Celebrating Hanukkah with Sufganiyot

By Helen Pak, Director of Nutrition Services
At Remuda Ranch at The Meadows, one of the ways we help our eating disorder patients improve their relationships with food is through a series of fun and educational culinary challenges.

This week, in honor of Hanukkah, patients in our residential treatment program made Sufganiyot. A Sufganiyah is a deep-fried donut that is filled with jelly or custard and topped with powdered sugar.
During Hanukkah, it is customary to eat Sufganiyot and other foods that are fried in oil. They symbolize the Biblical miracle of a small amount of sacred lamp oil burning in the Temple for eight nights rather than the expected one.

This challenge helped patients to face some of their fears about fried foods and desserts. It also helped to reinforce the idea that all foods, in moderation, can fit into a healthy meal plan.

Holiday celebrations are often centered around food, which can make them especially tough for eating disorder patients. With this activity, we wanted to help all patients, from a multitude of religious traditions and belief systems, enjoy a holiday tradition, as one of the many small steps they’re taking toward finding the joy, peace, and hope that they deserve.

 

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Adderall Abuse and Eating Disorders

Adderall is an amphetamine stimulant prescribed for ADHD, ADD, and narcolepsy. The effects of this drug include a heightening of attention, energy and awareness. Additionally, the drug can create the compulsion to achieve a task or goal the person taking it might not otherwise think possible. On top of all that, Adderall is an appetite suppressant. These qualities make the drug extremely attractive for college-aged women who are susceptible to disordered eating habits.

According to a study from the Substance Abuse and Mental Health Services Administration, full-time college students between ages 18 and 22 are twice as likely as their non full-time college student counterparts to have used Adderall for non-medical purposes. Prescription drug abuse has become an epidemic on college campuses, with more than 4 out of 10 saying they have abused prescription stimulants.

The Study Drug for Weight Loss

Young women entering college are experiencing an inordinate amount of stress and pressure for many reasons. Most college freshmen are worried about gaining the “freshman fifteen” – weight gain that is experienced by many new female students. The need to achieve academic and social success is paramount. And the more competitive the school environment is, the more pressure the student feels to succeed. This is where Adderall comes in: a drug that promises the ability to stay focused while studying and suppresses the desire to stress eat so you can avoid weight gain.

While Adderall will suppress appetite and increase the metabolism of almost anyone who takes it, those who have the potential to abuse it are typically biologically predisposed toward disordered eating. Adderall can bring out disordered eating behavior in someone who hasn’t dealt with that behavior before.

Adderall abuse for weight loss in itself isn’t exactly an eating disorder, but it’s a symptom of other eating disorders like anorexia and binge eating disorder. Women who already have a malnourished brain due to restricting food may even convince themselves they suffer from ADD or ADHD and are in need of Adderall, when really they need to increase their food consumption. Those suffering from anorexia will use Adderall as a way to restrict weight even more, and people engaging in binge episodes can use Adderall for alternative episodes of restricting food for long periods of time.

The Dangers of Adderall Abuse

Adderall produces dopamine in the brain, which is a neurotransmitter that suppresses appetite. It keeps the dopamine from being recycled and metabolized away. This means we connect taking Adderall with a feeling of pleasure, and this undoubtedly leads to a high potential for abuse and addiction for those who are not prescribed the drug. When you take a stimulant medication, or any abusive medication, after three or four months of taking it the brain restructures itself. You become tolerant so you have to take more of the drug to get the same effects.

Adderall can even be deadly. Without having a doctor go over your medical history and health problems, the drug could react with an underlying health problem for serious side effects that include:

• Abnormal heartbeat and cardiac risks
• Increased blood pressure
• Increased risk of stroke and heart attack
• Seizures
• Hair loss
• Sudden death

Used in excess, Adderall has the potential to bring out OCD, psychosis, paranoid personalities, and delusions.

