Study: ADHD Meds Given More Often to Youngest Kids in Class
Last updated on May 8th, 2017 at 09:47 pm
“Youngest children in class more likely to get ADHD medication, study says,” The Guardian reports.
The results of an Australian study have caused concerns that, in some cases, immature behaviour may be misinterpreted as evidence of a behavioural disorder.
In a brief report, researchers found nearly 2% of 6-15-year-olds in Western Australia received a prescription for attention deficit hyperactivity disorder (ADHD) medication in 2013. Those born in the last months of the school year intake were more likely to have had a prescription than the oldest children in the year.
The gap between the oldest and youngest children in the class had a small, but significant, association with the increased use of ADHD medications. The researchers say their findings compare with those of other international studies.
It’s possible the youngest children in a school year may find it harder to keep up in lessons than children almost a year older than them, and may be more likely to have problems with concentration.
But it would be a big assumption to say ADHD is being overdiagnosed and overtreated on the grounds of this study alone.
The use of ADHD medication for under-16s in the UK is far lower than in many other developed nations – 0.4%, compared with Australia’s 1.9% or the US’ 4.4% – so the potential problem of inappropriate treatment may not be as much of an issue in this country.
Where did the story come from?
The report was authored by four researchers from Curtin University, Murdoch University and the University of Western Australia, all in Australia.
The study was published in the peer-reviewed Medical Journal of Australia, and the researchers declared no conflict of interest or study funding.
It’s available to read online on an open access basis, so you can download the study for free.
The UK media coverage was accurate, but does not point out the limitations of this brief report.
What kind of research was this?
In this brief one-page report, the researchers say four international studies found the youngest children in a school year are more likely to be receiving ADHD medication.
They aimed to see how Western Australia compares by analysing data from the Pharmaceutical Benefits Scheme – a scheme similar to the NHS, where the cost of medicine is subsidised by the Australian government – to see how many children were receiving ADHD medication.
This brief report provides very limited information about the authors’ methods, making it difficult to critique.
And we don’t know how the authors identified the four international studies they reported, so we don’t know whether this is a fully comprehensive look at the subject.
This means the report must largely be considered to be the opinion of its authors.
What did the researchers do?
The researchers compared the proportion of children born in the first and last months of a “recommended school year intake” who were recorded in the Pharmaceutical Benefits Scheme as receiving at least one prescription for ADHD medication in 2013.
The study included a total of 311,384 children, covering two age bands: those aged 6-10 (born July 2003 to June 2008) and those aged 11-15 (born July 1998 to June 2003).
The researchers looked at the number of children receiving medication and the patterns by time of birth.
What did they find?
The researchers found 1.9% of the full study sample (5,937 children) had received at least one prescription of ADHD medication, with more boys than girls being prescribed for (2.9% versus 0.8%).
In the 6-10-year-olds, they found those born in the last month of the school year intake (June) were nearly twice as likely to have been prescribed medication as those born in the first month (the previous July): relative risk (RR) 1.93 for boys (95% confidence interval [CI] 1.53 to 2.38) and RR 2.11 for girls (95% CI 1.57 to 2.53)
The same pattern was seen for 11-15-year-olds, but the risk increase was less, though still significant (RR 1.26, 95% CI 1.03 to 1.52 for boys; RR 1.43, 95% CI 1.15 to 1.76 for girls).
The authors say similar effects were also seen when comparing those in the first three to six months of intake with the last three to six months.
What did the researchers conclude?
The researchers say at 1.9%, their observed prescription rate is comparable to a recent Taiwanese study, and both this study and three North American studies observed the effects of birth month on prescription rates.
They describe a professional from the American Psychiatric Association who feels ADHD is overdiagnosed and overmedicated, saying that, “Developmental immaturity is mislabelled as a mental disorder and unnecessarily treated with stimulant medication.”
The authors say the findings indicate that, “Even at relatively low rates of prescribing, there are significant concerns about the validity of ADHD as a diagnosis.”
Conclusion
Overall, this study suggests that in Western Australia – and reportedly in other countries, too – the youngest children in a given school year are more likely to be diagnosed with and treated for ADHD than the eldest in the year.
However, it’s important not to draw too many conclusions from this brief report. The authors provide very limited information about their methods, so it’s not possible to critique how they conducted their study.
We don’t know why they selected the 2013 school year, for example. It was said to be recommended, but we don’t know why. It could be it was known there were an unusually high number of prescriptions noted in the Pharmaceutical Benefits Scheme that year, which means it might not be representative.
