When your daughter has anorexia

Story highlights

  • Clare Dunkle's daughter had anorexia in her teens
  • Elena's anorexia stemmed from being raped at age 13

(CNN)In 2002, close to my daughter Elena's 14th birthday, her whole personality seemed to change. She became tense and silent, and she developed insomnia. Most troubling at all, she became skinny and stopped growing. Her rising anxiety seemed to keep her from being able to relax enough to enjoy a meal.

The changes we saw in Elena's weight and behavior worried her father and me, so I took her to a respected child psychiatrist. He tested her for hours and then told me I had nothing to worry about. "Your daughter is completely normal," he said.
    I trusted the psychiatrist's diagnosis, but I continued to worry. Elena seemed to stabilize, but she didn't regain her happy outlook. She was angry and cynical, and lots of things upset her that she would have laughed off before.
    Finally, in 2006, the summer before Elena's senior year, she saw another psychiatrist. "It's anorexia nervosa," he said. "I'm putting her in the hospital until she gains weight."
    At this point, Elena was thin, but her weight was above the anorexia guidelines, and her outlook and behavior didn't seem as troubling as they had four years earlier, when she had been pronounced completely normal. Elena's pediatrician disagreed completely with the psychiatrist. My husband and I talked it over, but we couldn't figure out which doctor to believe.
    Furious at being trapped in the hospital, Elena went on a hunger strike. She lost more weight each day. By the time she had been in the hospital for a week, her condition had changed for the worse. Now her doctors told me that her heart was dangerously weak. Elena had cardiomyopathy.
    I didn't know what to do, and I had never felt so confused and frightened in my life. Was my bright high school student really trying to starve herself to death, as the second psychiatrist insisted, or was the first psychiatrist right that she was normal? Was some serious medical condition causing the heart damage? Why couldn't the doctors agree?
    I asked Elena about it while she was lying in her hospital bed: "Do you have anorexia nervosa?"
    "No, Mom. That's stupid," she said.
    "Are you in some kind of competition with your friends?" I asked. "Is this some kind of diet?"
    Elena looked me in the eye. This was my honor student, my Red Cross volunteer.
    "Really, Mom, there's no diet," she said. "I don't have anorexia. I'm fine."
    That summer, I stayed with my daughter as she moved from hospital to hospital and her condition continued to worsen. I sat by Elena in two intensive care wards and flew or drove with her for thousands of miles to try to find some answers. The experts never could manage to explain to me what was happening to my daughter, but eventually, her mysterious problems improved enough that she was allowed to come home.
    I felt consumed with worry and self-doubt. Had I failed Elena somehow? Had I been too strict? Had my writing career forced me to spend too much time away from my family? No one could tell me what had happened to my child and what part I had played in her illness.

    Learning the truth

    For more than two years, Elena stayed well, but in 2009, her weight dropped again. She was 21 at the time, living at home as she attended college. Once more, I agonized as I watched her starting to eat less and less. When I confronted her this time, she admitted that she had anorexia, and she volunteered to go into a full-time treatment center.
    The best facility her father and I could find was several states away, so we put her on a plane two days later. I felt thrilled and deeply relieved. At last, Elena was ready to get better.
    But week after week, when I talked to Elena on the phone, she didn't sound better. Instead, she sounded angry and miserable, as if she were in the fight of her life. And then one night,