Relationship with Food

Do you have an Unhealthy Relationship with Food?

Eating is a required action we all share as a means to maintain our health.  There are those who struggle with eating due to a medical condition, but there are others who struggle with a medical condition due to their eating disorder. 

General statistics indicate that at least 30 million people of all ages and genders suffer from an eating disorder in the U.S., and at least one person dies every 62 minutes as a direct result from an eating disorder. Eating disorders are a serious medical problem that can have long-term health consequences if left untreated.  Eating disorders have the highest mortality rate of any mental illness of which adolescents and women over 50 are more prevalent.  

There are several types of eating disorders:

  • Anorexia Nervosa or a focus on weight loss in which the individual has a poor body image and believes they are never thin enough, prompting excessive dieting, exercise, purging or use of laxatives.
  • Avoidant/Restrictive Food Intake Disorder or restrictive eating or avoiding certain foods because of its texture or odor.  These symptoms usually begin early in childhood.
  • Bulimia Nervosa or the cycling of extreme overeating or binging to purging or other behaviors to compensate for overeating. 
  • Binge Eating Disorder or excessive overeating

An unhealthy relationship with food is oftentimes a symptom of an underlying problem.  Usually, it is prompted by various life stressors combined with psychological struggles, such as low self-esteem, depression, anxiety, and/or overall difficulty coping with emotions.  Overuse of substances, genetic traits or a having a family pre-disposition can also be contributors. Oftentimes, those with an eating disorder initially use eating, or lack thereof, as a way to control at least one aspect of their lives.  However, their eating behavior progressively spirals out of control and they end up not being able to manage their own eating. 

Treatment is complicated.  You may have a friend or relative that has an eating disorder, but do not even know it.  Oftentimes, those with eating problems hide their behaviors and deny having a problem, interfering in their first step in treatment; admitting they have a problem.  Mostly, individual or group out-patient or in-patient psychotherapy and possibly psychotropic medications are required to work through the denial, comply with a food monitoring plan, and deal with secondary symptoms of depression, anxiety, etc., through stress management, modification of unhealthy relationship patterns and learning adaptive ways to feel in control of their eating and other aspects of their lives.  Unfortunately, symptoms of an eating disorder can last for many years and return during times of stress, despite previous treatment.  Catch yourself if you have an unhealthy relationship with food.  There is too much at stake.

Claudia A. Liljegren, MSW, LICSW

St. Williams Mental Health 

What is All this Talk about PTSD?

Initially, PTSD (Post Traumatic Stress Disorder) was coined for Vets returning from war after experiencing military combat. Most returned without conversing about their horror stories, and instead kept the memories to themselves, likely contributing to their frequent and horrendous nightmares, flashbacks and intrusive thoughts.  Remarkably, many of these symptoms eventually became more manageable after realizing the importance of sharing their stories and developing support and comradery amongst each other. 

Since, PTSD has been recognized in numerous other traumatic events, including accidents, assaults, rape, natural disasters and the like.  Most of us know someone or even ourselves who have experienced trauma in some form or shape.  Oftentimes, people are able to return to equilibrium after a short time, but others continue to struggle to go on.  With PTSD, it isn’t about experiencing the trauma, it is about the effects it has that make it diagnosable.  The trauma experience becomes part of life, feeling stuck with repeated trauma-induced re-experiences. 

Theorists question if PTSD is simply our bodies not yet recovering from its attempt to survive the trauma after being so busy increasing its heart rate, pumping blood to muscles, preparing the body to fight or flee, and using all physical resources and energy to get out of harm’s way.  Others, find it a medical condition that needs treatment.

