In 1987, however, Rivers life began to spiral downward when her husband, Edgar Rosenberg, committed suicide. This event, combined with a declining career, was the onset of a deep depression for Rivers, as well as the beginnings of bulimia.
Rivers states how a devastating loss affects hunger in two ways - erasing it or launch it to new heights. "For me the suicide inspired a gastronomic space program." she claims (Rivers, 1997, p.98). She describes the beginnings of a binge - overeating rich foods until she felt bloated and her clothes became too small - at which point she reached the solution of self-induced vomiting. Occasional purges soon evolved into weekly then twice a day rituals. Rivers timed her purges to happen roughly a half hour after a meal; she realized she must admit the problem to her therapist when she pulled over to vomit in a rest area bathroom. When she finally admitted her bulimia to her therapist Dr. Michael Greenstein, his observation reflects the general state of her life: out of control. Because of this, one of the few things she has been able to control is her bodily intake and output, which has manifested itself in the form of bulimia.
Eating disorders are actually psychological disorders and can frequently be triggered by traumatizing events. The proper name of bulimia is Bulimia Nervosa (BN), which translates as "ox hunger", and refers specifically to a binge and purge cycle happening at least twice a week for at least six months. Purging methods include self-induced vomiting, or the abuse of laxatives, diuretics or enemas. Bulimics may also resort to fasting or exhibit obsessive compulsions to exercise. Sufferers often share similar personality traits: they tend towards perfectionism, while retaining a sense of low self-esteem despite their accomplishments. Depression is a frequent contributor to the disorder's development as well. Unfortunately, since the psychology of bulimia is often related to larger emotional issues, both the condition and the original problems complement and augment each other, resulting in a worsening of all symptoms (Eating Disorders, 2005).
There are several Cognitive-Behavioral Treatment (CB) methods for BN: such as various behavior, psychodynamic, family, or experiential therapies, or a Twelve-Step program using the disorder as an addiction. CBT is a process by which the patient comes to recognizes the true psychological issues, learn more constructive coping mechanisms in relation to these, and then modify their behavior to return to more acceptable eating patterns while preventing relapses. Anti-depressants frequently help, as they curb the appetite while inhibiting the root depression; different anti-depressants seem to work equally well (Wilson and Pike, 2001). With Dr. Greenstein, Joan Rivers learned to identify her grief of her husband's suicide and was able to return to host a daytime talk show through the years 1989-1993 (Wikkipedia, 2006), the ending of which coincided with the death of her therapist and her returning to live in New York. Her depression was growing worse. The combination of her husband's loss, her talk show ending, a brief Broadway show collapsing and the failure of her jewelry venture