-way street. As the go-to girl for others' problems, she easily avoided her own issues. Laura spent the first semester of her freshman year studying hard, which her friends did NOT understand. Laura just couldn't bear making a B in anything. In the past, if she did, she verbally beat herself up mercilessly for being so stupid or for not trying hard enough. She also dedicated herself to basketball; whereas she had played all sports before, basketball was her love. Her goal was to make varsity as a freshman. She had heard from the coaches her chances were good. Laura became stronger in her athleticism, and she filled out in muscle. She didn't mind, but she still hated her "fat butt and her fat thighs." No one could convince Laura she was not fat in those areas. She simply honed in on them and looked nowhere else. Those were her flaws. To her amazement, Laura began dating a guy named Lance right around homecoming. He had been a friend of her brother's ... sort of a friend of his. They played baseball together. Ryan told Laura the guy was a jerk, but Laura saw otherwise; she was pretty crazy about him. Laura and Lance got tight quickly. Every weekend they went out; they went out with groups of other kids, and they went out together to see movies and to make out where all the kids went on the weekends. Lance drank; Laura didn't. The smell of alcohol was familiar to her, but she never said in anything, and it never stopped her from getting in the car with him. She just wanted to make sure she didn't make him mad; she wanted to keep him. Laura wasn't completely comfortable with the making out part, either. She really cared for Lance, but like most guys it seemed, he was trying to move too fast. Laura wasn't sure how to say no, except to keep pushing him away, hoping he would get the message that she wasn't ready for all of his advances. As for basketball, Laura did make the varsity, but her stay there didn't last long. She couldn't cut it; she made mistakes she never made before. It's like she was choking, right there for all to see, and her coach embarrassed her in front of everyone, yelling at her that she couldn't play because she couldn't even catch the ball. It wasn't long before she moved down to junior varsity. From then on, Laura felt humiliated and viewed herself as a failure. It didn't matter that she excelled and was the "star" on JV and surely would have a spot on varsity the next year if she continued to improve. Laura didn't see anything but failure because she didn't reach her goal THIS season. Not long after basketball season ended in February, Lance broke up with Laura. Well, he didn't actually break up with her. He just treated her horribly until she broke up with him. He stopped calling or texting. He stopped talking to her at school. He walked away from her, and he flirted with other girls right in front of her face. Laura tried her best to win Lance back, but it seemed Lance was clearly done. Other boys asked Laura out, but she wasn't over Lance, so she always said no. Laura felt just as devastated about losing this first boyfriend as she had about basketball. And Ryan was no help. Well, Ryan had been helpful in the basketball ordeal. In spite of occasional meanness, he knew not to cross that line, and he encouraged her. But with Lance, all he could say was, "Hey, I heard you didn't put out." And Laura's mom? She wasn't there to notice. She was studying, going to school and drinking. A couple of times, she even showed up to Laura's games drunk. Laura pretended not to know and wouldn't speak to her mother at those times. Her dad simply didn't have the time and didn't have a clue what was going on in his kids' lives. Laura just felt alone. Her heart hurt. She realized Lance never cared for her. All he wanted was what she would give him physically. If he had truly cared about her, about who she was as a person, this would never have happened, she thought. She wondered why she wasn't good enough that Lance could wait. Laura felt like a failure, fat and ugly. To cope, she buried herself further in her studies. She went out with the girls some, but it hurt her too much to see Lance out, too. Laura became even more preoccupied with her appearance. She just had to get rid of those fat thighs and her fat rear-end. She decided the answer to her problems was to lose some weight. Just five pounds, she thought. That's all I need to lose, and I'll feel better about myself. SATURDAY, SEPTEMBER 17, 2011 Laura changes her life, part 4 Note: Laura is not one person. She represents many people with eating disorders. The decision to diet changed everything for Laura but not the way she expected. In her mind, five pounds would make all the difference. She thought she would get Lance back and that she would be better at basketball. She knew she would feel better about herself. So she went on a simple diet of cutting out the basic things the way most people do when they diet ... "junk" food, sweet sodas, high fat foods, etc. She easily reached that five-pound loss within two weeks. Funny thing, though. It wasn't enough for the perfectionist in her. The success of losing five pounds quickly propelled her into losing more. In her mind, "Five is good; ten is better." By the time she had lost ten pounds, a few friends had noticed, even her brother. Some expressed concern that it was time to stop losing