Fallout

For so long I felt that because my daughter did not overtly exhibit the extremes of this illness, that maybe it wasn't so bad.  But then I realized that I had no absolutely no idea what she was going through or even who she really was but I could see how much she had changed since moving away (and even more so after May 2010) and I mourned for the person who left in Oct 2009.  She seemed so strong and on the road to recovery but perhaps that was just a facade.

I knew I couldn't make her better - that she had to do on her own.  But suddenly, I felt like I couldn't even communicate with her on any level but a surface level and it was beginning to affect me to the point where I needed to search for some answers, or at least understanding.  So I reached out to NEDA again...

"I'm sorry to write again so soon but my son and daughter-in-law called and spoke with me last evening.  They are my only vehicle to learning what is really going on with my daughter, Tiffany, since she only tells me half-truths or lies.  And now I've learned that part of the Day Treatment program included family therapy yet I was never contacted.  How can I possibly provide meaningful support and understanding if I'm not included?

What I've since discovered is that while she did end the program, it may not have been successful (although it was 6 weeks).  From what I understand, it was possibly determined that she was not making the expected progress in the day program and her insurance did not want to pay for something that was not working.  Apparently it was suggested that she move into the residential program (which her insurance may have been willing to pay) but her fear of losing her job was too great so she returned to work yesterday.  This was a bit upsetting because it is unlikely that she would lose her job while out on disability although I have no idea how long the residential program would be.  It is also possible that she was reluctant to enter the residential program because it was only offered in Philadelphia and Florida.

Her job is all she has right now...literally.  She has no family living nearby - I am almost 3 hours away and her brother lives in Charlotte, NC which is 12 hrs away.  She lives with another girl she met through job interviews and who was with her in college at the same time.  However, the relationship has not proven to be successful as her roommate is not willing to be a friend to Tiffany.  I believe that Tiffany may have made one friend at work whom she spends some time with but she has a history of driving friends away or losing them for some reason.  However, my daughter-in-law did mention that she may have connected with some people at the center but that they lived a distance away.  Also, shortly before her move to CT, Tiffany broke up with her boyfriend of nearly 4 years even though it seemed to be a good strong relationship but I guess only Tiffany knows what is right for herself.

After her move to CT, I encouraged her to try become independent, live on her own completely for a while and refrain from getting into another romantic relationship.  However, that was not the case.  In January, she began dating someone new and she seemed to be quickly involved emotionally.  Unfortunately, that relationship ended just days before she started the day program.  In addition to that, she was considering moving to NC to be close to her brother but he told her they did not think that was a good idea.  I think that was a bit of a blow to her and I was upset with my son for not being more supportive of his sister.  I don't know if he's right or not but at that exact time, he was dealing with a new baby.

It seems pretty obvious that Tiffany is in a fragile emotional state.  She is clearly depressed and my fear is that she may be drifting towards anorexia (but I may be unduly worried).  She told my son that while she ate the meals at the center, when she got back to her apartment, she didn't feel like eating.  She said it wasn't due to the illness (supposedly she has the bulimia under control) but that she was simply too depressed to eat.  She has also said that she doesn't want to do anything other than stay in her room and read.

A lot of the other things that Kelly told me seem to follow the typical thought processes of an eating-disordered person.  The feelings of unworthiness, of being a failure and undeserving, always screwing things up, etc.  This is so sad to hear coming from a woman who is sweet, beautiful, smart and talented.  What was most interesting, to me at least, is that it seems Tiffany may be searching for someone who accepts and loves her for who she is with all her faults and weaknesses and will not abandon her when things don't go quite perfectly.  Someone other than her family, who, in her eyes, will always love her no matter what..."

It was shortly after writing this letter that Tiffany started lashing out at her brother and sister-in-law because they didn't support her moving to NC.  She told them she hated them even though she asked for the truth.  This was very upsetting but there was nothing I could do.  At this point, she began calling me about what she should do about a roommate after her lease was up and texting me that she no longer liked her job.  At this point, I could only listen and offer suggestions as best I could.  Her thinking started to become black and white while her binge drinking and impulsive behavior such as spending and shopping escalated.

