Viewing blog posts tagged with "Anxiety"

Tolerating our own children’s distress

posted by Julie O'Toole on October 20, 2016 at 8:32am

This post was originally published on November 13, 2013.

Until I lived in the world of therapists and mental health professionals as part of the Kartini multidisciplinary team treating children with eating disorders, I had never actually heard the phrase “tolerating distress”, particularly as it pertained to parents.  Like most parents, I have a very difficult time tolerating pain in my own children, either physical or emotional and, when put in that situation, I immediately get…

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Very Early Onset Anorexia Nervosa

posted by Julie O'Toole on April 3, 2015 at 3:20pm

For the purposes of this discussion I am somewhat arbitrarily defining “very early onset” as 12 years and younger.  Despite what you might think, this is not synonymous with “pre-pubertal onset” as Caucasian girls on average begin breast development - and the hormonal changes associated with this - at about 10 ½ years of age. Boys on average begin to go through pubertal changes about two years later.  And for girls and boys of African and Hispanic heritage average ages for these…

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The Promise of Personalized Medicine

posted by Julie O'Toole on September 3, 2014 at 8:15pm

Advances in medicine come in all shapes and sizes: vaccines, antibiotics, anti-virals, immune system boosters and reducers, technological changes and recently, the hope that faster, cheaper and more accurate genetic analysis can bring us the new approach to medicine and medications: personalized medicine.

As I have mentioned in a previous blog, a leading proponent of personalized medicine has been Dr Eric Topol, editor-in-chief of Medscape and director the Scripps Translational…

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Intranasal Treatment for Anxiety

posted by Julie O'Toole on July 3, 2014 at 1:36am

Providers are finally beginning to dip our toes in the waters which have flowed from the realization that psychiatric and psychological disorders are brain disorders.  Case in point: social anxiety.

I don’t know whether we see quite a few eating disordered patients with social anxiety because these diagnoses frequently run together or because social anxiety is so prevalent in the general population, but we do.

And now comes an article by Michael Liebowitz and colleagues from Columbia…

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Mixed Symptoms

posted by Julie O'Toole on April 2, 2014 at 9:10pm

Recently I was making our daily rounds at Randall Children’s Hospital and received a lesson from a very young patient of ours.  I say it over and over: “your patients are your teachers”, and it is really true.  I was first told this by Dr. Mizuo Tottori, pediatrician and mentor to many other pediatricians in Hawaii. And life itself has borne out the truth of it, again and again.

This particular little patient has anorexia nervosa and has done very well.  Her parents are competent and…

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Weight Restoration 2.0

posted by Julie O'Toole on February 20, 2014 at 2:59am

At Kartini Clinic we have been embarking on something we call “weight restoration 2.0”.  In other words we are trying to move beyond mere weight restoration (as critical as that is) towards a deeper assessment of each patient’s full physical recovery.  We have noticed, over the years of faithfully weight restoring each and every patient, that people respond differently to recovery from starvation, depending no doubt on their genetics and on the duration of their illness. Just one…

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Appeasing The Monster

posted by Julie O'Toole on December 18, 2013 at 11:55pm

Some blog topics draw in a continuous trickle of commentary long after they've been published.  One such blog is entitled “Determining Ideal Body Weight”. And little wonder.

 

The other day I answered a comment by a young reader named Charlotte. It started me thinking how urgent her question might be for others who may not have read the original blog (or at least not for some time).  Charlotte wrote:

"I am an 18 year old female with a history of initially EDNOS and then AN B/P…

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Relapse in Patients with Anorexia Nervosa

posted by Julie O'Toole on May 18, 2010 at 11:03pm

I am occasionally asked whether or not anorexia nervosa is a chronic illness.  As far as I am concerned, anorexia nervosa is a chronic illness of remission and exacerbation, which is a medical way of saying an illness that often returns after a period of stability.  Anorexia can be gotten into good remission, which may last many years, but it can flare up with a recurrence of symptoms during times of stress, life change or for no apparent reason.  We call this relapse.

As with the…

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