Vocal Tics (Sounds and Noises)

Some children (and adults) make repetitive sounds that serve no communicative or health purpose. These sounds are called “vocal tics.” A vocal tic can be a cough, much like the cough one has when one has a cold, except that in the case of a tic – there is no cold and consequently no need to clear the passages of mucous! Sometimes the doctor will mistake this kind of cough for post-nasal drip – a small irritant in the throat. However, a true vocal tic is more like a bodily habit without a physical cause; there is no post-nasal drip. In addition, the cough does not stem from “nerves” or nervousness and therefore, it is also inaccurate to call it a “nervous habit.” A vocal tic is a biological disorder that is usually inherited. Calm people can have tics just as easily as anxious people. Nonetheless, stress does tend to aggravate tics, resulting in a temporary increase in symptoms.

Coughs are only one kind of vocal tic. A person can make any sound, including words. There are barks, hisses, grunts, sniffles, clicks and other noises. There are words or phrases that are repeated and in one kind of vocal tic (corprolalia), there are expletives (swear words) or “dirty words” that seem to jump out of nowhere.

If a child has both vocal tics and motor tics (repetitive, non-purposeful movements like jerking, bobbing, twitching and so on), he may have Tourette’s Syndrome. If he has only one kind of tic for less than a year, he may have transient tic disorder. Chronic Tic Disorder is the name given to tics that last longer than one year. Some children with tic disorders also have other disorders such as ADHD, OCD, mood disorders, anxiety disorders and conduct disorders. Many children, however, have simple tic disorders that improve with treatment or even on their own over time.

What Causes Tics?
Brain abnormalities can cause tics. Both structural changes in the brain and biochemical changes have been found in those who have tic disorders. Tic disorders run in family trees. Tic disorders commence before the age of 18. Sometimes they begin after taking a medicine (i.e. Ritalin, antidepressant medication, Cylert and Cocaine can all trigger tics in sensitive individuals). Sometimes tics may begin after a strep infection (in a similar way to PANDAS – the post-viral form of Obsessive-Compulsive Disorder). Sometimes injuries or other health conditions (even a common cold) can trigger the development of a tic. In all cases, the environment is thought to trigger a gene that is present in the child.

Although more tics occur when a child is feeling stressed or anxious, neither stress nor anxiety cause tics. Emotional distress worsens or aggravates a tic disorder temporarily. Stress reduction techniques bring tics back under control. The condition waxes and wanes – sometimes throughout life, but very commonly only until the end of adolescence when the tics may just disappear by themselves.

What Helps Tics?
Some medications can be helpful for tics – speak to your doctor or psychiatrist about this approach. Behavioral therapy can also be very helpful in reducing the tendency to tic. A psychologist can create the proper intervention for this kind of therapy. In addition, some alternative treatments have been found to be helpful in treating tics. For instance, nutritional interventions such as abstaining from coffee, pesticides, certain chemicals and so on, can sometimes help. Bach Flower Therapy (especially the remedy called Agrimony) has been very helpful for some children and teens with tics – consult a Bach Flower Practitioner for best results. Homeopathy and acupuncture might also be helpful. In fact, any intervention that helps reduce stress can help reduce the tendency to tic. Experimenting with several different healing modalities will help parents assess which one or ones have a positive effect on the course of the disorder.

Asking a child to stop making noises is NOT helpful and in fact, may lead to more tic behavior as the request itself induces stress. Tics are not done on purpose and they CANNOT be resisted. A child can delay a tic, but not stop it. Therefore, the youngster needs parental understanding and tolerance. The tic is not the child’s fault; rather, he or she is suffering from a disorder of the brain. Fortunately, tic disorders can be relatively mild, they can remit spontaneously and even when they do persist, they do not tend to interfere with academic performance or other normal functioning.

Self-Care

One important parenting goal is to raise children who are independent. Hopefully, by the end of two decades of effort, parents have been able to teach their child to take care of him or herself in every way. When the young person leaves home, he or she should be able to cook, clean up, pay bills, manage money, do laundry, maintain healthy, hygienic personal standards and take care of him or herself in every other way. Training starts early in life: as soon as a little one can pull on his or her own socks, parents must stand back and give room for trial and error. While it seems easy in principle, in daily life teaching a child habits of self-care can be quite challenging.

In teaching your child to take care of him or herself, consider the following tips:

Baby Steps to Independence
At first, parents do EVERYTHING for a new human being – dressing the infant, grooming the infant, changing the infant’s diapers, washing the infant, carrying the infant, feeding the infant. As the child develops, we hope that he will be able to take over all of these functions. By toddlerhood we are hoping that the child can dress himself, brush his hair with a little parental assistance, toilet himself with minimal assistance, cooperate with the cleaning process (starting to learn to brush his teeth and use soap in the bathtub), walk about and feed himself using cutlery. By the time the child is in school, we expect that he can completely dress himself (perhaps with a little assistance for difficult snaps or buttons), brush his own hair, take care of his bathroom needs independently, brush his teeth, wash his face and bathe himself (with supervision), walk, run, cycle and perhaps skate and swim as well, and eat properly with a knife and fork.

Small Children Enjoy Being Helped by Their Parents
Very young children, and even kids up to 6 or 7 years old, enjoy parental attention and contact. Although they may be able to take their own clothing off or put new clothing on, they thrive on the feeling of being assisted. It reminds them of the “old days” when Mommy and Daddy nurtured them in every way possible, taking care of every tiny need. Now that they’re “big,” parents often abandon them to attend to the new baby in the family or just to do their own things. The young child misses the affectionate and gentle touch of the parent. An adult woman may be very skilled at putting her own coat on, but this doesn’t stop her from feeling oh so special if her special man holds it up for her to slip her sleeves into! In a similar vein, it is fine to assist young children in their dressing and grooming activities even though the child is capable of doing everything on his own. This sort of assistance is just one way of showing love and affection. Don’t do EVERYTHING for the child, however, as this may actually stunt his development. Rather, it’s fine to hand him his second sock as he is putting on his first one or help zipper up his pants after he pulled them on himself. Make sure that the child can, in fact, perform all the tasks adequately by giving him plenty of opportunity to demonstrate competence. Offer assistance in different ways rather than just the same way every time. This helps ensure that the child gets to practice his skills. Unless your child is severely disabled, you have every reason to expect that he’ll be able to perform all acts of self-care during the period of childhood; you needn’t worry that assisting him will somehow prevent his normal development.

Teach Your Child
Actually sit down and show small children how to get dressed, comb hair, brush teeth and so on. It’s fine to repeat aspects of the basic lessons with older kids as well. Some children need verbal instructions and demonstration – with everything broken down into small chunks. Don’t assume your child already knows what she is supposed to do. If the child needs practice, try to make it short and pleasant – even a form of “quality time.” Older kids can learn more indirectly. Bring home library books along with books on all sorts of other interesting subjects. Leave them in the bathroom and around the table. There are books on fashion, style, image and all aspects of personal appearance. If you feel your child needs a gentle hint, leaving such books around can be useful. An uninvolved party is delivering the important information. Similarly, local libraries may carry DVD’s on the subject. For teens who cannot get themselves together nicely, consider a consultation with a personal style consultant. Such a person can show your child how to pick out fashionable clothing, make-up and hair styles. A consultation such as this can give the child necessary confidence as well as skills.

