EATING DISORDERS IN ADOLESCENTS

Eating disorders (ED's) are on the rise. There are approximately 5-10 million females and 1 million males that presently suffer from eating disordered behavior. In addition, it is estimated that at least 80% of American women are dissatisfied with their size, and 1 in 2 women are on a weight loss regime.

Adolescents see images in the media of drastically this actresses and models and believe that to be the norm, and something to strive for. This is believed to be 'beautiful' and 'good'.

While Anorexia is the eating disorder that tends to gain the most public hype, Binge Eating Disorder is actually the most common disorder of the three types. A typical clinical case that I see consists of a young girl that vacillates within all of the disorders: anorectic behavior (restricting), binging (consuming a vast amount of calories typically in one sitting), and at time bulimia (binge/purge cycle).

However it should be noted, that there really is no 'typical' case. ED's can manifest in a multiplicity of different ways and are often found co-morbidly with other disorders; such as depression, anxiety and substance abuse. Gone are the days where it was assumed that the individual with the eating disorder is a pre-teen or teenaged female. Males that are exhibiting ED behavior is increasing. Adolescent males are presenting with ED's or ED like behaviors and compulsivity more often. This tends to create what I call the 'double shame' factor. Males are more reluctant to engage in treatment, for fear of being judged given the predominant nature of female ED's and also have the shame of suffering from the disorder.

What causes ED's to develop?  There are a vast number of theories about what causes ED's. I have come to the conclusion in my clinical work, that there truly is no easy answer. There is no one "cure".

What does tend to be present the majority of the time in these cases (whether male or female) is the following:
- The adolescent lacks positive coping skills in their life to tackle stress, depression, and/or anxiety.
- The adolescent closes off their emotions and feelings, and uses (or restricts) food as a means to put a block on any feelings that arise.
- They may have come from a background with mixed messages about food (all or nothing phenomenon).
- They suffer from low self-esteem and there may be an abuse history of some kind.

In terms of treatment, ED's require a team approach. There must be a primary therapist involved. The therapist aids the client in (as I like to say): 'figuring out why they do what they do, and then doing something about it'. A dietician can help the individual relearn how to eat properly and to develop a solid meal plan. A primary care physician monitors any coinciding health related issues, and sometimes, even an exercise physiologist is incorporated into treatment to help the person learn what is healthy and balanced exercise and activity versus abusive.

**If you or anyone you know is suffering from an ED (or you even suspect they are), do not wait to get help. Statistics have shown that in about 85% of cases, recovery is possible. If left untreated, the behaviors will get worse, and can prove to be fatal.**

Written by:
Tricia Stehle, LMSW
Psychotherapist
Fall 2008


EATING DISORDERS ON THE RISE

I can remember when I first started in the field, a number of years ago, that the majority of eating disorder clientele were between the ages of 15 and 30. That age range has decrease dramatically. Now, it is not uncommon for me to receive a phone call from a distressed parent stating that their child, as young as 5 years old, is asking them how many calories are in a particular food; they are labeling themselves as "fat".

A fairly recent study of 1st through 3rd graders (all female) showed that nearly half wanted to be thinner (source: National Institute of Mental Health, 2007). In addition, almost 85% of 10 year old girls are afraid of being fat.

Both young girls and boys see images constantly throughout their day in the media portraying unattainable body sizes and develop the concept that they should strive to achieve this standard.

When you consider that young children often tag along with their parent(s) shopping, and view the aisle tabloids problaiming how a particular superstar has shed her weight, it is no wonder that children, beginning at younger ages than ever, are striving for perfection when it does not exist.

The average American woman is 5'4'' and 140lbs. The average model is 5'11'' and 117lbs. When you pole youngsters which of the above is most desirable, they are bound to say the model.

Young children need to be educated on what is healthy and emphasize their positive qualities outside of body size and weight. This is where psychotherapy with children suffering from an eating disorder, or in danger of it, can be especially effective. Early intervention is crucial.

Written by:
Tricia Stehle, LMSW
Psychotherapist
Fall 2008
 MOOD DISORDERS IN TEENS: MYTH OR TRUTH?

