Bulimia Nervosa at a Glance

“For me, the bulimia was about stuffing my emotions. So I stopped suppressing my feelings.” ~Cheryl James

My friend’s dad is a dentist; within the first minute of looking into someone’s mouth, he can tell if the person struggles with bulimia nervosa. This is because bulimia–the binging and purging of food–wreaks havoc on a person’s teeth. The acid from the stomach visibly destroys the enamel of the teeth and causes noticeable discoloration. But this particular side-effect of bulimia is only the tip of the iceberg among much more serious consequences that come from this eating disorder and mental illness. Continue reading to learn what it is, what causes it, as well as the symptoms, consequences, and recovery options for bulimia nervosa. 

Even though Derek Zoolander downplays the significance of bulimia nervosa, it is a very serious, potentially life-threatening eating disorder. People with bulimia secretly binge and then purge to get rid of extra calories in an unhealthy and unnatural way. Binging includes discretely eating a large amount of food, within a small amount of time, accompanied by a lack of control during this episode. Purging methods vary from regularly self-induced vomiting, misusing laxatives, weight-loss supplements, diuretics or even enemas after bingeing. Other ways include denying calories to prevent weight gain through fasting, strict dieting or excessive exercise.  The severity of bulimia is determined by the number of times a week that a person purges, usually at least once a week for at least three months. 

The exact cause of bulimia is unknown. Many factors could play a role in the development of eating disorders, including genetics, biology, emotional health, societal expectations and other issues.  Women are more likely to struggle with bulimia than men, but the latter are still susceptible. Bulimia typically begins in the late teens or early adulthood.

Bulimia shares several symptoms with other mental illnesses: Negative self-esteem, problems with relationships and social functioning, difficulty concentrating, poor sleep patterns, withdrawal from friends, etc. Symptoms specific to bulimia nervosa include extreme preoccupation with self-image, body shape and weight; fear of gaining weight; feeling uncomfortable eating around others; trying to “fill up” by ingesting unsubstantial food (ie. condiments), drinking excessive amounts of water or non-caloric beverages, or trying to chew food for an unnecessarily long amount of time; hoarding food in strange places; disappearing after eating (often to purge in a private place); frequently using mints, mouthwash and gum to cover unnaturally bad breath; and maintaining a rigid exercise regimen to “burn off” calories ingested. 

Bulimia nervosa affects far more than how an individual perceives him- or herself or what he/she eats. This eating disorder truly harms a person’s body in the following ways:

  • Unusual swelling of the cheeks or jaw area  
  • Calluses on the back of the hands and knuckles from self-induced vomiting 
  • Bloating from fluid retention  
  • Stomach cramps and other gastrointestinal issues (constipation, acid reflux, etc.) 
  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate) 
  • Dizziness 
  • Fainting/syncope 
  • Feeling cold all the time 
  • Dental problems like enamel erosion, cavities, and tooth sensitivity 
  • Dry skin 
  • Dry and brittle nails 
  • Swelling around salivary glands 
  • Thinning of hair on head, dry and brittle hair (lanugo) 
  • Muscle weakness 
  • Yellow skin (in context of eating large amounts of carrots) 
  • Cold, mottled hands and feet or swelling of feet 
  • Menstrual irregularities
  • Poor wound healing 
  • Impaired immune functioning
  • Dehydration (leading to kidney failure)
  • Heart problems, such as an irregular heartbeat or heart failure
  • Severe tooth decay and gum disease
  • Absent or irregular periods in females
  • Digestive problems
  • Anxiety, depression, personality disorders or bipolar disorder
  • Fertility issues (in women)

Many people with bulimia nervosa also struggle with co-occurring conditions, such as self-injury (cutting and other forms of self-harm without suicidal intention), substance abuse, impulsivity (risky sexual behaviors, shoplifting, etc.), and even diabulimia (intentional misuse of insulin for type 1 diabetes). 

While bulimia nervosa is a very serious mental illness, the good news is that it is not a life sentence. There are many options available for treatment, including medication, support groups and group therapy, and individual therapy. By identifying your triggers, I can help you manage stress and avoid the cycle of binging and purging. Getting support and help often gives you extra strength to fight your eating disorder.  Because bulimia is related to self-image–and not just about food–bulimia can be hard to overcome on your own. Effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications. Contact me today to get started.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Getting Up With the Sun: Morning Routines

Steve Jobs, the late CEO of Apple, started his days off asking himself, “If today was the last day of my life, would I be happy with what I’m about to do today?” Ensure that you are starting your day off on the right foot with a productive morning routine!

