It’s Not Always Sunny in Philadelphia: Coping with Seasonal Affective Disorder

Daylight saving time is coming fast. If you are like many, the thought of an extra hour of sleep seems glorious. Plus, the fall brings pretty colors, fun holidays, crisp air, and pumpkin spice lattes. For others, fall brings with it feelings of depression—seasonal depression.

This type of depression is called seasonal affective disorder or SAD – a type of depression that happens seasonally. Its symptoms usually last through fall and winter, about four to five months each year. For some individuals, SAD occurs in summer. However, this is not common. 

SAD is thought to be caused by a chemical imbalance in the brain. This imbalance happens when the days shorten and there is less daylight available. Being exposed to less daylight can throw off someone’s biological clock. Because SAD is linked to lack of sunlight, it is more common in areas that are farther from the equator. It is also more common in people with a family history of mood disorders.  

Symptoms of SAD are like symptoms of depression. People may feel sad, overly tired, and like they do not have energy. They might have changes in their appetite, weight, and sleep. They may feel agitated, restless, guilty or worthless. Concentrating might be difficult. They may isolate themselves from other people and no longer be interested in things they used to enjoy. They may also have thoughts of suicide or of dying. 

If you are experiencing mild symptoms of SAD, there are things you can do to cope. They include: 

  • Going outside and getting exposed to natural light 
  • Exercising regularly  
  • Keeping a healthy diet 
  • Regularly seeing family and friends 
  • Having hobbies that you do regularly 
  • Taking a Vitamin D supplement (people get Vitamin D from sunlight) 
  • Cutting down use of alcohol or drugs, which might make SAD symptoms worse 
  • Maintaining a routine around bedtime for better rest

For some people, these coping strategies may not be enough. If you are experiencing severe symptoms of SAD, you might consider: 

  • Contacting your doctor (primary care provider) to discuss your symptoms and ask for help managing the,
  • Working with a doctor to see if there is medication that might help 
  • Working with a doctor to see if light therapy might help 
  • Discussing seeking therapy to learn how to best cope with SAD.

For more information about SAD, see: 

About the Author: Jaymes Fairfax-Columbo, JD, Ph.D. is a clinical-forensic psychologist. He works with the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) serving individuals who have behavioral health issues and are involved in the criminal justice system.

Connection and Resilience in the Asian American Community

The Asian American community in Southeastern Pennsylvania is diverse. The Asian diaspora includes people with roots in countries like China, Korea, the Philippines, India, and Cambodia, just to name a few.

Whether they were born in the United States or immigrated, many in the Asian American community feel pressure to create an identity that is acceptable to both their family and this country. This issue has gotten more attention as violence against Asian American people has increased since the start of the COVID-19 pandemic.

As a result, more people are in need of mental health support, says Dr. Noel Ramirez, psychotherapist and director of The Mango Tree in Philadelphia.

A Filipino-American, Dr. Ramirez works with a broad mix of clients, including multi-racial individuals, transracial adoptees, and people from across the Asian diaspora. Some are recovering from conflicts in their home countries. Some have internalized racial oppression. And others are addressing intergenerational tensions that often arise when cultural norms and expectations differ between parents and children. This usually happens when younger generations embrace modern American values that conflict with traditional Asian culture.

According to Dr. Ramirez, “We get folks who are struggling with navigating collectivism in a culture of individuality when the family is the focus. We get career changers who were told the only pathway to wealth was to be a doctor or engineer and that wasn’t their passion.”

Asian American: A Complicated Concept

According to the 2020 census, nearly 24 million people in the U.S. identify as Asian. “The concept of Asian American is complicated,” Dr. Ramirez says. “The first step is helping people develop language around their ethnicity. What does it mean to be Asian American? Korean-American actor Steven Yeun says that to be Asian American is not just having your foot in two different places; it’s a third space of identity.”

“Being labeled Asian American,” says Dr. Ramirez, “I’ve come to learn and appreciate all forms of Asian cultures in the U.S. because I’m lumped together with all of them. Even at The Mango Tree, the staff speak five languages. It’s a uniquely validating experience growing up in a pan–Asian community.”

