Eating Disorders

 The fear of gaining weight when there are all these special foods that your teen likes can create the stress of knowing they have to eat, but they don’t want to over eat, gain weight. So they may eat and throw up, called bulimia or skip meals throughout the day or for days so they can eat on a particular day, Anorexia. Make sure your teen is eating small meals regularly throughout the day. You may want to schedule a check-up with your doctor to assess for other medical signs of well being like their blood pressure, pulse and temperature. Other signs they are not doing well can include, light-headedness, poor concentration, irritable mood, keeping to themselves or eating alone and feeling cold when everyone else is alright. Being attentive is the only way to catch things early and not be misled by your teens denial there is no problem.

Depression

Feeling sad around the holidays is not a surprise to many people especially if any major life change has occurred for your teen over the past year: divorce, death, move, or a change with the economy. These changes can make it difficult for your teen to be happy this holiday season. Be sure you check in with your teen and don’t settle for “fine” as an answer. The third leading cause of death among teens is suicide and depression is the most common cause of suicide. Any teen that truly wants to end their life or commit suicide will leave little in the way of signs and so it is important that you look for anything unusual like giving things away, no concern for future events, loss of interest in things that once made them happy. These changes can be subtle so establish a connection to a mental health worker in the event your teen should be on medication or needs other support like group or individual counseling.

Anxiety

Anxiety disorders are very common among teens and can reveal themselves in the way of fear of strangers, counting, checking, or worry. These teens need constant reassurance and this may not seem developmentally appropriate. So your initial response may be annoyance at their lack of independence. Understanding is so important for these teens who can often appreciate that they need more reassurance and discussion than their peers. Still if there are little strides you can make like having them sit next to you at the family function or stay for an agreed upon time, you may get your teen to take baby steps through the holiday season. Safety for loves ones is also a major concern for these teens so constant check-ins via text or calls can help them relax when you are out running errands or traveling.

Substance Abuse

Substance use is such a tricky mental health disorder because substances of abuse are used excessively for so many reasons. Teens with the issues discussed above will self-medicate or try and relieve the pain of the above mental health issues by using substances to either make themselves forget, feel normal or relax. It is not a very effective way to do this and they often end up with a substance abuse problem as well. The desire to numb or escape or avoid is what can drive this even more and you may get so caught up in the substance abuse that you miss the underlying issue that has been driving the use of drugs or alcohol. So it ‘s important that you don’t avoid the issue either. Anything that appears concerning should be addressed. The sooner the substance abuse is addressed the sooner any other underlying issue is addressed eliminating the need for the substances. The forethought of removing alcohol in your home that is easily accessible is a second step after the first step of discussion with your teen about your expectations surrounding alcohol. These expectations should cover substances including alcohol consumed both in and out of the home.

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Eating Disorders are on the rise among women, men, and people of color. The old stereotypes of who had eating disorders no longer apply and this has caused a generation of self conscious teens to levels that have not been previous seen. It is normal for sometime in the tweens for body comparisons to occur. Tweens compare their bodies to their peers and decide that what they have must not be as good. They are too thin, too fat, too booby, too hippy or too muscular. These toos give way to more negative thoughts as there is some rejection from a love interest or comments from others around them on their being too thin, too fat, too booby, hippy or muscular. The negative recording can create a desperation that can begin with a simple diet and progress to a full blown body image and/or eating disorder.

Restricting junk food, then having guilt if it is eaten is a red flag. This should prompt parents to bring their teen to their pediatrician’s office for a weight check. Other variations in diet like vegetarianism or restriction of fats like olive oil and salad dressing can change the body causing complication like fractures, missed periods, slow heart rates, slow breathing, difficulty concentrating, sleep trouble and difficulty regulating body temperature.

It takes a lot of work to counter the negative thoughts of your teen’s body and Be Positive Body Day my just be the first step in trying to counter that message. Because the truth is no matter how beautiful, how thin, or how rich a person becomes without accepting yourself for who you are, you cannot be beautiful enough, thin enough or rich enough to make yourself happy.

Try This: Try making a positive statement about each body part as in I am grateful for my legs that allow me the freedom to step out of my house, walk down the street and run away from negative things. I am grateful for my belly that is able to digest food of all types and doesn’t need tubes in or out to allow me to take in calories or get rid of my waste. These body parts work and I am grateful for that. Building on this as a counter to each negative thought can help your teen develop acceptance and gratitude.

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Body Dysmorphic Disorder or BDD is a mental health condition where the person obsesses over their looks, or the perceived flaws of their looks. They’re never satisfied with the way they look so they are always working on something, changing something or dressing something up. You may be thinking, “this sounds like the average teen,” but if you look closer you’ll see that it is the obsession with flaws, which is really nothing, a crisis they must compulsively do something about.  Without changing the flaw, there is extreme anxiety.

BDD is a coping mechanism to avoid other things that the teen doesn’t want to deal with. It can start with something that is fairly reasonable maybe a legitimate flaw, or relative abnormality that is fixed either by a procedure or surgery, but then it just escalates until 40 surgeries later they are walking around unrecognizable to themselves and others. This disorder can be associated with eating disorders like anorexia nervosa (teens restrict their eating to almost nothing or nothing), or bulimia nervosa (teens binge on food and then do something to compensate for the overeating like vomit, exercise or use laxatives).

BDD can be very disabling causing extreme anxiety about socializing, leaving the house or initiating friendships. Can you imagine asking friends repeatedly for reassurance about your appearance? These characteristics create a certain level of stress for them that can be disabling. This is especially hard when they understand that what they are doing is extreme, but have no control to stop it.

BDD can be treated with cognitive behavioral therapy where the goal is to counter these negative thoughts with the reality of the situation slowly and with hard work decreasing anxiety about their flaws.  BDD may not seem like a big deal, but it is debilitating not only for those with the disease, but those who associate with and love them. So if you know someone that you think might suffer from BDD it is always best to have them seek help early before the patterns of obsession and compulsion set in about their body and change their lives forever.

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In anticipation of all the food, a teen with an eating disorder may begin to accommodate the overeating by starving themselves before the festivities begin. They may have anxiety about family and friends who mean well, but remind the anorexic teen to, eat. For the bulimic, the reverse may occur with secret overeating and hording  food then purging or excessive exercise to rid of the calories.

If your teen has been doing well distracting themselves and developing a more positive body image, the thought of family who have not seen them for a whole year commenting on weight gain or loss might send them into a tail spin. Be prepared for this and have some protective measures in place for your teen.

1. Avoidance

Keep anorexic family members away from your teen or excuse yourself from those gatherings.

2. Rules

Establish rules with extended family to eliminate body image discussion or appearance with your teen. If they can’t do this well then they probably shouldn’t be around your teen, but if they can, they are part of the buffer that should help protect your teen from other family.

3. Time-out

Let your teen know they should make you aware of what they are feeling especially if they’re overwhelmed or anxious. You can even have a secret code to help remove them from stressful or anxiety producing situations (e.g. a thumbs up from across the room). Discussing the plan and establishing a back-up plan can help reduce anxiety.

4. Medical Team

Check-ins with therapists and clinicians increased as needed. These resources help hold your teen accountable as well. They also serve to echo your rules, which give you a break from being the “bad guy.”

The holidays can be stressful for several reasons although they don’t need to be. With good communication and anticipation of potential pitfalls for your eating disorder teen, you can avoid unnecessary setbacks that could have your teen restart treatment or be hospitalized over the holiday season. Your preparation will keep them healthy and safe, home with you.

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