Dr. Kimberly Dennis is the Medical Director at Timberline Knolls Residential Treatment Center

Tuesday, July 26, 2011

Anorexia Kills, Timberline Knolls Saves

Timberline Knolls Residential Treatment Center is in the business of saving lives, because we've known for years what a recent study reported in the July issue of Archives of General Psychiatry supports: individuals who have eating disorders have an elevated mortality rate, especially those with anorexia nervosa. This is an important study, but it may not go far enough.

I think it’s always important to have studies which validate and quantify what we have seen and known for decades clinically. But this type of research needs to be expanded to include bulimia and especially EDNOS (eating disorder not otherwise specified), which is by far the most common and least likely to be treated of the eating disorders. My guess is that it is just as deadly as anorexia, just over a much longer period of time.

In the United States, as many as 10 million females and one million males are fighting a life and death battle with an eating disorder such as anorexia or bulimia, and millions more are struggling with binge eating disorder, according to the National Eating Disorder Association, which makes this study all the more relevant and critical.

The deadliness of eating disorders can never be overemphasized, since so many people, professionals and lay people alike, are in denial about the morbidity and mortality associated with eating disorders. We have long been advocates at the government level, fighting for the passage of bills to support eating disorder parity, and hope studies like this help in this arena, holding insurance companies accountable for paying for the amount and length of services needed to save lives from these deadly diseases. Recovery is possible, and help is available, when these diseases are taken seriously and recognized as fatal.

Monday, June 13, 2011

First Community Walk in Chicago to Help Raise Eating Disorder Awareness, One Step at a Time

Recovery from an eating disorder is a long and lengthy battle, and one that must be accomplished one step at a time. And on June 25, supporters and advocates will gather at 10:30 a.m. in Lincoln Park for the inaugural one-mile Chicago NEDA Walk, sponsored by Timberline Knolls.

The National Eating Disorder Association (NEDA) is bringing together the Chicago community to increase eating disorder awareness and raise funds to support individuals and families affected by eating disorders. Timberline Knolls is doing its part as the lead sponsor for the event and by forming its own walking team – The TK Trekkers – which will be led by me - with team participants that include staff, former residents, families and friends, and other behavioral health professionals. We have a goal to recruit 50 or more individuals to join its team for the event.

Awareness efforts are key in fighting eating disorders, and I hope many can join us on June 25, as we walk to raise awareness and help to fight these deadly diseases. If you can’t be there in person, any contribution will help NEDA continue to build on critical programs and services. We can all be part of the solution.

Chicago joins eight other cities around the country that will host upcoming walks in 2011: Napa, Calif.; Methuen, Mass.; Portland, Ore.; Florence, Mass.; Williamsburg, Va.; Charlottesville, Va.; Charlotte, N.C.; and NEDA’s largest walk will take place in New York City in October. Walks in other cities are continuously being added, which can be organized by anyone, anywhere. For more information on how to coordinate a walk in your city, visit http://www.nationaleatingdisorders.org/programs-events/neda-walk-coord.php.

You can pre-register for the Chicago walk online (http://neda.nationaleatingdisorders.org/site/TR?fr_id=1420&pg=entry) or in person beginning at 9:30 a.m. the morning of the event. Interested persons can join The TK Trekkers, form their own walking teams, or walk as individuals.

Eating disorders are serious, deadly diseases, but treatment is available, and lifelong recovery is possible for all those affected. We can all help to make a difference, one step at a time.

In the United States, as many as 10 million females and 1 million males are fighting a life and death battle with an eating disorder such as anorexia or bulimia, and millions more are struggling with binge eating disorder. This makes groups like NEDA all the more needed and important, and events to raise funds and awareness vital.

Thursday, May 12, 2011

Bipolar Disorder, a Serious Psychiatric Disorder, Often Misdiagnosed By Professionals and Unrecognized by Loved Ones

Bipolar disorder, also known as manic depressive disorder or manic depression, is a psychiatric disorder that causes extreme shifts in mood, energy, activity levels, and the ability to carry out everyday tasks. It is a serious mental illness requiring specialized treatment, but the problem is that bipolar disorder often gets misdiagnosed by professionals and is unrecognized by loved ones.

Bipolar disorder commonly co-occurs with other illnesses and addictions, making it hard to diagnose without a thorough diagnostic workup that includes looking at substance/drug abuse and use, and an evaluation for possible early life trauma – both of which can produce symptoms that look like bipolar disorder. Many times, residents come to Timberline Knolls with a diagnosis of bipolar disorder, but once evaluated are properly diagnosed with a drug abuse problem, which looks similar to bipolar disorder when an individual is going through stages of intoxication and withdrawal. Additionally, the diagnosis of bipolar disorder can be missed by professionals who think the patient is just suffering from substance abuse or dependence.

