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MISSOULA – Ali Caudle has always known determination and perseverance. She is a star swimmer, co-editor of her high school newspaper, and was accepted to Northeastern University to pursue a career in journalism.

Like so many other teens, she’s grappling with mental health issues exacerbated by the pandemic.

“A lot of my friends are also struggling with mental illness right now,” Caudle said. “Honestly, it’s harder to find a friend who isn’t struggling with anything. Almost everyone is.”

Caudle’s eating disorder began a few years before the pandemic, in ninth grade. She was 14 years old.

“My therapist talks a lot about how it’s kind of like an addiction, like you’re addicted to not eating,” Caudle said. “But unlike other addicts, you can’t just avoid food like you can avoid alcohol or avoid smoking. You have to eat, so you have to deal with it multiple times a day, every day.”

At 5 feet 2 inches tall, she dropped below 100 pounds. Her periods have stopped. That’s when her doctor talked to her about gaining a healthy weight.

“That’s all the conversation ever was; there was no discussion of the mental side of things,” Caudle said. “Like, where is this trauma coming from? It’s just, ‘Let’s get to a healthy weight, and everything will be resolved.'”

And that was the case until March 2020, the start of the COVID-19 pandemic.

“It just kept dragging on, and I remember I started saying, ‘I need to make sure I look good when we come out of lockdown,'” Caudle said.

She returned to school full-time at the start of her freshman year. Between swimming, pursuing an International Baccalaureate, and other extracurriculars, it became overwhelming.

“I fell into a full-fledged relapse,” Caudle said.

A CDC report released earlier this year found that the number of teenage girls visiting the emergency room for eating disorders nearly doubled during the pandemic.

The National Eating Disorders Association says its helpline reported a 58% increase in calls, texts and chats between March 2020 and October 2021, but experts believe the actual numbers could be even higher.

“[It] was unlike anything I’ve seen in my entire career: the explosion of pandemic needs,” said Dr Jillian Lampert.

Dr. Lampert is director of strategy for the Emily program. It has 20 locations across the country, from hospital care to virtual care.

“Overnight we had twice as many people knocking on the door or calling on the phone, sending emails,” Dr Lampert said.

Waiting lists across the country have become unmanageable.

“I think the pandemic has really provided the perfect recipe for getting an eating disorder,” Dr. Lampert said. “If you were ever to create an eating disorder, you would take a huge dose of anxiety, a huge dose of isolation, and stir it into a big container of social media pressure.”

Social media, designed to be addictive, is a constant presence in most teens’ lives. Experts say it was to blame for eating disorders long before the pandemic hit, but for teens like Caudle, more time online during lockdown has piled the pressure on.

“You click on a thing that can promote something…you shouldn’t engage, and then suddenly that’s all you see,” Caudle said. “Suddenly it’s everywhere, and you feel like you can’t escape it.”

Dr. Caitlin Martin-Wagar is the only doctor at the University of Montana to research treatments for eating disorders and also try to fill the gap in services through her own practice.

“I hadn’t even launched my website, and I was able to fill what I wanted with patients right off the bat,” Dr. Martin-Wagar said. “We know that the longer people suffer from an eating disorder, the less likely they are to make a quick and full recovery. However, there is a lot of hope. We have to keep an eye on things and make sure we get people into treatment as soon as possible.”

Advocates say no matter where you are, reaching out is key.

“We hear about our program and others where people waiting for care end up dying,” Dr. Lampert said. “These are treatable diseases. People shouldn’t have to die from eating disorders. It’s horrible. Every time we hear this it’s heartbreaking. We know someone dies every 52 minutes an eating disorder.”

“You convince yourself you have it under control, even though you clearly don’t,” Caudle said.

A turnaround came for Caudle when one of his professors noticed something was wrong.

“She stepped in and was like, ‘Something’s wrong, and I know it’s not true,'” Caudle said. “You feel so disconnected from everything, and you feel like if you look around, there’s no way out.”

It was the support she needed to crawl. Caudle began consulting and met with a dietitian. She changed her Instagram habits.

“One of the first steps I took was to clean up my social media feed,” Caudle said.

Now that Caudle and so many like her are gearing up for another big change – college – she’s arming herself with the tools to stay on track.

“I think I’m at a point where I can move forward into the future and not have to worry about it so much,” Caudle said. “I can sit down and enjoy a meal with my family, or I can let go, have late-night food with my friends, and it doesn’t sound like a big, insurmountable challenge.”

But she knows the challenge is still very real for so many others and hopes her story will inspire others to take the first step.

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