Eating Disorders and Depression

eating disorders depression

Do you know the connection between eating disorders and depression? (photo credit: BigStockPhoto.com)

Although it isn’t clear exactly how eating disorders, like anorexia nervosa or bulimia, and depression are related, they often seem to go hand in hand.  While there is some scientific evidence that depression may increase the risk of developing an eating disorder, there is also evidence that the reverse can be true, that have an eating disorder can increase the risk of developing depression.

This link with depression seems to be apparent with the three primary eating disorders to varying degrees. With anorexia, in some circumstances the physiological changes resulting from the disorder can lead to depression.  In others, the underlying cause of the eating disorder may be depression and anxiety.   In those with binge eating disorder, the disorder itself can cause feelings of guilt and shame that impact self-esteem and can contribute to or worsen existing depression.

The signs of depression in people with eating disorders are the same as the signs for anyone with this condition including:

  • All encompassing feelings of sadness, hopelessness, and/or unhappiness
  • Losing interest in activities
  • Irritability
  • Quick temper
  • Difficulties sleeping
  • Changes to sleeping patterns or habit
  • Loss of appetite
  • Changes in eating habits
  • Suicidal thoughts or tendencies

Mental health providers use the same diagnostic tools for determining if someone with an eating disorder has depression as they would for any patient.  But when it comes to treating the two co-existing conditions, some challenges present themselves.

In order to be effective, a treatment approach for people that have an eating disorder and depression must address both disorders in order to be successful.  This is one of the reasons it is so important for people who are suffering from both to get both disorders diagnosed.  If treatment focuses solely on the eating disorder or solely on the depression, progress and remission are unlikely in most cases.

Depression and eating disorders are generally treated with anti-depressant medications, cognitive behavioral therapy(CBT), and/or education on healthy eating habits. Those with binge eating disorder may also be treated with an anticonvulsant medication that has proved to be effective at reducing binge episodes.   CBT is a common treatment option for depression but it is also proving to be very beneficial for those with anorexia, bulimia, and binge eating disorder.

The fastest results come when medication is used but a medication only approach carries a higher risk for relapse.  Those who are treated only with CBT are less likely to relapse but it takes time to see results.  However, when used together, these treatment options can help those with these conditions overcome both disorders.

Treating eating disorders with underlying depression is possible but for the greatest chance of success, all mental health conditions including depression, anxiety, etc. must be diagnosed and the treatment plan implemented must be tailored to the individual’s needs.

What Parents Need to Know About Seasonal Affective Disorder

Seasonal Affective Disorder

Do you know if your teen suffers from Seasonal Affective Disorder? (photo Credit: BigStockPhoto.com)

There is something a little sad about the end of summer for all of us, but for people with Seasonal Affective Disorder(SAD), the changing seasons can cause episodes of deep depression that can impact relationships and quality of life.  For parents, it is important to understand what this disorder is, how to recognize it, and what to do to get your child the help they need to make it manageable.

Although this condition is more prevalent in people over 20, it can also affect children and teens.  Because of the seasonal nature of the disorder, it can be difficult to diagnose.  It may be written off as normal moodiness or even misdiagnosed as bipolar disorder.  While it looks like depression when it is affecting the person, the seasonal cycle it follows can make it hard to definitively diagnose.  It can also make it difficult to see it for what it is, a mental illness, rather than as bad behavior or acting out.  The most common form is called winter depression and it occurs during the transition from fall to winter.  However, the same symptoms can occur in the spring causing summer depression.  Some people with the condition experience a repeating pattern of one or the other each year.  While it is possible to experience both summer and winter depression, it is not necessary to have both to be diagnosed with SAD.

Causes

There is no clear indication of what causes SAD although many believe access to sunlight may be a key factor.  Increases or decreases in sunlight exposure may cause chemical imbalances or hormonal shifts in our bodies that most of us are unaware of.  Those people with SAD may be more sensitive or susceptible to these imbalances and shifts.   While still a hypothesis, this idea is supported by the fact that someone who lives in a northern state with less access to sunlight during the winter months is significantly more likely to experience SAD as someone living in a southern state with less sunlight fluctuation.  Additionally, people affected by SAD experience less symptoms when they spend winter in a place with less fluctuation.

