First Attempt

Someone asked me the other day if I was still searching for answers to the reason why my daughter decided to take her life.  I'm sure I'll always be looking for the answer to that question "why" but for now, what I'm really trying to do to is fill in the gaps.  The gaps in my knowledge of who she was.  I'm trying to find out who the girl was who decided one day when she was 12 that purging was some kind of coping mechanism or solution to whatever emotional pain she was experiencing.

For some reason tonight, I was looking through her email which I still have access to.  I hadn't looked at her email in months but I had logged on about a month ago because I have this fear every once in a while that I'm going to lose access to it.  I had kept promising myself that I would write to the person she had gotten Riley from, her Pomeranian-Chihuahua, just to send pictures of him all grown-up (which I did).  In the course of this casual search, I decided to look at one of her folders that I hadn't looked at in a long while.  In it was a text exchange she had with someone.  It was enlightening yet disturbing.  A look into her state of mind at the same time as a couple of the last entries that I've been writing...August of 2010.

She talked about her eating struggles of the last 11 years, getting her body to work normally again, how exhausting it was and how it wasn't easy to give up that way of life and be "normal".  Yet at the same time, at the start of the text conversation, there seemed to be a thread of strength and determination running through her words to get better...until I got to the part of her talking about being alone.  Spending so much time alone.  How she had to listen to her roommate and a friend talk about her through closed doors for two days in a row.  How they spread rumors at work that she had cancer or "something" while she was actually in treatment.  At that point, my blood froze and my heart stopped.  Although I had heard these stories before, this was Tiffany telling it in her own words...as if from beyond the grave!  This wasn't just a made-up story; it was really true!!

And I thought...someone like Tiffany, suffering from the disease that she did, would never share her struggles willingly and especially not with someone who was talking about her behind her back, spreading rumors, making her life miserable.  Would this reticence on Tiffany's part make that person dislike her so much as to drive Tiffany to despair?  It certainly drove her out of the apartment they shared.  I wonder if that could be considered a form of bullying; at the very least, the worst kind of gossip, criticism or persecution, I guess.  But we're talking adults here; we're not talking about high school students, for crying out loud.  But interestingly enough, it was 5 days after Tiffany moved into an apartment by herself that she attempted suicide for the first time.

It was about 4:00 pm on an overcast fall day.  It was October 22, 2010 and I was in Poughkeepsie having my laptop repaired.  I had been in Stamford shortly after the text conversation I mention above took place (end of August) at the request of Ryan.  Tiffany had threatened to drink herself to death so Ryan had called me and "Mom" drove to the rescue.  Tiffany was beyond angry and drunk like I'd never known her to be but I let it roll off my back.  I stayed with her that night, telling her I had come to "save" her (silly me) which she scoffed at but she assured me that she would never kill herself, that she didn't have the guts to do it and so I left the next day.

Who could believe that only 2 short months later that I would be sitting in my car at the Poughkeepsie Mall on a conference call and see a CT phone number pop up on my cell phone?  I wanted to tell the person on the conference call that I had an incoming call but sometimes you get someone you can't get a word in edge-wise so I had to wait until I could end the call.  I think I called the number back and Stamford Hospital answered.  Stamford Hospital?  How could that be?  The person I spoke to said that my daughter had been brought to the Emergency Room and that she had taken an overdose of pills.  Overdose?  Pills?  Oh my God!  Was she alive, I asked?  Yes, she was but I needed to come to Stamford.  Thank God she was alive, was all I could think.

Fortunately, Poughkeepsie was an hour and a half closer to Stamford than Schenectady so after I made some calls and pulled myself together, I got there probably by 6:00 pm.  What I wasn't to know was that the person in that hospital bed was not really my daughter. That was some angry, belligerent, incoherent facsimile of her who lashed out at me as if I were the devil incarnate who had put her there.  I felt completely helpless and utterly guilty...a poor excuse for a mother whose daughter obviously didn't want her there.  At one point she came unglued and had to be sedated while I sat useless in another room.

They finally admitted her to the medical wing of the hospital after several hours for observation and further testing while a watcher sat by her bedside...suicide watch.  She was admitted to the psychiatric ward the next day...I am still not sure if they ever ruled out BPD.  But that's a story for another day...

Two-Minute Run

Borderline personality disorder is…

•A serious mental illness characterized by powerful and unstable emotional states, tumultuous interpersonal relationships, and impulsive behaviors

•More common than both bipolar disorder and schizophrenia

•Highly and unfairly stigmatized

People with BPD…

•Suffer from extreme and constantly shifting emotions

•Experience intense anger and despair

•Struggle to maintain close interpersonal relationships

•Are plagued by fears of abandonment

•Engage in what is known as “all or nothing” and “black and white” thinking

•Cope with painful emotions by engaging in self-damaging behaviors such as cutting, substance abuse, and binging and purging

Recent advances in research have…

•Uncovered a significant genetic predisposition for the disorder

•Led to the development of treatments specifically designed for patients with BPD such as dialectical behavior therapy (DBT) and mentalization based therapy (MBT)

BPD by the numbers*

•Studies have estimated that almost 6% of the population suffers from BPD.

•In the US, at least 14 million adults may have this disorder.

•Up to 10% of people with BPD will commit suicide and as many as 70% of borderline patients will attempt suicide.

•BPD patients account for 20% of inpatient psychiatric hospitalizations.

•At the conclusion of a 10-year study of a population of BPD patients, 85% of participants saw a remission of symptoms such that they no longer fulfilled the diagnostic criteria for the disorder. 

http://projectborderline.org/Official_Site/Two_Minute_Run.html

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