HELP FOR PARENTS WITH STRONG-WILLED, OUT-OF-CONTROL CHILDREN AND ADOLESCENTS

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Adolescent Athletes & Performance-Enhancing Drugs/Supplements

If you're the mother or father of an adolescent athlete, your life is probably as busy as your son's or daughter’s. It's important, however, to make time to talk to your adolescent about the dangers of performance-enhancing drugs and supplements. By setting rules and consequences and explaining the possible health effects of drug use, you can help your adolescent steer clear of performance-enhancing drugs and supplements.

For adolescents, the most common performance-enhancing drugs and supplements include the following:
  • Steroid precursors, such as androstenedione ("andro") and dehydroepiandrosterone (DHEA), are substances that the body converts into anabolic steroids. They're used to increase muscle mass. Most steroid precursors are illegal without a prescription. DHEA, however, is still available in over-the-counter preparations. Side effects of steroid precursors are similar to those for steroids.
  • Creatine is a naturally occurring compound in the body that's also sold as an over-the-counter supplement. It's primarily used to enhance recovery after a workout and increase muscle mass and strength. Creatine is popular with athletes who participate in football, gymnastics, hockey and wrestling. Side effects include weight gain, nausea, muscle cramps and kidney damage. 
  • Anabolic steroids are synthetic versions of the hormone testosterone, used to build muscle and increase strength. They're popular with football players and weightlifters. Use of anabolic steroids can cause heart and liver damage, can halt bone growth, and can result in a permanently short stature.

Some adolescents experiment with performance-enhancing drugs as a way to cope with insecurities, difficulties fitting in with a peer group, or a desire for independence. Others may be influenced by societal pressure to win at all costs.

Common risk factors for adolescent use of performance-enhancing drugs and supplements include:
  • Pressure from moms and dads or peers regarding weight or muscles
  • Being male (males are more likely to use performance-enhancing drugs and supplements than are females)
  • Negative body image or a tendency to compare one's appearance with others
  • Desire to gain muscle mass or strength

You can take various steps to prevent your adolescent from using performance-enhancing drugs and supplements or supplements. For example:
  1. Monitor your adolescent's purchases. Check the ingredients of any over-the-counter products your adolescent uses. Watch for performance-enhancing drug paraphernalia, (e.g., vials, re-sealable plastic bags, hypodermic needles, etc.).
  2. Get involved. Attend games and practices. Encourage your adolescent's coaches, school and sports organizations to discourage the use of performance-enhancing drugs and supplements. Reassure your adolescent of your love and support, regardless of his or her competitive performance.
  3. Discuss ethics and proper training. Remind your adolescent that using a performance-enhancing drug is similar to cheating and, more importantly, could lead to serious health problems. Explain that a healthy diet and rigorous training are the true keys to athletic performance.
  4. Be clear about your expectations. Tell your adolescent that you expect him or her to avoid performance-enhancing drugs and supplements. Set rules and explain the consequences of breaking them (e.g., if your adolescent uses performance-enhancing drugs and supplements, he or she has to quit the team).

Warning signs of performance-enhancing drug use:
  • Needle marks in the buttocks or thighs
  • Increased acne and facial bloating
  • Enlarged breasts in males or smaller breasts in females
  • Changes in body build (e.g., muscle growth, rapid weight gain, development of the upper body)
  • Behavioral, emotional or psychological changes (e.g., increased aggressiveness)

If you suspect that your adolescent is using performance-enhancing drugs or supplements, talk to him or her. Encourage your adolescent to be honest with you. If your adolescent admits to using performance-enhancing drugs or supplements, encourage him or her to stop immediately and offer a reminder of the health risks. Make an appointment for your adolescent to see his or her doctor for a medical evaluation and counseling. Consider informing your adolescent's coach, so he or she is aware of the problem. In addition, be sure to tell your adolescent that you're disappointed and enforce the consequences that you've established (e.g., quitting the team). Most importantly, emphasize the healthy alternatives to achieving his or her goals.

My Out-of-Control Teen: Help for Parents

Preventing Alcohol Abuse in Teens

Adolescents are particularly vulnerable to alcohol use. The physical changes of puberty might make your adolescent feel self-conscious and more likely to take risks to fit in or please others. Also, your adolescent might have trouble understanding that his actions can have adverse consequences. Common risk factors for underage drinking include:
  • History of behavior problems or mental health conditions
  • Family problems (e.g., marital conflict, parental alcohol abuse, etc.)
  • Increased stress at home or school
  • Transitions (e.g., the move from middle school to high school, getting a driver's license, etc.)