Allow Time and Permit Failure
Whether you are encouraging your toddler to put on his own snow pants or encouraging your teen to get a driver’s licence, you need patience and a tolerance for the learning process. Everyone learns by trial and error. You can get your 5 year-old dressed faster so it’s very tempting to just grab those clothes and dress the child yourself when you’re in a rush to get to work. However, your child really needs the practice in order to become independent. Doing everything for your child not only delays skill-building, but may actually interfere with the child’s normal development.

The solution? Start the morning routine earlier to allow for time for the child to develop skills. Once your child knows how to dress herself, brush her teeth, do her hair, make her bed, get herself some breakfast and make her own lunch – you’ll have a much easier morning! It’s worth the investment of your time up front to help your child learn each skill.

Self-care for older children involves more complex tasks like thoroughly cleaning their own rooms, knowing how to cook healthy meals, knowing how to clean up afterward, knowing how to use the washing machine and dryer and wash clothing by hand, knowing how to get into bed at a decent hour and how to get up independently in the morning. It can also involve knowing how to apply for a job, take public transportation or learn to drive, go to work, purchase personal items, use a credit card and manage money. Of course, teens also need to be responsible for taking regular showers, brushing their teeth and arranging for regular medical and dental check-ups. Children grow into these skills over the second decade of life – but only if their parents encourage them to do so and give them opportunities to spread their wings.

Emphasize the Positive
Look for the “right” part of whatever the child is trying to do. If she is learning to wash her own hair, praise as much as possible before correcting her. For instance, tell her she is using the right amount of shampoo and you like the way she is scrubbing hard. Then, if correction is necessary, keep it short and emphasize what needs to be done, rather than what she is doing wrong. For instance, instead of saying, “you didn’t rinse all the shampoo out of your hair,” try saying, “you need to rinse a little longer to get all the shampoo out of your hair.” Obviously children need lots of guidance before they can become competent at any aspect of self-care. In order not to discourage them, ensure that your positive feedback far outweighs your negative feedback. If a small child has gotten dressed all by himself, it is more important to applaud his independence than to point out that his pants don’t match his shirt. All people go from strength to strength. Letting the child know that he is on the right track helps him to continuously improve.

Use Positive Reinforcement and/or the CleaR Method
Use simple praise to reinforce attention and competency in self-care routines. Trying telling a young child, “I like the way you got dressed all by yourself and so quickly!” To an older child you can offer, “You look really nice today. I really like the way you color-coordinated that outfit.” To a teen, you might quietly utter “Hmmm… someone smells nice!” When a child allows you to help him with a task the he needs help with (i.e. a 5 year-old who can’t tie up his shoe laces), you can praise his cooperative attitude: “Thanks for letting Mommy show you how to do this.” When a youngster struggles and struggles with some difficult article of clothing, finally succeeding at getting it on (or off), you can say, “I like the way you persevered with that! You worked hard and it paid off!”

The CLeaR Method takes praise a step further through commenting and labeling positive behavior and then providing a reward for such behavior. This can be especially important when a child has been having a very hard time learning some aspect of dressing or self-care and especially when the child’s attitude toward the task has been very negative. For instance, if your 5 year-old has been refusing to button his own clothing and finally relents, doing the whole job himself, you can Comment: “You did up all the buttons yourself today!” Then you can offer a Label such as “You’re a good dresser.” Finally, you can offer a reward for the effort he put forth, “You know, since you worked so hard at that today, I think I’ll make your favorite pancakes for breakfast this morning!.” You can say to a child brushing her hair properly, “You did a very nice job brushing your hair this morning (Comment). You’re getting to be very competent at that (Label). Do you need any new hair accessories? I’ll be in the store today (Reward).”

Some Kids Have Problems that Interfere with Self-Care
Ask your pediatrician about normal developmental milestones. If your child is not able to put his shirt on or use a fork properly or perform some other physical act as skillfully as you expect him to by his age, you might consider the possibility of some sort of perceptual deficit , muscle weakness or other problem. Alternatively, problems with following directions may make it difficult for the youngster to perform a complex task that has many steps. Short-attention span can lead to similar difficulties. Similarly, auditory processing difficulties, gross motor skills, immaturity, a mental health diagnosis and a host of other issues can impact on self-care performance. If your child is lagging behind his or her peer group in self-care activities, seek professional assessment. The sooner you intervene to give corrective treatment, the sooner your child can make progress. Young children can learn rapidly. However, if you don’t identify a lag in development, you are not giving your child the chance to receive the help he or she needs.

Nightmares

Everyone dreams. Most people probably remember having at least one nightmare – a very frightening dream. There are some people who are bothered by regular nightmares, so much so that they don’t want to go to sleep. This can happen to children as well as to adults. After experiencing a traumatic event, people can have nightmares virtually nightly, until the trauma is resolved. Whether it’s once in a blue moon or a regular occurrence, a child’s nightmare always requires parental attention.

If your child has had nightmares, consider the following tips:

Some Kids are Sensitive to Images
Some kids are particularly vulnerable to scary images they see in books, movies and on T.V.. They can also create their own frightening images based on what they hear in snippets of conversations around them.  It isn’t possible to always shelter kids from unpleasant images, but parents can certainly respect the child’s vulnerability and try to limit frightening stimulation – for example, there is no need to insist that a child confront a disturbing image that is only recreational in nature (i.e a violent movie). If a child has come across a disturbing image, parents can help the child to talk about it, both accepting the child’s fear and also explaining the pretend-nature of the picture. For children whose vivid imaginations and sensitivity often lead to nightmares, parents can try offering the Bach Flower Remedy called Walnut – a harmless, water-based form of vibrational medicine available at health food stores everywhere. Give two drops in liquid (water, juice, milk, etc.) four times a day until the nightmares stop. Or, for nightmares about ghosts and other vague, scary fantasies, try the Bach Remedy called Aspen. The remedy Mimulus can help with nightmares about more specific fears, such as people dying or scary events like being robbed or chased. A Bach Flower practitioner can help further. You may also find more information about Bach Flower Remedies on this site.

Nightmares can be Triggered by Food Sensitivities
If there is no other apparent reason for the nightmares, you might consider the possibility of food sensitivities. Sometimes such sensitivities can chemical processes that can cause nightmares. Any food can cause problems, so you might need a systematic approach to food elimination in order to find out if there is a sensitivity. Naturopaths and self-help books can help with the process, or you might be able to find a medical specialist who tests for sensitivities (not allergies).

Consider Stress or Traumatic Events
If your child has experienced a stressful event or situation lately (i.e. medical or dental procedures, moving, a mean teacher, examinations, and so on), or even a traumatic experience (car accident, robbery, bullying, assault, family violence), then it’s possible that the nightmare is a sign that he or she is having difficulty coping with the situation. If a child who recently experienced the death of a loved one, for example, gets recurring nightmares, it’s possible that there are feelings he or she can’t identify or express. The child may also have experienced some sort of traumatic or overwhelming experience that you aren’t aware of – at school, at a place of worship, at an extracurricular activity, while volunteering or babysitting or even in your own home with his or her siblings or other relatives.  If you KNOW that something stressful has happened, be sure to talk to your child, naming the feelings that YOU would have if you were dealing with that situation. Help the child to express his or her feelings by using Emotional Coaching  (learn how to use this technique in Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe). Unremitting nightmares should always best checked out by a child psychologist.