Also, this database can only tell us the number of children that filled out at least one prescription for ADHD medication. We don’t know how the children were diagnosed, how long they had been diagnosed or treated for, or whether they actually took the medication.
The authors also point out the possible limitation that they didn’t know how many children may have entered school outside of their recommended starting year – although this was thought to be few.
We also don’t know how the researchers identified the international studies, and we don’t know that these reported findings give a comprehensive look at ADHD diagnosis and treatment worldwide.
It would be a big assumption to say ADHD is being overdiagnosed and overtreated on the grounds of this study alone. And, as no UK studies were reported, we don’t know what the true situation is like in this country.
It’s possible the youngest children in a school year may find it harder to keep up with lessons than children almost a year older than them, and so could be more likely to be distracted – though this is clearly a big generalisation and is not always going to be the case.
However, it does perhaps highlight there is a need for children who are struggling or finding it difficult to concentrate at school to be recognised, and get the additional attention and support they need – something both teachers and parents of the youngest children in a school year may need to be aware of.
Analysis by Bazian. Edited by NHS Choices.
Links to the Headlines
- Youngest children in class more likely to get ADHD medication, study says. The Guardian, January 22 2017
- Children being diagnosed with ADHD and put on drugs when they are just ‘immature’. Mail Online, January 23 2017
Links to the Science
- Whitely M, Lester L, Phillmore J, Robinson S. Influence of birth month on the probability of Western Australian children being treated for ADHD (PDF, 163kb). Published online January 22 2017
How to Cope with Teen Arguments, Aggression and Violence
Last updated on May 1st, 2017 at 08:05 pm
Many parents find that when their child becomes a teenager, their behaviour becomes more challenging. But how do you cope if they become aggressive or even violent towards you?
If you’re experiencing aggression or violence from your teen, you’re not alone. A recent Parentline Plus survey found that 60% of calls (between October 2007 and June 2008) included verbal aggression from a teenager, and 30% involved physical aggression, much of it aimed at the parent themselves.
It is common to keep this kind of abuse behind closed doors and not confide in anyone. Many parents feel that they have failed to control their child, or that they are responsible for the behaviour in some way – or they may not know where to turn.
However, any kind of aggression can be stressful, and can cause an atmosphere of tension and fear for the entire family, not to mention the possibility of physical harm if their teen becomes violent.
No parent should feel obliged to put up with an unruly teen, and as with any type of domestic abuse, help and support is available. You can find appropriate organisations and helpline numbers (*for the UK) in “Help and Support” further below. There are also a number of techniques and tips that you might find helpful.
Defusing Heated Arguments
It’s useful to remember that your own behaviour can improve or worsen an aggressive situation, so it’s important to be a good role model for your teen.
Linda Blair, clinical psychologist working with families, advises: “Bear in mind that you are their principal role model. If you act aggressively but tell them not to, they won’t listen. It’s also helpful to remember that their anger is often based on fear – fear that they’re losing control.”
With that in mind, it is worth trying to maintain a calm and peaceful presence. You need to be strong without being threatening. Remember that your body language, as well as what you say and how you say it, should also reflect this.
Avoid staring them in the eye, and give them personal space. Allow them the opportunity to express their point of view, then respond in a reasoned way.
Breathing Exercises to Control Anger
If an argument becomes very heated, Linda suggests that you “stop for a moment”. Take a deep breath, hold it for a few seconds and then exhale. Repeat five times. This technique is very useful in intense situations.
If your teen is becoming aggressive during arguments, suggest this technique to them when they’re calm, so they too have a way of controlling their anger.
If an argument feels out of control, you can also try explaining to them that you are going to walk away, and that you’ll come back again in half an hour. Given the chance to reflect and calm down, you and your teen will both be more reasonable when you resume your discussion.
As with toddlers, if you give in to teenagers because their shouting and screaming intimidates or baffles you, you are in effect encouraging them to repeat the unreasonable behaviour as a way of getting what they want.
Counselling for Teenagers
Family Lives is a charity dedicated to helping families. They suggest that if very heated arguments happen frequently, it may be worth suggesting counselling to your teen. They’ll benefit from talking to someone new and unbiased, someone who isn’t in their family and who won’t judge them.
Read more about the benefits of talking treatments.
Remember they may not know how to handle their anger, and this can leave them frustrated and even frightened. Some guidance from an outsider can be very helpful.