Whatever causes an adolescent to drink, the consequences may be the same. For example, underage drinking can lead to:
  • Stunted development: Research shows that alcohol use may permanently distort an adolescent's emotional and intellectual development.
  • Sexual activity: Adolescents that drink tend to become sexually active earlier and have sex more often than do adolescents who don't drink. Adolescents that drink are also more likely to have unprotected sex than are adolescents who don't drink.
  • School problems: Adolescents that drink tend to have more academic and conduct problems than do adolescents who don't drink. Also, drinking can lead to temporary or permanent suspension from sports and other extracurricular activities.
  • Being a victim of violent crime: Alcohol-related crimes can include rape, assault and robbery.
  • Alcohol-related fatalities: Alcohol-related accidents are a leading cause of adolescent deaths. Drowning, suicides and murders also have been linked with alcohol use.
  • Alcoholism: Individuals who begin drinking as adolescents are more likely to develop alcohol dependence than are those who wait until they're grown-ups to drink.

To increase your odds of having a meaningful discussion about alcohol abuse, choose a time when you and your adolescent are relaxed. Don't worry about covering everything at once. If you talk often, you might have a greater impact on your adolescent than if you have only a single discussion.  When you talk about underage drinking, you might include the following:

1. Ask your adolescent's views. Find out what your adolescent knows and thinks about alcohol.

2. Be prepared to discuss your own drinking. Your adolescent might ask if you drank alcohol when you were underage. If you chose not to drink, explain why. If you chose to drink, you might share an example of a negative consequence of your drinking. If you drink today, be prepared to talk about why social drinking is OK for you and not for your adolescent.

3. Debunk myths. Adolescents often think that drinking makes them popular or happy. Explain that alcohol can make you feel "high" but it's a depressant that also can cause sadness and anger.

4. Develop a strong relationship with your adolescent. Your support will help your adolescent build the self-esteem she needs to stand up to peer pressure and live up to your expectations.

5. Discuss reasons not to drink alcohol. Avoid scare tactics. Instead, explain the risks and appeal to your adolescent's self-respect. If you have a family history of alcoholism or drinking problems, be honest with your adolescent. Strongly discourage your adolescent from trying alcohol — even as an grown-up — since there's a considerable chance that your adolescent could develop an alcohol problem, too.

6. Encourage healthy friendships. If your adolescent's friends drink alcohol, he is more likely to drink, too. Get to know your adolescent's friends and their moms and dads.

7. Establish rules and consequences. Rules might include no underage drinking, leaving parties where alcohol is served, and not riding in a car with a driver who's been drinking. Agree on the consequences of breaking the rules ahead of time, and enforce them consistently.

8. Watch for signs of alcohol drinking and issue immediate consequences. If you suspect that your adolescent has been drinking (e.g., you've noticed mood changes or behavior problems, your adolescent has red or glazed eyes or unusual health complaints), then talk to her. Enforce the consequences you've established so that your adolescent understands that using alcohol will always result in a loss of privileges.

9. Know your adolescent's activities. Pay attention to your adolescent's plans and whereabouts. Encourage participation in supervised after-school and weekend activities.

10. Plan ways to handle peer pressure. Brainstorm with your adolescent about how to respond to offers of alcohol. It might be as simple as saying, "No thanks" or "Do you have any Mountain Dew?"

11. Set an example. If you drink, do so only in moderation and explain to your adolescent why it's OK for grown-ups to drink responsibly. Describe the rules you follow (e.g., not drinking and driving). Don't serve alcohol to anyone who's underage.

12. Share facts. Explain that alcohol is a powerful drug that slows the body and mind, and that anyone can develop an alcohol problem — even an adolescent without risk factors for alcohol abuse.

If you think your adolescent might have a drinking problem, contact the doctor or a counselor who specializes in alcohol problems. Adolescents that have alcohol problems aren't likely to realize it or seek help on their own.

My Out-of-Control Teen: Help for Parents

Eating Disorders: Tips to Help Your Teenage Daughter

Eating disorders can take a devastating toll on teenagers — especially females. To help your teenage daughter, learn the possible causes of eating disorders and know how to talk to her about healthy eating habits.

The exact cause of eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge-eating disorder) is unknown. However, various factors might put adolescent girls at risk of developing eating disorders. For example:
  • Favorite activities. Participation in activities that value leanness (e.g., wrestling, running, ballet) can increase the risk of teenage eating disorders.
  • Low self-esteem. Teenagers that have low self-esteem might use their eating habits or weight loss to achieve a sense of stability or control.
  • Personal factors. Genetics or biological factors might make some teenage girls more likely to develop eating disorders. Personality traits such as perfectionism, anxiety or rigidity might also play a role.
  • Societal pressure. Modern Western culture tends to place a premium on being physically attractive and having a slim body. Even with a normal body weight, teenagers can easily develop the perception that they're fat. This can trigger an obsession with losing weight, dieting and being thin — especially for females.

At first, teenage eating disorders can cause signs and symptoms such as:
  • Constipation
  • Difficulty concentrating
  • Dizziness 
  • Fatigue 
  • Menstrual irregularities
  • Irritability
  • Trouble sleeping
  • Weakness

Eventually, teenage eating disorders can cause more-serious or even life-threatening health problems, including:
  • Anemia
  • Bone loss
  • Delayed growth and development
  • Depression
  • Digestive problems
  • Heart problems
  • Muscle wasting
  • Seizures 
  • Suicidal thoughts or behavior 
  • Thinning hair 
  • Tooth decay

To help prevent teenage eating disorders, talk to your daughter about eating habits and body image. It might not be easy, but it's important. To get started, try these parenting tips:

1. Use food for nourishment — not as a reward or consequence. Resist the temptation to offer food as a bribe. Similarly, don't take away food as a punishment.

2. Share the dangers of dieting and emotional eating. Explain that dieting can compromise your daughter’s nutrition, growth and health, as well as lead to the development of binge-eating over time. Remind her that eating or controlling her diet isn't a healthy way to cope with emotions. Instead, encourage her to talk to loved ones, friends or a counselor about problems she might be facing.

3. Schedule a medical checkup for your teenager. The doctor can assess your teen's risk of an eating disorder, as well as order urine tests, blood tests or other tests to detect complications. Your daughter's doctor can reinforce the messages you're giving her at home, as well as help identify early signs of an eating disorder. For example, the doctor can look for unusual changes in your daughter’s body mass index or weight percentiles during routine medical appointments. The doctor can talk to her about her eating habits, exercise routine, and body image. If necessary, the doctor can refer your child to a mental health provider.

4. Remember the importance of setting a good example yourself. If you're constantly dieting, using food to cope with your emotions or talking about losing weight, you might have a hard time encouraging your teenage daughter to eat a healthy diet or feel satisfied with her appearance. Instead, make conscious choices about your lifestyle and take pride in your body.

5. Promote a healthy body image. Talk to your child about her self-image and offer reassurance that healthy body shapes vary. Don't allow hurtful nicknames or jokes based on a person's physical characteristics. Avoid making comments about another person based on weight or body shape.

6. If your teenager is diagnosed with an eating disorder, treatment will likely involve a type of family therapy that helps you work with daughter to improve her eating habits, reach a healthy weight, and manage other symptoms. Sometimes medication is prescribed to treat accompanying mental health conditions (e.g., depression, anxiety, obsessive-compulsive disorder, etc.). In severe cases, hospitalization might be needed.

7. If you suspect that your teenage daughter has an eating disorder (e.g., you've noticed baggy clothes to hide weight loss, or perhaps excessive exercise, or reluctance to eat meals with the family), then start the conversation about body image. Encourage your adolescent to open up about her problems and concerns.

8. Foster self-esteem. Respect your daughter’s accomplishments, and support her goals. Listen when she speaks. Look for positive qualities (e.g., curiosity, generosity, sense of humor, etc.). Remind your adolescent that your love and acceptance is unconditional — not based on her weight or appearance.

9. Encourage reasonable eating habits. Talk to your teenage daughter about how diet can affect her health, appearance and energy level. Encourage her to eat when she is hungry. Make a habit of eating together as a family.

10. Discuss media messages. Television programs, movies, websites and other media might send your teenager the message that only a certain body type is acceptable. Encourage your child to talk about and question what she has seen or heard — especially from websites or other sources that promote anorexia as a lifestyle choice, rather than an eating disorder.

My Out-of-Control Teen: Help for Parents

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