This summer, buy healthy snack food options for your teen’s go to snack rather than stocking the shelves with unhealthy choices. (Photo credit: Wikipedia)

With so much attention on preventing both eating disorders and obesity in our teens, summer vacation means more than just a break from school.  For many parents, it also means there are teens home alone all day with no one minding the kitchen.  This summer, help your teen eat healthy even when they are home alone with these 7 secrets to healthy summer snacking.

1.     Plan Ahead

One of the most common reasons that our homes end up packed with unhealthy snacks or with no snacks at all is because we don’t plan for snacks like we do for meals.  Help your teen eat healthier this summer by incorporating snack planning into your normal grocery shopping routine.  This way you can choose snacks conscientiously rather than winding up with bags of chips and boxes of cookies.

2.     Stock Up

Most teenagers won’t go out of their way to procure unhealthy snacks if there are healthy snacks that they like easily available.  This means keeping the kitchen full of the kind of healthy snacks your teen likes to eat.

3.     Check the Labels

Checking the labels is good advice for all your food, but when it comes to buying healthy snacks, it is even more important because sometimes the snacks sold as healthy are not.  Check the labels for high sugar content, lots of fat and additional ingredients.  For example, if you are buying dried fruit, make sure that the contents are made from fruit with nothing else added.

4.     Pick Things They Like

The truth is, if they don’t like it, they won’t eat it.  While your idea of a healthy snack might be a fat free yogurt or an apple, you are only wasting your money if those aren’t things they will actually eat.  Consult your teenager and work together to come up with a list of healthy summer snacks that they will love.

5.     Prep for Portion Control

One of the challenges of healthy summer snacking is that eating too much of anything can be a bad thing, even if it is a healthy snack.  Help teens keep track of and control over their portions by pre-portioning their favorite snacks.  Rather than putting a big bowl of grapes in the fridge, split the grapes up in sandwich bag size portions.  This also works for things that teens like but may not be willing to do themselves like peeling oranges or popping air-popped popcorn.

6.     Availability is Key

If you don’t want your teen indulging in unhealthy snacks, don’t stock up on them.  By stocking the shelves with things that they like that are healthy to eat, you are setting your teen up for success.  But if you buy three bags of cookies, you can’t expect them to choose the healthy snack over the cookies every time.  If you would like the special treat of cookies in the house, buy only one package and stress moderation. Encourage your teen to consume one or two cookies a day, over the span of a few days as a special treat rather than several cookies as snacks repeatedly throughout the day. Bottom line – if you don’t want them to eat it, don’t have it in the house. If you do want it in the house, only have a moderate amount so you aren’t encouraging unhealthy options as a primary choice.

7.     Skip the Sweet Drinks

Soft drinks, juice, energy drinks, all of these are ways that teens can add an enormous number of calories to their summer days.  Encourage them to drink water, low fat milk, and other low calorie non-soft drink options.

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Here is a list of some fun and entertaining things your teen can do this summer. (Photo credit: Wikipedia)

One of the challenges of summer vacation is that teenagers often find themselves with more time on their hands than sense in their heads.  While getting a job and volunteering their time are both great ways for teens to make use of their summer vacation, those options aren’t always available.

Parents who are concerned that teens will get into trouble or go off seeking thrills if they don’t have anything interesting to do should try to address the issue proactively.  Rather than waiting until your teen is in trouble or until you notice undesirable changes in their behavior, take the first step and help them come up with fun, interesting, entertaining, and even educational ways for them to spend their summer.

To get you started and give you some ideas, here are 50 of our favorite fun ways for teens to spend their summer vacation.

