As a teenager, Bri Riggio struggles to understand her eating disorder and connect with her psychologist father.

Bri Riggio has spent the last six years working at various institutions of higher education, from a study abroad program in Greece to George Mason University, where she now supports the Office of Research at the executive level. While not a scientist by training, she has always loved research and the process of learning. She stupidly spent an extra year in graduate school after choosing to base her Master's thesis on a social science methodology that she didn't know and just barely managed to finish her MA in Conflict Resolution this past spring. To keep her sanity, she runs marathons, plays video games, and looks for opportunities to tell her stories.

This story originally aired on Feb. 3, 2017.

Story Transcript

You would think that, after having my blood drawn every day for a month straight, that needles wouldn’t faze me. But no, ever since my hospitalization following my diagnosis of anorexia nervosa at age fifteen, every blood draw would inevitably end up with me passed out in a heap on the floor.

As I explain this to the doctor who was getting ready to stick my arm with a needle, just so that she would be prepared for what was about to happen, she asked me again, “So why are you doing this?” It was a fair question. After all, how many patients waltz into their doctor’s office with their own set of vials, requesting a procedure that they say will incapacitate them? But ten years later and three thousand miles away from that hospital in Southern California, this was just something that I did now. “It’s for a research study,” I told her. “They’re trying to find the connection between genetics and eating disorders.”

Because you see, after that hospital visit, I wound up back in high school, dealing with all the angst of adolescence but now with the added stress of recovery on top of it. Because for the first time in nine years, my parents had managed to agree on something other than their divorce. And that was to pull me out of treatment AMA—that is, against medical advice—after I swore to them that I could beat this thing, this horrible voice in my head that told me that I was fat, stupid, and only worth something if I went to bed starving every night.

And so you see, it wasn’t for my own health that I felt I needed to recover. It was so as to not lose my parents’ faith in me or, even worse, to not jeopardize my chance at going off to college. Because from my highly educated psychologist parents, me going to college was just a given. And for my father, a professor at an elite school, I was going to a top-tier school.

This wasn’t a fate that I argued with. As an only child with few friends, I welcomed the company of books and the distraction of homework from real life. I learned early on that if I needed something, had a problem to solve, I could figure it out on my own. Usually by looking up the answer in a book or by searching on this fancy new thing called the internet.

Now, back in high school, I felt very much like I used to when I was little, alone and trying to cope on my own. Don’t get me wrong, my mom got me into some pretty intense therapy, but all of that talking about your feelings, that was slow going. The voices in my head weren’t getting any quieter, and I hadn’t gained any of the weight that I desperately needed to since leaving the hospital.

“I can’t believe you’d do this to yourself,” I remember my dad telling me during one of our rare visits, which, again, ever since the divorce was about once every other week. “You’re killing yourself you know? You’re smarter than this.” That was what was killing me, because he was right. I was smart. At least I had the grades to prove it. But no amount of A’s on my transcript could explain why I had done this to myself.

“I know that I’m hurting myself,” I told my therapist. “I know that what I’m doing is not sustainable.” But I couldn’t explain to her, to him, or to myself why I couldn’t just snap out of it. Then it dawned on me: I could do what I always did. I could figure this out myself. I could find the answer in a book. I raided my local library, checked out everything I could on eating disorders. Maybe if I could figure out where this voice in my head came from, I could figure out how to get rid of it.

But most of the books that I found, they were just memoirs form other people who had suffered from eating disorders. I mean, they were interesting, to be sure, but none of them explained why someone would choose to starve themselves. Although that was probably the wrong way to put it. I didn’t feel like I was choosing to do this. No, I felt compelled to.

“Maybe you’re looking in the wrong place,” my therapist suggested when I told her of my little research quest. “I know you don’t like to hear this, but anorexia is a mental illness.” I knew what she was implying. I was the daughter of two psychologists, after all. But I didn’t like it. I waffled back and forth for a bit before I finally resigned myself to what I was going to have to do.

“I need your help,” I told my dad the next time I saw him. “I need access to your school’s research databases.”

“For what?” he asked.

“For research on eating disorders,” I said.

“You should be focusing on school,” he told me, “and your college applications.” But he reluctantly wrote down his log-in credentials for me after I begged.

“Just don’t download anything that costs money,” he warned.

Now, peer-reviewed scientific journals, this was what I needed. This was where I would find my answers. There wasn’t a ton out there research wise, but there was definitely enough. Most of the studies I found on eating disorders talked about the side effects of them—increased heart attack risk, increased digestive problems, increased suicide rates. Stuff that doctors had been spewing at me for months.

Another set of studies focused on the similarities and personalities among those who developed eating disorders—perfectionists, people pleasers, high anxiety. I mean, at this point, tell me something I didn’t know. Then there were all these other random studies. Some of them found a correlation between those with eating disorders and other mental illness in the family.

And then there were these other ones that talked about chemical imbalances in the brain. One of these studies caught my eye, because the author was essentially blaming dopamine as the cause for anorexia. I thought this was strange because I distinctly remembered from AP Biology that dopamine was one of the pleasure drugs. But apparently, too much dopamine in the brain actually creates feelings of intense anxiety instead.

This doctor found that the brains of anorexic patients just produce way, way too much dopamine. But when those patients stopped eating, these dopamine levels reduced to a normal state, but induced those feelings of euphoria, not unlike that of a drug high. Could this be the answer? Could I be physically addicted to starvation?