You snoozed through your alarm to work out, woke up late, had no clean underwear, got toothpaste on your shirt, grabbed a fast, non-nutritious bite to eat, and rushed into work. You meant to wake up early, hit the gym, have a protein-packed breakfast, and beat the boss into work, but–yet again–it did not happen. Does this sound all too familiar? If you feel you are stuck in a cycle of good intentions and consistently disappointing follow-throughs, this post is for you. By making a few tweaks and additions to your morning, you can be on your way to a happier, healthier life–one where you are in control.

Last month I posted about nightly routines and promised to follow-up with a post on morning routines. We all know that starting the day off on the right foot is actually quite indicative of how the rest of the day will go. A morning ritual or routine can consist of many activities; whatever you choose, consistency in those activities is the key to jumpstart your day!

The hardest part of starting a morning routine is just that, getting started–both literally and figuratively. Do you know where to start? What type of morning ritual do you want to have in place? What types of things do you want to do? I scoured the internet and read blog posts about all sorts of morning routines, and I found the following six suggestions to be the most recurring:

  • THE GYM. We all know someone who is slightly smug about the fact that he/she made it to the gym before the sun arose. While getting exercise in to start the day does come with various health benefits, there is an additional benefit we all could use:  Focus. A friend of mine who has dealt with ADHD her entire life recently told me she got through the most stressful job she ever had by waking at 5 a.m. to go to barre class. It calmed her down, helped her focus, and allowed her to wean off coffee–which, in turn, reduced her jitters. Hit the gym in the a.m., or simply get out for a walk. You will never regret it.
  • MEDITATION. I have written about the benefits of meditation. Though often used to slow down and relax (before bed, for instance), it can also be used to focus the mind and prepare oneself for productivity. Whether your meditation includes actual yoga and stretching, prayer, spiritual study or simple breathing exercises, being in tune with your psyche will start your day off on the right foot. Meditation lowers stress levels and boost productivity and creativity.
  • NUTRITION. This one will be different for all of us depending on preferences and allergies. Some may have oatmeal, chia pudding, a green smoothie, or maybe it will be eggs, toast and sausage. Give yourself nutrient-rich food and you will be sure to notice heightened energy levels. Fuel up in preparation for a productive day. Take a few extra minutes and pack some healthy snacks to take with you. And don’t forget the vitamins!
  • APPEARANCE. My dad always showers at night because he likes to go to bed clean; but then, he will shower in the morning as well. Showering in the morning wakes him up and helps him feel refreshed, awake, and ready for the day. Whatever you choose, be sure to make time to get yourself looking and feeling presentable. Shower/wash your face, brush your teeth, do any necessary ironing, coordinate your outfit and accessories, so that you can leave your house feeling good and confident.
  • GAMEPLAN. Many nightly routines include making a plan, schedule, to-do-list, etc. for the next day. The reason for that is to streamline that process in the morning. During your morning ritual, review that game plan for the day, add in any specifics, and prepare yourself for any responsibilities you may have. Plan what you will need to take with you when you leave the house, as well as anything you may need throughout the day. This may seem obvious, but taking the time to sit and plan this step will help you feel less like a chicken with its head cut off as you haphazardly grab things while rushing out the door!
  • PRODUCTIVITY. Get right to work. Instead of wasting time idly catching up on your Facebook or Instagram feed (which has been proven to decrease overall motivation and productivity when done at the start of the day), get to work. Start your morning routine immediately.  It will reduce your stress!

Here is an example of a morning routine:
5:30 AM: Wake up, put on gym clothes, contacts, drink 8 oz. ice cold water
5:40 AM: Hit the gym (M/W/F: Weights; Tu/Th: Interval Cardio; Sa/Su: Walk)
6:40 AM: Return home, eat protein shake, shower, brush teeth, get dressed, etc.
7:10 AM: 20 minutes of meditation/prayer/spiritual study
7:30 AM: Review goals and day’s schedule, prepare to leave
7:45: Leave for work

