Categories
Anxiety Body Image Eating Disorders Mental Health

Thanksgiving and Eating Disorders: A Mini Survival Guide

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On the heels of my recent blog about fat talk and its negative ramifications, I am broaching the subject of food, anxiety, and eating disorders once again. It’s almost Thanksgiving, after all, a holiday which not only acts as a huge trigger for many suffering from or recovering from an eating disorder, but is often used as fodder for fat jokes and the subsequent fat talk. As if sitting down to dine with your already dysfunctional family isn’t enough.

As we set our gaze upon Thanksgiving and give thanks for all that we have, those suffering from an eating disorder may be having an entirely different experience. For one thing, the entire day is purportedly built upon the foundation of food; one is expected to eat…a lot.  With an eating disorder, those expectations can bring about a legitimate sense of fear, shame and anxiety. For example, an anorexic may be overly concerned with the appearance that he or she is not only eating, but enjoying a “normal” amount of food, while someone suffering from bulimia or binge-eating disorder may struggle with trying to manage their urges to binge and/or purge.  For both, there are triggers everywhere, from the wide array of food being offered to someone’s not-so-subtle commentary about your, or even their, current weight, shape, size, et cetera.

Eating disorders and disordered eating are complex conditions, emerging from a combination of behavioral, biological, psychological, emotional, interpersonal and social factors. For many, food becomes the one thing that is controllable, giving someone who feels inherent powerlessness some perceived power. My own experience is just that: I grew up in an out-of-control, dysfunctional environment, where food was used as a vehicle for mixed messages; controlling its intake became paramount to my own survival. Or at least I thought it did. What it really ended up doing was leaving an indelible mark of low self-esteem and body dysmorphia. I still occasionally encounter negative behaviors from some family members when I see them, but now I view it as an opportunity to stand up in the face of adversity, plant my feet in my recovery, and dine with dignity. See here for NEDA’s “Factors that may Contribute to Eating Disorders.”

Some things to think about for the holidays:

Get support: either via a therapist, a sponsor, or a good friend. Make sure that you have someone you can lean on during this holiday season. You don’t have to manage Thanksgiving alone.

Make a plan: I always make sure I have what I call an “escape” plan for these sorts of things. In other words, make yourself a schedule so you don’t have to wing it.

Don’t skip meals in “preparation” for the holiday: Maintain your regular eating schedule that’s become a part of your recovery. For example, don’t skip breakfast so you can “have room” for the Thanksgiving meal.

Ignore and don’t engage in the fat talk: It’s neither an act of self-care or helpful. If someone is engaging in this age-old, negative behavior: walk away or disengage. Other people’s issues surrounding food are not yours to manage.

Be kind to yourself: If you fall down and slip into old behavior, don’t use it as a springboard to self-destruction. Allow yourself to enjoy the things you like. I find that knowing my triggers allows me to navigate the stormy sea of family and impulse with better judgment. You can do this!

Breathe: Yes, that’s right. Breathe. If you’re feeling overwhelmed, take a step back and take 10 deep breaths and find your center. This really does help. (This is also the other reason bathrooms exist!)

Lastly, remember what Thanksgiving is really about: It’s not about the food. Not really. It’s about being grateful for those around you and for the blessings in your life. Bask in the glory of your recovery and sobriety, for without those, the least of your worries would be whether or not you can eat a piece of pumpkin pie!

Resources and articles used as reference:
Categories
Addiction Alcoholism Anxiety Mental Health PTSD Recovery

Addressing Recovery and Trauma

Image by Southworth Sailor via Flickr

A history of sexual violence can create an ideal environment for a variety of mental-health issues, addiction, and alcoholism. Often, the triggering event or events are hidden in the annals of one’s mind and perceived as shameful, deep, dark secrets too horrible to share…with anyone. As a result, drugs, alcohol, and risk-taking behaviors are often seen as the primary issue when one enters treatment. Time and again, we see that this isn’t always the case; That becomes clear when we look at it in terms of statistics:

  • One out of every 6 American women has been the victim of an attempted or completed rape in her lifetime (14.8% completed rape; 2.8% attempted rape)[1];
  • 29% are age 12-17;
  • 44% are under age 18;
  • 80% are under age 30.; 12-34 are the highest risk years.
  • Girls ages 16-19 are 4 times more likely than the general population to be victims of rape, attempted rape, or sexual assault;
  • 7% if girls in grades 5-8 (approx. ages 10-13) and 12% of girls in grades 9-12 (approx. ages 14-17) said they had been sexually abused;
  • 3% of boys grades 5-8 and 5% of boys in grades 9-12 said they have been sexually abused[2].