Risk Factors

Although anyone can have this disorder, there are some risk factors that increase the likelihood of developing the condition.  These risk factors include family history, gender, location, and overall mental health.   People who have close relatives with SAD are more likely to have the condition than those who do not have family members with it.  Women are more likely to be diagnosed with the disorder than men and the farther you live from the equator, the more likely you are to develop it.  People with other mental health conditions, specifically depression and bipolar disorder, may have worsening symptoms during these times of year.

Signs and Symptoms

SAD looks just like depression but it comes and goes on a regular cycle that follows the shifting seasons.  Symptoms include fatigue, moodiness, loss of enjoyment in regular activities, lack of energy, shifts in sleeping habits or patterns, difficulty concentrating, and changes in eating habits.

How Can I Tell if My Teen is Bipolar?

bipolar teen

Do you know how to tell if your teen is bipolar? (photo credit: BigStockPhoto.com)

Mood swings are a part of life when you have a teenager living under your roof because hormonal shifts and changing moods are a normal part of adolescence.  But this leaves many parents wondering how they can tell if their teenager’s moodiness is normal or if it is a sign that they are struggling with something beyond the normal ups and downs of being a teen.  The good news is that when it comes to bipolar disorder there are some specific things that parents can watch for that help delineate normal moodiness from mental illness.

1.      Mood Swings that are Extreme

If there is one characteristic of bipolar disorder that is the most common and the easiest to spot it is the extreme nature of the person’s mood swings.  People with this disorder experience periods of manic behavior that can include intense happiness or hyper-productivity and periods of devastating depression.  These moods can shift suddenly and unlike normal teenage moodiness may not seem to correlate to the current situation.

2.       Stepping Away from Normal Life

People with bipolar disorder may retreat from their lives and their normal activities.  This retreat can look like quitting a favorite sport or giving up a long cherished hobby.  The mood swings can also be so disruptive that it is difficult to continue to participate in things in the same way they did before.  Simple things like going to school or hanging out with friends can become unmanageable.

3.       Sleeping Less or Sleeping Too Much

A significant shift in sleep pattern can be another sign of bipolar disorder.  Some people with bipolar disorder, especially if they are experiencing a manic episode, may feel like they no longer need to sleep at all.  These people will be able to function almost as if they have been sleeping even if they haven’t slept at all.   Other people, including those facing the depressive side of the disorder may feel like they need to sleep all the time, no matter how much sleep they get.

4.       Taking More Risks

Teenagers, as a rule, tend to have fewer inhibitions and be more willing to take risks than younger children or older adults.  But people with bipolar disorder can take risky behavior to the extreme.  Teenagers with the disorder may participate in very risky activities that are well beyond the normal “acting out” seen in other teens.  They may abuse alcohol or drugs, drive recklessly, or act promiscuously.

5.       Talk of Suicide

Bipolar teenagers, especially when dealing with a depressive episode, may experience thoughts of suicide and talk about suicide as the feelings of hopelessness inherent to that kind of depression overwhelm them.

If your teenager is exhibiting any of these signs, especially if they are exhibiting more than one or two, it may be time to consult a mental health provider to get them assessed and diagnosed.  Bipolar disorder can be treated and those with the condition can live healthy lives once they get a diagnosis and treatment.

 

7 Things Parents Should Know about Teenage Depression

Make sure you know these 7 things about teenage depression (photo credit: BigStockPhoto.com)

Make sure you know these 7 things about teenage depression (photo credit: BigStockPhoto.com)

Depression in teenagers doesn’t always look the way we, as parents, expect it to.  Sometimes the symptoms of depression can look a lot like normal teenage angst which means it goes undiagnosed.  But getting teens who are dealing with depression the help they need is critical because depression impacts all areas of their life and if left untreated it can result in serious long-term problems.  Here are some of the important facts about teenage depression that parents need to know in order to recognize the signs in their own child and to know what steps to take to get them the help they need.