Not only do professionals miss the diagnosis, but loved ones and family members many times do not recognize the real problem – either because they do not know what bipolar disorder is, or because they are focused on something else, such as a co-occurring drug abuse problem.

Signs of bipolar disorder in its manic state include:

•extended periods of feeling overly happy or outgoing
•extremely irritable mood, agitation, or jumpiness
•being easily distracted
•little to no sleep for several days in a row without feeling tired
•having an unrealistic belief in one's abilities
•behaving impulsively
•suicide attempts

Signs of bipolar disorder in its depressive state include:

•isolation from friends and family
•loss of interest in activities once enjoyed
•feeling tired or slowed down
•having problems concentrating, remembering, and making decisions
•abuse of alcohol and drugs, especially cocaine
•dependence on sleeping pills

A correct diagnosis of bipolar disorder, and ensuring the appropriate treatment is offered, is critical for those who face and treat bipolar disorder and co-occurring disorders. People with this illness can achieve long-term physical, emotional and spiritual recovery. Everyone needs to remember this is a disease, and the individual did not choose to have the disease. Sufferers can choose to get treatment and recover. Help is available and manageability is possible when someone is connected to the right support system and specialized treatment is sought.

Monday, May 2, 2011

Self Injury a Growing Problem among Adolescents

According to the Cornell Research Program on self injury, 12 to 24 percent of young people have self-injured. Self injury, such as cutting, scratching or burning, can be a way to release or relieve unmanageable feelings and express intense inner pain. It is a growing problem among young people that needs to be addressed. Parents are a first line of defense and a key part to seeking help and I understand that the first conversation between a parent and a child can be a difficult one.

Using a ‘I see, I think, I feel’ formula is an effective way to approach a complex and delicate subject, and it allows parents to remain on their side of the street. This formula can be applied by saying to your child: “When I see cuts on your wrist, I think ‘this is a problem, my kid is cutting,' and I feel scared.” But I encourage parents to make their own observations and speak from the heart as this formula is just an outline for that conversation.

Having an open and honest dialogue is key when parents suspect there is a problem. Many times parents are worried their child will be mad or upset about being confronted, but this formula makes it more about a parent’s concerns, rather than adding to the guilt or shame the child likely already feels for his or her actions. Help is available and it works - at Timberline Knolls, we focus on healing from the inside out.

More often than not, self injury is associated with another co-occurring problem like depression, trauma, eating disorders or substance abuse. These young adults need attention - sometimes medical, sometimes emotional, sometimes spiritual. It’s important to not only recognize the signs of self injury, but as a parent, to know what steps to take to get proper care for your child. These are serious and deadly diseases, but there is hope and life long recovery is possible.

By fostering an environment of acceptance and understanding, facilities such as Timberline Knolls provide a safe space where those facing self-injury and co-occurring disorders can heal physically, emotionally and spiritually.

Tuesday, April 12, 2011

New National Study Shows Deeper Issues in Teens Today

A new report issued by The Partnership at Drugfree.org says teens today don’t see a big problem with downing five or more alcoholic drinks nearly every day and that there is an upward trend in marijuana and Ecstasy use among high school teens. I attribute this rise to the growing number of teens who identify themselves as “social” drinkers, denial in our society and deeper issues in teens today.

We see it extensively at Timberline Knolls Treatment Center in adolescents (and adults) who identify themselves as "social" drinkers but really have serious substance use disorders (abuse or dependence). But I say to the called "social" drinkers or drug users, please define social. Social to me means being fully alive and fully present to connect with loved ones and other people in our lives. I'm not sure what is social about pouring or snorting or inhaling or injecting a toxin into your body.

I also see denial as a part of the problem and call on parents to get involved. Some of denial and minimizing comes from families, especially if one or both parents drink or use "recreationally." Denial or blindness can also occur if the parent is not consistently emotionally involved with their teens, because they don't know how to be (their parents weren't) or they have their own substance/work/food/money/sex addiction.

The worst thing a parent can do is disconnect if they suspect a problem, and this can happen in the form of turning a blind eye, rationalizing it, or keeping it secret. Underage substance use is always a signal of deeper issues going on in a teen. Many times the issues are related to low-self esteem and trauma/abuse/neglect (including emotional neglect).

