I am in the midst of a very difficult and complicated situation.  My girlfriend is very sick.  She came to me a while ago with the self-admission of her eating disorder.  For a while, her descriptions made it seem as managed as it can be by one’s self.  However, things have recently taken a turn for the worse.  She has been unable to find work in GA (where I live) and is stuck in MN in a poor living situation with her parents.  This recent turn of events has made her symptoms worse and has since showed early signs of clinical depression.  In addition, from the information that I have, numerous cardiologists that I work with think there is a high risk for cardiac complications.

She has recently admitted her need for help, but that she simply cannot do it alone.  Despite my encouragment and support, along with my willingness to transport myself home for her initial help sessions, she will not go in despite the need by her own admission.

I feel as though something needs to be done if she admits the need for help but cannot take that next step alone.  I dont want to violate that trust, because if it is violated there is obviously a risk that she then confides in nobody.  Yet at this point, I feel like I need to get somebody else involved.  Would it be unwise to form a so called “intervention” with her immediate family? Or do I take a risk and let the situation play itself out and hope that her admission to needing treatment leads to her actually seeking it with continued encouragement and support?

It is just so difficult to sit by and watch a loved one hurt themself like this and more importantly to watch the ripple effect it has on the rest of their life

Your situation is unfortunate, but I think there are some things you can try…If your friend is fearful of eating disorder treatment, you might be more likely to get her to make an appointment with a caring physician.  This may seem less intimidating, and might increase her awareness of the serious medical problems that can arise from such a disease.  Upon sharing these concerns and her desire for more help, her doctor could be instrumental in assisting her with selecting the most appropriate form of treatment.  Interventions are a scary thing, and should be used as a last resort, in my opinion.  If she realizes the problem, and has admitted her need for help, an intervention is only redundant.  Please encourage her to see a doctor. Hopefully she can find a compassionate, knowledgeable person who can see her through the process.  Even if she doesn’t enter a treatment program now, at least her health could be monitored by a physician.  My best wishes to you and your friend.  It is a long, difficult struggle, so may you find the strength and patience you need to support her while keeping yourself healthy.

well the real issue is a lack of health insurance.  Her parents have zero knowledge of the situation, so I see a doctors appointment probably seeming nearly as daunting to her as treatment for the bulimia itself

This is indeed going to be a long road.  Admitting she needs help is a great first step, but it may still take her a very long time to actually seek the help.  I knew I needed help for years before I finally managed to ask for it.  And then it was months before I could work up the courage to call and make an appointment.  Be prepared for her to change her mind, go through many ups and downs, and to not want to talk when you are face to face.  The shame associated with eating disorders can make it easier to talk over the phone or email but very hard to do in person.

If there’s any way your friend can get health insurance of any kind before she seeks help, that is crucial.  I’ve had friends go through treatment, lose insurance, and then were unable to get insurance later because the eating disorder is considered a pre-existing condition.  The worst case scenario would be that she is unable to qualify at all; best situation would be she is covered but the ed is not covered for a year or so.

Thank you for the input JM.  That insurance information will be very helpful.

Any other input would be welcome and much appreciated

Have you tried to get her on minnesotacare or MA if she is not on any insurance right now? Also, you can try to see if she’d be interested in going to eating disorders anonymous (eatingdisordersanonymous.org) or another support group that is free until she gets insurance.

Here’s the info on applying for MN Care.

http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&dDocName=id_006255&RevisionSelectionMethod=LatestReleased

You should suggest she do that. Don’t even say it’s for possible treatment of the eating disorder, but that health insurance is important in general (which is not a lie).

If she’s living in the Twin Cities area, she’s going to have 3 choices on providers. In my experience, Medica works best at covering the emily program services (I had bad luck with Health Partners through MN Care covering emily program services).

Are you coming back here for Thanksgiving or Christmas? That would be a good time to get the ball rolling for her (if not sooner) at treatment. You could tell her about the emily program and see how she reacts. I personally was really angry at first about seeking treatment (as are most people I meet), but once I went a few times I realized that they were here to help me. It was not/is not easy, but going surely helps me understand myself better and sort things out.

That MN Care app is key though at this point. Treatment is expensive.

Has she had counseling for the abuse? It might be a helpful thing for her to consider.

As far as what YOU can do in the future… first, I would suggest that if you sense an argument coming on, try to control your temper. If you feel yourself becoming angry, like you might begin to raise your voice, walk away from the situation and discuss it at a later time when you both have had the chance to cool down.

What you should do immediately is have a discussion with her about what happened. And, make sure you explain it to her just as you did above. That you would never hurt her and love her more than anything in the world. Then, explain that, in the future, you do not want to make her feel that way again. So, if you begin to argue, you plan on walking away and talking about it at a later time.

Probably the yelling, loud voices, and your sudden movement of standing up gave her a flashback of her past abuse. She may be harboring some symptoms of post-traumatic stress disorder due to her past. Anything that you can do to avoid the triggers of bringing on her symptoms of panic would be helpful, i.e.—keep your voice low and calm, avoid sudden and quick movements, etc.

It’s a situation that can be worked through but I still recommend counseling for her.

I’m sorry to hear that. But at this time she really needs you.