A/N: So I went on this spree of Life With Derek fanfiction, come one we all know Disney set up the step-sibling incest thing, but anyways I couldn't help but just get caught on this idea. I wanted to do so much more with this, but at the same time I knew if I spent too much time simply obsessing then it would have never left my writing folder. So trigger warnings, this focuses on eating disorders, not right away but for a large chunk of it. It's really choppy, for that I apologize but I tried to keep it about as realistic as I could get it without making it horribly out of character. I also pulled from real life experience for some of it so if some parts seem a little to 'personal' it's because they are.

Disclaimer: I don't own Life With Derek or the characters mentioned.

She came home the weekend of St. Patrick's Day, the Thursday before to be exact. She seemed happy enough and calm too. Derek wasn't so sure, because right before a classic Casey freak out she'd be calm as a pickle. None the less when she walked through the door she smiled politely and thanked everyone for their support before she made her way to her bed room.

"Is Casey fixed now?" Marti asked from her spot on Derek's lap. See when Casey had her 'episode' Marti was in the room, it took Nora and George two hours and a bowl of ice cream to convince the small child that she didn't break her older step sister.

"She was never broken Smarti." Derek said as he rubbed at her hair.

George looked relieved as he thanked Derek before he made his way to the kitchen, Nora followed and ushered quietly for the rest of them to follow. "Team meeting."

"What's up?" Edwin asked as he took a seat at the table, Derek stood against the door frame, Marti was hoisted to the counter by George and Lizzie was... where was Lizzie?

"We just wanted to thank you guys for making this go smoothly, this couldn't have been easy on you." Nora started as she met the two boys eyes. "Lizzie is probably in with Casey right now, last time it took a whole two days before she would detach herself from Casey's side."

"Wait..." Derek said as he pointed accusingly at Nora, "this has happened before?"

George pointed back; "Knock it off." Derek held his hands up in surrender. "Yes this has happened before, but that doesn't make this any worse or better, got it?"

"Casey has had this happen twice before, but both times were instigated by something else. This was literally a random onset -which is why it was scarier." Nora said as she poured a glass of water. "It's also why it took her almost two months until she was able to come home again."

Edwin took the opportunity to ask; "So what is it that happened?"

"Just a minor set back Edwin." Everyone jumped at the sound of Casey's voice. "I was coming down to get some snacks for Lizzie and I, didn't mean to interrupt."

"You weren't interrupting!" George played the card quickly; "Was she interrupting?"

Everyone in the room over exaggerated their aggreeance with George. "You don't have to do this."

"Do what sweetie?" Nora asked sweetly with a smile.

"This." Casey held her hands in front of her to showcase the room. "Edwin being polite, Derek hasn't made a snide remark, and you guys are smiling those fake smiles."

Nora sent a look to George as she stepped forward; "We just want to answer any questions without stressing you out."

Casey nodded her head. "So what questions do you guys have?"

"Uh... Dad I'm late for hockey."

"I got an important meeting with... doesn't Marti have a play date? I'll walk her over."

Just like that the kitchen was empty except for Nora, George, and Casey. Casey said nothing as she walked over to the cabinet to pull out a bag of pretzels, chips, and she shrugged before she took the cookies.

"You guys don't need to make a big deal out of this." Casey said as she turned around and organized the goods on the counter. "If I wasn't perfectly fine I would still be at Mercy."

"We just don't want to stress you out, you just got home!" Nora said as she hugged her daughter. "Besides Dr. Hunt told you to take it easy for a little while."

"She also argued with you both about your trip this weekend. Which you should be getting ready to leave for right now." Nora was about to agree when George argued, he insisted that they could get a refund and they should have a family weekend. "I'm fine George, I thank you for your offer but I just want to relax and get back into my routine."

"You sure Case?" George asked as he wrapped an arm around her shoulder. "I don't want to go if you're not one hundred percent ok with it."

She hugged George back, in the last month and a half he was the most present figure. He visited her every day, he called when he couldn't, he was constantly there. It was comforting and a great feeling (not to mention it brought them closer than ever) but he needed to know that she was capable of continuing on.

