by Karen Young

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Anxiety, Depression and Physical Health in Adolescents – What’s the connection?

Anxiety, Depression and Physical Health in Adolescence - What’s the connection?

With research finding ever-increasing evidence in support of the mind-body connection, there is no doubt that our mental functioning affects our physical health, and vice versa. The connection is a powerful one, and science is on well on its way to uncovering more of the detail. 

New research from Switzerland and Germany has found that in children and adolescents, certain physical diseases will be more likely to follow anxiety or depression. Similarly, particular mental health conditions happen more frequently following particular physical illnesses. 

Researchers have identified that depression tends to affect the stomach, while anxiety is more likely to affect the skin. Specifically, arthritis and diseases of the digestive system happen more frequently following depression or bipolar disorder, and skin diseases (such as atopic dermatitis) are more likely after anxiety. 

Researchers also found a strong association between epilepsy and subsequent eating disorders (including anorexia nervosa, bulimia nervosa, and binge eating disorder).

‘For the first time, we have established that epilepsy is followed by an increased risk of eating disorders – a phenomenon that had previously been described only in single case reports. This suggests that approaches to epilepsy treatment could also have potential in the context of eating disorders.’ Marion Tegethoff, lead author. 

This research is the first to explore the connection between these symptoms in adolescents, however previous research has found a similar relationship between in adults. Research involving adults has found that in people who have depression and arthritis, relieving the symptoms of depression also decreases the pain of arthritis. Similarly, people who have anxiety and atopic dermatitis report an improvement in their skin when they receive therapy for their anxiety.

In relation to the connection between eating disorders and epilepsy, the study refers to two earlier research studies, both with very small samples sizes, which have found some evidence to suggest that the connection might be because of the parts of the brain involved. When epilepsy arises from the right hemisphere, lesions in a part of the brain that has a close relationship with the limbic system may influence the development of eating disorders. At this stage, more research is needed, but it is a promising pathway for future research and possible treatment options.

The promise of this research is in widening the treatment options available to strengthen physical and mental health during adolescence. If we know there is a specific connection between certain symptoms, there is mounting evidence to suggest that treating one set of symptoms, has great potential to improve the other connected symptoms.

And finally …

Even with the strongest support, the greatest love, and the most committed and engaged parents in the world, many teens, probably all of them, will still struggle from to time. Adolescence will present itself with certain challenges to all teens. That’s the whole point of adolescence – it’s the time for them to stretch and push right up against their edges, to discover who they are, where they fit in, and how they will leave their very important mark on the world. All of our teens have it in them to be happy, thriving adults, but it’s not always easy to know exactly what they need to get there. Protecting their mental health is critical. We’ve always known that, but with our increasing wisdom on the mind-body connection, there is no doubt that when we guide and support them to stronger mental health, we are helping to strengthen them in mind, body and spirit.

7 Comments

Kristi

My 15 year old daughter suffers from JIA (Juvenile arthritis) and right along with it came depression and anxiety. She now sees a therapist that specializes in chronic disease management, medication administration and anxiety, and depression. She has seen decreased pain levels, better confidence in herself and future (self-efficacy) and an overall better outlook. Getting help was the smartest thing we ever did.

Reply
No

Adolescents…adolescents…as theycontinue to wreck havoc and be wrecked havoc upon…some things never change…puzzling, why?

Reply
Karen - Hey Sigmund

Ahhh yes – it’s all about what’s happening in their brains! Adolescence is a time of massive brain changes. Everything they do and everything they go through can generally be explained by these changes. It’s all part of their development towards being happy, healthy adults. Here is an article that explains it, and will hopefully make even their most confusing behaviour easier to understand https://www.heysigmund.com/what-you-need-to-know-about-the-adolescent-brai/.

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IBikeNYC

May I assume that “eating disorders” refers ONLY to eating too little as opposed to eating too much?