1.     Depression isn’t Moodiness

Every teenager has down days and bad moods.  Teenagers may be overly dramatic or overreact to situations that don’t seem that serious to us.  They may rebel, act out, or seem annoyed by everything we do or say.  All of these things are normal during the teenage years.  Depression is different.  Depression isn’t about having a moody weekend or being bummed out about a bad test.  Depression is more pervasive, more overwhelming, more encompassing.

2.     Depression Doesn’t Always Look the Way We Expect

Teenagers don’t always act the way we expect them to and this holds true when it comes to teenagers who are suffering with depression.  You may expect them to be sad, to cry a lot, or to seem down all the time.  While some teens may experience these, others can seem very irritable, be angry at the world, and even display fits of rage.  Teenagers may also withdraw from friends, quit favorite activities, and experience changes in eating and sleeping habits.

3.     Depression Sticks Around

One red flag for parents is when teenagers seem to have a personality change or to be displaying the signs of depression for a long period of time.  This is one of the ways parents can differentiate between normal teenage moodiness and actual depression.  Moodiness comes and goes, depression doesn’t.

4.     Depression Can Cause Physical Symptoms

One of the ways that depression can look different in teens than it does in adults is the presentation of physical symptoms.  Teenagers may complain of aches and pains that have no source.  They may get frequent headaches or feel sick to their stomach with no medical explanation.

5.     Depression Can Increase Sensitivity

While it may seem like a teenager dealing with depression doesn’t care about much including what other people think, they can become very sensitive to any kind of criticism or rejection as these reinforce the sense of worthlessness they are already experiencing.

6.     Depression Can Cause Selective Withdrawal

Another way that depression can look different in teens is that teens don’t tend to pull away from everyone in their lives, unlike adults.  Teenagers may pull away from family members or change the group of friends they hang out with but do not always withdraw from all interpersonal relationships.

7.     Depression Can Lead to Real Problems

The consequences for teenagers whose depression goes untreated can be severe.  Depressed teenagers can have difficulties in school like poor attendance and failing grades.  They may run away from home, begin using/abusing drugs or alcohol, develop an eating disorder, participate in self-harming activities like cutting, become violent, or attempt suicide.  If you suspect your teenager may be depressed, seek the assistance of a mental health provider who can help you determine the right steps to take to get your teenager the help they need.

How to Tell if Your Teenager is Depressed

The teenage years can be tumultuous for every family which is one of the reasons so many parents struggle with understanding when their teenager’s behavior is normal and when it points to a problem.  This is especially true when the problem is clinical depression.  Teenagers are moody.  To parents, it can seem like they are angry at everything.  Small slights like fighting with a friend can seem to block out even the best news or happiest times.  Parents who are looking to help but don’t want to do more harm than good may feel like they are floundering and wondering how to tell if their teenager is depressed.

A Matter of Degrees

Part of the problem comes from our common use of the terms depressed, depressing, and depression.  Your teen may announce that she is depressed because everyone else is going to the dance this weekend and she has to work.  But that doesn’t really mean she is suffering from clinical depression.  The difference is a matter of degree – depressing is today, depressed is this month.  It may seem like a fine line but there are some key things that parents can look for to determine the difference between a bad day and a big deal.

Changes, Big and Small

There are some specific signs that parents can watch out for if they are worried about their child’s mental health.  These changes generally manifest in two areas, emotionally and physically.   Some teenagers will have many symptoms, others won’t.  The important thing is to know the signs so that you know when it is time to take action and when it is time to take a step back.