As I review what I knew back in August of 2010, compare it to what the DSM-IV-TR details as the symptoms of Borderline Personality Disorder and think about it in terms of Tiffany's behavior, it seems abundantly clear to me that this is what she could possibly have had.  If I, a lay person, can see this, how could the mental health professionals treating her have so completely missed it??  How could she not have been treated for this disorder is all I can wonder in disbelief.  My heart is broken all over again at the senselessness of her death.

First Warning

I had many moments of deep guilt and despair after learning that Tiffany suffered from an eating disorder.  Of course, none were as horrible as what was to come but in August of 2010, I was beginning to get a glimpse of just how much this disease had taken hold of Tiffany and her life and I truly began to fear for her.

This was written to someone at the National Eating Disorder Association in the hopes of finding a person I could talk to, someone who could give me advice on how to deal with this monster who had come into my family and changed my daughter so drastically.  Here is what I wrote...

I'm not sure where to start but I have a daughter who has been suffering from bulimia since she was 12 years old.  She is now 23 and has just finished an intensive outpatient day program at a center in Connecticut, taking a medical leave of absence from her job as a tax accountant.  This is the first time she has entered a formal program but has sought various types of assistance, counseling and medical/nutritional help over the past 8 years or so.

The reason I am writing is because she was able to keep her disorder secret and hidden until she was 18.  By this time, she was an adult and she was completely unwilling to discuss any aspect of her disease.  During the time while she was a minor and sought help, while I knew that she had emotional problems, suffered from depression and mood swings, and suspected that food was a preoccupation, I only thought that she was possibly at risk for an eating disorder.  And none of her counselors (if they actually knew) ever informed me.  I found out about the bulimia in 2005 (when she was a college freshman) because her older brother, whom she had confided in for a year, could no longer keep it secret or provide support.  The fallout was brutal, resulting in her not speaking to her brother (for telling me) and her refusing to have anything to do with me because she had never wanted me to know (something I have never understood).  I also suspect that one of the reasons she was able to keep it secret was because she had always had a job, even several at one time, from a young age, earning her own money.  At one time she had $12,000 saved but by the time she entered college, all but about $2,000 was left and I could never understand where all the money went.  I am making an assumption here because while food frequently disappeared in the household, it was never excessive to the degree that I have since read some bulimics go to.  Also, I never found laxatives or any other drugs that bulimics use, the bathroom was never a mess (despite her describing purging up to 7 times per day) and she displayed no observable side-effects other than weight loss.

Eventually, she began speaking to me again and one day agreed to discuss her problem, allowing me to ask questions.  After that, we were never to talk about it again nor was I ever to bring it up.  Not knowing much about the disorder, I probably didn't ask any of the right questions so have never really been able to understand the underlying problem driving her.  Of course, the guilt I have suffered from not only not seeing that there was a problem, but thinking that I contributed to it in some way has been overwhelming at times and has necessitated getting counseling myself.

Since 2005, I have tried to be supportive in every way while keeping my own counsel and ensuring her that I loved her no matter what.  In 2008, she moved back home for her graduate year of college.  During this time she did seek some medical attention from center for Eating Disorders here locally but assured me that she was no longer binging and purging.  In Oct of 2009, she moved to Stamford, CT, to start her career with a top accounting firm.  After 6 months, she told me that she had started back up with the binge/purge cycle and ask me to help her find a physician in CT in whom she was going to confide completely.  This physician referred her to a center and the center recommended their day program.  At the time, with her job, that was not an option so it was suggested that she attend the evening program.  Due to a rotation in NYC, she put this off until finally, in May, when her problem had escalated to such a degree, she approached her HR department about taking a medical leave of absence so that she could attend the day program which she was approved for in June.