Remember, this is just an example. Your morning routine should work best for you and your lifestyle, and should incorporate your goals. I have covered the basic suggestions to fuel productivity and focus throughout the day.  While this post contains six of the most frequently occurring ideas on the internet, there are so many other options out there! Through my research in writing this blog, I found a neat website, My Morning Routine, where you can sign up to receive a brand new morning routine idea in your inbox every Wednesday. The key is finding what works best for you and implementing that into a pattern you can consistently and happily follow. Should you find yourself with questions or desiring additional help, please don’t hesitate to contact me or schedule a session. And be sure to tune in next month as I talk about ways you can use your morning and nightly routines to help you reach your New Year’s goals!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Measuring Your Success

Measuring Your Success - Cluff Counseling, Lewisville Marriage & Family Therapist - TypeLegendary basketball coach, John Wooden, says success is, “…peace of mind, which is a direct result of self-satisfaction in knowing you did your best to become the best you are capable of becoming.” Are you doing your best to reach your 2018 resolutions?

As April approaches (and with it my birthday!), I have been thinking about my goals for the year and how I am doing with them. How are your resolutions going? Do you remember what they are? Did you write them down to begin with? Maybe you have a list displayed on your bathroom mirror, and you are actively thinking about daily steps you can make to reach your lofty goals. Or maybe you fall into that ⅓ group who do not work on resolutions after the first month of the year. Either way, I am here to give encouragement, and provide some tips on how you can measure your progress.

Life is busy. We get so caught up in the daily grind of simple survival that we may overlook seemingly extraneous things–like wanting to pick up a paintbrush or get into an exercise regimen. How can we stay motivated to learn the skills we want to learn, accomplish what we want to accomplish, and ultimately become who we want to be? The answer is simple:

Baby steps each and every day.

I want this blog post to inspire/motivate/rekindle your desire to grow and improve this year. You set your resolutions for a reason! With your own persistence, consistency, and organization you can accomplish whatever you set your mind to. Let’s get started.

First, take a look at your resolutions. Yes, I list this as an actual step because many people have intangible goals floating around in their brain space. You must write them down! You need to be able to see your goals; there is something about the action of writing them out that makes you more accountable to yourself, solidifies your desire to learn new things, and helps you remember your goals (muscle memory, maybe?). So step one, if you have not already done so, write your goals down.

Next, break down goals into measurable steps. “Learn to play the guitar” is a wonderful goal in and of itself, but it is very broad and difficult to quantify. How will you know if you have mastered or even “learned” the guitar? I would like to introduce a simple method that will help you break goals down to actionable steps and give you baby steps for each and every day. This step is perhaps the most important phase of goal setting, for this is where you can set yourself up for success!

  • VISION. Begin with your overarching goal. Let’s say that “learn the guitar” is your vision.
  • GOALS. How will you accomplish your vision? (Notice that the following can all be checked off yes or no; they are quantifiable steps that are easy to measure!)
      • Have formal guitar lessons weekly from a qualified teacher or musician
      • Practice the guitar for at least 15 minutes daily
      • Master one song a month
      • Perform Christmas song at family Christmas party
  • ACTIONS. Now take each of your goals and break them down into smaller steps with set time frames to accomplish each by. (Yes, this takes time and organization. But this is truly what enables you to reach your goals!)
      • Have formal guitar lessons weekly from a qualified teacher or musician
        • Research local music schools; find pricing options (by end of work week)
        • Call Dad’s friend and ask about his rates + availability (Wednesday @ 7 p.m.)
        • Find, clean and tune Dad’s guitar (before first lesson)
      • Practice the guitar for at least 15 minutes daily
        • Nightly after dinner, 6:30-6:45 p.m.
      • Master one song a month (if we are just now redefining or re-dedicating ourselves to goals, start with April)
        • April: “Leaving on a Jet Plane” (Key Signature G)
        • May: “With or Without You” (Key D)
        • June: “Brown Eyed Girl” (Key G)
        • July: “Silent Night” (Key G)
      • Perform Christmas song at family Christmas party
        • Practice basic key signatures monthly
        • Begin practicing “Silent Night” in July
        • Perform for a friend or small audience prior to family party in December
  • ACCOUNTABILITY. Who will you be accountable to? If you have a roommate, partner, sibling, parent, friend or coworker you are close to, consider telling him/her about your goal. Ask him/her to occasionally (or frequently–whatever will help you most) ask you about your progress. Often, knowing someone else knows about your goal helps motivate you to keep going when you are tired, busy, or discouraged. In fact, partner up–play guitar together or hit that yoga class with a friend!

