14 Sep 2021
Tips for Returning to School in a Difficult Time

In the best of years, going back to school is one of the most stressful times for families. This back-to-school period brings with it a number of unprecedented challenges: a return to in-person learning after last year’s exhausting remote or hybrid learning experiment, a rise in cases of COVID-19 among kids and teens because of the highly transmissible delta variant, the lack of vaccine authorization for kids under 12, and the polarizing debates over mask and vaccine mandates.

 

“Kids and parents were already dealing with the fall-out from the past year, like falling behind in learning and social development, because of remote school. In the last few weeks, everyone has had to face the health concerns about young kids and rising cases just as schools reopen,” says Alexis Wesley, M.D., child, adolescent, and adult psychiatrist at WCWCW. “Parents are overwhelmed and disappointed that this year isn’t turning out to be the return to school we’d hoped at the start of the summer.”

 

It’s impossible not to be stressed right now, and we’re not going to tell you otherwise. But we can provide some strategies to help you and your kids get through this trying period.

 

Talk to your kids about what to expect

Remote learning was challenging for many kids and teens, but transitioning back to in-person learning has its own set of challenges. Take time to calmly talk to your kids about what to expect for this school year, to the best of your knowledge, including information about what to expect in terms of masking and vaccination. It’s okay to acknowledge that things remain uncertain. Let your kids share what they’re nervous about. With things still changing, it’s important to check in regularly and continue to validate their feelings.

 

Help children with socializing

Returning to school after a year of remote learning is bound to create social anxiety for many kids. Things like bullying and cliques haven’t gone away, and now there’s also uncertainty about whether kids will have their normal social outlets, like sports and other extracurriculars. 

 

It’s important to support your kids during this time by helping them safely socialize and creating some sort of consistency in their communal environment. For example, if your kids’ activities are canceled, or if they’re doing virtual or hybrid learning, you could help them maintain connections with friends by organizing small group meet-ups outdoors.

 

Look for signs your child is behaving differently

Because of the challenges of the past year, your child may display behavior changes that are a clue to deeper issues. In younger children, look for shifts in appetite — either acting hungrier or saying that they are not hungry — or changes in sleeping patterns, whether sleeping less or sleeping in more. Young children may also complain about tummy aches and headaches. Older children and teens may display distress by withdrawing from friends and family and pulling away from activities or things that they previously enjoyed, engaging in risky behavior or self-harming, or being agitated or more irritable than usual.

 

Your child may benefit from mental health support such as talk therapy, play therapy, WCWCW’s social and emotional skills groups for children and adolescents. We also recommend our colleagues who run the Parent Child Journey program, which offers low-cost education for parents to help find effective strategies to address their child’s difficulties.

 

Develop routines

Developing healthy routines is key to navigating difficult times. Set a consistent sleep schedule, where you and your family go to bed and wake up at the same time. Exercise regularly, and encourage that for your kids. Eat first thing in the morning, eat regular meals, and make mealtime a family event, at least for dinner, as often as possible. Make sure to get your kids’ input when helping them develop their schedules. 

 

Minimize screen time

Parents are really struggling with weaning their kids from screens after last year’s virtual-heavy time. We’ll get into this more in a future post, but now is the time to start cutting down on unnecessary screen time. Here are some ways to start:

  1. Make bedrooms tech-free zones.
  2. Use parental controls on devices.
  3. Reward kids for doing things that are not tech-related.
  4. Remove yourself from tech devices when your child is present.

 

Here are some additional suggestions from the Mayo Clinic.

 

Practice self-care and model this for your kids

Let’s face it, caring for others, especially your children, is exhausting, and it’s easy to neglect and even forget yourself. Build self-care, such as meditation, self-healing, baths, or any simple practice you find restorative, into your routine. Talk about the things you do that help you feel calm and grounded, and encourage your kids to try some for themselves. 

 

Embrace ‘good enough parenting’

Psychiatrist D.W. Winnicott coined the term “good enough parenting,” which means not expecting perfection from yourself or your children. It’s okay to lower your expectations and let go of the need to be a “Super Parent” in exchange for sanity and self-care.

