She hated the idea of entering the hospital, and at 18, she could have refused, forcing us to commit her against her will. Fortunately, she agreed to submit to the program voluntarily. But she became more withdrawn than ever, curling up into a chair during family therapy sessions until she looked like a small child, and shaking one leg spasmodically in a severe kind of nervous tic, especially whenever she was spoken to or when she was talking herself. In those sessions, we learned that our daughter suffered from intense anxiety -- about school, about friendships, etc. -- and that she had a difficult time handling any kind of conflict.
It also became apparent to us that our daughter was and had been deeply depressed -- not just since the onset of her anorexia, but during high school as well. And though we suggested repeatedly to her therapists over the course of almost nine months that maybe she should be prescribed antidepressants, until last autumn they were unanimous in saying that they didn't think she needed them.
A primary reason for their reluctance to medicate our daughter was the same one that, up to a point, prevented us and, for a very long time, prevented her doctors from realizing that she was depressed. Anorexics, we have learned, are wonderful actresses, and our daughter seemed particularly adept. She might act depressed in our presence, but rarely did she do so in the presence of medical professionals, who for months misdiagnosed her as having a relatively minor, and recent, case of anorexia. Finally, once she was in the hospital, that diagnosis changed. After a few weeks of observing her round the clock, they realized hers was a severe case and that she was a prime candidate for the drug Zoloft.
After the Zoloft took effect, we began to notice dramatic improvements. Our daughter began eating more easily. She regained 25 pounds. She began to be able to eat socially and to talk about her eating habits. Best of all, for the first time in more than a year, she began to laugh and joke like her old self.
My wife and I are starting to laugh and joke, too -- and to think clearly for the first time in a year about things other than our daughter's health. We're not sure where all this will end. We're still a little skittish about feeling too confident. It's clear that anorexia is not something that simply goes away, like a case of the flu. It's something that, barring a miracle, will be with our daughter for years -- perhaps for her whole life.
These days, my daughter still finds it hard to eat socially, preferring to eat by herself, and as her weight has approached a normal range, she seems increasingly careful about what and how much she consumes. But I no longer believe, as I once did not too long ago, that this disease is something that will ultimately destroy her. Anorexia is something she can beat, something she can learn to master.
Looking back on this year, I am angry about a lot of things and grateful for others. I'm grateful for the treatment my daughter received from the eating disorders program, but angry that her therapists took almost a year to figure out that she could benefit from medication. I'm angry at myself for not recognizing the signs of trouble earlier, when my daughter was in high school. The clues were certainly there -- the days she'd stay holed up in her room, her complete lack of interest in after-school activities, her avoidance of social gatherings -- but we just assumed we were dealing with typical teenage alienation.
My daughter was a girl who earned straight A's all through school, who scored 1560 on the SAT , and who got into every top school she applied to. This was a girl who didn't do drugs or drink, and who didn't engage in casual sex or get into unhealthy relationships. During her adolescence, I would think back to my own teenage years, which included weekend binge drinking, drugs and all sorts of tortured relationships with girls, as well as a lack of communication with my parents. I figured, erroneously, that if she didn't have the kinds of problems I'd had, her problems could not have been serious.
Finally, I'm angry that school and public health authorities are so clueless about what constitutes a major health crisis. Our school district, like many others across the country, holds regular health sessions to counsel kids about anorexia and bulimia. They train kids to be "peer counselors" (our daughter was one), to help out other kids who exhibit such problems. But these programs are as ineffective as the "Just Say No" anti-drug and anti-sex campaigns. They appear to be fatally flawed in two ways: First, they focus on eating, and the need to be healthy, as though kids are falling into anorectic or bulimic behavior out of nutritional ignorance or because they're afraid of getting fat; and second, they assume that by warning kids about the disease, they will help them avoid it.
At this point, it seems clear to me that if a kid is going to become anorexic, no amount of cautionary warnings will prevent that from happening. The only thing that really offers the hope of prevention, most experts agree, is early intervention with therapy, to attack the underlying problems that push a child toward anorexia. It's parents and teachers, not the children themselves, who need to be alert to the problem and who need to intervene when the signs start to appear. Schools need to start offering preventive programs aimed not at kids, but at parents and teachers.
No teacher at my daughter's high school ever asked why she never ate lunch. Even as she wasted away at two different colleges, no professor, advisor or residence advisor took her aside to ask what was happening, no friend or roommate alerted an advisor, and no one called her parents to say something was wrong. My guess is they simply didn't know what to look for.
Our lives have changed dramatically since last year's airport shock. I used to talk with my daughter about what she wanted to do after college. Now I no longer think or care much about her career plans. I just worry about her current happiness (and of course her weight, which we require her to have monitored weekly as part of her deal to go back to college). I encourage her to enjoy college for itself, not as a step toward something else.
All this seems to come as a relief to her. She never brings up career plans anymore and instead talks about her courses and her current life, which I take as a good sign. If anorexia is about wanting to feel in control, it makes sense to live more in the present. No one can control the future, but we do have much more ability to control our present -- to choose that which makes us happy and reject that which makes us unhappy or uncomfortable.
As for my younger daughter, who's still in grade school, I focus on her being happy about herself and her school.
This isn't a bad way to be -- living in the moment and making the most of it -- and it reminds me of my own life in college. While getting a great education, I spent four years without giving any thought to a career.
Meanwhile, I have learned over this past year what I now consider to be the biggest lesson of parenting: It's a job that never ends.
About the writer
John George is the pseudonym of a writer living on the East Coast.
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