When taking Adderall for weight loss you are dealing with the negative side effects along with the issues that come with an eating disorder. Anorexia and bulimia cause thinning hair, low blood pressure, heart palpitations and heart failure, weak muscles, dizziness, insomnia and can make it difficult or impossible to get pregnant.

While at first Adderall may seem like the miracle study and weight loss drug, the reliance on the drug is not sustainable. Suffering the physical, mental and emotional consequences of addiction is an inevitable fate for the abuser. It’s not unlikely that the user could eventually turn to cocaine or methamphetamines.

Remuda Ranch Can Help

Amphetamines and stimulants are dangerous enough without the added risk of an eating disorder. At Remuda Ranch, we have treated eating disorders for more than 25 years. We know recovery from addiction and eating disorders is possible. For more information about our treatment program, please call to speak to one of our Intake Coordinators at 866-329-7713 and we will contact you with the information you need.

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Why is January the Peak Month for Depression?

The third Monday of every January has been declared “the most depressing day of the year.” Even though there’s little scientific evidence that depressed moods peak at this time, many people do start to feel blue this time of year for one reason or another. In many parts of the country, the weather is cold and dreary, the holidays are over and the credit card bills from said holidays need to be paid.

 

It’s important to note, that there’s a significant difference between feeling a little blue and suffering from clinical depression. If you’re not sure whether what you’re feeling is a temporary “funk” or something serious, please reach out to a healthcare professional.

But, for those suffering from clinical depression, January as a whole can be an extremely troubling period of time.

Family dysfunction or unresolved childhood trauma can play a big role in depression after the holidays. The holidays tend to be a time where we have an abundance of expectations and needs. Unfortunately for most of us, these expectations and needs do not get met in exactly the way we hoped or imagined. In a dysfunctional family, the results can be even worse with unmet needs leading to the feeling of “I don’t matter.”
“Since human nature is to resolve conflict and trauma, we often tend to replay our trauma with our family this time of year, looking for resolution. When we do not get the resolution we hoped for, we can end up feeling emotionally exhausted, distraught or sometimes completely numb, “ says Scott Davis, Clinical Director at The Meadows. “Depression becomes a way to cope with the anxiety and lack of fulfillment we feel throughout the holidays and immediately after.”
There’s also difference between a “winter funk” and the more severe condition, seasonal affective disorder, a form of clinical depression that takes place during the winter months. Most people do not get enough Vitamin D or Vitamin K during the winter, which can lead to a lack of energy and motivation, and eventually depression.
It’s important to recognize and treat depression because it limits people’s ability to live their lives to the fullest and function well on a daily basis.

Treatment for Depression

Cognitive-behavioral therapy (CBT) is an important and effective approach in treating depression at The Meadows Inpatient and Outpatient programs, where relief can be found through a change in negative thought patterns. Our clinicians and therapists specialize in treating the underlying causes of depression as well as the symptoms that have surfaced from the depression. 

 

Depression is overwhelming, but there is hope. Even the most severe and complicated cases of depression are treatable, and here at The Meadows, we offer individualized treatment so each of our patients can enjoy a more fulfilling life.


To learn more about our innovative treatment programs for depression, contact us here or call us at 866-332-2919.

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Your Eating Disorder Lies to You

By Margo, Remuda Ranch Alumna
Note: This is a letter I wrote to myself when I was still at Remuda Ranch, and I've revised it a bit. I still struggle quite a bit in my eating disorder, but every day, I strive to win those small goals. And if I don't, I try again.

Dear Margo,

You deserve to be loved. And yes, that does include loving yourself. In fact, apart from loving God, loving yourself is probably the most important person to love.
So each day you face, get your boots on and go get your horse because recovery is the longest and bravest ride of your life.

First, you need to remind yourself that you've used ED to love yourself, but the truth is he's only destroyed you. He's distorted your thoughts and feelings to use harmful behavior to cover up pain that you've covered up. He's told you lies, such as not eating, running, purging, and numbing out are the safest ways to go.
But he's a lie.

