https://www.youtube.com/watch?v=hLPT8NNOjPI

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog https://standingabovethecrowd.com/?p=16637

There are several ways to say goodbye to bad nights

Writer: Beth Arky

Clinical Experts: Anna Loiterstein, PsyD , Wendy Nash, MD

What You'll Learn

- What are some of the reasons kids might have trouble sleeping?

- What is sleep training for older kids?

- How can CBT help children sleep better?

- Quick Read

- Full Article

- Talk to your child

- Validate fears, encourage bravery

- Sleep training

- Create a routine

- Minimize dependence, reward bravery

- Instill good sleep hygiene

- When it’s time to evaluate

- Cognitive behavioral therapy for insomnia

- Medicating for insomnia

It’s frustrating for parents when a kid can’t go to sleep or stay asleep without help. But there are steps you can take to move your child to sleeping on their own.

The first thing to do is find out what’s keeping them from sleeping. Are they anxious? Afraid of the dark? Scared to sleep alone? Just talking to kids about fears around sleep can make them feel better. Once you’ve done that, you can start what’s called “sleep training.”

Sleep training for older kids involves parents using gradual steps to get kids to sleep independently. For example, you might go from sitting in a chair next to the bed one night to moving the chair across the room the next night. You can continue these small steps until they’re sleeping on their own. It’s good to let your kid know you understand how hard this is for them but that you’re sure that with practice, they’ll be able to do it. The goal is to be able to come in, say goodnight and have your child be able to fall asleep.

Posting a sleep schedule also helps kids stay on track. It can include everything from brushing teeth to turning out the light. This also helps parents keep track of any patterns or sleep problems. For example, you might find that Sunday night is harder because Monday is the first day of the school week. Other routines like a warm bath before bed and using bed only for sleep also help. If kids wake up in the middle of the night, it’s best to send them back to bed right away.

If your child still can’t sleep after making changes like these, it’s time to talk to their pediatrician. CBT (cognitive behavioral therapy) can be a helpful treatment for sleep issues, and medication may help in some cases.

Countless parents have experienced the frustration of trying to get kids to go to sleep and stay asleep. The coronavirus didn’t help matters. A lot of kids, even those who had no significant sleep issues previously, had trouble during the pandemic. And those who had struggled in the past may have regressed.

Confusing changes in routine and increased anxiety — older kids might worry, while younger children might sense their parents’ anxiety — can cause behavioral issues across the board. Sleep is no exception.

Fortunately, there are well-tested strategies for helping kids learn to fall asleep in their own beds and stay asleep. A form of behavioral therapy called CBT-I (cognitive behavioral therapy for insomnia) has been shown to be more effective than medication for treating kids with insomnia, explains Wendy Nash, MD, a child and adolescent psychiatrist. And for children with less severe problems, parents can use CBT strategies to change sleep habits.

So what’s a parent to do? First, you want to identify the issue. Then you can seek out solutions. The same guidelines can also be applied to naps, which are more invaluable than ever, given how many parents are working from home.

Talk to your child

Just chatting with a child about the issues surrounding sleep is a good jumping-off point. Anna Loiterstein, PsyD, a clinical psychologist, says parents should first try to understand what’s going on with their child. Let’s say they’re anxious. During the COVID-19 pandemic, it might have been fear that they or their parents will get sick. Now it might be related to school, conflicts with friends, or separating from their parents.

Validate fears, encourage bravery

Dr. Loiterstein says the idea is to empathize and validate the child’s fear. Start by saying, “I understand you’re feeling scared and that’s a really hard feeling,” and then encourage bravery. So, a parent could tell their child they understand it can feel really frightening to sleep in one’s own room, and then explain they’re going to practice going to sleep in steps to overcome this worry.  Let them know you are very confident that they can do it.

Sleep training

Once you know what’s going on with your sleep-challenged child, you can use behavioral techniques to help them move towards sleeping independently.

We aren’t talking about the “cry-it-out” form of sleep training used with infants, but rather one for older children that involves gradually moving farther away from the child.

“Again,” says Dr. Loiterstein, “we want the child to learn that they have the self-soothing skills to manage whatever it is that’s distressing them. Otherwise, they become too reliant on the parent for their presence or reassurance.”

She cautions parents to remember this will take time and patience. “You’re not going to go from one night sleeping in your child’s room to them sleeping independently the next,” she says.

There are systematic steps to work up to that. As an example, if you are lying in bed with your child, the first thing to do is to move to a chair next to them, just holding hands. The next thing could be to move the chair farther away, followed by sitting outside the door to get more distance away from the bed. Individual steps you might take would depend on the specific case.

Ultimately, your goal is to get to the place where you can come in and say good night and leave the room. It’s fine to have a sleep routine where the parent comes in, say, to read a story to a younger child or hug an older one, but the child shouldn’t be reliant on you to be there for them to fall asleep.

Create a routine

A posted sleep schedule with a consistent, predictable routine will help everyone, parents and kids alike, stay on track, from brushing teeth to lights out, as well as wakeup time. As the child accomplishes each step, they can be reinforced by that chart, which allows them to see their progress, earning them rewards for doing brave steps like staying in their room after their parents leave.

