Getting worse by the day even though in treatment

Dear Dr. Pitts, Please help me!  I binge and purge everyday and Im slowly slowly beginning to lose hope that I can get better.  I did it 10 times today one after another.  I have been in treatment program outpatient  for 6 months and I am geting worse.  I shoulod be getting better.  I think of food and when I will and what I will binge on.  I thought this program would help I don`t know why Im getting worser.  I used to do it once a day now it`s more and more why i don`t know.  I have only been a bulimic that binges for 1 year previous to that I did it even if i ate a cookie or even a salad.  I would gladly eat that now and do and don;t purge it but now im into the binging very heavely.  I sometimes feel I can just stop but I almost choose to because im affraid I will not be able to do it and have tried and failed and life is just easier to handle with this crutch I feel.  It helps me deal with stress.  I can do it anywhere and anytime in public and at work and it helps me.  I exercise moderately and do yoga for relaxation and have tried to play my music and do house work and distract myself but it doesnt work only a few minutes.  My mind then remembers that I didnbinge and purge and becasue i didnt i feel I should and need to to feel complete with my day .  Its a ritual that ads rhythum to my day and I feel incomplete without doing it.  I feel sometimes I want to die!  I cant have a normal life.  I have tried Celexa but it made me worse with binging and now I dont know what to do.  I was worse on it and I just the same with out the med.  I am completely out of hope and I feel so ashamed and embarrased I dont even want to share this extent of it with the professionals in the center.  PLease help me how possibly can someone recover from this.  
I cant do the in day program because I cant afford to not work.  I need a miracle or death.  What if any besidsadvice do you have for me.  Because I know what i have to do I just plain cant!  

[Patricia Pitts, PhD]

Dear marlane,
I am sorry to hear you are struggling so much.  I understand you are embarrassed to let even your treatment team know how entrenched you are in you Bulimia.  However, it is crucial that they know.  They cannot treat if they do not know what exactly going on with you.  You need the courage to say to them what you are saying to me.  Even if you cannot say it, take a copy of this letter to them and let them read it.
There is hope.  Over my 27 years of treating bulimics, I have seen many recover.  I do not know your insurance or financial situation.  However, it sound like you need to do a residential or inpatient stay to break the binge purge cycle, medication management and improved coping skills.  You can return to the outpatient program as you reenter you life.

To learn more about anorexia and different treatment levels of care, visit the bella vita website.

Best,

Dr. Patricia Pitts
The Bella Vita
Los Angeles, CA