January 2022

I’ve been with Catholic Charities ND for two months now, and I know that AASK staff speak with families that are just beginning to research adoption almost every week. Many of these families ask questions about current programs and process, length of wait for placement. But what about the questions about the future or what happens “after” the adoption?

Why is it important for families to ask their agency’s role after the adoption? Parenting is difficult in the best of circumstances, but there can be additional struggles with parenting children with hard beginnings. Children who have spent time in a foster home or have experienced trauma and neglect may require additional care from their parents. I encourage families to ask a different but still important question: “Who is going to be there for me after adoption?”

Families often dream of their adoption ending in a “and they lived happily ever after” scenario.  Parents often feel the adoption journey is the difficult part and once they bring home their child, all will be well. Parenting a child who has experienced trauma may take parenting skills and services that families weren’t aware of or prepared for. This is why post-adoption support is imperative!

Many children who join their families through foster care adoption may have deep wounds, and may behave in ways that don’t respond to typical parenting efforts. Which is why we at ND Post Adopt Network meet parents where they are at and for as long as necessary. We have compiled resources for adoptive and guardianship families to ensure families succeed.

Post Adopt can help with the transition of becoming a family after Finalization. We offer support groups, webinars and many different trainings, including Seven Core issues in Adoption and Trauma Knowledge Masterclass. There are even family events including a Mom and Dad’s retreat to help bring families together and get the support they need after finalization and a winter retreat that allows all family members to be involved. It’s imperative for families to know the services and supports don’t go away once finalization occurs.

This blog post was written by Post Adopt Coordinator, NaTasha Sawicki, LBSW

Throughout this blog post, I will discuss the diagnostic criteria, symptoms and warning signs, and ways to help someone struggling with Other Specified Feeding or Eating Disorder (OSFED). Also discussed is Unspecified Feeding or Eating Disorder and Orthorexia.

Other Specified Feeding or Eating Disorder

When a person receives a diagnosis of Other Specified Feeding or Eating Disorder (OSFED) it typically means that they have many of the same symptoms as anorexia nervosa, bulimia nervosa, and/or binge eating disorder still, they do not meet the full diagnostic criteria for those eating disorders. OSFED can affect individuals of all ages and genders. Previously, OSFED used to be known as Eating Disorder Not Otherwise Specified (EDNOS) (National Eating Disorder Association, 2018).

Diagnostic Criteria: Because OSFED has a unique diagnostic criteria with having the same symptoms of other eating disorders, but not meeting the full diagnostic criteria, OSFED might present as the following:

• Atypical anorexia nervosa: when the criteria are met for anorexia nervosa, but the individual’s weight is within or above the normal range. Those with atypical anorexia nervosa have the same physical and psychological complications as anorexia nervosa.
• Bulimia nervosa of low frequency and/or limited duration: when the criteria are met for bulimia nervosa, but the binge eating and compensatory behaviors occur less than once a week and/or less than three months.
• Binge eating disorder of low frequency and/or limited duration: when the criteria are met for binge eating, but binge eating occurs less than once a week and/or for less than three months.
• Purging disorder: when an individual engages in self-induced vomiting or misuse of laxatives/medications to achieve a certain weight or shape.
• Night eating syndrome: when an individual engages in eating after waking up or by eating large amounts of food following the evening meal. An individual who struggles with night eating syndrome is aware of the eating.

Symptoms and Warning Signs: Below are a few emotional, behavioral, and physical symptoms and warning signs. For a complete list, please visit: https://nedc.com.au/eating-disorders/eating-disorders-explained/types/other-specified-feeding-or-eating-disorders/

• Emotional and Behavioral: Negative body image, secretive behavior around eating, food preference changes, frequent trips to the bathroom during or after meals, and anxiety around mealtimes
• Physical: Inability to maintain normal body weight, sensitivity to the cold, fatigue, poor immune system, and signs of vomiting.

How to help: The most important way to help someone struggling with OSFED is to reach out for help. OSFED can be ias dangerous and serious as other eating disorders, so receiving help as soon as possible can aid in the recovery process.

Unspecified Feeding or Eating Disorder

Unspecified Feeding or Eating Disorder is similar to OSFED, which is discussed above. According to the National Eating Disorder Association (2018), unspecified feeding or eating disorder is typically used in situations when a clinician chooses not to specify the reasoning that the diagnostic criteria is not met for a specific feeding and eating disorder and this can also include having insufficient information to make a more specific diagnosis.

According to Ekern, in “Unspecified Feeding or Eating Disorder (UFED): Signs and Symptoms,” an individual with UFED can have certain thoughts and behaviors about food and body image, but it is not enough to diagnosis a specific eating disorder as typically, those thoughts and behaviors are not severe enough to cause significant distress.

