Tag: well-being

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Eating Disorders: Advice for Parents and Caregivers

March 1, 2023 | Dr. Dolores Roman

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.

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Loneliness is a Serious Condition Among Seniors

February 14, 2023 | IBX Insights Team

In Japan, 65 percent of seniors live with their children, and in Italy, about 39 percent do. But in the United States, the figure is only about 20 percent, despite a rise in multi-generational households in recent years.

It’s just one of many factors that cause approximately one-quarter of Americans aged 65 and older to be socially isolated. People over age 50 are more likely to experience the risk factors for social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and reduced vision and hearing abilities.

It’s not surprising that being lonely is associated with higher rates of anxiety, depression, and suicide. However, a substantial body of evidence shows that social isolation also poses a major risk for physical problems including premature death — a risk level that’s comparable to having high blood pressure, smoking, or being obese.

Social isolation — a lack of social connections — is associated with a 50 percent increased risk for dementia. And loneliness among heart failure patients was associated with higher risks of death, hospitalization, and emergency department visits.

Pandemic Fallout

“Senior isolation was a tremendous problem during the pandemic,” notes geriatrician Heidi J. Syropoulos, MD, medical director of Government Markets at Independence Blue Cross (Independence). “It affected people who would never have considered themselves socially isolated before — whose children visited them all the time, or who perhaps had a caregiver that took care of their finances, or brought them a meal once a week, or went grocery shopping for them.”

“During the pandemic, some of those things still happened, but the affected individuals did not see those caregivers. They just dropped off the groceries or a meal at the front door and then left. So social isolation definitely increased during the pandemic. I think it’s gone back down a little bit now, but not to where it was before.”

Technology has helped bridge the loneliness gap to some degree, as seniors have become accustomed to using computers and other devices to keep in touch with family, friends, and health care providers. However, there’s no substitute for face-to-face social contact. For this reason, many local houses of worship and community service organizations are working to fill the gap to help seniors build relationships and maintain their quality of life.

Local Supports Deliver Connection

If you’re feeling socially isolated, the World Health Organization offers three key pieces of advice:

  1. Get in touch with friends by either meeting them in person or contacting them by phone or through social media.
  2. Do the things you enjoy, like engaging in a hobby or spending time outdoors.
  3. Reach out to local services that can connect you to new people, communities, or professional help.

The Philadelphia Corporation for Aging, for one, provides Community & Connection programs at 28 PCA-supported senior centers in the City of Philadelphia. They also offer health and wellness programs, volunteer support, and job training services that keep seniors active and engaged. To learn more, call the PCA Helpline at 215-765-9040 Monday through Friday, 8:30 a.m. to 5 p.m., except for major holidays.

In Montgomery County, the Senior Adult Activities Center helps seniors continue to be active, creative, healthy, and engaged in the community. Other resources include three Meals on Wheels programs, two senior centers, and an inter-generational art center — the Ambler Senior Adult Activity Center.

Similar organizations and services exist in Bucks, Chester, and Delaware counties.

Isolation can take a devastating emotional, cognitive, and physical toll over time. If you are an older adult, any steps you can take to maximize your social interactions will have a huge benefit.

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

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Channeling Climate Anxiety Into Action

January 25, 2023 | IBX Insights Team

Intense heat waves. Severe weather damage. As dramatic events like floods, hurricanes, fires, and droughts have become frequent occurrences, it’s only natural to be concerned about what climate change may mean for our future. But for some of us, climate anxiety becomes overwhelming, leading to low moods or a sense of dread or hopelessness.

There is a difference of opinion about whether climate anxiety is a clinical condition, but both the United Nations and the American Psychological Association (APA) have found that people are increasingly at risk of climate change-induced mental health issues, especially young people.

