Families Empowered and Supporting Treatment of Eating Disorders…

…is a volunteer run virtual community you must check out if you love someone who struggles with an eating disorder or body image issues.

As described on their website, F.E.A.S.T. “is an organization of and for parents and caregivers to help loved ones recover from eating disorders by providing information and mutual support, promoting evidence-based treatment, and advocating for research and education to reduce the suffering associated with eating disorders.”

FEAST  relies on the following guiding principles to fulfill their mission of helping families, caregivers, communities and medical personnel to properly support people working to recover from eating disorders:

~ Eating disorders are biologically based mental illnesses and are fully treatable with a combination of nutritional, medical, and therapeutic supports.

~ Parents do not cause eating disorders, and patients do not choose eating disorders.

~ Parents and caregivers are a powerful tool for a loved one’s recovery from eating disorder.

~ Blaming and marginalizing parents in the eating disorder treatment process causes harm and suffering.

~ When available, patients should receive evidence-based treatment.

~ Families should be supported in seeking the most appropriate treatment in the least restrictive environment possible.

~ Food is medicine: all treatment should include urgent and ongoing nutritional rehabilitation.

~ When the family is supported, the patient is supported. Siblings and all family members are ~ affected by a family member’s illness, and deserve full attention to their needs.

~ Parents have unique abilities to offer other parents support, information, and the wisdom of experience.

If you or someone you know is living with or recovering from an eating disorder, check out F.E.A.S.T. today.
Get the help and support you deserve.

Or is it something more?

Pediatric bipolar disorder is a genetic, neurobiological illness that can present in childhood or the teen years.

It is often misdiagnosed  as ADHD, or dismissed as defiance, out-of-control behavior, and even a symptom of poor parenting.

But pediatric, or early onset bipolar disorder is very real and requires appropriate diagnosis and treatment.

Here are some of the most common symptoms:

Mania

• Severe mood swings — overly irritable or overly silly, giddy
• Inflated sense of self — seems to feel superior
• Talks too much, too rapidly, and/or changes topics quickly
• Easily distracted
• Decreased need for sleep
• Aggressive behavior
• Destructive
• Hypersexuality

Depression

• Sad
• Irritable
• Loss of interest in previously enjoyed activities
• Moves and/or talks slowly
• Cries often or excessively
• Feels worthless
• Feels unnecessarily guilty
• Talks of death or suicide

Bipolar disorder puts kids at increased risk of school failure, substance abuse, self-harm and suicide.

Bipolar disorder is serious, but it is treatable.

If you suspect your child’s moodiness may be something more, see your doctor immediately.

For more information on Pediatric Bipolar Disorder, visit Child and Adolescent Bipolar Foundation or Juvenile Bipolar Research Foundation.

Often Not

In the media and in personal circles I hear of medical practitioners, educators and community members who dismiss or deny the existence of mental illness, but a recent Baylor University study determined that one of the most dismissive of all professions is…

…are you ready for this?

…clergy …pastors …spiritual leaders …men and women of God!

Researchers at Baylor surveyed 293 parishioners who approached church leaders for guidance in response to  previously diagnosed serious disorders, including schizophrenia and bipolar disorder.

In one-third of those situations, religious leaders told family members and significant others that their loved ones did not really have a mental illness — even when they had been properly diagnosed by licensed mental-health care providers.

Church members were told that symptoms and behaviors resulted from one or more of the following causes:

1.- The commitment of sin

2. - A lack of faith

3. - A satanic or demonic influence

Lead researcher, Matthew Stanford, professor of psychology and neuroscience at Baylor University said during an interview, “The results are troubling because it suggests individuals in the local church are either denying or dismissing a somewhat high percentage of mental health diagnoses. Those whose mental illness is dismissed by clergy are not only being told they don’t have a mental illness, they are also being told they need to stop taking their medication. That can be a very dangerous thing.”

Very dangerous indeed.

Can you imagine caring for a medically non-compliant loved one whose clergyman encourages him to stop or resist taking medication? This is sheer ignorance at work. And I thought the dark ages had passed!