"I'm one hundred and ten percent sure." She smiled at both of them before she grabbed her organized pile. "Now you guys pack, maybe take a nap too, early flights are the worst."

After a few movies with Lizzie, some mindless girl talk, and an hour long nap with Lizzie playing with Casey's hair it was time for a late dinner. Nora made all of Casey's favorites, lasagna, caesar salad, and garlic bread. It was a quiet dinner, unnerved Casey but she wouldn't say anything, and before anyone knew it their plates were empty and the usual idle chit chat had started.

"It'll be great having the whole family here for the weekend!" Edwin said with a smile. It made Casey laugh a little bit and Nora exchanged looks with Edwin. "What? I thought that was the plan?"

Derek smacked him upside of his head. "Way to be."

"Actually guys Nora and I are still going on our trip. Casey," he winked at her, "had talked some sense into us."

"Really? Casey?" Derek said with a confused look. "She's the one that talked some 'sense' into you guys!?"

"Derek." Lizzie warned as she kicked him under the table, but Casey's laughter broke the tension. "Casey, you aren't offended?"

She was still laughing, her face was a bizarre shade of red but she shook her head and waved. "Smerek now YOU broke Spacey!" Which only caused Casey to laugh harder. Although she did make a mental note to talk to Marti tomorrow about it.

"Mom and George had great intentions but, they need this trip just for putting up with me in the last month." Casey joked lightly as she took a sip of her water. "Now if you'll excuse me I'm going to take a shower and go to bed."

When she was out of ear shot Lizzie confronted Derek. "She's not crazy."

"Never said she was." Derek said defensively.

"Well you act like it. She's not stupid either, she knows you're all playing some game to make her happy." Nora tried to explain, or defend, herself but Lizzie was having none of it. "She told me upstairs she looked forward to being home, she counted down the days from when she entered Mercy."

"We know that Liz..."

"So stop it!" Lizzie said as she crossed her arms across her chest. "She wants normal. If you want to help then stop acting." With that Lizzie stood up and left the kitchen.

"She's scary." Edwin said after a few seconds of awkward silence.

Although there was no agreement there wasn't any disagreements coming from the remaining people at the table. They continued to sit there before Derek made a move to get up, it was Nora's voice that made him pause.

"Repeat that?" He asked casually.

"Your father and I would like you to stay home with Casey tomorrow." Derek looked like he was about to say something, of course he was... it WAS Derek after all. "Before you say anything smart think about it. If you don't feel up to it I can sacrifice one more day with Lizzie."

Marti looked up at her father; "Why does Casey need a baby sitter?" she asked while making a face.

"She doesn't need a baby sitter," Nora started in a strained manner, "... she just can't be alone right now."

"You think DEREK is the best option then?" Edwin asked incredulously, then winced when Derek smacked him upside the head. "I'm just saying, you and her don't actually get along."

"As much as I hate to agree, Ed is right. Spacey and I don't see eye to eye and the situation considered..." he held his hands up as if he were weighing both options. "...I'd love to get out of school though."

George let out a small bark of laughter; "Right well! It won't be that simple, there would be things you'd need to do tomorrow."

"What do you mean?" Derek said as he leaned on the back of a chair. "What things?"

He wasn't skeptical at first, but when Nora insisted that Edwin go up and help Marti start to get her bed stuff together he grew more cautious. Dangerous area, he thought to himself, tread lightly.

"What things?" He asked bluntly when he noticed George and Nora had started stalling.

"Things like, like making sure she's up at a normal Casey hour -weekend Casey hour," he motioned for Nora to continue, which she did in a slightly uneasy voice. "... you can't let her skip any meals, even if its a plain bagel for breakfast and a bowl of cereal for lunch, she has to eat SOMETHING at every meal."

Derek shrugged effortlessly, basically he was baby-sitting the Princess, didn't sound major. "That it?"

George looked at Derek before he relieved a breath; "She can't skip her medications, she may think she's better but I -although Nora disagrees, would feel much better if she took them at least until we were back."

"What medications?" Derek asked as he crossed his arms over his chest and rose an eyebrow.