 

“Understand that everyone has fallen behind in the past year in certain areas, and be compassionate,” says Dr. Wesley.“In bumpy times, the best you can do is be honest about what you know, as well as what you don’t know, and provide love and support for yourself and your family.”

 

Get in touch with WCWCW to learn more about how our excellent and compassionate clinicians, mental health services and groups can help you and your children get through this difficult transition period

26 Aug 2021
Preserve the Good Changes You Made During the Pandemic

With the rise in delta variant cases as kids return to school and fights over mask mandates, the current period is in certain ways more stressful than lockdown. With everything in flux, it may be more difficult to have any kind of routine. But if you made positive changes during the lockdown period, like exercising, meditating, or spending more time with family, they are worth hanging on to. “With the stress of returning to work and sending kids back to school in an uncertain environment, you need the good habits that helped you get through the past 18 months more than ever,” says WCWCW psychologist, Dr. Susan Felzer

 

Read on for guidance on how to maintain healthy changes and why doing so matters.

 

Set priorities and adjust your routines

 

Lockdown gave many of us time and space to rethink priorities. Use this transitional time to solidify those priorities—in the areas of relationships, work opportunities, and activities. Once you’ve set your priorities, identify the behaviors and practices that will help you stick to them. For example, if a priority is mental health, a behavior could be a meditation practice. If you want to keep a meditation practice you began in lockdown, work on transitioning it to your post-quarantine routine. If while homebound you meditated during the time you would have normally commuted to work, and now you’re going back to the office for part of the week, you could wake up earlier to meditate. 

 

Even better, see if there’s a behavior that’s not serving you for which meditation could substitute. For example, if you habitually check your phone first thing in the morning, try meditating during the 10 minutes you might normally spend scrolling. Start small. If it’s hard substituting this every day, try three times each week. 

 

“Don’t feel like you need to stick with every habit you developed during the pandemic, just the ones that best serve you,” says Dr. Felzer.

 

Maintain a sustainable schedule

 

In order to stick with a routine, it needs to be easy enough to do so. It’s why people live close to their gyms or stock their fridge with healthy foods. Overscheduling is one of the biggest killers of routine. It’s easy for your calendar to fill up when children’s activities, playdates, volunteering, and social activities are ramping up. 

 

“It’s important to preserve time in your schedule for rest and self-care,” says WCWCW psychotherapist, Joy Paul. “When deciding whether to add something to your schedule, take a few moments to think about it. Do you genuinely want to participate, or are you feeling FOMO?”  You can return to your priorities, commit to activities in your priority buckets, and decline those that don’t make the cut. Block out free and unscheduled time for yourself each week, such as family time Saturday afternoon, no meetings on Fridays, or a movie or self-care night one night a week.

 

Ask to continue flexible work

 

The majority of those who worked remotely in the pandemic period want the option to continue. However, some organizations are eager to bring everyone back into the office. 

 

If you discovered working from home is a big post-pandemic priority but your company isn’t planning to support it, consider speaking to your manager about how you can work together to accommodate your needs. If your company refuses to budge, you may want to look into finding a more accommodating job.

 

Make quality time with family 

 

With the tempo of work, school, and activities building back up again, it’s likely not possible to spend as much time with your family as you did during the lockdown period. And for many, it is a relief to have kids back in school and activities. But you can still make family time a part of your schedule. 

 

A good way to maximize family time when you don’t have a lot of it is to focus your attention on it fully, instead of multi-tasking between work emails or social media. “When you get rid of distractions, not only are you more in the moment, but you remember that moment better later,” says Joy Paul, LCSW-C.

 

When change is out of your immediate control

 

Let’s face it: change is hard, especially when it requires the support or approval of others, such as a workplace that needs to okay a hybrid work situation, or a partner who needs to agree to watch the children while you take some self-care time.

 

“Change doesn’t need to come right away, but if you are able to maintain beneficial routines, it can help you deal with larger challenges in uncertain times,” says Dr. Felzer

Our mental health professionals can help you tease out what came out of your pandemic transformation and navigate uncomfortable or challenging conversations. For more information on how WCWCW can help you meet your needs for healing and personal growth, make an appointment with one of our clinicians today. 