The parents can also be using charts to track progress and notice any patterns. “If it seems to a parent, ‘Oh, my child’s having a harder time on a Sunday than they are on a Friday,’ that tells us something,” Dr. Loiterstein says. “So tracking this type of information can really help to target certain interventions.”

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Minimize dependence, reward bravery

Some kids get into the habit of falling asleep fine on their own but wake up in the middle of the night and go to their parents’ bedroom.

“They like to have these interactions with their parents,” Dr. Loiterstein says. “It’s their comfort zone.” She says the best thing when that happens is to bring them back to their own bed as soon as possible.

“We don’t want to reinforce this interaction and make it more likely that the kid is going to want to come in every night,” she says. “We want to minimize the reward they’re getting from their parents’ bedroom.” A reward system for their bravery can be used here, as well.

Instill good sleep hygiene

In addition to behavioral techniques, there are ways to create an environment that’s conducive to sleep. The idea is to train our bodies to go to bed and wake up at the same time each day. Some methods to get into that rhythm:

-  A calming, warm bath. “It can be helpful to have a hot bath one to two hours before bedtime,” Dr. Loiterstein says, “because it raises your body temperature, causing you to feel sleepy.”

- Meditation and relaxation techniques. Dr. Nash recommends meditation apps specifically for sleep, created for different ages. With calming music and a guiding voice, apps help kids relax, from a “body scan,” during which you relax your body starting with your toes, to breathing and visualization. All are meant to reduce anxiety and guide kids toward relaxing enough to fall asleep.

- Noise-canceling headphones. Some kids may tolerate the soft devices.

- Eye masks and room-darkening curtains. These can help create a dark, “cave-like” environment.

- A cool room. Adding a fan also provides soothing white noise.

- A weighted blanket. There is anecdotal evidence a weighted blanket can help kids. Just be sure it’s not too heavy or hot.

- No exercise right before bed. Exercising raises body temperature, speeds up heart rate and stimulates the nervous system, none of which are good for sleep.

- Make the bed for sleep only. Use the bed only for sleeping, not as a place for homework, eating or watching TV. “We really want to train our bodies to know that bed is associated with sleep and bedtime,” Dr. Loiterstein says.

When it’s time to evaluate

Dr. Nash says if these measures fail and there’s real, chronic insomnia, it’s time to talk to your pediatrician. “Make sure any underlying issue is being addressed,” she says. These could include asthma or sleep apnea; medication side effects might also be the reason.

If a child needs a sleep study, she adds, there are ones that can be done at home.

If none of the above is at play, it’s time for parents to check for any underlying psychiatric conditions with an evaluation, which can now be done via telehealth.

Disorders such as anxiety, depression, bipolar, ADHD, autism and OCD can all interfere with sleep, as can phobias and media stressors, says Dr. Nash. For instance, children and teens with autism may be kept up by sensory issues while separation anxiety might lead to clinginess.

Cognitive behavioral therapy for insomnia

If a child has persistent trouble sleeping, cognitive behavioral therapy for insomnia, or CBT-I, can be effective. CBT-I teaches children how to manage their own anxiety, now and in the future, and supports parents in helping their children get better. Dr. Nash says that CBT-I has been shown to be more effective than medication in treating insomnia.

Medicating for insomnia

Medications are the last resort. “We don’t have any FDA-approved medication for sleep in children,” Dr. Nash says. “I’d say the most commonly used is melatonin, for sleep initiation, but kids could wake up after four hours. Some parents try the timed-release XR but then you risk them being groggy in the morning.” The idea is to start with a low dose.

Dr. Nash notes that there have been anecdotally variable results with the blood-pressure medication clonidine; while she’s used it with some patients, it may not get them a full night’s rest.

Two more medications that are used off-label for sleep are the antidepressants trazodone and mirtazapine (Remeron). Dr. Nash notes that trazodone’s side effects can include grogginess, so again, she recommends starting at a low dose. “I’d probably only use in teenagers with really severe cases,” she says. As for mirtazapine, when used at low doses, it works like an antihistamine. It also increases appetite, so it tends to be good for kids who are on stimulants and anxious and have insomnia. For these reasons, she will usually try mirtazapine before trazodone.

Parents may have heard of gabapentin, an anti-epileptic drug also used to treat nerve pain in adults. But it can be sedating and cause nausea.

What about the antihistamine diphenhydramine, best known as Benadryl, some parents’ go-to when they want their child to sleep? Dr. Nash doesn’t recommend regular use because of side effects including tolerance and weight gain.

Frequently Asked Questions

How can you help kids fall asleep?

You can help kids fall asleep by using behavioral techniques to help them sleep independently. For instance, if you usually sleep in the bed with them, then you can try moving to a chair next to their bed and holding their hand instead. You can also create a clear sleep routine and instill good sleep hygiene, such as using a weighted blanket or taking a calming warm bath before bed. https://standingabovethecrowd.com/?p=16661

When was the last time you woke up feeling entirely refreshed, ready to tackle the day ahead? If you're like many people, those mornings might be few and far between. In our fast-paced world, sleep often takes a backseat to our daily responsibilities. But, did you know that prioritizing your sleep could be a game-changer for your mental health? In this blog post, we'll explore the intricate relationship between sleep and mental well-being, shedding light on why catching those Zzz's is more crucial than you might think.