"Simple little things, some different vitamins, a sleep aid, Xanax..." Those things didn't sound to simple to Derek, "... Other than those three things it'd be an easy day."

There was something that Nora wasn't telling him. Derek wouldn't press it with her though, he was Derek Venturi after all he'd be able to figure it out on his own. He shrugged and agreed to their terms before he made his way up stairs, Casey and Lizzie could be heard talking from Casey's bedroom. Now it wasn't his INTENTION to spy on them, because he would NEVER do such a thing, but he did just so HAPPEN to catch bits and pieces of the conversation.

"... mom will let me stay home tomorrow." He heard Lizzie said with a sigh.

"And you shouldn't! Liz I'm fine." He could hear the defensive tone in Casey's voice, when she thought she was right about something she simply didn't back down no matter who it was. It was that moment he decided to enter his room, clearly if Casey felt she was fine then she was fine and Derek... well he wasn't going to worry about the keener too much.

The remaining bits of the night were quiet, the family all tucked away safely under blankets and most of them sound asleep. Naturally of course there were some residents that just didn't see sleep as a possibility. Derek sat at the kitchen table, it was way passed midnight -not that it mattered he was staying home anyway, and had decided he wanted ice cream.

"Derek?" He heard the familiar voice of -here's the surprise, he thought sarcastically to himself, Casey MacDonald. "What are you doing up so late?"

"Pondering whether or not I should stage another freak out and send you back to the nut house." she didn't really react to his statement. Alright so maybe he conceded that was just a little TOO harsh considering she'd been home less than a week -less than two days!, but he didn't expect her to shrug and take a seat across from him.

They sat there in a heavy silence, Casey would occasionally glance over at him and raise her eyebrows, as if she were taunting him (or daring him) to say something else on the matter. Which being Derek... he did; "Have you talked to Smarti yet?"

Casey pursed her lips and took a deep breath. "Not yet, but I intend to tomorrow. I can't believe she thinks she broke me, must have been pretty bad if she won't even look at me."

"Must have been pretty bad?" He asked incredulously, "... pretty bad would have been if you slipped, fell, and MAYBE twisted your ankle again... whatever happened that afternoon was way, WAY worse."

"Well I would imagine!" Casey said defensively, it really wasn't her fault, she couldn't exactly remember what it was that set her off -usually she could pin point the trigger, but that time it just kind of... happened. "I don't actually remember much."

"You don't what?" She went to answer his outraged whisper but he cut her off; "You don't remember looking at Marti and then just not responding? How do you not remember!?"

She looked at him with her mouth agape, she didn't have a real response. She just DIDN'T remember, since moving into the Venturi household she's had more miniature panic attacks than she could ever remember, but she's only had three horrendous ones, and two long term in patient trips to Mercy Medical Center. "I remember not being able to breathe."

Derek hadn't realized he was on a rant until she said that. He stopped short and motioned with his hands as if to say 'What the fuck!?' which she answered. "Out of no where everything just popped into my head, graduation, university, growing up, the baby, and one minute I was contently day dreaming about my successful career and the next I was struggling to breathe and couldn't quite understand why this sense of dread and panic just rushed at me..."

"Casey," but she was still discussing how this suffocating feeling had just appeared, she was still going on about how she couldn't explain why and that if she could she would. Which he realized a little too late set her off on this tirade about how she could possibly get Marti to trust her not to do that, which led to a self discussion on her OWN children.

"Casey!" Derek had finally had enough he noticed the way she kept wringing her hands. He grabbed both of them and snapped her out of it. "Relax... Marti will still love bothering you, she was scared. We were all scared."

She regulated her breathing and thanked Derek with a gentle squeeze back, too which he abruptly pulled away. "YOU were scared?"

"I walk in the kitchen to find my six year old sister crying under the table and my incredibly ANNOYING step sister hunched over dry sobbing and gasping for breath." She looked at him this small crooked smile, the one that says 'Awe you DO like me!', "I was scared Space Case."

