A Terrific summary: How Parents Can Help Their Child Recover from an Eating Disorder

This 8-page document published in 2007 by the Hamilton Health Sciences McMaster Children's Hospital in Ontario, Canada offers a wonderful summary of not only how but also why parents or any team member(s) need to work together to help their loved one recover from an eating disorder.

The booklet provides important topic headings and then a list of the usual challenges that people will face during their partnership to help their loved one recover.

• Guiding principles for parents
• What BOTH OF YOU can do to help your child
• Facing challenges together including nutrition, exercise, emotions, and scheduling

I particularly liked the format of listing the challenges on each of the above four topics and then the discussion about the challenge.

The document's authors also highlight the value of and importance of reading Help Your Teenager Beat an Eating Disorder by Dr. James Lock and Daniel Le Grange, PhD.  The 8-page booklet is a wonderful introduction to the principles provided in Lock's and Le Grange's book.  Highly recommended!!

Post Traumatic Stress Disorder

[Warning:  this may be triggering to those on the path to recovery from an eating disorder.]

The National Institutes of Health website includes a document on Post Traumatic Stress Disorder.

As the article notes, PTSD is a type of anxiety disorder.  It can occur at any age.  It can follow a natural disaster.  It can follow traumatic events.  The causes listed include:

• Assault
• Domestic abuse
• Prison stay
• Rape
• Terrorism
• War

I believe that PTSD can occur to those who are witness to the destructive effects on a family member of serious diseases like cancer and an eating disorder.  One study documented that some family members are still feeling the effects of the trauma of cancer in a young family member 10 years after the event.

Wait, you say.  But eating disorders?

Yes.  Eating disorders are biologically based brain disorders that affect the behavior of people who develop them and affect family members who more often than not become distraught by the changes in personality and physical health that occur in their loved ones.

Yes.  It is believed that eating disorders are the deadliest of all brain disorders .  "Anorexia nervosa (AN), in particular, has the highest mortality rate of any psychiatric disorder.  Risk of premature death is 6-12 times higher in women with AN as compared to the general population, adjusting for age."   Work is continuing to reduce that number and, in fact, the number may have been reduced somewhat by the knowledge that has been gained in the past couple of years including the increasing visibility of family based training (FBT) and what is referred to as the Maudsley Method, first developed at Maudsley Hospital in England.

But, still.

So, to those who leap to the conclusion that a family member exhibiting behaviors that seem like PTSD
Quote from the linked article:
PTSD can cause many symptoms. These symptoms can be grouped into three categories:
1. Re-experiencing symptoms:

• Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
• Bad dreams
• Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.
2. Avoidance symptoms:

• Staying away from places, events, or objects that are reminders of the experience
• Feeling emotionally numb
• Feeling strong guilt, depression, or worry
• Losing interest in activities that were enjoyable in the past
• Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.
3. Hyperarousal symptoms:

• Being easily startled
• Feeling tense or “on edge”
• Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.

---

 or who appears to have  become or is enmeshed with the loved one with an ED, stop for a moment and think about the trauma that a parent especially often goes through when their child or adolescent or even adult child or spouse [only some behaviors are listed here of the many that occur]

• stops eating
• loses weight dramatically
• exercises compulsively, sometimes late at night or in their room behind a closed door
• becomes violent and abusive day after day after day when presented with food and asked to eat
• gets up after everyone has gone to bed and eats everything edible in the refrigerator or pantry and then either vomits the food into the toilet, into plastic bags they store in their bedroom, or into the garbage bin, or in the shower (while the water is running and running and running)
• turns to cutting, drugs and/or alcohol in an attempt to subdue their anxiety when presented with food that to them increases their anxiety when they eat or that helps them get through the cycle of binging and purging
• tries to separate family members such as the mom and dad so they can continue their ED behaviors because one of the parents may not believe the situation is as serious as a medical emergency, which eating disorders are
• drinks water to the point of hyponatremia or purges food and therefore electrolytes resulting in a visit to the ER only to receive an IV that corrects electrolytes and then sent out the door within 24 hours because they are determined to be "stable" even if they are visibly emaciated
• uses laxatives even though either there's nothing in the intestinal tract to process or because they believe the laxative will interfere with digestion and absorption (doesn't work, actually) and again terribly interfere with their electrolyte balance
• is ejected from a residential facility because their behavior is disruptive to other patients and the facility does not have the staff or the treatment area to help them through the rage phase 
• emerges from a long residential treatment only to return to those behaviors
• or even dies no matter what treatment has been available and/or provided

