"But you don't look, act, seem sick... so what gives?' You're probably right. It took even me a while to admit that I was sick, even though I don't 'look it'. But, that brings up the bigger question, why do we automatically go to physical appearance for a mental illness? Yes, it can and does manifest itself physically, but eating disorders are mental illnesses. You cannot see when someone is struggling.

 

And yet... it was in the little things that my clinical team noticed. I may not have had drastic physical changes, but my skin got duller, there were bags under my eyes, and I had trouble concentrating. But, that's just grad school getting to me, right? My therapist took one look at me and knew exactly what I was up to. It's really important that we don't ignore the signs, even if they seem small- our bodies are good at telling us what's wrong. It's up to us to not wait until it's glaringly obvious to first seek help. In this lies the secrecy that eating disorders are able to thrive in.

 

Okay, you might say, so maybe looks aren't all it's about. What about all the things you do? Aren't you in grad school and doing internships and volunteering? And the answer to that is, yes, I did. I ended my first semester with strong grades that I was very proud of. I had a really fantastic experience as an eating disorder intern. And yet, I was neglecting self-care and ignoring my very most basic needs for living and thriving. The truth is, I'm really great at doing everything else, but also really great at ignoring my own needs and not taking care of myself.

 

Okay, so it's not about what you do or how you look. What about your social life and your relationships? How could you possibly be 'sick' if you're seeing your friends, going to dinner with them, and in a long-term relationship? These things are all true. But, that's exactly what they were, just things, that didn't show the whole picture of how I was on the inside and how sick I was getting. And the thing is, my relationships did start to suffer. It's really challenging to maintain multiple relationships: both your relationship with your eating disorder, and your relationships with your loved ones and friends. The eating disorder will eventually make you chose it, as your behaviors get worse, your relationships and interactions get strained. Even if it is not obvious to the other person, it left me with tremendous guilt whenever I did something social with friends, and the urge to isolate. So, that's why I chose treatment. My relationships are way too important to me to jeopardize for the sake of something that's not benefitting me, even when it lies to me and says it is.

 

All of these counterarguments for why I'm 'not sick enough' are the thoughts that I've had, pretty consistently for the last few months. It was as if looking in from the outside, everything was great. I was a happy, well-adjusted 20 something year old who was finally living her dream in NYC. There was no way I could be sick, right?

 

This is something my individual therapists have been challenging me on, but it hasn't started to stick until recently. 'I'm just feeling like a phony, like somehow I fooled you all to get here. I'm not sick enough,' I told her. 'Think about it like this,' she countered. 'Would someone who is well be wishing ill on themselves? Would they want to be sicker?' And the truth is, no, they wouldn't. 'Sick enough' implies room to get sicker, or worse. And we wouldn't tell someone with the flu to wait until they were sicker to come back and get treatment, would we?

 

My takeaway from this is the following: ​

 

1. You cannot tell someone's health from their physical appearance

2. Someone's health cannot be determined from how they do in school, or the activities they are in

3. Someone can have amazing, supportive, healthy relationships and be struggling to feel understood

4. Not everyone has to understand where you're coming from for you to get the help and treatment you deserve

5. Invisible illnesses are just as valid as physical illnesses.

 

End of discussion, they simply are."