She nodded her head silently, she would have reached across the table for his hand but somehow she figured he would have flinched -which would have hurt her in a unnecessary manner. Whenever he did little things like that though it always hurt, she often wondered (obsessed really) why he couldn't just like her, then she remembered it was Derek and it shouldn't have ever crossed her mind.

"I was scared too," she decided that would do as a response. "I was scared that I lost control."

"Why is control a big deal?" Was his immediate response, he's always wondered it. Casey MacDonald was the queen control freak, but he could never understand why... who wants that much control.

"How about I tell you tomorrow, because I know for a fact that my mom convinced you to baby sit me." He snickered lightly as she giggled then sighed, but he didn't press the issue. He'd get his answer one way or another because he was Derek Venturi, and what he wanted he got -most times that was.

The remainder of his night he spent asleep, peacefully of course, but the girl on the other side of the wall however stared at the ceiling. She couldn't let her past suffocate her like this, she knew that, she cherished that knowledge actually (especially after her NEW therapist had mentioned that knowing those things was a huge deal). It was hard though, she thought dismally.

No one really understood what went through her head, how could they? Everyone interprets their thoughts differently and she was no exception, except maybe she was... she didn't know! All she knew was that the idea she built up of perfection when she was young ruined her, or maybe it was the conclusion she recently formed. She wasn't perfect enough for her dad to stay -which meant she wasn't perfect ENOUGH. Yes, she thought to herself, that was when it all started.

She remembered the first time she picked apart her physical imperfections. She stood in her and Lizzie's bathroom at the tender age of twelve and counted each blemish, she skeptically would brush her hair and shudder at each split end or messy highlight, she scolded herself for not wearing any make up to cover her giant fish eyes, but she mostly remembered being able to pinch the extra skin around her stomach. Her weight never bothered her before, but to be perfect she needed to be better than average weight, she needed to be thinner.

No one understood, she thought to herself again, no one at school got it. 'Why don't you eat lunch anymore Casey?' her friend Courtney asked once, why didn't she? Casey scoffed as if it was the easiest response in the world, she couldn't eat because that would mean gaining what she just lost yesterday, she couldn't eat because she couldn't stomach the idea of feeling guilty enough to get sick in the girls bathroom down the hall from her math class, she couldn't stomach food. Instead though... she'd lie; "My mom forgot to give me lunch money" or "I eat when I get home now, I won't have time to eat after dance.". They were such typical things to say though, perfect for adolescent children to believe.

She fell asleep going over and over those days. She woke up at nine thirty the next morning with a crick in her neck and a heavy mind. Obviously Derek wouldn't let his question go, he was Derek he just didn't do things simply, but could she just honestly tell him that control is everything? Without control she has nothing.

"Oh please Casey..." she whispered out to herself, "... you're just being over dramatic."

She was determined to have a decent day though, even if Derek was with her, but her first full day home from Mercy and she would NOT be deterred from the simple pleasantries of home. She dressed quickly and went down to the kitchen, she wasn't shocked when she noticed Derek's chair empty (it was part of his own personal bible to never be up before noon... ever) but she was shocked to see him eating cereal at the table.

"Morning Space Case, sleep well?"

She eyed him curiously before she responded with a good morning and assurance. She noticed three pill bottles on the counter and she inwardly groaned, of the all the embarrassing things to do. She popped the pills systematically as she grabbed a banana.

"That's all you're eating?" Derek questioned her, it would have been a normal breakfast for anyone else, but Casey loved breakfast (it was her favorite meal of the day).

"Not really hungry." she said as she peeled and nibbled at the mushy fruit.

The silence was back and she felt the need to look at anything but him, because he was staring (and the blush forming on her skin was not from his eyes). "So what are you going to do today?"

That was a great way to change the subject, she was proud of her quick and easy deflection. "I plan to do what I normally do. Watch T.V. maybe rent a movie, you?"

"I was planning on straightening up my room, kinda messy since I didn't have a chance to put anything away yet. A decent shower would be nice too..."

Derek nodded and shrugged before he got up and left. Typical Derek, Casey thought, leaving his empty bowl for her to clean up. She let out an irritated sigh as she rinsed the bowl and placed it under the running water to thoroughly clean it. She was startled when she heard him shuffle back in whistling.

