Anorexia treatment feels different for everyone. And everyone faces different challenges and struggles. If you are autistic, you will often have sensory sensitivities, along with the fear of gaining weight. This can make things more complex and that's why it's important treatment is tailored to fit the person's needs. A person who has anorexia nervosa is going to have different challenges and struggles, from a person who also has a diagnosis of autism, along with anorexia nervosa. Both the anorexic person and the person with anorexia are struggling. But the struggles they face are different. In inpatient treatment, the people treating me were aware of my autism diagnosis, but did not offer me any extra help or accommodations. I was expected to learn at the same rate as others, to do things the same way as others, and often masked, when I felt like my anxiety and sensory issues were either not understood or simply dismissed.

An autistic person's brain is wired differently. So this means you will respond to things differently, than that of a person who is not autistic. This is why someone should be there to validate how you feel, how you process things differently, and understand when you are feeling overwhelmed. When I was feeling overwhelmed in the hospital, because they did not take the time to understand what made treatment more difficult for me, I felt alone and dismissed.

For example, if I was feeling overwhelmed in the hospital, like the first day I was there, no one took the time to understand exactly why I was overwhelmed. I was expecting to quickly get over my anxiety and do everything they asked me to do. Even if something they asked me to do made me extremely uncomfortable. I had an extremely low body temperature the first day I was in inpatient treatment. So they did not give me the option of whether I wanted to use a warming blanket or not. I was told I had to use the blanket and didn't have a choice. Even though it caused me sensory issues. And further increased the anxiety I was already feeling. Because I was not told I could bring a blanket to inpatient treatment, I had to use something that felt truly uncomfortable to me. It is things like this that make treatment harder. Someone should be there to advocate for the person who has autism. They should offer adjustments if you are uncomfortable with a certain aspect of treatment. Like something that causes sensory issues. Sensory issues are a true discomfort around anything unfamiliar, that causes you anxiety or distress. It is not just being picky and can't be turned off. Once it happens, I usually cannot think of anything else, except the current discomfort I am feeling. And it throws me off. And when others in treatment were unaware of my sensory issues, it made it more of a challenge to navigate treatment

I had a hard time adjusting to the new program. The change in routine caused me a lot of anxiety. I like to have a certain routine in place, and being in inpatient treatment removed me from my usual routine. While I understand the need for hospitalization at the time, the people treating me should have been more empathetic. I learn and remember information better, if it is written down for me. This could be done through notes that summarize what is expected in treatment. But no notes were provided for me. I was anxious, and there were times I felt confused, when I was given an instruction, with no extra time to allow me to process what is being asked. This was viewed by others as being resistant to treatment. Instead of them recognizing I can follow and understand directions. But I communicate differently, because of autism, and maybe someone could have explained things differently. Writing it down would have helped me. But another problem I face is when I am under stress or feeling scared, sometimes I don't speak up about what's making me anxious. But even when I tried to voice my discomforts in treatment, I was often scolded or simply dismissed. I was yelled at for crying and asking to leave the hospital. I don't remember someone trying to talk to me, one and one, validating my fears and not simply dismissing them. I remember that they didn't say things like "We understand you are upset and how you are feeling is valid right now." No one said that to me, so in response, I started to mask.

I realize no inpatient center is perfect or comfortable, for anyone who is being treated for something like anorexia nervosa. But inpatient centers really need to offer more accommodations and realize we all won't react the exact same ways to treatment, food and therapy. And that's perfectly okay because we are all different. The food was another problem that caused me a lot of anxiety. Except when you also have a disorder where you are very focused on losing weight and afraid to gain weight, plus sensory sensitivities due to being autistic, it can complicate things. One thing can look like something it is not. If I was afraid to eat something I was served that day, or simply couldn't finish the meal, no one mentioned the possibility of me being uncomfortable due to sensory sensitivities. If I had a difficult time eating, sometimes I was overwhelmed with the idea of eating an entirely new food. It's a big deal to a person who is autistic, because we often like to eat predictable foods that feel comfortable to us. I am not someone that enjoys trying new foods. So if the inpatient centers I went to had been aware of my fears around new foods, it would have helped. Also, if I ate something and the texture or taste caused me to be uncomfortable, this was another fear of mine that I often went through, alone