Remember, before going to Remuda Ranch? Your friends had trickled down to toothbrushes, toilets, pavement,and errands because ED said there's no time for the people whose love you ignored.
But he's a lie.

Look back to your time at Remuda Ranch. Remember those who loved you, and pushed you? Remember the day everything looked brighter and clearer? Remember Casper, who showed you every day that he wanted to be with you, despite what you believed?

Now look at yourself. You have made more friends, you've faced fears, you've had fun, and you've let others love you. You have a job that you love, and are good at, and you are capable to do way more than what ED tells you you can.
Because he's a lie.

Remember that when you feel you're too fat, too ugly, not worth it, and that some days the world would be better without you, are all lies from ED. All he wants to do is crush you down. But don't listen to him.

Because he's a lie.

Despite of what's been done to you, or what others may say about you, you have good qualities. You're kind, gentle, genuine, funny, beautiful, you have good hair, and you deserve to be loved.
That's the truth.

Love,
The Part of You that Can See Light outside of ED’s Lies. P.S. Read this every day.

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Approach ‘13 Reasons Why’ with Curiosity Instead of Fear

By Lindsay Merrell, Therapist, Remuda Ranch at The Meadows

Since the years of my internship, working with patients facing suicidal thoughts has been concerning, challenging, and inspiring. Individuals struggling with such hopelessness come to professionals in desperate need of relief from what is starting to feel like an inevitable outcome. Our responsibility as professionals is to be persistently and empathically interested in the individual’s struggle. Our curiosity gives them the courage to look at the very pain they fear.

Netflix’s hit TV Show 13 Reasons Why provides the audience with a window into the multitude of opportunities a community often has to intervene when an individual is living in fear of their pain.

In 13 Reasons Why, the main character, Hannah, struggles with suicidal thoughts. She risks reaching out to her guidance counselor—the very person tasked with being a support to adolescence in the educational environment-- for help; but, as a result, we as an audience witness the harm that occurs when helping professionals lack curiosity.

The guidance counselor dismisses Hannah’s pain and a disconnection from help occurred. The show portrays very well how the disconnection from compassionate support leads to an increase in isolation and stigma for the individual and for the community as it experiences a traumatic event.
Adolescents are already at an anatomical disadvantage when it comes to seeking support. They are experiencing normal, but tumultuous hormonal changes within a neurological system that hasn’t yet developed insight into cognitive distortions or the ability to restructure distorted thoughts. As professionals, we have the opportunity to assist and educate individuals and families on how to navigate the ups and downs of the adolescent years; however, this opportunity often only comes after worrisome symptoms appear.

13 Reasons Why has given teenagers, schools, and families a framework from which to process situations which may already be occurring right under their noses, and will hopefully give them the chance to intervene before the individual’s desperation takes over.

Recently, the media has reported that many parents, teachers, and counselors are concerned that 13 Reasons Why “glorifies” suicide. But, it seems to me that 13 Reasons Why could bring about more awareness on how to support an individual struggling with suicidal thoughts or how those who are struggling with suicidal thoughts can seek support.

As friends, therapists, and parents, aren't we better equipped to help when we are more culturally aware and curious about the nuances individuals’ struggles? It seems unreasonable to make a judgment about the “dangers” of the show simply based on the fact that the characters in the storyline do not handle the situations in the one size fits all manner we deem best.

Before her tragic death, Hannah records a series of tapes to illustrate how ignorance, fear, and judgment disconnected her, and disconnects others, from necessary interventions and support within the community. Through the lens of fear, Hannah's tapes may appear to assign blame to everyone involved; however, when fear is replaced with curiosity and empathy, can’t the tapes be viewed as an educational opportunity for the viewer? The tapes teach us that asking questions, paying attention, and speaking up can provide hope for recovery from what feels like insurmountable pain.