"Must you do that?" She asked hotly.

"Your room is fine."

"Excuse me?"

Derek shrugged; "Your room looks fine. No reason to clean it, the shower I can understand you've been stinking up the house since you've been back."

"De-rek! Why were you in my room?" She asked angrily, he could tell she was frustrated because she always (ALWAYS) separated his name when she was aggravated. It was annoyingly familiar.

"I wasn't, I pushed the door open. It's practically spotless, besides wouldn't you rather just relax today?"

"I've done enough relaxing thank you, however I'm going to take a shower and try to pretend you didn't just insult me."

He let out a bark of laughter, his way of saying that pretending didn't take the insult away. He made himself comfortable once he heard the shower running. So Nora wasn't kidding around, Casey needed a form of surveliance, but he just didn't know why. At least not yet.

Fifteen minutes later he saw Casey sit on the sofa in a pair of baggy black sweat pants and a basic tank top. As always after a shower her hair was a curly mess but he knew by the time it dried it would be sleek, straight, and undeniable shiny. He liked to think he didn't think about that either.

"You asked me about control last night." He was stunned when she brought it up herself. "Oh don't play dumb Der, I know you've been dying to ask me all day."

He shrugged, sometimes she couldn't stand when he did that, and he appeared to think about his answer. "Your mom gave me rules, I thought she was bat shit, but she wasn't kidding."

"Rules for what?" Casey asked offended, of all the things a worried mother does, she chose to give Derek a secret operation to keep her what? safe?

"I don't know, she didn't tell me why. I was hoping you would have last night." He looked over at Casey and turned the T.V. off.

"Does it really matter?" She asked seriously. "You've made it known since day one that you want nothing to do with me."

"Which is exactly why you can tell me." Then he thought about what she said and decided to share something of his to open her up. "And I'm sorry for making you feel that way, you're my step sister though, and more importantly you're like my only girl best friend."

"Awe Derek!" she shrieked happily as he waved her off and motioned for her to talk. "Having control helps my anxiety, when I'm in control of what's going on with me then I can control the outcome, I'm safe."

"From what?" He immediately got heated at the thought of her not being safe.

"A lot of things Der..." she looked down at her hands. "... when I was twelve and my dad first left I couldn't control it. A typical mental response to the situation was to blame myself and the fact that I was not the perfect daughter he had built me up to be. I decided that I needed to fix it."

"How?" He watched her shrug before she let out a sigh. "Casey..."

"In order to be perfect I needed to look perfect. Make up, no more cheap bottles of dye for my mom to give me uneven highlights, but most importantly I needed to lose weight. I spent months avoiding meals, then I got the skill of calorie counting and would eat small meals only to do extra dance classes or exercises to work it off...

... when I was fourteen I had my first real bad anxiety attack. The school nurse and guidance counselor had called my mom in when they noticed my weight, they cornered me. I spent a full two months in St. Claire's Medical Center, floor eight. I started the process of recovery from Anorexia there. Then the next year I started school in a private all girls school and everything was perfect."

"You think not eating was control?" Derek asked angrily. "So what are you saying here Casey?"

"I'm saying the real possibility of that attack I had in front of Marti was because I had lost control of my new life." she said it so calmly -like discussing the weather, that he got more upset and threw his hands in the air. "I slipped into some old habits, I thought maybe if I lost a few pounds maybe I'd start to be noticed as something other than Casey MacDonald -straight A bore fest. I guess when I had that attack it was because I had subconsciously realized that the control and the recovery had worn off."

"You're not a bore fest." She was shocked when she heard his hard voice reach her ears. "You aren't ugly. You aren't fat. You're just Casey, Casey my step sister, the girl that has caught the attention of most the guys at our school, the girl that has no rumors going around because she obviously doesn't deserve them."

"Der... it's alright, I know all of this."

But he hadn't heard her; "... I just... you don't look like someone who would have an eating disorder!"

