Helping Teens Accept Themselves.

 
   February is National Eating Disorder Awareness month. Honestly, this is not my favorite topic to discuss or blog about, but last weekend I went to a CREDN (Columbia River Eating Disorder Network) work shop. One of the speakers pointed out even professionals, we all bring our inner biases and beliefs about food and our bodies to the table. I can work with alcoholics, drug abusers, depression, anxiety, self-harm without my personal experiences interrupting too much (aka counter-transference). But when we start talking about weight, eating disorders, and body image, all of a sudden, I am very aware of my body, of what I ate that day, and of my own insecurities. Even amongst counseling colleagues "fat shame" is common. "I'm fat." "I'm on the insert latest fad diet here diet." "I keep trying to lose weight." "You look like you've lost weight" said with an approving smile. We rarely hear "I love my body." And if we do, we may resent the speaker. "Why should they be able to be happy with their body when I cannot? What arrogance!"
   Eating disorders are deadly. One of the conference speaker's daughter died of Bulimia one year after the first time she purged. The thought makes me go cold all over. My stomach twists and turns this way and that and I recognize the feeling of helplessness. If you love or have loved someone who has an eating disorder (and statistics indicate you do), you may understand. What can we do to help?
   The conference challenged me to change my thinking and to watch what I say even subtle implications in conversation with others. My goal is to create a space where people know they are valuable regardless of appearance, weight, size, height, or food choices. This environment promotes an atmosphere of healing for those who struggle with their bodies and food. For our little ones who watch our every move, we can role model unconditional acceptance of our own bodies. This is hard but no one ever said it would be easy.
5 Practical Ways to Handle Fat Shame:

1. When someone asks if you have lost weight or praises you for losing weight, try "So you remember me being fatter?" This will discourage their comments.
2. Focus on the underlying feelings: "You sound really unhappy." or "How are you feeling otherwise?"
3. When someone comments on how much they need to lose weight, ignore it and change to another topic. Telling them they don't need to lose weight reinforces their talk. Agreeing with them increases shame. Just as you might ignore and distract an annoying behavior in your child, distract the speaker with another topic like, "How was your weekend?".
4. Put up some boundaries. "That's not a topic I discuss." "I have nothing to say to that." "I prefer not to talk about weight/diets etc..."
5. When someone shames food (i.e. how unhealthy or how many calories etc...), try "It's a insert food of choice, not a genocide." or "How about we just enjoy this?"

Find the approach which works for you. For some humor, even sarcasm can interrupt the cycle. Other's may need a gentler method. Remember 'fat shame' is another form of bullying. Because it is associated with health we may feel it is more acceptable. It's not. Just as we do not judge based on race, we should not judge based on weight. One woman said "God doesn't smile when we eat an apple and cry when we eat cake." Focus on health and listening to your body--not on appearance. Discover what you love about your body.
Spotting an Eating Disorder and What To Do
   Most people who struggle with eating disorders (not just girls), are really good at keeping secrets. Keeping secrets perpetuates the inner, and sometimes family, shame, thus reinforcing the secret keeping. Unlike other mental health issues, many with eating disorders look like they have it all together on the surface. They maintain their responsibilities in jobs and hobbies, have friends, and get good grades--often straight A's. They may be perfectionists. They may exercise excessively, keep track of their food intake obsessively, never eat in front of people, or hide their eating.
   If you are concerned about someone's eating habits, get them help. Working with a doctor, counselor, and nutritionist who are familiar to with eating disorders is imperative for change to occur. Remember, just like physical illness, healing takes time and is a long process. Just like cancer doesn't have a quick fix neither do eating disorders. Those with eating disorders often have a brain chemistry disruption. Ignoring the problem only prolongs it. Connecting them with the right help may very well save their life.
   I want my daughters and sons to love their body, comparing it to no one. I want to train them to listen to their bodies and encourage health. I want them to see people as valuable for who they are rather than having to conform to cultural standards of beauty. I want their definition of beauty to have nothing to do with attraction but to include inner qualities such as grace, kindness, and respect. Is it possible? I don't know but I am determined to work to facilitate the change so my children can love and accept the body God gave them without question.