04 Aug 2021
How to cope when so much is in flux

As the world has started to reopen over the last few months, many patients are finding themselves overwhelmed and confused. On the one hand, we can gather with family and friends again and return to the activities the pandemic forced us to stop. On the other, we’re quickly realizing that it feels unimaginable to return to the way things were after a year of such immense change. We’re not only reawakening to a world that’s very different from the one we knew, but one that’s still changing, and we’re different from who we used to be. Many of us have already made significant shifts, like moving, changing jobs, and spending more time with our families.

 Further complicating our decision-making is the most recent evidence that the pandemic isn’t over yet. COVID-19 is still a threat, particularly for the unvaccinated, which includes kids. While the CDC guidelines continue to evolve (and even give us a bit of emotional whiplash) because of variants and vaccinations, it means our normal routines remain unsettled, and we’re once again left with the stress of making important health and safety decisions for our families and our children. So, how do we get through this time when so much remains in flux?

At WCWCW, we’re here to help.

 

Don’t minimize what you’re experiencing 

 First, it’s important not to minimize what you’re experiencing. We’ve all survived and continue to brave an overwhelming amount of change. Recognizing and naming this as collective trauma, defined as a shared psychological response to a stressful or threatening event that impacts an entire society, is an important first step. 

 If you worked from home and were spared from family illness or death, you may feel lucky. Yet, the reality is we’ve all been uniquely scarred in some way. We’ve endured not just the virus but the polarizing political response to it. Add to this the events this year surrounding the election, as well as the brutalities against people of color, and the compounded emotional weight of the last several months has been a lot for even the most stable of us to carry.

 “Understanding the event as a trauma can help you become aware of and process your more challenging actions and emotions during this time,” says Dr. Wendy Hookman, WCWCW’s founder and medical director. “A lot of my patients are saying that they don’t understand why they are more irritable or less motivated right now, but once they actually start thinking and talking about the major stressors they’ve endured — and the way their lives have changed in such a short time — they have an ‘aha’ moment of insight and can start planning how they can pivot.”

Process and recognize underlying trauma and begin to heal

Compounding this upheaval is that our suffering is drawn out and uncertain. When humans experience a traumatic event, we react with a fight, flight, or freeze response. Because this trauma is drawn out, the fight-flight-freeze mode can be prolonged. Although it is an evolutionarily beneficial response, if we’re in this mode for too long, an overproduction of stress hormones can lead to anxiety, depression, sleep problems, memory impairment, and physical symptoms like headaches. Moreover, some responses to trauma can be unhealthy, such as picking fights if you’re in fight mode or overworking to stay busy in flight mode, as well as other obsessive-compulsive behaviors, such as substance abuse, or even physical responses like panic attacks.

 A mental health professional can help you process traumatic events first by encouraging you to identify and recognize the trauma and your response to it and next by helping you work through each stage of healing. He or she can work with you on a variety of therapeutic techniques that enable you to turn unhealthy responses into positive ones, ultimately helping you to build resilience, emerging stronger and more equipped to deal with future challenges. At WCWCW, we offer adult psychiatry, child and adolescent psychiatry, individual psychotherapy and group therapy — all aimed at helping you not only overcome but grow and thrive.

 “The truth is, everyone is figuring this period out in their own way. And no one has been unchanged by the past 18 months,” says Dr. Hookman. “It’s going to take time, distance, and thoughtfulness before we can begin talking about reversing the hidden trauma. The important thing to remember is you’re not alone.”

 

21 Jul 2021
How (and why) to protect yourself and your family from tick bites

Ah! The joys of summer – sun, vacation, bike riding, swimming, and hiking. All good things for our mental health. Generally. The thing is that lots of animals love this time of year, including ticks.

And where there are ticks, there is Lyme Disease. The black-legged tick is the only organism that can transmit Borrelia burgdorferi between animals or between animals and humans. Carried by a range of hosts, the black-legged tick is about the size of a poppy seed. If it is infected with Borrelia burgdorferi, its bite can have profound health implications.