Understanding the Basics: What Happens When We Sleep?

Before diving into the connection between sleep and mental health, let's quickly explore what happens when we sleep. During sleep, our bodies go through several stages, including REM (Rapid Eye Movement) and non-REM sleep. These stages are crucial for various bodily functions, such as memory consolidation, emotional regulation, and physical repair.

Think of sleep as your body's overnight maintenance crew. While you're blissfully unaware, your brain is busy processing the day's information, forming memories, and clearing out toxins. Without adequate sleep, these processes are disrupted, leading to a host of mental and physical issues.

The Impact of Sleep Deprivation on Mental Health

It’s no secret that a lack of sleep leaves us feeling groggy and irritable. But the effects of sleep deprivation go beyond temporary moodiness. Here are some ways that insufficient sleep can impact your mental health:

Anxiety and Sleep: A Vicious Cycle

Ever noticed how a sleepless night can make your mind race with anxious thoughts? There's a reason for that. Sleep deprivation can heighten feelings of anxiety, leading to a vicious cycle where anxiety keeps you awake, and lack of sleep fuels further anxiety. Over time, this cycle can contribute to chronic anxiety disorders.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Depression: The Sleep Connection

Research has shown a strong link between sleep disturbances and depression. People who suffer from insomnia are more likely to experience depression, and those with depression often struggle with sleep issues. It's a chicken-and-egg situation: does lack of sleep cause depression, or does depression lead to poor sleep? The answer is both. Improving sleep quality can significantly alleviate depressive symptoms, offering a glimmer of hope for those caught in its grip.

Cognitive Decline and Poor Mental Performance

Sleep is essential for cognitive functions such as attention, concentration, and problem-solving. Without enough rest, these abilities can take a nosedive, affecting everything from work performance to personal relationships. Imagine trying to solve a complex problem with a foggy brain—it's frustrating, right? ? Consistent sleep deprivation can also increase the risk of developing neurodegenerative diseases like Alzheimer's.

How to Improve Sleep for Better Mental Health

Now that we understand the profound impact of sleep on mental health, let's explore some practical tips to enhance sleep quality:

Create a Sleep-Friendly Environment

Your bedroom should be a sanctuary for rest. Ensure your sleeping space is cool, dark, and quiet. Investing in a comfortable mattress and pillows can make a world of difference. Consider using blackout curtains or a white noise machine to eliminate disturbances.

Establish a Consistent Sleep Schedule

Our bodies thrive on routine. Going to bed and waking up at the same time every day helps regulate your body's internal clock, making it easier to fall asleep and wake up feeling refreshed. Try to stick to this schedule even on weekends to maintain a consistent sleep-wake cycle.

Limit Exposure to Screens Before Bed

The blue light emitted by phones, tablets, and computers can interfere with the production of melatonin, the hormone responsible for regulating sleep. To promote better sleep, limit screen time at least an hour before bed. Instead, consider winding down with a book or calming music.

Practice Relaxation Techniques

Incorporating relaxation techniques into your bedtime routine can signal to your body that it's time to unwind. Consider trying deep breathing exercises, meditation, or gentle yoga stretches. These practices can help reduce stress and prepare your mind for restful sleep.

Conclusion: Prioritize Sleep for a Healthier Mind

As we've discovered, the connection between sleep and mental health is undeniable. Sleep is not just a passive state of rest; it's a fundamental pillar of mental well-being. By prioritizing quality sleep, you can enhance your mood, sharpen your cognitive abilities, and reduce the risk of mental health disorders.

So, the next time you're tempted to burn the midnight oil, remember that a good night's sleep could be the best investment in your mental health. Sweet dreams!

To order a signed copy of James Donaldson's Celebrating Your Gift of Life book Click Here!!! https://standingabovethecrowd.com/?p=16673

In our fast-paced, constantly connected world, finding a moment just for yourself can feel like a luxury. However, embracing mindfulness doesn’t require hours of meditation or a drastic lifestyle change. With just five minutes a day, you can cultivate a mindfulness practice that refreshes your mind and rejuvenates your spirit. Let's explore how you can effortlessly integrate this practice into your daily routine.

Understanding Mindfulness

Before diving into the practical steps, let’s briefly understand what mindfulness is. At its core, mindfulness is about being present in the moment, fully engaging with your surroundings and emotions without judgment. It’s about observing your thoughts and feelings from a distance, without labeling them as 'good' or 'bad'. This practice not only reduces stress but also enhances your emotional well-being and improves your focus.

Why Mindfulness Matters

Mindfulness is more than just a trend; it's a scientifically-supported tool that can significantly impact your mental and physical health. Research shows that regular mindfulness practice can reduce symptoms of anxiety and depression, improve your concentration, and even boost your immune system. By dedicating just a few minutes each day, you can experience these benefits firsthand.

Step-by-Step Guide to a 5-Minute Mindfulness Practice

Now that we understand the importance of mindfulness, let’s break down a simple five-minute routine that you can start today. This practice is designed to fit seamlessly into any schedule, no matter how hectic.

