Mental & Emotional Health

This is totally an anonymous example.  I can’t and won’t reveal any sources.  I’m just curious if anyone out there that is reading has seen such habits, felt such insecurities and has any idea how to go about helping someone in this situation.

Ok, we are talking about an 18 year old kid.  I’m going to call him Joey but obviously that is not his real name.  He lives with his mother who I am calling Carol, again, not her real name.  Joey’s father is not in the picture but there is an older brother but he too lives several states away.  Here’s the story.

Joey graduated from high school and wanted to go to college.  Because of his situation, not only did he not have help getting help getting into college, preparing paperwork for grants and loans, he didn’t have transportation to get to and from college either.  This kid leaves where there is no public transportation. 

As a side note, I’ve seen many situations like this and if the proper channels are doing their job, the kid ends up in college, with monetary help and someone who lives close by that doesn’t mind giving the kid a ride.  That simply didn’t happen in this case. 

Now, the kid is disappointed about not going to college.  That much is known for sure.  The kid is also binging and purging.  He is taking laxatives when he can and everyone around him is watching this from behind the scenes wondering who and when someone should intervene. 

Carol contacted a doctor who specialized in these behaviors but was told that he would prefer Joey see a doctor that specialized in teenagers because he felt that Joey’s situation was more out of control than he was comfortable dealing with. He also mentioned to the mother than many times when a young boy this age had issues with binging and purging, he was also struggling with his identity.  Indeed the child did say he thought he might be homosexual and was spending time with a man 20 years older than him that was a known homosexual.

Carol made the appointment with the doctors which just happened to be in a town an hour and half a way, Joey cut his wrists.  He was carried to the emergency room where the doctor sent him to the only hospital that would take him sense he was a medicaid (All-Kids actually) patient.

Joey was only kept for 3 days and the doctors declared that nothing was wrong with him.  He was sent home. 

Fast forward a few weeks and he was acting odd again.  His mother wasn’t home for a few days but when she returned, he had been serious beaten up.  Joey wouldn’t tell his mother anything but indicated that the man he had been with that was much older was the one responsible. 

Carol called the man, he had proof that he wasn’t even in town that weekend.  So Carol set about trying to figure out who was responsible.  Joey continued to blame the older man and then put a guilt trip on Carol for believing someone besides him.

Mom tightened the ropes on the child’s freedom by not allowing him to drive her car and such.  He worked with his uncle some doing hard labor work and seemed to be getting along much better.  No one seem to catch him binging and purging and he wasn’t allowed any freedom to roam so the situation seemed to be somewhat in better control.

I just got notice that Joey once again slit his wrists and had to have 5 stitches on inside and 9 staples on the outside.  He is now in a  hospital in a different place and has been for the last 24 + hours. 

My question is this:  Why are doctor’s ignoring what Carol is telling them about Joey?  Why aren’t they taking action?  Can’t they see he is having problems?  Did he have to take this drastic measure in order to kept help?

I am interested to see if anyone has any suggestions.

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Continuing yesterday’s post about 15 factors that can influence your osteoporosis risk, I’d like to leave you with the rest of the list. Later I will address depression in the elderly in more depth!

7. fractured a bone as an adult - simple actions (stepping off the curb too hard) can lead to early fractures

8. calcium intake - if your calcium intake is chronically low, this is a problem; for adolescents it’s especially important to get enough to reach their genetic potential for peak bone mass

9. physical activity - weight bearing activity increases your bone mass, you can increase your bone mass with training. It takes a an increase in bone mass density of 3-5% to decrease your fracture rate by 20-30%, but a +/- 5% bone mass change is huge.

10. protein - there is a link here still being studied, but it has been shown before that an increase in protein shows there may be a loss of calcium in your urine.

11. alcohol & smoking – can decrease your bone mass

12. excess caffeine – caffeine in very high doses increases your calcium loss in urine

13. medication can weaken bones – steroids, anticonvulsants, synthetic thyroid hormones, and antidepressants

14. vitamin D – is absolutely necessary for calcium absorption. Sunlight will increase the manufacture of vitamin D in your body (10-15 minutes a day on face & arms WITHOUT sunscreen). Homebound people, persons over the age of 70, those living in the northern US/Canada and people who don’t eat enough dairy or vitamin D supplemented foods are recommended to supplement with tablets.

15. vitamin K – helps blood coagulate and is needed for the beginning of bone mineralization

I have elderly family members who deal with depression due in part to physical ailments. Today I’d like to address a big depression cause in elderly that not many people think about osteoporosis.

Osteoporosis is a disease of low bone mass characterized by weakened and porous bones that have an increased risk of fracture.

* peak bone mass is reached at about 30-years-old
* women lose about 30-50% of their bone mass while men lose 20-30%
* 1/6 of women will fracture a hip in their lifetime
* Most common fracture sites are wrist, hip & vertebrae
* 20% of individuals (mostly male) will die within a year from fracture related complications - a lot of this is due to becoming depressed once you’re unable to function at your previous ability. These 20% are oftentimes elderly suicide deaths.
* 60% of falls occur in the home

There are 15 factors that may effect your bone mass:
1. gender - women have a higher risk as men have stronger bones and more base bone mass overall

2. age - over the age of 65 your risk increases, bone loss is gradual but for women, it speeds up during menopause, the full effects are felt later in life, even though they begin early-on

3. early menopause (or long periods of ammenorrhea) - menopause depletes your stores of estrogen, without estrogen, osteoclasts (holes dug in your bones) are more active than the osteoblasts (refilling of those bone holes), testosterone decrease also effects men’s bone mass

4. frame size - thin, small-framed body generally means you have a lower peak bone mass

5. ethnicity - African Americans normally have a heavier skeleton therefore a higher peak bone mass, Caucasian & Asians have a lower bone density

6. family history - especially if it’s a mom/dad/sibling with history of fractures