Covid-19 has dominated our attention for so long that none of us, doctors included, have been thinking all that much about tickborne infections but it’s important to remember that we are now at the height of the 2021 season for tickborne infections. In 2019, Maryland recorded over 1,400 cases of the most frequently diagnosed tickborne infection, Lyme Disease, but other tickborne infections like babesiosis, anaplasmosis, ehrlichiosis and Rocky montan spotted fever (RMSF) are also reported here every year. 

What is Lyme Disease?

With more than 300,000 cases diagnosed each year, Lyme Disease is the most common tick-borne illness in the United States. Caused by the bacteria, Borrelia burgdorferi, the early signs and symptoms of Lyme Disease include fever, chills, headache, fatigue, muscle and joint pain, and swollen lymph nodes. People often think they have the flu. One of the best indicators that the problem is Lyme Disease is the distinctive rash that is caused by the tick bite. Sometimes the rash looks like a “bull’s eye” but most of the time, the rash is simply a red circle. Left untreated, or in its chronic state, Lyme Disease includes symptoms of fatigue, restless sleep, aching joints or muscles, pain or swelling in joints, decreased short-term memory or ability to concentrate, and speech problems.

What does this have to do with mental health?

More than you might think. While the media and the public health community focus on many of the health consequences of Lyme Disease, less attention has been paid to the mental health consequences that can coincide with Lyme Disease. It is also often the case that mental health symptoms are overlooked. Both are true for Lyme Disease, but increasingly significant cognitive and psychological symptoms are being recognized as part of the symptom pattern associated with untreated and/or chronic Lyme Disease.

I’m depressed because a tick bit me?

Depression has been reported in 8-45% of patients with post-treatment Lyme symptoms. But these numbers don’t tell the whole story. Many researchers believe that Lyme disease is vastly underdiagnosed. Diagnostic tests lack sensitivity and the symptoms of Lyme disease often overlap with other disorders. Thus, the true prevalence of depression in those affected by untreated or undiagnosed Lyme disease may be much higher. And although better statistics are needed, Lyme Disease may be so debilitating in some cases that it is associated with increased risk for suicidality. The mental health implications may extend beyond depression and even suicide. Case studies suggest that Lyme Disease can be associated with symptoms common to schizophrenia and bipolar disorder, including paranoia, delusions, olfactory, auditory and visual hallucinations, catatonia, and mania.

Tick Bite Prevention Tips:

Wear insect repellent that contains DEET (≥20%) or another EPA-approved repellent and reapply as directed. Wearing clothing and gear that have been treated with permethrin will also help to repel ticks. 

Walk in the center of trails and stay away from wooded or brushy areas with high grass and leaf litter. 

Tuck pants into socks and shirts into pants. 

Wear light-colored long pants and long sleeves to help keep ticks off of skin.

Conduct a full-body tick check and shower or bathe within two hours of returning indoors. After removal, place clothes in a dryer on high heat for 10 minutes to kill any hidden ticks. • Remove any attached ticks with fine-tipped tweezers. 

Check yourself, your kids, and your pets daily for ticks, especially after spending time outdoors.

And if you do find a tick, consider sending it for diagnostics. Most states have labs where ticks can be tested to find out if they are infected.

19 Jul 2021
How to stay safe while having fun this summer

During this reopening period, many of our patients are enjoying summer, yet still feeling anxious about navigating the specifics. These feelings can be further complicated by the fact that, although many adults are vaccinated, kids under 12 remain ineligible to receive the vaccine and, though case rates are dropping in many areas of the country, other parts of the world continue to struggle with the virus.

“It is possible to balance having a fun and relaxing summer and keeping everyone safe,” says Dr. Valerie Relacion, child, adolescent and adult psychiatrist at the Washington Center for Women and Children’s Wellness. “If you or your kids are feeling anxiety, that’s normal. It will help to identify and even write down the questions you have and do a little extra research and planning, but the good news is so many summer activities take place outdoors and the risk of infection has been minimized greatly since last year.”

