Postscript : When the Financial Well Runs Dry - Minnesota leads the way

This article that appears in Minneapolis-St. Paul Star Tribune illustrates what can be done when insurance companies "get" that treatment for eating disorders is not only critical but also a necessarily prolonged process in order to help a person fully recover from an eating disorder.

In case this article is not accessible to the public beyond this week which often happens, the article written by Chen May Yee of the Star Tribune in the Lifestyle section on December 25, 2010 notes that treatment for eating disorders is available in Minnesota at a far higher level than in others due to "...the willingness of the state's insurers to pay for treatment." 


Two centers are cited:  the Melrose Institute in St. Louis Park Minnesota and the St. Paul-based Emily Program.  The Melrose program admitted ten percent of its patients from out of state and the Emily Program admitted six percent from out of state, according to the article.  The Emily Program has expanded to seven locations within the state.  The Melrose Institute apparently is considering opening another center in Twin Cities.


This development was spurred by an important and successful lawsuit ten years ago by Kitty Westin and her family after the death of her daughter when Blue Cross/Blue Shield failed to provide adequate treatment.  Now, to quote Dr. Murray Zucker, identified in the article as a medical director with OptumHealth, the care management arm of United Health Group, "...From a cost-effectiveness standpoint, it makes sense to treat eating disorders as quickly as possible and in as efficacious a way as possible."


I hope the national headquarters of these and other insurance companies will step up rather than wait for a similar lawsuit in other states.  To repeat what was said in the article, immediate and adequate attention to eating disorders can ultimately save hundreds of thousands of dollars for the insurance companies (there's that economic benefit again) as well as many lives.  The work of NEDA and other organizations is certainly important to this process.

Reflections on the team approach - massage therapy

Earlier, I wrote a piece on the team approach to be utilized when a person has been discharged from a residential treatment facility and clearly needs ongoing assistance in the process of recovery that often can take up to seven years.

I've also written twice about oxytocin and this hormone's potential/possible value to the recovery process.

I'm proposing the addition of a skilled massage therapist to the treatment team.  By skilled, I mean someone who has taken some sort of certification in the knowledge about eating disorders and body dysmorphic disorder that can accompany the symptoms of one with an eating disorder.

I believe that part of my recovery was thanks  to the monthly massages I obtained early in my recovery process.  To add a bit of a story to this proposal, I was a single mom at the time and could not possibly afford the luxury of a massage.  Fortuitously, my next door neighbor needed someone to haul out her trash bin and I was strong enough to do it so she paid me.  Each month I accumulated enough money to get a massage.  Touch.  How important that was.  The feeling of wellness that seemed to course through me each time.  Now I know at least part of that was due to oxytocin.  The feeling of lying there and becoming acquainted with touch on my body in a  non-threatening way.  The feeling that I was worth it.  The feeling of where my skin was and how my muscles felt being stretched.

I enjoyed a massage this week and talked about all of this with my massage therapist who is skilled in this area.  She recounted her treatment of those who needed a kinesthetic sense of their bodies.  Imagine if folks could be gradually introduced to their physical sense of self through the wise and trusted treatment of a massage therapist.  Imagine coupling this with the work being done in group and individually!

Reflections on Recovery: out with the old, in with the new

I think some of the most useful developments in understanding concepts in the fields of psychology, neurobiology, and medicine seem to happen when these concepts are applied to things that people who are healthy wrestle with from time to time.

An example, that I think will be translatable for those whose loved ones have an eating disorder or some other harmful/unhealthy behavior, is the topic of the article that appears in today’s Wall Street Journal, December 22, 2010, p. D1.

Sue Shellenbarger, one of my favorite writers for a very long time, has investigated “How to Keep a Resolution – Forget Willpower, Reaching a Goal Means Retraining Brain to Form New Habits.”  The first three paragraphs highlight the hurdle and I’m repeating them here.  I don’t know if the editors will decide to make this article accessible to the public in order to read the whole thing, but I hope so.  Here’s the link.

“As the peak season for making New Year’s resolutions draws near, most people, behavioral experts say, approach the process exactly wrong:  They rely on willpower.