Equally disturbing was the additional finding that women were far more likely than men to have their legitimate mental health concerns denied or disregarded by their religious leaders.

I’m stunned by the degree to which patriarchy thrives. How do we educate these good ole boys?

How do we guide institutions that cling to darkness, resist enlightenment, and fail at understanding?

Are finger-pointing and blame-laying so much more expedient than seeking the truth, accepting reality and working for the betterment of all?

Not in my God’s house.

I’m grateful that more and more information and light is being shared, understood, and reflected back into the community. It’s time to illuminate those dark places once and for all.

What’s more challenging: Being a Teen or Raising a Teen?

The teenage years are a time of transition for both parent and child as each struggles with boundaries of dependence, responsibility and independence. We learn what is ours and what is not. But lets face it, parents have the advantage of years of wisdom and experience, while teens are just getting started.

Teens can be overwhelmed by waves of normal emotional and physical changes as they navigate a sea of pressures to fit in, do well in school, participate in activities like sports or part-time jobs and prepare for the future.

How can adults best help teens?

Giving unconditional love is most important. Kids develop a sense of self based largely on how the adults in their life treat them. A warm, loving relationship will ease the challenges of the teenage years.

It’s also important to communicate your values and set expectations and limits. Insist on and always model honesty, respect and self-control. Treat everybody the way you want to be treated, especially your kids. If you cannot do this, get the help you need and develop these skills so that you can impart them to your kids.

Its easy for adults to get caught up in the need to teach and then get in the habit of criticizing and correcting. Although teens need guidance, they respond better to positive reinforcement. Praise appropriate behavior to give kids a sense of accomplishment and to reinforce desired values.

Here are guidelines to prepare for a child’s teenage years, developed by The American Academy of Child and Adolescent Psychiatry (AACAP):

-Provide a safe and loving home environment

-Create an atmosphere of honesty, trust and respect

-Allow age-appropriate independence and assertiveness

-Develop a relationship that encourages your teen to talk to you when he or she is upset

-Teach responsibility for your teen’s belongings and yours

-Teach basic responsibility for household chores

-Teach the importance of accepting limits

What is normal, what is not?

Teenagers experiment with values, ideas, hairstyles and clothing in order to find their own preferences and define themselves. This is normal. Don’t panic! But inappropriate or destructive behavior is usually a sign of a problem.

Teens are at risk for a number of self-destructive or dangerous behaviors including drug or alcohol use,  inappropriate or unprotected sexual relationships, self-injury and verbal aggression or physical violence toward others. In addition, biologically-based illnesses like depression, anxiety, eating disorders, and mental illnesses often emerge in the teen years. If you suspect these issues, learn all that you can and seek professional help.

The following may be warning signs that a teen needs professional help:

-Agitated or restless behavior

-Weight loss or gain

-A drop in grades

-Trouble concentrating

-Ongoing feelings of sadness

-Not caring about people and things

-Lack of motivation

-Fatigue, loss of energy and lack of interest in activities

-Low self-esteem

-Trouble falling asleep

-Run-ins with the law

What to do if there is a problem?

Maintain open communication. If you suspect a problem, ask your teen about what is bothering him or her. Don’t ignore a problem in the hopes that it will go away. It’s easier to cope with problems when they’re small. This also gives you the opportunity to work through problems together. Seek professional help. Talking to your family doctor or school counselor are good first steps.

You can also check out these online resources:

American Academy of Child and Adolescent Psychiatry

American Psychiatric Association

National Alliance for the Mentally Ill

National Institute of Mental Health

National Institute on Drug Abuse

National Mental Health Association

Increased Viewing = Increased Depression

Every Hour Per Day Your Teen Spends

-Watching television

-Playing on the computer

-Surfing the net

-Playing electronic games

-Listening to his I Pod

increases the likelihood that he will develop depression as an adult according to a study conducted by Dr. Brian A. Primack, an assistant professor of medicine and pediatrics at the University of Pittsburgh School of Medicine.

