How You Can Help A Child With an Eating Disorder

**Trigger warning: this post contains information about eating disorders and anxiety. Please read at your own discretion.**

Kids can be incredibly picky eaters, starting as soon as they start on solids. Two of my three kids are. The other will eat almost anything I cook, and someone will appreciate that one day.

There are differences, however, between being picky, having sensory issues and having an eating disorder. The last example can lead to life long health issues and even death if not treated. A child as young as 7 can be diagnosed with an eating disorder but can be overlooked for many reasons.

Four Kinds of Disordered Eating

Anorexia

  • Eating very little on purpose.
  • Intense fear of gaining weight- there is a fear of looking fat.
  • Distorted body image
  • May use laxatives, diuretics or even enemas to lose weight

Bulimia

  • Overeat and feel out of control to stop doing so
  • Do things purposefully to make up for it, as in throwing up- called purging. To prevent weight gain, they may also use laxatives, diuretics, and enemas along with exercise.
  • Judge themselves on body shape and weight

Binge Eating

  • Overeat and feel out of control
  • Eat large amounts even when not hungry
  • May feel upset/guilty after a binge
  • Often gain weight and become very overweight
  • Usually eat alone so that others do not realize what is going on

Avoidant/Restrictive Food Intake Disorder (ARFID)

  • Afraid of choking/vomiting
  • No other medical issues that would explain behaviors
  • Do not like smell, taste, texture or color of food
  • Lose or don’t gain expected weight
  • No body image issues

How Does an Eating Disorder Begin?

There are signs and symptoms to watch out for, as in with other disorders, but in this case, it can be seen as a way for a child to exert control over the one thing that nobody else can- their food intake. (This list is meant to use to watch for signs, not diagnose. Please consult a pediatrician or other specialist if you are concerned about your child’s well-being.) This information is from Mirror Mirror

  • Refusing to eat
  • Smaller portions
  • Worried about body image
  • Social withdrawal
  • Hiding/Hoarding food
  • Lack of growth
  • Angry when food is offered
  • Menstruation issues
  • Personality changes (irritability, depression, etc)

Did I cause my child to have an eating disorder?

There is not a single cause for eating disorders. There are events that contribute to them, like environment, stressful events, and genes. Some examples are:

  • Poor body image
  • Over-focus on looks/weight
  • Playing sports that focus on weight
  • Mental health issues
  • A family member with an eating disorder

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What are the Effects of an Eating Disorder on My Child’s Body?

The effects on a child’s body can be devastating. Girls can have irregular, if not stopped periods. Children of both sexes can have issues with:

  • low blood pressure
  • constipation and bloating
  • fatigue, weakness and dizzy (from lack of nutrients)
  • delayed puberty, slow/no growth
  • emotional issues- depression and anxiety, suicidal thoughts
  • tooth erosion and cavities

What can I do to help my child?

  • Trust your instinct. If you know something isn’t right, it probably isn’t.
  • Find a treatment provider, either in/outpatient
  • DO NOT BLAME YOURSELF
  • Educate yourself- read everything you can and attend therapy with your child.
  • Do not shame your child for their eating disorder. This can make things worse.

Above information from Kids Health

Some children will need hospitalization due to extreme weight loss and/or medical complications. Some will need medications to help with mental health concerns. Treatment includes counseling (sometimes for the family) and medical care.

A medical professional will complete an exam to assess your child and diagnose an eating disorder if needed.

Being there for your child throughout the process is what they need most. They will need your love, patience, and care while they work on what they need to be a happy, healthy child again.

How Do You Embrace Vulnerability?

Showing your feelings to others can be difficult. There are fears behind it that others may not see and/or understand. Those fears and feelings can be used against you by the wrong people, which is one of the worst things that can happen to your emotional well-being.

This can make you want to withdraw into a shell and shut people out. It can seem easier to shut people out than to let them in and see your not-so-amazing side. Showing others your tears, anger or even your deepest thoughts, can be mentally tiring and tough.