Medicines, Substances and Illness
Certain health conditions can trigger nightmares, as can mind-altering substances and even over-the-counter medications. Withdrawal from substances can also trigger nightmares. If your child has been unwell or on medication and is having unusual nightmares, speak to the pediatrician.

Ways to Help Your Child
Accept your child’s fear and anxiety. Saying things like, “It’s not real. Go back to sleep,” doesn’t do anything to comfort a child and may even make them feel ashamed simply for having a normal reaction. Remember: to a young child, a dream can be so vivid, it feels like it actually happened. Go slowly and gently, taking time to calm and soothe your child to help orient him back to reality. Give a hug or a kiss or rub his or her back. Get him or her a glass of water or even a cracker to munch on, as eating and drinking are “grounding” activities that bring a child back into his body and away from the fantasy in his head. Putting a few drops of Rescue Remedy in the water can be particularly helpful, or even dropping them on a child’s wrists will work (Rescue Remedy is available in health food stores and is a harmless Bach Flower Remedy that quickly turns off adrenaline and restores emotional balance in cases where the fight-or-flight response has been activated.)

After a bad dream, separation anxiety may re-surface. Kids may demand that you stay with them as they go back to sleep, or they might insist on following you back to your room. They may also put up a big fuss when you attempt to leave their presence. Remember that these responses to terrifying dreams are all normal. Because your child is feeling fearful and maybe even disoriented and confused, make the exception if possible, and indulge his or her need for physical presence.

Nightmares are ultimately fantasy, so fantasy is an excellent way to deal with them. If your child’s nightmare did not have a happy ending, perhaps you can continue the story together — with your child emerging triumphant against the object of his or her fear. For instance, if the nightmare is about being attacked by monsters, a child can be encouraged to pretend that he or she is a “monster exterminator.” The child can role-play assertively warning the monster that he’s toast, and capturing the monster with special weapons. Although this may seem silly, this very strategy is used very successfully to help victims of trauma to deal with their terrifying nightmares.

Help Your Child Cope with the Aftereffects of a Nightmare
Sometimes the fear isn’t just an aftershock to a nightmare. It’s also possible that a nightmare creates worry that tragedy will happen in real life. For example, dreaming that a loved one died can create fear in a child that the loved one will indeed pass away. Gently but firmly explain to your child that just because something happened in a dream doesn’t mean it will happen in real life. At the same time, acknowledge your child’s fear. For instance, you can say something like, “I understand that you’re worried that Grandpa will die because he died in your dream. That must make you feel very sad.” When you name the child’s feeling, the feeling will intensify (often to the point of tears) and then disappear. In this example, the child might cry when the parent acknowledges the sad thought and then the child might say, “Anyway, it was just a dream. I know Grandpa is fine.” Allowing a person to feel his feelings is a fast way of helping that person to clear the negative feelings out of his system.

Help Your Child Prevent Nightmares
If a nightmare has really made a child feel helpless and victimized, you can teach him ways on how to manipulate images in a dream. While controlling one’s dreams takes practice to learn to do, the steps are child-friendly. Just encourage kids to visualize their desired dream content when they get to bed (“think of something nice that you’d like to dream about”), and remind themselves that they are just dreaming when faced with bad dream content. They can wake themselves up and change their focus to a positive storyline as they fall asleep again.

In addition, using effective stress management techniques before bed can help alleviate bad dreams. For instance, you might teach your child EFT (emotional freedom technique – there’s lots of on-line resources for this technique as well as therapists who can teach it to your child) so that the child can remove worries, fears and problems from his mind before falling asleep (YOU should learn it too!). This helps the mind have a better, more peaceful rest.

For a recurring nightmare, ask the child to create a satisfactory ending for the bad dream. Have him tell you the dream along with the new ending. Have him do it over and over until he feels calm. If he’s old enough, he can also write and rewrite the new dream, helping to install it deeper in his unconscious mind.

Therapeutic Bedtime Stories
Parents can make up healing bedtime stories for young children. One way to do this is to create a main character whose name just happens to be the same name as that of your frightened child. By way of example, let’s call the main character in our story “Liam.” The title of the series of stories is “Liam the Brave.” You now make up a different story each night about episodes starring Liam-the-Brave. In each story, Liam fights off scary foes using his arsenal of magic weapons. For instance, on Monday night, Liam-the-Brave takes a canoe trip down the river in deepest Africa. As he passes through the tropical jungle, he encounters crocodiles, warrior tribes, hungry animals and more. Every time he faces a threat, he pulls out a magic weapon from his magic weapon bag and aims it at the “enemy.” By waving, shaking or otherwise triggering the weapon, Liam successfully makes the threat vanish into thin air. He then continues on his trip, observing the beautiful waterfalls, plants and friendly animals, until the next threat appears. And so on. Of course, the story always ends happily with Liam arriving at his destination. On Tuesday night, the parent tells a similar story, this time taking place in outer space. On Wednesday night, the events may take place in the Antarctic and so on. Although the stories are nonsensical, they have been shown to give children a sense of power over internal enemies. Try them for a week or so and see if they help end your child’s nightmares and his fear of having bad dreams.

Consider Professional Help
Your child should not have to suffer from regular nightmares. Be sure to speak to your doctor and/or a child psychologist if your interventions have not resolved the problem.

What is an Eating Disorder?

Eating is a way to get nourishment and sustenance; it is, for the most part, a pleasant and fulfilling act. Sometimes, however, eating becomes part of a disabling or even life-threatening disorder.

What is an Eating Disorder? 
As the term implies, an eating disorder is a mental health condition that is characterized by dysfunctional eating patterns such as overeating, deliberate starvation, binging and purging. Eating disorders are associated with extreme concern or anxiety related to one’s body shape, size or weight. Some family therapists have conceptualized eating disorders as illnesses related to issues of control, like addictions or obsessive-compulsive disorder. Whatever the cause, an eating disorder is conceded as both a physiological and a psychological problem.

Who are at Risk? 
According to the National Institute of Mental Health, eating disorders occur frequently among adolescents and young adults, although there have been reported cases of childhood eating disorders and eating disorders that occur during late adulthood. The disorders are more prevalent among women than men, although in recent years, men are suffering in greater numbers.

What are the Types of Eating Disorders?
Types of eating disorders may include:

Anorexia NervosaAnorexia Nervosa is characterized by the relentless pursuit of thinness despite severe negative consequences. People with Anorexia Nervosa are convinced that they are too fat or too heavy, even if objectively they are already underweight. They may therefore engage in excessive dieting, self-induced vomiting, overexercising, the use of diuretics and laxatives, and abuse of weight management pills. Alarmingly, people with Anorexia Nervosa are ten times more likely to die from the condition than those without the disease.