Connecting with the Community

Being an active part of your community is one of the most important things you can do for your mental health, especially if you belong to a minority group, says Dr. Esther Hio-Tong Castillo. Dr. Castillo is the founder and former program director of the Chinese Immigrant Families Wellness Initiative at the Philadelphia Chinatown Development Corporation.

“With Asian Americans, there is a lot of invisibility,” she adds. “We’re seeing more Asian representation in different fields today, but it’s still lagging. As a mom of a 7-year-old, I have to go out of my way for my daughter to see herself represented in children’s books.”

According to Dr. Castillo, this lack of visibility makes it even more important to seek out culturally specific activities within your community. Creating strong connections builds resilience within the Asian American community.

“Some people feel they’re not Asian enough or American enough. The Asian community is so diverse ― immigrants, people who speak different languages, eat different kinds of food, have different immigration stories. Sometimes it’s hard to find out what it means to be Asian American. But the process of discovery and exploration will help individuals to improve their mental health.”

For information on local resources and events in the Asian community, visit:

For information on national resources in the Asian community, visit:

For more information about mental health, self-care strategies, and where to find help, visit

Addressing Burnout in Health Care Workers

Throughout the COVID-19 pandemic, health care workers were celebrated as frontline heroes. They worked long hours, exposed themselves to illness, and witnessed death while somehow managing their own fears, stresses, and personal responsibilities.

But even for a profession characterized by empathy and dedication, the years of emotional losses and relentless demands have taken a toll on many health care workers.

Stressors Persist Post-Pandemic

Health care workers today face disproportionate rates of stress and burnout, putting them at greater risk of anxiety, depression, insomnia, post-traumatic stress disorder, and even suicide.

According to the AMN Healthcare Survey of Registered Nurses, the number of nurses who reported feeling “a great deal” or “a lot” of work-related stress grew from 65 percent in 2021 to 81 percent in 2023. Clearly, the support they felt during the COVID-19 pandemic has waned. And to make matters worse, a National Nurses United survey from late 2022 found that about 40 percent of nurses reported an increase in workplace violence.

Prior to the pandemic, the U.S. had been experiencing a nationwide shortage of health care personnel. That trend doesn’t look like it will be reversing anytime soon. A recent study predicts there could be a shortage of up to 450,000 bedside nurses by 2025. And by 2034, the country could also be facing a shortage of up to 124,000 physicians.

“We’re now operating in a mostly post-pandemic environment, but health care workers aren’t feeling much relief due to the impacts of staffing shortages,” said Diana Lehman, BSN, RN, MBA, vice president of Case and Condition Management at Independence Blue Cross (Independence). “Thankfully, many employers are sensitive to the mental health needs of their providers and are trying to address them where they can.”

From Federal Initiatives to Self-Care

To help address the high rates of burnout in health care workers, the National Institute for Occupational Safety and Health has launched a Health Worker Mental Health Initiative that aims to:

  • Improve data, screening tools, training, resources, and policies to address health worker mental health;
  • Identify workplace and community supports for health workers;
  • Reduce stigma related to seeking and receiving care for mental health; and
  • Eliminate barriers to accessing care.

Hospitals are trying to combat nurse burnout by offering flexible schedules, including days off for mental health and wellness checkups. On the job, experts recommend breaks for food, drinks, and rest, as well as scheduling that gives staff adequate downtime at home between shifts.

Many health care workers recharge by spending time with family and friends. “My children are my form of self-care,” said Christina Milligan, CRNP, of Children’s Hospital of Philadelphia (CHOP) Primary Care, one of Independence’s 2023 Celebrate Caring Winners. “They are my world, and when I can be focused on them and be present, the stress disappears. I also like to exercise.” Christina says she finds barre classes, a form of exercise that focuses on mindfulness, tremendously helpful.

Meditation, gardening, listening to music, journaling, and reading are other popular activities that can reduce stress.

For more information about mental health, self-care strategies, and where to find help, visit

Rowing in Sync for Mental Health

On Monday evenings, as the sun sets on the Schuylkill River in Conshohocken, Pennsylvania, you can see women in pink shirts and baseball caps rowing down the river in groups of two, four, or eight. Some are moving swiftly, while others are getting their bearings, guided by a coach in a skiff alongside them. All are part of WeCanRow, a national program founded in Boston in 2002 for breast cancer survivors.