She snorted, which stopped his rant. "There isn't supposed to be a 'look' with eating disorders... not always anyway... it's one of those glorifications that society has placed on a serious illness. There have been plenty of people who looked average, weighed an average weight, and never gained or lost large amounts of weight and they suffered just as much as the girl that gets plastered all over the internet that its literally bones."

"You're missing my point." Derek said shortly, he really didn't have time for a typical Casey freak out (not yet). "You're supposed to be confident in your skin. You're not supposed to spend time at Mercy Medical Center's Psychiatric Unit because you have us! You could have come to anyone just to talk."

"Derek, it's not that simple." He argued but she ignored it. "I needed professional help before it got out of hand. I won't let it get me, not again."

She didn't notice until that moment just how upset he was about this. He was quiet and he just stared with his fist clenching and unclenching. She was pleased and shocked to have him demonstrate such a protective stance for her, although she may have subconsciously (at one time, long ago) wished it was for different reasons. None the less she stood up slowly and walked until she was in between his legs.

He didn't notice until she was straddling him, not in an inappropriate way just so that she was on his lap. Then before he knew what was happening she was hugging him tight and he was returning it. It was like he had lost all control of his usual demeanor, he buried his face in her neck and admitted just how scared he was that she wasn't going to be ok. He admitted that he had missed her and that when anyone from school asked he would just walk away. He admitted that he wanted to visit he really did but he wasn't sure if he could have handled it. They spent a long time sharing a typical emotional moment (one of which no one would ever find out about).

Hours later when Lizzie and Edwin walked through the door with Marti, Derek and Casey had already discussed possibilities (her new therapist, her appointment plans, his part in helping her, etc.). They had spent most of the day watching old comedy films and when he had a question she'd answer it. Was she scared the first time someone asked her about it, no she replied, she wasn't scared in fact she got a thrill as she lied and was believed.

He asked about Courtney, did Casey still talk to her? No, Casey had answered, Courtney and Casey had lost touch and she didn't like the idea of reuniting with heavy hearts. He asked about her medications, what they were for, she told him then explained that she didn't intend to be on them for much longer.

"Hey Marti..." Casey said softly when the little girl entered the room. Marti just waved shyly before she attempted to make a brief break for it. "Can I talk to you for a minute?"

"I guess..." Marti said heavily as she dragged her feet over to the edge of the living room.

"Can you come a little closer?" Casey asked softly, she would be patient because she had inadvertently caused this, but Marti would come no closer than the coffee table. "I missed you."

Marti just looked at Casey with wide eyes. "I'm really sorry Marti, I didn't mean to scare you like that. I'm sure it didn't help that everyone else got upset, or that I disappeared for a long time..."

"Smerek told me you were sick."

Casey smiled a little and rolled her eyes; "He wasn't wrong. I was a little sick Marti but I'm all better now! I don't want you thinking it was your fault though."

"I know..." Marti looked like she was about to cry, but Casey didn't want to shock her by just reaching out and grabbing her. "You aren't gonna' get sick again are you?"

"No." Casey said sternly before she opened her arms, Marti didn't waste much time before she was tucked safe in her other best big sibling's arms. "How was school?"

"Boring! But Bobby Reton did eat two whole crayons!"

When Nora and George came home late that Sunday they were shocked (pleased) to see the house still standing, Lizzie and Edwin on the stairs scheming, Marti on Derek's lap, and Casey complaining about the hockey game that has been on for over an hour. It was a new found hope for the adults, a horrible incident somehow brought their family closer, but they noticed a new air as well... could the feud between Casey and Derek be at an end?

Well it wasn't a fairy tale storybook they lived in, once Casey threw the pillow at Derek to get the remote it was as if nothing had ever happened.

A/N: I'm not expecting many positive reactions to this, it was an idea I had to share though. I was thinking of making this a brief multiple chapter fanfiction, a prologue would be when she has this attack, a chapter on her experience at Mercy, and a chapter or two of getting used to being an out patient again. That depends on the response I get; also a little note on the title it's titled 'It's Heavy' simply because the content is. It's not a light topic, it's not a favorable topic, nor would anything really make sense.

I hope you all could get over the choppy and the sporadic attitude of this!

Leave me a review for improvement (and check out my other stuff!)