Common emotional changes that can signify depression include:

  • An overwhelming sense of sadness
  • Bursting into tears or experiencing crying spells that have no obvious cause
  • Easily irritable
  • Quick to anger, especially over little things
  • Losing interest in friends or favorite activities
  • Inability to find pleasure in doing things that were previously pleasurable
  • Fighting with or distancing oneself from friends and family members
  • Losing interest in friendships and spending time with friends
  • Feeling worthless
  • Focusing on negative events or failures
  • Blaming oneself for everything that is not right in their lives
  • Being highly self-critical
  • Difficulty concentrating
  • Overly sensitive to criticism
  • Feelings that their future is limited and bleak
  • Suicidal thoughts

Common physical changes that can signify depression include:

  • Excessive and unexplained tiredness or fatigue
  • Lack of or loss of energy
  • Not sleeping enough
  • Sleeping all the time
  • Not eating
  • Losing weight unintentionally
  • Overeating
  • Substance abuse
  • Acting agitated
  • Slowed response times
  • Physical discomfort from aches, pains, and headaches that have no medical basis
  • Rapid decrease in school performance
  • Stops taking care of their physical appearance
  • High risk behavior
  • Self-harm, like cutting

If you suspect your teen may be having more than just a bad day, make an appointment with a mental health practitioner to have them evaluated.  Since depression doesn’t normally get better without assistance, getting help as early as possible is the best course of action you can take.

Phoenix Teen Counseling: Mental Health 101: Teen Troubles

The teenage years can be troublesome and traumatic.  Faced with a myriad of pressures from every direction, teenagers often feel that they need twist and morph themselves into someone else in order to fit into other people’s molds.  This is made more difficult because they are only beginning to discover who they are and what they want.   They feel pressured to look a certain way, get good grades, fit in with friends, make the team, get the part, and be popular and sometimes that pressure can be too much.  Teens also have to deal with other issues like family financial problems, divorce, and illness.  Although the majority of teenagers make it through these tumultuous times to become well-adjusted adults, some teens struggle enough that they need professional help.

For parents, understanding when a teenager’s behavior is normal teen angst and when it is not is one of the biggest challenges.  In order to get teens the help they need to successfully navigate whatever challenges they are facing, parents need to know what to look for, what to expect, and when to seek help.  Here is a list of the most common mental health issues teens experience to help parents know when it’s time to seek outside help.

Mood Disorders

Bipolar Disorder – A teen with bipolar disorder has periods of mania and periods of depression.  When they are in a manic period, they may be extremely happy, hyperactive, and/or irritated.  They get by on very little sleep, get involved in multiple projects and activities, and may participate in risky behavior.  When they are in a depressive period, they display the signs of depression.

Depression – When teens are clinically depressed, they experience feelings of sadness and irritability along with several other symptoms that can include changes in appetite or sleep, rapid weight loss or gain, fatigue, loss of interest in previously enjoyable activities, problems concentrating, feeling hopeless, and suicidal thoughts.

Anxiety Disorders

General Anxiety Disorder – Feelings of anxiety are common in teens, but in some cases these feelings can rise to the level of a disorder.  Teens may worry excessively about situations, events, or activities to the extent that it interferes with their normal life.  Symptoms include feeling restless, having trouble sleeping, being irritable, and being unwilling or unable to participate in everyday activities.

Obsessive-Compulsive Disorder (OCD) – Teenagers dealing with OCD have distressing thoughts or impulses that occur over and over and repetitive behavior patterns like hand washing, counting, and hoarding that interrupt their ability to live their life normally.

Eating Disorders

Anorexia Nervosa – Teens with anorexia nervosa do not eat enough to maintain a healthy body weight.  Signs and symptoms include being significantly underweight, dry skin, low blood pressure, depression, moodiness, and unwillingness to eat around others.

Bulimia – Teens with bulimia participate in a cycle of bingeing and purging, eating a large amount of high calorie food and then inducing vomiting.  Bulimics may also use laxatives, exercise, diuretics, and diet pills to prevent weight gain.  Signs of bulimia include obsessing over weight, exercising hours at a time, eating in secret, spending time in the bathroom directly after eating, and low self esteem.

Trauma and Abuse

Teens who have been physically, emotionally, or sexually abused or who have lived through a traumatic event may need assistance to overcome the lasting damage these circumstances can cause.  Teens may experience Post-Traumatic Stress Disorder (PTSD), anxiety, depression, substance abuse, suicidal tendencies, and self harm.