Bulimia Nervosa. Bulimia Nervosa is an eating disorder characterized by repeated patterns of binging and purging. Binging refers to the consumption of large amounts of food in a short time, e.g. eating several plates of pasta in one sitting. Purging refers to the compensatory action to get rid of the food or calories consumed during the binge episode. Purging techniques include the ones people with Anorexia use to lose weight, e.g. self-induced vomiting, laxatives, diuretics and overexercising. Unlike sufferers of Anorexia, people with Bulimia may have normal body weight.

Obesity. Obesity is a condition of excess weight – essentially the result of consuming more calories than are needed for energy. It can affect a teenager’s self-image and self-confidence and it can also affect his or her health. For instance, obesity is sometimes associated with the development of insulin resistance – a sensitivity to sugars in the blood. This condition can be a precursor to a more serious condition such as diabetes.

How are Eating Disorders Treated?
There are three steps to treating eating disorders.

The first step is the physiological or medical intervention. Eating disorders may be classified under mental health issues, but they carry with them serious medical effects. People with Anorexia Nervosa, for example, can suffer from severe malnutrition that serious and irreversible damage to vital organs occur. Eating disorders may even be fatal if not arrested in time. Therefore the first order of business is to restore the patient to an ideal weight, address nutrient deficiency, and treat the medical side effects of the condition.

The second step to treating eating disorders is psychological assistance. Counseling and therapy must be employed to address the psychological reasons behind the dysfunctional eating patterns. Eating disorders are related to dysfunctions in perception of one’s weight or shape. Often, patients suffer from low self-esteem, obsession about body weight, and a sense of helplessness about their situation. It is also not unusual for other mental health issues to develop because of the eating disorder, such as depression, anxiety and substance abuse.

The last step is maintenance to prevent relapse. Like people with addictions, those with eating disorders must consistently monitor their behavior even after treatment to prevent symptoms from recurring. Joining support groups, on-going family therapy, and education about proper nutrition and weight management are ways to maintain progress in recovery from eating disorders.

How Can You Tell if Your Child is Suffering from an Eating Disorder?
You will not be ablet o diagnose an eating disorder on your own. However, what you CAN do is take your child to a doctor or psychologist for assessment if you suspect that something isn’t right. Most parents are able and willing to do this when they see that their child is overweight. However, kids suffering from bulimia may be a totally normal weight. Kids suffering from anorexia may gradually lose weight and cover it up with clothing (and excuses). However, there are some red flags that can alert a parent to the need to have the child assessed. For instance: consuming large amounts of food without gaining weight is a red flag for bulimia. Playing with food on the plate, cutting it into small bits and moving it around, becoming increasingly picky as to what is fit to eat and clearly not eating much, may be red flags for anorexia. Other symptomatic behaviors include being very cold, growing a thin layer of hair on the skin, engaging in excessive amounts of exercise, buying laxatives and vomiting without being ill. Don’t get into a conversation with your child about whether or not he or she has an eating disorder. Instead, tell your child that diagnosis will be left up to a professional.

Anorexia

The eating disorder known as “Anorexia” has become so common, that almost everyone now knows what it is. When we think of anorexia, we think of excessively skinny people – sometimes with a skeletal appearance of skin and bones – whose lives are at risk due to malnutrition. And this is exactly what the disorder leads to. Anorexia is a condition that causes people to starve themselves.

Anorexia Nervosa used to be a condition that was most commonly found in individuals whose professions demand subscription to particular “body image.” Models, actors and physical trainer, for instance, have long suffered from eating disorders because their jobs require them to look a certain way.

Unfortunately however, the incidence of Anorexia Nervosa is climbing among the general public, with highest rate found in adolescent girls. Furthermore, onset age of the disease get lower and lower each year, with girls now as young as 7 years old succumbing to the illness. It may be that the way the media portrays attractiveness, the decreased focus on healthy eating habits, and the decrease in parental guidance as dual-income families and divorcing couples increase, all contribute to the rise in adolescent anorexia.

What are the Symptoms of Anorexia Nervosa?

Anorexia Nervosa is an eating disorder characterized by an irrational obsession with having a thin body.  A person with Anorexia controls his or her body weight by limiting food intake and also by attempting to “un-do” eating by inducing vomiting, using laxatives or exercising excessively. When kids start restricting their diet to very low calorie foods, start obsessing about and avoiding “bad” foods like fats and carbs, cut up their food in small pieces and shuffle it around their plates, wear baggy clothing to hide protruding bones, claim they’ve eaten when they haven’t, exercise way too much, and so on, it’s time for parents to be concerned.

People with Anorexia suffer from a distorted body image. Regardless of their actual weight and height, or of their objective appearance in the mirror, they still feel that they are “too fat” and need to lose some weight.

Types of Anorexia Nervosa

There are two more common types of Anorexia Nervosa: a “restricting type” and a “binge-and-purge” type. Those who belong to the first type obsessively lose weight by fasting or eating extremely small portions. Those who belong to the second type alternate between binging (eating large quantities of food), and then later finding ways to remove the eaten food before the food is digested.

A Serious, Even Fatal Disorder 

Anorexia, like all eating disorders, must be taken seriously. It is not a “teenage fad,” but rather a serious health risk.  Aside from the psychological impact of the disease, Anorexia Nervosa can result to many serious physical conditions — even death. Starvation alone may result into cardiac arrhythmia, hypotension, gastric issues and low blood pressure — not to mention various complications resulting from many nutritional deficiencies. Anorexics may require hospitalization, and a full physiological therapy, before they can even start dealing with the emotional issues associated with the disease.

What Can Parents Do? 
Given the seriousness of this disease, what can parents do to protect their children?

Preventing Anorexia Nervosa in one’s home begins by promoting a healthy body image for the family. Contrary to what the media promotes, there is no one measure of attractiveness and beauty. Similarly, body size and shape doesn’t necessarily equate to health — ethnicity, bone/muscle mass and body structure must all be taken into account before one can be considered as underweight or overweight. While parents are recommended to be health and diet conscious in the home, they must also be affirming of their child’s natural beauty so as not to encourage a pre-occupation with body image. Neither parent should praise a child for being skinny. A thin body type is simply an inherited characteristic – as is a softer, bigger look. As long as your child is not eating poorly (i.e. living on a diet of coke and cookies, munching chips and ice cream instead of eating dinner), then just help him or her to learn the basics of dressing well. For instance, a “square” shaped child will look better in a certain type of sweater/pant or skirt combination than in a different kind of outfit – teach your adolescents about dressing to highlight their own good looks. Much can be accomplished with a few library books on the subject. If your child is actually eating poorly, encourage good eating habits without becoming so intense about it that the child swings the other way; many anorexics were once overweight and compensated by going too far in the other direction. When parents are too invested in the child’s “look” they may accidentally nurture the seeds of disease.

Even more important, however, is the emotional climate of the home. Kids act out their stress with eating disorders, so try to create and maintain a fairly low-stress environment. This means, work on your marriage (or even your divorce) so that there isn’t a lot of hostility being displayed, refrain from raising your voice or using very stringent punishments, keep demands light and reasonable considering the age of the child, bring laughter and love into everyday interactions EVERY day, and don’t get too stressed yourself. Although nothing a parent does can guarantee that a child won’t succumb to eating disorders, taking these steps can reduce the chances.