As I frequently tweet Intervention, one of the things I notice on a regular basis is the consistency in which the women on the show are frequently struggling with a history of sexual violence, and are using drugs, alcohol, and promiscuity as their  primary coping skill. From the outside looking in, it’s clear that the goal is to try to desensitize and anesthetize feelings of shame and guilt, et cetera; in other words, do anything and everything NOT to feel, remember, re-experience, or suffer from the emotional attachment to the event itself.

Twelve-step programs were written with specific goals in mind: to stop the alcoholic/addict from drinking and using. The steps work well in that regard, mostly because they are based on the disease model, addressing issues of alcoholism and addiction accordingly. However, the same tools provided to address addiction issues don’t always work in concert with mental-health issues, particularly those attached to sexual violence. We know the steps adequately provide an alcoholic/addict with the necessary skills needed to learn to take responsibility for and subsequently change their negative behaviors. They do so by asking the addict/alcoholic to take responsibility for their actions, face their fears, and acknowledge that they took part in creating their own demise. However, being sexually abused or raped isn’t a negative behavior to be changed but rather a causative, biting factor in things like:

  • Depression
  • Post-Traumatic Stress Disorder (PTSD)
  • Alcohol and Drug Abuse
  • Suicidal Ideation
  • Eating Disorders

What then, do we do from a recovery standpoint when the predominant disease model isn’t geared to address issues of this caliber? The Big Book, the 12-step primer, was written by men addressing men’s issues, in a time when women were typically viewed as the ones affected by their spouse’s alcoholism and not as the alcoholics themselves. As more women began to come forward as alcoholics and addicts, the tools didn’t always adapt to the new issues that arose because of gender disparity, but rather, they stayed the same, assuming a one-size-fits-all mentality.  In the cases of women dealing with sexual violence, being asked to take responsibility for an abuse event has the potentiality to create more or actually deepen the existing trauma, particularly if the innate issues of shame and guilt associated with it are ignored. The reality is, being victimized by sexual violence is not the fault of the victim. What does need to be addressed, however, is the anger, self-victimization, and negative behavioral byproducts occurring as a result.

We clearly have a multi-layered healing process on our hands, so first, the negative coping skills must be eliminated: Sobriety is an obvious first step and necessary component to support the healing process. Additionally, working with meditation and mind-body awareness techniques are also useful in helping one manage their anxiety, negative feelings toward oneself, and in re-building self-esteem. A therapist skilled in treating PTSD and this sort of trauma is also important, particularly since this is often a lifelong process.

It is in forgiving ourselves that we have the ability to become free.



[1] National Institute of Justice & Centers for Disease Control & Prevention. Prevalence, Incidence and Consequences of Violence Against Women Survey. 1998.
[2] 1998 Commonwealth Fund Survey of the Health of Adolescent Girls. 1998

Sources and support:
RAINN
One in Four
National Coalition Against Domestic Violence

Categories
Anxiety Mental Health Obsessive-Compulsive Disorder (OCD)

Destigmatizing OCD

 

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OCD is a form of anxiety occurring when the brain has difficulty dealing with worries and concerns. As a result, someone with OCD will constantly worry and obsess over things that may seem banal to a non-sufferer. For some kids, their worries are focused on cleanliness or germs, resulting in repetitive hand-washing rituals. For others, it could be repeatedly straightening out an area, trying to achieve perfection. These obsessive and repetitive behaviors are done ritualistically or compulsively in order to quell the pervasive anxiety induced as a result of obsessive thought patterns. Often, an OCD sufferer will focus on things being in “order” or “just right,” also as a means to reduce the lingering, scary thoughts infiltrating their minds.  While some kids may recognize they don’t need to act on these behaviors, the disorder itself propels then to do it anyway. It’s not their fault. Interestingly, acting on the repetitive thought patterns does minimally reduce the anxiety, albeit temporarily.