Dealing with Violent Behaviour
Sometimes, teen aggression can turn into violence. If they lash out at you, or someone or something else, put safety first.
Let your teenager know that violence is unacceptable and you will walk away from them until they’ve calmed down. If leaving the room or house isn’t helping, call the police – after all, if you feel threatened or scared, then you have the right to protect yourself.
Family Lives offer this advice for coping with, and helping, a violent teen:
- Give them space – once they have calmed down, you may want to talk to them about what has happened and suggest that they let you find them some help.
- Be clear – teenagers need to know that you will stand by the boundaries you set. They need to know that any kind of violence is unacceptable.
- Talk to their school and find out if their aggressive behaviour is happening there as well. Some schools offer counselling.
- Arrange counselling – if your teen admits they have a problem and is willing to get help, book an appointment with a counsellor or psychologist as soon as possible. Speak to your GP (*pediatrician or family doctor) or their school about what help is available.
Help and Support (*in the UK – see end for resources in other locations)
There are many organisations that offer emotional support and practical advice. Getting some support can help you and your child. At such an important development stage, it’s important that they learn how to communicate well and express anger in a healthy way.
- You can call Family Lives’ Parentline on 0800 800 2222 any time, or email parentsupport@parentlineplus.org.uk for a personalised reply within three days. They also offer i-parent modules to help you learn more about communicating better with your teen.
- You can call the Samaritans on 08457 909090 any time to talk about any type of distress and to get confidential support and advice.
- Youth Access has details about youth organisations and services offering teens counselling, advice and support.
- Young Minds is a charitable organisation supporting children and young people with mental health issues, and their parents. They provide information to help young people with anger issues. If you discuss your child’s behaviour with them and they are open to getting help, you might like to direct them to the information on the Young Minds website.
Concerned about Mental Health Issues?
If you’re worried that your teen has a mental health problem such as depression, talk to your GP (*pediatrician or family doctor). In the UK, he or she can refer them to the Child and Adolescent Mental Health Services, who in turn can refer all or some of you for Family Therapy. Or contact the Young Minds Parents’ Helpline on 0808 802 5544 for advice and support concerning mental health issues in young people.
If you are having trouble coping with your teenager, and you suspect you may have symptoms of depression or other mental health problems, discuss this with your GP (*pediatrician or family doctor). He or she can then suggest suitable treatment. You may, for example, be referred for counselling, or directed to support groups or other services in your area.
Editor’s Note: *clarification provided for our US readers.
US Resources for Family and Teen Challenges:
Canadian Resources for Family and Teen Challenges:
- Youthlink.ca – Links/Resources for Parents
- HealthLinkBC.ca – Aggression in Youth…and Violent Behavior in Children and Teens
- WWW.gov.mb.ca – Family Violence Prevention Program – Help for Teens and Children
Australian Resources for Teen Aggression:
Is Your Child a Bullying Victim? Read this Mother’s Story
Last updated on March 6th, 2017 at 05:21 pm
Halfway through the school year, Maria** became aware that her daughter Sam** wasn’t being invited to her friends’ houses anymore.
“She doesn’t always tell me what’s going on at school, but I noticed that she was biting her fingernails a lot and sleeping badly. She seemed quite upset.
“I talked to her about her friends and why they weren’t meeting up. Eventually, she told me that they didn’t get on anymore. I found out that her old friends were excluding her.
“For example, when she bumped into them in the street, one of the girls said directly to her, ‘This is the one we’re not talking to anymore’.
“They were also really nasty in the playground. They left her standing on her own. She was still trying to be friends with them but they just ignored her. She was very upset.
Bullying Incident
“Then I witnessed an incident one Saturday afternoon.
“Two of her old friends phoned her. They asked her if she’d started her periods. She said it was none of their business, but they kept her on the phone. She wasn’t strong enough to end the conversation.
“They were laughing and shouting, ‘We want to know, we want to know’. I was standing next to her, and felt disgusted. I felt really sorry for Sam. Afterwards, I thought of calling one of the girls’ mums, but I decided not to because I thought it might make things worse.
“I was very upset because I used to spend a lot of time with these girls, but now they didn’t think my daughter was good enough for them.
“I was worried about Sam because I thought it must be horrible to believe you’ve got really good friends and then they suddenly turn against you.
How Sam got Help with Bullying
“I told Sam that she should talk to Nicole, a learning mentor at her school. I knew that Sam liked Nicole, whose role was to sort out this kind of issue.