The start of the program was fraught with much emotional turmoil and personal trauma but she finished the program on Friday, July 30.  During this time, I rarely spoke with her and what few conversations (most of our communication was via text messages) we did have were very superficial.  She came home this past Friday and we had plans to do things and spend some time together.  She had told me that the program had helped with her eating disorder but that she was an "emotional wreck".  While she was home, I tried to get some information but as always, she was unwilling to discuss anything with me, using her favorite response of "I don't want to talk about it".  By Saturday morning, she told me she needed to leave, that she couldn't be there.  Needless to say I was distraught and upset but told her if that was what she needed to do, then she should do it.

I felt so lost and helpless after she left that day and I sometimes wonder if it was the first warning sign...

My Forever Beauty

This is a brief story of my sweet, lost daughter, Tiffany.  I originally posted this on her Facebook page on November 23, 2013, which was International Survivors of Suicide Day. I've expanded a little more here today.

Tiffany Gallo - In Memoriam

 This is the link to Tiffany's memorial video.  I couldn't paste the video here.

Tiffany was born 5 weeks prematurely in 1987...on a beautiful hot spring day in March.  She suffered no lasting trauma from this early arrival into the world although she did have a brief hospital stay for week when she was a year old.  As a result of being in the hospital, she seemed to develop a fear of men in white coats and needles which she dealt with for many years.

But for the most part, she was a happy, social child who had lots of friends and loved her older brother dearly.  She participated in sports and dance, enjoyed parties and sleepovers, and other than an early preoccupation with food and problems with reading, seemed like any other normal child.  She loved Barbies, Disney movies and the "Wizard of Oz" (of course!) and later on "Sex and the City" and "Harry Potter".

But then things changed drastically at age 12.  Somehow she discovered purging and from then until 24, she suffered from bulimia. Despite this struggle, she grew into a beautiful young lady. Never one to be without life goals, Tiffany received her masters, got a job as a tax accountant at a major accounting firm and earned her CPA license, all in a 2-year period. But all the while, underneath this facade of beauty and success, despair started to set in. Or maybe the despair had been there for a while.  Perhaps as early as age 15.

First Day of Work

CPA License

In 2010, she sought treatment for her eating disorder with little success and later that same year, attempted suicide for the first time. She was ordered back into treatment for her eating disorder but found it hard to stick with it.  She soon started back up with the cycle of binging, purging and overuse of alcohol along with the discovery of cutting; despair grew while hope that she would get better lessened.  Tiffany was told by one mental health practitioner that she had already tried all the drugs possible for her problem and the practitioner had none to recommend.  So she was basically told to go home, dance and smell the roses.  Who can blame her if she thought she was never going to get better?

I tried to help and support her but it was very difficult, if not impossible, for her to accept. I really thought she might be getting better from the reports I received from her doctors and the events of the night she died were no worse than many other times in her life as I've said. Although I think there were some people in her life at that time, as there had been along the way, who didn't understand the demons she fought and who made her life miserable and impossible in Stamford. Maybe there were things that happened during that Friday, an action or an event that I will never know about or that other people know about but have never mentioned or come forward with.  But to this day, I will never know why she had to go, why she did what she did. 

However, based on all I know now and what I now realize that I knew for a few years before she died, I am convinced that she had Borderline Personality Disorder. It would explain so much of her later life, the symptoms she experienced, the problems she faced.  I knew she wasn't Bi-Polar because she didn't have manic highs...she was mostly low...really low.  I'm just not sure why there was never a definitive diagnosis, at least none that I am aware of or that I was privvy to, other than that she had an eating disorder.

It is now 2 years, 9 months since Tiffany took her life. So often it has been hell on earth since her departure from this world. A life made surreal by her absence. I miss her with every fiber of my being. The pain does soften slightly with time then sometime comes back with a vengeance, but never, not ever, goes away...

Notables

 • People with eating disorders are at increased risk of deliberate self-harm
• Depression, anxiety, alcohol and substance problems often accompany eating disorders
• Binging and purging are associated with higher risk of deliberate self-injury
• A comprehensive mental health evaluation is an essential component of evaluating and treating people with eating disorders

Not All Eating Disorders Are the Same (When It Comes to Deliberate Self-Harm)

From the American Association for Suicide Prevention