I want to point out that worrying is also a natural part of childhood, so is having small rituals (like wearing your lucky t-shirt before a game), being super organized, double-checking to make sure the door’s locked, et cetera. Kids and teens naturally worry about things, be it school, whether they’re liked, whether they “look cool” for school or to impress that guy or girl, or whether their parents are ever going to get along. With OCD, these rituals become extreme. So, if you notice repetitive, ritualistic, and compulsive behaviors becoming more extreme and negatively impacting one’s day-to-day life, then it’s appropriate to take a closer look at the cause and take action.

That means seeing a psychologist or psychiatrist who will ask questions about obsessions or compulsions. Some of these questions may include:

  • Do you have worries, thoughts, images, feelings, or ideas that bother or upset or scare you?
  • Do you feel you have to check, repeat, ask, or do things over and over again?
  • Do you feel you have to do things a certain number of times, or in a certain pattern?

Once the diagnosis is made, then treatment can begin. Cognitive Behavioral Therapy (CBT) is a preferred treatment for OCD. A CBT therapist will work with a child or adolescent with OCD and help them learn that they are in charge, not the OCD. Often the CBT will integrate Exposure and Response Prevention (ERP) as part of the treatment. With ERP, the strategy is to gradually expose the sufferer to their trigger (fears) so they can develop skills and learn not to respond to them with such urgency. The process allows the OCD sufferer to begin to recognize that their fear is just that: a fear, not a reality; it also helps the brain “reset” the very mechanisms that trigger the obsessive behavior. It’s important to remember that treatment for Obsessive-Compulsive Disorder takes patience, time, diligence and hard work.

Remember, there is no shame in asking for help or in getting treatment. Having OCD doesn’t mean you’re crazy, or broken in some way. There is a solution.

Categories
Anxiety Bullying

Bullies: Not My Child!

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In today’s seemingly accepting society, why does bullying continue to be such a terrible epidemic? Why are gay teens still heavily targeted by kids in schools and social settings? And why are kids who are outside of the normative pop-culture box automatically seen as gay or weird? I see this behavior even at the elementary school level, where the biggest insult a child can throw at someone they don’t like is a gay slur. We have a problem–one that’s resulted in numerous suicides by teens breaking under the pressure of needless harassment and hatred.

Schools have anti-bullying programs in full effect, and in many ways, they are effective in eliminating the acute bullying attacks that kids experience. What is missing, however, is a way for kids to deal with the subtle bullying that continues to happen in the hallways and playgrounds. For instance, a child that alerts an authority will often fall subject to additional bullying for “telling,” enduring the continuation of threats and shaming albeit in subversive and low whispers. This goes on to create an intensely hostile environment for the victim and those who witness this behavior. I worry that the gap between the administration and hallway socialization is ultimately pushing bullying underground.
When children feel threatened, they cannot learn,” says Arne Duncan U.S. Education Secretary. Time and time again we see a bullied child revert inward to escape the emotional trauma induced by bullying antics, leaving things like school work on the wayside. Honestly, fractions become banal when one’s fighting for their survival on the social level.

Many things define bullying:

  • Verbal: name-calling and teasing.
  • Social: spreading rumors, leaving people out on purpose, breaking up friendships
  • Physical: hitting, punching, shoving
  • Cyberbullying: using the Internet, mobile phones, or technology to cause harm.

Remember, an act of bullying can fall into any of these categories, be it in one area, or several.

The BULLIED may:

  • Have higher risk of depression and anxiety, including the following symptoms, that may persist into adulthood:
    • Increased feelings of sadness and loneliness
    • Changes in sleep and eating patterns
    • Loss of interest in activities
  • Have increased thoughts about suicide that may persist into adulthood. In one study, adults who recalled being bullied in youth were 3 times more likely to have suicidal thoughts or inclinations.
  • Are more likely to have health complaints. In one study, being bullied was associated with physical health status 3 years later.
  • Have decreased academic achievement (GPA and standardized test scores) and school participation.
  • Are more likely to miss, skip, or drop out of school.
  • Are more likely to retaliate through extremely violent measures. In 12 of 15 school shooting cases in the 1990s, the shooters had a history of being bullied.