1. Make a movie.
2. Make a music video.
3. Grow a garden.
4. Build a fort for someone smaller.
5. Go swimming.
6. Plan a picnic.
7. Make your own ice cream sandwiches.
8. Learn how to cook.
9. Learn how to bake.
10. Host an all night movie marathon.
11. Setup a Frisbee golf league.
12. Go for a long bike ride.
13. Have a pool party.
14. Have a water balloon fight.
15. Hold a carwash with your friends and donate the money to charity.
16. Go to a museum.
17. Teach yourself to draw.
18. Go to the library.
19. Read one book for each year of your age.
20. Volunteer to mentor younger kids.
21. Play basketball.
22. Babysit for extra spending money.
23. Go fishing.
24. Learn how to kayak.
25. Teach someone else how to swim or ride a bike.
26. Learn how to do your own laundry.
27. Start your own business.
28. Camp out in the backyard.
29. Go to a planetarium.
30. Go hiking.
31. Get some friends to go geocaching with you.
32. Host the backyard Olympics for other kids on your block.
33. Read to younger children at the library.
34. Make your driveway into a drive-in movie theatre for bikes.
35. Host a backyard board game championship tournament.
36. Have a scavenger hunt.
37. Learn a new sport.
38. Play baseball.
39. Play mini-golf.
40. Go on a college visit.
41. Have a yard sale.
42. Go see a concert.
43. Put on your own concert.
44. Play tennis.
45. Start a band.
46. Go bowling.
47. Learn how to drive a boat.
48. Ride every rollercoaster at the local amusement park.
49. Learn how to cook on the grill.
50. Make new friends.

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Having a healthy self esteem has an impact on our whole lives. (Photo credit: heraldpost)

No matter what age you are your self-esteem acts as a buffer between you and the rest of the world.  You might even think of it as a kind of armor that protects you. In the simplest sense, self-esteem is our core belief about who we are and what we are capable of achieving.  While it fluctuates across a scale from healthy to unhealthy over the course of our lifetime, its foundation is established by our parents and other factors during our adolescence.

Having a healthy self esteem has a significant impact on our whole lives.  It can affect every area of our lives.  It dictates what we believe is possible, the goals we set out to achieve, and the relationships we have with others.  When people have low self-esteem, it limits them throughout their life.  It limits their employment options, the relationships they build with others, and their overall level of happiness.  It limits the opportunities available to them because their lack of belief in themselves and their abilities discourages them from trying to have more.  It can contribute to the creation of unhealthy relationships as an adult because low self esteem can make people feel like they do not deserve a better relationship or a better partner.

For this reason, parents can have a significant impact on how their children see themselves.  Parents can be instrumental in establishing the kind of foundation that can get them through the difficult times they will face throughout the teen years and into adulthood.   Here are some things that parents can do to help build up this foundation for a healthy self-esteem:

• One of the most important factors in our self esteem comes from the way others react to us.  This means that the way parents react to their teens behaviors, opinions, and actions has a lasting impact on their self esteem.  The teen years can be very challenging for parents but praising twice as often as you criticize may be even more important with teens than with younger children.
• Healthy self-esteem also comes from feeling a sense of belonging.  Parents can help children feel like they belong by showing through words and actions that they are loved, respected, and cared about.
• Healthy self-esteem is reinforced by good experiences.  Parents who can create opportunities for their teens to do things on their own, to succeed, and even to stumble give them the environment they need to have these kind of experiences.
• Parents should work at including teens in family responsibilities and even age appropriate decisions.  These activities foster healthy self-esteem.
• Supporting teens in their school efforts and helping them however they need to be helped to become successful learners also makes a real difference in forming this all important foundation.
• Developing healthy self-esteem comes from knowing that you are loved, that you are special, and that you are capable.  It doesn’t come from empty praise, never being challenged, and never coming in second.  It comes from genuine accomplishments and real expressions of love.

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When worry becomes all incompassing, it could be more than normal worry. Generalized Anxiety Disorder (Photo credit: Adams999)

Life provides ample opportunity to worry.  From natural disasters to job losses, there are many legitimate things for adults to worry about and we all do it, even our kids.  While their worries may be different than ours, they are just as real and just as valid.  But for both adults and teens, worry sometimes moves from everyday concern into excessive anxiety.  When worry becomes all encompassing, when it begins to impact every day activities, it can stop being normal worry and become Generalized Anxiety Disorder.