“Willpower springs from a part of the brain, in the prefrontal cortex, that is easily overloaded and exhausted.  What works far better, researchers say, is training other parts of the brain responsible for linking positive emotions to new habits and conditioning yourself to new behaviors.

“When setting a resolution, simply deciding to change your behavior may work for a while.  But when the cognitive parts of the brain responsible for decision-making become stressed by other life events, that resolve is likely to succumb to an emotional desire for instant gratification, says Baba Shiv, a Stanford University marketing professor who specializes in neuroeconomics, the study of the biological bases for making economic decisions.”

Pause here.  For those of you with loved ones working to recover from an eating disorder, doesn’t that sound sort of similar?  And for those who think their loved ones can just quit using their mighty willpower, do you understand now why this can be so difficult?  Willpower just can’t cut it, especially when a person is overwhelmed with anxiety or another brain disorder or whose brain is so malnourished that it isn’t working properly anyway.

Getting on the road to recovery is a process.  And, as I’ve mentioned in other posts here, our society is quite linear whereas recovery isn’t.  It’s very hard work but it can be done.

The article includes techniques for anyone to reinforce the behavior they are hoping to change ranging from overeating to organizing their office to preparing for Christmas.  I think this article would be a great tool for people beginning the process of trying to understand some of the “mechanics” that underlie getting into recovery.

A Swan of a Different Color

I've spent two days mulling over the movie (this next link provides a psychological discussion of the movie and has a couple of spoilers)  Black Swan, which is definitely not the original ballet Swan Lake although the music and the back story are somewhat similar.  In fact, there's been a more recent ballet that places men in the traditional lead roles.  The movie was beautifully done and beautiful.  It was also horrifying.

When I was a little girl (in 1950), my parents signed me up for ballet lessons.  I remember the shoes (by no means was I on my toes then) and the little outfit I wore although I cannot find any photos in my parents' vast collection that would give me any further memory of this.   However, shortly afterwards we moved to Colombia where I was introduced to something like gymnastics but I never returned to ballet.  Until I was in my late teens, I was quite short but otherwise had the slender figure for it.   I've always loved to watch ballet even though I never developed an aptitude for it.

So, when I heard about Black Swan, I wanted to see it in the theater for a larger than life view.  Whew!  A larger than life view it was.  And, I will say right up front here that I do not recommend that anyone see this movie if they are not solidly in recovery from an eating disorder.

This movie reminded me of my growing up experience with Gulliver's Travels.  When I was a little girl, the story was just that, a story.  When I reached junior year in high school, suddenly the story turned into a not so pleasant analysis of people (to make a long story short).

Black Swan became the same for me at several levels.  There is the story of a young woman who wants to be perfect and is compulsive about her work to get to that place.  There is the story of a young woman who is caught up in the requirement to have a lithe body, and what that means in terms of eating or not eating, in this case.  There is the story of a young woman who is striving to separate herself from the girl her mother sacrifices herself for in order to become the independent woman who needs to "let go" and have a life of her own.  Her struggle incorporates other behaviors often seen in those who also have eating disorders and Borderline Personality Disorder.

The mother especially embodied all the horrible theories that have been prevalent in the field of brain disorders -- the person who totally lacks boundaries and is responsible, it used to be/continues to be said, for signs and symptoms of illnesses like schizophrenia and eating disorders.

The struggle that involves the metamorphosis into the young woman we see on the screen is amazing and chilling and the ending left my husband and me totally exhausted, probably because he and I have been far too close to what we saw on the screen.  I suppose that some of us could even interpret the Black Swan to be the wicked ED.  Natalie Portman played this role to, forgive me, perfection, as did Barbara Hershey, Mila Kunis, and Winona Ryder among others.  I believe I have not given away too much here.  Again I would not recommend this movie for anyone who is not totally in recovery.

A Teenager's Brain

Newsweek Magazine has just published another article in the December 16, 2010 issue written by Russ Juskalian about the teenage brain, this one titled "The Kids Can't Help It."  As research continues about the vulnerability of the brain during the maturation process, I hope that more parents will read this information or learn it from their pediatrician or from others to learn how to facilitate their child's journey to adulthood.