Fear of judgment from peers and adults coupled with the stigma around asking for support unnecessarily leads adolescents to suppress their perceived realities to struggle through it alone more than they have to. This often leads to the manifestation of eating disorders, substance abuse, self-harm, and suicidal ideation. The challenge for the individual and the community portrayed in the show is the suppression of the struggling individual’s perceived reality and the ultimate lack of awareness of the real pain of that struggle.

Compassion’s enemy is fear. It paralyzes people and prevents them from helping those who struggle with suicidal ideation. Let’s not allow ourselves to be paralyzed by the fear of what 13 Reasons Why could teach young people; instead, let use it to teach ourselves how to be more compassionate, how to best offer the support that is needed, and how to stay curious and ask questions that can help lead those suffering to peace.

13 Reasons Why is a show that illuminates the difficulties adolescents face. As adults, when we put our fear aside and become curious, we open the door to protecting a vulnerable individual from a life-altering decision and breathe hope back into those we care about.

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A Letter To My Younger Self

To my former, wonderful self:
I know you’re hurting right now beautiful girl. I promise, it’s going to be okay. You’re feeling so out of control. All of your thoughts are racing in circles believing that the professionals surrounding you in these moments just want you to stay fat forever.

They want you to let them down; your grandparents, your parents, your classmates. Those are the ones that you thought if you lost all that weight, then they’d be proud of you. Maxie, they’re already proud of you and love you for being the kindest and most loving little girl in the world. I know it’s taking all of your strength to not give up and continue to listen to the voice of your eating disorder.

You hate your reflection and that all these doctors and nurses are forcing you to eat. You don’t understand it and can’t even begin to look at this situation from a positive perspective without hearing the voices of your grandparents lingering in the back of your mind every moment of the day. I’m so sorry that they let you down; that mom and dad didn’t stand up for you and say that those words weren’t true. I’m here to tell you sweetheart, that you don’t need to be worrying about how small your jean size is or how much the number on the scale says when it stares back at you as you nervously await its reading.

You are and will forever be perfectly imperfect and beautiful just the way you are no matter what your outside appearance looks like. Those cruel words they said calling you fat and demanding you to lose weight were all lies. They made you believe a vision of yourself that isn’t true. I’m so sorry for all the pain that they’ve caused you. I know you’re hurting right now. I promise, it’s going to be okay.

You don’t need to starve yourself to feel accepted into this world. You don’t need to deprive yourself of social outings with friends just because you’re so afraid they’re going to offer you something to eat. Go out and have fun every time you get the opportunity to. You deserve it.

You are so smart Maxie and so loving; this world is lucky to have you in it. Please don’t allow the voice of this disorder continue to allow you to think any differently. With your infectious spirit and personality, you touch the lives of every single person that you meet. Your smile, it lights up the room. Please remember this the next time you want to skip your breakfast or your afternoon snack.

You are so worthy of living a full life outside of this darkness called Anorexia and I need you to believe this. Your Grandpa Bob needs you to believe this. He thinks you’re brilliant and that you deserve to be the happiest girl in the entire world. Although he will leave your life too soon, he will be here long enough to make you a stronger person and help you fight those ED thoughts. Through his infinite presence in your life, you will keep fighting for the life you so desperately want for yourself and he will forever be proud of you.

The future is going to be so bright for you, beautiful girl. You’re going to meet an amazing man that’s going to love you unconditionally for a period of time in your high school years. He’s going to help you stop self-harming every day and eat delicious food without guilt afterwards. You are worthy of that kind of love.
Soon, you’re going to have so much energy that you’ll be able to run outside and go to the gym and lift heavy weights without any difficulty because you’ll be feeding your body the nutrition it needs. You’ll get to a point where you’ll run and exercise, not out of self-hatred, but out of self-love. You will care so much for yourself and the life you live more than anyone, including yourself ever has before.

You don’t need to harm your left arm anymore. There is nothing wrong with you, sweet girl. There is no need to punish yourself for being strong and consuming that mint chocolate chip ice cream or Reeses candy bar you deprived yourself of for so long. You deserve every bite and I hope you enjoy more of those.