WeCanRow gives these women the opportunity to become active participants in their cancer recovery. Together, they build strength, rediscover the joy of movement, and become part of a mutually empowering team. Rowing helps these survivors improve their physical and mental well-being.

WeCanRow – Philly

In 2018, WeCanRow – Philly found a home at the Whitemarsh Boat Club in Conshohocken. The group began with a handful of participants, facilitated by Dale Parenti, a Philadelphia-based graphic designer, rower, and breast cancer survivor. Today, the group has more than 30 active members of various ages and fitness levels who find the group physically and mentally energizing. Those who have no previous rowing experience find it easy to immerse themselves in the thrill of the sport. Learning something new seems to spark their energy and distract them from their diagnosis.

“When I was first being treated for breast cancer, I joined Hope Afloat, a dragon boat team for breast cancer survivors,” Parenti says. “I hadn’t exercised regularly in probably 20 years by that point. I was too busy raising children and building my career, and I didn’t prioritize myself or my body. Suddenly, exercising three times a week made a dramatic difference in my mental health. My mood suddenly lifted, and I felt like myself again. The team environment made it easy to commit to the regular exercise in a way that going to a gym on my own would not have.”

“A lot of breast cancer survivors often feel betrayed by our bodies when we are diagnosed with cancer, especially when we’ve taken good care of ourselves,” says Sue Ryan, PsyD, a psychologist in Collegeville and WeCanRow member. “When we row, we have to make friends with our body again. It gives us an appreciation of how our body works and how we can be in rhythm with others. When we have a good row together, it’s an exciting feeling. We also build friendships on the river and see others who may or may not have gotten through this journey with different issues. It gives you context.”

Well-being Beyond the Boat

Rowing as a team creates strong personal connections. According to Parenti, “the women of WeCanRow support each other on and off the water. Bonds form around the experience of being teammates and fellow cancer survivors. They learn to work as a team and realize they’re not facing any challenges alone.”

A cancer diagnosis can affect your peace of mind, so rowing can be a great distraction. “Rowing requires such focus and concentration that it’s not possible for the mind to wander,” Parenti notes. “Worries, stress, and fears are all left at the dock. Once you’re on the water, those problems are forgotten.” Of course, spending time in nature is good for your mental health. Being on the river, watching ducks swim by and birds land on the rocks, with the sound of oars slicing through the water can be therapeutic.

For many women, dealing with a breast cancer diagnosis is socially isolating. It changes how you see yourself in relation to others. Rowing helps breast cancer survivors improve their physical and mental well-being. With WeCanRow, the women learn how to support each other as rowers first, then as survivors. “Rowing gives us an identity other than being a patient,” Ryan says. “Our chant at the end — ‘We Can Row!’ — this is something we can do that is an identity apart from having had cancer.”

For more information about mental health, self-care strategies, and where to find help, visit

Men’s Mental Health: Building Connections at the Barbershop

In many neighborhoods, the barbershop doubles as a place of healing, where people ― particularly men of color ― can find support, perspective, and maybe a boost for their mental health.

“Barbershops have always been safe places to meet, vent, share personal experiences, and get a respite from the issues in their lives,” said Gabriel Bryant, coordinator of the Engaging Males of Color Initiative, managed through the City of Philadelphia’s Department of Behavioral Health and Disability Services. “You have a captive audience in one space, and they help you figure out solutions to your problems.”

A Place of Wisdom and Caring

Bryant tells the story of a man whose teenage son was having issues with another teen. The father was worried the conflict would lead to violence, and he decided to take his son to the barbershop. The men in the chairs talked for an hour, encouraging the boy to find other ways to resolve the issue. The father trusted the men at the shop to provide guidance, and it worked.

Building connections at the barbershop is important. In many communities, the barbershop is also a place where values and life lessons are shared across generations.

“It’s a place where men can trust their barbers with things near and dear to them and trust them to hold it close and not share it on the street,” said Will “Latif” Little, a barber for 18 years at the Jazz-U-Up barbershop in South Philadelphia. “It’s a hub. It’s a safe place. It’s a familiar place where [boys and men] get education on personal development.”

Little served 10 years in prison before finding his purpose. Now, as a life coach, he hosts Monday night classes at the barbershop for men and women on topics like financial literacy, careers in the trades, the importance of going to college, and conflict resolution.