The thing about this wacky dopamine levels, though, is you were just born with them. You inherited them from your parents. Which meant that I was probably doomed from the start. My parents had spent their entire lives studying psychology, but that didn’t stop them from passing on this psychological crap to me.

“This is my parents’ fault,” I told my therapist the next time I saw her. “They gave me bad genes.”

“They did what?” she asked. I got the sense that she had heard this explanation from her patients before, but perhaps not quite in the way that I was meaning it.

“It’s the only reasonable explanation,” I told her.

“Have you talked to your parents?” she asked.

“Not yet,” I said.

“Would you like to?”

I waffled for a bit on that before I finally resigned myself to what I knew I should probably do.

The next thing I know, I’m sitting on my therapist’s couch next to my father, which is probably the closest we had sat in years. My therapist gave me very explicit instructions: She would guide the conversation, but if I had something to say or wanted to change the direction, it was my responsibility to speak up.

She got us started, naturally, with some questions about how we were feeling. My dad went on about how stressful this whole ordeal had been for him and wasn’t it a shame that I couldn’t just eat normally again. I bit my tongue, not trusting myself to speak. But then when he started going on about my potential, and how I was risking not living up to my potential, that was when I saw red.

“You don’t get, do you?” I said. “This is your fault. I’m like this because of you.”

“She read a study about eating disorders and genetics,” my therapist tried to explain.

“No,” I said, “this is your fault. You’re the one who left. You’re the one who was never there. You’re the one who never cared. You’re the one who’s been pushing me. I’m like this because of you. I hate you! I wish I wasn’t related to you!” I stopped only because I saw the look on my father’s face, and he looked like he was about to cry. I couldn’t recall ever seeing my father cry.

Needless to say, we were both done after that. We ended the session a little early, and we drove in painful silence all the way back. “You know,” he finally said, “I may not totally understand what you’re going through, but I do get it.” Then he told me about his father—my grandfather. I knew my grandfather wasn’t the most loving of types—hell, he would barely hug me whenever I would see him.

But, apparently, when my dad was young my grandfather was diagnosed with bipolar disorder, at a time when there wasn’t a whole lot of research out there about that illness either. My grandfather’s condition meant that his emotions were sporadic. He had a really hard time being there for his family. My dad learned early on that if he had a problem or he needed something solved, he’d figure it out on his own. He threw himself into school, and then later his career, to distract himself from this terrible thing going on with his family.

“You probably did get some mania from me,” he concluded, “and you probably got some depression from your mother. Between the two of us, I guess you’re pretty much screwed.” He laughed and then I laughed, because as a psychologist I knew that that was just his way of trying to lighten the mood.

My dad did actually attend therapy sessions with me after that. Some of them were just as horrible and as explosive as the first. Others actually seemed to get us talking though. And he started helping me on my college applications, editing my essays for me, but mostly he would take me on tours of local campuses. When those applications came through, when those acceptance letters came rolling in that spring, my parents both celebrated. They had done the right thing by pulling me out AMA.

As I mulled over my options, there was one thing still eating away at me though. And that was the overwhelming research that I had seen about relapse rates. My parents should have heeded my doctor’s warnings. Over half of the patients hospitalized for anorexia, within a year of being discharged, they’re relapsed and back in the hospital. There was even a debate out there as to whether one truly could recover from anorexia. Some seemed to think that you just lived the rest of your life with these voices in your head, fighting them every day and fighting against a possible relapse.

It had been my dream to move out of state, to start over somewhere where I wasn’t known as that anorexic girl. But I had applied to a few local places, at my father’s urging, including the school where he taught. It’s the best safety school you could hope for. I had never seriously considered it, for obvious reasons. But now, knowing what I did about my illness, there we a lot about it that seemed to make sense.

If I did relapse, he would certainly see it, right? If I did ever need help again, well, I’d have a built-in support network. Plus I was pretty sure that attending the school where he taught would certainly satisfy that top-tier-school requirement. These were the reasons I gave him when I told him that I would in fact be attending his school that fall.

“You’re sure about this?” he asked, trying not to be too excited.

“I’m positive,” I said, and he actually pulled me into a big hug.

Now, I didn’t see him those first couple of moving days, but the end of that first week of classes, I got an email from him asking me to meet him in his office. When I got there, he had a pamphlet. He sat me down and he explained that he’d heard about a graduate student at a local university who was starting a new research study about eating disorders—anorexia nervosa, to be precise. She was looking for participants. It wouldn’t require much, just some interviews. A few tests here and there. It wouldn’t interfere with my studies at all.

“I think you should do it,” he told me.

“Why?” I asked. “I’m already messed up as is. Why I would I want another reminder about this?”

“Because maybe you don’t have to be messed up,” my father said. “Maybe you couldn’t find any good answers out there because there aren’t any good answers yet. Maybe you could be one of those answers.”

I took his damn pamphlet, but I definitely glared at him as I walked out of his office. This was the last thing I wanted right now. I was supposed to be celebrating my success. I wanted to look forward, not backward. This is what he had pushed for all this time anyway. The last thing I wanted from him right now was a reminder like this.

I stopped and I took a breath. Whatever his role was in this, it wasn’t like he wished it upon me. Just as he hadn’t wished for all that crap the he had to go through growing up. Maybe that was why he went into psychology in the first place. Maybe he was looking for answers. Maybe he was still looking.

I waffled back and forth for a bit before I finally resigned myself to what I already knew I was going to do. As I walked into that clinic a month later to start the first of what would be many, many research studies after that, I just hoped and I prayed that this time, maybe, I just wouldn’t pass out during that blood draw.

Part 2: Seth Baum