According to the U.S. Census Bureau, less than 17% of Americans live in rural areas in towns of less than 50,000 people. If you break the category of “rural areas” down and begin looking at the percentage of people who live in even smaller communities, say in towns that number less than 5,000, this figure dwindles dramatically.
This means that if you reside in a rural community and struggle with an eating disorder, you are a statistical anomaly. To put it bluntly, there just aren’t that many of us out there. Consequently, the challenges we face when attempting to access treatment, both acute and long term, can be formidable.
Get Ready to Drive
When I finally reached the point where I was amenable to the idea of participating in treatment, the closest facility I could find was a plane ride and a full state away. Once I stepped down from full care to an intensive outpatient program, I then had to find lodging. This lodging, as well as transportation to and from the facility, did not come without cost. The financial burden that came with accessing treatment was nearly overwhelming.
Lonely, Lonelier, Loneliest
While in treatment I became intensely homesick. Though I had dear friends who did their utmost to support me by phone, there was no one close enough to participate in group therapy sessions with me. In addition, I was unable to ride my horse or hike with my dogs. The acts of feeding them that had bookended my days had to be carried out by friends. Everything that I loved, everything that served as inspiration for regaining my health, was hundreds of miles away.
But You Don’t Look Like…
Returning home was a jarring experience. Friends and co-workers didn’t know how to integrate their experience of me with their understanding of what eating disorders and the people who struggle with them look like. In their minds, anorexia is a disease that afflicts women and girls living in urban and suburban areas, not in rural communities. This left many of them unable to quantify my experience and consequently made it difficult for them to support me.
How Can I Help You?
When you live in a rural area, finding support once you leave treatment can be incredibly challenging. Even if you are lucky enough to live in a town with a nutritionist and a therapist, the odds of even one of these individuals having experience working with people with eating disorders is slim. This means that in order to continue receiving care from highly qualified providers you either have to drive a long distance or relocate entirely in order to be closer to your treatment team.
If you are living in a rural area and are attempting to find support, know that you will need to be tenacious in your search. Know that you may need to drive many hours to access services. Know that after you leave treatment, you may need to relocate entirely in order to be near your outpatient team. These are challenges you will encounter and choices you will have to make. The process will be hard and, sometimes, it will be very lonely. As someone who has made it to the other side though, I can now say this without reservation. Recovery is worth it. Which means so is the drive.
Catherine Alene 