Read on for some tips to help you navigate your emotions while planning for fun activities , playdates, and vacations, as well as strategies you can use to help kids who are nervous about their safety or anxious about socializing.

Activities
If you’re anxious about allowing your children to engage in organized activities or summer camp this year (not to mention burned out from this past difficult school year), assuage your concerns by looking into the organization’s or camp’s masking, testing, and infection protocols, as well as staff vaccination requirements. The CDC has issued guidelines around summer camp practices, although each camp’s policies will be determined by the state, locality, and the camp itself. Camps that followed safety protocols last summer had an incredibly low transmission rate even as cases were rising in the country, according to studies from Maine and North Carolina.

Playdates
It has been heartening to see our kids with their friends again. However, it can be stressful planning playdates if you are concerned about the vaccination status of parents and teens in another household but are wary of an uncomfortable conversation.

“The pandemic pushed us to talk more openly about what we’re comfortable with and set boundaries in terms of health and our families, and that’s something we can hang on to,” says Dr. Relacion. She suggests asking about vaccination status in a straight-forward and diplomatic manner, from a place of concern for your children as well as respect for the other parent, who is likely also thinking of their kids’ safety. “In the end, you’ll feel less anxiety if you know you’re doing what you can to protect your children,” says Dr. Relacion.
You can always share your family’s vaccination status first, which often encourages people to say whether they’re vaccinated, too.

Events
Similar to navigating playdates, if you’re hosting a backyard barbecue or picnic this summer, being clear about boundaries upfront can help you feel more at ease, such as setting masking and distancing expectations in your invitation. For example “We’re asking everyone who’s not vaccinated to wear masks indoors, and choose what you’re comfortable with outdoors.” Have extra masks on hand in case anyone forgets to bring one. Check out Johns Hopkins’ guide on what’s safe after the vaccine, if you’re trying to figure out ground rules.
If you’re invited to an event, check with the hosts to see what they’re expecting. It may help you feel safer to stick to outdoor events, like patio dining and outdoor concerts if you have unvaccinated kids at home.

Planning a trip
Taking a vacation is a great idea, for the memories and your mental health, and there are ways to do it safely. Again, planning ahead will ease anxieties and keep everyone safe. This can include checking about the masking practices of your accommodation and mode of travel; researching activities and dining options ahead of time; checking on vaccination and infection rates in your destination; and finding out if adults and teens of families you’re vacationing with are vaccinated. And remember— you don’t need to add the pressure of an overloaded schedule. After the past year, some R&R is definitely in order!

If your child is nervous about re-entry
What if your child is more fearful than you are? Some kids are understandably frustrated that their parents are vaccinated and they’re not. Address their concerns directly. Sit down with your kids and a calendar and discuss what they can expect over the next several months. You could sign them up for fewer activities than they might normally do and build up to more, as they get comfortable. You can also update them about the vaccine timeline. As of now, a vaccine for kids is expected later this year, possibly as early as fall.

If your child is more introverted and feeling anxious about socializing, it’s a good idea to talk to them about it. “Understand who your child is. If they love to read and want to be home all the time, maybe you could sign them up for an activity where they’re getting some exercise but they don’t have to be at camp all day,” says Dr. Alexis Wesley, child, adolescent and adult psychiatrist at the Washington Center for Women and Children’s Wellness. If they’re still experiencing significant anxiety around this, consider having them see a professional.

As we’ve said before, you don’t need to go from zero to 100 overnight. In fact, being patient with yourself and your family will lead to a more successful transition. Says Dr. Wesley: “After this past year, it’s important to take the pressure off yourself, and focus on making this summer one of quality time and creating memories.”

05 Jul 2021
Telehealth: Online video sessions

Updated July 5, 2021

 

Telehealth: Online video sessions continue to be the most convenient method of meeting for our patients so we are seeing patients in person upon request only. While Montgomery County has lifted the mandate on wearing masks indoors, we care for many children, who are not yet eligible for the vaccine, in-person. For this reason, we’ll continue with the precautions instituted during the COVID-19 pandemic. If you are coming to the office for an appointment, please expect to wear a mask, fill out a questionnaire, have a temperature, and maintain social distance in the waiting room and public areas of the office. We will continue to post updates here with future plans.