Regardless, those with PTSD experience nightmares that remind them of the trauma, flashbacks of parts of the trauma itself or similar thoughts or memories that invade their mind.  Those with PTSD attempt to avoid anything that may remind them of the trauma or don’t even remember what happened.  Despite their effort to avoid, they continue to be trapped with anxiety.  Oftentimes they blame themselves/others for what happened, see the world through the lens of further danger or negative beliefs about the future, experience ongoing fear, horror, anger, guilt or shame, and detach from others and are less interested in usual activities they used to enjoy.  They struggle with ongoing negative thoughts and have difficulty thinking positively or enjoying supportive emotions.   In addition, those with PTSD are more likely to experience increased irritability or anger outbursts, sleep disturbance, feeling on edge and are easily startled, have concentration difficulties, and may engage in activities that cause them harm.  Like other mental health disorders, diagnosable PTSD results in an individual’s inability to function at work or school, at home, and other important areas in daily living.  Unfortunately, but understandably, many individuals struggling with PTSD symptoms also struggle with other conditions such as substance use disorders, depression and anxiety.

Though PTSD cannot be cured, it can be treated and managed in several ways.  Specifically, Psychotherapy, such as cognitive processing therapy or group therapy, Medications, service animals, and Self-management strategies, such as self-soothing, meditation/mindfulness, prayer, and support and consolation, are all helpful to ground a person and bring them back to reality.  The goal is a return to a normal life and move forward, after a tragedy long remembered, but without the effects of being in the midst of it.

Claudia A. Liljegren, MSW, LICSW

St. Williams Mental Health

Moodiness or Bipolar Disorder

We all get moody from time to time. It’s this sort of feeling that none of us want to have, yet still escapes when we are most vulnerable.  If it be times we have been too stressed, or not sleeping well or just down in the dumps, it takes a toll.  When our guard is down and logic is snuffed out from our arising emotions, we may even take some pleasure in being callous towards others, be it yelling at an innocent person, kicking the dog, or sitting on the couch like a lump and telling ourselves how bad life is.  Yet, when it is all done, we feel bad, pull ourselves out of it, and try to be better next time. 

Bipolar Disorder is different than moodiness.  It usually comes about from several factors, including genetics, brain structure and function, and a vulnerability to stress which can induce symptoms.  Bipolar Disorder is a mental illness that causes dramatic shifts in a person’s mood, different from the typical ups and downs most people experience, interrupting their ability to maintain work or school or cause significant family disruption.  There are several types of Bipolar Disorder, with the primary differences being the degree to which or severity an individual experiences manic and/or depressive symptom.  Mood frequency changes are usually at least 1-2 weeks in duration, although there are those that are more rapid cyclers, at 1-2-day overturns. 

Manic symptoms range in severity, but include a distinct period of at least one week in which the individual has an expansive, elevated or irritated mood and a persistent focus on goals or excessive physical energy or agitation, in addition to several other symptoms, including an inflated self-esteem, decreased need for sleep, excessive talking, racing thoughts, easy distractibility, and/or excessive involvement in activities that have a high potential for painful consequences (e.g., buying sprees, sexual indiscretions, foolish business investments).

Depressive symptoms in Bipolar Disorder are similar to symptoms when someone is experiencing Major Depression, are at least 2 weeks in duration, and include a depressed mood most of the day nearly every day, a lack of interest in usual activities, significant weight loss/gain, insomnia or sleeping too much, being more or less active than usual, feeling worthless with inappropriate guilt, a lack of ability to think clearly, and/or thoughts of wanting to die or hurt yourself.  Usually, with Bipolar Disorder, the depressive symptoms feel more severe and distinct, especially after moving from a manic state.

Sometimes, those experiencing Bipolar Disorder may also exhibit psychotic thinking, such as hearing voices, have delusional thoughts, or become paranoid. 

Treatment usually consists of Psychiatric medications (mood stabilizers, antipsychotic medications and occasional antidepressants), Psychotherapy (cognitive behavioral therapy and family-focused therapy), Self-management strategies (education and early detection, Complementary health approaches (such as aerobic exercise, meditation, faith-based help).

Moodiness mostly takes will power and self-control to manage.  Bipolar Disorder is like any medical diagnosis and needs treatment.  It is no one’s fault.  It just is.

Claudia A. Liljegren, MSW, LICSW

St. Williams Mental Health Service

Mental Health Awareness Week

Mental Illness Awareness Week takes place from October 6 – 12, 2019. This year, October 10 is World Mental Health Day and National Depression Screening Day.

