Soccer, baseball, swimming, track, dance, gymnastics, cheerleading, ice skating, community service, school, grades, college, SAT scores and the list goes on and on. How much of the pressure to look a certain way, compete to be the best in school, sports and have the perfect body is driving the epidemic of eating disorders in our society today?
When someone develops an eating disorder, their food, body and all eating disorder behaviors begin to be the focus. If they are restricting then counting calories, fat grams and restricting certain food groups might be how it begins. The isolation slowly creeps in and the eating disorder becomes their best friend and they lose touch with other friends.
When someone begins purging their food through vomiting, it is usually to lose weight, but not a lifestyle that they intend to keep because it is disgusting and shameful. As the cycle of restricting their food followed by binging and purging continues, they do begin to isolate. Planning where and when I can binge and purge is part of a daily activity that increases as time goes on.
Purging through exercise can release those endorphins and make you seem like you can conquer the world initially until the exercise takes all your time. The obsession with the exercise begins to occupy all your free time and there is less time for school, friends, family, etc. Running or burning calories after each meal is necessary in order to feel alright about eating.
That is why so many teens are turning to crystal methamphetamine as the answer to the pressure to be “perfect.” They can stay up for hours to study for school, have a social life and be thin. They do not have to obsess about food because they are not hungry. For the teenager, it appears to be the solution to the expectation to be successful in all areas of their life.
Our society is moving faster and the belief is that faster is better. Starbucks, Lattes, caffeine, diet pills, are all stimulants which differ only to the degree that they act in the brain. Stimulants increase awareness and alertness with a decrease in appetite and fatigue. For many Americans, stimulants are very much a part of their everyday regimen. Crystal methamphetamine is a stimulant which can be a quick fix for the adolescent. They can lose weight rapidly and be awake to complete homework and study without being tired the next day.
Crystal Meth, also known as crystal glass, tweak, and hot ice is a colorless, odorless addictive synthetic stimulant which produces a long lasting euphoric effect. It can be smoked or injected and is immediately followed by 12 hours or more of an intense euphoric sensation. The effect of the drug is similar to the highs felt when people get an adrenaline rush from bungy jumping or sky diving. The difference is that the person who is skydiving will stop between dives. Someone using crystal meth continues using the drug for days and weeks without food or rest. This places impossible demands on the body.
The drug forces the central nervous system to be overexcited. The heart rate and blood pressure increase and damage occurs to the small blood vessels in the brain. Feelings of hunger and fatigue disappear. Long lasting effects include damage to the organs, inflammation of the heart lining, scarred or collapsed lungs, pneumonia, tuberculosis, and kidney or liver failure.
The damages associated with the drug are overlooked by adolescents because the positives outweigh the negatives in their belief that they are invincible. Much like eating disorder clients who restrict their food intake, purge through exercise, and binge and purge; the euphoric feeling that is produced from the behaviors coupled with the desire to lose weight blinds them to the long term dangers of their choices.
The pressure felt by the teens of today to be successful, pretty and talented is so intense that the solution to their problem actually creates a larger problem when they become addicted to crystal meth. If there is the existence of an eating disorder prior to the use of the drug, it becomes the easy route for quick weight loss. Once the drug is stopped, there is weight gain and the immediate desire to return to the drug use. It becomes a vicious cycle much like the binge/ purge or the restrict/binge cycles which are difficult to break without the help of treatment professionals.
Although many teens may be resistant to treatment, it is definitely necessary. They may be treated for the drug addiction without the eating disorder being addressed as they may be unwilling to be honest about the eating disorder component. Outpatient therapy will be the first step in the treatment process for many, but if the adolescent is unable to be contained in this environment, it may be necessary to have a higher level of care, such as residential. It is essential that the treatment focuses on the eating disorder and the drug use. If both behaviors are not addressed, the adolescent will continue eating disorder behaviors if the crystal meth is no longer available. The resistant adolescent will want to give themselves a “back door” to escape from dealing with the feelings. Please be aware that if a teen is using some form of speed that there may possibly be the presence of an eating disorder.
As the treatment progresses and the teen is gaining weight due to the lack of crystal meth and the inability to practice eating disorder behaviors, you will begin to meet the resistance. The underlying fear of gaining weight will rear it’s ugly head.
Of course we want to deal with the underlying feelings and not the behaviors, but so many times with adolescents, we are met with anger, frustration, and an unwillingness to participate in treatment. Arms crossed and sullen faces stare at you as you begin to ask questions about their lives prior to coming in to treatment. You will need to meet them on their level to develop a trusting relationship. Taking walks and participating in art projects seem less like therapy to the adolescent, but you can also gain a lot of knowledge and information about them in a less threatening manner.
If you are seeing the adolescent in outpatient therapy, you will need the help of other treatment professionals. A psychiatrist, medical doctor and dietician to start with will help begin to piece the puzzle together. Family therapy is important so you may want to refer the family to another therapist so you can develop the trust with this client.
Limits and boundaries are so important in the family and the therapeutic setting. The adolescent will need a behavior contract in order to keep the expectations clear. There need to be consequences if the contract is not followed and the family will need to be strong enough to follow through with the consequences.
The client will need to be meeting with all treatment professionals as well as attending Narcotics Anonymous or Alcoholics Anonymous. If they are unable or unwilling to abide by the contract and consequences are not enforced then a higher level of care will become necessary.
You can begin to explore whether a residential setting will be the best for the client in order to contain the behaviors. Residential settings can be very expensive and not all families will have the financial resources to allow them to pursue this option. Intensive Outpatient Programs and Day treatment programs are available.
The question becomes whether to send them to a drug treatment for the crystal meth or to an eating disorder treatment facility. If you can find a treatment facility that treats dual diagnosis, that is the best. Be sure that they have a dietician as well as therapists who specialize in eating disorders and addictions. It is important that the staff is well versed in eating disorders as well as addictions because they will be dealing with the adolescent at each meal. If they are not using crystal meth, are they hiding food, purging after meals, or exercising at night when nobody is watching?
This can be a very difficult journey for families as they are filled with blame and guilt as they search for the right recipe of treatment for their child. It is also a very important time that families begin to seek treatment for themselves. The development of an eating disorder or drug addiction is a family problem. Families will need help with the ability to communicate and set appropriate boundaries with their newly clean and sober child. Families will need to learn how to share their concerns with the adolescent when there is suspicion that they could be engaging in eating disorder behaviors. Families can no longer walk on egg shells for fear they will upset the adolescent.
It is also very important to begin to look at why our society is placing so much pressure on our children today? After all, isn’t it balance in our lives that we are all looking for? Are we good role models for our children with regards to finding balance in our own lives? Are we continually striving for more? In that equation, do our children get the message that if they are not perfect then they will not be loved? That could be what is driving the new epidemic use of crystal meth today.