It’s hard to identify a single “most helpful thing” because it was truly the treatment as a whole and how all of those components worked together. I haven’t seen a therapist since 2017 and I think the reason I’ve been able to stabilize so well without it is because I was in it for so long! Between going to treatment 2X and regularly seeing a therapist and dietitian for years, I had a ton of ongoing support. I have posted a bit about this in the past, but I ultimately only engaged in treatment for as long as I did because the relationships were a motivating factor for me, but I of course couldn’t hinge my entire recovery on those relationships either, so navigating that balance was really important work for me.

For me personally, I think building the relationships with my providers was most helpful...like using my therapeutic relationships as “models” for real-life relationships...mostly repairing what my parents taught me (or did not teach me) about love, connection, conflict, boundaries, etc.

To not put a timeline on your recovery. And by that I mean to trust your team and let them guide your treatment.

The people that cycle in and out of treatment for years are the ones that decide they can only be in residential for 2 months during the summer until they have to go back to school (this was me the first time I went....and yep, you guessed it, I had to go back a second time). They are the ones that don’t make time for therapy, nutritional appts, and self-care. They are the ones that have every excuse in the book because they believe that they’re “not that bad” and “don’t need that much” and “just need a boost”...as well all know, they’re the ones that never quite seem to get better.

And yep, not everyone has the privilege to put their life on hold to focus on treatment. That is unfortunately a harsh reality. But if we are speaking in terms of eating disorder recovery success, the people that put in the time and put their schooling, employment, relationships, goals, etc. on hold are the ones that end up successful. Is it that black and white? No. Is this a notable observation I’ve had over the years? Yep.

I could not sleep while in the hospital because the alarms on my machines kept going off (my heart rate was dipping into the 20s and they went berserk every single time). I cried at every single meal, I did sit-ups in bed when nurses were not looking, and I hid food inside pillow cases and every crevice of the hospital bed I could. Then they found out about my sneaky behaviors and I had to have a sit-in CNA watching me 24/7, which made me especially anxious and unable to sleep. I had to get poked every 2hrs for lab work, I was not allowed to shower, and I had to be pushed in a wheelchair to use the restroom a few feet away. I was in the hospital for a month before I was stable enough to go to residential treatment. 

I knew that I was dying, I felt it, I had accepted it. I was not quite suicidal, yet I had accepted my eating disorder as my reality. I did not necessarily want to die, but I knew that I was never going to get better and I knew my body could not take much more. I did not see recovery as a possibility, and I stopped feeling sad about it. I simply did not care anymore. 

June 2020: 

I do not have an eating disorder anymore and I probably think about my diet/weight/body less than the vast majority of people. I graduated from the University of Oregon in 2016, I worked as a case manager for homeless individuals for nearly 4yrs, and now I have my dream job (career!) as a Child Protective Services Caseworker. I have friends whom light up my world and I have better relationships with each of my family members than I ever have before (they are not perfect, but they are healing). I no longer receive any form of mental health treatment because I have not needed it. 

Oh yeah, definitely...especially at the phase when I was eating *fairly* regularly but it was mostly mechanical. I think I had this mentality of “well, fine, I’ll eat what I have to but the food needs to be WORTH it” as in, not “wasting” calories on food that isn’t perfect. For me, that had to do a lot with safe foods and what I deemed to be the “right” food for the “right” time of day under the “right” circumstances. 

This will fade over time if you want it to. That will mean forcing yourself to have meals that are not “perfect” by whatever standards you use to define that and sitting with the discomfort. 

I would also challenge you to think about your perceptions of “good enough” and what makes certain foods fall into that category for you. Are these foods that simply taste the best? Or are these foods more “filling” because you fear the feeling of hunger (which you fear because you don’t want to give in to eating and thus gain more weight)? Are these foods filling something emotional for you? 

Thank you so so much! I really appreciate this ❤️

So the body image piece...you are not going to love this answer but based on my experience, these are the keys: 