And the BULLY may:

  • Have a higher risk of abusing alcohol and other drugs in adolescence and as adults.
  • Are more likely to get into fights, vandalize property, and drop out of school.
  • Are more likely to engage in early sexual activity.
  • Are more likely to have criminal convictions and traffic citations as adults. In one study, 60% of boys who bullied others in middle school had a criminal conviction by age 24.
  • Are more likely to be abusive toward their romantic partners, spouses or children as adults.

And the WITNESSES:

  • Have increased use of tobacco, alcohol or other drugs.
  • Have increased mental health problems, including depression and anxiety.
  • Are more likely to miss or skip school

Where the concern lies mostly in helping the bullied, and punishing the bully, it helps to remember that the latter is suffering as well. What makes a bully is often times another bully. It’s important that in our ardent efforts to heal the effects of bullying, we don’t forget to examine the cause. If you discover that your child is the bully, get them help. Find out the cause of their violence and do something about it.

Bullying impacts everyone: the bullied, the bully, and the witness. No one gets out unscathed.

Statistics sourced from:
StopBullying.gov

Get into ACTION:
Challenge Day (www.challengeday.org)

Categories
Addiction Anxiety Depression Mental Health Obsessive-Compulsive Disorder (OCD) PTSD Recovery Therapy Treatment

MDMA: Is This Psychotropic Drug Helpful, Harmful, or Both?

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Last time I wrote about ecstasy, it was about the rise in ER visits and the inherent dangers of using a drug that inevitably depletes one’s levels of serotonin and has the potentiality of long-term brain damage. So, when I came across an article talking about using MDMA (ecstasy) to treat post-traumatic stress syndrome (PTSD), my curiosity was sparked. Psychedelic drugs have been used to treat mental illness before, and with some success: In the 50s and 60s, psychology was in a Freudian phase, viewing psychological issues as conflicts between the conscious and unconscious minds. At that time, psychedelics were used to allow patients to face their unconscious minds while awake, which purportedly eliminated the variables of memory retrieval. Still, these methods of treatment weren’t without controversy.  With the influx of street use, and folks like Timothy Leary telling people to “”Turn on, tune in and drop out,” the use of psychedelia to treat mental illness was met with great discernment and fell to the wayside.

Currently, interest in using MDMA and other psychedelics to treat depression, obsessive-compulsive disorder (OCD) and PTSD is gaining traction. MAPS is doing extended research on this subject, and states that MDMA isn’t the street drug we call ecstasy, noting that while ecstasy contains MDMA, it also may contain ketamine, caffeine, BZP, and other narcotics and stimulants. According the MAPS site they are “undertakinga 10-year, $10 million plan to make MDMA into an FDA-approved prescription medicine.” They are also “currently the only organization in the world funding clinical trials of MDMA-assisted psychotherapy. For-profit pharmaceutical companies are not interested in developing MDMA into a medicine because the patent for MDMA has expired. Companies also cannot profit from MDMA because it is only administered a limited number of times, unlike most medications for mental illnesses which are taken on a daily basis.”

The use of this drug has leaned so far from its psychotherapeutic roots, proving to be one of the most popular, highly sought-after street drugs around. Because of this, the useful aspect of this drug may easily be overlooked, forcing us to question how we can take something that has morphed into a social enigma and call it useful. I’m curious, will sufficient research place this drug at the discerning hands of medical professionals once again? And how do we, as a recovery community accept this when we have kids coming in suffering from the long-term, negative effects caused by this very drug?

Related articles:

MDMA May Help Relieve Posttraumatic Stress Disorder(time.com)

Ecstasy As Treatment for PTSD from Sexual Trauma and War? New Research Shows Very Promising Results (alternet.org)

Clinical Study of MDMA Confirms Benefits Noted by Therapists Before It Was Banned (reason.com)

Neuroscience for Kids

Ecstasy Associated With Chronic Change in Brain Function

 

Categories
Anxiety

Can We Shut Off Anxiety?