A kid that needs to turn to a substance to connect with other people or have fun has missed out on some important human relationship/connection skills. But it is critical these teens seek help and that loved ones help them do so. It's never too early to ask for help as a parent or teen and to get potentially life-saving treatment. Recovery is possible with the right treatment and support system.

Wednesday, March 23, 2011

Does Social Media Really Encourage Eating Disorders?

With dozens of websites catering to the social media phenomenon, teenagers have a wealth of options to connect with each other online – and none is more popular than Facebook. But a new study reveals that the more teens use this platform, the more likely they are to develop an eating disorder. I have long warned against excessive use of social media and hope the new study will encourage more parental involvement in teens’ online activities.

Because Facebook has in some ways replaced interacting face to face with other people, we're becoming over-connected electronically and under-connected to the people around us. Social media can be an excellent tool for staying connected with friends and family when used in a balanced way, but like any tool, it can be abused.

The study also pointed to music videos, TV shows and fashion content as negative influences on teens’ eating habits. But there is hope; parents who get involved with their child’s surfing habits and make it a priority to discuss the content with them can reduce the risk of their child developing negative self body image and ultimately a negative relationship with food.

I'd like to offer the following advice to parents:

Time Out: Planning the time children have with their computers is crucial. Parents should limit the amount of time their children are allowed to be online recreationally. Whether the limit is 30 minutes a day or an hour a day, it is important to give children a set period of time. As time-consuming as this might be for parents, this activity must be monitored carefully.

Lights Out: Parents must also give their children boundaries on how late they can be online. The later the hour, the more likely parents will be asleep and unable to monitor the child’s online activities. It also is the time that objectionable pop up ads are most likely to appear. Worse yet, it is when online predators are scouring the Internet looking for victims.

Location, Location, Location: Time is not the only factor; parents need to know where their children are going on the Internet as well. Look at the site history on your computer. Find out what sites your child frequents and go to those sites to make sure they are appropriate. Prohibit children from visiting sites with objectionable content. If needed, purchase programs designed to block access to certain websites. Also, use a shared/family desktop computer and have it in a common area of the house like the kitchen or living room.

Stay in the Loop: Parents should also network with other parents and talk with them about what they are doing and seeing. Talk about children's patterns of computer use, what limits they set, and other ways they cope with use that may be unhealthy or unbalanced. Parents might also want to make sure their kids use a family computer, a desktop located in an open area of the house like the living room or kitchen where other family members are likely to be.

Keep Informed: Most importantly, parents need to explore what’s going on in their kid’s relationships and lives. If you notice an increase in isolated activities like being on a computer in place of spending face to face time with friends and family, there may be a deeper emotional or relational problem that is manifesting this way. Should you see this behavior, it’s always important to tell your child that you are concerned and seek help from a professional.

Facebook has dismissed the study saying, “Young people are surrounded by photo-shopped models in magazines and airbrushed film stars, but when they spend time on Facebook they're with their friends." But I'd like to counter these claims.

Teenagers will see in Facebook what they want to see. There are positive and empowering ways to use the site, but there are more sinister aspects. They might look at a picture of a friend and still see what they think is wrong with themselves. Frequently, girls and women with eating disorders use the site to post ‘skinny’ pictures of themselves when they are deep into their diseases. This can be triggering to other teens and also to themselves in their recovery. That’s why parental interest is crucial. But even the most involved and careful parent might miss small details that can become big problems in the future.

Learn more about eating disorders in teens from Timberline Knolls and Dr. Dennis.

Thursday, March 10, 2011

New National Study Gives Parents an Urgent Topic for Discussion

A government study has found that more than half a million teens have had an eating disorder, most commonly in the form of binge eating disorder and bulimia, and that most of the time these go untreated. How can we change this downward trend before it gets more out of control? At Timberline Knolls, we think it’s critical for parents to talk to their kids about eating disorders as early as possible, and be open to the possibility their kids (or they) may have an unhealthy relationship with food.

Parents don’t want to believe their child might have a fatal disease, especially when in a lot of cases the teen is still doing well in school and even excelling in sports. And when they suspect a problem, parents a lot of times think it’s ‘just a phase’ and are in denial it needs to be addressed. In addition to the critical need for parents to talk to their kids, is the need for all ‘first responders’ in a teen’s life to be aware of this growing problem. Pediatricians, primary care doctors, school nurses, teachers and coaches need to be educated as well, and not afraid to talk to teens about these issues; because early detection and treatment is critical to ensure a full and healthy life for these teens.

According to the National Eating Disorders Association (NEDA) Web site, “Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.”