A Big Word with a Bigger Meaning

It is hard to predict who will and will not be the right person to open up and be vulnerable around. Let’s start with the definition, according to Webster’s:

capable of being physically or emotionally wounded: open to attack or damage. (The third definition doesn’t apply to this situation)

Who really wants to be open to attack? Not me. I’m not a fan of being capable of being wounded either way mentioned. My immune system wounds me enough, thanks. I’ve been emotionally wounded enough for a lifetime, starting with my parents’ split when I was a kid and its aftermath.

Basically, my dad literally said in court that my mom could have my sister and I because he didn’t want us. To this day, we still aren’t very close. He didn’t walk me down the aisle when I got married in 2005 and has missed out on a lot of events.

That will mess a girl up and create some trust issues. If you can’t trust people, there goes the idea of vulnerability.

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I used to have a huge circle of friends, thanks to school, work and later college. This continued until 2015 when my life took a very sharp left turn. It took losing a lot of my friends after Jake’s death to realize who my friends really are.

Clue: it definitely isn’t anyone who flips on you at a funeral home. If someone asks you how you are doing (at the wake of someone you were in love with) then says, “This isn’t about you”, then maybe you should look into a new circle of friends.

I opened up to a circle of people that I shouldn’t have. They talked about me behind my back, didn’t believe in me at all, but I didn’t see it that way. I was too busy drinking away my problems.

In response, I blocked about 100 people from my social media and quit my job. I don’t normally recommend this, but it was a matter of my immediate mental health and I do enjoy having a clean legal record.

I have a bad temper, even after therapy, and I knew I would never make it back to that job without someone getting hurt. I also stopped talking to almost everyone that I still spoke to. I didn’t trust anyone and I wasn’t in the mood to try it again anytime soon.

Two things happened: therapy and Sara. She was the first person I was able to open up to in the time after my life blew up, and I had no idea if she was truly as nice as her cousins (Josh and Jordan) told me she was. Learning to be vulnerable again would have to start with her and Matthew.

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A Flower in Bloom

I consider embracing vulnerability as being somewhat like a flower in bloom. It starts out slowly because you have to take your time. It doesn’t happen overnight. This also requires patience, something Matthew had to learn the hard way. He didn’t understand that I couldn’t just forgive him and move on.

I needed space and time to deal with all of the events that made our marriage go bad, figure out if I wanted to stay and what we needed to do to change. This was a huge task to take on, with grieving Jake’s death added to it.

I had to basically relearn how to trust him with my thoughts, feelings and my body again. I also had to work on the anxiety of old thoughts returning, something that I still struggle with. Sometimes I’m like, “Did I really just say that? Is he gonna be pissed? What if he starts yelling at me?”

I learned, however, that if you don’t give yourself the chance to be vulnerable to others, people can see you as cold, as fake. They might see you as something that you aren’t, and that isn’t something you want.

Jake once told me that when he first tried flirting with me, I barely paid attention to him. I was so wrapped up in my own thoughts that I brushed him off repeatedly. He went home, rethought his approach (he was not used to being ignored) and talked to Jordan, who knew me a lot better. I felt so bad because that isn’t me. I apologized. Luckily, he kept speaking to me.

What can you try to be vulnerable to others?

  • Choose people that you can trust. Who is there for you? Who can you talk to about anything? Let trust build over time.
  • Start with small things. You don’t have to tell people everything that has happened in your life. Start with the smaller things- like if you’re having a bad day, if you’ve got a stomach bug and need soup, etc. This helps you build trust in others and realize it’s okay to show a softer side. Over time, it will be easier to let others in and be okay with risking yourself.
  • Remember that you’re not clingy or needy. Opening yourself up to others does not automatically mean that you are clingy or needy. There’s a difference.
  • There might be setbacks, but take the time to learn from them, pick yourself up and move along. This sucks. Mistakes are made. Feelings get hurt. You can and will get through this.
  • If you need to, talk to someone. This was a topic that I worked on for most of my time in therapy. For further reading, please see Rebuilding Trust in Others

If vulnerability is difficult for you, it may be holding you back from some great connections. Consider which parts are the hardest and work on them, either alone or with a therapist. This may take work and time, but your emotional wellbeing is worth the work.