To his satisfaction, Little sees that a lot of the young men he once mentored now have their own children. And those fathers are using the same tools they learned in his barbershop to help their children make better life choices.

Where Everybody Knows Your Name

Bryant recalls watching a basketball game at a crowded barbershop a few years ago. When someone shouted, “The Sixers stink!”, an older gentleman started sharing his memories of watching players like Dr. J (Julius Erving) hold court at the Spectrum. The shop fell quiet. The men listened and showed respect, as this older man owned the moment.

Many seniors go to the barbershop to avoid loneliness, Bryant says. Barbershops are important community support systems. “Men of color are socialized not to ask for help or seek care. The barbershop is a place where they know they can find support from other men. It’s a healthy move,” he said.

“Barbers have served as community counselors, comedians, and faith leaders,” Bryant added. “A trusted barber is a strong force in the community.”

For more information about mental health, self-care strategies, and where to find help, visit

Mind Matters: Mental Health and the African American Community

One of the reasons I started to work at Girard Medical Center was so I could better understand my mother’s addiction and depression. She behaved in ways I did not understand. I always wondered what made her so critical, mean, and sad.

In fact, I did not understand why a lot of people in my family acted the way they did.

Growing up, I heard a lot of code words being used for mental health. For example: “Don’t mess with her, she doesn’t take no stuff” or “You know something is wrong with her or him”. I would witness bizarre behavior within my family and neighborhood.

As I grew up and experienced my own mental health concerns, I began reading self-help books. But self-help books still left me with a lot of unanswered questions such as: “Why do people hurt children” and “How come some drunk folks become violent.” Sometimes I would listen to motivational speakers and felt great for as long as they were speaking.

When I started working at my job, I learned a lot about mental health. I learned about trauma and how it can create a chaotic person. I learned the value of peer support and how therapy can help people dealing with mental health concerns.

It is my belief that in the Black community mental health is still viewed as taboo. The fear and shame of admitting they have mental health challenges is a barrier and cause for many to not seek help.

Fear of what others will think of them or the things they will think of themselves stems from a common ideology within my community to not tell your business to strangers, to have better faith in God, and to pray your problems away.

A fear of being seen as weak with possible consequences of our children being taken away, and the mistrust we have of people outside of the community are all factors that drive the disconnect between mental health and the Black community. We have socialized dysfunction that has become normal behavior with some folks who live in fear and have very little faith that they have the ability to recreate their life.

Fear is only false evidence appearing to be real. There is nothing wrong with asking for help when you are in distress. We all have the ability to recreate our lives. I know I was not living my best life and I was capable of so much more. I learned that while in therapy. 

So I allowed others to help me help myself.

You don’t have to operate from a place of dysfunction and fear. We all have the ability to make our lives better and become contributing members of society. Don’t let pride and shame stop you from seeking help to help you become the best version of yourself.

Do you realize the powerful impact you will have in your family and the community with a stable mind?

About the Author: Imani Badie is a lived-experience consultant. She is a Community Recovery Specialist for the Miracles in Progress program at the Be Well Health Center at Girard Medical Center.

Original article:

Tips for Helping AAPI Parents Talk About Mental Health

*Content warning: Contains disclosure of behaviors of self-harm. 

“You are too much! And you talk too much!” was what I was told as a child when I expressed my feelings.

My parents emigrated from the Philippines and wanted the best for their six children: rigorous education, fine clothing, and a spacious home. They were advised by the pediatrician not to teach us their native language, warning it would cause confusion. I pinpoint this advice as the cause for our home’s emotional deficiency. It created a dynamic of tense silences, suspicion, and rivalries about everything from chores to college choices. My siblings were not my allies or advocates. I was intimidated, ruled over, and ridiculed. 

It was a priority to maintain appearances of mastery and stoicism, even interpersonally. When I would be overwhelmed with run-of-the-mill developmental anxieties such as the first day of school, there was no vocabulary for this. Make no mistake, my parents were loving and expressive. For me this looked like being spoon-fed by my father until first grade and through shopping trips with my mother. Their care was concrete and lavish.   

When it came to mental and emotional health, however, things were compartmentalized: If I wanted to stay home from school because of test anxiety,  I was said to be “faking it” unless I had a fever. Or my itchy skin patches were treated with steroid cream when really I just hated being ridiculed for “being so sensitive.” There had to be somatic proof. Sometimes this led to self-harm: scratching to the point of bleeding or abusing sleeping pills. It was a painful cycle.  

