Expert: Jeanne Rust, PhD - 9/4/2009

Question
QUESTION: I don't know if you would be able to help me with this at all... I've struggled with anorexia for about six years now. I've been in residential and inpatient treatments several times. After leaving my last treatment, I was doing well with my eating disorder, following my meal plan, etc. I relapsed about two months ago. I've talked to my doctor about this, so I don't think I'm in any real danger at the moment. What's been happening is that my chest will get tight, almost a sinking feeling, it's hard to explain... It can last a short time or up to twenty minutes or so, but it isn't painful, just annoying and worrisome. I don't understand why this is happening because it used to happen to me, but only when I was very underweight, and it would stop if I sat down. Now it's happening when I sit too. I'm losing weight, but I'm not emaciated, though I know I'm not eating nearly as much as I "should" be. Do you know if this is due to malnutrition, or something related to eating disorders? Anxiety and stress have been suggested in the past, which I certainly have as well, but this just happens out of nowhere. I do intend to talk to my doctor again, but I was just looking to see if someone else could give me feedback, and also because my doctor doesn't specialize in eating disorders. Thank you for listening.

ANSWER: Dear Jen,

I'm so glad that you wrote me!  I'm glad that you gave me the details of your recovery history.

I'm not absolutely sure, but I would guess that you're having a type of panic or anxiety attack.  When this happens again, sit down and focus on breathing deeply.  

I'm thinking too that you should probably be thinking about getting treatment again before you become emaciated!  Treatment is so much better for someone when their brains are still working!

Please take a look at Mirasol.  We are a very different kind of treatment program and most of our patients get well and stay well!

Are you in therapy now?  If not, think about going back into therapy  before you need treatment again!

Please let me know how you do - -

Warmly,
Jeannie Rust, PhD
www.mirasol.net
www.edrecovery.com

---------- FOLLOW-UP ----------

QUESTION: (I hope I'm writing this in the right spot, I didn't know if I was supposed to "ask a followup" or "add to the answer"). Thank you for responding so soon... I'm seeing my medical doctor early next week, and I guess I'll be having some tests done anyway. I'll be sure to ask her about this as well. Sometimes I think it could be an anxiety or panic attack, like you said, but often it just comes out of nowhere, when I'm not really feeling anxious at all. I don't know... Hopefully I'll find out next week.

I looked at the Mirasol website. Thank you for the suggestion. It sounds like a nice place, but my insurance is nearly up, and I really don't want my parents to have to pay for more treatment costs. I will keep it in mind though. Hospitalization is being discussed by my parents and treatment team because of the continuing weight loss and depression, but I really don't want to go anywhere. I'm 19, but I know that doesn't always mean much when it comes to voluntary/involuntary admission.

I am in therapy now, once a week, and I see a dietitian once a week as well. Honestly I don't know what I'm going to do or what's going to happen. I'm not feeling very ready for recovery, and I don't know when I will be, if ever, or how bad this will have to get before I am. I don't know. It's too overwhelming to even think about.

Thank you so much again.

Answer
Dear Jen,

In regards to anxiety and panic attacks, many people can all of a sudden find themselves in the midst of one without having a clue about how they got there!

It's great you're seeing your dietitian -- and can you see your therapist twice a week? Usually when you're being treated in private practice, when once a week isn't doing what it needs to do, then the next step is to up it to twice a week.

I do know one thing from a parent's point of view and that is we want our children to be ewel.  Money is nothing in comparison to the health of your child.  I bet your parent are worried about you and would be happy if you wanted more structured help!!

Let me know how you are!

Warmly,
Jeannie
www.mirasol.net
www.edrecovery.com