Further help and inspiration:
"Pretty" video
Eating Issues, Aging, and Women article
SPEAK: Students Promoting Eating Disorder Awareness and Knowledge
Providence Behavior Health Services: Adolescent Eating Disorder Services 503-216-2025 or 800-716-5325
Center for Discovery in Bellevue and Edmonds, WA
Rain Rock in Eugene, OR
Kartini Clinic for Disordered Eating in Portland
Free Eating Disorder Art Therapy Support Group @ A Better Way Counseling Center 503-226-9061 in Portland, OR

Natural Ways To Treat Teenage Mood Disorders Part 2: Sleep

Teenagers are notorious for their poor sleep habits. However, lack of sleep creates mentally ill symptoms. As Leanne Ernster, Preventative Nutritionist, said in my interview, "Sleep is fundamental to life."  Having had her own struggles with chronic insomnia growing up she discussed how to best help teenagers struggling with sleep. Common teenage sleep problems include,

• Having difficulty getting to sleep 
• Waking frequently
• Nightmares
• "Reverse cycling" -- sleep during the day, up most of the night.
• Inability to get up in the morning

For teenagers struggling with sleep, approaching evening will trigger stress as he/she knows another restless night is coming. Leanne shares her story: "I could not sleep. I hated sleep. The thought of going to sleep made me anxious, which [then] made it harder to sleep." While the average teenagers needs between 8.5-10 hours of sleep a night, one report indicated 85% of teenagers do not get enough sleep. Because sleep is so vital to good health, many doctors will prescribe medications to get their patients to sleep at night. Unfortunately, they have side effects, including disturbing dreams and morning grogginess. Also, many parents are hesitant to put their teenagers on medications at this key point in their development. 

Leanne recommends "Start thinking about sleep in the morning." Jump start your waking/sleep schedule with brighter lighting early in the morning and a glass of water to hydrate. Even a hot shower itself boosts serotonin which can encourage wakefulness. Do what you can to reduce the stress in your life often interfering with sleep. Encourage the following habits with your teens:

• Have a consistent bedtime to sync your body's circadian rhythm, not varied over an hour.
• Journaling before bed to release what is on your mind.
• Dim or turn off lighting on TVs, lamps, computer, smart phones, and mp3's to encourage the body's natural production of Melatonin.
• When laying down for bed, take long, deep, slow breaths to calm the brain down. 
• Snuggle or get a massage to create the chemical oxytocin, "the cuddle hormone", helping people relax.
• Warm baths/showers can help the body and brain calm down.
• Eat sleep inducing foods, such as popcorn, before bed.
• Make hot non-caffeinated drinks 1-2 hours before bedtime-- even holding a hot drink can be calming.
• No caffeine after 2 pm.
• No exercise 4 hours before bed (exception is bedtime yoga or light walking).
• Identify disruptions and resolve as much as possible. Need earplugs? earbuds? eye mask? Some people need complete quiet and others need background noise.

Melatonin is the natural hormone our bodies produce to help us fall asleep. It is also sold over the counter in the US. So many people have such positive results using Melatonin, doctors are including it on their list of sleep prescriptions. Leanne warns against using above 3 mg of Melatonin as it can be counterproductive. "It might be helpful to have a Melatonin complex which would also include low doses of other synergistic calmers like GABA, Vitamin B6, and other neurotransmitters that help you slow down."

Having enough sleep improves a teenager's ability to handle stress and do better in school. Lack of sleep increase irritability, difficulty focusing, weight issues, and many more negative side effects. Unfortunately, convincing a teenager to get to sleep can be difficult. Include the professional's encouragement such as doctors, coaches, teachers, and counselors. Keep an eye out for teens who experience days with few to no hours of sleep as it can be a symptom of Bi-Polar Disorder or substance abuse. Consult with a counselor if this is an ongoing issue.

Other resources: Sleep Foundation

Extra Tip: Vitacost.com is an inexpensive, quick access to high quality food and supplements.

Leanne Ernster started and manages Engedi, a nonprofit coffee shop serving healthy smoothies and organic coffee/teas. My personal favorite is their Chai tea bought local from a native Indian now residing in Oregon. She also coaches people through her business Celebrate Nutrition in helping clients make better health choices promoting whole foods. One of her favorite pastimes is creating new healthy recipes. Like Celebrate Nutrition on Facebook and get regular healthy tips for daily living.

Disclaimer: Check with your doctor before making changes to your diet. Neither Leanne Ernster or Kristal Mathis are medical professionals. Please note not all mental health issues are related to diet but it is an important factor for many people.

When Tragedy Strikes

The December blog was going to include natural health tips for better mental health but in light of last week's events I'm pausing the series to address the complicated grief we are experiencing as a nation, as as a member of the human race.