1. Find a Quiet Space

Begin by finding a quiet, comfortable spot where you won’t be disturbed. This could be a cozy corner of your home, a quiet park bench, or even your desk if you're at work. The key is to minimize distractions so you can focus solely on your practice.

2. Set a Timer

Set a timer for five minutes. Knowing that you have a set end time can help you relax and fully engage with the practice without worrying about the clock.

3. Focus on Your Breath

Close your eyes gently and take a deep breath in through your nose, filling your lungs completely. Hold for a moment, then exhale slowly through your mouth. Continue this deep breathing, focusing on the sensation of the breath entering and leaving your body. This simple act of focusing on your breath anchors you in the present moment.

4. Observe Your Thoughts

As you breathe, you may notice thoughts drifting into your mind. This is entirely normal. Rather than trying to suppress them, acknowledge each thought as it arises and then gently guide your focus back to your breath. This practice of non-judgmental observation is the essence of mindfulness.

5. Express Gratitude

As your timer approaches the end, take a moment to reflect on something you are grateful for. This could be anything from the warmth of the sun to a cherished relationship. Cultivating gratitude enhances your mindfulness practice by promoting a positive mindset.

Making Mindfulness a Habit

Incorporating mindfulness into your daily routine takes commitment but is entirely feasible with a few strategic steps. Consider setting a reminder on your phone or linking your practice to an existing habit, such as drinking your morning coffee. Consistency is key, and as you establish this routine, you’ll likely find yourself looking forward to these peaceful moments each day.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Conclusion

Creating a daily mindfulness practice in just five minutes is a powerful way to nurture your mental health and enhance your overall well-being. By finding a quiet space, focusing on your breath, observing your thoughts, and expressing gratitude, you can easily integrate mindfulness into your life. Remember, mindfulness is a journey, not a destination. Each moment spent in practice is a step towards a more peaceful, present, and mindful existence.

So, why wait? Take a few moments today to start this transformative practice and watch as it enhances your life, one breath at a time.

To order a signed copy of James Donaldson's Celebrating Your Gift of Life book Click Here!!! https://standingabovethecrowd.com/?p=16670

In today's fast-paced world, anxiety has become a common companion for many. While occasional anxiety is a normal part of life, persistent and excessive worry can lead to more serious health issues. Recognizing the early warning signs of anxiety can help you address problems before they escalate. Let’s delve into the top 10 signs you should keep an eye on.

1. Constant Worrying

We all worry from time to time, but if you find yourself constantly preoccupied with what-ifs and worst-case scenarios, it might be more than just everyday stress. Anxiety often manifests as relentless worrying that can consume your thoughts, making it hard to focus on anything else.

2. Restlessness

Do you often feel on edge or unable to relax? Restlessness is a common symptom of anxiety. It's as if your body is preparing for a fight-or-flight response, even when there’s no immediate danger. This can lead to physical discomfort and an inability to sit still.

3. Fatigue

Ironically, anxiety can be exhausting. The constant mental strain can leave you feeling drained, even if you've had a good night's sleep. If you're frequently tired without a clear reason, anxiety might be the culprit.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

4. Difficulty Concentrating

Are you having trouble focusing on tasks or remembering important details? Anxiety can cloud your mind, making it difficult to concentrate. This mental fog is often accompanied by racing thoughts that distract you from the task at hand.

5. Irritability

Feeling unusually irritable can be another sign of anxiety. When your body is in a heightened state of alert, small annoyances can feel overwhelming, leading to frustration and mood swings.

6. Muscle Tension

Chronic anxiety often leads to physical symptoms, one of which is muscle tension. You might notice tightness in your shoulders, neck, or back. This tension can cause headaches and even exacerbate feelings of stress.

7. Sleep Disturbances

Anxiety can wreak havoc on your sleep patterns. Whether it’s trouble falling asleep, staying asleep, or experiencing restless nights, disrupted sleep is a common complaint among those with anxiety. Unfortunately, lack of rest can worsen anxiety, creating a vicious cycle.

8. Panic Attacks

Panic attacks are intense episodes of fear accompanied by physical symptoms like a racing heart, sweating, trembling, and shortness of breath. If you've experienced these, it's essential to seek help, as they can be a hallmark of anxiety disorders.

9. Avoidance Behaviors

Do you find yourself steering clear of certain places or situations? Avoidance is a common coping mechanism for anxiety, but it can limit your life and prevent you from doing things you enjoy or need to do.

10. Increased Heart Rate and Palpitations

Feeling your heart race or having palpitations can be alarming. Anxiety can trigger these physical reactions, making you feel like you're in constant overdrive. While these symptoms can also be related to other health issues, they are often linked to anxiety.

Conclusion: Taking Steps Toward Calm

Recognizing these early warning signs of anxiety is the first step toward managing it effectively. If you identify with several of these symptoms, it might be time to seek professional help. Therapy, meditation, exercise, and mindfulness are excellent tools for managing anxiety. Remember, you're not alone, and taking action now can lead to a healthier, more balanced life.

Monitoring your mental health is just as important as caring for your physical well-being. By understanding these signs, you're better equipped to take control of anxiety before it takes control of you. Stay proactive and prioritize your peace of mind.