It is important to note that if an individual receives a diagnosis of UFED, that diagnosis can change as more information is obtained or as symptoms change.

Orthorexia

According to the National Eating Disorder Association (2018), orthorexia can fall into the category of the OSFED. It is not recognized in the DSM-5, but there is more and more research and awareness coming to light regarding orthorexia. Someone who may struggle with orthorexia is typically obsessed with healthy and proper eating, defining good and bad foods. It has been shown that many individuals with orthorexia also have OCD. There is no specific treatment plan for orthorexia, but professionals may treat it as anorexia or OCD. Eating healthy and following a diet does not mean someone has orthorexia. Orthorexia may appear when someone becomes fixated and obsessive over eating healthy.

Diagnostic Criteria: Due to orthorexia not being in the DSM-5, there is no formal diagnostic criteria for orthorexia.

Symptoms: Obsessively checking ingredient lists and nutrition labels, cutting out food groups at the same time, thinking about what foods might be served at different events an individual is attending, and distress when healthy foods are not available.

How to help: Connecting someone who has orthorexia to a registered dietitian or nutritionist can be helpful. Due to being fixated on eating healthy and defining what is good and bad, meeting with a dietitian can help explain what foods and why certain foods are beneficial for overall health, even if they think they are unhealthy.

This blog post was written by Post Adopt Coordinator, Jaclyn Stroehl, LBSW

References:

Ekern, Baxter. “Unspecified Feeding or Eating Disorder (UFED): Signs and Symptoms.” Eating Disorder Hope, 8 Mar. 2016, www.eatingdisorderhope.com/blog/unspecified-feeding-or-eating-disorder-ufed-signs-and-symptoms.

National Eating Disorders Association. (2018, February 22). Unspecified Feeding or Eating Disorder. https://www.nationaleatingdisorders.org/unspecified-feeding-or-eating-disorder

National Eating Disorders Association. (2018b, July 30). Other Specified Feeding or Eating Disorder. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/osfed

National Eating Disorders Association. “Orthorexia.” National Eating Disorders Association, 13 Dec. 2019, www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia.

https://nedc.com.au/assets/Fact-Sheets/OSFED.pdf

https://nedc.com.au/eating-disorders/eating-disorders-explained/types/other-specified-feeding-or-eating-disorders/

Seasonal Affective Disorder (SAD), more commonly known as “The Winter Blues,” affects millions of American adults and children every year.  A primary symptom of SAD is a change in mood resulting in feelings of sadness, depression, increased irritability, and possible feelings of hopelessness.  SAD also impacts an individual’s ability to think positively.  They may lack enjoyment, seek social isolation, have low energy, increase their want and/or need for sleep, and increase their cravings for comfort foods instead of healthier food choices.  SAD differentiates from clinical depression due to the fact that the depressed mood and symptoms typically will last 4-5 months.  Adults and children in northern climates are at a higher risk of developing SAD symptoms as the fall and winter seasons shorten the hours of sunlight significantly each day.  Whether parents notice symptoms of SAD in themselves, or their child(ren), the symptoms must be taken seriously.  Therefore, families need to be prepared to face SAD symptoms, or the Winter Blues, together!

The good news?  There are many things parents can do to help themselves, their children, and their family overall thrive throughout the bitterly cold winter days!