If you suspect that your child is developing symptoms of anorexia, then go with the child to a medical appointment to obtain a formal assessment. You can tell your child, “I’m not an expert. I don’t know if the way you are eating and the way you look is fine or not. I am, however, feeling concerned. So I’ve made an appointment for us to see Dr. So and So, who can tell me where things stand. If there’s no problem – great! I’ll leave you alone. But if there is any problem, then we can help you with it.” Such an appointment should never be optional. If you thought that your child’s lump on her skin was suspicious, you wouldn’t ask her to please come for a biopsy. You would TELL her that she needs to be seen by a medical professional. You would not allow your child to refuse to go, knowing that untreated cancer can be life-threatening. In the same way, you need to use all of your parenting power to get your child to a doctor when you suspect the life-threatening disorder of anorexia.

Only Eats Junk Food

Is your child a junk food addict? It’s not really surprising. Junk foods are readily available these days and can tempt anyone – especially children. While junk foods may be enjoyed as a special treat – as part of a birthday celebration or some other special occasion – regular ingestion of these products is unhealthy, leading to an array of issues ranging from cavities to diabetes. But how can parents get their children to enjoy real food that can truly nourish their bodies and souls?

If your child only eats junk foods, consider the following tips:

Start Early
If you can instill a love for healthy foods as early as toddlerhood, your child is less likely to jump on the junk foods bandwagon. After all, kids crave what their taste buds are used to. Introduce soft drinks, cakes and chips early in life, and you’ll be battling them for years. But introduce healthier alternatives like grains, seasoned vegetables, tender meats, cheese and yogurt, and fresh fruit to your young child, and they’ll enjoy these healthy foods for a lifetime. Since you have more control over your toddler’s diet than you will have at any point in the child’s life, it’s up to YOU to get your child started right with food. However, your child will also be exposed to your own diet and to the foods of others around him. If sweets and empty foods are being consumed by others (as they most likely are), don’t deprive your child! Rather, offer the occasional sugar-free look-alike (homemade cookies sweetened with juice, Stevia or agave), sugar-free candies and the occasional actual sugar treat. Junk food in moderation will not harm your child, just be careful that it is not consumed in excess.

Refrain from “Doctoring” the Food
Something that parents learn quite early is that making food sweeter increases its likelihood of being ingested. They put (sugar-based) ketchup on food and magically, their youngster eats it. They put chocolate chips on it, chocolate syrup in it, spoonfuls of sugar all over it and it suddenly becomes appetizing. Although most parents are aware that the sugar is not good for the child, they are just happy that the child is eating the good food along with the not-so-good food. In their mind, it is worth a bit of empty calories to get their child to eat some nutritious foods.

Unfortunately, in their enthusiasm to have the child eat something, parents have sacrificed long-term good eating habits for short-term meal solutions. They are soon dismayed to find that their child no longer likes anything that isn’t sugar-coated. Now they have a toddler who eats sweet cereal, chocolate milk, candy and french fries, but little that is actually good, normal, nutritious food. When the problem gets so out of hand that parents can no longer justify doctoring the food to make it palatable, they want to know how to retrace their steps and get their child eating right.

Serve Junk Foods Only When Kids are Full
Some parents believe that junk foods can be consumed as an occasional guilty pleasure. After all, an ice cream cone now and then can be a great treat. However, if you’d like to treat the family to occasional junk foods, try to do it after your child has eaten a full meal. This way kids won’t be tempted to eat too much of the bad stuff – as they have already eaten something. Allowing your child the occasional junk food treat – instead of letting junk food be the staple food of your child’s diet – will also make your child appreciate it more as the treat it is meant to be.

Limit the Processed Sugar in Your Child’s Diet
Research has shown that the more we eat sugar, the more we crave sugar. As most junk foods are rich in sugar, they are a natural choice to manage sugar cravings. To limit your child’s junk food intake, stick to sugarless alternatives (and there are many). To satisfy that sweet tooth, use dried fruits in moderation, fruit juices, Stevia (a herbal product), xylitol, palm sugar, coconut sugar and other low glycemic alternatives. None of these produces the sugar spike and sugar cravings that real sugar creates.

At first, your child may refuse to eat what you offer – don’t worry about it. In fact, you WANT the child to reach a state of hunger. Don’t worry – you’re child won’t let him or herself starve; rather, when hungry, he or she will be much more willing to try a new food. All food actually tastes a lot better when a person hasn’t eaten for awhile – when the person is really hungry. Now that the child has had even a small amount of real food, he or she will eat it again (because it was, at least, edible and perhaps even, good). Research has shown that after just one week of eating a food, it will start to taste really good, even if the person didn’t like it originally. For instance, a child who is used to drinking cow’s milk finds that cow’s milk tastes good. When offered a milk substitute for the first time (soy, rice, hemp or almond), the child will often balk. However, if cow’s milk is withdrawn from the diet and only the substitute is offered, the substitute will indeed indeed begin to taste good and normal, after only a few days. If the substitute is continuously given, then cow’s milk will be the unusual and odd-tasting food.

Using these principles, parents can re-train a junk-food addict of any age. However, the job is easiest with toddlers. Toddlers can’t help themselves to food, so they are totally dependent on what they are fed. As long as parents are willing to be firm and consistent, withdrawing sugar from regular meals and limiting it to rare snacks given at specified times during the week (i.e. the child gets a cookie snack in the afternoon daily, but never gets any other sugar in her diet), the child will soon be eating and enjoying real food!

Make Simple Rules
Instead of fighting with your child about junk food, make simple rules about its permissibility and stick to them. For instance, you can have a rule that candy is served only on Saturday – never at any other time. Or, you can have a rule that plain cookies and pretzels can go in a lunch box, while fancier cookies and pastries are for Sunday brunch only. Perhaps you want a rule that states that potato chips and colas are only served at family gatherings (birthday parties and celebrations). You can make any rule you like, but try NOT to make a rule that permanently and totally prohibits all junk food – such rules tend to cause kids to become obsessed with getting their hands on candy and other unhealthy snacks. Serving it in moderation at predictable times helps prevent obsession and other nasty behaviors like stealing other kids’ snacks. If children are served delicious healthy foods most of the time, they tend to have little craving for the junk.

Prepare a Healthy Lunch Box
If the school canteen has an array of tempting junk, try to provide school snacks from home. Eliminate the need to visit the cafeteria by packing your child a healthy snack box. Health food stores carry a large selection of delicious junk-food look-alikes and, if you have time to bake, you can control your own ingredients to make nutritious and delicious treats that your kids will love. They really won’t be pining for the canteen. Does your child yearn for cool packaging? Maybe you can even wrap your goodies in an appealing way. Here’s your chance to be creative!

Be Firm, Consistent and Patient
Don’t be swayed by your child’s tantrums and tears. Instead, simply remain calm and firm. No need to scream back! Just learn to say, ‘No.’ Don’t worry – as long as you don’t start yelling, your child will still love you plenty even if you stop feeding him or her tons of junk food. You needn’t be afraid of your child. You are NOT hurting your child by limiting junk to a small percent of the diet. On the contrary, you are helping your child be healthy life-long. Your child is too young to appreciate that right now, but YOU know the truth. Your child needs to learn to gracefully accept your guidance and limitations and is much more likely to do that when you remain calm, firm and consistent. Eventually, your child will stop protesting, settle down and enjoy his or her food. Patience will pay off.