The Mental Health Association is an organization that offers statistics, screenings and information on the primary diagnoses of mental health. 

  • Nearly 1 in 5 American adults will have a diagnosable mental health condition in any given year.
  • 46 percent of Americans will meet the criteria for a diagnosable mental health condition sometime in their life, and half of those people will develop conditions by the age of 14.

At mhascreening.org, there are available screenings that will help you determine if you are having any mental health concerns:  These screenings suggest that:

  • 74%of people score positive or show moderate to severe signs of a mental health condition.
  • 78% of people are likely to have a substance use disorder.
  • 72% of people show signs of moderate to severe anxiety.

Many people do not seek treatment in the early stages of mental illnesses because they don’t recognize the symptoms.

The Mental Health Association reports 7 major mental health conditions, including Anxiety, Bipolar disorder, Psychosis, Eating disorders, Depression, PTSD, Addiction/Substance Use Disorder.  As October 10th of National Depression Screening Day, the Mental Health Association offers the following questions to ask yourself about depression:

 Do you experience:

  • A persistent sad, anxious or “empty” mood
  • Sleeping too little, early morning awakening, or sleeping too much
  • Reduced appetite and weight loss, or increased appetite and weight gain
  • Loss of interest or pleasure in activities once enjoyed
  • Restlessness or irritability
  • Difficulty concentrating, remembering or making decisions
  • Fatigue or loss of energy
  • Thoughts of death or suicide

Screenings are not a professional diagnosis. Screenings point out the presence or absence of depressive symptoms and provide a referral for further evaluation if needed. You should see your doctor or a qualified mental health professional if you experience five or more of these symptoms for longer than two weeks or if the symptoms are severe enough to interfere with your daily routine.

Claudia A. Liljegren, MSW, LICSW

Clinical Psychotherapist

Resilience or Defeat

We all go through life with bruises and scars as we are tackled with knocks along the way.   But, why is it that some people are more able to bounce back while others struggle to get off the floor?  Of course, it is a complicated issue, and likely is impacted by a number of variables.  For example, an individual’s coping is likely dependent on how frequent and severe the knocks have been, or if the struggles are dealt with along the way or instead are accumulated.   Individuals are also more vulnerable if the difficulties began in early childhood when reasoning and problem-solving were not yet developed and misinterpretation and personalization are instead the norm.  Our personality characteristics also play a role; for example, an individual who is more sensitive and takes things to heart may have more difficulty getting through struggles compared to those that are more indifferent.   

Regardless, none of us want to feel defeated by the blows we encounter.  With a defeatist attitude, we are more susceptible to depression and anxiety, bent towards negative thinking, face the future with skepticism, and oftentimes go through life being defensive and guarded rather than freer and more open to new experiences.   So, what is the catch? How can we be more resilient? 

According to an article authored by the American Psychological Association, there are 10 ways to help build resilience: 

  1. Having good relationships that are reciprocal.  Giving and receiving help goes a long way.
  2. Interpret problems as being manageable vs. insurmountable.  Consider them “bumps along the road” vs. unsurpassable mountains.
  3. Accept that change is a part of living; focus on the circumstances you can change and let go of what you cannot change.
  4. Develop and pursue realistic goals, regularly.  Move forward.
  5. Take decisive action on problems vs. avoiding them or wishing they would go away.
  6. Look for opportunities for self-discovery.  Realize the strengths you have gained while feeling vulnerable; such as improved relationships, elevated self-worth, increased spirituality, heightened appreciation for life.
  7. Develop confidence in your ability to solve problems and that you can build resilience.
  8. Keep things in perspective; see the forest and not the trees.  Avoid blowing things out of proportion.
  9. Maintain a hopeful outlook; expecting good things to happen in your life.  Focus on outcome rather than being stuck with worry and fear.
  10. Take care of yourself; it helps your mind and body better deal with situations that require resilience; exercise, eat right, engage in enjoyable activities, delight in nature.