More programs need to be developed to go into schools to not only speak to the students, but also to the school nurses, teachers and coaches. And parents need to get involved and be educated on the seriousness of these diseases. I also encourage parents to listen to their gut and look for changes in behavior, including kids not eating with the family, frequent trips to the bathroom immediately after meals, changes in diet, and consumption of a large, unhealthy amount of food in one sitting.

More of these studies are needed to get our heads around the scope of the problem. I believe that eating disorders are far more widespread than anyone realizes. But recovery is possible when the right help is utilized and those most closely involved with these teens help them to get the help they so desperately need.

Tuesday, February 15, 2011

Calling All Colleges: Steps to Improve Emotional Health of Students on Campus

According to a recent national survey, “The American Freshman: National Norms Fall 2010,” the emotional health of college freshmen declined significantly during recent years, with the number of students saying that their “emotional health was above average,” falling from 64 to 52 percent. This is the same downtrend I am seeing at Timberline Knolls in the women I treat on campus.

People have spent significantly less time interacting face to face with other human beings with technology today, and this has had a deep impact on peoples' hearts and souls. We're over-connected electronically and under-connected to the people around us.

Because of this, colleges today have more responsibility to step up to ensure the well-being of their students and they need to help stop this severe decline in mental health with five steps that could make a difference for students on their campuses.

Step one: Provide education on campus. Students need to know the effects of their weakened emotional state because as mental health declines, dangerous behaviors can increase.

Step two: Increase the support for accessible on-campus counseling centers.

Step three: Conduct aggressive awareness campaigns.

Step four: Staff on-campus counseling centers with experts who can diagnose early – or work directly with outside experts who can provide immediate and individualized help.

Step five: Understand the fragile state of many students, especially college freshmen, so that proactive measures and support are planned.

Many times college-aged women cope with their new surroundings through using alcohol, other substances, engaging in eating disorders, and getting depressed and/or suicidal. And we’ve seen an increasing number of college students with higher and higher levels of acuity, or the severity of their illness, before they get to residential care.

Colleges also need to be held responsible for the behaviors that take place on and around their campuses and should better uphold boundaries around underage drinking. They can also help by establishing sober dorms on campus, as well as providing support groups on campus that practice the 12-step methodology such as Alcoholics Anonymous, Overeaters Anonymous and Eating Disorders Anonymous.

Access to information and help can be key in the battle against depression, eating disorders and alcoholism. Lifelong recovery is possible, but only if all of those in the mental health and education fields work together to share resources and information to better help those in need.

Tuesday, February 1, 2011

Timberline Knolls Responds to Washington Post Article on Food Addiction

A recent Washington Post column introduces readers to 53-year-old Michael Prager, a 5’10” man weighing 210 lbs, and discusses the disease that took over his life: an addiction to food. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the American Psychiatric Association’s guide of accepted psychological diagnoses, food addiction is not a recognized psychiatric disorder. But many eating disorder professionals, including myself, still view food addiction as an illness, not just a weakness in judgment, and appeal for its inclusion in the DSM-V Manual, due out in 2013.

Many times diagnostic restrictions, such as not including food addiction, limit access to treatment for those who need it most. If included in the DSM, food addiction would be legitimized and treatment would be covered by many insurance providers. It would also help treatment professionals work to accurately diagnose problems and provide appropriate treatment.

We need to treat these serious diseases whether they are listed in the DSM or not. But not being listed can make getting access to treatment difficult. At Timberline Knolls we are able to help many women and girls obtain recovery from unhealthy relationships with food, body and exercise who may not ever be diagnosed with a formal eating disorder in many other settings. But it is a serious obstacle when food addiction is not included in the DSM Manual, and we must fight for its acceptance as a real mental health disease. Stories like the Washington Post article echo the vital need for this.

Despite not being listed, many mental health professionals recognize and treat food addiction as they would treat other addictions such as drugs, alcohol and gambling. We see food addiction and treat it every day at Timberline Knolls. Most commonly we see it in the form of anorexia and bulimia, but we also treat a fair amount of binge eating disorders and other unspecified eating-related disorders. Many times this happens with adolescents and women who seek treatment primarily for depression or other addictions, and don’t realize overeating is a part of their disease.

Most people have difficulty seeing the impact of an unhealthy relationship with food, eating, exercise, or their bodies fully on their own. If not identified or treated during the early stages, eating disorders can become chronic, debilitating and even life-threatening. Professional help can lead to a greater sense of peace and manageability, and can save your life.