5 Rules for Mental Strength

It is not always easy to be mentally strong. I struggle with this a lot. I’m still working on this one. There are days that I feel fantastic and days that I can barely get out of bed because I feel so badly about myself. I’m sure that many others feel the same.

How does this “being mentally strong” thing work? It’s a little different for everyone, but here are a few ideas:

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Being yourself. This is number one for me. I have fought very hard to be accepted for who I am by my own husband and that’s something nobody should have to do.

People change, and sometimes people can’t accept that. When you are comfortable with yourself, it’s much easier to be strong, because you have more faith in yourself. You know you can get through things. You know that you can tackle what is in front of you.

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Trust yourself. Many of us tend to underestimate ourselves, including me. I’ve made many decisions and second guessed myself, even on picking clothes, shoes and maybe even mascara. This tends to occur when you have low self-confidence.

I’ve learned to trust myself a lot more through therapy-working more to shut down that voice in my mind that says “That’s a bad idea, Wrae. Don’t do it. You can’t pull this off”. When you trust yourself more, you will believe in yourself more. You will make decisions with a lot more confidence, even about the small things.

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Build confidence. As Demi Lovato once said, “What’s wrong with being confident?” First of all, I love Demi. She has an amazing voice, has great style and she’s one of my sobriety role models.

She had a point with that lyric. What is wrong with being confident? I’m not talking about crossing the line and being all-out cocky or anything like that, but knowing what you are capable of and what your limits are.

Everyone has them, physically and emotionally. Don’t feel bad about those limits. For sheer example, I hate spiders, extreme heights, and public speaking.

I had to take public speaking in college and almost had a panic attack once. I was also hugely pregnant with Cameron. My professor wasn’t in the mood to send me into early labor, so he allowed me to give my speech from my seat and things ended a lot better than I had anticipated.

Confidence is good. This also helps with looks and body image- I’m a size 14 now and weigh in at around 170. I do not care to disclose that. I weighed 125 in 2015 before my life imploded and I was a size 4. I have been confident both sizes and weights.

Like every other woman in existence, even the awesome Tess Holliday (my favorite model), I have days where I think I look like crap, but then I remember what my body has been through and will continue to do and move on.

This took a lot of work because, at some points, I didn’t take my 60 lb weight gain well. This confidence can be hard to attain, thanks to social media and Photoshopped images of models. It’s tough to look at, so I tend to look at body-positive models.

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Daily reminders. I remind myself daily to take care of myself- this is a must do. If I don’t take care of myself, who will? I have two chronic illnesses and self-care is a must for both. I also remind myself “One day at a time” because that is how I have set my life up.

I just can’t plan far in the future anymore. Whether it is a phrase, app, or something else that helps, once you set your mind on something daily, it becomes a daily habit to take care of yourself and that leads to and supports mental strength.

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Not caring so much what others think. My mother is 62 and does not care what anyone thinks of her. She has always been like this. She’s small, very feisty, and hilarious. Clearly, these genes have passed on to me.

It took me a very long time to get to the point that I really didn’t care what others think of me, but that’s where I am sitting. It’s not healthy at all to care so much what others think of you, because it will break you down in the end. It erodes your self-esteem when you don’t meet their standards.

Your individuality will fade as you try to be more like others and less like yourself. This isn’t good for anyone.
These tips may be what you need to move forward onto becoming stronger. Take them and consider what else you may need to form more strength within yourself.

A Brief Look at Electroconvulsive Therapy (ECT)

Depression and other mental illnesses have had many different options for treatment since the beginning of psychiatry. In Moving Forward: The Last Fifty Years of Psychiatry I discussed some of the ways that treatments have evolved.

One form of treatment is Electroconvulsive Therapy, otherwise known as ECT. This is used when other, less invasive treatments have not been effective for a patient. It may not work for everyone, but it is still considered a safe treatment.

In its earlier stages of use, electricity was often used without anesthesia, leading to broken bones, memory loss, and other negative side effects. It is commonly used today to treat schizophrenia, bipolar affective disorder, and treatment-resistant depression.