There are many helpful ways to strengthen resilience not mentioned above, including meditation or spiritual practices, feeling humbled by viewing other people’s problems having it worse than your own, and helping others.  Whatever way helps build resilience, the more able to enjoy life, with struggles.  Let resilience vs. feeling defeated be your story.

Claudia A. Liljegren, MSW, LICSW

St. Williams Mental Health

Generational Flow of Parenting

Good child-rearing is one of the most vital responsibilities us parents carry with us throughout our lifetime. More and more research reveal the degree of influence parents have on their children’s long range mental health.  It really isn’t about following the best child-rearing practices around; it is about what we personally bring to the table.  And, oftentimes, we bring to the table what was left with us when we were growing up.  Sadly, we transfer our own foibles to the next generation.  Although we thankfully don’t carry the whole load, giving some credit to peer influences, genetics, their own life experiences, and society’s effects, parents are truly the ones that have the most impact. 

There has been increased studies on the effects of plain, old, childhood emotional neglect.  This doesn’t include other types of abuse, such as emotional abuse, or being frequently criticized or manipulated as a child.  This is about not receiving sufficient affection, attention or nurturance.  So, let’s say you are a depressed parent who doesn’t seek help, or a parent who works all of the time and with good intentions.  There is no intent to harm, but the effects of child neglect can be great. 

It is our human nature, especially at a young age, to feel cared about and loved.  When emotionally neglected, a child is at risk for long-term adult problems, with common characteristics including feelings of emptiness, being hopelessly flawed with low self-esteem, dependency on others for validation, excessive guilt, feeling ashamed with some self-hatred mixed with anger towards those they feel harmed by, difficulty identifying and expressing their feelings, and their own lack of self-compassion.  If there is no insight as to what they bring to the table, the table will be the same for the next generation; a depletion of affection, attention, nurturance, and without intent.

The good news is that not all adults who experience emotional childhood neglect struggle with these problems.  We are all different, and children cope in various ways.  Among many factors, children’s level of coping depends on their own personal character.  For example, a child who is more sensitive and introspective is more likely effected from emotional neglect than a more resilient child who somehow holds some protective lining and is able to coast easier through times of vulnerability. 

The other good news is that we, as parents, can change.  With hope and understanding, we can gain insight about its effects and realize we can make a difference for ourselves and our children.   

As no one can predict how a child interprets their own world until they gain some insight later in life, it is still a generational flow.  Unless us parents deal with our own maladies, the table setting for our kids remains the same.

Claudia A. Liljegren, MSW, LICSW

St. William’s Mental Health Services

Generosity Gone Asunder

Have you ever offered a neighbor some apples from your tree only to later realize that there was none left over for yourself?  How about times you were generous with your money but then learned it was squandered?  Or maybe you borrowed out something only to receive it back in poorer condition, or not at all.  None of these are legal offenses.  They are occurrences that most of us experience from time to time.

Oftentimes, as the giver, it sets us aback and we are surprised at the rawness of it all.  It leaves us hurt and angry, and we gain a sense of distrust and fear that the same thing will happen again down-the-road if we aren’t careful.   We may even be more cautious with our generosity the next time around.  Of course, it helps when we learn that the deception was not intentional, or that the problem was merely missed communication; or, even if there may be a good underlying reason that we are not privy to.  None of us want to be taken advantage of, but being paranoid and distrustful are surely not virtues we seek.  What can we do to protect ourselves, yet remain a generous people?  

As most of us realize, being a “giver” abounds its own rewards.  It heartens our souls.  It has its own energy and we seek to do more giving because we are left with the good feelings it generates inside.  Giving to others helps our mental health.  It takes us away from our own hurts and insecurities, at least for a time.  It helps us feel valued and that we can make a difference. 

We are still left with the pre-ponderance of what to do when we are intentionally misled.  Do we want to teach others that it is ok to do self-serving damage to another by doing nothing?  Is it our duty to help others recognize the harm they have done so that they can change or challenge their motives?  And for those repeat offenders, what can we do to maintain our open-handedness without distrust lapping up our good intentions? 