The Prevalence of Climate Anxiety

In a 2021 global study published in The Lancet Planetary Health of 10,000 young people ages 16 – 25 in ten countries (Australia, Brazil, Finland, France, India, Nigeria, Philippines, Portugal, the UK, and the USA):

  • 45 percent of respondents said climate anxiety was affecting their daily lives.
  • More than 50 percent reported feeling sad, anxious, angry, powerless, helpless, and guilty.

“We were disturbed by the scale of emotional and psychological effects of climate change upon the children of the world, and the number who reported feeling hopeless and frightened about the future of humanity,” the research team wrote. “It underscores an urgent need for greater responsiveness to children and young people’s concerns, more in-depth research, and immediate action on climate change.”

Finding Satisfaction in Climate Action

Beyond the self-care strategies we may use to reduce other sources of anxiety — such as exercise, meditation, walking outdoors — taking specific actions to address climate change can help support our mental well-being.

In her TED Talk, “How to find joy in climate action,” marine biologist and policy expert Ayana Elizabeth Johnson, Ph.D., encourages us to create our own Climate Action Venn Diagram in which we ask ourselves, “What am I good at? What is the work that needs doing? What brings me joy and satisfaction?”

The point at which the three answers come together is a great place to start, Johnson says. Whether through protecting forests or oceans, building a bicycle infrastructure in our neighborhood, or promoting family planning and education, there are many ways we can reduce stress by using our interests and skills to develop solutions.

Even if we’re not experiencing climate anxiety, that’s no cause for complacency, as Greta Thunberg reminds us. Climate change is real and is affecting the health of our population. Climate change demands urgent action from all of us.

Local Opportunities for Making a Difference

In January 2021, the City of Philadelphia’s Office of Sustainability published a Philadelphia Climate Action Playbook (in English and Spanish) that details the climate actions the City is taking. Residents can sign up for the newsletter to stay informed and get involved. In addition, the region is home to dozens of local action organizations including 350philadelphia, the Clean Air Council, and ClimateActionPhilly.

What else can we do? The United Nations Environment Programme recommends:

  • Leave your car at home and walk, bike, or take public transportation whenever possible. Get a hybrid or electric vehicle if you can.
  • Rein in your power use by turning down your heating a degree or two, switching off appliances and lights when not using them, and use more energy-efficient appliances.
  • Eat more plant-based meals, which ultimately helps reduce the amount of agricultural land used for livestock grazing.
  • Shop locally for groceries, which reduces the energy used to transport foods.
  • Try to waste less food. Food waste contributes to global greenhouse gas emissions.
  • Buy fewer new clothes and wear them longer. The fashion industry accounts for 8 – 10 percent of global carbon emissions.
  • Plant trees.
  • Spread the word about the urgency of fighting climate change.
  • Encourage local politicians and businesses to cut their emissions and reduce their carbon footprint.

“The best way to cope…is to avoid dwelling on the terrifying scientific projections and instead pivot quickly to solutions,” Johnson says. “Choose the things that enliven you. The goal is to be at the heart of the Venn diagram for as many minutes of your life as you can.”

For more information about mental health, self-care strategies, and where to find help, visit ibx.com/knowyourmind.

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You’ve Got This: Five Tips for Setting Achievable Resolutions

January 19, 2023 | mindPHL

It’s a good idea to set goals at the beginning of the year. In fact, research shows that people are more motivated to make changes at the start of a year, a month or a week. Beginnings encourage us to muster our focus and resolve.

But research also shows that we’re unlikely to persevere unless we anticipate and plan for obstacles ahead of time, says Benjamin Converse of the University of Virginia. If the goal is to lose weight, for example, we might need to carve out the time and money to plan meals and grocery shop for healthy ingredients in order to maintain a home cooking routine.

How can we keep our good intentions alive, without quitting our goals and feeling worse about ourselves than before we started? Success is not necessarily a reflection on who you are as a person, says Ayelet Fishbach, professor at the University of Chicago’s Booth School of Business. Success can depend on being at the right place and time with the right people.

To help you along, we offer some advice from Independence Blue Cross Medical Directors Reetika Kumar, MD, FACP and Ryan Connolly, MD, MS; as well as academics who have researched the science of motivation.

