NEDA Week 2018 – Treatment myths and truths + an overview of options

Fortunately, there are a variety of resources out there for eating disorders treatment. Unfortunately, there are many stereotypes, worries, and false speculations about what treatment actually involves. I think it’s so important that what really happens with treatment is put out there. I want to encourage others to seek help by showing that it isn’t quite as scary as you may believe. This will be two-fold: dismissing the myths and talking about what types of treatment are available. A note: most of the myths will pertain to groups, IOP, PHP, inpatient, and residential, considering many fears come from being around others with EDs.

Everyone will be underweight. I felt this way, too. The media perpetuates this by showing emaciated suffers and focusing on weight loss. The truth is that most eating disorders don’t need a weight diagnostic. Even those who struggle with anorexia, like myself, aren’t always underweight. I have met a huge variety of shapes and sizes in my treatment experience. The ED may tell you this is a lie, but I can pretty much promise it won’t be the case. Even if that were true, especially with inpatient, it doesn’t make your struggle any less. People have been nonjudgmental of weight in my experiences, too. Also, body type does NOT determine sickness at all.

I’m not sick enough. Whether this applies to residential, outpatient therapy, or even seeking help in general, it isn’t true. If you believe in any capacity that you may need help but simultaneously “don’t need it” given your perceived lack of severity, please still reach out. These are signs that point towards that. Your struggle is enough, period. You deserve help, period.

Going means I’m weak. Making the choice to get better is the absolute strongest thing you can do. Recovery is hard, there’s no sugar-coating it. Take that glimmer of hope and longing for things to be better. It’s worth it. You don’t need to continue living this way for 6 months, a year, or 20 years.

I’ll be the oldest, only guy, “least sick,” largest, etc. Eating disorders are very diverse. They affect all races, genders, socioeconomic statuses, ages, etc. Even  if you happen to be the only one in your specific group, you aren’t alone. There are millions just like you, and that can be comforting.

If I’m not in residential or inpatient that means I’m not really sick. Residential and inpatient are not some badge of honor that proves you’ve become bad enough to have an eating disorder. Most people never end up there and that has not a lot to do with their amount of struggling. The important thing is getting the level of care you need and receiving help ASAP, even if you “just” need outpatient.

I will just be constantly eating. It absolutely will feel like this sometimes, especially when in IP or residential at first. What you’ll soon realize, though, is that you have so much more than meals and snacks. You’re kept busy with groups and all of the activities that are going to help you grow in recovery. Eating is a necessary part of treatment but the other work you’ll do is just as important.

All we’ll talk about is eating. Holy hell thank God this isn’t true. Behaviors are surface level. There It’s like an iceberg. You see these awful things on the outside, when what’s causing all of it really needs exploration. I’ve never spent that much time focusing on the food, minus nutrition groups really. It’s just not the main focus, even though it is ultimately an outcome we’re working towards.

No one will believe I’m sick. The thing about treatment is that no professional would ever recommend it for someone they don’t believe is struggling enough to need it. You don’t go through assessments for no good reason. The fact that you go into treatment means that you need the help and that you are sick enough.

No one will ever understand. I was convinced of this when I was first sick. I never thought I would find people who truly got it. That immediately changed my first day of PHP. Suddenly I had 5+ other people who could relate to me so well. I think it’s one of the most beautiful things about treatment.

There will only be anorexics and maybe bulimics. I haven’t been in any treatment setting for very long before I met people who didn’t struggle with anorexia or bulimia. Many have EDNOS (now OSFED) or BED as well. Another thing I’ve learned is that I can connect with any of the diagnoses. It doesn’t matter what the official label you carry is or what your behaviors are. The underlying problems are very similar.

It will be too hard. This will stretch you big time. There will be tears, maybe lots of them. You’ll want to quit, sometimes every day for weeks. You’re not going to like it and will sometimes hate treatment. Regardless, you have the power to press on and keep fighting for yourself. If it were easy that wouldn’t bring change. Trust me, you CAN do this.


Now I want to give just a quick overview of treatment types, mostly based off of my own time there.

Outpatient therapy and dietitian. This is exactly what the name implies: seeing a therapist or dietitian in the office on a regular basis.

Outpatient groups. These groups are made up of many people with eating disorders and may be a therapy style, experiential, art, or other type of focus. I would say that support groups fall under here, too, although those are typically free of charge. These are both a good stepping stone for someone who has never been in a setting with others before. I think the connection and similarities you can find are very helpful.

Intensive outpatient – IOP. Typically IOP will be for around 5 hours a day, covering one meal and one snack. This varies by facility, of course. My center goes 11-4 three days a week. Besides meals and snacks, there are a few groups a day. Some offerings include group therapy, nutrition, experiential/outings, art, and yoga.

Partial hospitalization – PHP. This is similar to IOP but is more intensive. It usually runs for 2 meals and 1-2 snacks. I’ve been to one that was M-F 8:30-3:30 and another that ran every day 10:30-5:30. The setting can be a psych hospital, residential, or just an outpatient center. It allows for the most structure and support that doesn’t involve staying somewhere.

Inpatient – IP. Inpatient, like it sounds, involves being hospitalized, usually in a psychiatric unit or hospital. This is typically shorter term and mainly for stabilization. It’s required if there are any medical problems that would be difficult to manage in another setting. There is a full-time medical staff with 24/7 support as needed. People with other diagnoses are on the units as well. You attend ED groups and support groups part of the day and then general groups as well. Where I was, the average stay is 1-2 weeks and then step down to another level of care like PHP, or even going to residential.

Residential. This is the longest-term and most intensive treatment. Program size varies, but it involves living in a home-like setting for around 30 days minimum. You are completely removed from the environment that allowed you to grow sick. It’s a huge adjustment but also is very effective because of the radical change. Like IP, there is also 24/7 support, but not the same level of medical care. You have to be medically stable in order to be admitted. Sometimes they may bump someone to IP if they need it. Residential tends to be much less restrictive than inpatient. You are able to go outside, do outings, start back with some exercise, and even get solo passes.

Transitional living. For those who live far away and are unable to travel back and forth to treatment, some enters offer transitional housing. In my case, we lived in apartments not far from programming. It offered a supportive environment while still allowing autonomy. I did this after residential, which was a great way to slowly transition back to real life. Some places only do this for PHP, but others allow IOP patients to stay as well.

I hope that this information has been helpful. Feel free to contact me if you would like to know more about my experience or have any questions regarding treatment. I will try to help in any way that I can. 

 

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