In 1995, Primack and his associates interviewed 4,142 adolescents with no history of depression to determine the number of hours they spent watching television or videos, playing computer games, or listening to the radio.

The average daily exposure was 5.7 hours, including 2.3 hours of television viewing.

Seven years later, 308 (7.4 percent) of the young people had symptoms of depression. Among those who were depressed, symptoms increased at a rate directly related to the number of hours they watched television and used other electronic media at the start of the study. Interestingly, the phenomenon was more prevalent in males than in females.

What exactly is the correlation between electronic media and depression?

There are several theories. As a classroom teacher, I had concerns about what wasn’t happening when kids were watching TV and playing video games.

Social, intellectual and athletic activities that safeguard against depression don’t take place in front of a monitor.

Another issue is that late-night watching disturbs normal sleep cycles, a phenomenon well-known to hamper emotional and intellectual development.

According to Primack, another “…theory is that you see a lot of depressing events on television and are likely to internalize them. Television emphasizes bad news, and repeated exposure to it might be internalized.”

Commercials and ads are also factors. “You see about 20,000 television advertisements a year, and a large proportion of them dwell on the fact that life is not perfect,” Primack said.

The message is this:

Help your children and teens develop into active, happy young adults by limiting the amount of time spent watching TV, playing video games, and listening to music alone.

It’s that simple.

Results from a recent study, cited in the journal SLEEP, shed some interesting light on sleep, physical activity, environment and childhood depression.

“We reported in a study previously, that genes were the most important factor in explaining the association between sleep problems and depression in eight year olds,” said lead author Alice M. Gregory, senior lecturer in the department of psychology at Goldsmiths College in London.

“However, when we examined this issue at age 10, we found that genes were less important in explaining the association and that environmental influences had become more important. This could be because environmental experiences are becoming more relevant as children grow older and could therefore play a role in both sleep problems and depression.”

Could it also be that the reduction or elimination of free play or recess in schools is contributing to increased depression in children?

Based on the information in yesterday’s post, I think we need to consider it.

Source: American Academy of Sleep Medicine

Recess Makes Students Better

My son Michael had a gifted and creative teacher for grades four and five who packed the school day with inventive activities and new approaches to learning.

The only downside?

She deemed recess less important than her curriculum, and the kids often got only one twenty-five minute lunch break between the hours of 8 a.m. and 3 p.m. Tack on the to-and-from bus rides, and those kids spent 8 or nine hours with the one wee break.

Michael began to dislike school.

After a few weeks the teacher and I talked. She was confused by the changes in Michael’s classroom behavior. He fidgeted, lost focus and talked at inappropriate times. This was all new.

My Suggestion:

“Let him go outside for 10 minutes every morning and every afternoon. Give him a responsibility if you want, but let him release some energy outside of the classroom.”

Michael became the tether ball and net monitor, responsible for installing and removing the playground equipment each day. His teacher saw an immediate improvement in classroom behavior, and Michael liked school a whole lot more.

Problem solved.

Now, over a decade later, other professionals are talking about the phenomenon of school days without breaks.

Dr. Romina M. Barros, from Pediatric Developmental Behavioral Health in New York, and her colleagues looked at a national database of over 11,000 third and forth graders. Children had one of two levels of recess: none/minimal (1 to 15 minutes a day) or “some recess.” The population was divided equally between boys and girls.

The Findings: Kids with more recess behaved better in school, according to a teacher rating system.

Barros says, “…we have to think that recess should be part of the education system, and if we have to get more help, we’ll have to get more help. Even if we don’t have space, if they could have 15 minutes indoors. Unstructured time, that’s all that they need.”

It’s clear that the No Child Left Behind Act of 2001 resulted in less recess for the majority of American children. “They started to find out that kids in the U.S. were not doing well compared to other countries and started penalizing schools when kids weren’t passing the state test,” Barros explained. “That’s when schools [reduced or eliminated recess] not only because of space, but also because they wanted to put more in academics.”