1. Set positive and realistic goals.

“It’s actually very hard to just stop doing something, particularly when it has become a habit,” says Dr. Connolly. A key approach is to commit to a positive habit that’s incompatible with the one you’re trying to get rid of. So, instead of deciding to “stop lazing in bed every morning,” it is much better to decide to exercise every morning at 7am. “It’s very hard to lie in bed while exercising!” he adds.

In addition, it’s important to set realistic goals, says Dr. Kumar. “Don’t set yourself up for failure. Losing the 20 pounds you’ve gained in the past year can’t be done in a month, but maybe a 1-2 pound a week goal will keep you going.”

2. Monitor your progress and see where you are at the midpoint.

If you need to adjust your goals, have the flexibility to do so. To-do lists can be helpful when one item motivates you to do the next one but keep sight of your priorities. University of Virginia professor Leidy Klotz has found that it’s often more important to remove items from your list than to add new ones.

3. Don’t work at cross purposes.

Make sure your rewards don’t sabotage your goals, Dr. Kumar says. “If you’re trying to lose weight, have your reward be a new pair of jeans rather than an all-you-can -eat buffet at your favorite restaurant.”

4. Seek social support.

Surround yourself with people who can help you succeed. Find a buddy who shares your goals and can keep you motivated, Dr. Kumar says. An accountability partner can help you stick to your goals.

5. Pair the hard work with something you like to do.

Based on the work of behavioral scientists Katy Milkman, Julia Minson, and Kevin Volpp, the technique of bundling temptations recognizes that we struggle to do what’s distasteful in the moment, but we can reach our goals by relying on short-term gratification rather than willpower.

If you find it hard to exercise, for example, pair it with listening to your favorite music or podcast. Need to stop putting off studying? Reward yourself with a favorite TV show if you finish by 9:00 pm. Don’t feel like raking leaves? Challenge a family member to a competition and the winner gets to pick the evening movie.

The goal is to “take the fun that might typically distract us from our goals and use it to transform an obstacle into an enticement,” Milkman says.

For more information about mental health, self-care strategies, and where to find help, visit ibx.com/knowyourmind.

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Finding the Right Type of Mental Health Provider

December 9, 2022 | IBX Team

The demand for mental health services has skyrocketed since the start of the COVID-19 pandemic. At the same time, the U.S. faces a chronic shortage of psychiatrists and other mental health professionals. As a result, 65 percent of mental health organizations reported having to cancel, reschedule, or turn away patients in 2020.

In order to fill the gap, some primary care offices have developed collaborative care models. With these models an affiliated psychologist or social worker provides therapy and patient management and consults with a psychiatrist on medications. Other health care providers are undertaking additional mental health training to meet patient needs.

Psychiatrist, Psychologist, Therapist: Which Do You Need?

Determining the right mental health provider can be confusing. Should you see a psychiatrist, a psychologist, or a therapist? What exactly is the difference? The first difference is whether a professional specializes in prescribing medication, providing therapy, or both.

Prescribers and therapists are both mental health professionals whose expertise is the mind and the way it affects behavior and well-being. They often work together to diagnose and treat a patient. For example, a patient might see a psychiatrist who prescribes medication for depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), or bipolar disorder, and also work with another mental health professional for psychotherapy, also known as talk therapy or counseling.

Prescribers

Psychiatrists are physicians (M.D. or D.O.) who specialize in the assessment and treatment of the biological, psychological, and social factors that lead to behavioral health conditions. A psychiatrist may prescribe medication and may provide therapy as well. Often, the psychiatrist prescribes medication and acts as the leader of a treatment team that may include other professionals who provide therapy.

Psychiatric mental health nurse practitioners are another kind of professional that can prescribe medication for behavioral health conditions. They have a master’s of science in nursing or doctor of nursing practice degree with specialized focus on psychiatry. They provide diagnosis and therapy for mental health conditions and can prescribe medications independently or under the supervision of a medical doctor, depending on the state.