1. First and foremost, you need to be at a healthy weight for your body. Not the BMI scale, not your “pre-ED” weight, not 10lbs above your lowest weight, not the weight you deem “minimally acceptable,” but a healthy weight for your body.   You should be seeing a specialized dietitian to help you determine what this is, but the short answer is that you should be able to eat regularly, not count calories, not diet, not binge, not purge, and not over-exercise and still maintain your weight. If your ED resulted in negative physical side effects, those should be absent (i.e. your hair should be growing back, you should lose the lanugo, your labs should come back normally with no nutritional deficiencies, your menstrual period should return, etc.). Why is this crucial? Because you WILL struggle with more disordered thoughts if you are not at a healthy weight for your body. I never believed it when professionals told me this but they were absolutely correct. It was amazing....it was almost as if the more weight I gained, the less anxious I was about losing it.  2. Sit through it. Cry, scream, swear on your life that you are done trying and losing weight again as of tomorrow. And then wake up and continue eating/exercising normally anyway. So much of enduring major body anxiety is simply getting used to your body. It feels WEIRD (well, that is a gentle way of putting it...it feels fucking MISERABLE) to exist in a body that simply doesn’t feel  right. This is going to be even more significant for you if you have been underweight for many years, or if you had to gain a large amount of weight in a short period of time.  3. Figure out what works for you. Test it out and be honest with yourself. For example, if the scale is a huge trigger for you, get rid of it. Or, if you want to take the route of simply getting comfortable with the number so that you are not triggered at the doctor’s office when they accidentally say it out loud, weigh yourself every once in a while. Maybe it makes you feel worse to wear fitted clothing, so wear comfortable loose-fitting clothing for a while. Maybe you spend too much time in front of the mirror body-checking, so you decide to get your outfit for the day ready the night before. The list goes on. It is all about trial and error. Recovery is not a black and white process, nor is the same for each person. The key is to be honest with yourself about what will support your true self and what will support your eating disorder

Calories...to be honest, this one was purely time. It took a long time for the calculator to subtly fade from my brain. I think the first key is to not fight the thoughts, but to fight the actions. So yeah, you might add up that those 12 crackers have 150 calories, but what are you going to do with that information? Your job is to have as many crackers as you want (or that you are “supposed” to if you are on a meal plan). Actively fighting against the information with actions that remove the significance of the numbers will, as you can expect, help the numbers go away. So fine, make a sandwich for lunch and add it all up. Whatever, no big deal, don’t fight it. Just don’t change your dinner because of the sandwich. The calorie counter in your head will go away naturally one you realize it doesn’t matter. If you are using the counter in your head to determine what you eat/how much you exercise, then you are still controlling your weight. If you are still controlling your weight, you are absolutely going to count calories. So start by not controlling your weight and getting to a healthy weight for your body (see above lol). The calorie counter in your head will follow suit. 

I feel qualified because I met the job requirements upon application and they made the decision to hire me for one available position out of a large pool of applicants (they told me over 200!) The interview process was extensive and contained multiple components, and it took over five months from time of application to hire date. That in itself makes me qualified lol.

People in CPS come from a diverse range of backgrounds, which is invaluable because each case is multifaceted and requires unique skill sets. If you have a team of CPS workers consisting entirely of recent MSW grads, your staff’s scope of experience and skills will be limited, which will inevitably limit the nature and quality of services that can be delivered. We have hospital cases, and our people whom worked in the medical field do a fantastic job with them. We have high profile legal cases, and our people with experience in law are top notch fits. We have cases with parents whom have substance use disorders that affect their ability to parent, and our people with lived experience know how to connect with the parents better than anyone. We have cases with teens whom are being sex trafficked, and our people with experience in social services programs for teens nail it. I have colleagues that used to be police officers, teachers, case managers, nurses, legal assistants, and more. All of them either have a qualifying degree, relevant experience, or a combination of the two. A CPS worker does not need a specific degree to be absolutely spectacular at their job. In fact, one of the best CPS caseworkers I have met has a degree in Marketing/Merchandising. 

So the specifics as to why I am qualified beyond clearly being identified as qualified by experienced workers in the field? 1. I have four years of experience working as a case manager with some of the most vulnerable individuals in the state. I served as one of two case managers on a pilot program called FUSE that has since secured ongoing funding for years to come, and the FUSE program itself has grown tremendously (both staff and service-capacity wise) over the last four years. I participated in budget planning, program development, new employee hiring processes, and I singlehandedly staffed client cases at large case coordination meetings with community partners. I was the coordinated entry lead for my entire agency and I served on the Human Resources committee. 2. I have a bachelors degree in English, and CPS workers must have strong professional writing skills. Nearly half of my job is preparing documents for court, and the writing load is very heavy. Just one assessment can be 20+ pages long and they need to be professional, objective/factual, comprehensive, and grammatically sound. This is something I am naturally very good at. 

Well, I certainly do not need to anymore, as my salary is comparable to what I would earn with a masters (plus excellent opportunities for advancement, guaranteed step pay raises each year, job security, union representation, unparalleled benefits that I pay a total of $15/mo for, generous PTO, and endless opportunities for OT pay....one of my colleagues makes almost the equivalent of her salary each year in OT 😱). 