Severe non-specific anxiety is often diagnosed as Generalized Anxiety Disorder (GAD) and it is estimated to affect about 3% of the U.S. adult population.  GAD also affects about one out of every eight children.    People with GAD experience excessive and unwarranted levels of anxiety about normal everyday events and possibilities.   Often, the anxiety is related to things that do not warrant the level of anxiety being experienced.  It is also not uncommon for those with GAD to focus on the worst possible outcome of every situation to the exclusion of everything else.  When these negative thoughts take root, it can feel impossible for the person with the condition to stop them.

When teenagers have this condition, they can struggle in all areas of their lives.  The residual impact of untreated GAD during the teen years can last throughout their lives. GAD can make it difficult to concentrate at school, impacting grades, college options, and future employment.  It can cause irritability and make people unwilling to engage in or participate in social situations.  When this happens, teens can miss important social milestones, fail to form friendships, and struggle with feelings of loneliness and ostracism.   The significant and long-lasting consequences of GAD in teens underscores the importance of seeking treatment rather than waiting for the problems to resolve themselves.  The good news is that with proper treatment, teenagers can overcome GAD by learning to manage their symptoms.

The difference between someone who worries a lot and someone with GAD is the level of anxiety they experience and how long the anxiety lasts.  GAD causes persistent, chronic anxiety that lasts for at least 6 months.  Unlike worrying about a date for the prom or about getting a good grade on a test, GAD is consistently present; symptoms are often experienced all day, every day.   Another differentiating factor for those with GAD is that calming methods, and even repeated reassurances, do not help to ease the feelings brought on by GAD.

People with GAD also experience physical symptoms including unexplained fatigue, problems sleeping, restlessness, edginess, irritability, difficulties concentrating and headaches.  It is also common for those with this condition to also suffer from gastrointestinal problems including nausea and diarrhea.

While there is no known cause for GAD, it is associated with several factors that seem to increase the risk of it developing.  These factors include stress, heredity, and experiencing traumatic events.  People with this condition generally respond well to therapy, medication, or a combination of both.

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8 women with the same Body Mass Index rating (BMI – 30) but with different weight distribution and abdominal volume, so they have different Body Volume Index (BVI) ratings. Select Research, 09-09-08 (Photo credit: Wikipedia)

Most of today’s parents grew up thinking about weight management in terms of calories and pounds.  We all knew how many calories we were supposed to be eating and how many pounds we were supposed to weigh.  We were taught about counting calories but today’s weight management buzzword, BMI, wasn’t part of our weight management vocabulary.  BMI is actually three words, Body Mass Index, and it is a screening tool that can be used to gauge where someone falls on the weight continuum.  It is calculated using your height and weight and shows whether you are underweight, overweight, obese, or at a healthy weight.

With all the buzz about BMI, many parents are left wondering whether or not it is a big deal and how it applies to their teenagers.   Here are the basic facts about BMI.

What is Body Mass Index?

According to the Center for Disease Control, body mass index is a cost effective and reliable method for determining body fatness for people of all ages, including children and teens.  While there are other methods for measuring body fat that are more precise, BMI is a simple, easy, no cost way to screen for possible weight related health problems.

How is it Calculated?

BMI is calculated by dividing a person’s weight by their height squared.  You can easily get your BMI without having to do any math by using the BMI Calculator for adults provided by the CDC.  To find the BMI for a child or teenager, use the CDC’s BMI calculator designed specifically for them.

How is BMI Read?

BMI is represented as a number that corresponds to a specific weight category ranging from underweight to obese.  For children and teens, this number is associated with a percentile that corresponds to where that BMI falls in these categories.  Adolescents with a BMI below the 5^th percentile are considered underweight.  Those who fall between the 5^th and 85^th percentile have a healthy weight.  A BMI from the 85^th to the 95^th percentile are considered overweight and anyone with a BMI in the 95^th percentile and above is obese.

The difference between how BMI is calculated for adults and for adolescents reflects the fact that body fat changes with age and across genders as children grow into adults.

What BMI Should Your Teen Have?