weight. Laura simply told them she wasn't trying to lose weight; she was just stressed out. Because of peoples' comments, especially at lunch, Laura stopped going to lunch with her friends. She didn't want to hear what they had to say. It was her body, not theirs. Laura also started running. She wanted to be in the best shape possible, and she wanted to burn more calories. Two miles a day turned into five, which later turned into ten. Because of her strenuous exercise schedule, Laura no longer had a social life. To miss a workout caused Laura extreme feelings of guilt. She could imagine the pounds globbing onto her butt and thighs if she missed a run. By this point, Laura was looking "scary skinny." She was proud of her accomplishment and irritated with anyone who said anything to her about her weight loss. The further into her diet she went, which now consisted of one orange a day plus a diet Coke ... and however much black coffee, tea and water she wanted ... the less she cared about having friends, much less Lance. She concentrated on her diet, exercise, and making straight A's. That was her life now. Laura continued to lose weight. Her mind had now adopted the motto of, "Let me see how low I can go." She was fascinated by the changes in her body ... seeing her hip bones and ribs. She liked seeing her collar bone the best. She no longer thought she was fat; she saw a thin girl, unlike some people with eating disorders who would still see fat. However, Laura did become terrified of regaining weight. To gain any weight lost meant in her mind that she had lost the game. Any weight gained would automatically equal fat pounds. She simply wouldn't stand for that. By the time Laura's mother noticed the drastic change in her appearance, she had dropped 30 pounds. At 5'7" tall, Laura had dropped from 125 pounds to 95. SUNDAY, SEPTEMBER 18, 2011 Laura reluctantly begins the journey towards help, part 5 It was clear to everyone by the time Laura reached 95 pounds that she had gone too far. Her usually self-absorbed mother was beside herself with fear and worry about what to do. Even Laura's father got involved. After all, being in the medical community helped him find contacts more quickly than he might otherwise find. Laura, however, continued to insist nothing was wrong with her, even though she no longer had the upper body strength to shoot baskets from the three-point range. She could no longer lift the same amount of weights she was lifting in preseason basketball. Laura could barely carry herself up the stairs at school or at home, and a few times, she fainted. Proof to Laura that she was still fine was that she could run 10 miles a day. This is actually not an unusual phenomenon among restricting anorexics, who, in spite of extremely low caloric intake, are able to function on adrenaline and sheer will power. Luckily for Laura, she had completed her freshman year of high school -- with straight A's -- and she would be able to more easily get into treatment without disruption. In many cases with eating disorders, patients can see someone on an outpatient basis because they don't carry it as far as Laura had before someone catches on and gets them help ... or they get themselves help. People with bulimia are far more likely to get help than those with anorexia. Anorexics tend to feel in control, as Laura did; bulimics, because of the bingeing and purging, feel out of control and generally want help. Laura's parents sought help at a well-known treatment center in Buffalo Gap, Texas, near Abilene. Laura felt furious about having to go. She was certain treatment would make her fat and she would lose all control of her life ... she would lose control of her body, her diet and her exercise program. In some ways, she was correct, but it wouldn't happen the way she thought it would. Laura's parents were distraught and blamed themselves. Thoughts such as, "If I'd only been there more," and "If I hadn't put so much pressure on her," and "Where did I go wrong" plagued them. Even Ryan blamed himself for all the times he was mean to her and called her fat and stupid. He also blamed himself for not being more encouraging when she and Lance had broken up. He wishes he had beat the crap out of Lance, rather than make fun of Laura. In fact, maybe Ryan would go after Lance, just to prove a point. The older two siblings, being out of the house, were concerned, but they faced less self-blame and frantic feelings. They had not seen Laura at her skeletal 95 pounds. They did not see her once thick, curly hair become thin and brittle. Nor did they see the hollow, dead look in her eyes. And by the end of the school year, Laura had so alienated herself from her peers that, in reality, she felt more like a freak show than a real person. People stared and whispered, but those who had once tried to help by encouraging her to get help had moved on. As Laura explained it, "Who wants to hang out with someone who isn't mentally present and feels depressed?" Still, Laura couldn't deny the sting that she'd been abandoned by those who once supposedly cared about her. She felt glad school was out, because then she wouldn't have to face them every day. She just didn't want to go to treatment ... but her parents were giving her no choice.

Jami Wilmarth, M.A., LPC

Helping you live life to the fullest

LICENSED PROFESSIONAL COUNSELOR