01 Jul 2021
Collective Trauma: What is it and what can I do about it?

As we start to emerge from the isolation of the pandemic, the term collective trauma is being used quite a bit to describe what we’ve all been going through. The is the first time in my memory that the term is being used so widely outside of psychotherapeutic circles and we’re being asked what it means and what it can tell us.

Collective trauma refers to the psychological reactions to a traumatic event that affect an entire society; it does not merely reflect an historical fact, the recollection of a terrible event that happened to a group of people. It suggests that the tragedy is represented in the collective memory of the group, and like all forms of memory it comprises not only a reproduction of the events, but also an ongoing reconstruction of the trauma in an attempt to make sense of it.

Collective trauma differs from individual trauma as it is recollected in the memory of the group and creates a process of on-going reconstruction and reproduction of the memory in order to make sense of it.

Well known collective traumas include: The HolocaustSlavery in the United States, the Atomic bombings of Hiroshima and Nagasaki, Genocide of Indigenous Communities, the Attack on Pearl Harbor, the September 11, 2001 attacks in the United States, and too many others.

The COVID-19 global pandemic is not the first event to be shared by the entire world, but in this age of technology and social connection when information travels the earth at lightning speed, we are all living the full impact of this collective experience, in real time. The daily “losses” we’ve all experienced and the countless individual tragedies of the virus come together in a cumulative and mutual loss to which few of us are immune.

The whole truth is that some of us will be more affected than others by the stressors covid-19 has placed on our daily lives and that of our communities. We won’t really know for years to come the totality of the physical and psychological effects we’ve endured. That said, we can take notes from survivors of previous events to get a sense of what we can do to mitigate any negative effects. 

Aspects of the COVID-19 pandemic can contribute to both individual and collective trauma. In a rapid review published in a 2020 issue of The Lancet, researchers found that isolation and quarantine contributed to a number of negative psychological effects including panic, depression, hopelessness, anxiety, stress, grief, confusion, anger, and even PTSD.

Research on past pandemics including earlier SARS and Ebola outbreaks provides some clues into the potential long-term collective impact of the COVID-19 pandemic. Commonly observed reactions include panic, depression, hopelessness, anxiety, stress, grief, and PTSD.

Some steps that you can take that may help manage collective trauma include:

Limit Media Exposure

Research on the aftereffects of 9/11 found that people who reported watching more television coverage of the attack experienced greater negative psychological effects. People who watched four to seven hours a day of news coverage of the attack were four times as likely to report PTSD-like symptoms.

Stay Connected with Others

Even if working from home requires limiting your face-to-face contact with other people, it is important to maintain your social connections. Thanks to technology, it’s possible to get creative and continue meeting friends, family, co-workers, and others virtually.

Rely on Trustworthy Information

People experience greater stress and panic if they are not able to accurately and realistically gauge the risk of a threat. While emotions can sometimes cloud judgment, particularly in stressful situations, research suggests that people are pretty good at making accurate assessments of the potential danger if they are provided with trustworthy, reliable information. Helping people make good choices by providing honest, transparent facts is imperative.

Utilize Mental Health Resources

Consider visiting a mental health professional either in person or via telehealth. One benefit of the pandemic is that there are many more online options than there were previously. Please reach out to us at WCWCW or another trusted healthcare provider if you need help.

02 Jun 2021
Questions you should ask yourself when considering professional help

Knowing when to seek professional help can be difficult. Here are a few questions to help guide your decision.

1) How severe are my symptoms? How large is their negative impact on my life?

2) How long have I been in this state of distress?

3) Am I becoming more avoidant or isolative due to this change in mood?

4) Am I less able to properly care for myself (eat, shower, exercise, go to work)?

5) Are friends and family noticing the change in my behavior and expressing their concern for me?

6) Am I beginning to feel hopeless?