A Glimpse Into the Past

ECT was discovered by accident when early asylum workers (I use “asylum” only because of the time frame in which ECT was discovered) realized that patients that had epilepsy improved after a seizure.

A Portuguese psychiatrist, Ladislas Meduna, started experimenting with different ways to induce seizures. In 1934, he found that a stimulant, Metrazol, produced seizures if given in high doses.

(I’ll wait while you, the reader, cringe.)

This worked because he was able to note that psychotic behaviors decreased after a seizure. The treatment soon became known as convulsive therapy.

However, after a convention on this treatment, the drug was found to produce a feeling of “morbid apprehension” before the convulsions, so psychiatrists began to look for other ways to induce seizures.

Meanwhile, in Italy, at about the same time, a neurologist named Ugo Cerletti was working with dogs to create similar results by delivering electrical shocks to their heads. (Not cool at all.)

There is a legend that he saw the same thing occur in a butcher shop with pigs before they were slaughtered and they were in a coma-like state. He wondered if this would work with humans. Cini and his colleague created the first ECT machine and treated their first patient, a man with schizophrenia.

I wonder, honestly, how they got consent for this.

The treatment worked as they had hoped and the man’s condition improved a lot. In the 1940s, this became a technique all over the world, including the United States. By the 1950s, the earliest antidepressants showed up- the ones that had major side effects, like tardive dyskinesia.

ECT later stopped being used due to falling out of favor with many throughout the US, because it was seen as inhumane and torturous. It has come back into use, and as of 2012, about 1 million people receive it annually. All of this information is from Psychology Today

What are the risks? The benefits?

ECT has been associated with memory loss and difficulty with learning. Some have issues with remembering events that occurred in the weeks before the treatment, but the memory issues can be permanent in some patients. The memory issues usually improve within a few months. ECT may not be an option for those with heart problems because the procedure increases the heart rate.

On the day of ECT, some patients report fatigue, nausea, confusion, and other slight effects. Confusion is seen more in older patients.

The main benefit of ECT is that it is a faster treatment than medication. In some cases, this can save lives.

Is ECT Effective? What are the Steps?

According to Psychiatry.org, ECT creates great improvement in about 80% of the patients that choose it. Some patients are candidates if they become catatonic, suicidal or otherwise need rapid treatment for life-threatening depression.

To prevent the return of symptoms, those who are treated with ECT need to maintain ECT treatment under the guidance of their psychiatrist or another prescribing doctor. They usually also take medication and/or attend therapy.

Most patients receiving ECT will do so 2-3 times a week, totaling 6-12 treatments, depending on their situation.

Getting to ECT:

The patient will need the following:

  • Psychiatric assessment
  • Medical exam
  • ECG to check heart health
  • Informed consent
  • Basic blood tests

The patient, of course, should discuss all options for treatment with their psychiatrist before making any decisions. They should be aware of any risks, benefits and side effects of any treatment plan they choose, ECT included.

The patient is then given general anesthesia and a muscle relaxant. Electrodes are attached to the scalp and the brain is stimulated with a brief series of electrical pulses. The seizure in the brain occurs for less than a minute, and the patient awakens after about 10 minutes.

ECT can be done as an in or outpatient procedure.

Once Upon A Time..

As a Mental Health Associate, I was assigned to accompany patients to two other facilities for ECT treatments once or twice a week. (This was before I transferred to the unit for the kids with autism.)

All of the patients were adults. Their vitals were taken before they left and after they returned. They left very early on 1st shift, meaning about 7:10 AM, and they were not allowed to eat after midnight before treatment.

We sat in the waiting room, were called back and I was allowed to sit in the triage area with the patients but that was as far as I could go. Once they went back for treatment, I had to go back to the waiting room, where I usually read a book until everyone was done.

While the patients were in the triage area, they were taken to the bathroom, just in case they needed to do so. They were hooked up to heart monitors and filled out paperwork.

Once the patients were done with ECT, they stayed in recovery for about 30 minutes, then we went back to the main facility and I took their vitals as soon as we got back so the nurses could track any issues. They were usually hungry and wanted to go back to bed.

I don’t have all the experience there is, but this hopefully gives you a better view.