   Its unthinkable to believe people could do so much harm to an innocent crowd of shoppers, children, and teachers. And not just one incident but multiple .We are not on a battle field. Holiday shopping, education-- they should be safe times.  It leaves us stunned, paralyzed in horror. With the holidays so close, the pain is only magnified. This is the time of year we sit with loved ones and treasure watching them excitedly open gifts. We give to local charities and churches abundantly this time of year so not one family goes without food or presents. But this year we are keenly aware many families have been robbed of their loved ones. Our hearts physically ache for them. Money, food, and presents we can give but life we cannot return. We feel helpless and maybe even guilty for being able to enjoy our families and friends. For those who have lost loved ones before, the grief is deeper still as they empathize in ways I can only imagine. 

   I find myself pulled in two opposite directions. First, I want to know more of what happened. Its as if an explanation or answer to my many questions somehow would help. But the more I know, the more grieved I seem to become. Part of me doesn't want to hear anything about it. I don't want to see it on TV. I don't want to read it. I don't want to hear it on the radio. I want to pretend like it didn't happen. But I can't ignore it either because 1.) it did really occur & 2.) Ignoring it seems to dishonor those who were  touched by the horrific tragedies. 

   How do we offer support to the next generation when we are just as saddened and just as heartbroken as the young people? 

1. Remember everyone grieves in their own way. It is all too easy to judge the way someone grieves when it doesn't seem effective or mirror our own methods.
2. Give lavish grace to other's process of grief. 
3. Listen. Let the teenagers and children talk. You don't have to have the answers but people do need a place to express their fears, concerns, and worries in order to heal. Talking is the process for healing, even when it hurts.
4. Keep an eye out of physical symptoms: upset stomach, headache, tension, fatigue, changes in appetite or sleep, increased anxiety/depression. If symptoms continue consistently for over 2 weeks, interfering in the day's schedule, and/or relationships recommend a support group or a counselor. Support groups and counselors are there to help people cope with the craziness of life. 

 

Ironically, it was one of my childhood hero's who offered me comfort even though he is no longer alive. Mr. Fred Rogers words are as relevant today as they were years ago.

     “When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.” To this day, especially in times of “disaster,” I remember my mother’s words and I am always comforted by realizing that there are still so many helpers – so many caring people in this world.“

We cannot change what happened but we can sit, listen, and cry. By being one of those caring people, those helpers, the wounds begin to mend. 

Natural Methods to Treat Teenage Mood Disorders Part 1

      One of the most often asked questions I get is "Can you suggest natural ways to treat depression (or anxiety/anger/mood swings)?" Without training, it is unethical for the average counselor to make recommendations for any medications, natural or otherwise. However, many parents would like to utilize alternate natural ways of supporting their teens before trying a myriad of psychotropics. So, recently, I sat down with Holistic Health & Preventative Nutritionist Leanne Ernster to discuss what could be done naturally to improve moods.
      While research supports exercise as one of the best ways to improve mental health, Leanne had a forerunner to exercise. While she agrees exercise is very helpful, she stressed the number one priority is whole foods because food is our fuel for fitness, physically and mentally. Leanne noted "whatever we feed ourselves, on a cellular level everything is affected!-- our hormones, our organs. If we don't have what it takes to build healthy neurotransmitters, to slow our bodies down at night, and rev them up in the morning... then it's no wonder the snowball effects happen." Leanne continues to illustrate the snowball effect in the life of a teenager.  "So let's say a teen is living off of Trix cereal, bagels, mac n' cheese, and energy drinks. There isn't one phytonutrient [since they] are only in plants. [Teenagers] will quickly find they are lethargic. Maybe they sleep in late because they have no energy, and then they miss the sun. They aren't as active, they have low moods, and eat more junk to try and find energy. It is very cyclical. People don't know where to start and get overwhelmed." Long-term this affects the hormones, adrenals, brain development showing up in symptoms consistent with depression, anxiety, and moods swings.
      With nutrition being so vital to our mental health here are so some practical tips Leanne recommended to help the teenagers in your life build a healthy mind.

