Monthly Archives: September, 2015

Opposite Land: A Blog about parenting your child playfully (Oh, and you, too)

I stole the Opposite Land game from the most time-honored parenting resource of all: another mom. Here’s how it works: When you are going somewhere or doing something that requires a certain kind of behavior, visit opposite land first. So for example, before we go to the regular grocery store, we go to the opposite land one. In opposite land grocery stores, all the kids ride on IMG_1635the carts flinging their legs and feet into the aisles, toppling cans and boxes off the shelves. They race around banging into people, don’t say excuse me, and throw eggs out of the carton. They fill the cart up with cookies, chocolate, rainbow sprinkle doughnuts and NO GREEN VEGETABLES. Never. Not Ever.

This technique works if you really get into it and are silly, authentic, and loving. Then your kid knows your intention is to connect and stay connected with them. Kids are right brained and have not yet left the land of implicit knowledge, of being deeply connected with their bodies and felt-sense of another person. So if you’re not authentic and silly with opposite land, they will see right through you and know you are just trying to get them to behave in the grocery store (which, of course, you are, but in a child friendly and respecting-ly, playful way).

A Random Confession related to Opposite Land and Never Eating Tomatoes:

My child is a picky eater. Even though I am a HUGE advocate for the intuitive eating, there-are-no-bad-foods, philosophy, I still relapse into encouraging, bordering on nagging, my child to eat vegetables. As you can imagine, sometimes I “win” a particular battle, but I never (Never, Not Ever 🙂 ) win the war. My little one is all over implicit knowing on that. I know you are trying to get me to do what you want, but I am not going to leave what I know to be true in my body and my preferences. So I keep returning to presenting the food, being playful with it, model-ing eating vegetables, but not forcing them.

I recently was given a book in another great chain of motherhood wisdom (also known as passing-along-stuff-please-help-me-clear-a-little-space-in-my-house). It is fabulous. In it, Lola, the younger sister of Charlie, states that she won’t eat carrots (they are for rabbits), peas (too small and green), and:

“I absolutely will never Not Ever eat a tomato.”

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Her older brother, well versed in opposite land and creative, playful parenting, assures Lola that they are not eating carrots, potatoes, peas, or fish sticks. They are eating “orange twiglets from Jupiter, cloud fluff, green drops from Greenland, ocean nibbles from the supermarket under the sea…” You get the idea.

As you can imagine, by the end of the book, Lola is experimenting with trying all kinds of new foods, including the dreaded Never Not Ever (re-named moon-squirters) tomatoes.

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How does this apply to You?

(Parents, Non-parents, and people recovering from Eating Disorders, Depression, Anxiety or General Self-Hatred)

Opposite Land looks different for adults. It includes such blasphemous ideas as:

“You ARE good enough.”

“All foods are possible to eat without guilt, including chocolate cake.”

“Recovery from an Eating Disorder (Depression, Anxiety, General Self-Hatred) is possible.”

“Mistakes are allowed.”

“You can be loved the way you are.”

“There is nothing wrong with you.”

“What happened in your family of origin was not your fault.”

“It is okay to feel angry, sad, ashamed, or insecure.”

“You are not bad.”

I get it- these may seem to live in a fantasy world if you are accustomed to believing the opposite. They may seem even more preposterous than eating cloud fluff or orange twig-lets from Jupiter. But considering the possibility can be the beginning of believing it. Having a trusted loved one (spouse, therapist, supportive peer) help you in this process can be the most healing. You may even, like Lola, decide that you can sometimes, Not Always but Not Never, have the experience of being Good Enough. And that can be even more phenomenal than eating a moon-squirter.

Special thanks to Lauren Child and Candlewick Press for permission to reprint the beautiful images from:

WILL NEVER NOT EVER EAT A TOMATO. Copyright © 2000 by Lauren Child. Reproduced by permission of the publisher, Candlewick Press, Somerville, MA.

What causes an Eating Disorder or Depression and if I have it, is my child doomed to have it, too?

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The short answer? “It’s complicated.”

The longer answer: Genetics and temperament both play a strong role in the possibility of Depression or an Eating Disorder developing, but do not determine it.

The hopeful answer: Even if your child develops an Eating Disorder or Depression, it is possible to recover.

In this post, I will look at some of the risk factors that can lead to an Eating Disorder or Depression.

Eating Disorders: Are they inherited?

Eating Disorders develop as a combination of genetic vulnerability combined with temperamental traits and a facilitating environment. Some (but not all) risk factors named in Carolyn Costin and Gwen Schubert Grabb’s book 8 Keys to recovery from an Eating Disorder (W.W. Norton, 2012) that can contribute to developing an eating disorder include:

  • being overweight or dieting as a child
  • having a mother who diets or has an eating disorder
  • early menstruation
  • being bullied or teased
  • engaging in sports or activities with a focus on appearance or weight (for example ballet, cheerleading, ice skating, wrestling, gymnastics, modeling)
  • a history of childhood abuse

In a 2000 study in the American Journal of Psychiatry, results showed that anorexia nervosa has a heritability of 58%, but the authors were unable to rule out the contribution of environment. However, they did conclude that genetic factors influence anorexia and contribute to comorbidity of anorexia and depression.

Along with genetic links being discovered with both anorexia and binge eating, certain temperamental traits tend to foster the birth of an Eating Disorder. Ovidio Bermudez, in presenting at Eating Disorder Recovery Services conference* this past year discussed the following temperament traits as those at risk of developing an Eating Disorder:

  1. Anxiety, Depression, or OCD
  2. Low stress tolerance
  3. Low distress tolerance
  4. Sensitivity to real or perceived injury

So in other words, if you have a sensitive child who struggles with tolerating “distressing” feelings such as sadness, anger, or shame and you (or a family member) struggle with Depression, Anxiety or OCD, the ground is fertile for the seed of an Eating Disorder to sprout.