Often times the controversy occurs as to what is normal in terms of adolescent mood and what may fall under the auspice of a mood disorder. This controversy is a very real debate because many adolescents can present as having extreme difficulty, bouts of anxiety or irritability, and/or severe mood swings. But isn't that what being a teenager is all about? Hormones are raging, bodies are changing, and moods are altering. Sometimes from day to day moods can appear as night and day...and this could all be just a part of normal developmental growth as an adolescent...

Unfortunately, due to this belief, many struffling teens are discounted or not validated, therefore at mood disorder goes undiagnosed and hence untreated.

Research shows that up to 14% of children will have one bought of clinical depression prior to the age of 15. Up to 30% of bipolar patients report having their first episode prior to age 20. These statistics are alarming and certainly give credence to the fact that mood disorders are very real in children and adolescents. Out of 100,000 adolescents, two to three thousand will have mood disorders - out of which 8-10 will commit suicide...definitely a reason to take the subject very seriously.
So the question becomes a matter of differentiating between normal developmental symptoms and/or moods, and those that are out of the ordinary. If you know a teen that is struggling and there is a possibility or a potential for a mood disorder, it is better to take precaution. Always refer to a professional for a thorough assessment of the situation, the symptoms, and the impairments. Professionals that specialize with adolescents would be able to quickly determine whether the stuggles are within developmental limits or whether there is a possible mood disorder. Professionals with minimal experience in adolescent development may misdiagnose, so it is important to refer to a specialist.

Mood disorders can be a manifestation of life's stressful events for an adolescent, such as a death, parental divorce, a move, loss of friendship, etc. More commonly adolescent mood disorders are retrieved either environmentally or biologically, i.e. one or both parents struggle with a mood disorder. The key is to take a genuine interest in the adolescents around you, whether you work with them in a professional manner, or as a family member. Observe, listen, and believe.

Written by:
Leslie Rae Johnsen, MA, LLP
Clinical Director & Director of Adolescent Services
Spring 2008



HOW TO BE AN EMOTIONAL WELLNESS ADVOCATE

I believe as Mental Health Professionals it is our ethical obligation to re-evaluate our own standards of practice as often as possible. We have chosen to invest our careers in the care of children and therefore it is important to look not only at mental health issues but at the whole mind, body, and spirit of the children we serve. Of course we want to assess, diagnoses and treat mental health issues, but often when we take the extra step to explore our clients lifestyle and environment there may be many extraneous factors which are contributing to their struggles emotionally. Ask yourself the following questions.

Have I asked my client/patient/student lately...
     1. How are you sleeping?
     2. Are you getting 3 meals plus healthy snacks daily?
     3. Are you completing age appropriate activities of daily living/ self care?
     4. Are you participating in at least 1 hour of physical activity daily?
     5. What current issues are effecting your home/envrionment?
     6. How are you feeling physically?

Inquiries like these have helped me as a therapist recognize financial crises in a clients' home, medical issues that were not addressed and situations where abuse was occurring. I was therefore able to provide the appropriate referrals to access financial assistance, medical resources and contact protective services when necessary. Remember, if you don't ask, they may never tell. Let us take this as a foundation for our  work with children and be a true emotional wellness advocate.

Written by:
Malissa Wood, MA, LPC, LLP
Director of Children's Services
Spring 2008



MYSTERIES OF CODEPENDENCY

Defining "codependency" can be challenging. In my professional experience, I find that many people aren't sure what it means and if they have "it". It seems to effect people to varying degrees and in different ways. One common thread weaving its way through is when people are driven by compulsion more than by choice, guilt more than peace, and fear more than love. Codependency is not a mental disorder, but many people suffering the effects of it present with anxiety and depression, mood swings, addictions, and low self-esteem. The "Breaking Free from Codependency" group helps participants realize that there really are practical, user-friendly ways to develop emotional and relational wellbeing. Interactive, educational, and visual teaching methods are used. Attendees are encouraged to bring a notebook and pen, and to read Codependent No More by Melodie Beattie. Join in promoting wellness. Refer someone today.

Written by:
Elaine Booth, LMSW
Psychotherapist
Spring 2008

 
   
   
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