“Soon after, Nicole contacted me. Both she and Sam’s form teacher had noticed that Sam was being bullied.
“I found out that she wasn’t only being bullied by this group. Sam is half-Polish, and another girl was calling her a ‘Polish sket’ in class.
“The school intervened quickly. They cracked down on the racist comments and the use of the insult ‘sket’. After that, the problem with that particular girl was completely resolved.
“Nicole, the learning mentor, also set up a friendship group to understand the dynamic in this circle of girls who’d all moved up from primary school together. She asked the bullies and a few other pupils to talk together about friendship, boyfriends, fashion, puberty and growing up. A lot was revealed.
“It seems that Sam’s primary school (*elementary school) friends got to know other girls at secondary school (*middle school) and became more interested in fashion, make-up and boyfriends. Because Sam was more childlike, they didn’t want her in their group anymore. She wasn’t cool enough.
“Sam was different. I think that’s often what bullying is based on. She has her own style and doesn’t follow everyone else.
“Nicole had several chats with Sam, and helped to strengthen Sam’s self-esteem. When she was picked on, Sam used to get quite upset and would try to defend herself, but now she’s able to ignore it.
“When I spoke to Sam about the meetings with Nicole, I could see that things were improving. At home, I explained to her that friendships change, and primary school (*elementary school) friends don’t necessarily stay friends for life. I didn’t want to suggest that Sam was the victim because that can make you feel weaker.
“Sam has finally found a new set of friends and is really happy with them. She’s become more confident, and she no longer tries to be friends with girls who don’t want to be friends with her.”
**The names in this article have been changed.
Bullying: Information and Support for Parents
To find out more about how you can help your child if they’ve been bullied, read Bullying: advice for parents.
Editor’s Note: *clarification provided for our US readers.
How to Reframe Your Child’s Negative, Anxious Self-Talk
Last updated on February 27th, 2017 at 01:52 am
Do you have a child who is often emotional or moody – or prone to anxiety or depression? If so, you might be familiar with the negative self-talk that often contributes to these conditions. And, actually, any child – or adult – is subject to these thoughts on occasion.
Negative or anxious self-talk – sometimes also called “automatic negative thoughts” – is unhelpful, often skewed thinking that tends to drive negative emotions and behaviors. For example, your daughter might react to a friend who gets angry while playing and goes home, by thinking “I’m no fun to play with….nobody likes me” – and might avoid inviting any other kids to come over and play.
I learned about the concept of negative self-talk years ago through cognitive behavioral therapy while dealing with issues from my childhood. But I was surprised when I first began noticing examples of this thought pattern in my young son. When Elliott was in his first couple of years of elementary school, he would often come home at the end of the day and report that his day was “terrible”.
After digging a little I would often find out that one “bad” thing had happened each of these days – which then tainted the whole rest of the day. This overgeneralization / all-or-nothing thinking is an example of negative self-talk – and caused Elliott to have negative emotions about school and resist going in the mornings.
There are several different types of negative or anxious self-talk. A good reference book on anxiety for teens and kids – My Anxious Mind: A Teen’s Guide to Managing Anxiety and Panic (by Michael A. Tompkins, PhD and Katherine Martinez PhD) – gives an interesting classification for these unhelpful thoughts (a summary is listed at the end of this post). This book was recommended to me by a child and family psychologist and is well worth a read.
As the book title suggests, there are ways to deal with and manage such unhelpful thinking – and it’s useful to start early with kids who are prone to negative thoughts. At a minimum, it helps to start by identifying and unpacking the negative thought.
For example, with my son Elliott and his “terrible” days at school, I started asking him if anything good happened during the day. This got him to go over all the events of his time at school and put the “bad” experience into context – and I suggested that one or two bad experiences might not make a whole day terrible. Pretty soon, when I asked him how his day was, Elliott would outline how different parts of the day went (great, so-so, neutral, awful, etc) – and this pattern has persisted for more than five years! Even better, he has generally been much more positive about his school days ever since.
Additional exercises for recognizing and dealing with negative self-talk are provided in My Anxious Mind. Another practical book, with useful exercise to help teens cope with negative thoughts and other drivers of anxiety, is The Anxiety Workbook for Teens, by Lisa M. Schab, LCSW.