Reply
Chrissy

My understanding (and experience as a parent) of an eating disorder is that it’s all about having a wrong relationship with food; whether it’s depriving or indulging, both are symptoms of a food obsession and a food fear at the same time. A right relationship with food is what we all want; one that brings ‘disorder’ into order, so that freedom can be found in a renewed way of thinking. It’s not impossible. But it takes time, love, patience and faith!

Reply
Karen - Hey Sigmund

Yes – when this research talks about eating disorders, it is specifically talking about when those eating disorders co-occur with epilepsy. In those cases, there might be a common area of the brain contributing to the symptoms. Similarly, in instances where a teen has anxiety and skin problems, or depression and digestive problems, or eating disorders and epilepsy, it may be that they are somehow related. It doesn’t mean there will always be digestive disorders with depression, or skin problems with anxiety, or epilepsy with eating disorders, but when there is, it may be that treating one set of symptoms (as in the physical symptoms or the symptoms related to the anxiety, depression or epilepsy), may see an improvement in the other set of symptoms. It’s an interesting area of research because of the treatment options that open up when there are co-occuring symptoms, and also because of what it might mean about the possible causes of various symptoms.

Reply
Karen - Hey Sigmund

Good question. The eating disorders part of the research included anorexia nervosa, bulimia nervosa, and binge eating disorder. I’ve amended the article to show this. Hope that clears things up.

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Melbourne, Adelaide … Will you join us?

The @resilientkidsconference is coming to Melbourne (15 July) and Adelaide (2 September), and we’d love you to join us.

We’ve had a phenomenal response to this conference. Parents and carers are telling us that they’re walking away feeling even more confident, with strategies and information they can use straight away. That’s what this conference is all about.

We know taking care of the young people in our lives is up there with the most important thing we can do. Why shouldn’t there be a conference for parents and carers?!

I’ll be joining with @maggiedentauthor, @michellemitchell.author, and @drjustincoulson. We’ve got you covered! And we’re there for the day, with you.

For tickets or more info, search ‘Resilient Kids Conference’ on Google, or go to this link https://www.resilientkidsconference.com.au/conference/.

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Jun 3

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Melbourne, Adelaide … Will you join us? The @resilientkidsconference is coming to Melbourne (15 July) and Adelaide (2 September), and we’d love you to join us. We’ve had a phenomenal response to this conference. Parents and carers are telling us that they’re walking away feeling even more confident, with strategies and information they can use straight away. That’s what this conference is all about. We know taking care of the young people in our lives is up there with the most important thing we can do. Why shouldn’t there be a conference for parents and carers?! I’ll be joining with @maggiedentauthor, @michellemitchell.author, and @drjustincoulson. We’ve got you covered! And we’re there for the day, with you. For tickets or more info, search ‘Resilient Kids Conference’ on Google, or go to this link https://www.resilientkidsconference.com.au/conference/.

karenyoung_heysigmund

We have to change the way we talk about anxiety. If we talk about it as a disorder, this is how it feels.

Yes anxiety can be so crushing, and yes it can intrude into every part of their everyday. But the more we talk about anxiety as a disorder, the more we drive ‘anxiety about the anxiety’. Even for big anxiety, there is nothing to be served in talking about it as a disorder.

There is another option. We change the face of it - from an intruder or deficiency, to an ally. We change the story - from ‘There’s something wrong with me’ to, ‘I’m doing something hard.’ I’ve seen the difference this makes, over and over.

This doesn’t mean we ignore anxiety. Actually we do the opposite. We acknowledge it. We explain it for what it is: the healthy, powerful response of a magnificent brain that is doing exactly what brains are meant to do - protect us. This is why I wrote Hey Warrior.

What we focus on is what becomes powerful. If we focus on the anxiety, it will big itself up to unbearable.

What we need to do is focus on both sides - the anxiety and the brave. Anxiety, courage, strength - they all exist together.

Anxiety isn’t the absence of brave, it’s the calling of brave. It’s there because you’re about to do something hard, brave, meaningful - not because there’s something wrong with you.

