Dr. S (Ch. 1)

My primary care doctor says I need to find a new psychiatrist now that I’m back in Chicago for good. She tells me that a specialist needs to manage my medication for my ADHD and binge eating disorder. The Concerta isn’t doing anything for the binge eating, and that’s what’s bothering me most. She thinks I should be on Vyvanse, since that’s the gold standard for BED. I tell her that was Wendy’s first choice too—Wendy was my psychiatric NP back in Virginia—but it was over $200/month even with my insurance and the Concentra was only $18/month. I’m with Dr. S. for almost an hour even though the waiting room is packed. I really like her. I found her while I was searching online, profiling doctors before making my decision. I wanted someone Black, and her being a woman was a bonus. I feel like I don’t have to over-explain things to her, which is rare. She just gets it. She listens without cutting me off or trying to fix everything in one sentence.

Dr. S is patient and thorough when it comes to educating. She doesn’t make me feel judged as I answer her questions as honest and accurately as possible.  She does a full physical and wellness check—takes her time with it, too. Most doctors try to be in and out in 10 to 15 minutes, but she doesn’t seem rushed. I tell Dr. S. that I’ve been binging since I was in my early 20s and I’m approaching 30 in a few months. We discuss the previous lab tests Wendy had ordered and my Genomind report. The Genomind report is used for "determining my genetic makeup, potential neurochemistry, and insights related to drug metabolism, absorption, and penetration." I tell Dr. S. that my only other diagnosis is pre-diabetes but how I think it’s because I binge so often. She agrees that it could be a contributing factor since I choose sweets and carbs as my vice. She recommends that we just monitor it for now.

My binges are disgusting and shameful. They used to only last 2-4 days but then turned into 7+. I can eat 3000+ calories in one day and not feel full. On workdays, I’ll eat everything in my lunchbox by noon and still be snacking out of my pockets.. I’ve stopped up to 3 times driving home to continue binges multiple times. Convience store or gas station.. Burger King for an apple pie.. then McDonald’s for a McDouble and small fry. I’ve stood in my kitchen multiple times for 1+ hours, still wearing my coat, as soon as I got home because all I could focus on is food. I’ll get almost to the point where I need to vomit.. pause until it passes.. then continue. I’ve frequently had to replace foods that I’ve “borrowed” from roommates before they noticed.

I get pissed when someone points out that I won’t stop eating. I’ll screen phone calls because I don’t want anyone to hear me ordering or chewing. I’ve missed out on social outings/dates because I become disgusted with myself and have been told that my body image is distorted. I’ll stay in the house because I feel like the bloating and weight gain are tale tale signs that I lacked “self control.” My face gets fuller and my clothes don’t fit the way I want them to.

It’s upsetting when people refuse to acknowledge BED as a disorder/addiction or how I feel when I try to open up about it . I get told that I’m being irrational and/or dramatic because, “anyone would love to be your size. Stop complaining.” It’s dismissive and I don’t feel like I’m being heard because I feel like people choose to only see my exterior. I hated spending 2+ hours in the gym on following days to try to drop the new weight faster or at least turn some of it into muscle so I stopped. BED is an addiction just like alcoholism and drug abuse because all three need some type of treatment. The most memorable thing that Wendy ever told me as I bawled in her office one day was, “you’ll lose the weight when you stop binging.” Easier said than done.

Dr. S. has me schedule a follow up appointment to see her in a month. She wants to go over my labs once they come back and see how things go after I talk with the psychiatrist. She points out that nurses are notorious for being bad patients and I laugh because she's right.

Fast forward a month—I tell Dr. S I still haven’t found a psychiatrist. Cigna insurance has an online portal but it's difficult to navigate and there's no available appointments until almost 2 months out with the providers they have. Wait lists for seeing a psychiatrist are commonly long so she’s understanding. I let her know I have a phone intake scheduled with a behavioral health facility later that day. She writes me a one-month prescription for Concerta but cuts the dose in half just to get me by until I see someone.

I'm pretty much begging for the medicine at this point. Even though the Concerta isn't working for my binge eating I still need it because but I feel like my ADHD has gotten worse. I’m horribly anxious and can’t focus on anything. People and conversations are overwhelming me. When I get this way I see moving shadow figures out the corner of my eyes that take up the form of something like a dog. I know nothing is there but I will see them a couple of times over a few days. My anxiety is high.

The woman doing my intake at the behavioral health facility gives me an appointment that’s two and a half weeks out. She also schedules me for a therapy session right after, in the same building. I thank her and hold my breath. Thank God!