Therapists

Psychotherapy (also known as talk therapy, or just “therapy”) helps people deal with various mental illnesses and emotional difficulties. Therapy can help eliminate or control troubling symptoms so a person can function better. Depending on the issue, therapy can be short-term (a few sessions), or long-term (months or years). Psychotherapy is often used in combination with medication to treat mental health conditions. Therapy can be provided by several different kinds of professionals:

Psychologists have a doctoral degree in psychology and know how to evaluate and treat behavioral health disorders, but generally are not licensed to prescribe medication. In order to receive their license, psychologists also complete an internship with specific training in behavioral therapy and other methods of treatment. Once licensed, a psychologist is qualified to provide psychotherapy, counseling, psychological testing, and mental health disorder treatment.

Master’s level professionals

Licensed clinical social workers have a master’s or doctoral degree in social work and also complete two years of postgraduate supervised clinical work to become licensed. They are trained to evaluate and treat mental health issues, provide individual and group counseling, and like other therapists have varied specializations.

Licensed professional counselors and licensed marriage and family therapists are qualified to provide counseling or psychotherapy for mental health treatment. They have a master’s degree in psychology, counseling, or a related field, plus at least two years of postgraduate training working alongside a qualified mental health professional.

This list is not exhaustive and requirements often vary by state. It’s also important to note that your behavioral health is often best managed by a team that communicates well and uses each area of expertise to take care of you as a whole.

Getting Started

Your primary care provider is a great place to start discussing your mental health concerns. They are well-equipped to assess mental health needs and prescribe necessary medications, or to refer you to an appropriate specialist for counseling or psychotherapy.

In addition, many Employee Assistance Programs can be a source of mental health services to help employees with emotional and substance use issues, interpersonal relationships, legal problems, or financial difficulties. These services might be delivered in person, by telephone, or via online platforms.

There are also companies available, like Quartet*, that use specialized technology to help people more easily find and access care that’s right for them. Quartet does not provide direct mental health care. It works with health plans, like Independence Blue Cross, to match members with licensed mental health providers and programs that meet their needs and preferences, and accept their health insurance.

In summary, there are different types of support available to people seeking mental and behavioral support, and there are professionals skilled in getting you to the right provider. It all begins with that first call.

For more information about mental health, self-care strategies, and where to find help, visit ibx.com/knowyourmind.*Quartet is an independent company.

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Act to Curb Election Anxiety

October 28, 2022 | IBX Insights Team

Feeling anxious about the upcoming midterm elections? You’re not alone. Prior to the 2020 U.S. presidential election, more than two-thirds of Americans surveyed reported that the election was a significant source of tension in their lives. People across the political spectrum felt anxious, including 76 percent of Democrats, 67 percent of Republicans, and 64 percent of Independents.

Take Action and Vote!

“The best action to take for election anxiety? Volunteer, talk to people about the issues that matter most to you, and vote!” says clinical psychologist Tamar E. Chansky, Ph.D.

The American Psychological Association offers the following additional evidence-based advice:

  • Uncertainty is stressful, so don’t dwell on things you can’t control. Avoid imagining worst-case scenarios.
  • Focus on what you can control. Monitor your media consumption, and limit highly charged content.
  • Engage in activities or issues that are meaningful to you.
  • Stay socially connected. Spend time with friends and family.
  • Stay physically active.
  • Realize that you might not know the election results right away. Keep busy with other activities and social support, so you aren’t continually checking for “bad news.”

Recognizing Tension

Stress affects us in a variety of ways. “We notice it in our bodies, the tension in our shoulders,” said Robert Bright, MD, a psychiatrist at the Mayo Clinic, of the stress leading up to the October 2020 presidential election. “Sometimes people get GI [gastrointestinal] upset or headaches. People have trouble sleeping. There’s a lot of sleep disturbance going on right now — tossing, turning, and worrying, and not being able to get to sleep — or having bad dreams about the election.”