There are also specific circumstances when you might consider seeking help:

  • The first is when you have thoughts, emotions or behaviors that are out of control, especially when they are affecting your relationships, your work or your sense of well-being. Never feel embarrassed to ask for help at times when you are upset or depressed.
  • Next is when you are struggling to deal with life’s painful challenges – such as a major illness, the loss of a loved one, divorce or job problems. These issues may be your own, but could also include those of others you care about.
  • The third is when the use of alcohol or drugs interferes with your health, your emotions, your relationships, your job or your ability to fulfill your daily responsibilities.
  • Another is when you are confused, fraught with emotions and need the perspectives of a caring yet unbiased person to help sort among difficult choices.
  • And lastly, when you feel that life is no longer worth living, that you are hopeless and have reached the end of the line, and you would rather die than feel the pain of the present. In the midst of such distress, you are not prepared to make life-or-death decisions. Ask for help.

Connect with our talented specialists and get help from the comfort of your home today.

 

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16 May 2021
Symptoms of an Eating Disorder: Parents, Know the Signs

The unfortunate truth is that eating disorders are prevalent in our society. According to surveys conducted by the National Eating Disorders Association (www.nationaleatingdisorders.org), current estimates are that 20 million women and 10 million men in the US will have an eating disorder at some point in their lives.

Parents are often the very first to recognize or suspect that their own daughter or son may be showing behavioral symptoms of suffering from an eating disorder.  Those afflicted can be embarrassed, ashamed and may not even feel worthy of treatment. They can be secretive and may also go to great lengths to hide their disorder, so it is important to educate yourself and understand the signs and ways to identify the problem and seek treatment as soon as possible.

Individuals suffering from eating disorders drastically change their relationship with normal eating. Typical sufferers will go to great lengths to limit calories. Eating disorders can involve different techniques from not eating or restricting overall food intake, to binging and purging meals, and in some cases abusing over the counter or prescription medication. If you suspect your child is possibly showing signs, what do you look for and what are the next steps to take? Here are some of the warning signs:

Restricting Food or Dieting

• Making excuses to avoid meals/situations involving food (had a big meal, isn’t hungry, upset stomach)
• Eating tiny portions or only low-calorie foods and often banning entire categories of foods such as carbs and fat
• Obsessively counting calories, reading food labels and weighing portions
• Developing restrictive food rituals such as eating foods in a certain order or rearranging food on a plate, excessive cutting or chewing
• Taking diet pills, prescription stimulants or even illegal “speed-like” drugs to eliminate appetite

Bingeing

• Unexplained disappearance of large amounts of food in short periods of time
• Lots of empty food packages and wrappers, often hidden at the bottom of the trash
• Hoarding or hiding stashes of high-calorie foods such as junk food and sweets
• Secrecy and isolation; may eat normally around others, only to binge late at night or in a private spot where they won’t be discovered or disturbed

Purging

• Disappearing during or right after a meal to make frequent trips to the bathroom
• Showering, bathing or running water after eating to hide the sound of purging
• Using excessive amounts of mouthwash, breath minds, or perfume to disguise the smell of vomiting
• Taking laxatives, diuretics or enemas
• Periods of fasting or compulsive, intense exercising, especially after eating
• Frequent complaints of sore throat, upset stomach, diarrhea or constipation
• Discolored teeth (the result of repeated vomiting)
• Backs of finger joints are callused or discolored from using fingers to induce vomiting.

Distorted Body Image and Altered Appearance

• Extreme preoccupation with body or weight (e.g. constant weigh-ins, spending lots of time in front of the mirror inspecting and criticizing their body)
• Significant weight loss, rapid weight gain, or constantly fluctuating weight
• Frequent comments about feeling fat or overweight, or a fear of gaining weight
• Wearing baggy clothes or multiple layers to hide weight

If some of these warning signs are familiar, it’s important to speak up. You should set aside a time to speak to your loved one about your concerns. It’s also very important not to use any language that indicates blame, but instead take a concerned approach. And discussing the need for professional help and guidance in encouraged. Don’t be afraid to have the conversation or worried you may say the wrong thing, it’s more important to speak up. Without treatment, eating disorders only get worse.