It was a very, very difficult decision to make. I loved my job as a case manager and that role will always hold a special place in my heart. I never pictured myself working with the homeless population but it ended up being an invaluable experience. 

I ultimately left for a few reasons:  1. Nonprofits are absolutely wonderful to work for, but the pay is often low and the benefits are often subpar. I knew when I got hired a few years ago that I would not be able to stay in it long term just due to the wages. I was struggling to get by each month (rent in Eugene is inordinately and disproportionately high compared to the rest of the country and state) and I was relying on my credit card much of the time. I was covered through my mother’s insurance throughout the duration of my employment, but I turn 26 this August and that would be my cut off. I was very anxious about that because the employee contribution was high and I was already struggling financially.  2. Doing direct service work is draining. Doing direct service work with the homeless population is even more draining. Doing direct service work with the top 100 frequent utilizers (most arrests, most E.R. admits, etc) within the homeless population is unparalleled. It was not uncommon for me to spend my days de-escalating crisis after crisis and quite literally running around site juggling 10 different things at once. I completed comprehensive intakes with men with severe untreated schizophrenia and co-morbid meth and heroin addictions. I called the ambulance so often that I knew every EMT in the area on a first name basis. I put out literal fires that my clients set. I advocated for my clients in court as they screamed at the judge until getting us both kicked out of the court room. I visited them in jails, in swamps (yes), and just about every crevice of every hospital in town. I walked into their apartments to discover feces/urine everywhere and over 200 empty alcohol bottles. These are, in theory, the most difficult people in our society to work with. Many of them used to be in the state hospital and many of them had been to prison. A few had killed people and even more were sex offenders. Many were dying. I watched at least a dozen or more of my clients pass away due to drinking themselves to death, overdosing, and suicide. Most of them had been homeless the majority of their lives and did not know anything different. And the bottom line? My job was to get these people into apartments in the community and help them stabilize, which is often a very unrealistic goal when you throw on government regulations and funding-related timelines. I highlighted all of the “challenges” in this bullet point but there were plenty of incredible, beautiful, heart melting moments to balance it out. Tbh, I wasn’t burned out. I could have kept doing it and I could have been one of those people doing it for 20yrs. It was more a question of whether I really wanted to be in that specific capacity for long. I knew that I wanted to continue working with vulnerable populations and with some of the most intense of the intense, but I also knew that I wanted more of a balance with higher order tasks. It was time for me to get to start using my brain again and to really maximize my skillset.  3. The overall culture of both the agency and my office changed dramatically over the time I was there. Turnover at nonprofits is very high and when I started, I was in an office of experienced, older workers. The agency shifted to hiring people right out of college (which is what they did for me, so I know this is hypocritical to say lmao) and it just really makes a difference when you have an experienced staff versus a new staff. There was also a ton of petty drama happening in my office and even though I fortunately stayed out of it and was never the target or participant, it was still really disappointing to see. People were gossiping about one another, criticizing each other, correcting each other, etc. and it was just starting to feel like a toxic environment. I was out with clients all the time so I did not have to deal with it that much but when I did, it was an isolating experience (if you engage in drama, you won’t be lonely but you might get stabbed, and if you don’t engage in drama you will be lonely but less likely to get stabbed...I chose the latter lol). It really wasn’t that big of a deal, but it was just a change and I missed the close-knit nature of our office before turnover started happening.  4. I have wanted to work with children/families for as long as I can remember and I have had my eye on a position with the Department of Human Services for a couple years now. 

I am so glad that it gives you hope because you SHOULD have hope. People really can recover and have a life beyond it. I wholeheartedly believe that.

So I struggle to place official dates on any of it because the development of my ED and the gradual progression to recovery by going to treatment and then going back to treatment and then receiving treatment/support on an outpatient level all kind of blurs together. There was no definitive beginning or end.

Given that^, I would say that my eating disorder began during my senior year of high school in 2011ish. I went off to university in 2012 and my first year was the “worst” or what some may consider the peak of my ED. Went into the hospital in spring of 2013 and residential treatment directly after that. Returned to school in the fall, was still very much entrenched in ED but was seeing a therapist/dietitian and was “contemplating” recovery. Then I decided to spontaneously run away to London to study abroad lol. I got even more sick over there and slipped fast so I re-entered treatment in summer of 2014. Six months later I “graduated” from treatment. Was def in recovery mindset by that point but still receiving outpatient treatment (weekly therapist/dietitian + alumni groups at treatment center). Gradually decreased number of sessions over time. I’d say that by the time I graduated from university in June 2016, I was doing pretty well. Since then, thoughts have just gradually decreased and food/exercise has gradually become less important.

