Personally Speaking is our quarterly newsletter in which we discuss mental health topics.  The purpose of our newsletter is to inform and educate the community on personal issues, concerns facing our community, methods of treatment, and developments in related fields.  It is Avenues intent to not only provide care for individuals but to promote and create a healthy environment for our families.

Teenage Romance: Puppy Love or Addicted Love Disaster?
The Many Faces of Anxiety
Looking to the Mirror to Find Themselves
ADHD vs. the Bipolar Child: Facts vs. Fiction
Self-Mutilation vs. Suicide Attempts: The Tragedy of Mood Instability
Coping with Trauma
The Power of Perception
Sharpen Your Saw this Spring

Looking to the Mirror to Find Themselves  

American women--especially young women--use their body image as a way of creating an identity. Anorexia Nervosa and Bulimia Nervosa are eating disorders with distinct clinical presentations.

Common signs and symptoms of Anorexia Nervosa include, but are not limited to:

• Absence of menses
• Aversion to meats
• Cold sensitivity
• Compulsive behavior
• Distorted body image
• Hoarding of food
• Hypotension
• Excessive bodily hair growth
• Overexercise
• Weight at least 15% below normal

• Addison's disease
• Alzheimer's disease
• Crohn's disease
• Thiamine deficiency
• Hyperthyroidism

• Binge eating
• Excessive exercise
• Diuretic abuse
• High-fiber diet
• Teeth etched or rotting
• Weight fluctuating by 10% or more

• Hypertension
• Migraine headaches
• Opiate withdrawal
• Gastrointestinal disorders

Patient Management

The single greatest difficulty in managing a patient with Anorexia Nervosa is that the patient often denies the extent of her illness and is thus unwilling to accept treatment. A family member may bring the anorectic patient to the physician against her will. The patient may believe that her ability to exist on small amounts of food makes her special or that the maintenance of a low body weight signifies control over her life.

Initially, it may be helpful to educate the patient about the disorder. The disruptions of daily life associated with anorexia should be pointed out to the patient. The patient may eventually be willing to acknowledge problems with concentration on school, work, depression, isolation from peers, sleep disorders, and physical complaints such as hair loss or cold intolerance. Long-term complications, including osteoporosis with an increased risk of bone fracture, should be discussed.

In contrast to patients with anorexia nervosa, bulimic patients are of normal weight who binge and purge. They usually find their symptoms disturbing and are generally more willing to accept treatment.

Treatment

We have found the management of both of these eating disorders is best when a multidimensional treatment plan is followed, including

• Physician involvement
• Psychiatric evaluation
• Individual and group psychotherapy

Did You Know?

• Anorexia nervosa has an average mortality rate of 5%.
• 90-95% of anorectics are female.
• The typical eating disorder client is a white, teenage girl from the middle and upper middle classes, who will attend college.
• The anorectic patient is typically childlike in her logic, appearance and emotions.
• About 75% of people with bulimia nervosa will develop major depression in addition to their eating disorder, and almost half will also have substance and/or anxiety disorders.
• Approximately 3,000 calories is the average binge for those with bulimia, but consumption ranges from 1,200 to 11,500 calories.
• Most binges will last for about one hour.
• Bulimics sometimes spend over $100 per day on food.
• At least 5% of bulimics are overweight.

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