Bulimia

Bulimia is an eating disorder – but one that is not necessarily easy to spot in one’s own child. Other eating disorders are more visible. For instance, pills almost anyone can recognize obesity – a condition in which the sufferer is significantly overweight. People can also often recognize cases of anorexia nervosa – the condition in which a person is severely under his or her ideal weight (and may therefore look painfully skinny and boney). However, it is not possible to identify someone with Bulimia Nervosa just by looking. The sufferer of this eating disorder may be a perfectly normal weight. It is not the WEIGHT that is disordered in this condition, but rather the way in which the person maintains that weight.  A bulimic (one who suffers from bulimia nervosa) eats way too many calories in one sitting (for example, a number of grilled cheese sandwiches, a full tub of ice cream, a box of crackers, a bag of chips and a plate of waffles). This episode of overeating is called “bingeing.” It is normally followed by feelings of panic (about gaining too much weight), shame and guilt and an intense effort to “undo” the eating behavior by engaging in excessive exercise or using laxatives to empty the gut, or inducing vomiting for the same purpose. Episodes of bingeing and purging (over-eating and then “undoing” the calories somehow) can sometimes occur many times a day. On average, people with Bulimia binge 12 times a week, consuming as much as 11,500 calories. Foods rich in processed sugar and fat, such as pastry, ice cream, bread and donuts are the most common objects of binges.

Bulimia Nervosa is more common than Anorexia, and affects girls more than boys.

Signs of Bulimia
Although parents can’t tell from LOOKING at their child that the youngster is suffering from bulimia, they may be able to discern a problem by observing their child’s behavior. Those suffering from bulimia usually feel a lack of control when it comes to eating. While most of us stop eating when we feel full, those with bulimia keep on eating to the point of feeling pain.  This inability to control their eating can be very embarrassing and typically bulimics try to hide their binging and purging.  Some typical symptoms that may indicate bulimia are:

  • Wanting to eat alone
  • Eating very little in public
  • Frequent trips to the bathroom after meals
  • Disappearance of food
  • Hidden stashes of junk food
  • Eating large amounts of food without putting on weight
  • Excessive exercising
  • Using laxatives, enemas or diuretics

People with bulimia may also have physical symptoms caused by purging.  These include:

  • Puffy cheeks caused by repeated vomiting
  • Discoloured teeth caused by exposure to stomach acid when throwing up
  • Frequent fluctuations in weight
  • Calluses or scars on knuckles and hands caused by putting fingers down the throat to induce vomiting

An Impulse-Control Issue
Are sufferers of Bulimia Nervosa aware that their eating pattern is dysfunctional? Yes. However, they have difficulty controlling themselves; the act of binging and purging is a compulsion. In fact, many Bulimics report that they only stop a cycle of binging or purging when they feel physical pain. Otherwise, they can’t help themselves. They have a compulsion that is too strong for them to overcome, much like an addicts relationship to his substance.

Bulimia Nervosa has been linked to emotional stress as well as body image issues. Low self-esteem, a history of abuse, a difficult life transition, traumatic experiences and other stresses have been found to be higher in those suffering from Bulimia. In addition, there is a higher rate of bulimia in those who are drawn to a body-conscious hobby or profession like modeling, ballet, gymnastics or physical fitness training. It is not clear whether the activity and peer pressure found in the activity actually induces bulimia or whether those with bulimic tendencies (obsession about body image) may choose those activities to begin with.

A Serious Health Threat
Bulimia is a serious health issue. Chronic bingeing and purging can cause serious gastro-intestinal diseases. The purging (in the form of vomiting, laxatives, and diuretics) can lead to electrolyte imbalances, usually in the form of low potassium levels. Low potassium results in symptoms such as lethargy, confusion, irregular heartbeat, and cardiac and kidney dysfunction. In severe cases it can even cause death. Other effects of bulimia may include:

  • Weight gain
  • Constipation caused by chronic laxative use
  • Abdominal pain and bloating
  • Tooth decay
  • Chronic sore throat and hoarseness
  • Broken blood vessels in the eyes
  • Weakness and dizziness
  • Loss of menstrual periods
  • Acid reflux

Risk Factors
Bulimia generally begins in adolescence and 90 – 95% of those with the disease are women.  There is no single cause for bulimia but low self-esteem and poor body image are often contributing factors.  Some of the more common risk factors for bulimia are:

  • Dieting – people who diet on a regular basis are more likely to develop an eating disorder than those who don’t.
  • Involvement in professions/activities that emphasize weight control – the pressure placed on gymnasts, dancers, models, actors, and other athletes to maintain a certain weight can lead to the development of eating disorders.
  • Low self esteem – this can be a result of abuse, depression, a critical home environment, and a desire for perfection.
  • Poor body image – young women are often influenced by our culture’s glorification of thinness and beauty.
  • Major life changes – bulimia is sometimes a reaction to stress, which can accompany a major life change.  Examples of major life changes may be; moving away from home, puberty, divorce, and the break-up of relationships.
  • Biological factors – since eating disorders run in families there is likely a genetic component.  In addition, research indicates that low serotonin levels play a role in bulimia.

Treatment for Bulimia
Treatment for Bulimia should be a combination of a medical and a psychological program. At times, an in-patient weight management program needs to be implemented alongside counseling in order to address the two critical aspects of the illness. Most often, however, bulimia is effectively treated on an out-patient basis. People do heal from this disorder. They may have relapses occasionally but when they learn effective stress-management techniques they can usually prevent relapses over the long-run. Seeking counseling and using self-help strategies are both important for long term recovery.

Psychotherapy is the main form of treatment for bulimia.  Specifically, cognitive behavioural therapy is often used to break the binge-and-purge cycle and change unhealthy thought patterns.

Medication such as anti-depressants may also be used.  These help to reduce binge eating and treat the depression that is often a part of bulimia.

Suicidal Feelings

A certain number of people kill themselves each year, most of whom were suffering from severe depression. Fortunately, 90% of people with depression are able to live full lives while managing their episodes of depressed mood. Only about 10% will end their lives (this number depends on where a person lives – countries vary in their availability of effective treatments and support for depression, so there is a wide international variability in suicide rates).  The pervasive sad mood that comes with depression, as well as the increased tendency among the depressed to obsess on negative thoughts, makes them susceptible to the hopelessness and irrationality characteristic of the suicidal person. People do not “choose” suicide; they fall victim to it as part of their illness.

What are the Implications for Parents?
The link between suicidality and depression should serve as alarm bells when helping our children deal with mental health issues. If we have a loved one who is suffering from depression, it is always prudent to watch out for signs of suicidality. A depressed child is at risk for succumbing to suicidal thoughts; it is up to parents to help prevent this. Vigilant parents can be familiar with the warning signs of suicidality and take action. Moreover, they can do everything possible to get their child the right kind of help. In addition, they can work hard to reduce the other stressors in the child’s life – like school work (negotiate accommodations with the school) and conflict in the home. In fact, when the parents work on their own marriage and parenting skills to increase peace in the home, this can help tremendously.

