Helping a loved one get well when they’re ill usually involves doing what you can to help them relieve their discomfort and fight to overcome their illness. You’re working together. This isn’t the case with mental illness. For a teenager with an eating disorder like Julia, wellness and relief from pain were not her endgame when she was in crisis, nor we were in it together. It was so complicated and counterintuitive as a parent and caregiver. I couldn’t understand why anyone would feel compelled to harm themselves. But mental illness sends a different message to the afflicted. It makes everyday living full of conflict. Anorexia, experts say, is the worst of all of them with its high mortality rate and long-term physical damage.
For Julia, the conflict in her mind was slowly building during 7th grade and became a crisis when she started 8th grade. Suddenly, she was terrified of the foods she ate her whole life. How do you get someone to eat when they’re being told by a disease that it’s better off to die than to survive? The bottom line for eating disorders is that the mind will continue its disordered thinking if the body isn’t fueled properly. For caregivers of an adolescent with an eating disorder, the mission is to reverse this problem as quickly as possible. For us, that meant getting Julia to eat at a level that would get her weight restored to her normal growth curve and then a little more on top of that so the mind could function rationally.
There’s an approach called The Maudsley Method that we learned at her first intensive outpatient treatment program (IOP). It’s also referred to as Family-based Treatment (FBT) and involves the family taking complete control of the teen’s eating until they can do it for themselves. It required our full supervision of Julia’s eating, a schedule of three meals and three snacks daily that we prepared and served, and a higher calorie and larger portions diet, all with a sense of urgency to reach weight restoration.
But how were we to accomplish this? Well, it certainly wasn’t easy. I still hesitate to reveal what I had to do since so much of it had to be very underhanded to outsmart the disease. Sorry, Julia. I read about what other caregivers were doing with 2000 calorie milkshakes full of heavy whipping cream and Häagen-Dazs ice cream. Knowing Julia, I went with another approach. I worked with what I knew had calories that wouldn’t change the taste and texture of foods Julia was eating: ground walnuts and almonds, ground coconut, unsalted butter, coconut oil, egg yolks, full-fat yogurt, ground flaxseed, and nutritional drinks such as Boost Plus and Ensure Plus. At the same time, I had to stealthily switch the fat-free products she grew to depend on to full fat. I learned to operate quickly and quietly around her and always with an air of confidence. It felt like the eating disorder was watching me to see if there was any hesitation or missteps. By the way, Julia gets her craftiness (definition: skilled in or marked by underhandedness, deviousness, or deception) from me, so while I was on edge all the time, I also knew how and where to hide things around the kitchen and how to have a quick answer for her concerns and resistance.
We got through somehow and are now able to tell the story here on Nourish. My message to all of you reading this is to step up to the challenge of caring for a loved one through a difficult time. Do it quickly and with kindness and vigilance. Our experience changed both of our lives for the better. I’ll finish with a saying that sums up this post: “You can do the impossible because you have been through the unimaginable.”