First, acknowledge the anxiety. Without this validation, anxiety will continue to do its job and prepare the body for fight or flight, and drive big feelings to recruit the safety of another human.

Then, we speak to the brave. We know it’s there, so we usher it into the light:

‘Yes I know this is big. It’s hard [being away from the people you love] isn’t it. And I know you can do this. We can do hard things can’t we.

You are one of the bravest, strongest people I know. Being brave feels scary and hard sometimes doesn’t it. It feels like brave isn’t there, but it’s always there. Always. And you know what else I know? It gets easier every time. I’ve know this because I’ve seen you do hard things, and because I’ve felt like this too, so many times. I know that you and me, even when we feel anxious, we can do brave. It’s always in you. I know that for certain.’♥️

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Jun 1

Open
We have to change the way we talk about anxiety. If we talk about it as a disorder, this is how it feels. Yes anxiety can be so crushing, and yes it can intrude into every part of their everyday. But the more we talk about anxiety as a disorder, the more we drive ‘anxiety about the anxiety’. Even for big anxiety, there is nothing to be served in talking about it as a disorder. There is another option. We change the face of it - from an intruder or deficiency, to an ally. We change the story - from ‘There’s something wrong with me’ to, ‘I’m doing something hard.’ I’ve seen the difference this makes, over and over. This doesn’t mean we ignore anxiety. Actually we do the opposite. We acknowledge it. We explain it for what it is: the healthy, powerful response of a magnificent brain that is doing exactly what brains are meant to do - protect us. This is why I wrote Hey Warrior. What we focus on is what becomes powerful. If we focus on the anxiety, it will big itself up to unbearable. What we need to do is focus on both sides - the anxiety and the brave. Anxiety, courage, strength - they all exist together. Anxiety isn’t the absence of brave, it’s the calling of brave. It’s there because you’re about to do something hard, brave, meaningful - not because there’s something wrong with you. First, acknowledge the anxiety. Without this validation, anxiety will continue to do its job and prepare the body for fight or flight, and drive big feelings to recruit the safety of another human. Then, we speak to the brave. We know it’s there, so we usher it into the light: ‘Yes I know this is big. It’s hard [being away from the people you love] isn’t it. And I know you can do this. We can do hard things can’t we. You are one of the bravest, strongest people I know. Being brave feels scary and hard sometimes doesn’t it. It feels like brave isn’t there, but it’s always there. Always. And you know what else I know? It gets easier every time. I’ve know this because I’ve seen you do hard things, and because I’ve felt like this too, so many times. I know that you and me, even when we feel anxious, we can do brave. It’s always in you. I know that for certain.’♥️

karenyoung_heysigmund

Our job as parents isn’t to remove their distress around boundaries, but to give them the experiences to recognise they can handle boundaries - holding theirs and respecting the boundaries others.

Every time we hold a boundary, we are giving our kids the precious opportunity to learn how to hold their own.

If we don’t have boundaries, the risk is that our children won’t either. We can talk all we want about the importance of boundaries, but if we don’t show them, how can they learn? Inadvertently, by avoiding boundary collisions with them, we are teaching them to avoid conflict at all costs.

In practice, this might look like learning to put themselves, their needs, and their feelings away for the sake of peace. Alternatively, they might feel the need to control other people and situations even more. If they haven’t had the experience of surviving a collision of needs or wants, and feeling loved and accepted through that, conflicting needs will feel scary and intolerable.

Similarly, if we hold our boundaries too harshly and meet their boundary collisions with shame, yelling, punishment or harsh consequences, this is how we’re teaching them to respond to disagreement, or diverse needs and wants. We’re teaching them to yell, fight dirty, punish, or overbear those who disagree.

They might also go the other way. If boundaries are associated with feeling shamed, lonely, ‘bad’, they might instead surrender boundaries and again put themselves away to preserve the relationship and the comfort of others. This is because any boundary they hold might feel too much, too cruel, or too rejecting, so ‘no boundary’ will be the safest option.