Dr. Bright added that television, radio, and social media ads flood us with catastrophic messages about the candidates that heighten our sense of anxiety and can feel overwhelming. “And it affects our emotions after a while. So, we start getting irritable and short, and snapping at people, not trusting people, seeing people as [either] the other or as the same. And that starts affecting our relationships at home. It starts affecting our work.”

“Our stress level is something we need to take seriously,” says Dr. Chansky. “Many of us never got that much-needed re-set from the earlier years of the pandemic. And we’re also still dealing with ongoing COVID cases, climate crises, war, and disruption. Even if these events don’t seem to be affecting us directly, we’re still processing them — and our emotional and physical resources are being strained.”

Check Your Facts and Have Hope

“Compartmentalization is a key skill for emotional well-being,” Dr. Chansky says. “Particularly when something is causing us ongoing stress, it doesn’t help to think about it all the time. But it does serve us to address it at designated times — what we may think of as ‘worry appointments.’

“At those times, write out your feelings about the election and fact-check them against what you know,” Dr. Chansky advises. Choose to have hope, she suggests, even if it’s not your natural inclination. Hope is not about imagining a particular election outcome. Rather, it’s a way of life and a continual commitment to not give up.

For more information about mental health, self-care strategies, and where to find help, visit ibx.com/knowyourmind.

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De-Escalating Stress For Improved Mental Health

June 29, 2022 | Amy Edelstein

After two years of living with the COVID-19 pandemic, people are feeling stressed. We have less patience for slights that we used to shrug off. We want people to listen to us and support us, but we sometimes may forget that they probably want the same things from us.

We might also feel we don’t have the bandwidth to extend more support to others. We might be a little less kind than we could be.

But in today’s reality, small annoyances can mushroom into big conflicts. We’ve seen shootings over parking spaces, people yelling at each other for wearing masks or not wearing masks, and a frightening uptick in violence throughout Philadelphia and across the country.

Sensational Headlines Can Raise Our Stress Levels

The smartphones we carry around often add to the tension. Social media, television, and radio programming often thrives on conflict and emotion. We are fed a steady stream of provocative headlines, whether they’re about the war in Ukraine, politics, or racial injustice. Even sports updates and weather forecasts are often presented in dire terms.

It’s important to be mindful of how these stories may upset us and try to avoid getting overwhelmed. Otherwise all this negative news can raise our blood pressure and increase our risk of heart disease or stroke, weaken our immune systems, affect the quality of our sleep, and generally worsen our mental health and sense of well-being.

Take Back Control

There are a few things we can do to de-escalate the level of stress in our lives.

Start by practicing love and kindness to yourself. Affirmations — positive statements we repeat to ourselves to help us overcome negative thoughts — can be a useful tool. Repeat gentle affirmations in your mind, such as wishing happiness and freedom from suffering for you and the people you care about. It sounds simple, but studies show that this kind of practice helps us feel connected and supported and increases our patience.

It’s also important to take breaks. Give your phone a rest and go outside. Take a walk, play with your dog, or say hello to your neighbors. Get together with friends in person.

And consider reading the news rather than listening to it. You’ll be able to better control which stories you read. Take them in at your own pace, and stop before you become overwhelmed.

Finally, remember that most people are having a hard time, so resist the temptation to assume the worst about them. If a friend, stranger, or co-worker makes an insensitive comment, it may be because they’re experiencing a lot of stress themselves. A well-meaning compliment or kind word from you could change their whole attitude and lead to a more positive relationship.

For more information about mental health self-care strategies and where to find help, visit ibx.com/knowyourmind.

It's okay to not be okay.

Call 888-545-2600 or visit HealthyMindsPhilly for wellness tools designed to support the mental health and well-being of all Philadelphians regardless of insurance or income status.

Contact the Philadelphia Crisis Line at 988 or 215-685-6440 for emergency help.

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