The self-harm or cycle is preventable. It can be interrupted. How? 

1. Understand intergenerational trauma.

Intergenerational trauma is the transmission of racial distress from parent to child. It is usually unspoken. For example, a child can feel sad and scared watching her father place an order at McDonald’s or trying to help grandmother schedule a doctor’s appointment due to language barriers. These examples do not seem to be traumatic. However, they can be profoundly overwhelming. 

2. Regularly discuss internalized oppression. 

Internalized oppression is self-hatred due to perceived racial inferiority. This is an effect of colonization, enslavement, and white-centering/white supremacy. Notice how your child idolizes people with whom they are in stark contrast: “I see that you adore Rapunzel’s golden hair, but I adore your black tresses.”

3. Normalize identifying racism.

Identify racism. There can be a myth within the AAPI community that, because Asians are perceived as white-adjacent, racism does not occur. Parents/caregivers must call things what they are. It empowers children to know about microaggressions and how to handle them resiliently. 

4. Frequently ask: Is this developmentally appropriate? 

Define suffering and sacrifice in terms that make sense to your child. It is commonly said, “My parents have sacrificed so much for me to have a better life, so I must also sacrifice.” This is harmful because the term “sacrifice” is weighty and not proportional to a developing child’s understanding. Help your child create a small, manageable world in which they can flourish.  Identify and praise their effort and growth, however small.

About the Author: Maria Beatty completed Trauma-Focused Cognitive Behavioral Therapy Training and booster training under Yale Medical School’s Carrie Epstein, MA, as well as Completed Cognitive Behavioral Intervention for Trauma in Schools Plus Racial Trauma Module by the Center for Safe and Resilient Schools under Won Fong Lau-Johnson, Ph.D. and Audra Langely, Ph.D. This spring will mark her three year work-a-versary at Hall Mercer. 

Original article:

Make Your Mood Bloom: Mental Health Benefits of Gardening

Since the days of the visionary nurse Florence Nightingale (1820-1910), people have used gardens to promote healing and reduce stress. What is it about a garden that lifts our spirits, and how can gardening improve our mental health?

Studies show that observing nature or even images of natural scenes have positive effects on our mood and mental health. Patients who can see plants from their hospital rooms need less pain medication and have fewer surgical complications. Hospital courtyard gardens lift the spirits of patients, visitors, and staff.

Gardening is great for your mind and your body. Activities like digging and weeding build strength and dexterity. They can also increase focus and decrease anxiety and depression. Outdoor gardening exposes you to sunlight, which increases vitamin D levels. This can help lower your blood pressure and heart rate.

Even Better with Others

While gardening offers a lot of personal benefits, it doesn’t need to be a solitary activity.

Working with neighbors to beautify a park, school, or other outdoor space can increase community pride. It can also restore social connections that may have been lost during the pandemic.

Community vegetable gardens are growing in popularity. They provide nutritious food for people who live in food deserts or are struggling with food insecurity. And growing food is good for you, too. Studies show people who grow food tend to make healthier food choices.

“Gardening is an all-ages activity, but it’s a great activity for seniors,” says geriatrician and Independence Blue Cross Medical Director for Government Markets Heidi J. Syropoulos, M.D. “Most people think of gardening as an outdoor activity. But gardening is also watering houseplants, growing fresh microgreens on a kitchen windowsill, or tending strawberry bushes on your porch. You get physical and mental health benefits from plants, regardless of whether they are indoors or outside.”

No Green Thumb Necessary

Some people have a talent for growing plants. If that’s not you, don’t worry. Gardening websites and home and garden centers can help you find your inner green thumb.

Seed mats make it easy to grow flowers or veggies. These thin sheets have seeds woven into them. You put the sheet in dirt, cover it with soil, and water as directed. In a few weeks, you have a beautiful garden. If you need something easier, mini-cactus blooms can brighten your space and your mood.