  1. Before giving, decide if it matters what happens in the end; how would you feel if all the apples are indeed taken, or your gift of money is squandered; or your possessions are returned in poor condition, or not returned at all?  If it doesn’t matter, there probably isn’t a problem
  2. If there are stipulations:
    1. Make the conditions clear.  Set boundaries
    2. Know your receiver; usually, but not always, history is a good predictor of the future.
    3. Work collaboratively with the receiver to ensure your intention is followed and the end result is mutual

Regardless of any ill-will done by some, generosity is truly a gift to our mental health.  Giving makes the world go around. It helps us repair the parts of ourselves that otherwise would be left to its own devises.  Being generous is a boomerang effect most of the time; a gift to both, and a virtue too significant to restrain. 

Claudia A. Liljegren, MSW, LICSW

St. William’s Mental Health

St. Williams Living Center

“Blunder Catching”

So often, we trust our reasoning.  I mean, why would our logical mind lie to us?  Unfortunately, we oftentimes base our logic on our own sensitivities and perceptions, and not on the facts.  Our thoughts can easily be blundered and we don’t even realize it.  “Feeling Good Handbook”, by Beck and Burns scopes out these problems, identifying at least 11 mistakes in our thinking.  Maybe if we can catch these mistakes, we will be more rational and have an easier time with ourselves and in our relationships.  The following is a list of common reasoning blunders, or better known as Cognitive Distortions:

1. All-or-Nothing Thinking / Polarized Thinking, without finding a middle ground (e.g., “I have to get all A’s or I’m a failure”

2. Overgeneralization, or taking one instance and making across-the-board statements (e.g., “I burned the potatoes, so the whole meal was a disaster”).

3. Mental Filter, or despite all being positive except for one, all is negative (e.g., “Because I received a warning, although I never got a ticket in all the years of driving, I’m a poor driver”).

4. Disqualifying the Positive, or rejecting positive feedback vs. embracing them (e.g., “He is just saying I’m an excellent employee because he is trying to be nice”).

5. Jumping to Conclusions – Mind Reading, or believing that you know what others are thinking with negative interpretations (e.g., “They are not looking at me when they pass me by because they don’t like me and are avoiding me”).

6. Jumping to Conclusions – Fortune Telling, or making conclusions/predictions with little to no evidence (e.g., “I’ll never get married because none of my dating experiences”).

7. Magnification (Catastrophizing) or Minimization, or exaggerating or minimizing the importance of the meaning of things (e.g., “I dropped the ball when playing sports, so I’ll never be a good player”, or “I got the last point in the game, but it was just luck – I’m not that good of a player”).

8. Emotional Reasoning, or letting emotions be your logic (e.g., “I feel angry, so what is happening right now is unjustified”).

9. Should Statements, or feeling guilty if the “shoulds” aren’t done (e.g., “I should have called and maybe everything would have been ok”

10. Labeling and Mislabeling, or judging someone based on one instance or experience (e.g., “He is a lazy bum” when individual is mislabeled and instead had sleeping problems for the past couple nights)

11. Personalization, or taking things personal when they aren’t meant to be (e.g., “We didn’t have fun last night because I was late”

“Blunder catching” is a way to help keep ourselves more logical when emotions get in the way.  It is good mental health and it does make it easier to deal with ourselves and our relationships.

Claudia A. Liljegren, MSW, LICSW

St. William’s Mental Health

www.stwilliamslivingcenter.com

Helping a Friend at School

A True Friend When Going Gets Tough

Friends are a demanded commodity when there are upsetting times.  In fact, more than not, teenagers oftentimes depend on their friends when things aren’t going well or unexpected things happen.  Teens can relate to each other at a level most adults have grown out of.  Adults only offer what adults offer, rational and mature advice or direction that really doesn’t resemble what kids seek.  They want to feel understood, like their friends who “get it”.    Friends are crucial fore-runners in helping each other out when things get hard.  Giving support, spending time, giving hugs, and just being there are “must do’s” for those kids hurting.  Friends truly understand and feel the pain their friends experience.  Nothing can take the place of what friendships can do.