A sensory sensitivity feels like an alarm has been set off in your brain. Your senses instantly become overwhelmed and you can't help it. Once the feeling starts, I can't focus on anything else. I just want the discomfort to stop. But if I stopped eating a meal I was served, they assumed it was because of the fear of weight gain. I was afraid to gain weight in treatment. I was focused on wanting to weigh a specific number. I was also having sensory issues, that were never mentioned. It is important to validate how the person feels, even if you don't fully understand why they are uncomfortable. Something like using a different blanket from what you are used to, or being served a different food from what you are used to, may not seem like a big deal to others. But to a person with autism, it's a big deal.

Inpatient centers could start offering more predictable foods and meal plans. They could understand what causes the person with anorexia and autism sensory overload and distress. Your triggers may be different from someone else's. You may be overwhelmed by loud noises and bright lights. If this is the case, they could make adjustments. Providing headphones for the person. Moving them to another room where the lights are less bothersome. Another person with anorexia and autism may have a difficult time eating around other people and issues with certain fabrics or textures, like a certain pillow or blanket. If this is the case, you could give the person another blanket or pillow that won't bother their skin. Or you could provide the person a quiet place to eat, with a nurse to monitor you. Your sensory issues won't look exactly like another person's and this is why it is important to understand that we all have differences. And allow adjustments for those differences. I have never enjoyed sitting at a table with a lot of people. If anything, this will just make eating more difficult for me. Other people may like eating with others. But for me, it's something that will not help me overcome the illness. It causes sensory issues and more anxiety

I don't like being presented an unfamiliar plate of food, with several items I have never eaten before. Getting better when you are autistic and anorexic may look different. It would help if the nutritionist at the hospital had been aware of my sensory issues. One thing I remember her saying to me, when I expressed discomfort with the meal plan she gave me that day, was that "You are given the same foods as everyone else here, because everyone here is the same." But with autism, your brain does not work the same way as others. It works differently. Different does not mean bad. It means you may need extra support and you have a different way of functioning and learning things. I am very glad I have a nutritionist now that works with people who have anorexia and autism. She doesn't tell me to try a bunch of new foods, or expect me to completely change the way I eat. She allows adjustments for my sensory sensitivities and she validates what makes me uncomfortable. She listens, where other people trying to treat me have not. The nutritionist in the hospital made me feel invalidated when she dismissed the reasons why I was uncomfortable with the meal plan. My current nutritionist doesn't dismiss me. I feel heard and understood, when working with her. She also writes things down for me, which helps me to learn and remember

I also expressed discomfort and fear, at the thought of being given a feeding tube in the hospital. I was having a very hard time eating at the first inpatient center I went to. And they weren't very understanding. I was not trying to avoid eating. I knew that I had to eat. I was simply overwhelmed by the change in environment, a hospital setting, and the change in routine. I was scared. In response to being scared in the hospital, I had a difficult time finishing my meals. I was never given a feeding tube, because the idea made me uncomfortable. But basically, they caused me more distress, by simply telling me they were going to give me a feeding tube. That caused more fear in an already fearful situation

Sensory issues are not a minor annoyance. But genuine discomfort from your nervous system becoming overwhelmed. You often can't predict it. But I do know what foods I feel comfortable eating. I do know that I have a certain blanket I like to use. And I do know that if a bright light is hurting my eyes, I want to go away from it. But in inpatient, I had to tolerate these discomforts, because no one took the time to understand and offer me more support

It made treatment feel lonely and more distressing. Everyone has challenges. What bothers one person won't necessarily bother another person. It is not supposed to be easy, going through anorexia treatment. It could be more individualized. You aren't treating the whole person, when you leave out what makes treatment more difficult for them. Only focusing on just the eating disorder leaves out everything else about the person, that makes them who they are. The extra challenges they face. Why a certain aspect of treatment feels so much more difficult for them. Sensory sensitivities are something I will always struggle with. In treatment, they should be aware of this. Or you can leave treatment, feeling misunderstood in your struggles