"If you really knew me, you'd know that ...." - for parents to consider

"If you really knew me, you'd know that ...." is the title of a thoughtful link on the Something Fishy website and a segue to another post that was shared this morning by Kathleen McDonald of the Eating Disorders Coalition who continues the challenge of persuading our country's legislators to pass the FREED Act, among other things. 

 The link on the Something Fishy website lists some statements shared by those who are and/or were in the throes of an eating disorder.  I think it's important for parents to carefully read through these and just ponder that these thoughts are real to the person even if they do not make sense or seem possible to those who love her or him.  I am not suggesting that you show your loved one the list and ask something like, "do you really feel this way?"  Rather, these statements are a starting point from which a parent can become an ally with their loved one against the eating disorder.  These statements are relevant whether your loved one is still a child or now an adult.

The post by Kathleen McDonald is a presentation she made in 2002.   This is her story; this is her experience.  It is intense yet helpful to understand what goes through the mind of a person with an eating disorder.  I'm reprinting it here with her permission:


"Fighting for Survival: When Treatment Becomes a Matter of Life or Death
Kathleen MacDonald, person recovering from an eating disorder
June 13, 2002

My name is Kathleen MacDonald and I am here before you today to talk about the total devastation and destruction an eating disorder brings upon one’s life, and why equal coverage for treatment of eating disorders is so desperately needed.
It is impossible to condense 60% of my life down into just 10 minutes. I don’t know if I should start at the beginning or begin with where I’ve ended up as a result of having anorexia – which would make the biggest impact on your thoughts? Regardless of where I begin, when I finish, I hope you understand how simply an eating disorder oftentimes begins, and how my life digressed to the devastated plight it is in today because of a simple beginning. You need to hear these details not for the sake of feeling compassion for me specifically, but to know that I, Kathleen Ann MacDonald, a daughter, a granddaughter, a sister, a niece, a girlfriend, a sister-in-law, a best friend, am only one among seven million, nine hundred ninety nine thousand, nine hundred and ninety nine other Americans whose lives bare too close a resemblance to the hell I have lived through day after day for the past 16 years. I hope the details you hear from me today do not make you pause to think about someone you know and love who suffers from an eating disorder, but chances are they will. I hope my words convey to you the misery those of us with eating disorders live through every day; both during the disease and throughout recovery. I hope my words bring you closer to understanding what this mental illness is truly about. And what I hope my words do most today, is convince you to follow the outstanding example of so many of your colleagues, by pledging your support for mental health parity.

Sixteen years ago I watched a movie called, “The Best Little Girl in the World”. Those of you familiar with the movie know that it is based on a young woman who falls victim to anorexia. In the movie, she gets ‘sick’, gets an exorbitant amount of attention, gets taken to the hospital where she makes new friends, and gets better by the end of the two hour long movie – her family and friends acknowledging her more, and her life going on more beautifully than before. The movie made anorexia look easy and attractive. This movie, coupled with all the other messages I received from media, friends, and family, compelled me to take a simple step the next day that would change the rest of my life.

The day after watching the movie, I threw away my lunch for the first time. I was twelve.

The next time I remember eating lunch was 16 years later. You may not believe that I can remember the exact day, but the reason I can recall exactly when I ate my next lunch is I actually called my mother to tell her I was eating lunch. Most people at my age don’t call their parents every time they eat something – they call to tell them about a job promotion or a raise, or to tell them they’ve completed a graduate program. I called because I’d eaten half a cup of soup. It was the first time I ate during the day (outside of a hospital setting) in sixteen years.

I was scared to death that I’d just eaten a ½ cup of soup – part of me wanted to rejoice in feeling healthy, but most of me, having lived without being healthy for so long, did not even know how I was going to go into work that night with a full stomach. I was crippled by the fact that I had food in me and that I would have to be seen in public having just eaten. I was crippled by these thoughts, knowing they were crazy. And I was crippled by the sickness that wouldn’t let me let go of these crazy thoughts. It is a vicious circle that doesn’t let go of your mind once an eating disorder takes control. I called into work sick.