Please listen to your therapist and let those wounds heal. I know you’re hurting right now. I promise, it’s going to be okay. Those scars will be reminders of every battle you fought and won; and every battle you’ll continue to fight and win for years to come. Although there will be more challenges awaiting you in the future, the victories that come with surviving this disorder will make it all worth it. I believe in you, beautiful girl.

You can silence the voices of your grandparents that remain a constant in your head and create new ones. Ones that describe the real Maxie. The Maxie that is worthy of love, kindness, and care to herself. I just want to let you know, that even at the young age of 11 years old, you are strong beyond measure and have the will to keep going. A life of joy, body positivity, and acceptance of yourself awaits you on the other side where full recovery lives on and I’ll be right here rooting for you once you get there.

I’ll love you always and forever,
Maxie

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Diabulimia: Abusing Insulin to Lose Weight

Type I diabetes and an eating disorder can be the worst possible combination. While most people with bulimia purge through vomiting or excessive exercise; someone with diabulimia purges by under-dosing insulin, which causes sugar to be eliminated from her body through urine reducing their caloric intake.

In the last 10 years, this dangerous new trend of manipulating insulin doses to lose weight has emerged among women with diabetes and eating disorders. Several studies have come to the conclusion that women with type 1 diabetes are twice as likely to be diagnosed with an eating disorder as their non-diabetic peers. (Although diabulimia is more common among women, men with type1 diabetes can and do struggle with it as well.)

Living with type 1 diabetes is not easy. Sometimes insulin manipulation and other behaviors that indicate the person is struggling with an eating disorder start out as small acts of rebellion, but can escalate over time into an overwhelming cycle of eating disordered thoughts and symptoms.

For some people, the necessary emphasis on food and dietary restraint associated with the management of type 1 diabetes can create an unhealthy focus on food, numbers, and control. The psychological and emotional effects of having to manage a chronic medical condition such as type 1 diabetes can also play a role in developing the dual diagnosis of an eating disorder. Depression, anxiety and poor body image are also common co-occurring conditions.

The Dangers of Manipulating Insulin Dosages

Manipulating insulin dosages isn't healthy and can be deadly. When an eating disorder accompanies type 1 diabetes, the mortality rate climbs to nearly 35 percent.

In addition to the increased risk of death, there is also an increase in the escalation of medical complications from diabetes such as vision loss and kidney failure. The health issues that a diabetic might typically expect to experience in 30 years can begin to occur within five or seven years if she is abusing insulin and exhibiting disordered eating behaviors.

For example, if a type I diabetic begins insulin manipulation at the age of 17, she could become totally blind, begin suffering from extreme nerve pain or need to be on a kidney transplant list by her mid-20s. Her ability to have children may be permanently compromised as well.

Signs of Insulin Abuse

If you are a parent, spouse, or family member of a diabetic, and you think believe she may be manipulating her insulin dosages to lose or maintain her body weight, it’s important to take action. The earlier you get seek help, the greater the possibility for a positive outcome. Here are some of the signs of insulin abuse:

• The person seems dehydrated, tired and irritable.
• The person’s insulin supply seems to be lasting them longer than expected. They purchase fewer bottles than usual.
• The blood sugar log on their glucometer shows that they have not been maintaining healthy levels.
• You might also encourage your loved one to go to their doctor for a Hemoglobin A1C test.

Share your concerns about their possible eating disorder with the doctor, if you can.

Get Help for Diabulimia

The complications from diabulimia and other disordered behaviors are very serious. Those who struggle with type 1 diabetes along with anorexia or bulimia can experience recovery with the right medical and psychological interventions. At Remuda Ranch at The Meadows, our expert team of doctors and therapists can develop a personalized inpatient treatment program to help women and adolescent girls learn to control their diabetes while recovering from an eating disorder. We also offer the Remuda Ranch Eating Recovery Intensive Outpatient Program for both men and women at The Meadows Outpatient Center. Call today for more information: 866-332-7381.

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