Suicidal Tendencies

According to the American Academy of Child & Adolescent Psychiatry, suicide is the third leading cause of death amongst teenagers.  Warning signs include depression, frequent thoughts of and conversation about death, substance abuse, previous attempts, and traumatic events.

Seasonal Affective Disorder in Teens

It isn’t uncommon for people of all ages to get a little down as fall changes to winter, the days get shorter, and the temperatures drop.  In most places around the country, the long, fun, sunny days of summer are gone and the bleak, cold days of winter loom ahead for months.  But for some people, the transition from season to season can cause a type of depression that is much more serious than being bummed out that summer is over.  This condition is called Seasonal Affective Disorder (SAD).  It is a type of depression and it affects more people, of all ages, than you might think.   Current estimates indicate that about 6% of people, including adults, teens, and children, have Seasonal Affective Disorder.

For parents of teenagers, it can be enough of a challenge to figure out what is natural teenage moodiness and what is a mental health concern.   When the source of the moody behavior is Seasonal Affective Disorder, it can be even more challenging because the condition is rare in children and teens.  The average age for onset of the illness is 20 and more females than males are affected.

The main thing that differentiates Seasonal Affective Disorder from depression is the seasonal pattern.  A teenager with this condition will only experience symptoms for the same few months every year.  The most common form of the disorder is winter depression which affects people as the seasons shift from fall to winter.  There is also a form of the disorder called summer depression that begins in the late spring and runs through the summer.

What Causes Seasonal Affective Disorder?

The cause of SAD is unclear but lack of access to sunlight is suspected to play a part in the disorder.  When the amount of sunlight decreases or increases, it may affect the way our body and brain produces chemicals.  People with SAD may be more sensitive to these chemical and hormonal shifts.   These theories are supported by research that shows a person inNew Hampshireis seven times more likely to have SAD than a person inFlorida.  Anecdotal evidence that people with SAD who spend the winter months in a place with more access to sunlight do not experience symptoms.

Who is at Risk for Developing SAD?

While anyone can get this disorder, there are some factors that increase the risk of developing it including:

  • Family history – If you have a close relative with SAD you may be more likely to develop it.
  • Gender – More women have been diagnosed with the disorder than men.
  • Location – People who live far from the equator, either north or south, are more likely to have SAD.
  • Mental Health – Those people with depression or bipolar disorder may find that their symptoms are worse depending on the season.

What are the Signs and Symptoms?

The signs and symptoms of SAD are the same as those for depression but are only experienced during a specific season.  These symptoms include:

  • Fatigue
  • Mood changes
  • Loss of enjoyment in activities, socializing, and pastimes
  • Lack of energy
  • Changes in sleep patterns
  • Problems with concentration
  • Changes in eating habits that includes craving high sugar foods

 How is it Treated?

There are several ways to treat SAD in teenagers.  The first type of treatment involves increasing the person’s exposure to full spectrum lights during the months when they experience symptoms.  These types of light bulbs mimic daylight and can relieve symptoms.  If simple exposure to more light isn’t sufficient to alleviate symptoms, light therapy may be used.  This approach uses special lights as well but concentrates the light in a light box or light panel.  The person with SAD sits in front of the lights for a specific amount of time each day until the seasons change again.  Psychotherapy and medication may also be used to treat teens with SAD.

 

Preventing Teen Suicide: What Parents Need to Know

Teenagers

For many parents, it is difficult to understand why an adolescent who has their whole life in front of them, would consider ending it prematurely through suicide.  As children make the transition to teenagers, they become more private and generally stop sharing their thoughts and feelings as openly with their parents.  This can make it even more difficult to gauge when normal teenage angst develops into clinical depression, an anxiety disorder, or suicidal tendencies.