What are the Warning Signs?
According to the American Academy of Child and Adolescent Psychiatry these signs are:

  • Change in eating and sleeping habits
  • Withdrawal from friends, family, and regular activities
  • Violent behavior or running away
  • Substance abuse
  • Neglect of personal grooming
  • Personality change
  • Difficulty concentrating, persistent boredom
  • Drop in academic performance
  • Marked personality change
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Loss of interest in previously enjoyable activities
  • Speaking positively about death or romanticizing dying (“If I died, people will appreciate me more.”)
  • Writing about death, dying, or suicide
  • Engaging in reckless or dangerous behavior; being injured frequently in accidents
  • Giving away or discard favorite possessions
  • Saying permanent sounding goodbyes to friends and family
  • Seeking out weapons, pills, or other lethal tools

A child or teen  who is planning to commit suicide may also:

  • Complain of being a bad person or feeling rotten inside
  • Give verbal hints with statements such as: “I won’t be a problem for you much longer.”, “Nothing matters.”, “It’s no use.”, and “I won’t see you again.”
  • Become suddenly cheerful after a period of depression
  • Have signs of psychosis (hallucinations or bizarre thoughts)

The risk of suicide is high among those who have attempted suicide before, know someone who has killed themselves, and are pessimistic about the chances of getting relief from chronic depression. Also, teens who have a family history of mental illness and suicide are more likely to attempt suicide as are teens who have clinical depression or who suffer from active addiction. Teens who’ve already made a suicide attempt have a higher chance of committing suicide successfully. Vulnerable teenagers who suffer a serious loss (like the breakup of a romantic relationship) may try to stop the pain with suicide. A history of physical or sexual abuse, incarceration, alienation from parents and refusal to access mental health services all increase suicidal risk. Males have a higher “success” rate for suicide than females, but females make many more suicide attempts than do males. Also take note if your depressed child suddenly seems unusally happy. Sometimes this switch in attitude happens because a child has decided to end his suffering and he is actually experiencing a state of relief. Remember that depressed mood is a serious and potentially life-threatening condition and should always be professionally treated.

The American Academy of Child and Adolescent Psychiatry recommends taking a child’s suicidal statements seriously. If a child or adolescent says, “I want to kill myself,” or “I’m going to commit suicide,” ask him what he means. Don’t be afraid of saying the word “suicide.” You won’t be giving the teen an idea that he hadn’t thought about. Instead, you’ll help him or her think things through. Ask about depression, anxiety and unhappiness. Don’t just tell the child no to talk that way.  Show interest and concern and get your child to a qualified mental health professional (such as a psychiatrist or clinical psychologist).

Suicidal Behavior in Teens
Teenagers are a vulnerable group. They experience tremendous pressure from all sides: from inside their changing bodies, from their parents, from their schools and from their peers. No one can be perfect in every area and so everyone is doing poorly in something. But teenagers can feel isolated with their failures and setbacks, lacking the perspective that older people have that “we’re all in this together.” Teenagers are intent on fitting in, looking good, being acceptable. If the only group they can fit into is a violent, drug-ridden street gang, then that’ll be the group they might very well join, especially if they have little support elsewhere or few sources of success and strength.

Because the pressure is so intense, many teens do not cope well. Their survival strategies depend to a large extent on their genetic make-up and the strategies they learn at home. Some teenagers have “hardy” genes that help them survive and thrive under stressful conditions. They can laugh their way through almost anything or simply tough it out. Others are genetically vulnerable to bouts of depression. However, the depressed teen is more at risk than depressed adults. Teens are very focused in the present. They have trouble imagining that in a few years life can improve tremendously. Their impulsivity can lead them to put an end to it all right now because they just can’t see any way out.

What You Can Do
Parents can also help buffer teens from stress by keeping the doors of communication open. Make it easy for your kids to talk to you. Keep criticism to a minimum; instead, give praise and positive feedback generously. Have fun with your teenager and try to make your home pleasant, comfortable and safe. Keep conflict down with your spouse. Avoid drama. Take care of yourself and create a healthy model of stress management strategies for your kids to learn from. Create a positive atmosphere. Have a dinner table several times a week and use it to have discussions on politics, human nature, interesting things in the news or whatever—keep talking with your kids. Make your values clear. Bring tradition and ritual into your home.  Accept all feelings without correction or disapproval. Ask for behavioral change gently and respectfully. Never yell at your teenager. Never insult, name call, use sarcasm or any other form of verbal abuse. Instead, be sensitive to your teen’s feelings at all times. Discipline when necessary but only after you’ve warned a child that discipline will occur and only with mild discipline—never affecting the teen’s social life (see Raise Your Kids without Raising Your Voice for safe and effective ways of guiding teenagers).

If your teen demonstrates any of the symptoms of depression or suicidality, talk to him or her about what you are observing and arrange an appointment with a mental health professional. You can call suicide helplines in your area to get information about how to help your child. You can take your child for a mental health assessment. If your child is uncooperative, seek mental health guidance yourself. Since a suicidal person feels isolated and hopeless, any steps that family members take to address the situation can be powerfully preventative. Remember, too, that many parents have walked this road before you. Access on-line and community support if your child has been threatening suicide.

Symptoms of Depression

Depression is the most common complaint presented to mental health practitioners. This is not surprising; almost all of us have experienced sadness at some point in our lives, with some episodes being quite intense. However, clinical depression is not just sadness. It is a multifaceted illness that affects every aspect of a person’s functioning. It causes major distress and disrupts the sufferer’s ability to carry on with work, school, or other responsibilities. The illness can occur among the young and old, the rich and poor, the educated and the uneducated, and it can come at any point in a person’s lifetime. The good news is: depression is treatable. When sufferers are trained to spot the early symptoms, the onset of depression can be managed and relapses can be avoided.

What are the Symptoms of Depression?
Symptoms of depression can be classified into four categories: emotional, mental, behavioral and physiological symptoms. Let’s take a closer look at each one:

Emotional Symptoms of Depression
Mood disturbance is the most significant among the symptoms of depression. An individual with depression may be prone to feelings of sadness, emptiness, dejection, helplessness, hopelessness and lack of self-worth. Episodes of crying, irritability and/or of anger are also common. A marked loss of interest in work, relationships and self-care may also be seen.

Mental Symptoms of Depression
There are also cognitive symptoms associated with depression. Psychologist Beck believes that people with depression are tortured by what he calls the cognitive triad: a negative view of one’s self, a negative view of the world and a pessimistic view of the future.

Self-accusation and mental anguish are typical, especially when the obsessions start to come. For instance, a depressed individual may constantly tell himself that he is ugly, incompetent or unwanted; that others do not care about his welfare; and that tomorrow will offer no relief. It is this cognitive triad that keeps a depressed person stuck in the rut, unless some form of therapy is conducted to correct and heal the debilitating thoughts.

Depression can also cause a person to have difficulty making decisions or concentrating on tasks.