• Take advantage of the “nice” weather days! When the sun is shining, bundle up the whole family and release some physical energy outside by going sledding, ice skating, building a snowman, ice fishing, snowshoeing, or participate in a family snowball fight!  Be sure to capitalize on all of the “fun” traditional winter activities whenever possible!
• Be creative when stuck inside! Minimize time on the TV, phones, computers, gaming systems, etc.  Here are a few ideas to engage in indoor activities together as a family:
  • Paint the snow! If you can’t go outside, bring some snow inside.  Fill a large bowl or multiple small bowls with snow, and then use watercolor paints to create fun designs.  This activity will stimulate excitement, laughter, and communication for all involved.
  • Create your snowman! Grab some construction paper, mini marshmallows, glue, cotton balls, and markers.  Engage in this creative activity together and then follow-up with a conversation of why each person chose to make their snowman the way they did.  You can also hang the finished products on the wall to show pride in your family’s work and remind each member of your family of a fun memory!
  • Pick your favorite summer activity and recreate it at home! Go “camping” in your living room or set up a beach-style party!  Whether you eat s’mores in a tent and tuck into your sleeping bags that night or decide to put on swimming attire and create a beach vibe, there will be excitement and fun had by all!
  • Find more creative ideas for indoor winter activities online. Pinterest has a plethora of ideas!  The three ideas noted above were retrieved from the following article: 15+ Indoor Winter Activities for Kids to Beat the Winter Blues (momooze.com).  If you like the three ideas I mentioned, be sure to check out the rest!
• Create a well-balanced meal plan with your family each week to avoid the comfort food cravings!
  • It is challenging as a parent to juggle all appointments, activities and keep up with daily chores when all family members are healthy and not struggling with symptoms of SAD. Therefore, by having each family member sit down weekly to create a menu focused on ensuring nutritional values are met through most meals will help parents stay focused.  Depletine of the essential nutritional food groups occurs often during the 4-5 month window of The Winter Blues.  You have the power to offset that depletion and engage in more family time!
  • Take the time to shop for your meal plan/weekly menu as a family. Although taking your kids to the store can create stress, it will get you all out of the house for a while.
  • Make cooking supper a family event each night or as often as possible. Engage your children in the process of preparing and cooking as age-appropriate.
• It is essential to know when to seek professional help! Monitor the well-being of yourself and your family members as The Winter Blues can become very serious!
  • Severe cases of SAD can be treated through four main categories: Light Therapy, Psychotherapy/Talk Therapy, Medication Management, and Vitamin D Therapy.
  • Schedule an appointment with your primary care provider or an established mental health provider as soon as you recognize the symptoms of SAD are worsening.
  • Know that if you, your child, or someone you know is in immediate distress or thinking about harming themselves, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). If you reside in North Dakota, you can also reach out to FirstLink National Suicide Prevention Lifeline by calling 211 (dial 2-1-1).

This blog was written by Post Adopt Coordinator Katie Davis, LBSW

References/Resources:

Hull, M. (2021). Seasonal Affective Disorder Statistics. The Recovery Village.  Retrieved from Seasonal Affective Disorder Statistics – The Recovery Village Drug and Alcohol Rehab.

U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. (2021). Seasonal Affective Disorder. (NIH Publication No. 20-MH-8183).  Retrieved from NIMH » Seasonal Affective Disorder (nih.gov).

Lyness, D. (2020). Seasonal Affective Disorder.  KidsHealth.  Retrieved from Seasonal Affective Disorder (for Parents) – Nemours KidsHealth.

There is so much happening these days, between switching seasons – summer to fall to winter,  holidays to be celebrated, such as Halloween, Thanksgiving, to Christmas – and a change of years.  These holidays, season changes, and new years are typically to be filled with joy, excitement, celebrations, connectedness to family and friends.  However, adoptive families may experience the holidays with a different shade than what was hoped or expected.

The intent of these hopes and expectations comes from a place of generally good but may leave you feeling frustrated or let down.  Parents, if you’re finding yourself in a hazy lens of mixed emotions, you’re not alone.  Many parents have found themselves in some array of disappointment as plans didn’t go as expected.  In planning for the remaining holidays of this year or planning for the holidays of years to come, there may be a few options to consider:

1. Plan a getaway if need be. Large group celebrations characteristically take place over the holidays, filled with feasts, conversations, games, etc.  These details may create a cause of anxiety or feelings of fear for your youth.  Talk with your youth ahead of time about what to expect, and provide opportunities that can be done to help ensure there is an escape route to take place or a quiet place to unwind if need be.
2. Plan events that are in the best interest of your youth. If the large group celebrations cause a great deal of dysregulation, plan to do something that better suits your youth and immediate family.  Perhaps dinner and movies/games at home will lessen the amount of dysregulation.
3. See and acknowledge the loss your youth may be experiencing. Youth in the realm of adoption may have a multitude of losses.  These losses may include birth families, former foster families and traditions.  These loses may take a toll on a youth, leading a youth to feel isolated during the holiday season.  It’s important to have conversations with youth to acknowledge the losses.  Implementing some of the aspects of the youth into traditions in the adoptive home can allow for more connectedness for them.
4. Allow your youth to grieve the important people they miss through the holiday season, as well as traditions that might not be able to be held. The change of plans or expectations you had hoped for may cause a sense of sadness or feelings of being let down.  Allow yourself to acknowledge and grieve the loss of your unmet expectations, too.

The key is to implement and tweak what works best for your youth, your family, and you.  It’s ok to do holidays, gatherings, and this season differently.  Step into having conversations with your youth and validate their emotions and losses.  Not only are your youth important, but so are you!  Allow yourself to be honest with how you’re feeling – be gracious with yourself as you reflect on where you may be at, as well.  Look at your family’s needs, and dare to step out of your norm to meet those needs.

This blog post was written by Post Adopt Coordinator, Darcy Solem, LBSW