If we want our children to hold their boundaries respectfully and kindly, and with strength, we will have to go first.

It’s easy to think there are only two options. Either:
- We focus on the boundary at the expense of the relationship and staying connected to them.
- We focus on the connection at the expense of the boundary.

But there is a third option, and that is to do both - at the same time. We hold the boundary, while at the same time we attend to the relationship. We hold the boundary, but with warmth.♥️

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May 29

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Our job as parents isn’t to remove their distress around boundaries, but to give them the experiences to recognise they can handle boundaries - holding theirs and respecting the boundaries others. Every time we hold a boundary, we are giving our kids the precious opportunity to learn how to hold their own. If we don’t have boundaries, the risk is that our children won’t either. We can talk all we want about the importance of boundaries, but if we don’t show them, how can they learn? Inadvertently, by avoiding boundary collisions with them, we are teaching them to avoid conflict at all costs. In practice, this might look like learning to put themselves, their needs, and their feelings away for the sake of peace. Alternatively, they might feel the need to control other people and situations even more. If they haven’t had the experience of surviving a collision of needs or wants, and feeling loved and accepted through that, conflicting needs will feel scary and intolerable. Similarly, if we hold our boundaries too harshly and meet their boundary collisions with shame, yelling, punishment or harsh consequences, this is how we’re teaching them to respond to disagreement, or diverse needs and wants. We’re teaching them to yell, fight dirty, punish, or overbear those who disagree. They might also go the other way. If boundaries are associated with feeling shamed, lonely, ‘bad’, they might instead surrender boundaries and again put themselves away to preserve the relationship and the comfort of others. This is because any boundary they hold might feel too much, too cruel, or too rejecting, so ‘no boundary’ will be the safest option. If we want our children to hold their boundaries respectfully and kindly, and with strength, we will have to go first. It’s easy to think there are only two options. Either: - We focus on the boundary at the expense of the relationship and staying connected to them. - We focus on the connection at the expense of the boundary. But there is a third option, and that is to do both - at the same time. We hold the boundary, while at the same time we attend to the relationship. We hold the boundary, but with warmth.♥️

karenyoung_heysigmund

Sometimes finding the right words is hard. When their words are angry and out of control, it’s because that’s how they feel.

Eventually we want to grow them into people who can feel all their feelings and lasso them into words that won’t break people, but this will take time.

In the meantime, they’ll need us to model the words and hold the boundaries firmly and lovingly. This might sound like:

‘It’s okay to be angry, and it’s okay not to like my decision. It’s not okay to speak to me like that. I know you know that. My answer is still no.’

Then, when they’re back to calm, have the conversation:

‘I wonder if sometimes when you say you don’t like me, what you really mean is that you don’t like what I’ve done. It’s okay to be angry at me. It’s okay to tell me you’re angry at me. It’s not okay to be disrespectful.

What’s important is that you don’t let what someone has done turn you into someone you’re not. You’re such a great kid. You’re fun, funny, kind, honest, respectful. I know you know that yelling mean things isn’t okay. What might be a better way to tell me that you’re angry, or annoyed at what I’ve said?’♥️

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May 25

Open
Sometimes finding the right words is hard. When their words are angry and out of control, it’s because that’s how they feel. Eventually we want to grow them into people who can feel all their feelings and lasso them into words that won’t break people, but this will take time. In the meantime, they’ll need us to model the words and hold the boundaries firmly and lovingly. This might sound like: ‘It’s okay to be angry, and it’s okay not to like my decision. It’s not okay to speak to me like that. I know you know that. My answer is still no.’ Then, when they’re back to calm, have the conversation: ‘I wonder if sometimes when you say you don’t like me, what you really mean is that you don’t like what I’ve done. It’s okay to be angry at me. It’s okay to tell me you’re angry at me. It’s not okay to be disrespectful. What’s important is that you don’t let what someone has done turn you into someone you’re not. You’re such a great kid. You’re fun, funny, kind, honest, respectful. I know you know that yelling mean things isn’t okay. What might be a better way to tell me that you’re angry, or annoyed at what I’ve said?’♥️

karenyoung_heysigmund

We humans feel safest when we know where the edges are. Without boundaries it can feel like walking along the edge of a mountain without guard rails.