Many factors may contribute to teen suicide. Compared to the stress and pressures of adulthood, teenage problems may seem small and unimportant to us.  Things like not fitting in at school, being bullied, and losing friends and first loves are just a normal part of growing up to most adults.  It is often hard for us to remember that these normal things often carry a huge emotional toll for teens.  We know that her boyfriend breaking up with her isn’t the end of the world, but it can feel that way to her.  We can see that not making the basketball team doesn’t mean he won’t be successful in life, but it can feel that way to him.

As the third leading cause of death for those aged 15 to 24 and the fourth leading cause for those aged 10 to 14, suicide is a serious issue for teenagers.  A survey of high school students showed that more than half of them had thought about suicide and almost 10% admitted to trying it at least once.  No matter how well-adjusted you think your teen is, it is important to know the warning signs and when to intervene to keep your child safe.

Who is at Risk?

Adolescence and the teen years are a time of turmoil and rapid change.  Between forming their own identities, learning to deal with new sexual feelings, struggling to figure out where they fit in, and the pressure to perform in school, teens can easily become overwhelmed.  If teens feel like they don’t have a reliable support system or if they lack healthy outlets for dealing with their tumultuous emotions, it can leave them feeling disconnected and alone both of which increase the risk of suicide.

For many teens who attempt or commit suicide, this desperate act comes directly after a stressful event in their lives like the end of a relationship, death of someone close to them, parental divorce or separation, or something they perceive as a life altering failure like being cut from a sports team or doing poorly in school.

Teenagers, especially girls, who were subjected to any kind of abuse as children are more likely to attempt suicide.  In general, girls are more likely to think about suicide and are twice as likely to attempt suicide as boys.  However, boys are four times as likely to succeed.  The risk of suicide increases when there are guns in the home which means parents need to maintain safe storage practices for all firearms even when their children have grown into teens.

Here are other factors that increase the risk of suicide in adolescents and teenagers:

  • A psychological problem like depression or bipolar disorder. 95% of people who commit suicide were mentally ill when they took their life.
  • Recurrent unpleasant feelings like isolation, distress, hopelessness, worthlessness, and irritability.
  • Learning how to handle emerging sexuality including homosexuality in an unsupportive environment.
  • Previous suicide attempts.
  • A family history of mental health problems or suicide.
  • Being a victim of physical, sexual, or emotional abuse.

The Warning Signs

In order for parents to be able to protect their children from suicide, they need to know what to watch for.  Here are some of the warning signs that your teen may be suicidal.

  • Drastic changes in personality, appearance, sleep habits, or appetite.
  • Relationship drama with a girlfriend/boyfriend.
  • Withdrawing from friends, social groups, and activities.
  • Unexplained drop in grades.
  • Participating in rebellious and/or dangerous behavior
  • Running away from home or giving away personal items that are important to them.
  • Substance abuse.
  • Writing or talking about death and suicide.
  • Previous suicide attempts.

What Parents Can Do

The most important thing parents can do is talk to their children and listen when their children talk to them.  Many teenagers who contemplate suicide feel like no one understands them or cares about them.  Talking to your teen about their lives, expressing your love for them, and ensuring your teen knows you are there to help, no matter what problem they are facing, all help reassure them that you are there, that you care and that you want to understand.

When your teen opens up, don’t minimize, judge, or dismiss their concerns.  Regardless of whether or not you think her failure to make the cheerleading squad is a life or death situation, she might and downplaying her emotional reaction only shows her you don’t understand what she is going through.

Pay attention to your parental intuition.  If you feel like something is wrong, don’t downplay your own emotions either.  Ask your teenager about what is going on in their lives, what they are concerned about, and share your concerns with them.  Talk in specifics rather than generalities.  Listen to what they say and don’t say.  Don’t talk over them, interrupt them, correct them, or be dismissive of their concerns or problems.    Ask the other people in their lives like teachers, counselors, and friends.  Don’t shy away from the “s” word.  If you are concerned about suicide, ask directly and invite your teen to participate in an open discussion on the topic.  Get help right now.  If you have concerns about suicide and think there is a possibility of your child being a danger to themselves, don’t wait.  Find a mental health professional to assess your child today.