To order a signed copy of James Donaldson's Celebrating Your Gift of Life book Click Here!!! https://standingabovethecrowd.com/?p=16664

How to recognize (and treat) avoidant restrictive food intake disorder

Writer: Hannah Sheldon-Dean

Clinical Expert: Jerry Bubrick, PhD

https://www.youtube.com/watch?v=Q7RM3z2ZDEM

What You'll Learn

- What is avoidant restrictive food intake disorder (ARFID)?

- How is ARFID different from picky eating?

- How is ARFID treated?

- Quick Read

- Full Article

- What does ARFID look like?

- Warning signs of ARFID

- ARFID and other disorders

- Treatment for ARFID

ARFID stands for “avoidant restrictive food intake disorder.” ARFID is a relatively new eating disorder that looks very different from other eating disorders like anorexia and bulimia. Kids with ARFID aren’t worried about how much they weigh, though they sometimes do lose too much weight. Instead, they have rigid and restricted eating habits for other reasons.

Many kids with ARFID avoid foods that have a certain taste, texture, color or some other specific quality. For example, they might refuse to eat anything green or anything crunchy. Others have an extreme fear of vomiting or choking that prevents them from eating. And some kids with ARFID just have very little interest in food. It’s common for kids with all kinds of ARFID to like only a very limited set of foods.

What sets ARFID apart from normal picky eating is that ARFID has significant negative impacts on the child’s physical and/or mental health. About half of kids with ARFID are underweight for their age. Many have nutritional deficits, which means that they’re not eating enough for their bodies to function normally. ARFID often gets in the way of kids’ daily lives too. They might avoid social gatherings or even school if eating is involved.

ARFID can show up in kids as young as six, and it’s diagnosed about equally in boys and girls. Symptoms of ARFID can overlap with other disorders and some kids have ARFID as well as another disorder. In particular, autism and OCD can have a lot in common with ARFID. If you think your child might have ARFID, it’s important to get a thorough evaluation from a mental health professional, ideally an eating disorder specialist.

Researchers are still exploring the best ways to treat ARFID. Early studies of forms of cognitive behavioral therapy (CBT) and family-based treatment have shown promising results. Kids with ARFID who don’t get treatment often continue to experience symptoms as adults, so seeking treatment early can make a big difference.

When we think of eating disorders, we think first of young women who are obsessed with losing weight, and go to unhealthy extremes of diet and exercise to do it.  But in the case of an eating disorder called ARFID (avoidant restrictive food intake disorder), the picture looks very different.

ARFID stands for “avoidant restrictive food intake disorder,” and it became a clinical diagnosis in 2013 with the release of the DSM-5. Because it’s a relatively new diagnosis, clinicians are still learning about the disorder and how to treat it. But a few key features set it apart from other eating disorders.

“Kids with ARFID don’t particularly care about weight or shape, definitely not in the way that young people with bulimia nervosa, typical anorexia nervosa or atypical anorexia nervosa do,” says Daniel Le Grange, PhD, director of the Eating Disorders Program at the University of California, San Francisco. “What distinguishes ARFID from those three eating disorder diagnoses is their worry about the taste, texture, color or even ‘movement’ (such as Jell-O) of food.” Kids with ARFID may or may not be underweight, but losing weight isn’t the motivation behind their eating habits. Instead, they avoid certain foods or groups of foods for a wide variety of reasons — which are often mystifying to their families.

Additionally, ARFID typically shows up in much younger kids than other eating disorders do. Signs can become clear by the time a child is six or seven, but because it can be hard to tell ARFID apart from normal picky eating, they may not get a diagnosis right away. And boys are diagnosed with ARFID about as often as girls are — unlike other eating disorders, where girls are much more likely to be diagnosed.

Lots of kids are picky eaters. So how is ARFID different?

What does ARFID look like?

The hallmark of ARFID (avoidant restrictive food intake disorder) is restriction or avoidance of certain foods or groups of foods in a way that is so extreme that it interferes with the child’s daily life and physical health. The specifics can look very different for different children.

Many kids with ARFID avoid foods that have a certain taste, texture, color or some other specific quality. For example, they might refuse to eat anything green or anything crunchy. They often have a very limited set of foods that they like and get intensely upset or even nauseated if they have to eat something else. This is often called “avoidant” ARFID.

Other kids with ARFID restrict their eating due to a fear of choking, vomiting or otherwise getting ill. They may have vomited or choked on a certain food before (or seen it happen to someone else) and developed extreme anxiety about having it happen again. For example, if they once got a piece of tomato stuck in their throat, they might refuse to eat not only tomatoes but all red things or things with a similar smell. This form of fear-based ARFID is sometimes called “aversive.”

Finally, some kids with ARFID simply have little interest in food or eating. They might forget to eat, get distracted easily during meals, or eat extremely slowly. They also tend to like only a narrow set of foods. This is often called “restrictive” ARFID.

It’s common for kids with all types of ARFID to have rigid habits or rituals around eating. For example, they might insist on eating things in a certain order or keeping foods they don’t like away from their plates.