ECT can be used when other treatments don’t work or aren’t an option. Medication and therapy are additional tools. Anyone who chooses to use this treatment should be well informed before doing so.

What are your thoughts? Leave them in the comments!

Love Through Bipolar

This post might be triggering, as it discusses loving someone with a mental illness, so here is the official **TRIGGER WARNING** Topics discussed in this post include bipolar disorder and loss.

I Was Enchanted

I could go on for a while about all the good things about Jake because there were so many.

But yet, he struggled, like many of us do. When I met him, I really had no idea. Mental illness really isn’t the first thing most people talk about when they first meet someone. In fact, our first conversation was about Julian. However, ADHD and autism is a whole different story from bipolar disorder.

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Jake had beautiful blue eyes and a smile that would melt your heart. I didn’t know that he hid so much, even up until the very last day I saw him, the day before he died.

Meds and the Truth

I’ve tried many medications for migraines and one just happened to be Depakote. This is also used to treat mental health illnesses, including bipolar disorder. We were talking about this one day and finally…

I take that too, but not for migraines.”

What?? Was this it? I’d been waiting for Jake to say something. I’d seen signs of something going on, but I wasn’t sure what. Sometimes we would talk constantly and then go days without speaking. His birthday had just gone by and instead of wanting to hang out, he had said he’d rather be alone. He’d even told me he considered himself as a “project” for me to take on. I didn’t see him like that at all and made sure he knew it.

“What do you take it for?”

He looked away for a minute and then back. “Because I have bipolar disorder.”

Well, then, that was explained. He actually asked me if that changed how I felt about him (nope, not even a little). Apparently, this had caused issues in the past. Some people just aren’t equipped to deal with it, but that’s still really painful for the person involved.

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“The stakes are high, the water’s rough..” – “Ours”, Taylor Swift

Jake’s darker side did make a few appearances, but never once did he get aggressive towards me. We argued a bit, but that’s it. In two years, he only yelled at me twice. Me? More. But then, I’m just naturally loud.

Meds? It’s a well-known fact that many people that have bipolar disorder (and other illnesses) have compliance issues with taking medications, and he was one of them. Along with his brother, I tried to remind and encourage him to take his medications, but it didn’t always work.

Jake and I learned how to read each other- I have always been good at reading others. Thanks to this skill, I was able to tell when he was or wasn’t taking his meds, or when he was or wasn’t having a good day. This helped on his end when I was deeply upset and didn’t want to talk.

He tried so hard to hide this from me, but I still saw everything. I told him that I wasn’t scared of what he was trying to hide. I needed to see it to know what I was dealing with. There were days he just wasn’t the person I knew. He wouldn’t talk or return my texts, but everything was in his eyes.

In his manic episodes, he’d barely sleep, get paranoid (this went really bad a couple months before he died and we didn’t speak for a month), and other things would happen. In a depressive episode, he basically shut down. I would literally have to wait for him to come out of these periods.

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Google Became My Friend

I started researching. I knew a lot already about mental illness, but how to love someone with one? Totally clueless. I learned to give Jake his space, even though it hurt. I made sure he knew I was there when he needed me. I learned not to take everything so deeply, especially if he was agitated and it just wasn’t him. None of this was easy, and it hurt so much to watch him struggle.

This wasn’t perfect, not from the first day. Let’s start with the fact that I’m married. Jake was a huge flirt, and that’s a whole different post. I had to learn that just because he didn’t show me that he cared in the ways I thought he should have didn’t mean he didn’t care at all. He just cared differently. He made sure I took my migraine meds and had breakfast at work, asked me daily how Julian was doing, let me cry, and among many other things, he cared about me for me. That is the best thing he could have done. I did exactly the same for him.

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I know you can’t love someone out of a mental health situation, but you can definitely help them through it. Love helps with that. Jake was a bit quiet and distant in the days before his death, but none of us saw anything like what would happen on September 1, 2015, coming.

It is entirely possible to love someone with a mental illness. Just remember to take care of yourself, don’t let them get away with everything because of whatever they may have and as always, reach out if you need to.

NAMI

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