I recently exchanged emails with a young woman who is entering eating disorder treatment for the first time. She’s working with her treatment team to decide which level of care she ought to start on: partial hospitalization (day treatment) or residential treatment.
We’ve corresponded a number of times over the last few months, so she asked what I thought about the possibility of going to residential. She worries about being away from her family and about inevitably having to transition to lower levels of care with less support. The question behind these worries is, “Is such a sacrifice worth it?”
I wanted to write about this topic here, because she’s not the first person to ask me that question. It’s a difficult question to answer, and the answer won’t be the same for everyone. There are so many factors and circumstances that enter into what kind of treatment and which level of care a person needs (which also depends on what he or she is able to access, since insurance, unfortunately, is usually the deciding factor).
But I want to say this: I truly believe that if you have the opportunity to do any kind of treatment — especially in a residential facility — then you should do it.
How Residential Treatment Helps
On the practical side of things, being in a residential facility allows you to start breaking the habitual aspects of your eating disorder, which is difficult to do by willpower alone. In my case, it provided a supportive environment (along with medical monitoring) while I went through weight restoration, which I simply hadn’t been able to do on my own. That turned out to be a key part of the process — you can’t do the hard work of recovery if you are underweight, malnourished, and starving.
But there’s more to residential treatment than just weight restoration (or stopping the binge/purge cycle, in the case of bulimia and other eating disorders). Two years ago next month, as I was preparing to go to residential treatment, my therapist said to me, “Residential is a gift.” She was right. Yes, residential was difficult and at times very scary; the first week there I was exquisitely homesick; it was hard to transition to lower levels of care and adjust to having to be more responsible for my meals.
Yet it saved me. It gave me the space and time to focus entirely on my health and my recovery. I learned so much about myself. Very few people get that kind of opportunity.
Many people worry about taking the time off from school or work to go away for treatment. I get that — I was the kid with near-perfect attendance in high school (I was absent once my junior year to attend a funeral). I was the college student who freaked out whenever something didn’t go according to the strict academic plan I had set out for myself. And at the time, I was so invested in these things that I would not have been convinced there was any other way to “success.” (I know I wouldn’t have, because people did try to tell me to relax a bit, to no avail.) I understand how hard it is to put your life on hold in such a drastic way.
It is worth it. You’re going to have to trust me on that. School can wait. People take semesters off all the time. Jobs have to give you medical leave and they don’t need to know why. None of these other things are worth more than your life and wellbeing. A mother recently told me that she had to drain her teenage daughter’s college fund to pay for treatment. But what else could she do? What point is a college fund if there is no one to use it?
There are no guarantees, of course. Residential treatment isn’t the magic bullet, nor is there a guarantee that it will “work” or set up the recovery process to unfold cleanly and efficiently.
I can promise, though, that you won’t regret going.
Life Isn’t That Short
I can’t help but think of my own journey as I’m writing this. Lately I’ve been feeling drained and ever so slightly hopeless. I have had my eating disorder for 13 years now. It turns out that, just as all the stats and research will tell you, the longer you go before receiving treatment, the harder it is to get rid of this illness. It often seems that just when I get my eating disorder symptoms under control, depression or anxiety spikes, or my obsessive compulsiveness flares up, or I fall back into any number of the bad habits I’ve picked up along the way. It feels like a game of whack-a-mole, but there are 60 moles, and I can’t reach half of them.
Being sick for a long time doesn’t mean that recovery is impossible, but the road is significantly rougher. That in itself is a reason, I think, to go “all in” with treatment. It doesn’t mean the road will be easy or short, nor will it necessarily spare you from a relapse or two. But it will definitely benefit you in the long-run.
Obviously, I can’t tell anyone what they ought to do when it comes to making decisions about treatment. However, I were speaking to my 2013-self, and if I had a choice between residential treatment and a lower level of care, I would say without flinching to go to residential.
One more thing: I imagine right now that your eating disorder is chiming in that going to residential also means you’re “sick enough” to need such a high level of care. Well, screw what your eating disorder is saying about how sick you are or aren’t. Don’t go to residential because anorexia or bulimia tells you to. Go because you deserve to be well, and you deserve to have a place in which to get well.
Contrary to how the saying goes, life can actually be quite long. Go and learn about who you are and what you really want from life, so that you can spend the rest of your years living it.
174 Days | 11 Hours | 16 Minutes | 4 Seconds
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