Teen Turbulence and Ten Things for Parents to Watch Out For
By Mel Fabrikant Thursday, September 26, 2013, 03:27 PM EDT
By Christy Baker Rogers, MSW, LCSW, Clinical Director, Carolina House
The beginning of the school year can be a triggering and emotionally difficult time for many teens, especially as they adjust to new academic expectations, new peer groups’ expectations of them, and increasingly challenging societal pressures around various types of performance (social, academic, athletic, etc).
Your teen may be dealing with a new crowd of peers, or a teacher with expectations different from what your child is accustomed to. The images and examples teens are seeing in the media for people their age frequently portray strong partying, drug and alcohol abuse, extreme thinness and/or obsession with body appearance, and careless or reckless behavior with no consideration for consequences. As young adults and teenagers face these demands and stressors, here are ten indicators and questions parents need to watch for and ask themselves in keeping an eye out for eating disorders.
1. Change in school performance and changes in affect. Is your child’s mood/temperament declining or noticeably different in some way? Are their grades deteriorating? If so, this may be a sign they need support or some type of intervention from a trusted adult. Depression and anxiety can often be a key piece in the development of an eating disorder, and the disorder itself can make it so challenging for a person to concentrate or for a person’s brain to perform properly that they cannot function as they used to.
2. Isolation from peers and shying away from/avoiding activities and people they previously found enjoyable or interesting. The eating disorder frequently leads people to believe that they’re somehow “not good enough” or that they will not be successful in whatever it is they’re attempting to do, whether that’s forming a new friendship or trying out for a team. They may experience a fear of judgment from others that is so intense they’d rather avoid the situation in order to avoid the perceived or feared judgment from others.
3. Skipping meals, over-eating emotionally, or a change in weight. A change in their relationship with food or a change in their bodies could be a sign that something deeper is going on. Behaviors with food can often become a coping strategy for stress, anxiety, depression or other emotions that may be difficult for your child to tolerate. Are family meals being refused? Are previous favorite foods being avoided? Does your child seem to be eating excessively or when they’re not physically hungry? Of important note, because teens’ bodies are naturally changing at this crucial developmental stage, be careful not to assume that a change in your child’s body is automatically problematic. Consultation with a physician, therapist, or dietitian may be necessary before coming to these conclusions.
4. Increased or decreased interest or participation in exercise. Like food, the eating disorder can lead a person to ineffectively use physical activity or exercise as a coping mechanism. Some body movement is healthy and can be useful for a person in managing stress, but if the exercise becomes a mandate and you begin hearing phrases like, “I have to”, or “I need to” around exercise plans, and if the body movement begins to feel compulsive and excessive in time and intensity this could be problematic.
5. Frequent, urgent, or immediate visits to the restroom after meals and snacks. This type of behavior could indicate that purging is occurring. If you notice this behavior, pay attention and do not ignore it. Again, consultation with a medical or clinical provider may be useful in approaching your teen about this observed behavior and concern.
6. Comparison talk. If you notice your child comparing his/her own body to that of his/her peers or to that of celebrities and public figures, this could be a sign of increasing body image dissatisfaction. In today’s society, this type of comparison is unfortunately often pervasive in peer groups and “cool” to engage in. This type of comparison is dangerous however and can lead to competition around weight and body shape/size, which can fuel the fire of the eating disorder. Teens need education about the media’s use of air-brushing and editing to “perfect” the image portrayed in magazines, billboards, and on television/movies. They need the message that their bodies are wonderful, just the way they are, and the focus rather should be on the productive and useful ways that their body can serve them in moving towards their goals and values, rather than as an object to judge, compare, or perfect.
7. Secrecy and defensiveness. If your child seems to be sneaking around, especially around food and exercise, this is important to take note of. Hiding food can be a sign of binging behavior or restricting behavior. Hiding frequency or duration of trips to the bathroom may indicate that compensatory behaviors are being used, such as purging, laxatives, or diuretics. Does your child seem very guarded or protective about his/her body movement and exercise, especially in terms of the frequency, duration, and intensity? The eating disorder thrives off of secrecy and shame. The person with the disorder often tries to hide or conceal their eating disorder behaviors due to feelings of shame. Make sure that when you approach these behaviors with your child you are not shaming in your language or behavior. Shame will only fuel the eating disorder further.
8. Perfectionism can also be a factor in the development and maintenance of an eating disorder. Is your child frequently dissatisfied with his/her performance or with his/her body? Does it seem like nothing he/she does is “good enough” or that an inordinate amount of judgment is placed on his/her grades, weight, shape, size, performance, or achievements? These observations and phrases like, “If I can’t be the best at this, I don’t want to do it at all” may be indicators that your teen is struggling with perfectionism, which often exacerbates and fuels an eating disorder. Competition levels increase, comparisons are commonplace, and nothing he/she does is good enough. The eating disorder can be a way for this person to manage these feelings/fears around perfectionism.
9. Impulsivity. The eating disorder can alter a person’s ability to make clear, sound decisions and to think through things before acting. If your teen is behaving impulsively, doing things they wouldn’t typically do without much consideration or thought, especially around exercise, food, and their body, this could indicate something troublesome for you to attend to.
10. Harm avoidance vs. novelty seeking. If you notice that your child is either aversive to taking risks, even appropriate and even normative and age-appropriate risks or if your teen is constantly seeking something new, and even risky or dangerous, these temperament traits and behaviors could indicate that something like and eating disorder is present.
Christy Baker Rogers, MSW, LCSW – Clinical Director Raleigh
Christy completed her undergraduate degree at the University of North Carolina at Chapel Hill, and afterwards entered the University of North Carolina at Chapel Hill School of Social Work, where she completed her Masters degree, developed a passion for, and began her research in the treatment of eating disorders.
She then spent two years working in a child and adolescent mental health clinic in Richmond, Virginia where she specialized in abuse, neglect and violent trauma. Christy provided both individual and family therapy there and employed evidence-based cognitive behavioral, psychodynamic, and extensive play therapy techniques. She received specialized training in the treatment of physical and sexual abuse and acute trauma with children and adolescents. Christy also gained experience working with a broad array of mental health issues including but not limited to Posttraumatic Stress Disorder, depression, anxiety, grief and loss, personality disorders, crisis management, and domestic violence. After having extensive experience with abuse and trauma, Christy observed strong co-morbidity with these issues and histories of body image distortions, self-harm, and eating disorders. This led her to continue following her interest in eating disorder treatment at Carolina House.