Dr. Barrios isn’t the only medical expert speaking out for more recess time. And exercise isn’t the only reason.

“Conflict resolution is solved on the playground, not in the classroom,” said Dr. Jane Ripperger-Suhler, an assistant professor of psychiatry and behavioral science and pediatrics at Texas A & M Health Science Center College of Medicine. She recommends at least one 20-minute break during which children participate in freely-chosen physical activities,  saying that Asian students tend to out-score their American counterparts and that “most Asian elementary schools allow children a 10-minute break after every 40 minutes to 50 minutes of instruction.”

Perhaps we need to reevaluate the manner in which we “leave no children behind,” and reconsider the Alfred Adler quote, “Play is a child’s work and this is not a trivial pursuit.”

As a teacher and parent, I believe kids develop better social, coping and problem solving skills when given time to explore, roam and learn from their environments and peers. New research from the UK proves my assumptions, finding that children with more free rein to roam have more positive “emotional, social and cognitive development.”

Out of worry, fear or a need to control, parents are increasingly less likely to allow their children much independence, says Dr. Angie S. Page and her colleagues from the University of Bristol. This has lead to an increase in obesity-related health issues as well as more social-emotional problems.

Page and her team investigated independent mobility — the degree to which children moved around without adult supervision. Examples include allowing children to walk to school or to a friend’s house without being accompanied by an adult.

Findings

Children with more independent mobility:

Interact more with other children and their environments

Develop better peer relations and social skills

Are more interested in physical and outdoor activities

Are less likely to develop depression, to be overweight, or to struggle socially

Page and her colleagues say that parents and caregivers should create more opportunities for children to function more independently, since those experiences lead to greater confidence, self-sufficiency and good old-fashioned common sense. Additionally, leadership skills and the ability to work in a team are developed.

“Understanding the factors that influence independent mobility is necessary to determine the optimum social and physical environment that encourages parents and adult caregivers to allow their children to be physically active outside unsupervised,” the researchers say. “This should be in addition to encouraging children (and parents) to be more physically active outside together.”

Bottom Line: Give those kids some independence!

SOURCE: International Journal of Behavioral Nutrition and Physical Activity, published online January 7, 2009.

As many of you know, two of my three children have bipolar disorder; and in our extended family a dozen family members have this or a related diagnosis. And we are far from alone.

The fact is, over 100 million people have friends or family members diagnosed with bipolar disorder. Tom and Fran Smith were a part of that group until their daughter Karla ended her own life at age 26, after a seven-year struggle with this serious mental illness.

During those seven years, Tom Smith says “…we received very little guidance…no one attempted to understand or clarify our frustration, concern and fear; we had no manual that suggested ways to cope…”

After grieving the loss of their vibrant young daughter, the Smith’s were compelled to ease the way for other families in similar circumstances. To that end, they founded The Karla Smith Foundation for  parents and loved ones of people with mental illness. Through support groups, peer-to-peer coaching, and educational programs and events, the KSF helps bring balance into lives that are affected by  mental illness or the suicide of a loved one. In addition to that ambitious endeavor, Tom Smith wrote A BALANCED LIFE: 9 Stategies for Coping with the Mental Health Problems of a Loved One (Hazelden, Sept 2008).

Here, in brief, are those strategies Smith believes will make a difference in the lives of others living with a serious mental illness:

1.–Help our loved one find and continue to take the medication needed for a balanced life.

2.–Urge our loved one to maintain a supportive relationship with a therapist, counselor or sponsor.

3.–Learn as much as we can about the mental disorder of our loved one.

4.–Assist our loved one in developing a healthy self-esteem, since it is critical for a balanced emotional live.

5.–Accept mental illness as a fact of life for our loved one, even though mental illness does not encompass all of life.

6.–Take care of ourselves by proper exercise, sleep, diet, relationships, and by monitoring our feelings.

7.–Become a supportive network of family and/or friends who know about the mental illness and who commit to acting in the best interest of our loved one as far as we are able.

