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06 December 2011

Bulimia in Men.

Bulimia is an eating disorder characterised by bingeing on large amounts of food followed by purging of the food by vomiting or the use of laxatives. For men with bulimia it is not uncommon to binge and purge as many as 10 or even more times a day. Repeated vomiting causes other complications such as sore throat, bad teeth and poor skin.

Unlike anorexia which inevitably leads to weight loss and the scrutiny of worried onlookers, bulimia can often be hidden well. In fact some of the men with bulimia are overweight.

Central to the experience of bulimia in men is low self-esteem. The repeated bingeing on food creates feelings of self disgust and shame which mirrors how the man feels about himself. For men, the fact that eating disorders are often presented as "woman's issue" just adds to the shame and guilt. Some straight sufferers are concerned about seeking help in case professionals think they are gay.

Why do men get bulimia? Well bulimia is most likely to occur in the teen years. These are painful and confusing times in any boy's life as hormones and social pressures mix to form, for many, intolerable emotional burdens. It is true that bulimia is more common in families that do not meet the boys emotional needs. It is also true that bulimia is more common in boys with high standards and a degree of perfectionism. But the more we find out about bulimia, like other mental health problems, it looks likely that there is a high genetic component to the illness.

Whatever the reasons for the disorder, if you are suffering from bulimia, or other forms of eating distress, you can expect to be treated sympathetically and with respect if you approach a professional for help. The excellent work by Sam Thomas of Men Get Eating Disorders Too has done much to raise the profile of eating distress in men throughout the health care system.

Treatment for bulimia should ideally be three pronged. The first is to bring the bingeing and purging under control. The second is to understand why bingeing and purging became the method the man used to cope with their emotional pain. The third is to teach new and more effective techniques for emotional regulation. There is a way out of bulimia, but you do need to ask for the help.

Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK. He offers:

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Posted by Dr Phil Tyson on 06 December 2011 at 04:07 PM in Eating Disorders | Permalink | Comments (0) | TrackBack (0)

28 November 2011

Anorexia in Men.

As we move into winter living, with the cold weather and dark nights upon us, for many of us our energies start to flag, and we look forward to the Christmas and New Year festivities. For some men, though, the festive season brings new challenges. With its emphasis on food and drink, men with eating disorders can feel particularly challenged. To mark this difficult time, I will focus my posts in the run-up to the New Year on eating disorders in men.

For many, "eating disorders" is synonymous with anorexia, but this is just one of several ways in which men experience eating distress. But what is anorexia in men?

The headline with anorexia is that the man restricts his intake of food to such an extent he becomes dangerously thin. When a man is this thin his brain is not sufficiently fuelled by nutrients, and this distorts his thinking further, and the illness can spiral out of control. If your body fat falls below 15% of your mass you are in the danger zone of anorexia. If you continue to restrict your intake of food, you may die.

Why do men get anorexia? The vulnerable time for men is in the teen years. It is during this period that we compare our physical capabilities and attractiveness with other boys. Not surprisingly, unlike girls, where our anorexia is motivated by the fear of fat, anorexia in men is often motivated by a desire to build a better physique. Anorexia in men is often associated with excessive exercise.

Trends in the media represent male beauty as involving a flat stomach with rippling abdominal muscles. For most men abdominal muscles are not visible until our body fat is at or below 14%. This is a dangerously low level to maintain our body fat. In fact professional models often "strip down" their body fat before a photo shoot and then allow it to creep up again after the shoot.

Representations of male beauty and what it means to be a man is only part of the story. For many men, they already have low self-worth before they started dieting and exercising excessively. In this sense anorexia might be a symptom of more complex underlying problems around feeling valued by family and friends. A proportion of anorexic men have had experiences of being bullied early in childhood for being overweight.

For many men with anorexia, their emotional world is extremely painful. Anorexia, if anything, is a way of coping with that pain. In a dark emotional world, sometimes controlling your weight is the only control you feel you have left.

For further information and support check out the Men Get Eating Disorders Too website.

Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK. He offers:

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Posted by Dr Phil Tyson on 28 November 2011 at 08:36 PM in Eating Disorders, Mental Health | Permalink | Comments (0) | TrackBack (0)

02 November 2011

New Hope for Treatment Resistant Depression.

Depression can affect anyone. Unfortunately once you’ve had one bought of depression, you are more likely to have a second. Quickly your condition can become chronic. Although standard psychological and medical methods can help most people with chronic depression, there is a hard core of people who are ‘treatment resistant’. Whatever we do simply doesn’t seem to work. As many as 30% of chronic depression cases fall into this category.

Exciting new research by Professor Thomas Lynch of Southampton University and his collaborators promises to offer insight into the world of people with chronic treatment resistant depression, and possibly offer a solution.

What Professor Lynch has found is that many people with treatment resistant depression are emotionally over controlled. Emotional control is best seen as a continuum. At one end are people who are not very good at controlling their emotions. They are life’s ‘drama queens’, and have learnt that they are more likely to get what they want if they escalating their emotion. At the other end of the spectrum are people who are extremely good at regulating their emotion, in fact they are so good at it hardly anything slips through. They are lifes cool guys, and have learnt that they are more likely to get what they want if they withhold their emotional expression.

Of course being able to control one’s emotion in many situations is a good thing. What Professor Lynch and colleagues have found, however, is that if you withhold too much emotion, this creates mistrust in other people. Basically if you don’t show an appropriate socially acceptable amount of emotion, other people don’t like you. And this is the problem for many treatment resistant depression patients. They are so good at regulating their emotional expression they do it inappropriately. This makes them unpopular. As a consequence of this they become socially withdrawn. Of course if you do not connect effectively with people you can become vulnerable to depression.

Professor Lynch’s approach to treatment resistant depression is therefore quite radical. He does not treat depression as the primary problem. Rather his treatment strategy is to target emotional over control itself. By helping patients to communicate their emotions more appropriately, this enables them to get closer to other people; they become more popular, and as a consequence, social isolation and the vulnerability to depression decrease.

Does it work? Well preliminary findings suggest this approach may well be effective in helping patients with treatment resistant depression. The findings have been so good in fact it has led to a full scale clinical trial over the next five years. The project is called REFRAMED. If you feel this approach might be appropriate for you, you don’t have to wait until these results become available. Professor Lynch is starting to roll out his ideas to other therapists. You might not be able to get on the clinical trial, but you could well be able to access something very similar.

Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK. He offers:

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Posted by Dr Phil Tyson on 02 November 2011 at 05:34 PM in Academic, Depression, Mental Health, Psychology | Permalink | Comments (0) | TrackBack (0)

20 September 2011

Book Review: Buddha’s Brain by Rick Hanson and Richard Mendius.

If you are like me, you will be pretty suspicious of anything that sounds a bit cranky. Primal scream therapy, rebirthing and neuro linguistic programming all fall into that camp for me. But what about meditation?

Over the last decade what is interesting has been the way evidence-based therapies have taken meditation on board. It is as if no self-respecting new treatment approach can afford to ignore it. There is good reason for this; the evidence shows meditation is really helpful in conditions as diverse as borderline personality disorder to depression, and anxiety to chronic pain.

What most of these treatment approaches do, of course, is separate meditation from its Buddhist cultural heritage. It is as if by dropping the ‘religion’, it makes meditation more palatable to the Western practitioner/client. Although this is understandable, in a way it's a shame. Buddhism's raison d'être is the alleviation of human suffering, and has developed sophisticated psychological models of how to do just that.

What is great about this book is that Hanson and Mendius don't drop the Buddhist heritage of meditation. Neither do they drop the scientific method. In fact Hanson and Mendius are deeply immersed in brain science, Rick Hanson as a neuropsychologist, and Richard Mendius as a neurologist. They draw on their scientific understanding of the brain to integrate Western science with Buddhist psychology.

This book isn't a hard read though. The authors skilfully explain the intricate workings of the brain in straightforward language. If you are interested in the relationship between brain science and Buddhism and meditation, but don't want something too taxing, this is the primer for you.

Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK. He offers: