Selective focus loneliness young asian woman sitting on bedroom floor near the balcony.
Depression sadness breaking up asian teenage girl sitting alone hugging knees closing eyes and thinking.
(CNN) --
Like many girls in high school, Ella (not her real name) had days when she struggled with self-esteem issues.
"I was able to cope because I had sports, I had friends and I had school. Then the pandemic came in March (2020) and I lost all of that," said Ella, who looks younger than her 15 years.
"I wanted to do something proactive to help me cope, so I turned to exercise. I ran almost every day. I would go for a bike ride and walk for an hour."
Ella's mother, Alice (also not her real name), also a runner, was pleased to see her daughter adopting such healthy habits during the dreary months of lockdown in her hometown of Ottawa, Canada.
But it wasn't long before she noticed that if Ella wasn't exercising, she seemed nervous and tense.
Eating disorders: what are they, who do they affect and how to seek help?
"I couldn't sit down. I couldn't enjoy things like watching a movie anymore because I felt like I needed to be active all the time," Alice said.
advertising
"I couldn't stop. I don't know why. I just couldn't," Ella said.
"One point, I didn't even like the exercise. I felt like I had to do it."
She said her need to exercise intensified.
In June 2020, she told her mother that she was losing weight.
"It was almost like it was controlled by an alien," Alice said.
"At one point she was fine, but if you tried to get her to eat or stop exercising, you could see in her eyes that she would get very intense."
"I wasn't talking to Ella anymore. I was talking to this alien, or whatever."
Alice's growing concern turned to fear.
She and her husband began looking for a dietitian, counseling, or any type of support service.
"It took us months to be able to access those services at that stage of the pandemic."
A growing problem
Across town at the Children's Hospital of Eastern Ontario, Dr. Mark Norris was busier than ever.
As a specialist in pediatric eating disorders, Norris was used to being called into the emergency room to evaluate a young patient.
Earlier in the summer, "I got called into the ER more than ever in my career," Norris said.
Requests for urgent consultations from concerned parents have also skyrocketed, she said.
The surge in demand for services began "almost immediately" after the lockdown was relaxed in June, he said, and his team "soon had more patients in hospital than they had ever witnessed."
How to fight depression?
Experts explain treatments and options
Eating disorders are often triggered or exacerbated by stress, so like many specialists, Norris was concerned that the upheaval caused by the pandemic would lead to a relapse in young people (and adults) who were recovering from eating disorders. acquaintances.
While that happened, Norris said he was surprised to find that many of the young people who showed up at his ER had never shown any prior signs of an eating disorder.
She was part of a team that evaluated 48 teens in mid-2020 about their experiences with an eating disorder.
When asked what they thought triggered their illness, 40% of children blamed the effects of the pandemic, Norris said.
There were also other surprising findings.
"Especially in the first six months of the pandemic, we noticed that patients were presenting at lower weights than we were used to seeing on a regular basis before the pandemic, and that these patients were getting sick very quickly," Norris said.
"Our data suggested that in addition to lower weight, patients also reported higher levels of impairment and were more likely to require hospitalization for medical reasons."
Norris and his team would later publish these results in the June 2021 medical journal of eating disorders.
Consultations at other pediatric hospitals in Canada and the US found a similar increase in young people evaluated and hospitalized for eating disorders during the summer and fall of 2020. He was approached by a family doctor, Norris, Dr. David Little, who worked as a clinical informatician at the Epic Health Research Network, which produces electronic medical records.
"Dr. Norris suggested that we look at data from the EPIC database, which has more than 100 million patients in the US," said Little, a family physician in Verona, Wisconsin.
"Across 80 hospitals, we found a 25% increase in admissions for eating disorders after the start of the pandemic in March (2020) compared to pre-pandemic trends," Little said.
The increase was even more pronounced when looking specifically at girls: 30%, Little said.
"What's really interesting is that when we look at other mental health diagnoses -- anxiety, depression, and even suicide attempts -- we see slight increases. But nothing as dramatic as the 30% increase in adolescent girls hospitalized for anorexia and other eating disorders." .
Statistics show that calls to youth and adult eating disorder hotlines have skyrocketed during the pandemic.
Chelsea Kronengold, associate director of communications for the National Eating Disorders Association, said the association's helpline has seen "a 107% increase in contacts since the start of the Covid-19 pandemic."
"Despite two years having passed since the pandemic, our helpline volume continues to increase," Kronengold told CNN by email.
Based on contacts of people who revealed his age, he said the majority of people seeking help in 2021 were between the ages of 13 and 24.
It's not the kid's fault
After scheduling delays, Ella was finally evaluated in September 2020. But according to her mother, that specialist deemed her weight loss "borderline" and decided the family would have regular blood tests and other checkups. vital until a bed in the eating disorders unit became available.
"I was running half marathons by myself by now," Alice said.
"She was out of control. I didn't know how to keep her in the house. I was riding my bike next to her terrified that something was going to happen, that she wouldn't have enough energy to do it."
Weight alone is an imperfect criteria for treatment, experts say, but there was a required threshold before Ella could be considered for inpatient services.
Months passed without Ella meeting that criteria, and finally in January "it was our family doctor who said, 'You have to go to the ER.' We went in that morning, and after a couple of hours Ella was admitted," Alice said.
"They said her blood work was unreliable and her vitals were in a sticky spot. And I remember feeling tremendous guilt about the whole thing, you know, like, 'How could I let this happen?'" she said.
"But we were told that (Ella) is basically being controlled by a disease right now," Alice continued.
"She's not herself. You're talking to someone who can't process information the way she used to."
The inpatient eating disorders unit at Children's Hospital of Eastern Ontario.
Norris was Ella's doctor.
He told his family to externalize the illness, to view the eating disorder as an external entity or "aggressor" threatening their daughter: "It's an illness, not something wrong with the child, and it's certainly not the child's fault. little boy".
With children and teens, he explained, this "bully" will want to be in control.
"He will try to isolate the minor, he will try to limit support that the eating disorder may find threatening," he said.
"So the eating disorder goes under the radar, so to speak, because the individual has found ways that they can have some of these symptoms and not alarm the caregiver at home."
"Although there may be a part of your brain that definitely recognizes that it needs help, there is another part that may not be interested in getting help or may not see the need for help," Norris said.
"My job is to help the child understand that while certainly a lot of their brain feels like the eating disorder is there to help them, it really isn't."
Today, Ella says she is doing well, finishing her senior year of high school and looking forward to college.
She remains an outpatient for Dr. Norris and his team.
"Dr. Norris assured me that full recovery is possible, but it may take time," Ella said.
"We keep a week-by-week summary of all my improvements, and looking back, I definitely feel like I've come a long way. But there's still a way to go."
pandemic stress
Eating disorders typically arise when internal distress increases, Norris explained.
While there is no single cause, experts say food insecurity, childhood trauma and abuse, gender role concerns and stressful life events can contribute.
Recent research indicates that genetics may also play a role.
Now, it appears that the fallout from covid-19 may be a prominent example of such stress.
"The evidence that is emerging would suggest that the pandemic itself is acting as a significant trigger," Norris said.
During the pandemic, children often turn to other activities that increase their vulnerability and susceptibility to eating disorders, he said.
"A lot of what we hear from young people talks about social isolation or, if you will, social malnutrition."
Number of people around the world who reported anxiety and depression increased by more than a quarter during the covid-19 pandemic
That includes engaging in more solitary activities, "such as exercising alone rather than group activities," Norris explained.
"For others, it's spending more time online, visiting websites and looking at social media that might not be in their overall development interests."
An overwhelming demand for services likely means cases like Ella's aren't being handled as quickly as needed, a fact that worries specialists like Norris.
"It's important to try to get to patients as quickly as possible, because the longer an eating disorder stays, the more difficult it is to treat," Norris said.
"Awareness is the number one message," Little said, "not just for health professionals, but also for families, parents, children, school systems and the community at large. Because by the time these kids have access to health care, they're pretty sick.
There's yet another problem: Most of the inpatients at Norris Hospital were hospitalized for anorexia nervosa, a type of eating disorder that manifests as an intense fear of weight gain due to distorted body image.
Many people suffer such extreme weight loss that they become medically critical, often getting available inpatient beds, Norris said.
However, there are many other types of eating disorders, including bulimia, in which people overeat and then purge, which may not be getting the expert help they need, she said.
"It's really challenging. Even though we know a lot of people are suffering, there are only a limited number of providers with the expertise to treat an eating disorder," Norris said.
"Clearly, we do our best for those who need to be admitted in those life-threatening conditions, but for every patient who is admitted to the hospital, there are a number of patients who are not."
Where to find help
Most countries have official help lines for those suffering from eating disorders and there are also associations that deal with these problems.
United States
National Association of Eating Disorders: https://www.nationaleatingdisorders.org
Telephone: 1-800-931-2237.
They also have a confidential help chat.
You can also call 911 or the National Suicide Prevention Lifeline: 1-800-273-8255 in Spanish;
1-888-628-9454 in English.
Argentina
Association for the Fight against Bulimia and Anorexia (ALUBA) is a non-profit association that has been a leader in the treatment of eating disorders for more than 25 years.
It has a toll-free line (0-800-22-25822) and can also be contacted online.
http://www.aluba.org.ar/contacto
Colombia
The Colombian Family Welfare Institute provides information on the disease.
It has a free line that is open 24 hours a day, 365 days a year (018000 91 80 80).
In addition, the Colombian government enabled line 192 that provides professional assistance and guidance.
Mexico
The Mexican Institute of Social Security has a free line (800 623 2323), from 8:00 a.m. to 8:00 p.m., Monday through Friday, and from 8:00 a.m. to 2:00 p.m., on Saturdays, Sundays, and holidays.
In addition, they have attention through a chat, an email and social networks.
www.imss.gob.mx/contacto
Suicide help lines in Spain and Latin America
ARGENTINA
Suicide prevention hotline – online suicide help
PHONE: (54-11) 5275-1135 or 135 from Buenos Aires and GBA
Let's talk about everything
E-mail: contacto@hablemosdetodo.gob.ar
BOLIVIA
Phone of Hope
La Paz: 2248486
BRAZIL
Centro de Valorização da Vida, CVV
Telephone: 188
Chat: (help by chat)
E-mail: atendimento@cvv.org.br
CHILE
Telephone of hope
Telephone: 005642221200
Everything improves, help by email or chat
COLOMBIA
Telephone of Hope
Barranquilla: (00 57 5) 372 27 27
Bogotá: (57-1) 323 24 25
Medellín: (00 57 4) 284 66 00
San Juan de Pasto: 3016326701
COSTA RICA
Telephone of hope
E-mail: telefonodelaesperanzacr@gmail.com
ECUADOR
Hope Telephone
Quito: (593) 2 6000477 - 2923327
SPAIN
Telephone of hope: 717 003 717
HONDURAS
Phone of Hope
San Pedro Sula: (00 504) 2558 08 08
MEXICO
Hispano-American Institute of Suicidology, AC
Phone: +5255 46313300
Email: info@suicidologia.com.mx
PERU
Sentido (Peruvian Center for Suicidology and Suicide Prevention)
Telephone: 01 498 2711 Lima
Hope Telephone
: (00 51 1) 273 8026
PUERTO RICO
PAS Line (First Psychosocial Aid)
Telephone: 1-800-981-0023
URUGUAY
Last resort
Telephone: 0800-Vive (8483)
VENEZUELA
Phone of Hope
Valencia: 0241-8433308
National: 0-800-PSIQUE
coronaviruspandemic impactEating Disorder