How helpless and angry a parent can feel  when they are blamed for an eating disorder even though in multiple children households no one else exhibits or exhibited eating disorders at the same age or even if they do; when their family is labeled dysfunctional because when they finally seek help they are all torn apart by watching what has been happening; when they cannot scrape together the funds to pay for treatment that may or may not -- after many attempts -- work; when their insurance policy listed as comprehensive only provides 10 days or a month of treatment when research is showing a person needs a full year at least of complete and steady nourishment in order to even get on the path to recovery; when there is no one for them to talk to/with because a support group is not available or they themselves cannot afford supportive therapy to cope with the horror of what is occurring in front of them.

I have touched upon some of this in my essay here on this site.  I am grateful for the support I have found among friends, at an Al-Anon weekly meeting I attend without fail unless I am out of town, by working with a therapist who "gets it" and who has worked with me so I have the tools to keep going, from the people on supportive websites such as Something Fishy and Around the Dinner Table/F.E.A.S.T., and by working with a team of professionals to address the effects of this horrid, horrid disease on my family member.

PTSD is very real among us parents.  It can disable us when the illness goes on for months or even years (and to some parents even a few weeks can feel like a very long time).  If you are reading this and are a professional who is working with a child or adolescent or adult and often seeing his or her parent or significant other in the waiting room, please remember to ask her or him how they are doing and if they need help.  Recommend that they carve out some time for themselves to do something they enjoy even if it's only a nap or a brief walk with the dog or a date with their significant other.  Recommend that if they can afford to, to see a professional themselves.  If you have time, develop a list of  resources for that parent or significant other.

It can be for some a very long road and sometimes the light just doesn't seem to appear.

Hope for those fighting depression?

Help for those fighting depression for which nothing seems to work? 

This morning's Wall Street Journal (January 3, 2012, p. D3) reports that Deplin, a prescription form of the B-vitamin folate, provides L-methylfolate "....which is needed to produce serotonin, dopamine, and norepinephrine, three neurotransmitters that are critical in regulating mood." 

Here's the link. 

 

[coming back later with more details......]

 

 

Laughter is the Best Medicine

For years, I eagerly opened Reader's Digest and read the section titled "Laughter is the Best Medicine."  In fact, eventually a book was published with the same title that contained many of the stories included in that column.  My mother subscribed for a very long time and when she and my father moved here to Tucson, I rarely turned down the opportunity to catch up with the column.

Another proponent of laughter (and a whole bunch of other things that sustained him for years and I believe enriched the world we live in) was Norman Cousins.  I came to know of him because one of my classmates in eighth grade was one of his children.  I also met him, so to speak, through the pages of the Atlantic Monthly (one of my favorite publications for many years) for which he was an editor.  He was also the editor of the Saturday Review in which he once published an article (also appeared in the New England Journal of Medicine) that eventually became part of a book titled Anatomy of an Illness.  The story also became a movie starring Ed Asner as Mr. Cousins.  Here's the movie plot summary.

The effect of his book under the title "Laughter Remains Good Medicine" was also written about in Science Daily.

So, what's my point?

My son, his wife, and their two boys (my grandsons) flew here to stay nine days with us over the holidays.  After a good night's sleep the evening of their arrival, we soon were introduced to -- among many things -- Olivia, which is my younger grandson's favorite show on Nick, Jr.  If you haven't met Olivia yet either through the book  or the show, I invite you to listen to the theme song.

The ten days they were here were packed with laughter, adventures in our yard, trips to fly a model airplane, and photography (we gave our eight year old grandson his first camera which yielded many photos including this one):

We enjoyed a lot of sunshine and fresh air, too, thanks to Mother Nature who provided some of the best holiday warm weather we've experienced in a while. 

One would think that after they left the house was too quiet (true) and sad (actually, not true since the joy experienced here is still vibrating in the walls, I think).

But, oh do we miss them all!!

However, I went to my usual Saturday morning gathering where the topic was dealing with aging and joined several friends in expressing the happiness that comes from sharing time with children.  In spite of discouragement, frustration, and sadness on another front, I realize that I not only feel happier inside, I also am motivated to complete a number of tasks much more sooner than later.  This is a very good thing.  I think laughter had a lot to do with it.