As outlined above, because of the considerable changes experienced as adolescents grow from childhood into adulthood, healthy weight should be gauged by your teenager’s BMI percentile.  Using the BMI calculation and categories specific to teenagers accounts for the differences caused by gender, age, puberty, and height.  If you are concerned that your teenager’s BMI percentile is outside the healthy weight range, it is a good idea to discuss your concerns with their primary care physician or a registered dietitian.  Additional testing may be needed to determine actual body fatness which can be ordered or conducted by these medical professionals.

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Teenagers are often bullied in silence. (Photo credit: Wikipedia)

Bullying happens everyday. But, what many parents don’t realize is that most of it is never reported to an adult.  According to the U.S. Department of Education, only one third of bullying incidents are reported to adults.  This often means that parents are unaware of the torment, humiliation, and abuse their children are suffering at the hands of their peers.  It also means that the parents of the bullies are also unaware of their child’s behavior and therefore unable to intervene.

One of the questions we get asked a lot is why kids who are being bullied don’t ask for help.  While there are many different reasons a specific teen would choose not to report an incident of bullying, there are several common reasons we have seen in our clients.  Bullying can make teens feel powerless which includes feeling powerless to stop the abuse.  Sometimes, they don’t report it simply because they don’t believe it will make a difference.  Teens may also choose not to report bullying because they feel like handling it on their own gives them back a little of the power and control they feel they have lost.  Others may be afraid of retribution or of being bullied more for being a snitch.

Another reason teens don’t report bullying behavior is because it would expose something they don’t want to share with their parents.  Humiliation and nasty gossip are often a part of bullying and may be an exaggeration or an exposure of something that is true but secret – like experiencing some sexual confusion.  The teenager may feel that in order to report the bullying, they would have to divulge and discuss their secret which they are not ready to do.

These are just some of the reasons that teenagers who are being bullied suffer in silence.  The problem for parents is that being bullied and being a bully, and even being a witness to bullying behavior can have real, long-lasting repercussions.

Teens who are bullied are more likely to be depressed, suffer from anxiety disorders, feel sad and alone, lose interest in hobbies, sports, and interests, and struggle with sleep or food.  Being a victim of bullying can also impact school performance and school attendance and may decrease the likelihood of graduating from high school which compromises their future opportunities. These problems can last well into adulthood impacting every aspect of their adult life.

Teens who bully others are more likely to struggle with substance abuse problems both as teens and as adults.   They are also more likely to get in frequent fights, participate in violent behavior, be violent towards others including partners, spouses, and children, be convicted of crimes, and be sexually active at an early age.  These problems, which can also last into adulthood, can have very serious life-long ramifications even if they do not persist past the teen years.

Teens who are neither bullied themselves nor bullying others but who witness bullying behavior can also be impacted.  These teens are more likely to drink, smoke, or try drugs and to skip school.  Witnessing acts of bullying can also increase the likelihood of suffering from depression and anxiety disorders.

The bottom line for parents is that when it comes to bullying, no one gets off without damage and those scars can last a lifetime.  Talk to your child about bullying, encourage them to be open about their experiences with it, and if you suspect they are being impacted by bullying, get them help.

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Do you know the signs of PTSD? photo credit: Sean Molin Photography via photopin cc

There has been a lot of press in recent years about the many post-9/11 veterans coming home with PTSD or Post Traumatic Stress Disorder.  What many people don’t realize is that you don’t have to survive a war to be affected by this condition.  Anyone, including children and teenagers, who experiences a traumatic event can develop the disorder and many who do will require treatment to overcome its challenges and obstacles.  When left undiagnosed or untreated, PTSD can cause long-term problems that negatively impact quality of life.  Because of the potential for lasting consequences, it is important for parents to understand what can cause the disorder, what symptoms teenagers with PTSD often experience, and how to get help for the disorder.

When the Worst Happens

There is no question that traumatic events impact everyone who is touched by them.  Survivors and witnesses of trauma often experience a period of extraordinary stress and undergo a period of extreme emotional response following the event.  Many of those touched by trauma will have trouble sleeping, experience difficulty concentrating, and develop anxiety specific to the circumstances of the event.  These are all normal reactions experienced when we are exposed to trauma.