For a child with any of these eating patterns to be diagnosed with ARFID, their eating habits must have a significant negative impact on their physical and/or mental health. Often, kids with ARFID lose an unhealthy amount of weight, or they fail to gain weight and grow as they get older. About 50 percent of kids with ARFID are underweight for their age. They may also have significant nutritional deficits, which means that they don’t get enough calories or a wide enough variety of nutrients for their bodies to function normally.

The social impacts of ARFID are profound as well. “You don’t go out with your family to a restaurant,” says Dr. Le Grange. “You don’t accept invitations from your friends if it involves eating. It can even get in the way of going to school.”

Warning signs of ARFID

In general, early symptoms of ARFID (avoidant restrictive food intake disorder) look like extreme forms of picky eating. Some behaviors to look out for in young children include:

- Liking very few foods

- Avoiding specific foods or groups of foods based on qualities like texture or color

- Pickiness that gets worse over time, including refusing to eat foods that they once liked

- Anxiety at mealtimes

- Intense fear of choking or vomiting

- Eating very slowly

- Lack of appetite or getting full quickly

- Complaints of feeling sick after eating

Because kids with ARFID are often malnourished, there may be physiological warning signs as well. These signs can also be indicators of other eating disorders, especially anorexia nervosa, and it’s important to seek medical treatment if your child shows any of them. Physiological warning signs include:

- Weight loss, or failure to gain weight and grow as expected for their age

- Digestive problems that don’t have another medical explanation

- Trouble concentrating

- Dizziness or fainting

- Sleep issues or feeling tired all the time

- Feeling cold

- Dry skin, brittle nails or hair loss

- Missing menstrual periods

- Weakened immune system

ARFID and other disorders

One of the things that can make ARFID (avoidant restrictive food intake disorder) difficult to diagnose is that its symptoms often overlap with other eating disorders (most likely anorexia nervosa) or another disorder altogether — and many kids have both ARFID and another disorder.

Attention and anxiety disorders can show up in ways that look like ARFID. Kids with ADHD might show less interest in food or eat slowly because they’re easily distracted. Or a child with social anxiety might be too scared to eat lunch at school in front of their classmates.

Moreover, ARFID can be confused with, and overlap with, autism. Like kids with ARFID, kids on the autism spectrum are often very sensitive to the sensory experience of eating. For instance, they might refuse to eat anything too mushy or too crunchy.  

Finally, because kids with ARFID often have ritualized behaviors and rigid habits around eating, their behavior can look like — and overlap with — obsessive-compulsive disorder (OCD). “Emetophobia, or fear of vomiting, is the main condition under OCD that might be confused with ARFID,” says Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. He gives the example of a child who eats too much at Thanksgiving and vomits, and then develops an intense fear of vomiting and everything else that reminds them of that incident. “They might throw away that outfit, refuse to sit at the same place at the table, and refuse to eat any Thanksgiving foods,” Dr. Bubrick explains.

Because this child’s fear of vomiting is causing them to compulsively avoid so many different things — not just foods — their diagnosis would more likely be OCD, even though their eating is restricted. “The nutritional deficits are often the thing that sets ARFID apart,” says Dr. Bubrick. “If that same child were eating far less overall and not taking in enough calories because of that experience, and they’re starting to suffer from a nutritional perspective, then the diagnosis would tend more toward ARFID.” It’s also possible for a child to be diagnosed with both OCD and ARFID.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Treatment for ARFID

Because possible signs of ARFID (avoidant restrictive food intake disorder) can be so hard to interpret, it’s important to get a thorough evaluation from an experienced professional if you think your child might have it. It’s best to start with an eating disorder specialist if possible, though other clinicians (such as those who work with kids with autism or gastrointestinal issues) may also pick up on signs on ARFID in kids who initially seem to have a different problem. And if you think that your child may have another diagnosis as well, such as OCD, it’s helpful work with a specialist in that field too, particularly during evaluation.

Because ARFID is a relatively new diagnosis, researchers are still exploring the best ways to treat it, and there’s not yet a clear evidence-based treatment model. “There are a couple of pilot studies, treatment development studies, but there are no randomized clinical trials,” says Dr. Le Grange. “So we can’t say with any certainty. But there are a couple of treatment candidates that are pretty promising.”

For cases where a child with ARFID is underweight or malnourished, a big part of treatment (as with other eating disorders) is helping them regain weight and maintain medical stability. This might involve working with nutritionists and endocrinologists, while occupational therapists can help children overcome sensory challenges related to eating.

Treatment for ARFID also has a lot in common with treatment for OCD and other anxiety disorders, especially in cases where the child is not underweight. There are several promising initiatives underway to adapt cognitive behavioral therapy (CBT) for use in kids with ARFID. These include a model called CBT-AR, as well as one that combines family-based treatment for eating disorders and an anxiety treatment model called the Unified Protocol (FBT-UP).

Dr. Bubrick notes that kids with ARFID often believe very strongly that their irrational fears are true — that is, they believe that they really will vomit if they eat something green, rather than being able to acknowledge that that outcome is unlikely. For that reason, it can be difficult to use exposure therapy for these children, since even the smallest exposure to the thing they fear triggers too much anxiety. Accordingly, Dr. Bubrick says that it’s often helpful for ARFID treatment to start with cognitive work to help kids view their fears in a more rational way. Then, they can proceed with exposure therapy knowing that the foods that make them anxious aren’t actually dangerous.

