Dealing with Depression/Eating disorder

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Question
My daughter is aged 15 years. Until last year she was healthy and her body weight was 42 Kgs. But, unfortunately, since last year she has not been eating  well, she eats only very less food, due to which she did not have menstruation for the past two months, she also complains of muscle problems on her legs sometimes. She likes to eat all foods but she fears that she will become overweight if she eats enough food, and so she does not eat what she desires to eat.She told me that some of her friends and relatives told her that she is overweight(but I did not feel so, I felt she was healthy and normal), she worries that her hands will become more fat than her body if she eats, Now her weight is only 32 kgs, and height 150 cms and appearing very weak and slim. We took her to two psychologists but she still continues to avoid eating, she eats only very little enough to remain alive. She does not have most of the complications of anorexia. She is one of the best students of her class. I would like you to advise me whether it is possible to restore her previous condition by neuro psychiatric treatment or she will become a permanent  psychiatric  case or reach a fatal condition and will have to discontinue her studies, and should I take her to a neuro-psychiatrist?

Answer
Hello.

Thanks for writing to me. It seems your daughter might be suffering from Anorexia Nervosa. Of course, this is not a diagnosis I am trying to provide here. But the signs do point towards that.

The management of her situation needs to be multifaceted. First of all, she needs to accept that she has a problem. For this purpose, it might help to get a physician's consultation about her body mass index, weight for her height and age, her diet habits, etc. This way, she might gradually start her journey towards accepting that she has a problem.

After this, she might benefit from the medical treatment. For this purpose, you can take help of a Psychiatrist. You might also need to visit a Nutritionist for a complete diet advice for her condition, along with the psychiatrist's advice. There are certain medicines that are known to be helpful in Anorexia.

However, for a more long term relief, medical treatment has to be associated with psychotherapy.

At the core of her problem are some irrational beliefs she is carrying in her mind. For example, she fears she will be over weight by eating normal amounts, that her hands will be more fat compared to her body, etc. Now these are superficial thoughts and wrong assumptions. It is possible that there are underlying fears and anxieties she may not have explored herself. Psychotherapy can help her explore these irrational beliefs. Once they are explored, she can modify them into more rational and healthy beliefs. This will in turn affect her eating habits and the unhealthy anxiety about getting overweight. A particular form of therapy called Rational Emotive Behavior Therapy (REBT) can help her. You may search for a therapist trained in REBT in your region. If an REBT trained person is not available, you can go for a CBT trained therapist. (Cognitive Behavior Therapy)

I hope this helps a bit. Please let me know if you need more information about anything.

Take care.  

Dealing with Depression

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Dr Abhijeet Deshmukh

Expertise

Hello. I have volunteered here to help you with questions regarding Depression. I intend to focus on the questions which are about how to deal with depression. Even if the depression is part of some other disorder, you can ask me about that. You can also ask me questions related to Psychotherapy for depression. I apply the principles of Rational Emotive Behavior Therapy in my own life, and also help my clients/patients with those. I believe in providing my clients/patients with the best possible and evidence based information. The same applies to the online answers here, too.

Experience

I am a trained Psychiatrist working since over 9 years. I am also a certified Psychotherapist (Rational Emotive Behavior Therapy).

Organizations
Indian Medical Association, Nagpur Academy of Medical Sciences, Nagpur

Publications
"Effect of Indian classical music on quality of sleep in depressed patients: A randomized controlled trial" - (Main Author) - Nordic Journal of Music Therapy, Volume 18, Issue 1 March 2009 , pages 70 - 78

Education/Credentials
I have done my MBBS from the Government Medical College and Hospital, Nagpur. Psychiatry training - DPM (Diploma in Psychological Medicine) from BYL Nair Charitable Hospital, Mumbai. Psychotherapy training - Primary + Advanced Certificate in REBT from Albert Ellis Institute, New York. Basic + Advanced Certificate in REBT from In Vivo - Mumbai Center for REBT, Mumbai.

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