Approximately 95% of those affected by anorexia are female, but males can develop the disorder as well.  In the U.S. and other countries with high economic status, it is estimated that about one out of every 100 adolescent girls has the disorder.  Caucasians are more often affected than people of other racial backgrounds, and anorexia is more common in middle and upper socioeconomic groups.  According to the U.S. National Institute of Mental Health (NIMH), an estimated 0.5% to 3.7% of women will suffer from this disorder at some point in their lives.

Anorexia nervosa is one type of eating disorder.  It is also a psychological disorder or condition that goes beyond out-of-control dieting.  A person with anorexia initially begins dieting to lose weight.  Over time, the weight loss becomes a sign of mastery and control where the drive to become thinner is actually secondary to concerns about control and/or fears related to one’s body.  The individual enters a continuous endless cycle of restrictive eating often to a point close to starvation in order to fell a sense of control over their body.  This cycle becomes an obsession similar to any type of drug or substance addiction.

Body Dysmorphic Disorder (BBD) is classified as a type of chronic mental illness that permeates a persons thinking making them believe that they have a flaw with their appearance.  This flaw may or may not exist and often is very minor, but to the person can be very distressing. 

To a person with body dysmorphic disorder there is an intense obsession with their appearance and body image. Often a person with BBD will wake up worrying about their appearance and spend countless hours obsessing over their weight, nose, hair, etc.  Body dysmorphic disorder is a serious disorder that is becoming a pervasive problem in adolescent girls and some boys.

Generally, when we speak of body dysmorphic disorders we think of two of its complications which are Anorexia and Bulimia.  This month these two complications will be our focus and in coming months we’ll tackle other complications of BDD such as, self-mutilation, obsessive-compulsive disorders, social isolation, difficulty attending work or school and lack of close relationships.

According to Mothers Against Drunk Driving (MADD), research has shown that the brain continues to develop into the early twenties. The pre-frontal cortex, the part that controls reasoning and cognitive ability takes the longest to mature. This is why drinking, especially heavy drinking, before the brain finishes development affects memory and damages this pre-frontal cortex region.  Since this region is responsible for the ability to learn complex tasks and controls impulses and organizing, this is a significant loss.  Some studies indicate that this damage may be permanent. The hippocampus, which is responsible for forming new memories, was noticeably smaller in youth who abuse alcohol than in their non-drinking peers. Additionally, studies show that alcohol use in adolescence decreased ability in planning and executive functioning, memory, spatial operations and attention – all of which are important to academic performance and future functioning.

1. Clearly, real physical brain damage caused by alcohol is a danger for teenagers.
2. Most teens do not know that a 12 oz can of beer = a 5 oz. glass of wine = a 1.5 oz. shot of hard liquor.  They think beer and wine are safer.
3. Youth who begin drinking before age 15 are four times more likely to become alcoholic adults that those who start to drink at 21.
4. In Sacramento County, 11 percent of 7th graders, 29 percent of 9th graders and 38 percent of 11th graders have used alcohol in the last 30 days.

What can a concerned parent do to help their children successfully resist alcohol?

• Be Involved – spend time, know where your child is and who they are with.
• Communicate – be clear about family values, listen, talk about their problems, practice how they could say “no” when offered a drink by friends.
• Walk the Walk – set high standards of responsible alcohol use for yourself.
• Lay Down the Law – make sure they know your rules and the punishment involved in drinking.
• Praise, Reward, Show Love – Catch them being wonderful, form a strong bond.

“I wish I’d known…how important it is to be awake when your teen comes home in the evening. Give him or her a big hug, and take a deep sniff for tell-tale signs of alcohol or marijuana use.  Engage your teen in conversation about the evening to make sure your teen is sober and coherent before going to bed.  Teens are awake and talkative late at night and you’ll probably find these conversations enlightening and insightful.” By Christy Crandell local author of Lost & Found: A Mother and Son Find Victory Over Teen Drug Addiction

Want more ideas and resources?  Go to www.parentsempowered.org

In spite of everything that parents and schools are doing to get the message about not smoking out to kids, according to the recent county-wide results of the California Healthy Kids Survey, 8 percent of 9th graders and 14 percent of 11th graders report that they have smoked a cigarette in the last 30 days.

Is there anything more a parent can do to prevent tobacco use beyond the basics of communicating family values, being a role model and making sure that our children know what the consequence at home would be if they were ever found to be smoking or chewing tobacco?  Here are two more ideas:

1. Help your child practice saying no to offers of tobacco.  Offer to be used as an excuse as in “if my parents smell smoke on me, I’ll lose my cell phone for two weeks and I’ll have to write a two page report on 50 reasons not to smoke.”
2. Use teachable moments (such as when you see tobacco use on TV or a movie or when you have to walk through a cloud of foul smelling smoke to get in a store) to pass along a few facts.  Ask your child, “did you know…”