Thursday, January 20, 2011

Timberline Knolls Residential Treatment Center Teams with “In the Wildflowers” Program to Help Trauma Victims Cope and Heal Through Prayer

I wanted to let everyone know that Timberline Knolls Residential Treatment Center has partnered with producer Julie Woodley to present “In the Wildflowers” program. It's a 10-part DVD series aimed at educating and helping victims of childhood sexual abuse cope with their trauma as they heal in a safe and supportive environment. Julie is a member of the team here at Timberline Knolls and serves as the ministry outreach representative. She works to touch as many people’s lives as possible with the powerful and healing message offered in “In the Wildflowers” DVD series.

"In the Wildflowers” is set to spread its message throughout college campuses. Typically “In the Wildflowers” takes 10 weeks to fully experience, but the DVDs and accompanying curriculum was condensed into a one day and one night session for college-aged participants and will include a 3 ½ day training session led by Julie for those who want to learn how they can use “In the Wildflowers” to help others to heal.

The Wildflowers program is the brainchild of Julie, a victim of childhood sexual abuse herself, who developed the idea when she was stricken with cancer and wanted to take her own healing journey.

Julie began developing “In the Wildflowers” by journaling about her healing processes and reading almost 60 books dealing with the power of faith, prayer and healing.

Julie met, interviewed and filmed upwards of 40 professionals all specializing in various areas of Christian therapy and healing, as well as six women all from very different backgrounds in need of healing. She filmed the women’s progress over several years and was amazed at the strides they made in their own journeys.

Monday, January 10, 2011

MentorCONNECT’s Free Teleconference Presents Two of the Country’s Leading Eating Disorder Experts

MentorCONNECT is a global online eating disorders mentoring community that provides individuals with the tools needed to break through the isolation of eating disorders and share in supporting relationships. Members are able to connect individually and in mentored groups to share experiences, provide guidance and help each other through the struggles and successes of their journey to recovery. In addition to these support systems, MentorCONNECT holds a free teleconference each month with nationally-recognized eating disorder experts and survivors.
This month, Dr. Stan Selinger, PhD, the family therapy coordinator, from Timberline Knolls Residential Treatment Center and I will make our treatment advice available online for free to the public in MentorCONNECT’s teleconference on Family Healing and Communication. We’ll discuss how patients can best communicate their needs for support to their loved ones, and how loved ones can best offer support to the patient during the recovery process. The teleconference takes place on Wednesday, January 12, 2011 from 8:00 p.m. – 9:15 p.m. (CST). To sign up for this free event, please visit http://familyhealing.eventbrite.com/.
I’ve always felt that teleconferences are a great way to talk to people who are looking for both information and guidance while working toward the lifelong recovery from their disease. They are also great ways to teach loved ones and family members about how to offer support in the best way possible for those coping with disordered eating.
One of the biggest roadblocks to recovery is the lack of support from loved ones, but many of those suffering from an eating disorder don’t understand how to reach out and ask for help, and on the reverse side – many loved ones don’t know how to help. Groups like MentorCONNECT provide survivors with an educational outlet like these monthly teleconferences, and I am happy to offer my own expertise on the subject.

Wednesday, January 5, 2011

Anorexic Model Isabelle Caro Showed Everyone the Reality of the Illness that Took Her Life

The horrifying photos of Isabelle Caro first displayed in 2007 were her last message to the world about her disease. First appearing during fashion week in Italy, it was Italian photographer Oliviero Toscani's attempt “to use the naked body to show everyone the reality of this illness, caused in most cases by the stereotypes imposed by the world of fashion." But the fact that the "reality" didn't seem to stop Caro is hard to understand if you've never struggled with disordered eating.

It saddens me that she died of the disease. I admire her courage in exposing the disease on a public level. We need to acknowledge how serious this disease is. At the same time, for the women and their families who continue to struggle with eating disorders, I want to extend a message of hope. There are effective treatments.

This model took the first step of a 12-step recovery model. She admitted publicly that she was powerless over her anorexia, and it caused significant unmanageability in her life – losing teeth, hair, breasts for example. The healing steps and solution steps are outlined in the next 11 steps.

We facilitate this healing at Timberline Knolls. We are unique in using the powerful combination of 12 step facilitation therapy and Dialectical Behavioral Therapy (DBT) to help women with eating disorders, which could kill them, not only to stay alive, but to recover and live happy, joyous, free and abundant lives.

As many as 10 million females and one million males are fighting a life and death battle with anorexia or bulimia, and another 25 million are fighting a binge eating disorder, according to the National Eating Disorders Association. Eating disorders are usually shrouded in secrecy, but those who are suffering need to know that reaching out for assistance is the first step to getting back on track.