Despite the complexities, Dr. Le Grange emphasizes that whatever treatment children get, involvement of parents and support at home are key. And it’s clear that early intervention is important. While kids who are picky eaters usually outgrow their fussiness, kids with ARFID who don’t get treatment often continue to experience symptoms as adults (although ARFID rarely begins in adulthood). 

“When you look at the few studies that are available for ARFID, there are a significant number of young persons who, when they were six or seven, were already showing clear symptoms and signs, but the parents just thought they were picky eaters or awkward eaters,” he says. Because it can be so hard to pinpoint what’s ARFID and what’s not, it’s important to reach out for help if your child’s picky eating is having a negative impact on their physical, social or emotional well-being.

Frequently Asked Questions

What is ARFID?

ARFID is an eating disorder. ARFID stands for “avoidant restrictive food intake disorder.” Kids with ARFID have rigid and restricted eating habits, but they aren’t trying to lose weight. Kids with ARFID avoid certain foods or groups of foods. ARFID causes significant problems with kids’ physical and mental health.

How is ARFID treated? https://standingabovethecrowd.com/?p=16610

Tips that young kids might need support to thrive

Photo by Pragyan Bezbaruah on Pexels.com

Writer: Rae Jacobson, MS

Clinical Expert: Daryaneh Badaly, PhD, ABPP

https://www.youtube.com/watch?v=hyP7Fs7zd-w

What You'll Learn

- What are the earliest signs that a child might have learning challenges?

- How old do kids have to be to be diagnosed with a learning disability?

- What can parents to do help?

- Quick Read

- Full Article

- What is a learning disability?

- The earliest signs of learning challenges

- What parents can do

- What parents can do at home

- Supporting kids’ self-esteem

It can be hard to tell if a preschool-age child is likely to have a learning disability. When kids are young, they develop skills at different speeds, and kids have different strengths and weaknesses. As they get older their abilities usually even out.

But there are some signs in preschool and early school that a child may be diagnosed with a learning disorder later on. For example, children who struggle to pick up rhyming may later have difficulty with reading. Likewise, kids who have trouble grasping the basics of counting may have trouble with math.

Children who have trouble holding a crayon or using a fork may have issues with what is called fine motor control. Trouble understanding or using language can be a sign of a language-based learning disorder. Speech and language issues can also be an early sign of autism.

Kids’ behavior can offer clues. If a child often gets frustrated during an activity, like drawing, it might mean those skills are a challenge for them. And if kids are more active, more impulsive, or more distracted than most of their peers, they could be signs of ADHD, which is usually not diagnosed until kids are older. Though ADHD is considered a behavioral disorder, it has a big impact on how kids learn, and many children with ADHD have learning disorders as well.

Some of these kids can benefit from early intervention. For instance, children with fine motor issues may be helped by an occupational therapist (OT). OTs can work with kids to improve their grasp, muscle tone, and hand-eye coordination. If you suspect your child is having speech or language issues, make an appointment with their healthcare provider. You may be referred to a speech-language pathologist (SLP) who will help them work on communication.

If you notice your child is struggling you can help by supporting their self-esteem. And you can work with them to build skills outside the classroom. Activities like reading, counting, or drawing together can help kids practice skills in a low-stress environment.

My daughter, age four, has been trying to write the number five. She wants to make a birthday card for a friend. “No, that’s not right…” she mutters, her squiggles snaking across the page. On attempt number six, frustration gets the better of her. “I just can’t do this!” she wails, throwing her pen to the floor. “Fives are too hard!”

This is hardly unusual for a preschooler just starting to her learn numbers and letters (and who still sometimes flops to the ground in distress if her banana accidentally breaks in half) but I can’t help feeling a little pang of worry.

Growing up, I had dysgraphia and dyscalculia. Seeing my daughter struggle, I wonder how I’ll know if she has learning challenges of her own. When children have learning issues, early intervention can be a big help. But how can parents tell if, and when, to be concerned?

What is a learning disability?

Learning disorders (LDs) are diagnosed when a child is having serious trouble with a specific academic skill or subject, like math or reading. LDs are defined by a gap between what it is developmentally expected for a child to be able to do, and what they’re actually able to do. For example, a child who has no trouble keeping up with their peers in other ways but is falling way behind in reading.

Though some disorders, like autism, can, and often are diagnosed during a child’s preschool and early school years, learning disorders usually don’t become apparent until kids are a bit older — when they’ve had a chance to be exposed to formal schooling.

This is partially because when it comes to early learning, kids develop skills at different speeds. A child who seems to be behind their peers when it comes to forming letters or reading short words may just need a little time to catch up. Being at the younger — or older — end of the class can mean some children are little ahead or behind other students. And, just like adults, different kids have different strengths and weaknesses. One child might excel at counting but struggle to write their name, while another might be reading basic words early on but have trouble with numbers. As they grow and mature their abilities usually even out.

For some children, however, those early learning struggles may signal future academic difficulties. And though kids may be too young for a formaldiagnosis in the preschool and early kindergarten years, support and, if necessary, early intervention can have big benefits. Daryaneh Badaly, PhD, a clinical neuropsychologist, explains that there are a few signs parents can be on the lookout for during children’s early learning years. 

