Leanne Hall is a clinical psychologist with a private practice in Sydney, Australia. She has 15 years of experience in treating teenagers with a range of problems, with a special interest in teens and families affected by divorce. Leanne is currently completing her PhD in the early detection of eating disorders, and has been involved in the development of Federal Government initiatives aimed at providing early interventions for teens in trouble. Many thanks to Leanne for bringing Australia into our conversation, and for sharing her expertise with us today!
Divorce is one of the most stressful events a family will ever go through. Part of what makes it so difficult is the fact that unlike many other stressors, the effects are prolonged - and unpredictable. In addition, it impacts everyone—child and parent alike—in varying ways and and to various degrees.
For teenagers caught up in the web of divorce, it’s quite emotional, and in a myriad of ways. For instance, sometimes the teen experiences a parental abandonment, as the adults become tangled in negotiating the distressing and rocky path of property settlement and custody/access issues. I often use the analogy of a jigsaw puzzle in a counselling session with a teen patient; when parent’s divorce the family puzzle is thrown into the air. Pieces are flying everywhere, and it’s difficult to make sense of where they will fall. The “old picture of the family” has disappeared, and in time, a new one will form as each piece falls into place. This can take time. In the meantime, it’s quite normal to feel confused, sad, or angry. Some teens even feel a tinge of excitement at the prospect of having two bedrooms and twice as much stuff!
As an adult, a divorce represents a challenge—a need to confront the future constructively, at a time when you are feeling lost. For some teenagers, the world as they know it vanishes in one fell swoop. It can be undoing for some. Combine this with the fact that the teenage brain continues to undergo major changes called “neural pruning” that’s required for them to develop abstract reasoning and understanding. They are confused by the world around them and the world within. It’s no wonder that you can end up with a scared, confused or angry kid.
In his past posts, Mark has outlined some of the important factors to consider when asking the question: Does my teen need help? As Mark points out, it’s important to understand that most teenagers will pass through this difficult time in one piece, provided they have the support and understanding of either a parent, or another adult support figure. One of the most important things is to keep the lines of communication open. Keep talking with your teen, and be mindful of your own reactions.
So how do you know whether your teen will be ok? Research shows that most mental health problems first rear their head during adolescence, which is why in Australia the Federal Government has invested substantial amounts of money towards early intervention for the 12-25 year age group. We know this is a vulnerable time; we also know that stress can trigger the first onset of a mental health problem. What this means is that for teens who may be predisposed to developing a mental health problem, the stress associated with divorce can tip the scales.
There are many things that can predispose a teen to developing a mental health problem; have they experienced mood swings, or significant anxiety in the past? Is there a family history of mental health problems? Do they have a healthy self-esteem? Do they have good coping skills? These are just a few of things that can contribute to a teen’s vulnerability. In these cases, it is important to know what signs and symptoms to look for.
For some teens, symptoms of clinical depression may develop. Others may experience significant anxiety. What we know, is that the very first thing that happens, is that the teen will develop signs of disability or dysfunction before they start exhibiting more specific signs of a mental health problem.
You may notice that they start withdrawing from their peer group, they may begin refusing to go to school or their grades might take a steep dive, you may notice changes in sleep and eating habits.
Some parents will even just tell me that they know “something is just not right, but I can’t put my finger on it.” The advice I always give parents is “go with your gut” if you feel something is not right, talk to your local or family doctor.
For other teens, the stress associated with divorce can lead to very significant changes in appetite with subsequent weight loss. Sometimes this can be explained by other symptoms such as depression and/or anxiety.
In some cases however, it can be a sign of disordered eating. Eating disorders are a very serious illness affecting 2-3% of the population. Typically they fall into four categories; anorexia nervosa, bulimia nervosa, eating disorders not otherwise specified, and a more recent addition; binge eating disorder.
In general, they are characterised by an extreme dissatisfaction with weight and body shape, patterns of food restricting and bingeing, and compensatory behaviours such as vomiting, laxative use, chewing and spitting out food, and/or over exercising. Usually, an eating disorder of this type will not “suddenly” appear following divorce. For example there may be a history of dieting, preceded by weight related bullying at school and emotional disturbance. The teen may already have lost weight before the divorce, which may then lead to more serious symptoms associated with a full-blown eating disorder. Some of the important signs to look for include:
- Significant weight loss over a relatively short period of time
- Distorted perception of body shape (thinking “I’m fat”)
- Frequently skipping meals
- Using compensatory behaviours following eating (running on a treadmill, not eating at all the next day)
- Going to the bathroom immediately following meals
- In girls that have begun having regular periods, having amenorrhea, or the absence of at least three consecutive menstrual cycles.
- Suddenly wearing oversized and/or baggy clothes
- Avoidance of eating in public places
- An obsessional preoccupation with food
- Low mood/depressive symptoms
Eating disorders are also one of the only psychiatric illnesses that result in a number of medical complications such as electrolyte imbalances, osteoporosis, and dental problems. In cases where an eating disorder has been diagnosed, it’s important to have regular contact with a GP or Pediatrician to monitor and treat any physical symptoms.
If you have noticed a few of the signs listed above, this does not necessarily mean your teen has an eating disorder. However, it may be worthwhile talking to your doctor about your concerns.
If your teen does have the early signs of an eating disorder, they will get quite defensive if you confront them directly. This is because when an eating disorder takes hold, it’s very powerful, and your teen will be terrified that you’re going to make them put on weight.
The best thing you can do for your teen, is help boost their self-esteem by encouraging and supporting them to engage in activities that they are good at (which do NOT focus on looks or appearance).
It’s also helpful to teach them how to deconstruct the images seen in the media displaying the “thin ideal”. Talking openly about airbrushing, trick photography and clever marketing ploys can actually be quite enlightening for some teenagers.
Finally, always reinforce that appearance is not everything! Our society places way too much emphasise on appearance, and this certainly does not help matters if your teen is struggling with their body image.
Celebrate diversity with your teen, and be very mindful of the messages that you may be indirectly sending about your own body image. If you are constantly complaining of being “fat” or consistently dieting, your teen is likely to internalise these messages and form the belief that achieving the “thin ideal” is something to aspire to. After all, if Mom thinks it’s important then it must be!
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