But these normal post-traumatic responses are generally worst immediately following the event and then begin to fade and dissipate in the days and weeks that follow.  In some cases, however, these responses do not fade but intensify instead lasting for months or even longer.  This is when our response shifts from a normal reaction to a diagnosable disorder.

Cause and Effect

Although PTSD is directly caused by experiencing some form of trauma, there is not a specific list of traumatic events or circumstances that cause PTSD.  It can result from catastrophic events that impact thousands like an earthquake to individually impacting events like sexual abuse. However, experiencing trauma, no matter how catastrophic, does not guarantee that any specific individual will develop PTSD.  The important thing to understand is that anyone who experiences trauma including those who are directly involved, those who are peripherally involved, and even those who simply witness the event, can develop this condition, but not everyone will. Even if someone has experienced multiple “smaller” incidences of traumatic events, they can end up with PTSD symptoms that are very disruptive and interfering.

Why One and Not the Other

There is no clear distinction between people who develop PTSD and people who don’t.  There are some theories that PTSD stems from a disruption in the fight or flight response, the physiological response we experience when faced with fear, danger, or trauma.  This is the biological process responsible for the surge of adrenaline we get when someone almost hits us while changing lanes or that makes it possible for a mother to lift a car off of her child.  It is one of our base survival responses and is triggered during traumatic experiences.  The thinking is that for some people, the exposure to trauma changes the way this biological process works, creating a new, very sensitive trigger that is directly correlated to the traumatic event.   This new trigger sets off the fight or flight reaction outside of the normal parameters which creates the anxiety, fear, flashbacks, and other symptoms associated with PTSD.

If you are concerned that your teen may be suffering from PTSD, schedule an appointment with a mental health practitioner to have them evaluated.  For many people, PTSD does not resolve on its own or get better over time which is why getting help is the best path to recovery.

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Exercise regularly to help maintain physical as well as mental health. (Photo credit: Wikipedia)

This May, join us in celebrating National Mental Health Month by raising awareness about mental health issues and helping everyone understand the benefits of treating mental health conditions.  According to the National Institute of Mental Health (NIMH), 1 out of 4 adults in America suffers from a diagnosable mental health condition in any given year.  This means that mental health issues affect us all, either directly and indirectly.  This month, commit to learning more about our country’s mental health challenges and to taking steps in your own life to work towards wellness.

The focus of this year’s campaign is wellness.  Many times, when confronted with mental health conditions, our focus narrows to getting healthy.  While this is an important part of the process, the goal for every American is not only to achieve a healthy mental state, but to maintain that mental health as well.  By shifting the focus from getting better to staying better, the campaign aims to help everyone, even those without mental health issues, understand how important an attitude of wellness is to maintaining both your physical and mental health.

Wellness, like health, can mean different things to different people.  At the core, it is the absence of disease but it is also much more than simply not being sick.  Wellness is about our overall well-being.  It involves more than just our mental health.  It is about achieving a state of health physically, emotionally, spiritually, and mentally.   It is the tools and techniques we develop that help us overcome adversity, manage change, and recover from illnesses of all kinds.  Wellness is about getting healthy and staying that way.

The numbers tell a story that most of us don’t like to hear.  No matter how happy we are, how successful we feel, how much money we make, or how healthy we feel today, we are all at risk of developing a mental health disorder.  While this may be something we think happens to other people, the truth is that is happens to all of us and the best way to safeguard ourselves is to pay attention to our overall well-being.  When we are taking care of ourselves and making sure our most important needs are being met, we are working towards wellness.

The national campaign stresses the following four steps as the key to following your own Pathway to Wellness:

• Eat a balanced diet filled with healthy food and plenty of water.
• Exercise regularly to help combat stress and increase resilience.
• Remember to relax, to laugh, and to let go.
• Get a good night’s sleep.