What about Depression?

At least 10% of people in the U.S. will experience Major Depressive Disorder at some point in their lives. According to statistics, two times as many women as men experience major depression. (There is a lot to be said there in terms of mis-diagnosis of symptoms, gender bias, and who reaches out for support to mental health professionals, that can affect these statistics, but that is for another blog.)

According to two Stanford doctors writing about genetics and brain function, genetics play a strong role in causing Major Depression (Levinson, Douglas F. M.D. and Nichols, Walter E. M.D., Professor in the School of Medicine Department of Psychiatry and Behavioral Sciences, Stanford, 2015). They write:

  • The heritability (or percentage of the cause due to genes) is probably 40-50%, and might be higher for severe depression.
  • The situation is a little different if the parent or sibling has had depression more than once (“recurrent depression”), and if the depression started relatively early in life… the siblings and children of people with this form of depression probably develop it at a rate that is 4 or 5 times greater than the average person.

What else contributes to Depression? And what about Postpartum Depression?

Stressful life events (trauma, loss of a loved one, moving/loss of support, having a baby) can lead to depression in and of themselves. When combined with a genetic risk, there is a stronger possibility of developing depression. And having one (or more) episode of depression increases the risk of having future episodes. (Kendler, Thornton, and Gardner, 2001)

While many women experience some mild mood change or “the blues” during or after the birth of a child, 1 in 7 women (and some recent research says 1 in 5) experience more significant symptoms of depression or anxiety. 1 in 10 Dads become depressed during the first year. (Postpartum Support International)

Risk factors for Postpartum Depression

Some women are more likely than others to develop Postpartum depression. The following factors put you at an increased risk:

  • Previous history of depression
  • History of severe PMS or premenstrual dysphoric disorder
  • Medical complications for you or your baby
  • Lack of support from family or friends
  • A family history of depression or another mental illness
  • Anxiety or negative feelings about the pregnancy
  • Problems with a previous pregnancy or birth
  • Marriage, Relationship, or money problems
  • Stressful life events
  • Substance abuse

How does Postpartum Depression impact children?

Postpartum Depression and other Perinatal Disorders (Anxiety, OCD, Psychosis) can affect children in the following ways:

  • Behavioral Problems
  • Delays in Cognitive Development
  • Emotional Problems and/or Depression

 According to Zero To Three, a research-based resource for federal and state policymakers and advocates on the unique developmental needs of infants and toddlers, untreated Depression can have detrimental effects on children’s functioning and future outcomes (2009).

The mental health of parents can affect young children… infants of clinically depressed mothers often withdraw from caregivers, which ultimately affects their language skills, as well as their physical and cognitive development. Older children of depressed mothers show poor self-control, aggression, poor peer relationships, and difficulty in school.

and

Unlike adults, babies and toddlers have a fairly limited repertoire of responses to stress and trauma. Mental health disorders in infants and toddlers might be reflected in physical symptoms (poor weight gain, slow growth, and constipation), overall delayed development, inconsolable crying, sleep problems, or aggressive or impulsive behavior and paralyzing fears. Early attachment disorders predict subsequent aggressive behavior. Some early mental health disorders have lasting effects and may appear to be precursors of mental health problems in later life, including withdrawal, sleeplessness, or lack of appetite due to depression, anxiety, and traumatic stress reactions.

So, if you have had or are currently suffering with and through (because it is possible to recover and get through it) an Eating Disorder or Depression, your child does have risk. But that does not mean they are doomed. It means, even more important than ever, that you get treatment and recovery yourself! When I attended Postpartum Support International’s training on Perinatal Mood Disorders, the message that they gave was: There is Hope and You are not alone. It is possible to recover and in recovering yourself, you help build a more protected base from which your child can thrive and grow. 

References/Resources:

Wade, Tracey D, Ph.D., Cynthia M. Bulik, Ph.D., Michael Neale, Ph.D., and Kenneth S. Kendler, M.D., “Genetic and Environmental Risk Factors Anorexia Nervosa and Major Depression: Shared Risk Factors,” Am J Psychiatry 2000; 157:469–471.

Eating Disorder Recovery Services The mission of EDRS (Eating Disorder Recovery Support), Inc. is to promote recovery and wellness for those impacted by eating disorders by providing support, information, and education to individuals, families, professionals, and the community at large regarding eating disorders and recovery resources. EDRS.net

Ovidio Bermudez, MD Dr. Bermudez has lectured nationally and internationally on eating pathology across the lifespan, obesity and other topics related to pediatric and adult healthcare, and has been repeatedly recognized for his dedication and advocacy in the field of eating disorders.  eatingrecoverycenter.com

“Major Depression and Genetics” Douglas F. Levinson, M.D. and Walter E. Nichols, M.D., Professor in the School of Medicine
Department of Psychiatry and Behavioral Sciences (2015) Depression and Genetics

Zero To Three The Zero To Three policy Center is a nonpartisan, research-based resource for federal and state policymakers and advocates on the unique developmental needs of infants and toddlers. zerotothree.org

Link to Depression during and after Pregnancy Fact Sheet

Perinatal Depression Fact sheet

Link to study on teaching sleep with infants to prevent Postpartum Depression:

postpartum+depression+sleep

Link to study on effects of Lexipro on treatment of Postpartum Depression:

clinical trials postpartum+depression

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