The hard part comes when hugs, listening or spending time with a troubled friend isn’t enough    All the good intentions in the world just aren’t enough when friends have serious problems.    In fact, offering naïve advice, suggesting quick fixes, sympathizing too much or keeping the problem a secret can actually make the problems worse. 

Being a true friend is realizing when their friend’s problems are too much to handle without an adult or professional involved.   Teens struggle with many difficult problems these days.  When a friend is self-harming (e.g., cutting themselves), engaged in high-risk activities (e.g., speeding, promiscuity or unprotected sex, drugs/alcohol), throwing up their food, displaying drastic mood changes, doing poorly in school, withdrawing, or threatening suicide, the best thing to do is get them the right support from a trusted adult.  As a friend, you need to be there for them, stay by their side and let them know you care.  However, it is not your job to carry the burden of fixing their problems.  Your friend needs and deserves help from adults and/or trained professionals who take on that responsibility. 

Being a friend means being there in easy and more tough times. If your friend is experiencing a mental health condition, support them and make sure they get the help they need.   You can make a huge difference in someone’s life by being a true friend.

Claudia A. Liljegren, MSW, LICSW

St. Williams Mental Health

Returning to School

If you are returning to school, you likely are asking yourself many questions to prepare for what this new year may bring.  Common questions include what your teachers will be like and how much homework you’ll get, if you will like your classes and if they will be hard or easy, what friends will be in your classes, where will your locker will be located, how involved you will be and what activities will you join, what it will be like without last years’ senior class?  

Returning to school can be a strange experience indeed, captivated by the changes as you walk the hallways. You may even do a double-take as some kids have grown taller, or wider, or thinner; boys entering manhood as they wear mustaches/ beards and girls turning into young ladies, with make-up and swanky hair styles; those changing their garb style with shabbier, more suggestive or cosmopolitan dress.  After a couple days, you realize some have changed their character, like overcoming shyness and being outgoing, or taking up partying and risking so much.  Some may just seem more mature.  As you take in all of these changes, how are you different?  What do your school mates say about you?  And, as you ask yourself how school will be different this year, how much will you be able to adjust?  What feelings are you having as you face this next school year? 

Lots of kids are a little out of sorts during the first week or two of school.  Oftentimes, students display different levels of intensity with their emotions, and usually swarmed with many kinds of emotions, be it excitement, anxiety, relief, fear, eagerness, and even depression.  Some emotions can be severe, such as elongated mood swings with screaming outbursts at home in the bathroom with the door locked ; or heightened anxiety or panic reactions to a whirlwind of worries or fears, such as if there will be any rumors spreading from summer events, or if they will be teased or bullied again this year, or if they will fit in and if their friends will stay loyal or leave them, and so many more.   It is so important to know that there are plenty of people that can help calm the beast of emotions.  It just takes a nod to accept help from those available, be it friends, teachers, parents, or professionals.

There are some good suggestions that may help ease the transition of returning to school:

  • Make sure you take care of your health by getting enough sleep, eating right and regular exercising. 
  • Share your concerns or fears with someone you trust. It helps make the situation feel less intense; that way, you aren’t keeping things pent up inside which usually makes the problem worse.  We all need someone to care and listen to us when we are struggling.
  • Try to solve the problems you are having; don’t let yourself feel stuck and unable to fix the situation.  And, don’t create drama or a crisis when there isn’t one; instead, figure out ways to get to the solution.  If you don’t understand an assignment, talk to the teacher.  If you are having trouble with a friend, find ways to communicate better and work it out.  If you made a mistake or didn’t do as well as you wished, give yourself a pat on the back for trying and learn from it.  If you feel insecure, sad, or are covered with bad thoughts inside, talk to someone who can help you see what a great person you are.  Being a kid is tough enough.  Let someone help.
  • Focus on the positives.  Try to keep your worrying from becoming too gigantic.    Know that who you are is just fine.  Generally, you are doing the best you know how right now.   Don’t let your worrying take your energy.  Know that you are a good person and generally things work out in the end.

Claudia A. Liljegren, MSW, LICSW, Psychotherapist

St. William’s Mental Health Services

www.stwilliamslivingcenter.com