04
Feb 25

Antipsychotic Weight Gain and Teens

Teenager“The routine helped her to get through the days, and the activity improved her mood.”

It can be heartbreaking to watch your teen put on unwanted pounds after starting a new medicine. My daughter once gained twenty pounds in one month on a new antipsychotic. It was as though her brain was no longer getting the message that she was full after eating. She would eat a meal and half an hour later be starving. This is a positive story about how a psychiatrist and his patient worked together to get her through it.

While my daughter’s psychiatrist set to work adjusting her medication, she and I began focusing on exercise. She was barely out of psychosis and had been sedentary for some months. Her psychiatrist wanted her to walk for an hour and twenty minutes a day, but the extra weight made her feel exhausted and winded.  He told us to break it into four 20-minute segments per day. Somehow, this seemed manageable to my daughter and we were able to get in a total of 80 minutes of daily walking. The routine helped her to get through the days, and the activity improved her mood.

I removed every scrap of sugar from the kitchen and replaced it with fruit, cut vegetables, and whole grain breads for when she was desperate. I reasoned that if she was going to overeat, at least it would not be calorie-rich food with no nutrition. This limited the weight gain. The psychiatrist also urged me to push high-protein, fiber-rich foods, which satisfy the appetite longer. I tried not to let her eat after dinner. Fortunately, she only had to make it to bedtime because her medicine made her fall asleep ten minutes after she took it.

Fortunately, her doctor had the problem resolved within a month. He slowly cut her offending antipsychotic with a smaller amount of the antipsychotic Geodon. The Geodon counteracted the hunger issue. The nightmare was over, but she was up twenty pounds. We continued with the walks. I took her to the Lily Pulitzer store, and I saw what a difference a well-cut garment can make in terms of flattering a heavy figure. Patterns hide a paunch better than a solid color. The tops I bought her were designed to be worn out, not tucked in, and they were sewn to glide over her hips so that it slimmed her and made it look like she had a waistline. She wore jeggings with boots and that was slimming too. I’ll never forget the day I saw her look in the mirror and smile at herself.

She lost the twenty pounds in two months. Geodon requires food to work. In fact, a couple of clinical trials suggest that 500 calories is the magic number. So I fed her a 500-calorie breakfast and dinner with her medicine, which is taken twice a day. Once we became rigorous about getting her calorie count up with each dose, the appetite-suppressing effect kicked in. Now she wasn’t hungry. She ate a light lunch, usually some low-fat cheese or turkey and a piece of fruit, along with a bottle of water. After the weight came off, it was easier for her to walk and we condensed our walking times. She began running ten minutes a day before our morning walk. When her psychiatrist ran blood work again, we held our breaths, but her cholesterol levels were the best they had been. Then something completely unexpected happened. My blood work was better than it had ever been too!


02
Feb 25

Dealing With an Angry Teen

Boyyellsatdad“Often, hurting teens lash out in anger at their parents when they’re actually angry at the illness.”

Because you are the person responsible for your child, you are likely to be the target of their anger when life feels out of control for them. For once, you cannot fix their problems. Keep in mind that you are being graced with this unwelcome emotion precisely because you are the person who matters most to them. More, unlike their friends, you aren’t likely to leave if they explode at you.

You have my sympathy. You’re being called upon to carry out one of the most formidable tasks known to parents: convincing your teen that they are still lovable. In order to carry out this important job, you may first have to remind yourself that they are lovable. Remember that they don’t mean much of what they say to you. Even more, bear the following in mind:

More than anything in the world, they want you to approve of them.

I know it doesn’t feel that way. But deep down, they desperately want to see that you still hold them in esteem. Your view of them reflects back at them, although they don’t consciously realize it. So be lavish with your praise. I know it’s difficult to look for the good when your teen is making themselves so unappealing, but try. A simple, “One thing about you, dear, is that you never gossip” will go a long way. Try to come up with a sincere compliment each day. Even if they glare at you, persist. They are glaring at you because they don’t feel good about themselves.

You may feel partly responsible for your teen’s misery. Let’s say you initiated the divorce that is making them feel so miserable. An empathetic, “I’m sorry the divorce has caused you so much pain” can go a long way. You may not be able to change the way things are, but you can let them know that you regret how it has affected them. What do you have to lose? Your teen has already figured out that you’re not perfect. If you find that your empathetic remark results in a volcanic eruption of anger, sit quietly and listen. Let it flow. All that anger and resentment is much better outside than broiling inside. It may not be pretty to watch, but it won’t last. If you can’t think of anything to say without inciting more anger, simply say, “I hear you.” You can’t very well get in trouble for saying that now, can you?

Bear in mind that, especially in boys and men, anger can be a symptom of depression. The first time I heard that I was confused. It didn’t seem to make sense to me, but therapists and doctors now recognize that this occurs. If you have a boy, make sure the doctor is treating your son for the right thing.

A teen’s anger can be one of the most painful symptoms to bear. Just when you want to believe you’re doing well for your child, you are told that you a terrible parent. Be confident: this will end. Often, hurting teens lash out in anger at their parents when they’re actually angry at the illness. Give it time. If you feel discouraged, look at baby pictures or play videos of your teen’s childhood years. You might find them sitting down to watch with you while you relive better times together. At night, before you go to sleep, make a list of five things you do well as a parent. Beside the list, try to record five positive things about your teen. Do this every night, even if you repeat the same qualities. You will be surprised at how powerfully it can bolster and hearten you, giving you the courage you need to persist.