• Smoking damages the fibers (collagen and elastin) that give your skin strength and elasticity.  Ask them what they think the result will be.  Sagging skin and wrinkles is the answer.
• The Surgeon General has said recently that “smoking harms nearly every organ of the body.”  Choose a body part or organ system that you think would be most interesting to your individual child (i.e. healthy lungs for an athlete) and discuss how their life would change if that area of their body was damaged by smoking.
• One hour in a smoke filled room fills your body with as much poison as if you had smoked a cigarette yourself.  Ask if there are ever times when someone is smoking around your child.
• Nicotine, the addictive drug in tobacco, is as addictive as heroin and cocaine and is as difficult to quit.  A teen can get hooked during their first pack of cigarettes.
• Often when you are in a store that sells tobacco, ask your child to figure out the cost of smoking or chewing (include the taxes that are not in the advertisements).  Ask which would be more fun: spending that much on their favorite stuff or buying dried leaves and paper, lighting it on fire and pulling the smoke down into their lungs?
• Spit tobacco and cigars are not safe alternatives to cigarettes; low-tar and additive-free cigarettes are not safer either.

For a complete website that will give you all the information and ideas you need about tobacco go to www.cdc.gov/tobacco

What can a caring parent do to help their child grow up drug free?

1. Walk the Walk.  Be a role model of the person you want your child to become.
2. Be absolutely clear with your child that using illegal drugs or abusing prescription drugs is out of the question.  Explain your family’s values related to drug use.  Speak often of the dangers of drugs and the fact that their use would drastically damage their ability to be the successful person you know they can be.
3. Create rules and discuss in advance the consequences of breaking them.  Don’t make empty threats or let the rule breaker off the hook.
4. Set a curfew and stick to it.  Know where your child is at all times.
5. Call the parents whose home is to be used for a party.  Ask about adult supervision.  If you are not satisfied with the answers, tell your child they are not allowed to attend the party.
6. Make it easy for your child to get out of a situation when they are offered drugs. Repeatedly practice with them ways to say no.  Tell them that they call you to give them a ride home at any time if they do not feel safe, and tell them they are doing the right thing and would not get in trouble for it.
7. Teenagers whose parents talk to them regularly about the dangers of drugs are 42 percent less likely to use drugs than teens whose parents don’t, yet only  one in four teens report having those conversations.

Are you concerned that your son or daughter or their friends might be either using illegal drugs or abusing prescription drugs?  Here are some of the warning signs:
- Bloodshot eyes
- Moodiness or unusual behavior
- Change in sleeping habits – either sleeping more or less
- Change in friends or spending habits
- Isolation/depression/loss of motivation or on the other extreme: agitation and restlessness
- Drop in grades
- Drug paraphernalia – either as pictures decorating their room or as personal belongings

The presence of one or two of these signs may not mean that your child has started to experiment with drugs.  They could mean there is a different kind of problem or no problem.  However, if you see any of these signs, dig a little deeper.  Talk to your child to try to understand what is going on.

If you find out that your child has begun experimenting with drugs, be courageous enough to get help immediately.  Talk to your doctor; call the California Youth Crisis Line (1-800-843-5200) and definitely wait until your child is sober then have a heart-to-heart talk with them. Your child will need a great deal of love and firm discipline from you to get back on track.

www.theantidrug.com is a website that is rich in ideas and resources for parents to use if they want to learn more about preventing drug use or if they have a child that they suspect has already started to experiment.

If you find out that your child is deliberately excluding, harmfully teasing or even physically threatening another child, they need all the help you can give them.  Six percent of elementary school age children are identified as bullies.  These children are three times more likely to break the law by age 30.  Sixty percent of the boys who are identified as bullies in middle school have at least one criminal conviction by age 24 and 40 percent have three or more convictions.

What can you do to help your child?

1. Make it very clear that in your family, any level of bullying is absolutely unacceptable.  Reassure the child that they are loved unconditionally but this behavior has to stop.
2. Dig deeper.  Try to uncover anything that your child may be angry or worried about.  If you can get a conversation started with your child, you might find they are experiencing a lot of anxiety or even guilt that can be resolved.
3. Form a team.  Have an honest conversation with your child’s teacher.  Consider taking your child to a counselor and/or discussing the situation with your pediatrician or a school administrator.
4. Supervise your child’s interactions with others very closely.  Intervene immediately if you see a problem developing.  Use it as a teachable moment.
5. Often a child who bullies is looking for power and control.  Why should they change?  Give them a clear reason that matters to them.
6. Help them evaluate the results of their actions.  They must clearly understand that bullying will result in negative consequences to them every time.  They must decide if it is worth it.  Use behavior modification which is rewarding a child’s positive behavior and consistently disciplining him/her in an entirely predictable way.
7. A meaningful consequence has the elements:
   a. Ouch – determine what causes enough of a “sting” for your unique child to make him/her think twice about bullying.  This could be loss of video games, 30 minutes of weed pulling, etc….
   b. Light Bulb – create an “AHA moment”.  Help your child write down what they did and why it was harmful.
   c. Restitution – do something kind for the child who was the target of the behavior. 

For helpful fact sheets that discuss many aspects of bullying for parents go to: http://www.hazelden.org/web/go/olweusparent

If your child is exhibiting some of the following signs, they may be the target of a bully or there might be something else going on that warrants a heart-to-heart conversation.