Sure thing! To be honest, I forget that I even used to have an eating disorder. I KNOW, like how is that possible?! I sometimes wonder that too! 

I often go days without even remotely thinking about it...and when I do, it is usually because I see a social media post from someone I was in treatment with, I overhear something in public about dieting/eating disorders, or I come across an article or something like that. Usually my thoughts are along the lines of: “oh yeah, that used to be a thing for me, and I am fucking glad that it’s NOT anymore” or “oh yeah, I remember what that was like. I totally get what she is going through” etc. 

So with that, I really don’t put much thought into my food. Most nights I am just getting home late and want to make something that requires minimal effort. I do not think about calories at all really. I am not sure how out of the scope of “normal” this is but I notice that I am always very aware of largely displayed calorie counts on restaurant menus and the like, but it’s not because I am looking for them, because I care about them, or because I would make any food decision off of them. Wow, even writing that out feels weird because I’m like “fuck I can’t believe I used to do something so stupid” (which YES, I know that it was not “stupid” and it was an eating disorder lmao). 

My orientation towards exercise is similar to food in that I don’t put too much thought into it, but I will say that I definitely think about it more because I make an effort to stay active. I know that the best way for me to “transition” between work and home life is to get some time outside exercising so I make an effort to do that. So there will be some nights that I am in bed lazing after work and I’m like “NOPE not going to move” and then I’m like “Melissa...you will feel so much better if you do” and my pep talk voice to myself is always correct lol. The beauty of it is that I try to be active because it makes me feel better physically/mentally, NOT because I “need” to burn calories/alter my appearance and not because I need to feel better in the sense of alleviating anxiety due to not exercising lol. I would also say that my exercise has changed in that I used to exclusively run and lift weights. Now, I do a combination of running, hiking, playing tennis, lifting weights, and swimming.

Body image...hmm...I would say that for the most part I do not think about my body [appearance] throughout the day. I do when I am getting dressed in the morning, trying on clothes in a fitting room, or sometimes just standing in front of a mirror for a long time -- sometimes those thoughts are negative, sometimes neutral, and sometimes positive. There are days when I will put on a pair of jeans and say something to myself like “omfg why do I look so much larger than yesterday ugh” and other days I will say something like “wow I love the way I look in these,” but regardless of the nature of the thought, I would say that it takes up very little space in my brain. I have not put any amount of makeup on in probably a year? I get ready for work in about 20-30min. Which, there is NOTHING wrong with wearing makeup or spending a long time getting ready; however, for all of you that have followed me for years, you know that I used to have an extremely unhealthy relationship with each so that is why I point it out. 

Overall, most of my thoughts surrounding eating disorders are gratitude-based...gratitude for the experience and all that I learned about myself through both sickness and recovery, gratitude for the relationships I have been able to form through healing, gratitude for no longer feeling like a shell of a human, gratitude for how BIG the world feels now, gratitude for being able to use my brain/emotions for something more complex, interesting, and important than food/weight, gratitude for being in a place where I can truly help others (which I was 100% convinced that I could still do while recovering but that was absolutely not the case). 

As far as mental health treatment goes (outside of eating disorders), I have not needed much and I am doing really well. I have not seen a therapist in 3yrs and I do not feel the need to at this point in my life. I have stopped taking most of my medications, including Wellbutrin, which I was on the max dose of for around 5yrs. I used to be on 12 medications and now I am on 4 (Armour Thyroid for hypothyroidism, Adderall for ADHD, Singulair for allergies, and birth control). Also experimenting on/off with a variety of meds for rheumatoid arthritis but holding off at the moment until I can get in with my new rheumatologist. 

Well, hi people! It has been a long time? When I logged in, I went “okay okay, it’s time for me to post something on Tumblr” after receiving an anon asking if I had died lmao 😂

If I were to do a proper update I would have to write a lot more than I am going to, but here’s the gist of life right now:

So I left my job as a case manager a couple months ago and I am now working for the state as a CPS Caseworker. Most of you are probably familiar with the role, but essentially my job is to conduct assessments of child abuse/neglect, make determinations of when/if a child needs to be removed from the home, create safety plans, prepare for court, connect families to services, and complete a ton of documentation. I love it so far. I cannot even adequately describe how much I love it...if you were to tell me to design a perfect job for myself, THIS would be it. I feel so confident that I am going to do super well.

Hating COVID-19 and everything that goes along with it so much. Leaving it at that lol.