1. Depression: Vitamin D3 drops (2,000 units aka 2 drops) are a necessity. In the NW we sorely miss absorption of Vitamin D through the sun. Lack of Vitamin D can cause, among other things, depressive symptoms. Light boxes can also be helpful for some people with depression (Costco has them locally for under $50. Check out the reviews.).
2. Anxiety: Vitamin B metabolizes stress and improves cognitive functioning. You can find Vitamin B in whole grains like oats, whole grain breads (Dave's Killer Good Seed is Kristal's favorite), nuts and avocado, spinach, and nutritional yeast. As there are many types of Vitamin B, a Vitamin B Stress Complex supplement can help for additional support to better manage stress.
3. Memory & Moods:  Ground Flax Seed (2 Tablespoons daily). Just like coffee, freshly ground is best for the maximum nutritional benefit. It can often be added to a smoothie or hot cereal with almost no change in taste. The Omega-3's in flax seed protect our neurotransmitters in the brain to improve memory and stabilize moods. 80% of Americans are deficit in their Omega-3's.

Developmentally, teenagers often struggle with the idea of good nutrition for two reasons: The benefits of good nutrition are not typically immediate but long-term. Teens often want a quick fix, an immediate result. Second, teenagers often feel invincible. Warnings about effects of junk food do not seem real because it is not an instant consequence. To get them on board, work with them, leading by example to make small changes. Find out what healthy foods they like. Prepare foods together since they are more willing to eat something they have participated in making.

Extra Tip: Vitacost.com is an inexpensive, quick access to high quality food and supplements.

NEXT MONTH: Part 2--Leanne and I discuss supplements and strategies avoid insomnia and get a good nights sleep. Proper sleep is crucial in healthy minds.


Leanne started and manages Engedi, a nonprofit coffee shop serving healthy smoothies and organic coffee/teas. My personal favorite is their Chai tea bought local from a native Indian now residing in Oregon. She also coaches people through her business Celebrate Nutrition in helping clients make better health choices promoting whole foods. One of her favorite pastimes is creating new healthy recipes. Like Celebrate Nutrition on Facebook and get regular healthy tips for daily living.

Disclaimer: Check with your doctor before making changes to your diet. Neither Leanne Ernster or Kristal Mathis are medical professionals. Please note not all mental health issues are related to diet but it is an important factor for many people.

Does Your Teenager Need Counseling?

One of the lines in a recent movie I saw compared lawyers to counselors (and it was not in a positive light). "They just want your money -- they keep you coming back again and again." While there may be some truth in the statement for some counselors, most do really care about people first. When you are concerned about your teenager it can be more confusing. How do you know if your teenager would benefit from seeing a counselor? Would a few visits fix the issue? How long will the counseling take? How do you know if counseling is working? Here are questions to gauge your teens needs-- you be the judge:

Self-esteem

1.) How does your teenager like themselves? Are they confident? Teenage girls often tell me part of the reason they self-harm is because they don't care about themselves An identity attached to inappropriate or negatives behaviors is a problem to address as quickly as possible. Notice if your teen takes care of their own needs. Hygiene, eating, exercise, and sleeping can be indicators of how they rate themselves. Extremes on either end can point to a deeper self-hatred. Counselors can help identify the source of the hatred and teach your teenager to accept themselves. 

School/Work

2.) How is their school/work going? Are they passing their classes? Are they participating? Are they able to complete the work? Anxiety, trauma, ADHD, depression show up at school and interfere with focus. Sometimes their feelings are so intense they are unable to be successful at school without extra help. Many therapists work with teenagers on attention strategies or ways to lower moods interfering with schoolwork. 

3.) Relationships

What are their relationships like? Conflictual, messy, exclusive, enmeshed? How intense are the family arguments? Have they ever gotten physical? Do they let everyone walk all over them or the opposite, fight with everyone? Maybe your teenager doesn't really have friends, or know how to make friends. Do they handle their technology responsibly (i.e. Facebook, Twitter, Instagram, text)?  Counselors can work with your teenager to help them grow their ability to communicate and develop appropriate levels of trust. 

For each of the domains above, family involvement can expedite counseling. Duration of counseling is based on several factors 

1. How long has this been an issue? It could potentially take just as long to practice new behaviors. Anything earlier is a bonus. 
2. Is it a good fit with the counselor? Does your teenager like their therapist? If he/she does not, don't waste the time or money.
3. How intense/severe is the issue? The more intense, the longer it may take to address. Counselors and clients start as strangers. 

If you feel like your teenager's therapist is keeping them engaged far longer than is necessary, talk with your teen and the counselor. Often times, weaning sessions is much safer than going cold turkey. Remember improvement may not yet have the roots to stabilize the progress. While teenagers may continue to need check-ins with their counselors, the goal of a good counselor is work themselves out of a job (not keep them coming back indefinitely).