In addition to these four steps on the Pathway to Wellness, commit to making your mental health as important as your physical health.  Make regular mental health checkups part of your overall health management plan and make it a habit to monitor your own mental and emotional well-being.

Take time this month to lend your voice to the awareness campaign and encourage everyone in your life to seek their own Pathway to Wellness.

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As a parent, do you know the warning signs of eating disorders? (Photo credit: Wikipedia)

Millions of people in the U.S. are impacted by eating disorders every year.  This includes those suffering from the eating disorder as well as their family members and friends.   Unfortunately, many people who have these disorders do not get the help, support, and treatment they need to be healthy.   Recent research indicates that as many as half a million teenagers may be suffering from an eating disorder but according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD) on average only 1 in 10 people with these conditions get treatment.  This means we all need to do a better job of identifying those who are in trouble, preventing disorders from developing, and treating those who are struggling; the consequences of doing any less are simply too high.

Prevention and early detection are critical to minimizing the long term damage suffered by those who are dealing with these potentially life-threatening conditions.  The key to early detection is to know what to look for and what actions to take if you suspect that someone in your life is suffering from an eating disorder.  To help, here are the most common immediate symptoms of the most prevalent eating disorders.

Anorexia Nervosa

• Unusual eating habits or patterns, may skip meals and/or avoid certain foods
• Eating only small amounts
• Weighing and measuring food
• Obsessive calorie counting
• Excessive exercise
• Intense fear of gaining weight

Bulimia Nervosa

• Bingeing or eating excessive amounts of food in a single sitting
• Inability to control their bingeing
• Self-induced vomiting
• Abuse or misuse of laxatives or diuretics
• Skipping meals
• Excessive exercise
• Intense fear of gaining weight

Binge Eating Disorder

• Bingeing or eating excessive amounts of food in a single sitting
• Inability to control their bingeing
• Eating to discomfort and eating when not hungry

These behaviors and symptoms can indicate the presence of an eating disorder and if you are concerned that your teen may be struggling with any of these disorders, you should make an appointment to discuss your concerns with their doctor.

The longer term symptoms and consequences of these eating disorders, which are outlined below, are increasingly more serious which underlines why prevention and early detection is so critical.

Anorexia Nervosa

• Brittle hair and nails
• Anemia
• Dry skin
• Swollen joints
• Osteoporosis
• Slower than normal heart rate
• Low blood pressure
• Brain damage
• Heart failure

Bulimia Nervosa

• Dehydration and electrolyte imbalance
• Constipation, bloating, and diarrhea
• Dental problems including loss of enamel, gum disease, and cavities
• Throat and esophageal problems including tears and ruptures
• Anemia
• Dry skin
• Vomiting blood
• Irregular heart beat
• Low blood pressure
• Heart failure

Binge Eating Disorder

• Obesity
• Type 2 Diabetes
• High blood pressure
• High cholesterol
• Gallbladder disease
• Heart disease
• Specific kinds of cancer

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Newest Intensive Outpatient Program Track: OCD/Anxiety Disorder IOP

OCD/Anxiety Disorder IOP

Who:  Boys and Girls, ages 12-17.  This track is open enrollment (you may join at any time).

What:  Small group format good for adolescents who are struggling with extreme social phobia, extreme fears, and can’t talk to people.

When:  Tuesdays, Thursdays, Fridays, June 25 – August 16 (8 weeks), 10:00 a.m. – 1:30 p.m.

Where:  Doorways Arizona, 1825 E. Northern Ave, Suite 200, Phoenix, Arizona 85020

How:  Email Trina or call Doorways, (602) 997-2880

Other Intensive Outpatient Program Tracks

Young Adult Trauma IOP is for ages 17-25.  This track is 3 days per week, a total of 10 hours per week. Open enrollment, join any time.

The Adolescent Eating Disorders IOP is for ages 13-18. It is 3 days per week, a total of 13 hours per week.  Open enrollment, join any time.

If you know anyone who may benefit from either of these specialty programs, please don’t hesitate to give us a call at 602.997.2880.