Lastly, REGULARLY review your resolutions. Set a time to remind yourself of your goals. I have long preferred to do this early each Monday–after my morning rituals (like exercising, eating, and getting ready for the day) and before beginning my professional/scholastic duties. Having a set time to go over your goals makes them more prominent in your mind, schedule, and priorities, and helps you to achieve ultimately them. Plus, if you fall off the horse one week, you can reevaluate how to get back in the saddle. If you find your goals to be too easy or too demanding, you can adjust them as necessary. Having a regular check-in with yourself will keep you progressing.

Winston Churchill once said that success is being relentless. If you want to be successful, be relentless in your pursuit to achieve your goals and to become the best version of yourself. Only you know if you are exerting your best effort to reach those goal or not; are you happy with your progress? Is there room for improvement? If you are not on track to reach your goals right now, sit down, write your goals out, and divide each into quantifiable, actionable steps. I can assure you that this is one surefire way to both measure your success and achieve your dreams. And, as always, I am here to help however I can. Contact me or schedule a session today.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The Beauty of Journaling

Cluff Counseling - The Beauty of JournalingSome of the most influential people in history kept detailed journals of their lives. Those journals are both a permanent record for posterity, as well as a cathartic release for the people writing them. Even if you don’t think you need either, keeping a journal has benefits you can enjoy immediately.

Imagine you had a friend you could share everything with–literally everything: when you feel frustrated or hurt by your partner, when you are stressed because of work, when you feel guilty after making a mistake or hurting someone else, or even just when you feel discouraged because of social media comparisons. Yes, you may have a friend, family member, or a partner in whom you can confide, but that person may not always be available and/or what you are facing may be too private, at times, to discuss with others. This is the beauty of journaling.

Journaling is powerful. It is an incredible tool that we can tap into when life is overwhelming, wonderful, or anything in between. When stressful events occur, writing through emotions and feelings has long been known to cause improvements in health and psychological well-being. This is because expressive writing reduces intrusive and avoidant thoughts about negative events and improves working memory. In addition to stress management, these enhancements free up our cognitive resources for other mental activities. There are so many positive benefits to journaling, but today I would like to focus on the following four:

  1. Journaling helps you organize. To do’s, goals, and dreams come out while journaling; it is all part of your stream of consciousness. Not only that, but if you are facing a problem in life, journaling can help you problem solve. A clear plan of action often surfaces when journaling, which is so helpful if you are feeling scattered, disorganized, or overwhelmed!
  2. Journaling clears your emotions. As you write freely in your journal, you will experience reduced feelings of scatteredness, increase focus and stability, release pent-up feelings and emotions, bridge outer events and inner thinking, and detach from the past. There is no greater way to be present in day-to-day life than to regularly clear your emotions and start with a clean slate. In fact, you can even reduce your stress by journaling!
  3. Journaling solidifies learning. I cannot tell you how many times I have read something I learned but had forgotten from my own journal. Writing down experiences and lessons learned reinforces them, and enables you to remember details you might not otherwise remember.
  4. Journaling leads to gratitude. No matter what mood you are in when you begin writing, journaling has the power to naturally steer you towards thankfulness–towards appreciating what you do have and strengths you do possess. When we pause to consider all the good in our life (and I recommend taking the time to write down your gratitude list), a cascading effect occurs and we inevitably realize we have more than we originally considered.

So how can you get started? There are infinite options! In the resources section below, I included one of my favorite possibilities, “The Five Minute Journal.” There are prompts divided into a morning section (to start your day off awesome), as well as a night section (to reflect on what happened throughout the day). Prompts include things like, “I am grateful for…,” “What would make today great..?” “Daily affirmations: I am…,” “3 amazing things that happened today,” and, “How could I have made today better…?” These prompts foster meaningful thought and do not take much time to answer.  A quick google search will render many additional ideas on how you can get started writing in your journal today.

There is great power in picking up a pen and writing freely in your journal for a few minutes every day. While some sources recommend writing for 20-30 minutes at least once day, I often tell my clients to start with what feels natural. If you want to write for five minutes at the start of your day, try it. If you prefer summarizing the day before going to bed, go for it! I recently started bullet journaling because it seemed easier than paragraphs; though many of my entries morph into traditional journaling format, I enjoy following what feels natural to me. Let your creativity run free and journal the way that feels most natural to you–that is how you will get the most out of it. If you have questions about journaling or would like to schedule a session, please do not hesitate to contact me or set up a session today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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