A Local Tradition

In our region, the Pennsylvania Horticultural Society (PHS) promotes horticulture – the science and art of growing fruits, vegetables, flowers, and plants – to advance the health and well-being of the people of Philadelphia. The PHS plans and oversees the Philadelphia Flower Show, which is the largest, longest-running horticultural event in the country. In addition to working throughout the year to maintain free public gardens in more than 250 neighborhoods, PHS offers educational activities for gardeners of all levels.

Gardening improves your mental and physical health. Whether it provides a creative outlet, a chance to strengthen community ties, or a way to brighten your home and mood, the benefits of gardening keep blossoming.

For more information about mental health, self-care strategies, and where to find help, visit

Making Sure the Kids Are Alright

It’s a question parents, teachers, and researchers alike are asking. The COVID-19 pandemic robbed many teens and young adults of precious learning and socializing time. Add to that the challenge of not having enough mental health providers to meet the demand for counseling, and you’ve got a serious problem.

According to the Harvard T.H. Chan School of Public Health, the pandemic led to a decline in kids’ overall mental health. But that impact varies, depending on factors including age, family circumstances, and preexisting conditions.

Results from a 2021 National Survey on Drug Use and Health showed that nearly half of kids ages 12 to 17 who had a major depressive episode (MDE) in the past year said the pandemic negatively impacted their mental health either “quite a bit or a lot.” That’s concerning because only 12.4 percent of their peers without an MDE reported similar levels of impact.

Not a New Problem

Although the pandemic may have put a spotlight on teen mental health, rates of depression and anxiety in children have risen steadily in the last ten years. Many experts think this trend is unlikely to improve without rethinking how we approach teen mental health care. As a result, the U.S. Preventive Services Task Force now recommends regular anxiety screenings for children ages 8 to 18 and regular depression screenings for adolescents ages 12 to 18.

The Power of School Connection

According to the Centers for Disease Control and Prevention, one of the most important factors in boosting students’ emotional resilience is “school connectedness.” This is the feeling of being supported and belonging at school. Students who felt connected to adults and peers at school were significantly less likely to report feelings of sadness or hopelessness.

Experts believe that students can benefit from multiple support systems in school. But given the shortage of available counselors, only about half of U.S. public schools offer mental health assessments, and even fewer offer treatment services.

In Philadelphia’s public schools, the STEP Program provides mental and behavioral health and social services to students and families. The school district works with the Mayor’s Office of Education, Community Behavioral Health, Drexel Community Partners, and the Department of Human Services to provide this support.

At the state level, Pennsylvania recently made $190 million available for school mental health and safety programs for the 2022‒23 school year. Districts that applied by August could receive a base grant of $100,000 for safety and security improvements, with another $100,000 for mental health programs and training. Additional funding may be available based on population.

“What we need is to build capacity through all of the systems that are part of children’s lives — in families, in schools, in the education of everybody who interacts with children,” says psychologist Ann Masten, Ph.D., a professor of child development at the University of Minnesota.

Focusing on Student Mental Health at Girard College

Youth from underserved communities are less likely to receive mental health care services. To address this disparity, the Independence Blue Cross Foundation is funding a multi-year pilot initiative to provide access to mental health care for every student at Girard College. Girard College is an independent, five-day boarding school in Philadelphia. It serves approximately 300 students in first through twelfth grades from families with limited financial resources. More than 80 percent of the student population identifies as African-American.

This innovative care model integrates school support with telehealth services provided by Children’s Hospital of Philadelphia. “The pandemic amplified the urgent need for access to mental health care as young people were faced with additional difficulties such as school closures, family stress, social isolation, and economic challenges,” said Foundation Executive Director Heather Major. “A key goal of this collaboration is to create a replicable model for bringing mental health services into schools in a sustainable way.”

The pandemic showed us students of all ages need greater access to mental health care. “The focus needs to shift up toward preventive care and secondary and early intervention,” says Archana Basu, research scientist and clinical psychologist at Massachusetts General Hospital. Independence Blue Cross will continue to support efforts to improve access to mental health care for youth in the community.

If you or someone you know may be experiencing anxiety or depression, please seek help. If you don’t know where to begin, visit If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline by dialing 988.

Eating Disorders: Advice for Parents and Caregivers

Aside from opioid use disorder, do you know what the second deadliest kind of mental health problem in the United States is?

Eating disorders.

Tragically, eating disorders are very common in children and adolescents.