That night I started thinking about what a waste my life had become. I started thinking what a waste I’d been for sixteen years– focused solely on food and whether or not I was fat, disappointing my parents, disappointing myself, disappointing family, losing friends, losing best friends, losing boyfriends, having to leave college, re-entering college and being asked to leave again, losing jobs because I was always sick, lying all the time, depleting my finances, and seemingly never able to get rid of the awful disease that controlled my life and made me miserable.
I finally came to the conclusion that day, that if I couldn’t get better, I didn’t want to live any longer. I wanted nothing more than to die because getting better seemed to be harder than being sick, and the toll anorexia had taken on my life seemed to be greater than my will.

I was compelled to kill myself because of a ½ cup of soup.

Just when I thought I had made a breakthrough in my sickness by eating, my heart sank. The thought of having to live this way for the rest of my life, was unbearable. I was caught in the game anorexia plays with you and won’t let you win on your own. I needed to eat to live, but I couldn’t live with eating. The absolute control this eating disorder retained over my every thought, my ability to like myself, my power to function in any capacity within society, was just that; absolute.

Unlike what I saw in the movie when I was 12 years old, I realized, yet again, that this disease isn’t simple or pretty. The thinness you sustain from being anorexic gets you nothing. I looked at my life, consumed in the torment of contemplating suicide because I’d eaten some soup, and saw the devastation of the disease all around me.

Imagine waking up every day for two years not wanting to wake up in the first place. And then, when you do wake up it is to a life filled with disappointment and regret. The reality of having had anorexia for 16 years had set in. I lived for so long up until that point thinking that my thinness would reward me for all the years of pain. It didn’t.

What it did bring me was over $60,000 worth of debt - that doesn’t include what my parents spent. Twice my parents hospitalized me in a 28-day program costing upwards of $1,000 per day. They paid for therapy sessions – not just for me, but for themselves and for my sister because my anorexia destroyed my entire family’s life, not just mine. I depleted my IRA’s, my mutual funds, and my bank account. I used this money because I couldn’t seem to keep a job for more than a year at a time, and when I did hold a job, I called off sick so often that my paychecks didn’t amount to enough for rent. Because of so many years of being sick, therefore calling off from work constantly, therefore increasing my debt, I now fight every single day trying to figure out what to do – to simply manage. Last week I called a lawyer to discuss bankruptcy; he advised me to file. Bankruptcy is not something one normally associates with anorexia. I know I didn’t, but now I do – every day.

I did have times when I thought I was strong enough to go to therapy and hopefully get rid of this disease. So I made appointments. I canceled most of the appointments - for a couple of reasons. First of all, the overpowering thoughts I had that I was too fat to be seen by anyone, or that the therapist would think I was too fat to be anorexic, prevented me from going. The other reason I canceled appointments, which I needed so that I could stop the insanity of feeling too fat to be seen by anyone, was cost. Most therapy sessions cost $110/hour, sometimes more.

Because of anorexia, I am still in college. I now pay for tuition on my own because my parents grew tired of watching me waste their money when I had to withdraw from semesters because I was sick. I cannot receive financial aid from the government because I defaulted on a student loan, because I couldn’t go to work enough to earn enough money. I cannot receive a loan from a bank because of defaulting on my student loan.

This is only part of the vicious, cyclic toll anorexia has taken on my life. I wake up knowing that if I continue being sick I will die. I wake up therefore, wanting to go to therapy so I don’t die and become a statistic. But, because I haven’t been able to afford therapy for so long, I feel too fat to attend sessions.

I do not want to live my life as a result of anorexia; I want to live my life beyond anorexia and all the years of torment and mistakes made. However, I am scared that I might have been sick for too long now, and I wonder if the costs of anorexia will force me to become part of the 2-5% statistic of eating disorder victims who take their own life.