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Anxiety is among the most common psychiatric disorders as well as a contributing factor for major depression and substance abuse, affecting around 18% of the population (Adults 18 and older). Adolescents aren’t exempt from this, though. Anxiety in the teen years is quite common. For some, “anxiety often hums along like background noise,”  but for others, it can become a “chronic, high-pitched state, interfering with their ability to attend school and to perform up to their academic potential.” It can create difficulties with making and keeping friends, participating in activities, and even having positive relationships with family. Anxiety can be present itself as simply as feeling uneasy in a situation or it can develop into panic attacks and phobias.

Most recently, Stanford University published a paper talking about a new study using optogenetics to look at the brain circuitry involved in anxiety. They used optogenetics to look at the amygdala (the part of the brain responsible for emotional processing) for answers. They discovered when the amygdala was stimulated in mice, the mice were able to explore spaces where they had previously shown fear. Interestingly enough, “The anxiety-reducing brain circuit is located — counterintuitively — in a part of the brain that is typically associated with fear, which may explain why scientists have overlooked it before.” What this will do for humans will take time to research, but the findings in this study are encouraging.

While the scientists continue to work toward discovering better treatments for anxiety and fine-tuning this particular study, we still need to be aware of symptoms and behaviors that may be affecting us or someone we care about.
Symptoms can include: restlessness, vigilance, signs of extreme stress; in social settings, one may appear dependent, withdrawn, or uneasy. There may be some physical symptoms as well, like stomachaches, headaches, fatigue, skittishness, and trembling.
Adolescence is tough on its own and this is an opportunity to have a dialogue with your teen so they can have the opportunity to get help before they start self-medicating with drugs and alcohol.

Surely, we would love an immediate answer and “fix” to our anxiety troubles, but it is going to take some time. The good thing is, there is hope that this will lead to new and better treatments. This is definitely a study to watch! 

Categories
Anxiety Depression Mental Health Recovery Self-Harm

Cutting: Beyond YouTube

Cutting is back in the spotlight after a study by TheJournal of the American Academy of Pediatrics brought attention to the high numbers of YouTube videos showing teens and young adults exhibiting self-harming behaviors. By simply typing “self-harm” and “self-injury” into YouTube’s search engine, Dr. Steven P. Lewis, et al, discovered numerousvideos showing various levels of self-harming behavior.After extensive review and documentation, these were the findings:

“The top 100 videos analyzed were viewed over 2 million times, and most (80%) were accessible to a general audience. Viewers rated the videos positively (M = 4.61; SD: 0.61 out of 5.0) and selected videos as a favorite over 12 000 times. The videos’ tones were largely factual or educational (53%) or melancholic (51%). Explicit imagery of self-injury was common. Specifically, 90% of noncharacter videos had nonsuicidal self-injury photographs, whereas 28% of character videos had in-action nonsuicidal self-injury. For both, cutting was the most common method. Many videos (58%) do not warn about this content.”

Researchers worry that these videos might lead to a normative view of cutting and self-harming. As one who self-harmed for years (even into my sobriety), my concern isn’t whether or not this will be viewed as normal, but rather, is anyone taking action and listening to this loud cry for help?
It’s not fun to self-harm. It isn’t a source of pride. It’s not something you share with those around you. It’s not something you do to feel “a part of” or to be “cool.” For me, it was something I did to actually feel because I was so numbed out. In the flash of the adrenaline rush, I felt alive and present when I self-harmed. I felt like it was the only way to feel “real” in my otherwise surreal life. I also felt immediate and devastating shame. It was scary. It was embarrassing. Having to explain abhorent injuries to the curious when the perpetrator is you is nightmarish.
Getting help took an act of bravery on my part. I had to tell someone. I had to talk about it…openly. I had to face my shame and fear so I could transform it into something positive. I had to do some deep, spiritual work in order to learn how to turn self-harm into self-care. I continue to do this work, so I can  revel in self-care and be of service to others. I had to build a fellowship of support that would be there if I slipped back. I empathize for the kids on YouTube. I hope someone reaches out the hand of recovery and lets them know they don’t have to hurt like that anymore.

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