Boundaries must come with two things - love and leadership. They shouldn’t feel hollow, and they don’t need to feel like brick walls. They can be held firmly and lovingly.

Boundaries without the ‘loving’ will feel shaming, lonely, harsh. Understandably children will want to shield from this. This ‘shielding’ looks like keeping their messes from us. We drive them into the secretive and the forbidden because we squander precious opportunities to guide them.

Harsh consequences don’t teach them to avoid bad decisions. They teach them to avoid us.

They need both: boundaries, held lovingly.

First, decide on the boundary. Boundaries aren’t about what we want them to do. We can’t control that. Boundaries are about what we’ll do when the rules are broken.

If the rule is, ‘Be respectful’ - they’re in charge of what they do, you’re in charge of the boundary.

Attend to boundaries AND relationship. ‘It’s okay to be angry at me. (Rel’ship) No, I won’t let you speak to me like that. (Boundary). I want to hear what you have to say. (R). I won’t listen while you’re speaking like that. (B). I’m going to wait until you can speak in a way I can hear. I’m right here. (R).

If the ‘leadership’ part is hard, think about what boundaries meant for you when you were young. If they felt cruel or shaming, it’s understandable that that’s how boundaries feel for you now. You don’t have to do boundaries the way your parents did. Don’t get rid of the boundary. Add in a loving way to hold them.

If the ‘loving’ part is hard, and if their behaviour enrages you, what was it like for you when you had big feelings as a child? If nobody supported you through feelings or behaviour, it’s understandable that their big feelings and behaviour will drive anger in you.

Anger exists as a shield for other more vulnerable feelings. What might your anger be shielding - loneliness? Anxiety? Feeling unseen? See through the behaviour to the need or feeling behind it: This is a great kid who is struggling right now. Reject the behaviour, support the child.♥️

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May 23

Open
We humans feel safest when we know where the edges are. Without boundaries it can feel like walking along the edge of a mountain without guard rails. Boundaries must come with two things - love and leadership. They shouldn’t feel hollow, and they don’t need to feel like brick walls. They can be held firmly and lovingly. Boundaries without the ‘loving’ will feel shaming, lonely, harsh. Understandably children will want to shield from this. This ‘shielding’ looks like keeping their messes from us. We drive them into the secretive and the forbidden because we squander precious opportunities to guide them. Harsh consequences don’t teach them to avoid bad decisions. They teach them to avoid us. They need both: boundaries, held lovingly. First, decide on the boundary. Boundaries aren’t about what we want them to do. We can’t control that. Boundaries are about what we’ll do when the rules are broken. If the rule is, ‘Be respectful’ - they’re in charge of what they do, you’re in charge of the boundary. Attend to boundaries AND relationship. ‘It’s okay to be angry at me. (Rel’ship) No, I won’t let you speak to me like that. (Boundary). I want to hear what you have to say. (R). I won’t listen while you’re speaking like that. (B). I’m going to wait until you can speak in a way I can hear. I’m right here. (R). If the ‘leadership’ part is hard, think about what boundaries meant for you when you were young. If they felt cruel or shaming, it’s understandable that that’s how boundaries feel for you now. You don’t have to do boundaries the way your parents did. Don’t get rid of the boundary. Add in a loving way to hold them. If the ‘loving’ part is hard, and if their behaviour enrages you, what was it like for you when you had big feelings as a child? If nobody supported you through feelings or behaviour, it’s understandable that their big feelings and behaviour will drive anger in you. Anger exists as a shield for other more vulnerable feelings. What might your anger be shielding - loneliness? Anxiety? Feeling unseen? See through the behaviour to the need or feeling behind it: This is a great kid who is struggling right now. Reject the behaviour, support the child.♥️

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