This is the reality of anorexia. It does not resolve itself easily like in the movie. It is not simply about being thin or getting attention. It is a exhausting mental illness and those of us suffering need help. My life is an emotional, financial, social, and familial conundrum as a result of anorexia. Every day I toggle between starting back up with anorexia (sure suicide) because I have created so many messes in my life, or continuing to try and plod through the cement-like consistency of this nightmare anorexia brought me, that only seems to thicken every day I remain alive.

I never dreamed that throwing my lunch away one day would 16 years later result in me seriously considering suicide– for two years, every day, all day.

I am one of many millions of reasons you need to support mental health parity."


Some people think that recovery is a matter of just quitting.  By the time most parents discover that their loved one has an eating disorder, the eating disorder is already on its way to totally taking over the life of the person.  This situation is a medical emergency.  It's not a matter of "just quitting".  It's a matter of medical attention, re-nourishment, and assistance (not only for the person with the ED, but also for the family members to help them help him/or her).

Others think one can never be in recovery.  I'm here to tell you that one can be in recovery.  I am.  Kathleen is.  Others are.   One can be recovered.  Believe it.  At first your son or daughter may simply need to believe in your belief before they go on to actually believe it themselves.  Your belief is critical and something for them to hang on to as they start on their way.

Reflections on life

Sometimes life takes my breath away.  

Last week, after reading Laura's soapbox offering that morning, I set aside my plans to write more about nutrition and specifically serotonin, to think about my own loved one's struggle and how impossible life would have been without the work that has been accomplished in the world of eating and brain disorders since the diagnosis in the late 1980's.  How much more needs to be done.

Then, the following day I was shocked to read an obituary in our local newspaper that revealed the accidental death of a woman in her prime; a loving, nurturing healer who brought a ray of sunshine into my and others' lives.... and so much more.  Who many in reflection on her life have called an angel for she shined a light on a path for the rest of us.  Who was younger than I but in many ways wiser and older.  Her life and story is not related to the current subject matter of this blog.

I have not been able to write here until today.  She, too, was among our best and brightest and I will miss Marta Kellogg. 

Among our best and brightest

Several years ago, when I was working on a project that needed funds, a colleague of mine suggested I focus on the economic benefit the project would offer to society.    I revised the presentation with economic benefit in mind and noticed that more attention was paid to the proposal.   Later, when I was involved in a major overhaul where I worked, I advised people to do the same and in the process saw ideas, projects and even departments benefit from that change.  The bottom line matters to many people when they are attempting to balance their own budgets.  It’s wise to determine what is valued and point to that value.

This was on my mind this morning when I learned that another battle for the life of a loved one with an eating disorder was lost.  This was on my mind when I heard Lynn S. Grefe, Chief Executive Officer (New York) of the National Eating Disorders Association (NEDA), say that the stage in New York’s Central Park wasn’t big enough for the families who came to represent their lost loved ones at the walk.    

This thought is actually on my mind daily as I learn of people with illnesses ranging from cancer to eating disorders to other brain disorders like schizophrenia who have died from lack of health care, expertise, continuing education, funds, and a host of other variables including sponsored research and especially time.

Pause for primal scream!!!!!!!!!!!!!!!!!!!!!!!!

How does one put a value on a human being?  I know this happens all the time in courts in accident cases, for example, but when you get right down to the nitty gritty, how in the world is it really possible to quantify – in our case – a beautiful (inside and out), brilliant, compassionate, multi-talented, loving human being who can offer the world a mind that could change it.  Who was handed to me immediately after birth and who nursed at my breast.  Who laughed and sang and played beautiful music.  Who, in this person’s case, majored in psychology, minored in math and business, and took every single darned course in architecture even though not admitted into that specific program.  Who can write exquisitely.  Who is still, after more than twenty years, courageously struggling so hard.  How does one quantify this?

Multiply this one person who is struggling against an entrenched eating disorder the claws of which go very deep by hundreds of thousands if not millions of people who in their own way with their own special talents and energy and passion could change the world into a better place.