You should be prepared for an emotional response from your loved one. Individuals suffering from eating disorders are often afraid to ask for help or don’t believe they deserve help. They will often deny that there is an issue, or will become defensive. However, it is important to educate yourself and to also not give up after one or two discussions. Eating disorders are a very serious illness and in many cases, require the ongoing guidance and help of professional licensed counselors and therapists who have expertise and are trained in this area.

If you think you have a child, teen or young adult suffering from an eating disorder, you can contact us for help at the Washington Center for Women’s and Children’s Wellness at 301-881-9464 or reach out to us via email at info@wcwcw.org.

03 May 2021
The Health and Wellness Benefits of Meditation

The practice of meditation has existed for thousands of years, and it was originally meant to help deepen one’s spiritual self. However, today it has evolved to also be used as a purposeful way of quieting the mind, and encouraging deep relaxation and stress control.

When practiced regularly, meditation provides tremendous health and wellness benefits. It can help you manage your stress level, lower your heart rate and can even teach you how to calm yourself and slow down your breathing in stressful situations.  According to the Mayo Clinic, some of the benefits from regular meditation include:

Gaining a new perspective on stressful situations

• Building skills to manage stress

• Increased self-awareness

• Focusing on the present

• Reducing negative emotions

• Increased imagination and creativity

• Increased patience and tolerance 

Studies prove that meditation training changes the “mental muscles” in the brain by increasing activity in the portions dedicated to processing stress, focus, and calmness, 1  making it the perfect complement to conventional treatments for mood, anxiety, eating and sleep disorders, as well as ADHD. This is such an important finding, that WCWCW decided to stop just recommending meditation and to start providing it to patients (see more info on this at the end of this article!).

Meditation also offers additional health benefits and may help people manage symptoms of medical conditions including:

• Asthma

• Cancer

• Chronic Pain

• Heart Disease

• High Blood Pressure

• Irritable bowel syndrome

• Tension Headaches 

How long is a meditation and what is involved?

A typical meditation can be anywhere from 5 to 30 minutes or more. If you are just starting out, it might be helpful to participate in a group or guided meditation, where people share a setting, and someone skilled in meditation provides direction and guidance. A guided meditation can be a great way to get introduced into meditation, and teach you the foundations of breathing and quieting your mind.

A meditation session will usually begin with the individual in a comfortable position, sometimes seated on a cushion on the floor. The setting will be typically very comfortable with low lighting, and a quiet environment. The guide will provide directions on breathing and paying attention to your breaths. The idea is to free your mind of distracting thoughts as much as possible, and focus on the quiet around you and the simple sound and motion of your breath. You can also pay attention to various parts of your body as you become aware of each area as it relaxes more deeply.

When I prescribe meditation, my patients will often respond “I know I should meditate but I’ve tried and I’m not any good at it! I keep thinking about my to-do list or my kids or what’s for dinner tonight…..” The important thing to remember is that meditation is a practice, meaning that no matter how many years you’ve meditated, the goal is not to simply start out with no thoughts whatsoever. The goal is to continue to have thoughts (because you will) but become less “interested” in them – to notice that they’re there but to decide you’re not going to attend to them right now.

Making the time and space to make meditation a regular part of your routine in itself is an act of self-care that will lead to positive results. Over time you will improve your ability to more easily access the meditative state, release your stress and manage your thoughts for clarity. In the hustle and demands of our too busy lives, learning how to quiet your mind, slow your breathing and find a relaxed state can have multiple benefits to your life, health and even your productivity!

Washington Center for Women’s and Children’s Wellness has recently announced the launch of Recharj Bethesda, at 6430 Rockledge Drive, Suite 400 in Bethesda. Starting November 15th, Recharj Bethesda is providing guided meditation 3 times a day at the WCWCW Bethesda office location.  For hours and sign up information visit www.Recharj.com.

1,Creswell, J.D., et.alAlterations in Resting-State Functional Connectivity Link Mindfulness Meditation With Reduced Interleukin-6: A Randomized Controlled Trial; July 1, 2016, Volume 80, Issue 1, Pages 53-61.
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