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August 16th, 2007

A Prescription for Parents

How do you know when your child at college needs help

 
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ANXIETY DISORDERS

Anxiety is a normal human emotion. We commonly feel anxious before we give a speech, or start a new job, or send our children off to college. But anxiety disorders are serious medical illnesses that according to the National Institute of Mental Health affect approximately 19 million American adults [NIMH 2000] and 9.1 percent of college students [American College Health Association, 2002].

Unlike the relatively mild, brief anxiety accompanying everyday events, anxiety disorders like Sasha’s are chronic, relentless, and can become progressively worse if not recognized and treated. Although some disorders have a genetic base, the stress of college seems to be a trigger in susceptible people and that’s why it is not uncommon for a person to experience his or her first anxiety disorder attack during the stressful college years.

The most common anxiety disorders are:

  1. panic disorder
  2. obsessive-compulsive disorder
  3. post-traumatic stress disorder
  4. phobias
  5. generalized anxiety disorder

The National Institute of Mental Health defines each http://www.nimh.nih.gov/healthinformation/anxietymenu.cfm

Each anxiety disorder has its own distinct features, but they are all bound together by the common theme of excessive, irrational fear and dread. As you observe your child for signs of good mental health, it’s important to remember that it is common for an anxiety disorder to accompany another anxiety disorder, substance abuse, eating disorders, or depression.

EATING DISORDERS

From early childhood, women receive messages from society and the media that push them to use food for psychological comfort. Too often the end result is eating disorders that, as this story of Ashley illustrates, can severely disrupt their college experience.

To keep eating disorders from ruining their college years, our daughters need to hear from us over and over again that their value as human beings has nothing to do with the size of their body.

Eating on Campus

I remember watching Geneen Roth, an author of books on obsessive eating, being interviewed on a television news show. She was talking very intelligently about the tragic consequences of eating disorders, but her words were soon drowned out by louder societal messages from the companies who bought advertising time on the show.

During the first commercial break Pillsbury advertised a cake product with the message: “If you bake a cake for your family, they will love you.” The next commercial break showed an advertisement for a health club with the implied message: “Work out at our club and you’ll soon look like this svelte super model.” This is a perfect example of the mixed messages women receive: Food is nurturing and a sign of love; you must be excessively thin in order to be attractive to others.

These are the two things people in college most crave as they struggle to fit in: to be in control and be attractive to others. When this doesn’t happen easily, some (especially females) will use food to numb the pain and go on to develop an eating disorder. It is likely that this cause of eating disorders combine with a complex mix of physical, psychological and social factors that during the college years can be overwhelming. Eating too little, too much, or binging and purging becomes a comfortable way of gaining control over one aspect of life, and this helps manage the emotional symptoms of distress—but at a very high price. One study published in the American Journal of Psychiatry found that there was a 10-year mortality rate of 5.6 percent with roughly half dying from direct medical effects and 27 percent from suicide. This mortality rate is 12 times higher than that of 15-24 year olds in the general [Sullivan 1995].

The three most common types of eating disorders found on college campuses are:

  • anorexia nervosa
  • bulimia nervosa
  • binge eating

These eating disorders commonly peak at the age of 18—the time when young women start their adult lives and start college.

The Hard Facts: A Gender Bias
Females are much more likely than males to develop eating disorders. Only an estimated 5 to 15 percent of people with anorexia or bulimia and an estimated 35 percent of those with binge-eating disorder are male.

In would seem that the cure for all eating disorders is simple enough: for anorexia—start eating more; for bulimia—stop binging and purging; for binge eating—stop eating so much. But in reality, the reason these disorders are so rampant on college campuses is because they are coping mechanisms that serve a purpose and function. They cannot be given up without leaving these young women adrift and insecure in their high-pressure environment.

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The Author : Dr. Richard Kadison
Dr. Richard Kadison is the Chief of Mental Health Services at Harvard University
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