How does one quantify this?  How can we, the parents and friends, present this information to the policymakers, the rainmakers and the tycoons of the world so they can hear, be persuaded, and pass legislation and/or open their bank accounts to help those families who desperately need the funds, knowledge, health care and the expertise (for themselves and for their loved one) to provide a way out of the terrible pit that eating disorders cause? 

 

Somehow, some way,  it must be done.  I know we can.

Update on research on oxytocin

Perhaps the tipping point has been reached re study of oxytocin.

I've written about oxytocin here earlier.  I'm excited to see the latest research in MSNBC's "My Health News Daily."  Here are some known effects of oxytocin.  There certainly are ways to increase the natural amounts in our bodies, for example massage. 

Children and eating disorders

I just came across this entry in the Huffington Post, added the link to my "Of Note" collection, and provide a link here, too.  The article, titled "Eating Disorders: Identifying Warning Signs in Children",  is written by Melinda Hutchings.  Not only does she note the signs to watch for but also provides valuable tips on how to interact with your child to actually see these signs in action.

Since 60-65% of those who began to fight anxiety disorders early in life go on to develop eating disorders, this is an important addition to the parent tool box.

Nutrition: the brain and neurotransmitters

3/24/19

When I posted this originally, I wanted to take a brief look at the brain and in general the importance of neurotransmitters, the chemical messengers in the brain.   The most familiar to many parents on this journey is serotonin but there are other important neurotransmitters, as well, among them dopamine, norepinephrine and GABA which is really a derivative of an amino acid.  For those who want to learn more, here’s a great synthesis.

I note that serotonin is/may be familiar because one of the first lines of offense for eating disorders other than food are medications called SSRI's (or selective serotonin reuptake inhibitors) like prozac, celexa, lexapro and zoloft.  Take note, though, that many of these medications will not work or will not work effectively until the brain itself is functioning better through nutrition.

This chart linked above reveals that these chemical messengers – the neurotransmitters -- don’t just exist indefinitely in the body.  Rather, they are manufactured in the body which means we must eat foods that are known to help create these messengers.  This is why a full complement of protein, complex carbohydrates, and fats (lipids) is so very important.  We need brain food.  Our brains need on average 500 calories of glucose each day from complex carbohydrates (so the glucose is released slowly throughout the period between eating) to carry out its functions. 

The brain itself is composed of about 78 percent water, 10 to 12 percent lipids (fats) and smaller percentages of protein and carbohydrates and salts.  Again, it’s what’s in the food we eat that matters.  If, for genetic reasons, our bodies do not manufacture enough or manufacture too much of these substances or if we don’t utilize these substances or if the medications we are given interrupt this balance to our detriment, problems develop.

So, for example, for our bodies to manufacture serotonin, we need an essential amino acid.  Amino acids are the building blocks of protein and essential amino acids must come from food sources.  L-tryptophan is necessary for our bodies to manufacture serotonin.  Food sources include dairy and poultry including eggs, especially.  And, if one is taking a medication to block the reuptake of serotonin (e.g. Celexa, Lexapro, and Zoloft) so the neurotransmitters remains available to the neurons (and is therefore depleted eventually), these nutrients are even more important to synthesize more serotonin. 

In addition, remember that serotonin decreases dopamine activity in the brain so the person presumably feels more relaxed and less anxious.  However, if we aren’t eating well to produce the serotonin in the first place, our levels will drop and dopamine, that is manufactured by the body and that is also stimulated by caffeine and nicotine, for example, will predominate.  Excess dopamine can cause anxiety, insomnia, shaking, increased blood pressure, irritability and anger among other things.   Folate and Vitamin B12 are also required for the manufacture in the body of neurotransmitters.  It all works together and an imbalance can cause havoc.

Moderation and a healthy food plan is key.  As material provided by Martie Fankhauser indicates and as the Maudsley Method advocates, “….Work with the healthcare professional [in this case your loved one’s entire team] to be sure that nutrition, sleep (to help the body manufacture more neurotransmitters), exercise (to activate neurotransmitters and to convert melatonin back to serotonin), sun exposure (to combine with cholesterol to manufacture Vitamin D) and hormone balance are brought to maximum potential.”