The earliest signs of learning challenges

 “In younger kids, learning challenges don’t look the same as they do for older children, because the work they’re being asked to do is very minimal,” explains Dr. Badaly. “That said, there are some specifics issues that may suggest a child is struggling with some specific early skills.”

Fine motor control: “Issues with fine motor control can come out early on. You might see children struggling to learn how to hold a crayon correctly, having trouble using utensils, or shying away even from coloring or drawing shapes because it’s physically hard for them,” says Dr. Badaly. “Catching those issues early gives parents the chance to put supports like occupational therapy in place to strengthen those skills so they don’t become a barrier to learning later on.”

Language problems: Trouble understanding or using language can be a sign that a child may later be diagnosed with a language-based learning disorder. “There are different functions of language that can be impaired,” says Dr. Badaly. Children can have issues with receptive language, meaning they have a difficult time understanding words they’re hearing or reading. Or they can struggle with expressive language — trouble using words to express themselves. Children can also have issues with both. “If a kid is having trouble understanding oral language or expressing themselves, intervention can be helpful,” she says.

Early reading skills: Though most children are barely reading basic words during the preschool years, they’re building the skills that form the building blocks of reading in other ways. “There’s a lot of play with sounds, like rhyming games, or word and sound matching during this time,” says Dr. Badaly. “If a child is really struggling to pick up on the sounds, or doesn’t seem to grasp rhyming, that’s someone you should watch a bit more closely.”

Early math skills: “When kids are just learning to count, if the numbers just don’t come that easily to them, or they’re not seeming to grasp the fundamentals of counting, like putting things in order, that might be something to watch,” says Dr. Badaly. Issues with numbers can become especially clear around first grade, she explains: “If by the end of first grade a child wasn’t really grasping the basic concept of addition, that would definitely be cause for concern.”

Behavioral clues: If you notice your child frequently gets frustrated or upset during a certain activity, like drawing shapes or building with blocks, that may be a sign that the skills required for that type of learning are a challenge for them. “If there’s something that a kid is unwilling to do or is getting really upset when they’re asked to do it, it’s probably because it’s hard,” Dr. Badaly says. The question, she says, becomes: Why is it hard? “Is it that they haven’t been taught this skill? Or is it because the child is having a hard time staying focused, or because the task itself is hard?”

ADHD symptoms: Another behavioral clue worth considering during the early years is signs of ADHD. Though ADHD is considered a behavioral disorder, it has a big impact on how kids learn, and many children with ADHD have learning disorders as well. “In preschool, even though we likely wouldn’t make a diagnosis of something like ADHD, if you have a kid who’s bouncing off the walls and can’t sit still, you might say, well this kid might end up being diagnosed with ADHD, and might benefit from a behavioral intervention,” Dr. Badaly notes.

What parents can do

For children struggling with fine motor control, or receptive or expressive language, specific help is available.

- Children, even very young children, with fine motor issues may benefit from seeing an occupational therapist (OT). OTs can work with kids to improve their grasp, muscle tone, and hand-eye coordination, and help children build their social and self-regulation skills.

- If you notice your child is having speech or language issues, or has delayed speech, make an appointment with their healthcare provider. Your child’s doctor may ask for a hearing test and check your child’s throat and reflexes to rule out any other causes before suggesting next steps. If it seems like early intervention is necessary, your child may be referred to a speech-language pathologist (SLP) who will help them work on communication.

Speech and motor issues (especially when also seen with social challenges) can also be signs of autism, which, unlike learning disorders, “can be accurately diagnosed during early childhood,” says Dr. Badaly, “and early detection and intervention can be extremely beneficial.” If you, or your child’s teacher or doctor, notice your child is showing some of the early signs of autism, make an appointment to have them evaluated by a professional.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

What parents can do at home

Supporting your child’s learning outside the classroom is key. Simple activities like reading, counting, or drawing together can help kids practice skills in a low-stress environment. “Taking time to build enjoyment of reading by letting your child choose the books you read together” can help, says Dr. Badaly, “Or even just helping them get used to how a book works, here’s the title, here’s the story.” Likewise, “math practice can be as simple as counting the apples when you’re making a pie together.”

The point, she explains, is to make learning feel more natural and less fraught. “All practice is good.” But she warns, parents should be careful not to overwhelm kids. “You really want to approach learning in a fun and enthusiastic way instead of turning it into work, which can backfire and make kids feel less engaged, not more.“

Supporting kids’ self-esteem

Learning differences can wreak havoc on kids’ confidence. If you suspect your child is struggling in school, supporting their self-esteem can be a huge help, whether or not they’re ever diagnosed with an LD. Learn more here about how help kids with learning challenges build self-esteem, gain confidence, and learn the skills they need to be more resilient when setbacks happen.

Frequently Asked Questions

What are early signs of learning challenges?

What are some signs a child might develop learning challenges?
If a child often gets frustrated during a particular activity, it might be a sign that those skills are a challenge for them.

What interventions can help young children who show early signs of learning challenges?

How can parents support kids who show early signs of learning issues?

Photo by Pragyan Bezbaruah on Pexels.com https://standingabovethecrowd.com/?p=16654