Types of Anxious Self-Talk (from My Anxious Mind: A Teen’s Guide to Managing Anxiety and Panic)
Book Ends
This is anxious thinking that assumes there are only two possible outcomes of a situation – both at opposite extremes, with no possibilities in the middle. So, the child in the earlier example might be focused on how the play date with her friend needed to be perfect, and if that didn’t happen it would be a disaster.
Binocular Vision
In this unhelpful thought process, your child will “magnify” the effect of something bad – like failing a test – and assume that he won’t be able to go to college as a result. Or he might “shrink” the importance of something good, like all his excellent grades in other classes.
Fortune Telling
This type of self-talk involves your child thinking he or she can predict the future – usually thinking something bad will happen. For example, your child is engaging in fortune telling if she decides to audition for a part in the school play but spends the weeks leading up to the audition thinking “I’m not going to get the part”. Maybe she will, maybe she won’t – but she doesn’t know, and anxious self-talk won’t help the outcome either way.
Mind Reading
In the earlier example, the girl whose friend got angry and went home assumed that she could read her friend’s mind; that the friend thought she wasn’t fun and didn’t like her anymore. This is the mind reading track – and it’s important for the girl to know she isn’t a psychic and her friend will probably be back to play the next day.
Overgeneralization
With overgeneralization, similar to binocular vision, your child will focus on something small (usually bad) to make broad conclusions or sweeping statements – like, if one friend gets angry at me then no one likes me. Or if your son has one bad soccer game, assuming he’s no good and will get cut from the team.
End of the World
With this anxious track, your child is always expecting something terrible to happen. This could be at school or in relationships with friends, but it could also be thinking that every noise around the house is a burglar.
Should-y/Must-y Thinking
Too many thoughts with “shoulds” and “musts” can set the bar for performance and life experience way too high – and make your child anxious and less confident.
Mind Jumps
In this type of unhelpful thinking your child will jump to conclusions (usually negative) without all the facts – like when hearing that he isn’t invited to a party at a friend’s house, your son assumes his friend doesn’t like him. Getting the facts might tell him otherwise, especially if he finds out it’s a family-only affair (for example).
How to Support Your Child’s Development Through Boredom
Last updated on July 13th, 2017 at 12:20 am
We have heard the stories in the news all the time—some say kids are “overscheduled” and need more time to play. On the other side, parents of the “tiger mom” variety tend to want their children constantly in activities and lessons to encourage their growth and development.
Until recently, the one voice you hadn’t heard on this topic was the one of science. Child development researchers are now trying to delve into this topic and understand the relationship between structured activities and children’s development.
In one of the first studies of this kind, researchers at The University of Colorado (CU) looked at the connection between how kids spend their time (structured vs. unstructured activities) and the development of executive function.
As you may know, executive function is one of the key regulatory skills that develops during childhood and is crucial to children’s success and well-being later in life. Executive function includes things like planning ahead, goal-oriented behavior, suppression of unwanted thoughts or behaviors, and delaying gratification. These skills have been shown to predict children’s academic and social outcomes years down the road. Based on this, you can see why researchers (and parents) are interested in understanding anything related to how executive function develops.
In the recent CU study, scientists asked 6-year-olds to record their daily activities for a week. They then categorized these activities as “structured” or “unstructured” according to a classification system previously developed by economists.
For example, activities such as sports lessons, religious activities, and chores were classified as “structured activities.” In contrast, activities such as free play (alone or with others), sightseeing, or media use were considered “less structured.” Routine activities such as going to school, sleeping, or eating were not classified in either category.
The researchers then analyzed the relationship between children’s time activities and their level of executive function. The results showed that there was, indeed, a correlation between these factors. The more time children spent in structured activities, the lower their scores on the assessment of executive function. In contrast, the more time children spent in less structured activities, the higher their assessment of executive function.
First of all, it’s important to note that this is just one study in what I hope will be a whole line of research in this area. In social science, you cannot base recommendations on one study.
Secondly, this study was small (70 children) and was only correlational, meaning we do not know if structured vs. unstructured activities cause a change in executive function or if there is something else going on here. What this study does show is that there is some relationship between these factors that deserves further study.
What does this really mean? How could unstructured activities help in the development of executive function? Although researchers do not know for sure, it seems like this may be related to the research on boredom. More and more studies are showing how “boredom” or what adults would simply call “downtime” is related to a variety of positive mental states.
For example, boredom is likely associated with people being more creative. Boredom also allows for the development of new interests, self-reflection and goal-setting.