For me specifically (anorexia/subtype bulimia), I figured out and Martie corroborated this for me in detail, that to prevent the urge to binge and purge, I needed to eat a full breakfast that did not include simple sugars but rather included a good balance of protein, complex carbohydrates and lipids.  I chose eggs and dairy for my protein and lipids as well as fruit for complex carbohydrates.  Later in my recovery when I gained confidence that this method worked, I added whole grain bread and higher protein cereal.  I avoided anything “sugared.”  I also made sure to supplement this with my vitamins and minerals and during the day snacked on foods that would not spike my sugar but rather would introduce, through complex carbohydrates and protein with lipids (like peanut butter), nutrients gradually during the day.   I frankly didn’t know what I was really doing at that point from a nutritional standpoint, but it seemed to make sense so I did it.  I am not saying this will work for everyone with bulimia, either, since we all are different.  But, it’s worth investigating as part of the package.  And, as I’ll mention when I talk about serotonin, there is a serotonin receptor in the gut that encourages vomiting when one creates too much, perhaps from overeating.  One can wonder if our ancestors developed this protective mechanism to avoid becoming too overweight, therefore slower, and therefore unable to go out to hunt and gather.  I hope more research continues about this very interesting neurotransmitter that is so important to bodily function.

In the Spring of 2007, when my loved one was rapidly losing ground and I was convinced that something was going on besides “just” starvation, I learned about the National Alliance on Mental Illness from a friend whose adult daughter was also struggling with a brain disorder.  NAMI maintains a terrifically informative website on which you’ll also learn about a class offered by chapters nationwide called NAMI Family-to-Family Education.  I signed up for the class and was taken through an immense amount of valuable material by two women whose family members had brain disorders and who received training to help us new parents navigate the mental health system with tools and understanding.  We all became educated advocates as a result of this class.   

I would highly recommend it to anyone whose loved one has an eating disorder because eating disorders have been shown to be the result of brain dysfunction, too.  There is a lot of stigma associated with mental illness.  We must get beyond that if we are to help those whose brains aren’t working “right.” 

 

In addition, as I’ve written before and others are emphasizing as well, if upon return to (through testing) that nutrition is maximum but behaviors regarded as abnormal or unusual (as was the case for my loved one) are still continuing, then it’s time to get another psychiatric opinion (or more) to evaluate if another brain disorder is present (what’s known as co-morbidity) in which case the eating disorder may have been your loved one’s way of coping with other imbalances such as an anxiety disorder.

A good example of this compound issue is Marya Hornbacher whose memoir Wasted  (Harper Collins, 1998) was followed ten years later by her book Madness (Houghton-Mifflin, 2008) in which she reveals that she was later diagnosed with Type 1 rapid-cycle bipolar disorder.  Hornbacher's memoir builds upon and adds important information to the earlier published and insightful memoir by Kay Redfield Jamison titled An Unquiet Mind (Vintage Books, 1996).

The fourth week of the NAMI class was devoted to brain biology and the underlying reasons for brain disorders from a chemical point of view.  Each class lasted a couple of hours.  I think it would be helpful for NEDA and other groups that offer conferences on eating disorders to include this session or one like it to educate parents about the workings of the brain and why nutrition is so very important.

Here is a very simple brain map on which you can click to illustrate which areas of the brain are keys to behavior and abilities.  Carrie Arnold's book Decoding Anorexia - How Breakthroughs in Science Offer Hope for Eating Disorders (Routledge, 2013) offers a detailed and in layperson's terms the functions of the different areas of the brain.  More recently even more details have been learned by those studying fMRI brain scans.

Clearly, if the brain is starved (remember, the brain itself needs 500 calories each day to function and it needs the neurotransmitters, that are dependent on nutrition and synthesis by the body, to work), everything falls apart.  If the brain’s chemicals are all messed up by binging and purging (electrolytes and nutrients are vomited  which means the body/brain regulatory systems in their frantic efforts to bring the body back to balance start setting off alarm bells)  biochemical balances that are also key to everything working right are disrupted, too.

Wise nutrition is key.