  • Nearly a third of children aged five – six have a body size ideal that’s thinner than their current perceived size.
  • By age seven, one in four children has engaged in some kind of dieting behavior.
  • 93 percent of young women engage in “fat talk” (criticizing each other’s appearance and weight) in everyday life.
  • 53 percent of American girls report being unhappy with their bodies at age thirteen, 78 percent at age seventeen.
  • 95 percent of people with eating disorders are between the ages of 12 and 25.

If anything, the COVID-19 pandemic has increased the prevalence of child and adolescent eating disorders by compounding the stress that young people experience daily. If you’re a parent or caregiver, it’s vitally important for you to be aware of these disorders and know what to do if you notice any troubling eating behaviors in your home.

Types of Eating Disorders

There are many kinds of eating disorders. The most common ones include:

Anorexia Nervosa

People with anorexia severely restrict how much food they eat. They may also exercise compulsively and/or purge (see Bulimia Nervosa, below). They usually see themselves as overweight, regardless of their body size. This can cause thinning of the bones and infertility, and can ultimately result in heart, brain, or multi-organ failure and death.

Bulimia Nervosa

Bulimia is characterized by binge eating (devouring large amounts of food uncontrollably) and then purging (trying to undo these binges through vomiting, fasting, laxatives, compulsive exercise, and other methods). Purging can cause an inflamed or sore throat, tooth decay, acid reflux, and severe dehydration. Ultimately, bulimia may create electrolyte imbalances that can lead to stroke or a heart attack.

Binge Eating Disorder

As with bulimia, people with this disorder will eat large amounts of food at one sitting. They may feel shame, disgust, or guilt about this. But, unlike people with bulimia, they don’t purge. They face an increased risk of complications like heart disease, stroke, and type 2 diabetes.

Avoidant Restrictive Food Intake Disorder (ARFID)

People with this fairly newly recognized disorder only eat a very limited number of foods. This is easily dismissed as just “picky eating,” especially in children. But individuals with ARFID don’t ingest enough calories to develop properly, or even maintain basic body functions. This can create dangerous electrolyte imbalances.

The Role of Body Image

Many kids and teenagers (and grownups) have body image issues, and this can play a big role in anorexia and bulimia. There’s so much pressure in our society to look a certain way — coming not just from in-person peer interactions, but also social media, TV, and other sources.

Kids and teenagers may compare themselves to unrealistic ideals and try doing something drastic to look the way they think they’re supposed to. Or to fit into a particular weight class for their favorite sport.

One thing you can do to help keep your child healthy is to encourage them to accept themselves the way they are and recognize that they’re attractive and worthy. Bodies come in all sizes and shapes. We can’t all look like [insert your child’s celebrity role model here].

Eating Disorders Aren’t Just for Girls

It’s commonly believed that only girls get eating disorders. However, the truth is much more complex. People of all genders and sexualities experience eating disorders. So it is important to tune in and recognize the signs of an eating disorder in all persons.

If You Think Your Child May Have an Eating Disorder

As a parent or guardian, you’re better positioned than anyone else to notice changes in your child’s eating patterns or an ongoing obsession with food or their weight. With that said, don’t try to diagnose or manage your child’s eating issues yourself. You and your child may not be the best judges of whether their weight or eating habits are healthy, or what to do if they’re not.

If you think your child may have an eating disorder, talk to their pediatrician or family doctor. They’ll also be screened for eating disorders at every well visit. If a health care provider believes your child has an eating disorder, they will probably be able to recommend where to take them for treatment.

There are many strategies for treating eating disorders. Treatment usually begins with some form of psychotherapy as well as nutrition education. More advanced cases may require hospitalization, a day treatment program, or a residential treatment program.

Independence Blue Cross members can find all these resources on our Provider Finder. All our health plans cover nutrition counseling and behavioral health treatment. And Registered Nurse Health Coaches are available to our members 24/7; call 1-800-ASK-BLUE (1-800-275-2583) (TTY/TDD: 711). You can also call the National Eating Disorders Helpline at 1-888-375-7767.

If your child has an eating disorder, they will have to learn to change their relationship with food. And you’ll need to learn how to support them along the road to wellness.

It probably won’t be a “quick fix.” It could be a long, tough journey. But it’s a necessary one, for your child’s immediate and long-term health. And the sooner it begins, the better.