Cassie Holley with her family parents Lisa and Jim, and brother Christian
To her family, 14-year-old Cassie Holley seemed like a happy, active teen. She was on her Texas school's basketball, volleyball and track teams. She played trumpet in the band. And, she'd started cheerleading.
But, in 2008, Cassie's mom, Lisa, began noticing some changes. Cassie sometimes skipped lunch at the middle school where her mom was a teacher. And, she lost weight over the summer. But, it wasn't until Cassie began blacking out at school that Lisa knew something was seriously wrong.
A visit to the doctor's office revealed a problem the Holley family never expected. And, it kicked off a three-year struggle to save Cassie's life.
A shocking, scary situation
Cassie's family knew she was thinner than ever. But, they assumed it was just the result of exercising more now that she was a cheerleader.
Her doctor, however, recognized that Cassie was malnourished and immediately sent her to Texas Children's Hospital for treatment. When she arrived, Cassie's condition was critical. Her heart rate was dangerously low. And, her kidneys were beginning to shut down.
Her doctors said it would take weeks of hospital care to renourish her. And, that's when Cassie's parents first heard the diagnosis: anorexia nervosa.
Cassie had been starving herself. "We were in shock," Lisa says. "We really didn't believe it."
People with anorexia often see themselves as overweight, even though they're not. The condition can coexist with other illnesses, such as depression and anxiety disorders. And, without treatment, it can be fatal.
"We really needed information"
This was all new ground to Lisa and her husband, Jim. They knew they had to learn as much as they could to help their daughter and quickly. So, they turned to one of UnitedHealthcare's many online tools, liveandworkwell.com.*
They found information that helped them learn about anorexia. And, they also wanted to know what services their benefits plan would cover. The website helped them understand their mental health benefits as well as how to put together a treatment team.
According to Lisa, at the time, an eating disorder wasn't classified as a mental illness in Texas. That meant there were some limits on the resources available to them. So, the Holleys began to research Cassie's long-term treatment options. They got advice from other families who'd been in the same situation. And, UnitedHealthcare provided information that helped them get Cassie the care she needed.
"UnitedHealthcare was our vital partner," Lisa says.
After Cassie was well enough to leave the hospital, she began visits with a team of specialists. That included a nutritionist, an eating disorders specialist and a mental health therapist. The whole family, including Cassie's older brother, Christian, started counseling together to better understand her disorder and how to help.
"It's not about food, really," Lisa says. "There are other deep emotional issues at play." Anorexia may have complex causes, including mental health conditions and social pressure. It can run in families or even be triggered by a traumatic event.
In Cassie's case, the family discovered that she had been bullied about her weight. She also had an anxiety disorder that contributed to her condition.
Understanding the roots of Cassie's eating disorder was the first step. But, it was just the beginning.
A rocky recovery
Thanksgiving photo of Cassie Holley with parents Lisa and Jim
Over the next three years, Cassie had various treatments. But, she continued to struggle. Six months into treatment for anorexia, she began showing signs of bulimia, as well. People with bulimia binge-eat and then try to rid themselves of the calories. They might force themselves to vomit, take laxatives or exercise too much, for example.
Soon, Cassie had to be hospitalized again. But, the treatment she received was a temporary solution, not a cure. After she was well enough to go home, she still resisted eating. And, her family feared that a third hospital stay was looming.
"We were getting close to losing her," Lisa says. The Holleys realized they needed another approach.
They began looking into live-in treatment centers around the country. They found one they liked in Arizona but they had to act fast. Cassie wouldn't eat or drink. And, her condition was getting close to critical again.
So, the family packed the car and hit the road. It was a 22-hour dash across the desert, from Texas through New Mexico to Arizona. They drove straight through the night in the hopes of getting her checked in before her condition got much worse. "She cried the whole way," Lisa says.
Cassie was treated there for 60 days. During her stay, she remained fixated on her weight, Lisa says.
And, once she returned home, she relapsed again. Her parents were frantic yet determined to find a way to save their daughter. They wondered what to do next.
Turning a corner
The Holleys finally felt a ray of hope when Cassie's therapist told them about the Maudsley approach. In this family-based therapy, parents take a primary role in treating their child at home.
Again, Lisa researched it on liveandworkwell.com. "Any time the therapist or the doctors threw new terms at me, that became my go-to website for helpful information," she says.
Both Jim and Lisa took time off work in order to put the therapy into action. They prepared all of Cassie's food and stayed with her day and night.
It was an extremely trying time for all of them. Cassie was highly agitated. And, she resisted their efforts to help. By the end of the first week, her parents were on the verge of taking her back to Arizona. And, for Cassie, that finally led to a breakthrough.
She didn't want to go. "Bless her heart, she just emotionally deflated like a balloon," Lisa says.
That lowest of lows was a turning point. To her parents' great relief, the teen who had fought so hard to resist their help began working hard to regain her health. "From that second forward, she never relapsed again," Lisa says.
An unexpected and tragic loss
It hasn't been an easy road for the family. In 2011, the family endured an unthinkable loss. At the age of 21, Christian, Cassie's beloved brother, died in a matter of months after being diagnosed with a brain tumor.
As Lisa and Jim grieved for their son, they also feared this terrible blow might trigger a setback for Cassie. But, as difficult as it was, Cassie showed amazing strength and weathered her grief without relapsing. In fact, she wrote a poem for Christian's funeral that she later set to music. You can listen to it here scroll down to "Guardian Angel."
A journey of love, faith and learning
What helped the Holleys stay strong through such difficult times? Lisa credits her family's faith and the support of friends and family.
She's also thankful they had resources when both Cassie and Christian needed them most. During all the ups and downs, UnitedHealthcare was there to help answer her questions and talk through her concerns, she says. "They truly partnered with our family."
Today, Cassie is in college studying English and music. As a young adult, she actively takes charge of her own continuing treatment. Above all, she hopes her story will help others. In fact, she spoke on a panel at an eating disorders conference in 2013. And, Cassie plans to publish a book based on the journals she wrote during her treatment.
As her grateful mother says: "She's a thriving young woman with a promising future. We're so proud of her."
*Check your benefits plan to see whether liveandworkwell.com is available to you. Liveandworkwell.com is a private resource to support members and their loved ones. Use is not shared with your benefit sponsor and it does not become part of your medical record.