• Torn, damaged or missing clothes, books or other belongings
• Unexplained cuts, bruises or scratches
• Seems afraid or anxious about going to school; finds excuses to stay home
• Lost interest in school or dropping grades
• Sad, moody or emotional (either angry or tearful) at home
• Physical symptoms such as trouble sleeping, loss of appetite, headaches or digestive problems

You could start by asking your child something like, “I am worried about you. Is there anyone at school who is being mean to you?”

If you find out that yes, your child is being deliberately excluded, teased or even physically threatened at school:

1. Reassure your child they did the right thing by telling you and that you will work with them to find a solution. 
   -Explain the difference between tattling (purpose is to get someone in trouble) and telling (purpose is to keep someone safe).
   -Make sure they understand that together you will find a solution that does NOT involve fighting back.  If they fight back physically, they face consequences which include suspension and possibly expulsion.
2. Discuss the situation with your child’s teacher and if necessary, a school administrator.
3. Teach your child to use HAHASO survival skills:
   Help – continue to talk to caring adult
   Assert – make eye contact with the bully. Do not be the first to look away. Use an “I message” like “I am going to…” Use a low voice and stand tall.
   Humor – Let it roll off your back.  Most bullies are looking for a scared reaction so surprise them. Laugh it off. Make a joke out of what they said if possible.
   Avoid – Find safe places and people.  Ask yourself, “Where is the bully? Where am I?” Deliberately stay near adults.
   Self-talk – Give yourself a compliment or a “put up” every time you are “put down”.
   Own it – You could agree with whatever the bully says and not fight back. The important thing is to not give the bully the reaction they are looking for.

Some of these survival skills may not be helpful in your child’s unique situation. Choose the skills that are most relevant and practice them with your child over and over. 

For more information about bullying, go to www.stopbullyingnow.hrsa.gov

One of the most effective ways that you as a parent can give your child or teenager everything that they need to succeed is to have a positive relationship with them where communication flows freely in both directions – parent-to-child and child-to-parent. Communication is not always easy! Effective communication may take practice. Here are a few ideas to get you started.

• Find a quiet place where you will not be interrupted.  Car trips are a great place to talk.  Turn off the TV if necessary.
• Bridge the gap into your child’s world.  Position yourself at their eye level.  Use words they are familiar with.
• Take turns talking.  Few teenagers will keep an open mind through a long message from a parent that comes across like a lecture.
• Nod your head; give them little verbal prompts like “I see”; and resist the temptation to multi-task so the young person knows that you are listening.
• Check with each other to see if you heard what the other meant to say.
• Use “I” rather than “you” statements to keep the conversation going.  For example, you might say “I felt upset because I don’t think you understand how this affects me” instead of “You make me so angry.”
• Set a family rule that some words are not allowed because they are too hurtful such as put downs, telling lies, name calling, blaming and threatening.
• If you are wrong, admit it.  Saying “I’m sorry” sets a great example for your child and makes you more approachable.
• STAY CALM!  Use a calm voice.  Take deep breaths.  It is OK to take a time out to calm down if you need it. 

The Partnership for a Drug-Free America has a very helpful website for parents at www.timetotalk.org.  You can download a free parent toolkit that is full of great ideas about talking to your children about drugs, alcohol and tobacco as well as general positive family communication.

As a parent, you have an opportunity to be a very strong positive influence that will last throughout your child’s lifetime.  You can give your son or daughter the connection with a loving adult that he or she needs to become a strong and successful person.  The strengths or assets that all young people need can be grouped into eight categories:

1. Support – Parents who show that they love their children and will stand by them, no mater what.
2. Empowerment – Parents who make it clear that children are valued for who they are.
3. Boundaries and Expectations – Parents who have high yet realistic expectations for their children, and who set and uphold clear limits for their behavior.
4. Constructive Use of Time – Parents who help their children balance school, activities, time with friends, and time at home.
5. Commitment to Learning – Parents who encourage and model a love of learning.
6. Positive Values – Parents who talk about and model basic values such as honesty, trust and responsibility.
7. Social Competencies – Parents who instill in their children an interest in and comfort with other people, and help them develop strong skills to relate respectfully to everyone.
8. Positive Identity – Parents who nurture their children’s self-esteem, feeling of control over their own lives, and sense of hope.

Young people who have more of these strengths are much more likely to be academically successful and free of alcohol, tobacco and drug use problems.

What are some of the specific practical ways you can give your children and teens what they need to succeed every day?  Here’s a checklist to start with:

TODAY I WILL…
 Ask my child how he or she is doing
 Really listen to my child
 Set an example of responsibility and respect for others
 Be honest with my spouse, kids, friends, neighbors – even salespeople
 Offer my child opportunities to contribute to the family and others in meaningful ways
 Notice what is happening in our neighborhood
 Ask my child what they learned, liked and didn’t like in school
 Keep track of what my child is doing and where they are
 Provide a quiet place for homework
 Know when to turn off the TV
 Tell my child one thing I love or appreciate about her or him

Check out www.search-institute.org for more ideas about how to give your child what they need to succeed.