Additionally, some would argue that a lack of downtime or time for boredom allows kids to become so accustomed to a fast-paced lifestyle that anything less-than-exciting seems uninteresting. One philosopher put it this way,
“A life too full of excitement is an exhausting life, in which continually stronger stimuli are needed to give the thrill that has come to be thought an essential part of pleasure.”
All of this is definitely food for thought in terms of parenting. While we do not know for sure how these factors impact each other, it looks like there is some relationship between level of structured activities and the development of executive function. This is something to consider as you plan activities for your child.
The next time your child says, “I’m bored” consider looking at it as an opportunity to support their creativity and problem-solving abilities.
How to Help Your Underweight Teen Boy Get Healthy
Last updated on February 20th, 2017 at 07:51 pm
You may have friends who are taller, heavier and more muscular than you. We all grow and develop at different rates. Lots of boys don’t reach their adult weight until they are over 18.
You can check whether you’re a healthy weight by using our healthy weight calculator. If you are underweight, your GP (*pediatrician), practice nurse or school nurse can give you help and advice.
There may be an underlying medical cause for your low weight that needs to be checked out. Gut problems like coeliac disease, for example, can make people lose weight.
Read about other medical problems that can cause unexplained weight loss.
Maybe you’re having mental or emotional problems that have affected your eating habits. Depression and anxiety, for example, can both make you lose weight.
Or perhaps you haven’t been eating a healthy, balanced diet.
Whatever the situation, if you’re concerned about your weight or your diet, the best thing to do is tell someone. There’s a lot that can be done to help.
Why Being a Healthy Weight Matters
Being underweight can leave you with no energy and affect your immune system, meaning you could pick up colds and other infections more easily.
If your diet is poor, you may also be missing out on vitamins and minerals you need to grow and develop.
The good news is that, with a little help, you can gradually gain weight until you get to a weight that is healthy for your height and age.
Healthy Diet for Teen Boys
It’s important that you gain weight in a healthy way. Try not to go for chocolate, cakes, fizzy drinks and other foods high in fat or sugar. Eating these types of foods too often is likely to increase your body fat, rather than building strong bones and muscles.
Instead, aim to eat three meals and three snacks a day. You should be having:
- Plenty of starchy carbohydrates, such as bread, pasta, rice and potatoes (choose wholegrain versions or potatoes with their skins on if you can)
- At least five portions of a variety of fruit and vegetables a day
- Some meat, fish, eggs, beans and other non-dairy sources of protein
- Some milk and dairy food
We all need some fat in our diet, but it’s important to keep an eye on the amount and type of fat we’re eating. Try to cut down on the amount of saturated fat you eat – that’s the fat found in sausages, salami, pies, hard cheese, cream, butter, cakes and biscuits.
Cut down on sugary foods, such as chocolate, sweets, cakes, biscuits and sugary soft drinks.
Strength training can also help to build strong muscles and bones. Find out how to increase your strength and flexibility.
Boost Your Calories
To bump up your energy intake in a healthy way, try these tips:
- Make time for breakfast. Try porridge made with semi-skimmed (*1% or 2% milk) milk and sprinkle some chopped fruit or raisins on top. Or how about eggs on toast with some grilled tomatoes or mushrooms?
- Crumpets, bananas or unsalted nuts all make good snacks.
- A jacket (*baked) potato with baked beans or tuna on top makes a healthy lunch and contains both energy-rich carbohydrates and protein. Adding cheese will provide calcium.
- Try yoghurts and milky puddings, such as rice pudding.
- Have a healthy snack before bed. Cereal with semi-skimmed milk is a good choice (choose a cereal that is lower in sugar), or some toast.
Find out how many calories the average teenager needs.
You should also make sure you get plenty of sleep. About 8 to 10 hours a day is ideal for teenagers. Avoid smoking and alcohol.
Teen Boys and Eating Disorders
Sometimes there can be other issues that stop you from eating a healthy diet.
If you feel anxious when you think about food, or you feel you may be using control over food to help you cope with stress, low self-esteem or a difficult time at home or school, then you may have an eating disorder.
People with eating disorders often say they feel that their eating habits help them keep control of their lives. But that’s an illusion: it’s not them who are in control, but the eating disorder.
If you feel you may have an eating disorder, help is available.
Tell someone: ideally your parents, guardians or another adult you trust.
The eating disorders charity b-eat has a Youthline, where you can get advice.
Editor’s Note: *clarification provided for our US readers.