8.–Identify the early warning signs that precede a more difficult phase of the mental illness, and help our loved one when these signs emerge.

9.–Acknowledge our dependence on a Higher Power and seek guidance from that Higher Power in whatever way that is comfortable to us.

In A BALANCED LIFE, Smith commits a chapter to each strategy, illuminating his points with real life stories and experiences. In addition, he includes a series of questions that help families or support groups clarify their feelings and understanding of the facts; as well as easy to understand definitions and explanations of  various mental health issues.

If you know or love someone diagnosed with a serious mental illness, or if you belong to a support group related to this topic, this book is a necessity. An excellent resource on so many levels, A BALANCED LIFE helps families achieve just that.

You think your child, or someone you care about, has an eating disorder.

Now What?

If you’re worried about your child’s eating behaviors or attitudes, it’s important to express your concerns in a loving and supportive way. It is also necessary to discuss your worries early on, rather than waiting until your child has endured many of the damaging physical and emotional effects of eating disorders.

It’s Time to Talk

In a private and relaxed setting, talk  in a calm and caring way about the specific things you have seen or felt that have caused you to worry.

What to Say - Step by Step

Set a time to talk. Set aside a time for a private, respectful meeting to discuss your concerns openly and honestly in a caring, supportive way. Make sure you will be some place away from other distractions.

Communicate your concerns. Share your memories of specific times when you felt concerned about your child’s eating or exercise behaviors. Explain that you think these things may indicate that there could be a problem that needs professional attention.

Ask your child to explore these concerns with a counselor, doctor, nutritionist, or other health professional who is knowledgeable about eating issues. Tell your child you will make an appointment and go along on the visit.

Avoid conflicts or a battle of the wills. If your child refuses to acknowledge that there is a problem, or any reason for you to be concerned, restate your feelings and the reasons for them and leave yourself open and available as a supportive listener.

Avoid placing shame, blame, or guilt on your child regarding their actions or attitudes. Don’t use accusatory “you” statements like, “You just need to eat.” Or, “You are acting irresponsibly.” Instead, use “I” statements like, “I’m concerned about you because you refuse to eat breakfast or lunch.” Or, “It makes me afraid to hear you vomiting.”

Avoid giving simple solutions. For example, “If you’d just stop, then everything would be fine!”

Express your continued support. Remind your child that you love him and want him to be healthy and happy.

Make an appointment with a doctor. Click here for a list of providers in your area.

Write down your observations and concerns to share with the doctor.

Accompany your child to the doctor.

Follow through with the treatment plan.

What you can expect. How eating disorders are treated.

Adapted from the National Institute of Mental Health

Anorexia nervosa - The first goal for the treatment of anorexia is to ensure the person’s physical health, which involves restoring a healthy weight (NIMH, 2002). Reaching this goal may require hospitalization. Once a person’s physical condition is stable, treatment usually involves individual psychotherapy and family therapy during which parents help their child learn to eat again and maintain healthy eating habits on his or her own. Behavioral therapy also has been effective for helping a person return to healthy eating habits. Supportive group therapy may follow, and self-help groups within communities may provide ongoing support.

Bulimia - Unless malnutrition is severe, any substance abuse problems that may be present at the time the eating disorder is diagnosed are usually treated first. The next goal of treatment is to reduce or eliminate the person’s binge eating and purging behavior (NIMH, 2002). Behavioral therapy has proven effective in achieving this goal. Psychotherapy has proven effective in helping to prevent the eating disorder from recurring and in addressing issues that led to the disorder. Studies have also found that Prozac, an antidepressant, may help people who do not respond to psychotherapy (APA, 2002). As with anorexia, family therapy is also recommended.

Binge-eating disorder - The goals and strategies for treating binge-eating disorder are similar to those for bulimia. Binge-eating disorder was recognized only recently as an eating disorder, and research is under way to study the effectiveness of different interventions (NIMH, 2002).

REMEMBER!!

All eating disorders require treatment. Earlier treatment results in a higher success rate. Act now.