Behavioral Symptoms of Depression
Depression may be about an internal state, but symptoms of depression can be objective and observable. In many cases, physical appearance already provides a clue regarding the depressed person’s mental health. People with severe depression may not care much about their appearance or even their hygiene. They may gain or lose significant amounts of weight. Their movements may be slower or faster than those of the average person, and there may be a delay in their communication. They may have difficulty in accomplishing their job or otherwise carrying on their normal tasks. They may withdraw from others.

Physiological Symptoms of Depression 
Depression is an illness that affects the entire person — his or her physicality and biological processes included. People with depression suffer from disturbed patterns of eating and sleeping. They can have loss of appetite or an increase in appetite (what is called emotional eating). They can suffer with various forms of insomnia (trouble falling asleep, staying asleep, waking up in the wee hours, etc. Or, they can end up sleeping much longer than the average person. They may be more prone to ailments such as heart conditions, stomach disturbances, infections, unexplained pain and vague disorders.

If you or loved one has symptoms like those above, consult a doctor or mental health practitioner. Treatment not only provides more rapid relief than “waiting it out,” but also helps prevent recurrences of the disorder.

Diabetes

Diabetes is an umbrella term used for various conditions related to high blood sugar  or hyperglycemia. The exact cause of diabetes is still unknown, but most cases are related to the body’s inability to secrete enough insulin (the hormone that metabolizes sugar), or the inability to use secreted insulin optimally. The former is called Type 1 diabetes; the latter is known as Type 2 diabetes.  People with diabetes can suffer from high blood sugar, unless they pay careful attention to their daily sugar intake. High blood sugar (also called high glycemic index or high GI) can lead to many health complications, including heart and liver disease. Complications associated with diabetes include blindness, kidney problems (including hepatic failure), and leg amputation. Diabetes is also linked to an increased risk for heart problems including hypertension, stroke and heart attack.

Alarmingly, the age onset of diabetes is getting younger and younger, with most cases of childhood diabetes of the Type 1 variety. Even more alarming: most children with Type 1 diabetes have no family history of the disease! While official findings have yet to be released, current research suggests diet and lifestyle as the culprits of this increase.

According to the Center for Disease Control (CDC), the number of children diagnosed with Type 2 diabetes is increasing as well. This finding is significant, as Type 2 diabetes is typically found only among men and women 40 years old and above. The CDC attributes this increase to what it calls an “epidemic of obesity,” as well as the low level of physical activity among young people. Exposure to diabetes in the womb also increases children’s risk of developing diabetes.

Know the Signs
Parents can be on the lookout for symptoms of diabetes in their children. Increased thirst, increased urination, constant fatigue, and unexplained weight loss are often signals of high blood sugar. Stomach pains and headaches may also be indicators. If you spot these symptoms in your child, arrange a visit to your child’s doctor.

How Can Parent Help Prevent and Treat Diabetes in Their Kids?
Kids (and adults too!) gravitate towards sweet food. Cakes, candies, soft drinks, and all sorts of preserves are too tempting to resist. The same can be said about meals made from starch. Have you ever known a child who says “no” to a bowl of spaghetti, a slice of bread or a chocolate sprinkled donut? Delicious and convenient as these meals may be, parents have a responsibility to try to control their children’s sugar and starch intake – not only because these foods often have very little nutrient value, but because they put the children at risk for diabetes.

For most people, sugar refers only to the sweet crystals from the sugar cane plant, the one we add to our coffee and tea. Thus, when asked to limit sugar intake, they only avoid these sweeteners. But the fact is, our body transforms almost all of the food we eat into sugar. Parents should ideally be aware of what foods contain natural sugars. For instance, foods rich in carbohydrates and starch are rich in a type of sugar called glucose. Thus, people with diabetes, whether it’s Diabetes Type 1 or Type 2, should limit their intake of breads, pastries, pastas, rice and starchy vegetables like potatoes. Heavily processed foods, such as those that  underwent various treatments to be better preserved, can release these sugars too quickly into the bloodstream and so must be carefully avoided.

Contrary to popular belief, people with diabetes are not required to abstain totally from sugar. After all, our body gets energy from carbohydrates. The trick is to eat only enough to maintain normal blood glucose levels. If one is taking insulin injections, then it’s important to match one’s carbohydrate intake with insulin dose. Hypoglycemia (low blood sugar) must also be avoided. A doctor and/or dietitian can help provide information and diets to maintain optimum health.

Offer Lots of Fiber and Water
Offer your child the kinds of food that balance blood sugars. People with diabetes are encouraged to include in their diet rich sources of fiber. These foods include whole grain and whole grain products, fruits and vegetables. These natural products are less likely to impact the body’s glycemic level. Also, they provide vitamins and minerals integral to overall health.

Liquids are also important in helping manage our blood sugar. Aside from the recommended 8 glasses of water a day, people with diabetes are advised to have more, especially if they just ate sugar. Drinking lots of fluids can help flush down the sugar in one’s system.

Offer Alternative Sweeteners
Having diabetes need not necessarily mean that a child has to totally avoid sweet food and food products like cakes and soda. Today, there are many artificial sweeteners that can provide flavor to many meals, and thus create sugar-free options. Many of these sweeteners are approved by the Food and Drug Authority. Note though: the label “no sugar added” is different from “sugar-free.” If there are natural sugars in a product (like orange juice which naturally contains sugar from the orange fruit), “no sugar added” simply means that there’s no additional sugar that what’s naturally found in the product. To be safe, always read the nutritional information in product packages. Your child dietitian can recommend a range of sugar substitutes, some of which you can find in your local supermarket and some of which you’ll find in your neighborhood health food store.

Healthy Proteins
The good news for your youngster is that there are no recommended restrictions on protein-rich foods (chicken, turkey, meat, fish) for diabetics, no more than the restrictions imposed on people without diabetes. The usual dietary allowance of protein, around 20% of the person’s total source of energy, is recommended for diabetics. Make sure though that fat intake is limited to what is called good cholesterol as hypertension and obesity are additional health risks for people with diabetes.

Helping Your Child with Diabetes
While parents can understand the need for nutritional control in managing diabetes, many children cannot! They want to eat what they want to eat and they want to eat what their friends are eating. Parents can help reduce resistance to dietary management by showing understanding and empathy. “I know it’s hard and frustrating. It seems so unfair.” By acknowledging the child’s feelings out loud, parents can help the child release those feelings and move on. Parents need to be aware that because children lack maturity, they will often be tempted to “cheat” on their dietary restrictions. Because teens perceive themselves as invincible, they will do the same. Parents need lots of patience! Realize that this is all a normal part of life for diabetic youngsters. Eventually they will come to terms with their health condition and learn to be responsible for themselves. Meanwhile, parents can try to guide their children without resorting to heavy duty criticism, supervision or scare tactics. If necessary, have your pediatrician or nutritionist speak to your child directly. Sometimes the authority of a medical health professional is more powerful than the coaxing of a parent.

An Incurable and Progressive Disease
It’s important for parents to understand that diabetes is an incurable disease. Worse, left unmanaged, diabetes can produce serious – even fatal—complications.

No treatment has been found to cure or eliminate diabetes. Once your child develops this disease, he or she has it for life. While there are medications that can help control blood sugar, all these drugs can do is to help manage the disease. Constant monitoring of blood sugar, as well as the right diet and lifestyle, are critical to ensure that the condition do not turn for the worse.